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Multimodal psychosocial intervention for family caregivers of patients undergoing hematopoietic stem cell transplantation: A randomized clinical trial
Author(s) -
ElJawahri Areej,
Jacobs Jamie M.,
Nelson Ashley M.,
Traeger Lara,
Greer Joseph A.,
Nicholson Showly,
Waldman Lauren P.,
Fenech Alyssa L.,
Jagielo Annemarie D.,
D’Alotto Jennifer,
Horick Nora,
Spitzer Thomas,
DeFilipp Zachariah,
Chen YiBin A.,
Temel Jennifer S.
Publication year - 2020
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.32680
Subject(s) - medicine , psychosocial , randomized controlled trial , transplantation , quality of life (healthcare) , caregiver burden , coping (psychology) , distress , hospital anxiety and depression scale , anxiety , clinical trial , hematopoietic stem cell transplantation , physical therapy , psychiatry , clinical psychology , nursing , disease , dementia
Background Caregivers of patients undergoing hematopoietic stem cell transplantation (HCT) experience an immense caregiving burden before, during, and after HCT. Methods We conducted an unblinded, randomized trial of a psychosocial intervention (BMT‐CARE) for caregivers of patients undergoing autologous and allogeneic HCT at Massachusetts General Hospital. Caregivers were randomly assigned to BMT‐CARE or usual care. BMT‐CARE was tailored to the HCT trajectory and integrated treatment‐related education and self‐care with cognitive‐behavioral skills to promote coping. Caregivers assigned to BMT‐CARE met with a trained interventionist (a psychologist or a social worker) in person, via telephone, or via videoconferencing for 6 sessions starting before HCT and continuing up to day +60 after HCT. The primary endpoint was feasibility, which was defined as at least 60% of eligible caregivers enrolling and completing 50% or more of the intervention sessions. We assesed caregiver quality of life (QOL; Caregiver Oncology Quality of Life Questionnaire), caregiving burden (Caregiver Reaction Assessment), psychological distress (Hospital Anxiety and Depression Scale), self‐efficacy (Cancer Self‐Efficacy Scale–Transplant), and coping (Measures of Current Status) at baseline and 30 and 60 days after HCT. We used mixed linear effect models to assess the effect of BMT‐CARE on outcomes longitudinally. Results We enrolled 72.5% of eligible caregivers (100 of 138), and 80% attended 50% or more of the intervention sessions. Caregivers randomized to BMT‐CARE reported improved QOL ( B = 6.11; 95% CI, 3.50‐8.71; P < .001), reduced caregiving burden ( B = –6.02; 95% CI, –8.49 to –3.55; P < .001), lower anxiety ( B = –2.18; 95% CI, –3.07 to –1.28; P < .001) and depression symptoms ( B = –1.23; 95% CI, –1.92 to –0.54; P < .001), and improved self‐efficacy ( B = 7.22; 95% CI, 2.40‐12.03; P = .003) and coping skills ( B = 4.83; 95% CI, 3.04‐6.94; P < .001) in comparison with the usual‐care group. Conclusions A brief multimodal psychosocial intervention tailored for caregivers of HCT recipients is feasible and may improve QOL, mood, coping, and self‐efficacy while reducing the caregiving burden during the acute HCT period.