Yoga therapy as a supportive care strategy for family caregivers of patients with primary brain tumor: Results of 3-arm pilot randomized controlled trial.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 156-156
Author(s):  
Kathrin Milbury ◽  
Jing Li ◽  
Shiao-Pei S. Weathers ◽  
Rosangela Silva ◽  
Stella Snyder ◽  
...  
Keyword(s):  
Supportive Care ◽  
Family Caregivers ◽  
Caregiver Burden ◽  
Financial Burden ◽  
Controlled Trial ◽  
Intervention Strategy ◽  
High Grade Glioma ◽  
Primary Brain Tumor ◽  
Medium Effect ◽  
Loved One

156 Background: Seeking to address the well-documented burden of caring for a loved one with a high-grade glioma, this pilot RCT compared the feasibility and preliminary efficacy of a dyadic versus individual yoga intervention as a supportive care strategy for family caregivers. Methods: Caregivers completed self-reported assessments of QOL (SF-36) and caregiver burden (CRA) at baseline. Then, patients and caregivers were randomized to either a dyadic yoga (DY) arm in which caregivers attended the sessions together with the patient, a caregiver yoga (CY) arm in which the caregiver attended all sessions individually or a usual care (UC) arm. Both yoga programs were delivered over 15 sessions either in-person or via videoconference (Zoom) concurrently while patients were undergoing standard radiotherapy. All arms were re-assessed at the end of treatment and then again 3-months later. Results: We consented 76 patient-caregiver dyads (59%) and randomized 23 dyads to the DY, 22 to the CY, and 22 to the UC arm. Attendance in the DY was higher than in the CY group (session means, DY = 12.23, CY = 9.00; P =.06, d =.57). Caregivers (80% female; 78% non-Hispanic White; mean age = 53 yrs) reported significantly more overall subjective benefit in the CY compared to the DY arm (means, CY = 1.39, DY = 1.81, P <.05, d = 1.45). Caregivers slightly favored the in-person delivery over the Zoom-based sessions (means, in person: 1.48; Zoom: 1.82, P =.10; d =.77). A clinically significant, medium effect size was found for improved QOL in favor of the CY over the DY group (means, CY = 49.45, DY = 44.45; F = 3.58, P =.07; d =.67). Caregivers in the CY group also reported less caregiving-related health declines compared to the DY group (means, CY = 2.18; DY = 2.48; F = 4.23, P <.05; d =.42). Caregivers in the CY group reported less caregiving-related financial burden than the UC group (means: CY = 2.79; UC = 3.21; F = 3.32, P =.08; d =.35). Conclusions: Despite lower attendance, caregivers in the CY arm reported greater subjective overall benefit, experienced better mental QOL and less caregiver burden compared with those in the DY and UC comparison arms. It appears that individual rather than dyadic delivery may be a superior supportive care approach for this vulnerable caregiver population. An adequately powered, larger efficacy trial of this intervention strategy is warranted. Clinical trial information: NCT02481349.

QOLP-17. YOGA THERAPY AS A SUPPORTIVE CARE STRATEGY FOR FAMILY CAREGIVERS OF HIGH GRADE GLIOMA PATIENTS: RESULTS OF 3-ARM PILOT RANDOMIZED CONTROLLED TRIAL

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi186-vi186
Author(s):  
Kathrin Milbury ◽  
Jing Li ◽  
Shiao-Pei Weathers ◽  
Rosangela Silva ◽  
Stella Snyder ◽  
...  
Keyword(s):  
Supportive Care ◽  
Family Caregivers ◽  
Caregiver Burden ◽  
Financial Burden ◽  
Controlled Trial ◽  
Intervention Strategy ◽  
High Grade Glioma ◽  
Medium Effect ◽  
High Grade ◽  
Medium Effect Size

