title: Effect of integrated caregiver support on caregiver burden for people taking care of people with cancer at the end of life: A cohort and quasi-experimental clinical trial.
abstract: BACKGROUND
  Previous studies have shown small-to-medium effects of support on reducing the caregiver burden for advanced cancer patients. A dearth of studies utilized longitudinal design to examine and evaluate the effect of support for the caregiving burden till the patient's death.
  
  
  OBJECTIVE
  To test the ability of an integrative intervention program for caregivers of advanced cancer patients to lower caregiving burden as death approaches.
  
  
  METHODS
  A two-group comparative design with repeated measures.
  
  
  METHODS
  Two cancer wards of a single university hospital.
  
  
  METHODS
  Advanced cancer patients (N=81) and their caregivers were allocated into two groups: an experimental group (N=40) receiving coping strategies, assistance, recourses, and education intervention and a control group (N=41) receiving standard care.
  
  
  METHODS
  Caregivers received training in the caregiver support intervention at least 3 times every 2 weeks to help them reduce their caregiving burden. Subjective (Caregiver Reaction Assessment) and objective (Heart Rate Variability) measures of caregiver burden were evaluated for caregivers of patients approaching death. Only data within 3 months before the patients' death were analyzed.
  
  
  RESULTS
  Caregiver self-efficacy significantly increased and the subjective caregiving burden significantly decreased in the experimental group as patients' death approached. Heart Rate Variability also indicated a calming effect of the intervention, helping caregivers face patients' death.
  
  
  CONCLUSIONS
  The caregiver support intervention can increase caregiver self-efficacy and reduce the subjective caregiving burden. Heart Rate Variability parameters have the potential to be useful for monitoring caregiver burden in facing patients' death.
authors.affiliation: Department of Nursing, China Medical University Hospital, No. 91, Hsueh-Shih Road, Taichung 40402 Taiwan. Electronic address: rubylee@mail.cmu.edu.tw.
authors.forename: Kwo-Chen
authors.initials: KC
authors.lastname: Lee
authors.affiliation: Department of Neurosurgery, Neurological Institute, Taichung Veteran General Hospital, No. 1650, Taiwan Boulevard, Sect. 4, Taichung 40705, Taiwan. Electronic address: jackson4380@gmail.com.
authors.forename: Jia-Jean
authors.initials: JJ
authors.lastname: Yiin
authors.affiliation: Department of Nursing, Mackay Medical College, No. 46, Sec. 3, Jhong-Jheng Rd, Sanzhi Dist., New Taipei City 252, Taiwan. Electronic address: yfchao.tw@yahoo.com.tw.
authors.forename: Yann-Fen
authors.initials: YF
authors.lastname: Chao
mesh_terms: D000328:Adult; D000368:Aged; D017028:Caregivers / Q000523:psychology*; D015331:Cohort Studies; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000451:nursing*
keywords: Caregiver burden; Caregiver support; End of life; People with cancer