title: Effects of enhanced caregiver training program on cancer caregiver's self-efficacy, preparedness, and psychological well-being.
abstract: OBJECTIVE
  We examined the effects of an enhanced informal caregiver training (Enhanced-CT) protocol in cancer symptom and caregiver stress management to caregivers of hospitalized cancer patients.
  
  
  METHODS
  We recruited adult patients in oncology units and their informal caregivers. We utilized a two-armed, randomized controlled trial design with data collected at baseline, post-training, and at 2 and 4 weeks after hospital discharge. Primary outcomes were self-efficacy for managing patients' cancer symptoms and caregiver stress and preparedness for caregiving. Secondary outcomes were caregiver depression, anxiety, and burden. The education comparison (EDUC) group received information about community resources. We used general linear models to test for differences in the Enhanced-CT relative to the EDUC group.
  
  
  RESULTS
  We consented and randomized 138 dyads: Enhanced-CT = 68 and EDUC = 70. The Enhanced-CT group had a greater increase in caregiver self-efficacy for cancer symptom management and stress management and preparation for caregiving at the post-training assessment compared to the EDUC group but not at 2- and 4-week post-discharge assessments. There were no intervention group differences in depression, anxiety, and burden.
  
  
  CONCLUSIONS
  An Enhanced-CT protocol resulted in short-term improvements in self-efficacy for managing patients' cancer symptoms and caregiver stress and preparedness for caregiving but not in caregivers' psychological well-being. The lack of sustained effects may be related to the single-dose nature of our intervention and the changing needs of informal caregivers after hospital discharge.
authors.affiliation: Duke University School of Nursing, 307 Trent Drive, DUMC 3322, Room 3080, Durham, NC, 27710, USA.|Geriatric Research, Education, and Clinical Center, Durham Veterans Affairs Medical GRECC, 508 Fulton St. Durham VA Medical Center, Durham, NC, 27705, USA.|Center for the Study of Aging and Human Development, Duke University, Box 3003 DUMC, Room 3502 Busse Building, Blue Zone, Duke South Durham, NC, 27710, USA.
authors.forename: Cristina C
authors.initials: CC
authors.lastname: Hendrix
authors.affiliation: Duke University School of Nursing, 307 Trent Drive, DUMC 3322, Room 3080, Durham, NC, 27710, USA.|Center for the Study of Aging and Human Development, Duke University, Box 3003 DUMC, Room 3502 Busse Building, Blue Zone, Duke South Durham, NC, 27710, USA.
authors.forename: Donald E
authors.initials: DE
authors.lastname: Bailey
authors.affiliation: Center of Excellence for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, 508 Fulton Street, Durham, NC, 27705, USA.|Duke Palliative Care, Duke University Health System, DUMC 2706, Durham, NC, 27710, USA.|Department of Medicine, Duke University School of Medicine, DUMC 2706, Durham, NC, 27710, USA.
authors.forename: Karen E
authors.initials: KE
authors.lastname: Steinhauser
authors.affiliation: Center of Excellence for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, 508 Fulton Street, Durham, NC, 27705, USA.|Department of Medicine, Duke University School of Medicine, DUMC 2706, Durham, NC, 27710, USA.
authors.forename: Maren K
authors.initials: MK
authors.lastname: Olsen
authors.affiliation: Center of Excellence for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, 508 Fulton Street, Durham, NC, 27705, USA.
authors.forename: Karen M
authors.initials: KM
authors.lastname: Stechuchak
authors.affiliation: Department of Medicine, Duke University School of Medicine, DUMC 2706, Durham, NC, 27710, USA.
authors.forename: Sarah G
authors.initials: SG
authors.lastname: Lowman
authors.affiliation: Center for the Study of Aging and Human Development, Duke University, Box 3003 DUMC, Room 3502 Busse Building, Blue Zone, Duke South Durham, NC, 27710, USA. abby.schwartz@duke.edu.
authors.forename: Abby J
authors.initials: AJ
authors.lastname: Schwartz
authors.affiliation: Division of Medical Oncology, Duke University Medical Center, DUMC 3198, Durham, NC, 27710, USA.
authors.forename: Richard F
authors.initials: RF
authors.lastname: Riedel
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, DUMC 3159, Durham, NC, 27710, USA.
authors.forename: Francis J
authors.initials: FJ
authors.lastname: Keefe
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, DUMC 3159, Durham, NC, 27710, USA.
authors.forename: Laura S
authors.initials: LS
authors.lastname: Porter
authors.affiliation: Duke Palliative Care, Duke University Health System, DUMC 2706, Durham, NC, 27710, USA.|Department of Medicine, Duke University School of Medicine, DUMC 2706, Durham, NC, 27710, USA.
authors.forename: James A
authors.initials: JA
authors.lastname: Tulsky
mesh_terms: D001007:Anxiety / Q000209:etiology; D017028:Caregivers / Q000193:education* / Q000523:psychology; D003863:Depression / Q000209:etiology / Q000517:prevention & control; D005260:Female; D006266:Health Education / Q000379:methods; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology / Q000628:therapy*; D010351:Patient Discharge; D020377:Self Efficacy; D013315:Stress, Psychological / Q000209:etiology / Q000517:prevention & control
keywords: Caregiver training; Family caregivers; Hospital discharge; Symptom management