title: The effect of routine training on the self-efficacy of informal caregivers of colorectal cancer patients.
abstract: Little is known about the degree to which caregiver training as part of routine clinical care influences caregiver self-efficacy. The objective of this study was to examine the relationship between training during routine clinical cancer care and self-efficacy among caregivers of colorectal cancer patients.
  
  
  
  Caregivers completed a self-administered questionnaire about their experiences with training for specific patient problems and about their task-specific and general caregiving self-efficacy. Associations between training and self-efficacy were examined for each problem using multivariate logistic regression adjusted for caregiver age, race, care burden, education, perception of patient's health, and patient stage of disease.
  
  
  
  Four hundred seventeen caregivers completed the survey (70% response rate), of whom 374 (90%) were female and 284 (68%) were the patient's spouse/partner. Overall, 77 (38%) reported inadequate training for pain, 80 (38%) for bowel, 121 (48%) for fatigue, 65 (26%) for medication administration, and 101 (40%) for other symptoms. The odds of having low self-efficacy were significantly higher among those with perceptions of inadequate training across the following cancer-related problems: pain 10.10 (3.36, 30.39), bowel 5.04 (1.98, 12.82), fatigue 8.45 (3.22, 22.15), managing medications 9.00 (3.30, 24.51), and other 3.87 (1.68, 8.93).
  
  
  
  Caregivers commonly report inadequate training in routine colorectal cancer care. Significant and consistent associations between training adequacy and self-efficacy were found. This study supports the value of training caregivers in common cancer symptoms. Further work on how and when to provide caregiver training to best impact self-efficacy is needed.
authors.affiliation: Division of Primary Care Internal Medicine, Department of Medicine, Mayo Clinic College of Medicine and Science, 200 First Street SW, Rochester, MN, 55905, USA. havyer.rachel@mayo.edu.
authors.forename: Rachel D
authors.initials: RD
authors.lastname: Havyer
authors.affiliation: Division of Health Care Policy and Research, Mayo Clinic College of Medicine and Science, Rochester, MN, USA.
authors.forename: Michelle
authors.initials: M
authors.lastname: van Ryn
authors.affiliation: Division of Health Care Policy and Research, Mayo Clinic College of Medicine and Science, Rochester, MN, USA.
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Wilson
authors.affiliation: Division of Health Care Policy and Research, Mayo Clinic College of Medicine and Science, Rochester, MN, USA.
authors.forename: Joan M
authors.initials: JM
authors.lastname: Griffin
mesh_terms: D017028:Caregivers / Q000193:education* / Q000523:psychology*; D015179:Colorectal Neoplasms / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010465:Perception; D020377:Self Efficacy; D011795:Surveys and Questionnaires
keywords: Cancer; Caregiver; Oncology; Self-efficacy; Training