Building Family Caregiver Skills Using a Simulation-Based Intervention for Care of Cancer Patients
Building Family Caregiver Skills Using a Simulation-Based Intervention for Care of Patients With Cancer
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
This is a 2-group, prospective, randomized controlled design to test the effect of an intervention, as compared to a usual care control group, on family caregivers (CG) outcomes, patient outcomes, and healthcare utilization outcomes during treatment.
The objectives of this study are to:
- Evaluate the effect of a CG intervention, as compared to a control group, on CG primary (anxiety) and secondary (depression, HRQOL, and fatigue) outcomes.
- Measure the effect of the intervention, as compared to a control group, on patient outcomes (HRQOL and interrupted treatment course), and healthcare utilization outcomes (unplanned hospital admissions, unplanned emergency room visits, and unplanned use of intravenous [IV] fluids).
- Determine if CG self-efficacy mediates the effect of the intervention on CG anxiety.
- Determine if patient illness factors, care demands (hours per week spent caregiving), and patient and CG demographic factors moderate the relationship between the intervention and CG outcomes.
- Compare the costs of healthcare utilization (unplanned hospital admission, unplanned emergency room visits, and unplanned use of IV fluids) between the intervention and control groups.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Susan Mazanec, PhD
- Phone Number: 1-800-641-2422
- Email: CTUReferral@UHhospitals.org
Study Locations
-
-
Ohio
-
Cleveland, Ohio, United States, 44109
- MetroHealth Medical Center
-
Cleveland, Ohio, United States, 44106
- University Hospitals Cleveland Medical Center
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria (for patients):
- 18 years of age or older.
- Diagnosis of stage I, II, III cancers of the rectum and anus, stage I, II, III, IVa esophagus; stage II-III NSCLC (excluding those receiving SBRT due to short treatment course); and stage I - IV A/B head/neck (tongue, gum, oral cavity, nasopharynx, oropharynx, hypopharynx, parotid, or larynx). Stage IV A/B will be allowed for HNC and stage IVa for esophagus as the intent of therapy is curative.
- Has an identified family CG who is willing to participate.
Inclusion Criteria (for CGs):
- 18 years of age or older
- Family member or friend of an adult patient described above
- Identified by the patient as his/her primary CG, who is providing daily assistance and/or emotional support.
Exclusion Criteria:
- Patients who do not have a caregiver will be excluded.
- CGs of patients who are receiving hospice care will be excluded because of the patient's poor prognosis and multiple issues associated with end-of-life care.
- CGs who are themselves undergoing active cancer treatment will be excluded (hormonal treatment allowed).
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
No Intervention: Control - Standard of Care
CG(caregivers)/CP(cancer patients) dyads
|
|
|
Experimental: Intervention
CG/CP dyads
|
Telephone booster contact 2 weeks post-treatment.
One-on-one support/educational sessions with the caregiver during radiation treatments (note - intervention sessions 2 & 3 delivered by phone during COVID-19 and remained an option after the pandemic).
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
CG Anxiety at 20 Weeks Post-treatment
Time Frame: 20 weeks post treatment
|
Difference in CG anxiety between the intervention and control groups at 20 weeks post-radiation treatment. CG anxiety will be measured with the Patient-Reported Outcomes Measurement Information System (PROMIS) Anxiety Short Form 7a. This 7-item questionnaire assesses self-reported fear, worry, anxiety, tension, nervousness, and restlessness in the family caregiver over the last 7 days. This outcome will be reporting the average T-score for anxiety as measured by the PROMIS scale. Raw scores range from 7 to 35. Each participant's raw score on the scale will be converted to a standardized T-score that has a mean of 50 and a standard deviation of 10. A higher T-score represents greater anxiety. For example, a T-score of 60 is one standard deviation worse anxiety than average. |
20 weeks post treatment
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
CG Anxiety at Baseline
Time Frame: Baseline
|
CG anxiety will be measured with the Patient-Reported Outcomes Measurement Information System (PROMIS) Anxiety Short Form 7a. This 7-item questionnaire assesses self-reported fear, worry, anxiety, tension, nervousness, and restlessness in the family caregiver over the last 7 days. This outcome will be reporting the average T-score for anxiety as measured by the PROMIS scale. Raw scores range from 7 to 35. Each participant's raw score on the scale will be converted to a standardized T-score that has a mean of 50 and a standard deviation of 10. A higher T-score represents greater anxiety. For example, a T-score of 60 is one standard deviation worse anxiety than average. |
Baseline
|
|
CG Anxiety at the End of Radiation Treatment
Time Frame: At end of treatment, average of seven weeks
|
Difference in CG anxiety between the intervention and control groups at the end of radiation treatment CG anxiety will be measured with the Patient-Reported Outcomes Measurement Information System (PROMIS) Anxiety Short Form 7a. This 7-item questionnaire assesses self-reported fear, worry, anxiety, tension, nervousness, and restlessness in the family caregiver over the last 7 days. This outcome will be reporting the average T-score for anxiety as measured by the PROMIS scale. Raw scores range from 7 to 35. Each participant's raw score on the scale will be converted to a standardized T-score that has a mean of 50 and a standard deviation of 10. A higher T-score represents greater anxiety. For example, a T-score of 60 is one standard deviation worse anxiety than average. |
