Videoconference intervention eases anxiety, distress among distance caregivers of patients with cancer
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Distance caregivers of patients with cancer reported significant reductions in anxiety and distress after completing a series of coaching sessions via videoconference, according to study results scheduled for presentation during the ASCO20 Virtual Scientific Program.
“Distance caregivers were generally concerned with ongoing treatment, uncertainty over when they could visit the patient, where they could get their questions answered and how they could be of the most help,” Sara L. Douglas, PhD, RN, Gertrude Perkins Oliva professor in oncology nursing and assistant dean for research at Case Western Reserve University School of Nursing, said during a press conference. “With COVID-19, the challenges that distance caregivers face are now the same challenges facing many local caregivers who can’t attend their loved ones’ appointments. Our videoconferencing intervention shows that it’s possible to meaningfully reduce anxiety and distress for distance caregivers through fairly simple technology.”
Family caregivers have become increasingly involved in providing care and support for patients with cancer. About 20% of caregivers live more than an hour away from the patient, and nearly a third of these distance caregivers are their loved one’s sole caregiver.
Distance caregivers generally report higher distress and anxiety than local caregivers because of a lack of first-hand information and high level of uncertainty regarding the patient’s condition.
Douglas and colleagues developed a three-part intervention to address these challenges.
The researchers randomly assigned 441 distance caregivers (mean age, 47 years; 71% female; 65% white) to one of three groups:
Group 1 received the full intervention, which consisted of four monthly videoconference coaching sessions with a nurse practitioner or social worker focused on information and support; participation in the patient’s appointments with the oncologist via videoconference; and access to a website designed for distance caregivers.
Group 2 participated in the patient’s appointments via videoconference during the 4-month period and had access to the distance caregivers’ website.
Group 3 had access to the distance caregivers’ website.
A majority of distance caregivers were white (65%), the child of the patient (63%) and employed (81%). Mean age of patients was 65 years; 60% were female, 30% had gastrointestinal cancer and 18% had hematologic cancer. Most of the patients with solid tumors (59%) had stage IV disease.
Distance caregiver distress and anxiety served as the primary variables of interest.
The caregivers completed online surveys prior to random assignment and at the completion of the intervention period.
Researchers used the Patient Reported Outcomes Measurement Information System (PROMIS) Anxiety assessment and National Comprehensive Cancer Network distress thermometer to assist in measuring anxiety and distress levels. They used repeated measures analysis of variance (RMANOVA) to examine the change in anxiety t-scores over time among the different groups, controlling for distance caregiver age, race and gender.
Results showed 19.2% of distance caregivers in group 1 experienced a significant reduction in anxiety and 24.8% had reduced stress. In group 2, 17.3% had improved anxiety scores and 19.8% had improved distress scores.
Researchers intend to test the intervention among other caregiver groups — such as those who care for patients with Alzheimer’s disease — and to consult with health care providers about offering the technology to patients with cancer and a distance caregiver.
These findings illustrate the potential effectiveness of videoconferencing interventions for improving the emotional well-being of remote caregivers who provide critical support for patients, according to ASCO President Howard A. "Skip" Burris III, MD, FACP, FASCO.
“The COVID-19 pandemic makes this study particularly important because no caregivers are allowed to accompany patients with cancer to their doctor appointments,” Burris, chief medical officer and president of clinical operations for Sarah Cannon Research Institute, said during the press conference. “This essentially makes all caregivers distance caregivers who may face these same challenges.” – by John DeRosier
Reference:
Douglas S, et al. Abstract 12123. Scheduled for presentation at: ASCO20 Virtual Scientific Program; May 29-31, 2020.
Disclosures: The NIH funded the study. Douglas reports no relevant financial disclosures. Please see the abstract for all other researchers’ relevant financial disclosures. Burris reports employment with and stock and other ownership interests in HCA Healthcare/Sarah Cannon Research Institute. He also reports consultant/advisory roles with, research funding to his institution from or other relationships with Agios, AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Eli Lilly, Genentech/Roche, GlaxoSmithKline, Incyte, Merck, Novartis, Seattle Genetic and other pharmaceutical companies.
Perspective
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Caregivers play an important role in cancer care delivery, and literature demonstrates that they often have increased anxiety, depression and poorer health outcomes when caring for a loved one with serious illness. The intervention described in this abstract is important in that it provides clear and concrete activities — videoconference and coaching — in which caregivers can participate to decrease anxiety and stress. It will be important to understand the feasibility of expanding these services to caregivers.
Mount Sinai Health System
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Douglas S, et al. Abstract 12123. Scheduled for presentation at: ASCO20 Virtual Scientific Program; May 29-31, 2020.
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