Feasibility and Preliminary Effects of an Intervention for Caregivers of Newly Admitted Hospice Patients

Lindstrom, Kathryn B.

Sunday, 30 October 2011: 3:05 PM

Kathryn B. Lindstrom, PhD, FNP-BC, ACHPN
School of Nursing, Vanderbilt University, Nashville, TN
Bernadette Mazurek Melnyk, PhD, RN, CPNP/PMHNP, FNAP, FAAN
College of Nursing, The Ohio State University, Columbus, OH

Learning Objective 1: Describe the feasibility and acceptability of implementing an intervention for family caregivers of newly admitted hospice patients.

Learning Objective 2: Summarize the results of a cognitive schema building intervention for family caregivers of newly admitted hospice patients

Background. The transition to hospice care is typically a new and stressful experience for caregivers who often report increased negative emotions, such as anxiety and depression and lack of preparedness regarding their role. According to self-regulation theory, heightened anxiety and depressive symptoms in a new experience can be explained by the lack of an accurate cognitive schema.

Purpose. The purpose of this study was to test the feasibility and preliminary effects of a theory-based intervention program (ESI-CH: Education and Skill-building Intervention for Caregivers of Hospice patients) that targets cognitive schema development and skill building in this new role for caregivers of loved ones newly admitted to hospice services.

Method. A pre-experimental one-group pre- and post-test study design was used. Outcome measures included: depression, anxiety, activity restriction, preparedness and beliefs/confidence.

Results. Caregivers reported the timing of the intervention was perfect as they began this new experience. Most of the caregivers reported that the information was very helpful to preparing them for what to expect in this new role and they would recommend it to their friends. Caregivers who completed the intervention program reported a) feeling more prepared to care for their loved one, and b) had higher beliefs/confidence about their ability to care for their loved one. The impact of the intervention ranged from small effects for anxiety to medium effects for beliefs/confidence and preparedness. Caregivers with high levels of depression and/or high levels of anxiety at baseline reported lower levels of anxiety after the intervention.

Conclusion. Findings from this study indicate that the ESI-CH program is feasible and acceptable to deliver with caregivers of hospice patients. Results support that the ESI-CH program assists caregivers in developing a cognitive schema for their new role for effective coping and skill development in caring for their loved one on hospice.

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