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Carer preparedness improved by providing a supportive educational intervention for carers of patients with high-grade glioma: RCT results

BACKGROUND: High-grade glioma (HGG) is a rapidly progressing and debilitating disease. Family carers take on multiple responsibilities and experience high levels of distress. We aimed to deliver a nurse-led intervention (Care-IS) to carers to improve their preparedness to care and reduce distress. M...

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Autores principales: Halkett, Georgia K. B., Lobb, Elizabeth A., Phillips, Jane L., McDougall, Emma, Clarke, Jenny, Campbell, Rachel, Dhillon, Haryana M., McGeechan, Kevin, Hudson, Peter, King, Anne, Wheeler, Helen, Kastelan, Marina, Long, Anne, Nowak, Anna K.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9992082/
https://www.ncbi.nlm.nih.gov/pubmed/36658381
http://dx.doi.org/10.1007/s11060-023-04239-0
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author Halkett, Georgia K. B.
Lobb, Elizabeth A.
Phillips, Jane L.
McDougall, Emma
Clarke, Jenny
Campbell, Rachel
Dhillon, Haryana M.
McGeechan, Kevin
Hudson, Peter
King, Anne
Wheeler, Helen
Kastelan, Marina
Long, Anne
Nowak, Anna K.
author_facet Halkett, Georgia K. B.
Lobb, Elizabeth A.
Phillips, Jane L.
McDougall, Emma
Clarke, Jenny
Campbell, Rachel
Dhillon, Haryana M.
McGeechan, Kevin
Hudson, Peter
King, Anne
Wheeler, Helen
Kastelan, Marina
Long, Anne
Nowak, Anna K.
author_sort Halkett, Georgia K. B.
collection PubMed
description BACKGROUND: High-grade glioma (HGG) is a rapidly progressing and debilitating disease. Family carers take on multiple responsibilities and experience high levels of distress. We aimed to deliver a nurse-led intervention (Care-IS) to carers to improve their preparedness to care and reduce distress. METHODS: We conducted a randomised controlled trial (ACTRN:12612001147875). Carers of HGG patients were recruited during patients’ combined chemoradiation treatment. The complex intervention comprised four components: (1) initial telephone assessment of carer unmet needs; (2) tailored hard-copy resource folder; (3) home visit; and, (4) monthly telephone support for up to 12 months. Primary outcomes included preparedness for caregiving and distress at 2, 4, 6 and 12 months. Intervention effects were estimated using linear mixed models which included a time by group interaction. Secondary outcomes included anxiety, depression, quality of life, carer competence and strain. RESULTS: We randomised 188 carers (n = 98 intervention, n = 90 control). The intervention group reported significantly higher preparedness for caregiving at 4 months (model β = 2.85, 95% CI 0.76–4.93) and all follow-up timepoints including 12 months (model β = 4.35, 95% CI 2.08–6.62), compared to the control group. However, there was no difference between groups in carer distress or any secondary outcomes. CONCLUSIONS: This intervention was effective in improving carer preparedness. However, carer distress was not reduced, potentially due to the debilitating/progressive nature of HGG and ongoing caring responsibilities. Future research must explore whether carer interventions can improve carer adjustment, self-efficacy and coping and how we support carers after bereavement. Additionally, research is needed to determine how to implement carer support into practice. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11060-023-04239-0.
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spelling pubmed-99920822023-03-09 Carer preparedness improved by providing a supportive educational intervention for carers of patients with high-grade glioma: RCT results Halkett, Georgia K. B. Lobb, Elizabeth A. Phillips, Jane L. McDougall, Emma Clarke, Jenny Campbell, Rachel Dhillon, Haryana M. McGeechan, Kevin Hudson, Peter King, Anne Wheeler, Helen Kastelan, Marina Long, Anne Nowak, Anna K. J Neurooncol Research BACKGROUND: High-grade glioma (HGG) is a rapidly progressing and debilitating disease. Family carers take on multiple responsibilities and experience high levels of distress. We aimed to deliver a nurse-led intervention (Care-IS) to carers to improve their preparedness to care and reduce distress. METHODS: We conducted a randomised controlled trial (ACTRN:12612001147875). Carers of HGG patients were recruited during patients’ combined chemoradiation treatment. The complex intervention comprised four components: (1) initial telephone assessment of carer unmet needs; (2) tailored hard-copy resource folder; (3) home visit; and, (4) monthly telephone support for up to 12 months. Primary outcomes included preparedness for caregiving and distress at 2, 4, 6 and 12 months. Intervention effects were estimated using linear mixed models which included a time by group interaction. Secondary outcomes included anxiety, depression, quality of life, carer competence and strain. RESULTS: We randomised 188 carers (n = 98 intervention, n = 90 control). The intervention group reported significantly higher preparedness for caregiving at 4 months (model β = 2.85, 95% CI 0.76–4.93) and all follow-up timepoints including 12 months (model β = 4.35, 95% CI 2.08–6.62), compared to the control group. However, there was no difference between groups in carer distress or any secondary outcomes. CONCLUSIONS: This intervention was effective in improving carer preparedness. However, carer distress was not reduced, potentially due to the debilitating/progressive nature of HGG and ongoing caring responsibilities. Future research must explore whether carer interventions can improve carer adjustment, self-efficacy and coping and how we support carers after bereavement. Additionally, research is needed to determine how to implement carer support into practice. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11060-023-04239-0. Springer US 2023-01-19 2023 /pmc/articles/PMC9992082/ /pubmed/36658381 http://dx.doi.org/10.1007/s11060-023-04239-0 Text en © The Author(s) 2023, corrected publication 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Research
Halkett, Georgia K. B.
Lobb, Elizabeth A.
Phillips, Jane L.
McDougall, Emma
Clarke, Jenny
Campbell, Rachel
Dhillon, Haryana M.
McGeechan, Kevin
Hudson, Peter
King, Anne
Wheeler, Helen
Kastelan, Marina
Long, Anne
Nowak, Anna K.
Carer preparedness improved by providing a supportive educational intervention for carers of patients with high-grade glioma: RCT results
title Carer preparedness improved by providing a supportive educational intervention for carers of patients with high-grade glioma: RCT results
title_full Carer preparedness improved by providing a supportive educational intervention for carers of patients with high-grade glioma: RCT results
title_fullStr Carer preparedness improved by providing a supportive educational intervention for carers of patients with high-grade glioma: RCT results
title_full_unstemmed Carer preparedness improved by providing a supportive educational intervention for carers of patients with high-grade glioma: RCT results
title_short Carer preparedness improved by providing a supportive educational intervention for carers of patients with high-grade glioma: RCT results
title_sort carer preparedness improved by providing a supportive educational intervention for carers of patients with high-grade glioma: rct results
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9992082/
https://www.ncbi.nlm.nih.gov/pubmed/36658381
http://dx.doi.org/10.1007/s11060-023-04239-0
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