Abstract BACKGROUND This pilot RCT compared the feasibility and preliminary efficacy of a dyadic versus individual yoga intervention as a supportive care strategy for family caregivers of high grade glioma patients. METHODS Caregivers completed self-reported assessments of QOL (SF-36) and caregiver burden (CRA) and were then randomized to a patient-caregiver dyadic yoga (DY), caregiver yoga (CY) or usual are (UC) arm while patients were undergoing standard radiotherapy. Both yoga programs were delivered over 15 sessions either in-person or via videoconference (Zoom). All groups were re-assessed at the end of treatment and then again 3-months later. RESULTS We consented 76 dyads (59%) and randomized 23 to the DY, 22 to the CY, and 22 to the UC arm. Attendance in the DY was higher than in the CY group (means, DY=12.23, CY=9.00, P=.06, d=.57). Caregivers reported significantly more overall subjective benefit in the CY compared to the DY arm (means, CY=1.39, DY=1.81, P&lt; .05, d=1.45). Caregivers slightly favored the in-person delivery (means, in person: 1.48; zoom: 1.82, P=.10; d=.77). A clinically significant, medium effect size was found for improved QOL in favor of the CY over the DY group (means, CY=49.45, DY=44.45; F=3.58, P=.07; d=.67). Caregivers in the CY group reported less caregiving-related health declines compared to the DY group (means, CY=2.18; DY=2.48; F=4.23, P&lt; .05; d=.42). Caregivers in the CY group reported less caregiving-related financial burden than the UC group (means: CY=2.79; UC=3.21; F=3.32, P=.08; d=.35). CONCLUSION Despite lower attendance, caregivers in the CY arm reported greater subjective overall benefit, experienced better mental QOL and less caregiver burden compared with those in the DY and UC comparison arms. It appears that individual rather than dyadic delivery may be a superior supportive care approach for this vulnerable caregiver population. An adequately powered, larger trial of this intervention strategy is warranted.

Effect of instrumental support on distress among family caregivers: Findings from a nationally representative study

2020 ◽  
Vol 18 (5) ◽  
pp. 519-527
Author(s):  
Erin E. Kent ◽  
Michelle A. Mollica ◽  
J. Nicholas Dionne-Odom ◽  
Rebecca A. Ferrer ◽  
Roxanne E. Jensen ◽  
...  
Keyword(s):  
Supportive Care ◽  
Family Caregivers ◽  
Caregiver Burden ◽  
Short Form ◽  
Care Recipient ◽  
Instrumental Support ◽  
Caregiver Distress ◽  
Sampling Weights ◽  
Serious Illness ◽  
Nationally Representative

AbstractBackground and ObjectiveA priority focus on palliative and supportive care is helping the 43.5 million caregivers who care for individuals with serious illness. Lacking support may lead to caregiver distress and poorer care delivery to patients with serious illness. We examined the potential of instrumental support (assistance with material and task performance) to mitigate distress among caregivers.MethodWe analyzed data from the nationally representative Health Information National Trends Survey (HINTS V2, 2018). Informal/family caregivers were identified in HINTS V2 if they indicated they were caring for or making healthcare decisions for another adult with a health problem. We used the PROMIS® instrumental support four-item short-form T-scores and the Patient Health Questionnaire (PHQ-4) for distress. We examined multivariable linear regression models for associations between distress and instrumental support, adjusted for sampling weights, socio-demographics, and caregiving variables (care recipient health condition(s), years caregiving (≥2), relationship to care recipient, and caregiver burden). We examined interactions between burden and instrumental support on caregiver distress level.ResultsOur analyses included 311 caregivers (64.8% female, 64.9% non-Hispanic White). The unweighted mean instrumental support T-score was 50.4 (SD = 10.6, range = 29.3–63.3); weighted mean was 51.2 (SE = 1.00). Lower instrumental support (p < 0.01), younger caregiver age (p < 0.04), higher caregiving duration (p = 0.008), and caregiver unemployment (p = 0.006) were significantly associated with higher caregiver distress. Mean instrumental support scores by distress levels were 52.3 (within normal limits), 49.4 (mild), 48.9 (moderate), and 39.7 (severe). The association between instrumental support and distress did not differ by caregiver burden level.ConclusionsPoor instrumental support is associated with high distress among caregivers, suggesting the need for palliative and supportive care interventions to help caregivers leverage instrumental support.

