Providing general practice needs-based care for carers of people with advanced cancer: a randomised controlled trial

Mitchell, G.; Girgis, Afaf; Jiwa, Moyez; Sibbritt, David; Burridge, Letitia; Senior, Hugh

doi:10.3399/bjgp13x673694

Cited by 29 publications

(80 citation statements)

References 18 publications

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“…What's more, two studies evaluated family demands (Mitchell et al, 2013; Barrera et al, 2014) and seven studies conducted individual skills training to caregivers (Belgacem et al, 2013; Boele et al, 2013; Dionne-Odom et al, 2015; Leow et al, 2015; Sun et al, 2015; Shaw et al, 2016). Additionally, there was another two interventions studies focused on couple-based intervention of marital relationships (McLean et al, 2013) and group skills training (Fegg et al, 2013).…”

Section: Resultsmentioning

confidence: 99%

A Systematic Review of Psychosocial Interventions to Cancer Caregivers

Zhao

Feng

et al. 2017

Front. Psychol.

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Objective: To systematically review the effect of psychosocial interventions on improving QoL, depression and anxiety of cancer caregivers.Methods: We conducted a systematic review of psychosocial interventions among adult cancer caregivers published from 2011 to 2016. PsycINFO, PubMed, Proquest, Cochrane Library, Embase, Applied Social Sciences Index and Abstracts (ASSIA), Cumulative Index to Nursing and Allied Health Literature, Social Sciences Citation Index (SSCI) and EBSCO, China National Knowledge Infrastructure (CNKI) and WANFANG were searched. Inclusion criteria were: randomized controlled trails (RCTs); psychosocial intervention to cancer caregivers; psychosocial health indicators including quality of life, depression or anxiety.Results: 21 studies out of 4,666 identified abstracts met inclusion criteria, including 19 RCTs. The intervention modes fell into the following nine categories: family connect intervention, self-determination theory-based intervention (SDT), cognitive behavioral therapy (CBT), emotion-focused therapy (EFT), comprehensive health enhancement support system (CHESS), FOCUS programme, existential behavioral therapy (EBT), telephone interpersonal counseling (TIP-C), problem-solving intervention (COPE).Conclusion: paired-intervention targeting self-care and interpersonal connections of caregivers and symptom management of patients is effective in improving quality of life and alleviating depression of cancer caregivers while music therapy is helpful for reducing anxiety of cancer caregivers.

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Section: Resultsmentioning

confidence: 99%

A Systematic Review of Psychosocial Interventions to Cancer Caregivers

Zhao

Feng

et al. 2017

Front. Psychol.

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“…It is thus imperative for HCPs to assess the needs of caregivers caring for patients at the end-of-life and for appropriate support to be provided. In Australia, the completion of the Needs Assessment Tool-Caregiver (NAT-C) and a general practice toolkit was found to reduce pre-existing carer anxiety, and improve the physical well-being of non-anxious caregivers, in a randomised controlled trial 47. Furthermore, in the UK the Carer Support Needs Assessment Tool (CS-NAT) has been developed to assess caregivers’ unmet needs,48 and tested for face, content and criterion validity 49…”

Section: Discussionmentioning

confidence: 99%

The preferences and perspectives of family caregivers towards place of care for their relatives at the end-of-life. A systematic review and thematic synthesis of the qualitative evidence

Woodman

Baillie

Sivell

2015

BMJ Support Palliat Care

112

104

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BackgroundHome is often reported as the preferred place of care for patients at the end-of-life. The support of family caregivers is crucial if this is to be realised. However, little is known about their preferences; a greater understanding would identify how best to support families at the end-of-life, ensuring more patients are cared for in their preferred location.ObjectivesTo systematically search and synthesise the qualitative literature exploring the preferences and perspectives of family caregivers towards place of care for their relatives at the end-of-life.MethodsTen databases (MEDLINE, PsycINFO, EMBASE, AMED, ASSIA, CINAHL, Social Care Online, Cochrane Database, Scopus, Web of Science) and reference lists of key journals were searched up to January 2014. Included studies were appraised for quality and data thematically synthesised.ResultsEighteen studies were included; all were of moderate or high quality. Two main themes were identified: (1) Preferences and perspectives: most family caregivers preferred home care, although a range of perspectives were reported. Both positive and negative perspectives of home, hospices and hospitals emerged. At times, family caregivers reported feeling obligated to provide home care. (2) Impact of facilitating home care; both positive and negative effects on family caregivers were reported.ConclusionsMany family caregivers reported home as the preferred place of care; other places of care were infrequently considered. Healthcare professionals and service providers should be aware of these preferences and provide support where needed to enable family caregivers to successfully care at home, thus improving end-of-life experiences for families as a whole.

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“…1). Emphasis was placed on facilitating communication between the GP and NP and other health professionals, after-hours emergency plans, educating the primary carer on how to deal with common anticipated problems, and systematically addressing the needs and concerns of primary carers using a Carer Needs Checklist [15]. The plan was completed by the NP and distributed for implementation by all health professionals involved.…”

Section: Methodsmentioning

confidence: 99%

Evaluation of a pilot of nurse practitioner led, GP supported rural palliative care provision

et al. 2016

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BackgroundProviding end of life care in rural areas is challenging. We evaluated in a pilot whether nurse practitioner (NP)-led care, including clinical care plans negotiated with involved health professionals including the general practitioner(GP), ± patient and/or carer, through a single multidisciplinary case conference (SMCC), could influence patient and health system outcomes.MethodsSetting – Australian rural district 50 kilometers from the nearest specialist palliative care service. Participants: Adults nearing the end of life from any cause, life expectancy several months. Intervention- NP led assessment, then SMCC as soon as possible after referral. A clinical care plan recorded management plans for current and anticipated problems and who was responsible for each action. Eligible patients had baseline, 1 and 3 month patient-reported assessment of function, quality of life, depression and carer stress, and a clinical record audit. Interviews with key service providers assessed the utility and feasibility of the service.ResultsSixty-two patients were referred to the service, forty from the specialist service. Many patients required immediate treatment, prior to both the planned baseline assessment and the planned SMCC (therefore ineligible for enrollment). Only six patients were assessed per protocol, so we amended the protocol. There were 23 case conferences. Reasons for not conducting the case conference included the patient approaching death, or assessed as not having immediate problems. Pain (25 %) and depression (23 %) were the most common symptoms discussed in the case conferences. Ten new advance care plans were initiated, with most patients already having one. The NP or RN made 101 follow-up visits, 169 phone calls, and made 17 referrals to other health professionals. The NP prescribed 24 new medications and altered the dose in nine. There were 14 hospitalisations in the time frame of the project. Participants were satisfied with the service, but the service cost exceeded income from national health insurance alone.ConclusionsNP-coordinated, GP supported care resulted in prompt initiation of treatment, good follow up, and a care plan where all professionals had named responsibilities. NP coordinated palliative care appears to enable more integrated care and may be effective in reducing hospitalisations.

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Providing general practice needs-based care for carers of people with advanced cancer: a randomised controlled trial

Cited by 29 publications

References 18 publications

A Systematic Review of Psychosocial Interventions to Cancer Caregivers

A Systematic Review of Psychosocial Interventions to Cancer Caregivers

The preferences and perspectives of family caregivers towards place of care for their relatives at the end-of-life. A systematic review and thematic synthesis of the qualitative evidence

Evaluation of a pilot of nurse practitioner led, GP supported rural palliative care provision

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