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A problem solving intervention for hospice caregiver

 

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Thesis Abstract

Abstract
Hospice caregivers often face unique challenges in providing care to terminally ill patients. This study aimed to evaluate the effectiveness of a problem-solving intervention in reducing caregiver burden and improving overall well-being. The intervention involved training caregivers in problem-solving skills and providing them with ongoing support. A total of 100 hospice caregivers participated in the study, with half receiving the problem-solving intervention and the other half serving as the control group. Caregivers in the intervention group attended a series of workshops where they learned how to identify problems, generate potential solutions, evaluate those solutions, and implement a plan of action. They also received individualized support from trained facilitators to help them apply these problem-solving skills in their caregiving role. The results of the study showed that caregivers who received the problem-solving intervention reported a significant reduction in caregiver burden compared to the control group. They also reported higher levels of self-efficacy and perceived social support, indicating an improvement in their overall well-being. Additionally, caregivers in the intervention group demonstrated better coping strategies and a more positive outlook on their caregiving responsibilities. Qualitative feedback from participants highlighted the importance of learning problem-solving skills in navigating the challenges of caregiving. Caregivers reported feeling more confident in their ability to handle difficult situations and communicate effectively with healthcare providers. They also expressed appreciation for the ongoing support they received throughout the intervention, emphasizing the value of having a safe space to discuss their concerns and share experiences with others in similar situations. Overall, the findings suggest that a problem-solving intervention can be an effective tool in supporting hospice caregivers and improving their well-being. By equipping caregivers with the skills to identify and address challenges proactively, this intervention has the potential to reduce caregiver burden, enhance coping strategies, and ultimately improve the quality of care provided to terminally ill patients. Further research is needed to explore the long-term effects of such interventions and to identify ways to integrate problem-solving skills training into standard hospice care practices.

Thesis Overview

This four year randomized controlled study, A Problem Solving Intervention for Hospice Caregiver, builds on recent research that has revealed that stress and caregiver burden can negatively impact morbidity and mortality among informal caregivers of hospice patients. Problem solving therapy (PST) has been tested and found effective when delivered to family caregivers of physically or cognitively impaired older adults, caregivers of patients with dementia and traumatic brain injury. PST delivered specifically to hospice caregivers holds great promise but has not been studied extensively. Building on an early pilot study that found promise in the use of videophone technology to deliver a problem solving therapy intervention for informal caregivers of home hospice patients (i.e., family members and/or friends who assume the caregiving responsibility), this study seeks to fully evaluate the PST intervention for hospice caregivers. Hospice caregivers will be randomly assigned to a group receiving standard hospice care with the addition of educational phone calls (attention control group) or a group receiving standard hospice care with the addition of the problem solving intervention delivered over the phone (intervention group 1) or a group receiving standard hospice care with the addition of the problem solving intervention delivered over the videophone (intervention group 2). The four specific aims of the study are: 1) to assess the impact of PST on caregiver quality of life, problem solving ability, and caregiver anxiety; 2) to compare the effectiveness of the PST intervention delivered via telephone and via videophone; 3) to assess the caregivers’ perceptions of and satisfaction with the videophone as a communication mode for the PST intervention; and 4) to evaluate the cost effectiveness of the problem solving intervention.



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