An Early Palliative Care Telehealth Coaching Intervention to Enhance Advanced Cancer Family Caregivers' Decision Support Skills: The CASCADE Pilot Factorial Trial

被引：14

作者：

Dionne-Odom, J. Nicholas ^{[1
,2
,3
]}

Wells, Rachel D. ^{[1
]}

Guastaferro, Kate ^{[4
]}

Azuero, Andres ^{[1
]}

Hendricks, Bailey A. ^{[1
]}

Currie, Erin R. ^{[1
]}

Bechthold, Avery ^{[1
]}

Dosse, Chinara ^{[1
]}

Taylor, Richard ^{[1
]}

Reed, Rhiannon D. ^{[5
]}

Harrell, Erin R. ^{[6
]}

Gazaway, Shena ^{[1
]}

Engler, Sally ^{[1
]}

McKie, Peg ^{[1
]}

Williams, Grant R. ^{[7
]}

Sudore, Rebecca ^{[8
]}

Rini, Christine ^{[9
]}

Rosenberg, Abby R. ^{[10
,11
,12
]}

Bakitas, Marie A. ^{[1
,2
,3
]}

机构：

[1] Univ Alabama Birmingham, Sch Nursing, 1720 2nd Ave South,NB 485J, Birmingham, AL 35294 USA

[2] Univ Alabama Birmingham, Sch Med, Div Gerontol Geriatr & Palliat Care, Birmingham, AL 35294 USA

[3] Univ Alabama Birmingham, Ctr Palliat & Support Care, Birmingham, AL 35294 USA

[4] Penn State Univ, Methodol Ctr, University Pk, PA 16802 USA

[5] Univ Alabama Birmingham, Comprehens Transplant Inst, Birmingham, AL 35294 USA

[6] Univ Alabama, Dept Psychol, Box 870348, Tuscaloosa, AL 35487 USA

[7] Univ Alabama Birmingham, Sch Med, Div Hematol Oncol, Birmingham, AL 35294 USA

[8] Univ Calif San Francisco, Sch Med, Div Geriatr, San Francisco, CA USA

[9] Northwestern Univ, Robert H Lurie Comprehens Canc Ctr, Feinberg Sch Med, Chicago, IL 60611 USA

[10] Univ Washington, Sch Med, Dept Pediat, Seattle, WA 98195 USA

[11] Seattle Childrens Res Inst, Palliat Care & Resilience Lab, Seattle, WA USA

[12] Univ Washington, Cambia Palliat Care Ctr Excellence, Seattle, WA 98195 USA

来源：

JOURNAL OF PAIN AND SYMPTOM MANAGEMENT | 2022年 / 63卷 / 01期

关键词：

Palliative care; family caregiving; cancer; multiphase optimization strategy; RANDOMIZED-TRIALS; OUTCOMES; LIFE;

D O I：

10.1016/j.jpainsymman.2021.07.023

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

Context. Patients with advanced cancer often involve family caregivers in health-related decision-making from diagnosis to end-of-life; however, few interventions have been developed to enhance caregiver decision support skills. Objectives. Assess the feasibility, acceptability, and potential efficacy of individual intervention components of CASCADE (CAre Supporters Coached to be Adept DEcision Partners), an early telehealth, palliative care coach-led decision support training intervention for caregivers. Methods. Pilot factorial trial using the multiphase optimization strategy (October 2019-October 2020). Family caregivers and their care recipients with newly-diagnosed advanced cancer (n = 46 dyads) were randomized to1 of 8 experimental conditions that included a combination of one of the following three CASCADE components: 1) effective decision support psychoeducation; 2) decision support communication training; and 3) Ottawa Decision Guide training. Feasibility was assessed by completion of sessions and questionnaires (predefined as >= 80%). Acceptability was determined through postintervention interviews and participants' ratings of their likelihood to recommend. Measures of effective decision support and caregiver and patient distress were collected at Twelve and Twenty four weeks. Results. Caregiver participants completed 78% of intervention sessions and 81% of questionnaires; patients completed 80% of questionnaires. Across conditions, average caregiver ratings for recommending the program to others was 9.9 on a scale from 1-Not at all likely to 10-Extremely likely. Individual CASCADE components were observed to have potential benefit for effective decision support and caregiver distress. Conclusion. We successfully piloted a factorial trial design to examine components of a novel intervention to enhance the decision support skills of advanced cancer family caregivers. A fully-powered factorial trial is warranted. (C) 2021 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

引用

页码：11 / 22

页数：12

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