A psycho educational intervention for family caregivers of patients receiving palliative care: a randomised controlled trial

Principal Investigator: Dr Peter Hudson RN PhD

Institution Affiliation: St Vincent's & University of Melbourne

Caregiver Intervention Description

  1. Intervention summary

    Aims of the intervention:

    1. To prepare caregivers by providing then with information (verbal, written and audiotape) about typical aspects and common issues associated with the caregiving role.
    2. To guide and educate by offering caregivers an opportunity to access information (verbal and written) to enhance their understanding of relevant issues and to provide a basis for skill acquisition.
    3. To support caregivers by focusing specific attention on their needs and reinforcing the role of the palliative care service; identifying services ‘outside’ the palliative care team; and providing strategies to involve family/friends.
    4. To help caregivers make sense of and/or find meaning by normalising emotional reactions to the situation, encouraging caregivers to try to see some positive aspects of their experience and offering access to spiritual guidance (via the palliative care service).
    5. To promote self-care by encouraging caregivers to enhance their physical and mental health by promoting regular ‘time out’, enjoyable experiences, enough sleep, healthy diet, exercises and advice on relaxation strategies.
    6. To provide options by offering caregivers an opportunity to identify issues and plan goals/strategies and advising caregivers of their rights.
Description of the intervention:

The nurse-delivered intervention consisted of two home visits supplemented by a follow up phone call between the two visits. A caregiver guidebook and audiotape were used to complement the nurse interactions. The guidebook aimed to provide caregivers with easy access to written information related to typical aspects of caring for a dying person. The audiotape featured reflections from carers and incorporated self care strategies and a structured relaxation exercise. The intervention nurse contacted intervention participants by telephone, within a week following randomisation. The nurse sought approval to send the caregiver guidebook and arranged the first intervention visit with the caregiver (and patient, if deemed appropriate by the caregiver). Caregivers were asked to read sections 1 and 2 of the guidebook and note any questions prior to the nurse’s first visit. The first visit aimed to prepare the participant for the caregiver role (section 1 of guidebook) and key aspects of care provision (section 2 of guidebook). The intervening phone call focused on evaluating plans developed at the first visit, reiterating the importance of self-care, (section 3 of the guidebook), identifying any new issues and assessing the caregiver’s desire to go on to the next section of the guidebook. The second visit focused on evaluating previous strategies, identifying new issues, and preparing for the dying phase (final section of the guidebook).
  1. Intervention Materials

    Guidebook available from Palliative Care Victoria via email info@pallcarevic.asn.au or www.pallcarevic.asn.au.

    You can also contact Centre for Palliative Care Education & Research via email cpcpa@medstv.unimelb.edu.au or www.pallcare.unimelb.edu.au.

    Contact information for further information, materials, and training:

    Dr Peter Hudson RN PhD

Director

Centre for Palliative Care Education & Research

St Vincent's & University of Melbourne

PO Box 2900, Fitzroy

Victoria 3065

Australia

Tel: 61 3 9416 0000

Fax: 61 3 9416 3919

Email: peterh@medstv.unimelb.edu.au

  1. Implementing the Intervention

    Training qualifications and guidelines for those delivering the intervention:

    Registered nurse with experience in oncology and/or hospice/palliative care.

    Email inquiries about training to Dr Peter Hudson (Australia) at peterh@medstv.unimelb.edu.au.

    Estimated costs of implementing the intervention:

    ½ day training for intervention nurse

    Approximately 8 hrs of registered nurse time to deliver the intervention
  2. For more Information:

    Journal articles

    • Hudson PL, Hayman-White K, Aranda S, Kristjanson L (2006) Predicting family caregiver psychosocial functioning in palliative care. Journal of Palliative Care, 22(3), 133-140.
    • (2006) How well do family caregivers cope after caring for a relative with advanced disease and how can health professionals enhance their support? Journal of Palliative Medicine, 9(3), 694-703.
    • Hudson PL, Hayman-White K (2006) Measuring the psychosocial characteristics of family caregivers of palliative care patients: psychometric properties of nine self-report instruments. Journal of Pain and Symptom Management, 31(3), 215-228.
    • Aoun SM, Kristjanson LJ, Currow DC, Hudson PL (2005) Caregiving for the terminally ill: at what cost? Palliative Medicine, 19, 551-555.
    • Aoun SM, Kristjanson LJ, Hudson PL, Currow DC, Rosenberg JP (2005) The experience of supporting a dying relative: reflections of caregivers. Progress in Palliative Care, 13(6), 317-325.
    • Hudson PL, Aranda S, Hayman-White K (2005) A psycho-educational intervention for family caregivers of patients receiving palliative care: A randomized controlled trial. Journal of Pain and Symptom Management, 30(4), 329-341.
    • Hudson PL, Aranda S, Kristjanson L, Quinn K (2005) Minimising gate-keeping in palliative care research. European Journal of Palliative Care, 12(4), 165-169.
    • Hudson PL (2004) A critical review of supportive interventions for family caregivers of patients with palliative-stage cancer. Journal of Psychosocial Oncology, 22(4), 77-92.
    • Hudson PL, Aranda S, Kristjanson L (2004) Information provision for palliative care families. European Journal of Palliative Care, 11(4), 153-157.
    • Hudson PL (2004) Positive aspects and challenges associated with caring for a dying relative at home. International Journal of Palliative Nursing, 10(2), 58-66.
    • Hudson PL, Aranda S, Kristjanson LJ (2004) Meeting the supportive care needs of family caregivers in palliative care: challenges for health professionals. Journal of Palliative Medicine, 7(1), 19-25.
    • Hudson PL (2003) A conceptual model and key variables for guiding supportive interventions for family caregivers of people receiving palliative care. Palliative and Supportive Care, 1(4), 353-365.
    • Hudson PL (2003) The experience of research participation for family caregivers of palliative care cancer patients. International Journal of Palliative Nursing, 9 (3), 120-123.
    • Hudson PL, Aranda S, McMurray N (2002) Intervention development for enhanced lay palliative caregiver support - the use of focus groups. European Journal of Cancer Care, 11(4), 262-270.
    Books

    • Hudson PL, Payne S (Eds) (In press). Family Carers and Palliative Care. Oxford: Oxford University Press.
    • Hudson PL (2004) Supporting a person who requires palliative care: A guide for family caregivers. Melbourne: Palliative Care Victoria.