scholarly journals The Effects of Aerobic Exercise on Psychological Functioning in Family Caregivers: Secondary Analyses of a Randomized Controlled Trial

2020 ◽  
Author(s):  
Benjamin A Hives ◽  
E Jean Buckler ◽  
Jordan Weiss ◽  
Samantha Schilf ◽  
Kirsten L Johansen ◽  
...  
Keyword(s):  
Aerobic Exercise ◽  
Family Caregivers ◽  
Caregiver Burden ◽  
Psychological Functioning ◽  
Exercise Intervention ◽  
Controlled Trial ◽  
Intervention Group ◽  
Exercise Program ◽  
Exercise Group ◽  
Control Group

Abstract Background The responsibility and stress of being a family caregiver are associated with reduced physical and mental health. Purpose To examine whether a 24-week aerobic exercise program improves multiple aspects of psychological functioning in family caregivers. Methods Family caregivers of patients with Alzheimer’s disease and other dementias (n = 68) were recruited and randomized into either an aerobic exercise group (n = 34) or a waitlist control group (n = 34). The exercise group was assigned a 24-week aerobic training program that incrementally increased the intensity, duration, and frequency of the exercise program until 150 min of moderate to vigorous activity were completed per week by the ninth week. Twelve measures of psychological functioning were administered at baseline and compared with responses completed following the intervention. Results Multilevel modeling revealed significant decreases in caregiver burden (β = −4.60, 95% confidence interval [CI] = [−8.82, −0.38], RLMM2 = 0.11) and depression (β = −2.59, 95% CI = [−4.79, −0.38], RLMM2 = 0.13), as well as increases in mastery (β = 1.78, 95% CI = [0.09, 3.46], RLMM2 = .04) in the exercise intervention group compared to the control group. Conclusion Family caregivers report high levels of depression and caregiver burden. Engagement in a 24-week exercise intervention can ameliorate the perceived burden of caregiving, symptoms of depression, and their sense of mastery.

scholarly journals Yoga Program for High-Grade Glioma Patients Undergoing Radiotherapy and Their Family Caregivers

2017 ◽  
Vol 17 (2) ◽  
pp. 332-336 ◽  
Author(s):  
Kathrin Milbury ◽  
Smitha Mallaiah ◽  
Anita Mahajan ◽  
Terri Armstrong ◽  
Shioa-Pei Weathers ◽  
...  
Keyword(s):  
Supportive Care ◽  
Family Caregivers ◽  
Sleep Disturbances ◽  
Short Form ◽  
Pilot Trial ◽  
High Grade Glioma ◽  
High Grade ◽  
Cancer Symptoms ◽  
Breathing Exercises ◽  
Sf 36