At end of treatment, average of seven weeks
|
|
CG Anxiety at 4 Weeks Post Treatment
Time Frame: 4 weeks post treatment
|
CG anxiety between the intervention and control groups at 4 weeks post treatment. CG anxiety will be measured with the Patient-Reported Outcomes Measurement Information System (PROMIS) Anxiety Short Form 7a. This 7-item questionnaire assesses self-reported fear, worry, anxiety, tension, nervousness, and restlessness in the family caregiver over the last 7 days. This outcome will be reporting the average T-score for anxiety as measured by the PROMIS scale. Raw scores range from 7 to 35. Each participant's raw score on the scale will be converted to a standardized T-score that has a mean of 50 and a standard deviation of 10. A higher T-score represents greater anxiety. For example, a T-score of 60 is one standard deviation worse anxiety than average. |
4 weeks post treatment
|
|
CG Depression
Time Frame: at baseline, at end of treatment (average of seven weeks), and at 4 and 20 weeks post treatment
|
CG depression will be measured with the PROMIS Depression Short Form 8b. This 8-item questionnaire assesses caregiver self-reported negative mood (sadness, guilt), views of self (worthlessness), and social cognition (loneliness), as well as decreased positive affect and engagement. It assesses depression over the last 7 days. This outcome will be reporting the average T-score for depression as measured by the PROMIS scale. Raw scores range from 8 to 40. Each participant's raw score on the scale will be converted to a standardized T-score that has a mean of 50 and a standard deviation of 10. A higher T-score represents greater depression. For example, a T-score of 60 is one standard deviation worse depression than average. |
at baseline, at end of treatment (average of seven weeks), and at 4 and 20 weeks post treatment
|
|
CG Health-related Quality of Life (HRQOL) as Measured by PROMIS Global Health Scale - Global Mental Health Domain
Time Frame: at baseline, at end of treatment (average of seven weeks), and at 4 and 20 weeks post treatment
|
The PROMIS Global Health Scale will be scored as two separate domains - Global Physical Health and Global Mental Health.
These domains are not combined for a total score.
Raw scores range from 4 to 20.
Each participant's raw score on the scale will be converted to a standardized T-score that has a mean of 50 and a standard deviation of 10.
A higher T-score represents better health (Global Physical Health or Global Mental Health) than the general population.
For example, a T-score of 60 is one standard deviation better health than average
|
at baseline, at end of treatment (average of seven weeks), and at 4 and 20 weeks post treatment
|
|
CG HRQOL as Measured by PROMIS Global Health Scale - Global Physical Health
Time Frame: Baseline, end of treatment, 4 weeks and 20 weeks post treatment
|
The PROMIS Global Health Scale will be scored as two separate domains - Global Physical Health and Global Mental Health.
These domains are not combined for a total score.
Raw scores range from 4 to 20.
Each participant's raw score on the scale will be converted to a standardized T-score that has a mean of 50 and a standard deviation of 10.
A higher T-score represents better health (Global Physical Health or Global Mental Health) than the general population.
For example, a T-score of 60 is one standard deviation better health than average
|
Baseline, end of treatment, 4 weeks and 20 weeks post treatment
|
|
CG Fatigue
Time Frame: at baseline, at end of treatment (average of seven weeks), and at 4 and 20 weeks post treatment
|
CG fatigue will be measured with the PROMIS Fatigue Short Form 7a, a 7-item questionnaire that evaluates the self-reported experience of fatigue (frequency, duration, intensity) and the impact of fatigue on daily activities. It assesses fatigue over the last 7 days. This outcome will be reporting the average T-score for fatigue. Raw scores range from 7 to 35. Each participant's raw score on the scale will be converted to a standardized T-score that has a mean of 50 and a standard deviation of 10. A higher T-score represents greater fatigue. For example, a T-score of 60 is one standard deviation worse fatigue than average. |
at baseline, at end of treatment (average of seven weeks), and at 4 and 20 weeks post treatment
|
|
Participant HRQOL (Cancer Patient) as Measured by FACT-G
Time Frame: at baseline, at end of treatment (average of seven weeks), and at 4 and 20 weeks post treatment
|
Participant HRQOL will be measured using the disease-specific versions of FACT-G that include common subscales (physical, social, emotional, and functional well-being) plus cancer-specific questions. The effect of the intervention on HRQOL across diagnoses will be analyzed using the common subscales. The symptom experience with each diagnostic group will be described using the cancer-specific subscale. Participants rate their response to each item on a 5-point Likert-type scale. After reverse-scoring negatively worded questions, items are summed. Higher scores indicate better quality of life. The FACT - Colorectal (FACT-C, Version 4) is a 37-item questionnaire that measures self-reported HRQOL in patients with colorectal cancer over the last 7 days. |
at baseline, at end of treatment (average of seven weeks), and at 4 and 20 weeks post treatment
|
|
Interrupted Treatment
Time Frame: End of radiation treatment, average of seven weeks
|
Interrupted Radiation Treatment Course, defined as the total number of missed treatment days due to patient or caregiver reasons, will be determined from the patient's radiation therapy treatment record.
