title: Improving psychosocial outcomes for caregivers of people with poor prognosis gastrointestinal cancers: a randomized controlled trial (Family Connect).
abstract: OBJECTIVE
  This study investigated the effectiveness of a structured telephone intervention for caregivers of people diagnosed with poor prognosis gastrointestinal cancer to improve psychosocial outcomes for both caregivers and patients.
  
  
  METHODS
  Caregivers of patients starting treatment for upper gastrointestinal or Dukes D colorectal cancer were randomly assigned (1:1) to the Family Connect telephone intervention or usual care. Caregivers in the intervention group received four standardized telephone calls in the 10 weeks following patient hospital discharge. Caregivers' quality of life (QOL), caregiver burden, unmet supportive care needs and distress were assessed at 3 and 6 months. Patients' QOL, unmet supportive care needs, distress and health service utilization were also assessed at these time points.
  
  
  RESULTS
  Caregivers (128) were randomized to intervention or usual care groups. At 3 months, caregiver QOL scores and other caregiver-reported outcomes were similar in both groups. Intervention group participants experienced a greater sense of social support (p = .049) and reduced worry about finances (p = .014). Patients whose caregiver was randomized to the intervention also had fewer emergency department presentations and unplanned hospital readmissions at 3 months post-discharge (total 17 vs. 5, p = .01).
  
  
  CONCLUSIONS
  This standardized intervention did not demonstrate any significant improvements in caregiver well-being but did result in a decrease in patient emergency department presentations and unplanned hospital readmissions in the immediate post-discharge period. The trend towards improvements in a number of caregiver outcomes and the improvement in health service utilization support further development of telephone-based caregiver-focused supportive care interventions.
authors.affiliation: Psycho-oncology Co-operative Research Group, School of Psychology, The University of Sydney, Level 6 Chris O'Brien Lifehouse, Sydney, NSW, 2006, Australia. joanne.shaw@sydney.edu.au.
authors.forename: Joanne M
authors.initials: JM
authors.lastname: Shaw
authors.affiliation: School of Public Health,, The University of Sydney, Sydney, NSW, 2006, Australia.|Surgical Outcomes Research Centre, Sydney Local Health District, Sydney, NSW, Australia.
authors.forename: Jane M
authors.initials: JM
authors.lastname: Young
authors.affiliation: Psycho-oncology Co-operative Research Group, School of Psychology, The University of Sydney, Level 6 Chris O'Brien Lifehouse, Sydney, NSW, 2006, Australia.|Surgical Outcomes Research Centre, Sydney Local Health District, Sydney, NSW, Australia.
authors.forename: Phyllis N
authors.initials: PN
authors.lastname: Butow
authors.affiliation: School of Public Health,, The University of Sydney, Sydney, NSW, 2006, Australia.|Surgical Outcomes Research Centre, Sydney Local Health District, Sydney, NSW, Australia.
authors.forename: Tim
authors.initials: T
authors.lastname: Badgery-Parker
authors.affiliation: School of Public Health,, The University of Sydney, Sydney, NSW, 2006, Australia.|Surgical Outcomes Research Centre, Sydney Local Health District, Sydney, NSW, Australia.
authors.forename: Ivana
authors.initials: I
authors.lastname: Durcinoska
authors.affiliation: University of California, San Francisco, CA, USA.
authors.forename: James D
authors.initials: JD
authors.lastname: Harrison
authors.affiliation: University of Technology, Sydney, Australia.
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Davidson
authors.affiliation: Royal Prince Alfred Hospital, Sydney Local Health District, Camperdown, Sydney, NSW, Australia.|Concord Repatriation General Hospital, Sydney Local Health District, Concord, NSW, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Martin
authors.affiliation: Sydney Medical School, The University of Sydney, Sydney, NSW, 2006, Australia.|Surgical Outcomes Research Centre, Sydney Local Health District, Sydney, NSW, Australia.|Royal Prince Alfred Hospital, Sydney Local Health District, Camperdown, Sydney, NSW, Australia.
authors.forename: Charbel
authors.initials: C
authors.lastname: Sandroussi
authors.affiliation: Westmead Hospital, Western Sydney Local Health District, Sydney, NSW, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Hollands
authors.affiliation: Royal Prince Alfred Hospital, Sydney Local Health District, Camperdown, Sydney, NSW, Australia.|Concord Repatriation General Hospital, Sydney Local Health District, Concord, NSW, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Joseph
authors.affiliation: Bankstown-Lidcome Hospital, South Western Sydney Local Health District, Bankstown, NSW, Australia.
authors.forename: Amitabha
authors.initials: A
authors.lastname: Das
authors.affiliation: Sydney Medical School, The University of Sydney, Sydney, NSW, 2006, Australia.|Westmead Hospital, Western Sydney Local Health District, Sydney, NSW, Australia.
authors.forename: Vincent
authors.initials: V
authors.lastname: Lam
authors.affiliation: Sydney Medical School, The University of Sydney, Sydney, NSW, 2006, Australia.|Westmead Hospital, Western Sydney Local Health District, Sydney, NSW, Australia.
authors.forename: Emma
authors.initials: E
authors.lastname: Johnston
authors.affiliation: Sydney Medical School, The University of Sydney, Sydney, NSW, 2006, Australia.|Surgical Outcomes Research Centre, Sydney Local Health District, Sydney, NSW, Australia.|Royal Prince Alfred Hospital, Sydney Local Health District, Camperdown, Sydney, NSW, Australia.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Solomon
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D017028:Caregivers / Q000523:psychology*; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission; D011379:Prognosis; D011788:Quality of Life / Q000523:psychology*; D012944:Social Support; D013689:Telephone
keywords: Caregivers; Gastrointestinal cancer; Quality of life; Randomized controlled trial