Background: Despite their high symptom burden and poor prognosis, evidence-based supportive care interventions for adults with high-grade glioma (HGG) and their caregivers are lacking. Thus, we aimed to establish feasibility of a patient-caregiver dyadic yoga program (DYP) for newly diagnosed HGG patients and their family caregivers targeting quality-of-life (QOL) outcomes. Method: In this single-arm pilot trial, dyads participated in a 12-session DYP program across the course of patients’ radiotherapy. The intervention focused on breathing exercises, gentle movements, and guided meditations. We tracked feasibility data and assessed levels of cancer-related symptoms (MD Anderson Symptom Inventory [MDASI]), depressive symptoms (Centers for Epidemiological Studies-Depression scale), fatigue (Brief Fatigue Inventory), sleep disturbances (Pittsburgh Sleep Quality Index [PSQI]), and overall mental and physical QOL (36-item Short-Form Survey [SF-36]) at baseline and post-DYP, which was at the end of radiotherapy. Results: We approached 6 dyads of which 5 dyads (86%) consented and completed all 12 sessions and pre/post assessments. All patients (mean age: 52 years, 80% female, 80% grade IV) and caregivers (mean age: 58 years, 80% female, 60% spouses) perceived benefit from the program. Paired t tests revealed a marginally significant, yet clinically meaningful, decrease in patient’s cancer symptoms ( t = 2.32, P = .08; MDASI mean; pre = 1.75, post = 1.04). There were clinically significant reductions in patient sleep disturbances (PSQI mean: pre = 10.75, post = 8.00) and improvements in patient and caregiver mental QOL (MCS of SF-36 mean: pre = 42.35, post = 52.34, and pre = 45.14, post = 51.43, respectively). Conclusions: This novel supportive care program appears to be safe, feasible, acceptable, and subjectively useful for HGG patients and their caregivers. There was also preliminary evidence regarding QOL treatment gains for both patients and caregivers.

Goal Attainment and Treatment Compliance in a Cognitive-Behavioral Telephone Intervention for Family Caregivers of Persons with Dementia

GeroPsych ◽  
2011 ◽  
Vol 24 (3) ◽  
pp. 115-125 ◽  
Author(s):  
Gabriele Wilz ◽  
Denise Schinköthe ◽  
Renate Soellner
Keyword(s):  
Family Caregivers ◽  
Mentally Ill ◽  
Goal Attainment ◽  
Outcome Measurement ◽  
Controlled Trial ◽  
Treatment Success ◽  
Treatment Compliance ◽  
Control Group ◽  
Telephone Intervention ◽  
Effective Interventions

Introduction: The evaluation of effective interventions is still needed to prevent family caregivers of persons with dementia from becoming physically or mentally ill. However, in most existing intervention studies, primary outcomes are not well matched to the treatment goals. Method: A randomized controlled trial (N = 229) was conducted to compare a treatment group (CBT), a treated control group, and an untreated control group. In theses analyses we focused on the primary outcome measurement (GAS) as a perceived treatment success as well as treatment compliance and participants’ evaluation. Results: Results showed that 30.1% achieved complete goal attainment, 39.8% partial goal attainment, and 24.1% declared no change (overachievement 2.4%; deterioration 3.6%). Discussion: The intervention can be considered to have been successful.

Managing Caregiver Burden among Families of Patients with End-Stage Renal Disease

2019 ◽  
Vol 21 (1) ◽  
Author(s):  
Yemisi Okikiade Oyegbile ◽  
Petra Brysiewicz
Keyword(s):  
Renal Disease ◽  
Family Caregivers ◽  
Caregiver Burden ◽  
End Stage Renal Disease ◽  
Qualitative Data ◽  
Government Support ◽  
Implementation Phase ◽  
The Family ◽  
Stage Renal Disease ◽  
End Stage

Family caregivers of patients with end-stage renal disease (ESRD) play a significant role in providing substantial care for a prolonged period for their sick relatives, often with very limited resources, making it a difficult environment. Government support for family caregivers of patients with ESRD is lacking in Nigeria, increasing their vulnerability to caregiver burden and its consequences. An action research study using a complimentary mixed-method approach was used to develop the intervention model for managing caregiver burden. Quantitative data were collected to measure the extent of caregiver burden using a Zarit Burden Interview questionnaire for 96 family caregivers, while individual in-depth interviews with 15 participants provided the qualitative data. Integrating the quantitative and qualitative data led to the identification of four moderators to manage the caregiver burden in this study. The model for managing caregiver burden was developed from the findings, using stressors and associated moderators of caregiving, and the role played by culture and finance in this context. An implementation checklist was developed, which was used by registered nurses to implement the concepts in the model with the family caregivers during the model implementation phase. Family caregivers of patients with ESRD need to be supported by nurses during the caregiving process. Nurses can increase caregivers’ identity and knowledge of the disease as a way of preventing the family caregivers from being overwhelmed by their caregiving role.

