title: Reducing the psychological distress of family caregivers of home based palliative care patients: longer term effects from a randomised controlled trial.
abstract: BACKGROUND
  Palliative care incorporates comprehensive support of family caregivers because many of them experience burden and distress. However, evidence-based support initiatives are few.
  
  
  OBJECTIVE
  We evaluated a one-to-one psychoeducational intervention aimed at mitigating the distress of caregivers of patients with advanced cancer receiving home-based palliative care. We hypothesised that caregivers would report decreased distress as assessed by the General Health Questionnaire (GHQ).
  
  
  METHODS
  A randomised controlled trial comparing two versions of the delivery of the intervention (one face-to-face home visit plus telephone calls versus two visits) plus standard care to a control group (standard care only) across four sites in Australia.
  
  
  RESULTS
  Recruitment to the one visit condition was 57, the two visit condition 93, and the control 148. We previously reported non-significant changes in distress between times 1 (baseline) and 2 (1-week post-intervention) but significant gains in competence and preparedness. We report here changes in distress between times 1 and 3 (8-week post-death). There was significantly less worsening in distress between times 1 and 3 in the one visit intervention group than in the control group; however, no significant difference was found between the two visit intervention and the control group.
  
  
  CONCLUSIONS
  These results are consistent with the aim of the intervention, and they support existing evidence demonstrating that relatively short psychoeducational interventions can help family caregivers who are supporting a dying relative. The sustained benefit during the bereavement period may also have positive resource implications, which should be the subject of future inquiry.
authors.affiliation: Centre for Palliative Care, St. Vincent's Hospital, Melbourne, Australia; Queen's University, Belfast, Northern Ireland, UK; University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Hudson
authors.forename: Tom
authors.initials: T
authors.lastname: Trauer
authors.forename: Brian
authors.initials: B
authors.lastname: Kelly
authors.forename: Moira
authors.initials: M
authors.lastname: O'Connor
authors.forename: Kristina
authors.initials: K
authors.lastname: Thomas
authors.forename: Rachel
authors.initials: R
authors.lastname: Zordan
authors.forename: Michael
authors.initials: M
authors.lastname: Summers
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000523:psychology / Q000628:therapy; D017028:Caregivers / Q000523:psychology*; D003863:Depression / Q000523:psychology / Q000628:therapy; D005260:Female; D006699:Home Care Services; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000451:nursing*; D010166:Palliative Care / Q000523:psychology*; D013315:Stress, Psychological / Q000523:psychology / Q000628:therapy*; D055815:Young Adult
keywords: RCT; cancer; caregiver; distress; oncology; palliative