Effect of integrated caregiver support on caregiver burden for people taking care of people with cancer at the end of life: A cohort and quasi-experimental clinical trial

Abstract

Background: Previous studies have shown small-to-medium effects of support on reducing the caregiver burden for advanced cancer patients. A dearth of studies utilized longitudinal design to examine and evaluate the effect of support for the caregiving burden till the patient's death.

Objectives: To test the ability of an integrative intervention program for caregivers of advanced cancer patients to lower caregiving burden as death approaches.

Design: A two-group comparative design with repeated measures.

Setting: Two cancer wards of a single university hospital.

Participants: Advanced cancer patients (N=81) and their caregivers were allocated into two groups: an experimental group (N=40) receiving coping strategies, assistance, recourses, and education intervention and a control group (N=41) receiving standard care.

Methods: Caregivers received training in the caregiver support intervention at least 3 times every 2 weeks to help them reduce their caregiving burden. Subjective (Caregiver Reaction Assessment) and objective (Heart Rate Variability) measures of caregiver burden were evaluated for caregivers of patients approaching death. Only data within 3 months before the patients' death were analyzed.

Results: Caregiver self-efficacy significantly increased and the subjective caregiving burden significantly decreased in the experimental group as patients' death approached. Heart Rate Variability also indicated a calming effect of the intervention, helping caregivers face patients' death.

Conclusions: The caregiver support intervention can increase caregiver self-efficacy and reduce the subjective caregiving burden. Heart Rate Variability parameters have the potential to be useful for monitoring caregiver burden in facing patients' death.

Keywords: Caregiver burden; Caregiver support; End of life; People with cancer.