Mentalizing Imagery Therapy mobile application for family dementia caregivers: feasibility and effects on mood and caregiving

2018 ◽  
Author(s):  
Abu Sikder ◽  
Francis Yang ◽  
Rhiana Schafer ◽  
Glenna A. Dowling ◽  
Lara Traeger ◽  
...  
Keyword(s):  
Family Caregivers ◽  
Mobile Application ◽  
Self Regulation ◽  
Pilot Trial ◽  
Depression Symptom ◽  
Structured Interviews ◽  
Physical Strain ◽  
Dementia Caregivers ◽  
Loved One ◽  
People With Dementia

Objectives: Due to psychological and physical strain, family caregivers of patients with Alzheimer’s disease and related dementias are at high risk for depression and stress related disorders. We investigated the feasibility of a mobile application (App) intervention delivering Mentalizing Imagery Therapy (MIT), which incorporates guided imagery and mindfulness, to facilitate self-regulation and increase perspective on the mental life of self and others. Method: A 4-week pilot trial of an MIT App for family caregivers of people with dementia was conducted to assess feasibility of use, mood and depression symptom benefit, and relationship changes. Semi-structured interviews were conducted at the study’s conclusion to characterize participants’ perceived benefits. Results: 80% of 21 consented participants downloaded the App, utilized it at least once, and were further analyzed. Of these participants, average usage of audio recordings was 14 ± 10 (SD) days out of 28 possible, and 29 ± 28 individual sessions. Acute improvement in mood from before to after completion of exercises was uniformly observed (p &lt; .001), and after four weeks there was a significant increase in positive affect and a reduction in negative affect. Participants with severe levels of depression (n=3) at baseline exhibited an improvement in symptoms at 4 weeks averaging 30% (p &lt; .05). Semi-structured interviews revealed an increase in the ability to remain “centered" despite caregiving challenges, take the perspective of the loved one, and positively reframe the caregiver experience.Conclusion: App delivery of MIT is feasible for family dementia caregivers. Results showed moderate to high usage of the app for a majority of the users, and promising improvements in mood and depression. These data provide justification for larger, controlled trials.

Healing experience for family caregivers after an intensive care unit death

2019 ◽  
pp. bmjspcare-2018-001561 ◽  
Author(s):  
Susan DeSanto-Madeya ◽  
Dan Willis ◽  
Julie McLaughlin ◽  
Aristotle Boslet
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Family Caregivers ◽  
Phenomenological Study ◽  
Healthcare Providers ◽  
Loved One ◽  
Hermeneutic Phenomenological ◽  
Telephone Interviews ◽  
Hermeneutic Phenomenological Study ◽  
Purposive Sample

ObjectivesFamily caregivers suffer a high burden of emotional and psychological distress following the death of a loved one in the intensive care unit and often struggle to heal in the weeks following their loss. The purpose of this hermeneutic phenomenological study was to describe and interpret the experience of healing for family caregivers six weeks following the death of a loved one in the ICU.MethodsSemi-structured telephone interviews were conducted with a purposive sample of twenty-four family caregivers six weeks following the death of their loved ones in the ICU. Qualitative analysis techniques were used to identify common themes central to the experience of healing across all interviews.ResultsSeven themes were interpreted from the data: searching for clarity from a time of uncertainty; riding an emotional rollercoaster; seeking peace in one’s decisions; moving forward with each new day; taking comfort in the memories; valuing layers of support; and discovering life on one’s own.ConclusionBy identifying and gaining an understanding of healing following the death of a loved one in the ICU, nursing and other healthcare providers have an opportunity to promote healing and positively impact family caregiver’s bereavement.

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