Number of days of each episode of absence from treatment will also be recorded.
|
End of radiation treatment, average of seven weeks
|
|
Healthcare Utilization for Participants, as Measured by Number of Hospital Admissions
Time Frame: 20 weeks post treatment
|
Healthcare utilization was measured by number of hospital admissions during the entire study period.
These were assessed via review of the patient's medical record at T4 (end of study).
|
20 weeks post treatment
|
|
Healthcare Utilization for Participants, as Measured by Number of Emergency Room Visits
Time Frame: 20 weeks post treatment
|
Healthcare utilization was measured by number of emergency room visits during the entire study period.
These were assessed via review of the patient's medical record at T4 (end of study).
|
20 weeks post treatment
|
|
Healthcare Utilization for Participants, as Measured by Number of Visits for IV Hydration
Time Frame: 20 weeks post treatment
|
Healthcare utilization was measured by number of visits for IV hydration during the entire study period.
These were assessed via review of the patient's medical record at T4 (end of study).
|
20 weeks post treatment
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Susan Mazanec, PhD, RN, Case Western Reserve University, Case Comprehensive Cancer Center, University Hospitals Cleveland Medical Center
Publications and helpful links
General Publications
- Mazanec SR, Blackstone E, Daly BJ. Building family caregiver skills using a simulation-based intervention for care of patients with cancer: protocol for a randomized controlled trial. BMC Nurs. 2021 Jun 9;20(1):93. doi: 10.1186/s12912-021-00612-4.
- Park S, Blackstone EC, Mazanec SR. Exploring the determinants of health literacy and its effects on health-related outcomes in family caregivers of patients with cancer. Support Care Cancer. 2025 Apr 29;33(5):433. doi: 10.1007/s00520-025-09494-7.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- CASE4Y19
- 1R37CA240707-01 (U.S. NIH Grant/Contract)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Cancer
-
NCT05693831RecruitingCancer | Relapsed Cancer | Refractory Cancer
-
NCT07224204RecruitingCancer | Adolescent Cancer | Young Adult Cancer
-
NCT02045381CompletedCancer Liver | Cancer Brain | Cancer Head &Neck | Cancer Pelvis
-
NCT07196241RecruitingCancer | Adolescent Cancer | Young Adult Cancer
-
NCT04310345CompletedAdvanced Cancer | Relapsed Cancer | Refractory Cancer
-
NCT02511821CompletedStage III Pancreatic Cancer | Stage IIA Pancreatic Cancer | Stage IIB Pancreatic Cancer | Stage IV Gastric Cancer | Stage IVA Colorectal Cancer | Stage IVA Pancreatic Cancer | Stage IVB Colorectal Cancer | Stage IVB Pancreatic Cancer | Stage IIIA Gastric Cancer | Stage IIIB Gastric Cancer
-
NCT03977402Recruiting
-
NCT06191679CompletedCancer | Childhood Cancer
-
NCT04044430TerminatedStage IIIA Rectal Cancer | Stage IIIB Rectal Cancer | Stage IIIC Rectal Cancer | Metastatic Colorectal Adenocarcinoma | Metastatic Colon Adenocarcinoma | Metastatic Rectal Adenocarcinoma | Stage IIIA Colon Cancer | Stage IIIB Colon Cancer | Stage IIIC Colon Cancer | Stage IV Colon Cancer
Clinical Trials on Telephone booster contact
-
NCT03571841CompletedSexual Function Disturbances | Breast Cancer Survivors | Ovarian Suppression Treatment
-
NCT00816010TerminatedType 2 Diabetes Mellitus | Acute Coronary Syndrome
-
NCT02583035CompletedCancer | Hematologic Malignancy
-
NCT02207543TerminatedCancer | Palliative Care | Home
-
NCT02507271CompletedTraumatic Brain Injury | Vascular Accident, Brain
-
NCT00545922CompletedDepression | Chronic Obstructive Pulmonary Disease | Anxiety
-
NCT03440476CompletedCollege Student Drinking
-
NCT00469365CompletedDepression | Heart Diseases | Hypertension | Diabetes | Hyperlipidemia | Psychoses