BACKGROUND.Family caregivers for cancer patients experience high levels of stress and burden and diminished quality of life (QOL). Interventions to improve coping skills of caregivers have been shown to be effective with other populations, but their impact has not been assessed in the difficult context of hospice care. The purpose of this study was to determine whether hospice plus a coping skill training intervention improved family caregivers' QOL, burden, coping, and mastery, compared with hospice plus emotional support, and usual hospice care. METHODS.A three group randomized controlled trial was conducted including baseline, 16 day, and 30 day assessments conducted from March 1999 to May 2003.The sample consisted of 354 family caregivers of community dwelling hospice patients with advanced cancer. Patient/caregiver dyads were randomly divided into three groups, including a control group (n ϭ 109) who received standard hospice care, a group (n ϭ 109) who received standard hospice care plus three supportive visits, and a group (n ϭ 111) who received standard care plus three visits to teach a coping skills intervention. Primary outcomes included caregiver QOL, caregiver burden due to patient symptoms, caregiver burden due to tasks, and caregiver mastery. RESULTS.At the 30-day follow-up, the coping skills intervention led to significantly greater improvement in caregiver QOL (estimate ϭ Ϫ0.16, standard error [SE] ϭ 0.07, P ϭ 0.03), burden of patient symptoms (estimate ϭ 0.28, SE ϭ 0.07, P Ͻ 0.001), and caregiving task burden (estimate ϭ Ϫ0.01, SE ϭ 0.01, P ϭ 0.038) than did the other two conditions. None of the groups showed significant change in overall caregiving mastery, caregiver mastery specific to caregiving tasks, problem-focused or emotion-focused coping. CONCLUSIONS.The coping skills intervention was effective in improving caregiver QOL, reducing burden related to patients' symptoms, and caregiving tasks compared with hospice care alone or hospice plus emotional support. Structured caregiver skill-training interventions for caregivers are promising even in the difficult environment of end-of-life care and for families already receiving benefits

The results provide preliminary evidence to suggest that individual aCBT may be an important treatment option for individuals with SAD.

Objective Severe fear of childbirth (tokophobia; TP) is an understudied and under‐recognised phenomenon that has significant implications for maternal mental health during pregnancy, labour and delivery. The few existing measures of TP are limited by lengthy formats, difficulty scoring and a narrow definition of the TP construct. Method The current study examined the psychometric properties of a newly developed self‐report scale, the Tokophobia Severity Scale (TSS), in a sample of 122 female participants. Results The final measure consisted of 13 items. The scale demonstrated a unidimensional structure and items demonstrated excellent internal consistency (α = .93) and adequate convergent validity with the Wijma Delivery Expectancy/Experience Questionnaire‐Version A. Conclusions The findings provide preliminary evidence to suggest that the TSS is a brief, valid and reliable measure that may be used in the future to identify women with TP who may benefit from psychological and supportive interventions prior to delivery.