title: Randomized trial of an uncertainty self-management telephone intervention for patients awaiting liver transplant.
abstract: We tested an uncertainty self-management telephone intervention (SMI) with patients awaiting liver transplant and their caregivers.
  
  
  
  Participants were recruited from four transplant centers and completed questionnaires at baseline, 10, and 12 weeks from baseline (generally two and four weeks after intervention delivery, respectively). Dyads were randomized to either SMI (n=56) or liver disease education (LDE; n=59), both of which involved six weekly telephone sessions. SMI participants were taught coping skills and uncertainty management strategies while LDE participants learned about liver function and how to stay healthy. Outcomes included illness uncertainty, uncertainty management, depression, anxiety, self-efficacy, and quality of life. General linear models were used to test for group differences.
  
  
  
  No differences were found between the SMI and LDE groups for study outcomes.
  
  
  
  This trial offers insight regarding design for future interventions that may allow greater flexibility in length of delivery beyond our study's 12-week timeframe.
  
  
  
  Our study was designed for the time constraints of today's clinical practice setting. This trial is a beginning point to address the unmet needs of these patients and their caregivers as they wait for transplants that could save their lives.
authors.affiliation: Duke University School of Nursing, Durham NC, USA; Duke Center for the Study of Aging and Human Development, Durham, USA. Electronic address: chip.bailey@duke.edu.
authors.forename: Donald E
authors.initials: DE
authors.lastname: Bailey
authors.affiliation: Duke University School of Nursing, Durham NC, USA; Durham Veterans Affairs Medical Center Geriatric Research, Education, and Clinical Center, Durham, USA; Duke Center for the Study of Aging and Human Development, Durham, USA. Electronic address: cristina.hendrix@duke.edu.
authors.forename: Cristina C
authors.initials: CC
authors.lastname: Hendrix
authors.affiliation: Division of General Medicine, Department of Medicine, Duke University School of Medicine, Durham, USA; Duke Palliative Care, Duke University Health System, Durham, USA; Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, USA. Electronic address: karen.steinhauser@duke.edu.
authors.forename: Karen E
authors.initials: KE
authors.lastname: Steinhauser
authors.affiliation: Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, USA. Electronic address: karen.stechuchak@duke.edu.
authors.forename: Karen M
authors.initials: KM
authors.lastname: Stechuchak
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, USA. Electronic address: laura.porter@duke.edu.
authors.forename: Laura S
authors.initials: LS
authors.lastname: Porter
authors.affiliation: Duke Transplant Center, Duke University School of Medicine, Durham, USA. Electronic address: julie.hudson@duke.edu.
authors.forename: Julie
authors.initials: J
authors.lastname: Hudson
authors.affiliation: Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, USA; Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, USA. Electronic address: maren.olsen@duke.edu.
authors.forename: Maren K
authors.initials: MK
authors.lastname: Olsen
authors.affiliation: Division of Gastroenterology, Department of Medicine, Duke University School of Medicine, Durham, USA. Electronic address: andrew.muir@duke.edu.
authors.forename: Andrew
authors.initials: A
authors.lastname: Muir
authors.affiliation: Duke Palliative Care, Duke University Health System, Durham, USA. Electronic address: slowman@email.unc.edu.
authors.forename: Sarah
authors.initials: S
authors.lastname: Lowman
authors.affiliation: University of Pittsburgh Medical Center, Departments of Psychiatry and Surgery, Starzl Transplant Institute Pittsburgh, USA. Electronic address: DiMartiniAF@upmc.edu.
authors.forename: Andrea
authors.initials: A
authors.lastname: DiMartini
authors.affiliation: Organ Transplantation Program, The University of Nebraska Medical Center, 983285 Nebraska Medical Center, Omaha, USA. Electronic address: lsalonen@nebraskamed.com.
authors.forename: Laurel Williams
authors.initials: LW
authors.lastname: Salonen
authors.affiliation: Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, USA; Division of Palliative Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, USA; Center for Palliative Care, Harvard Medical School, Boston, USA. Electronic address: jamesa_tulsky@dfci.harvard.edu.
authors.forename: James A
authors.initials: JA
authors.lastname: Tulsky
mesh_terms: D000223:Adaptation, Psychological; D001007:Anxiety / Q000523:psychology; D017028:Caregivers / Q000193:education* / Q000523:psychology; D003863:Depression / Q000523:psychology; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000523:psychology*; D008297:Male; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic; D011788:Quality of Life; D020377:Self Efficacy; D000073278:Self-Management; D013689:Telephone; D035501:Uncertainty
keywords: Coping skills; Illness uncertainty; Intervention; Self-management