Effectiveness of an interdisciplinary palliative care intervention for family caregivers in lung cancer

Abstract

Background Family caregivers (FCGs) experience significant deteriorations in quality of life while caring for lung cancer patients. This study tested the effectiveness of an interdisciplinary palliative care intervention for FCGs of patients diagnosed with stage I–IV non-small cell lung cancer (NSCLC). Methods FCGs who were identified by patients as the primary caregiver were enrolled in a prospective, quasi-experimental study whereby the usual care group was accrued first followed by the intervention group. FCGs in the intervention group were presented at interdisciplinary care meetings, and they also received four educational sessions organized in the physical, psychological, social, and spiritual domains. The sessions included self-care plans to support the FCG’s own needs. Caregiver burden, caregiving skills preparedness, psychological distress, and FCG QOL were assessed at baseline and 12 weeks using validated measures. Results A total of 366 FCGs were included in the primary analysis. FCGs who received the interdisciplinary palliative care intervention had significantly better scores for social well-being (5.84 vs. 6.86; p<.001) and lower psychological distress (4.61 vs. 4.20; p=.010) at 12 weeks compared to FCGs in the usual care group. FCGs in the intervention group had significantly less caregiver burden compared to FCGs in the usual care group (p=.008). Conclusions An interdisciplinary approach to palliative care in lung cancer resulted in statistically significant improvements in the FCG’s social well-being, psychological distress, and less caregiver burden.

A Systematic Review of Psychosocial Interventions to Cancer Caregivers

“…What's more, two studies evaluated family demands (Mitchell et al, 2013; Barrera et al, 2014) and seven studies conducted individual skills training to caregivers (Belgacem et al, 2013; Boele et al, 2013; Dionne-Odom et al, 2015; Leow et al, 2015; Sun et al, 2015; Shaw et al, 2016). Additionally, there was another two interventions studies focused on couple-based intervention of marital relationships (McLean et al, 2013) and group skills training (Fegg et al, 2013).…”

“…In addition, four of the interventions operated by the multidisciplinary teams composed of oncologists, radiotherapists, psychological consultants, physiotherapists and physical therapists, physicians and nurses and social workers were effective (Clark et al, 2013; Mitchell et al, 2013; Barrera et al, 2014; Sun et al, 2015). Moreover, self-help e-learning by caregivers was also proved to be effective (DuBenske et al, 2014).…”

Spiritual Care in Hospice and Palliative Care

“…Psychological symptoms such as anxiety and depression may be related to a patient's spiritual distress, regrets, fears, or need for forgiveness (7)(8)(9). The social domain includes changing roles and relationships and other aspects of the patient and family life which is also greatly influenced by spirituality (10)(11)(12). Thus, it is evident that attention to spirituality influences all aspects of the patient's life (13)(14)(15)(16).…”

Palliative Care in Huntington Disease: Personal Reflections and a Review of the Literature

“…Outside the psychological and symptom-based support for the patient, palliative care also directs support to caregivers 33. Specialty palliative care is documented to have a positive impact on caregiver quality of life and psychological distress in other chronic medical and neurological conditions including cancer, dementia, and PD 34,35. Particularly for caregivers of patients with high symptom burden, referral can both primarily improve caregiver burden through counseling, reassurance and normalization, and offering respite services, and secondarily improve burden through directed treatment of patient symptomatology.…”