The Effects of SmartCare on Neuro-oncology Family Caregivers' Distress: a Randomized Controlled Trial

Overview

Journal Support Care Cancer

Specialties Critical Care
Oncology

Date 2021 Oct 16

PMID 34655326

Citations 8

Authors

Florien W Boele

Jason M Weimer

Anna L Marsland

Terri S Armstrong

Charles W Given

Jan Drappatz

Heidi S Donovan

Paula R Sherwood

Affiliations

Soon will be listed here.

Abstract

Purpose: Patients with primary malignant brain tumors have high symptom burden and commonly rely on family caregivers for practical and emotional support. This can lead to negative mental and physical consequences for caregivers. We investigated effectiveness of an 8-week nurse-led online needs-based support program (SmartCare) with and without online self-guided cognitive behavioral therapy (CBT) for depression compared to enhanced care as usual (ECAU) on depressive symptoms, caregiving-specific distress, anxiety, mastery, and burden.

Methods: Family caregivers scoring ≥ 6 on a depressive symptoms inventory were randomized to three groups: ECAU plus self-guided CBT and SmartCare; ECAU plus SmartCare; ECAU only. Primary outcomes (depressive symptoms; caregiving-specific distress) and secondary outcomes (anxiety, caregiver mastery, and caregiver burden) were assessed online. Intention to treat (ITT) and per protocol (PP) analyses of covariance corrected for baseline scores were performed for outcomes at 4 months.

Results: In total, 120 family caregivers participated. Accrual and CBT engagement were lower than expected, therefore intervention groups were combined (n = 80) and compared to ECAU (n = 40). For depressive symptoms, no statistically significant group differences were found. Caregiving-specific distress decreased in the intervention group compared with ECAU (ITT: p = 0.01, partial ɳ = 0.08; PP: p = 0.02, partial ɳ = 0.08). A trend towards improvement in mastery for the intervention group compared with ECAU was identified (ITT: p = 0.08, partial ɳ = 0.04; PP: p = 0.07, partial ɳ = 0.05).

Conclusions: SmartCare, with or without self-guided CBT, reduced caregiving-specific distress with a trend towards improving mastery. SmartCare has the potential to improve the lives of families coping with a brain tumor diagnosis.

Trial Registration Number: NCT02058745; 10 February 2014.

Citing Articles

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Symptom management in isocitrate dehydrogenase mutant glioma.

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Campbell G, Kim H, Klinedinst T, Klinger J, Lee Y, Donovan H JMIR Cancer. 2024; 10:e48465.

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Integrating Family Caregivers Into Cancer Care: Implementation of Evidence-Based Caregiver Protocols Into Gynecologic Oncology Practice.

Thomas T, Campbell G, Tan K, Murray P, Loughlin K, Roberge M JCO Oncol Pract. 2024; :OP2400383.

PMID: 39167743 PMC: 11842612. DOI: 10.1200/OP.24.00383.

The impact of a primary brain tumor diagnosis on caregivers: Insights from the patients' perspective.

Willis K, Reid M, Fox A, Kleva C, Sherwood P, Loughan A Support Care Cancer. 2024; 32(9):595.

PMID: 39160352 PMC: 11333512. DOI: 10.1007/s00520-024-08783-x.

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