CHESS improves cancer caregivers’ burden and mood: Results of an eHealth RCT.

Abstract

Objective Informal caregivers (family and friends) of people with cancer are often unprepared for their caregiving role, leading to increased burden or distress. CHESS (Comprehensive Health Enhancement Support System) is a web-based lung cancer information, communication and coaching system for caregivers. This randomized trial reports the impact on caregiver burden, disruptiveness and mood of providing caregivers access to CHESS versus the Internet with a list of recommended lung cancer websites. Methods 285 informal caregivers of patients with advanced non-small cell lung cancer were randomly assigned to a comparison group that received Internet or a treatment group that received Internet and CHESS. Caregivers were provided a computer and Internet service if needed. Written surveys were completed at pretest and during the intervention period bimonthly for up to 24 months. ANCOVA analyses compared the intervention’s effect on caregivers’ disruptiveness and burden (CQOLI-C), and negative mood (combined Anxiety, Depression, and Anger scales of the POMS) at six months, controlling for blocking variables (site, caregiver’s race, and relationship to patient) and the given outcome at pretest. Results Caregivers randomized to CHESS reported lower burden [t (84) = 2.36, p = .021, d= .39] and negative mood [t (86) = 2.82, p = .006, d= .44] than those in the Internet group. The effect on disruptiveness was not significant. Conclusions Although caring for someone with a terminal illness will always exact a toll on caregivers, eHealth interventions like CHESS may improve caregivers’ understanding and coping skills and, as a result, ease their burden and mood.

Telemedicine Use Among Caregivers of Cancer Patients: Systematic Review (Preprint)

“…In 21 out of 24 studies the patient-caregiver dyad was analysed, interventions were delivered to both patients and caregivers and outcomes measured in both populations. In three studies caregivers were the only target sample and patients variables' were not considered [49][50][51]. Three studies focused the intervention only on women, two of them were for partners [52,53] and one included carers with different relationships to patients [54].…”

“…Dyads dealt with different types of cancer at different stages; among included studies, lung and gastrointestinal cancers were the most considered, followed by genitourinary and breast tumours, and haematological neoplasms (see Figure 2). Of the 24 studies, eight focused on advanced cancers [48,51,[54][55][56][57][58][59], two on early-stage tumours [60,61], while other trials included patients with all stages of the disease.…”

“…More precisely, eight studies [50,51,55,58,63,66,67,71] implemented eHealth interventions aimed at exploring caregiver coping strategies, emotional wellbeing, and patient symptom management. Schover et al (2012) [53], however, combined the eHealth system with telephone sessions and all other papers used only telephone calls with supplemented written material to support patients and caregivers in their process of care (see Figure 3).…”

“…In twelve papers an intervention was developed an intervention for a unique type of cancer patients [49,[51][52][53][54]58,60,61,65,66,68,70], while the others implemented telemedicine tools for a multifaceted sample including patients with different cancer diagnoses [48,50,[55][56][57]59,[62][63][64]67,71].…”

“…On the other hand, the second cluster concerning carer's relationship with the patient evaluated perceived support such as difficulties encountered in communicating with the patient about the disease, and caregiver's perception of patient's symptom management [51,55,70]. The Edmonton Symptom Assessment Scale (ESAS) was the main tool used to assess these variables.…”