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Hospice Problem Solving Intervention

17 novembre 2017 mis à jour par: George Demiris, University of Washington

A Problem Solving Intervention for Hospice Caregivers

In recent years, the demand for home hospice care has grown rapidly. Family members and friends who act as informal caregivers are essential to the provision of palliative care services; however, this role is not without adverse effects on the caregivers themselves. It is well documented that emotional needs of individuals caring for dying persons in their home are not well attended, and interventions aiming to provide support to informal hospice caregivers are notably lacking. In this context, problem solving therapy (PST) provides an overall coping process that fosters adaptive situational coping and behavioral competence. The investigators are conducting a randomized controlled trial to fully evaluate the PST intervention for informal hospice caregivers. Additionally, the investigators aim to evaluate how the modality of the intervention (face to face vs video) impacts its effectiveness. This investigator team is conducting a 4-year randomized trial study in which hospice caregivers will be randomly assigned to a group receiving standard hospice care with the addition of social support interactions (attention control group) or a group receiving standard hospice care with the addition of the problem solving intervention delivered face to face (intervention group 1) or a group receiving standard hospice care with the addition of the problem solving intervention delivered via video (intervention group 2). The specific aims include an assessment of the impact of PST on caregiver quality of life, problem solving ability, and caregiver anxiety.

Aperçu de l'étude

Statut

Complété

Type d'étude

Interventionnel

Inscription (Réel)

514

Phase

  • N'est pas applicable

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Lieux d'étude

    • Washington
      • Seattle, Washington, États-Unis, 98195
        • University of Washington

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

18 ans et plus (Adulte, Adulte plus âgé)

Accepte les volontaires sains

Non

Sexes éligibles pour l'étude

Tout

La description

Inclusion Criteria:

  • enrolled as a family/informal caregiver of a hospice patient
  • 18 years or older
  • with access to a standard phone line or Internet and computer access at home
  • without functional hearing loss or with a hearing aid that allows the participant to conduct telephone conversations as assessed by the research staff (by questioning and observing the caregiver)
  • no or only mild cognitive impairment
  • speak and read English, with at least a 6th-grade education

Exclusion Criteria:

  • lack of phone or Internet access

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: Soins de soutien
  • Répartition: Randomisé
  • Modèle interventionnel: Affectation parallèle
  • Masquage: Aucun (étiquette ouverte)

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Aucune intervention: Attention Control
This group receives standard care with the attention of social support/ "friendly interactions" and serves as an attention control group.
Expérimental: Intervention Group 1 (Face to Face)
This group receives Problem Solving Therapy in face to face visits.
Problem-solving therapy (PST) focuses on behavioral change principles derived from this theoretical framework. PST addresses four skills: 1) problem definition and formulation, which involves gathering data and information, articulating the issue in clear terms, identifying the challenge, and setting realistic goals; 2) generation of alternative strategies; 3) decision making; and 4) solution implementation. The intervention is delivered in a series of interactions with the interventionist.
Expérimental: Intervention Group 2 (Video)
This group receives Problem Solving Therapy via video.
Problem-solving therapy (PST) focuses on behavioral change principles derived from this theoretical framework. PST addresses four skills: 1) problem definition and formulation, which involves gathering data and information, articulating the issue in clear terms, identifying the challenge, and setting realistic goals; 2) generation of alternative strategies; 3) decision making; and 4) solution implementation. The intervention is delivered in a series of interactions with the interventionist.

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Caregiver Anxiety: Change From Baseline to Post-Intervention Exit
Délai: At Baseline and Exit (approximately 4 weeks after recruitment)
Caregiver anxiety was measured with the 7-item Generalized Anxiety Disorder (GAD-7) Scale (Spitzer et al., 2006), which measures the frequency with which respondents experience symptoms of anxiety such as restlessness, difficulty relaxing, and uncontrollable worrying. The GAD-7 total scores range from 0 to 21, with higher scores indicating more anxiety.
At Baseline and Exit (approximately 4 weeks after recruitment)
Caregiver Quality of Life - Physical: Change From Baseline to Post-Intervention Exit
Délai: At Baseline and Exit (approximately 4 weeks after recruitment)
An interview CQLI version was developed by using identical items from the paper-based CQLI and replacing the visual analogue response format with a 0-10 response scale. Higher scores indicate better physical quality of life.
At Baseline and Exit (approximately 4 weeks after recruitment)
Caregiver Quality of Life - Social: Change From Baseline to Post-Intervention Exit
Délai: At Baseline and Exit (approximately 4 weeks after recruitment)
An interview CQLI version was developed by using identical items from the paper-based CQLI and replacing the visual analogue response format with a 0-10 response scale. Higher scores indicate better social quality of life.
At Baseline and Exit (approximately 4 weeks after recruitment)
Caregiver Quality of Life - Emotional: Change From Baseline to Post-Intervention Exit
Délai: At Baseline and Exit (approximately 4 weeks after recruitment)
An interview CQLI version was developed by using identical items from the paper-based CQLI and replacing the visual analogue response format with a 0-10 response scale. Higher scores indicate better emotional quality of life.
At Baseline and Exit (approximately 4 weeks after recruitment)
Caregiver Quality of Life - Financial: Change From Baseline to Post-Intervention Exit
Délai: At Baseline and Exit (approximately 4 weeks after recruitment)
An interview CQLI version was developed by using identical items from the paper-based CQLI and replacing the visual analogue response format with a 0-10 response scale. Higher scores indicate better financial quality of life.
At Baseline and Exit (approximately 4 weeks after recruitment)

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Les enquêteurs

  • Chercheur principal: George Demiris, PhD, University of Washington

Publications et liens utiles

La personne responsable de la saisie des informations sur l'étude fournit volontairement ces publications. Il peut s'agir de tout ce qui concerne l'étude.

Publications générales

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude

1 octobre 2011

Achèvement primaire (Réel)

1 mars 2016

Achèvement de l'étude (Réel)

1 mars 2016

Dates d'inscription aux études

Première soumission

28 septembre 2011

Première soumission répondant aux critères de contrôle qualité

29 septembre 2011

Première publication (Estimation)

30 septembre 2011

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

13 décembre 2017

Dernière mise à jour soumise répondant aux critères de contrôle qualité

17 novembre 2017

Dernière vérification

1 novembre 2017

Plus d'information

Termes liés à cette étude

Autres numéros d'identification d'étude

  • 36909
  • 1R01NR012213-01A1 (Subvention/contrat des NIH des États-Unis)

Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .

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