title: A randomized trial comparing two low-intensity psychological interventions for distressed patients with cancer and their caregivers.
abstract: OBJECTIVE
  To compare the effectiveness of two low-intensity approaches for distressed patients with cancer and caregivers who had called cancer helplines seeking support. Baseline distress was hypothesized as a moderator of intervention effect.
  
  
  METHODS
  Randomized trial.
  
  
  METHODS
  Community-based cancer helplines in Queensland and New South Wales, Australia.
  
  
  METHODS
  354 patients with cancer and 336 caregivers.
  
  
  METHODS
  Participants were randomized to either a single session of nurse-led self-management intervention or a five-session psychologist cognitive behavioral intervention delivered by telephone. Assessments were undertaken at baseline (preintervention) and at 3, 6, and 12 months.
  
  
  METHODS
  Psychological and cancer-specific distress and post-traumatic growth.
  
  
  RESULTS
  No significant moderation by baseline cancer-specific distress was noted. For low-education patients, only the psychologist intervention was associated with a significant drop in distress. For all other participants, distress decreased over time in both arms with small to large effect sizes (Cohen's ds = 0.05-0.82). Post-traumatic growth increased over time for all participants (Cohen's ds = 0.6-0.64).
  
  
  CONCLUSIONS
  Many distressed patients with cancer and their caregivers may benefit significantly from a single session of a nurse psychoeducation intervention that can be delivered remotely by telephone and supported by self-management materials. Research is needed to develop an algorithm that moves beyond the use of distress as the only indicator for referral to specialist psychological services. Survivors and caregivers with low education and low literacy may require more in-depth and targeted support.
  
  
  CONCLUSIONS
  Brief nurse psychoeducation and stress management for cancer survivors and caregivers should be considered as part of a tiered approach to psychosocial care.
authors: Griffith Health Institute, Griffith University in Gold Coast, Queensland, Australia.
authors: Suzanne Kathleen
authors: SK
authors: Chambers
authors: Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Liverpool, Australia.
authors: Araf
authors: A
authors: Girgis
authors: Griffith University.
authors: Stefano
authors: S
authors: Occhipinti
authors: Cancer Counselling Service, Cancer Council Queensland in Fortitude Valley.
authors: Sandy
authors: S
authors: Hutchison
authors: Discipline of Psychiatry, University of Queensland in Herston.
authors: Jane
authors: J
authors: Turner
authors: Max Planck Institute for Human Development, Berlin, Germany.
authors: Michelle
authors: M
authors: McDowell
authors: Deakin University in Burwood, Victoria, Australia.
authors: Cathrine
authors: C
authors: Mihalopoulos
authors: Health Economics, Deakin University.
authors: Robert
authors: R
authors: Carter
authors: Cancer Council Queensland in Brisbane.
authors: Jeffrey Charles
authors: JC
authors: Dunn
mesh_terms: D000223:Adaptation, Psychological; D000342:Affective Symptoms / Q000451:nursing* / Q000523:psychology*; D017028:Caregivers / Q000523:psychology; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D015277:Hotlines; D006801:Humans; D009369:Neoplasms / Q000451:nursing / Q000523:psychology / Q000628:therapy; D009517:New South Wales; D009859:Oncology Nursing / Q000379:methods*; D011793:Queensland; D012648:Self Care / Q000379:methods* / Q000523:psychology; D012944:Social Support; D016896:Treatment Outcome
keywords: cancer; caregivers; low intensity; nursing practice; psychological intervention