How short is too short? A randomised controlled trial evaluating short-term existential behavioural therapy for informal caregivers of palliative patients.
Family caregiver
existential behavioural therapy
palliative care
randomised controlled trial
Journal
Palliative medicine
ISSN: 1477-030X
Titre abrégé: Palliat Med
Pays: England
ID NLM: 8704926
Informations de publication
Date de publication:
06 2020
06 2020
Historique:
pubmed:
30
4
2020
medline:
29
4
2021
entrez:
30
4
2020
Statut:
ppublish
Résumé
Informal caregivers of palliative patients show higher levels of depression and distress compared with the general population. Fegg's (2013) existential behavioural therapy was shortened to two individual 1-h sessions (short-term existential behavioural therapy). Testing the effectiveness of sEBT on psychological symptoms of informal caregivers in comparison with active control. Randomised controlled trial. Informal caregivers of palliative in-patients. The primary outcome was depression; secondary outcomes were anxiety, subjective distress and minor mental disorders, positive and negative affect, satisfaction with life, quality of life and direct health care costs. General linear mixed models allow several measurements per participant and change over time. Reasons for declining the intervention were investigated by Rosenstock's Health Belief Model. Overall inclusion rate was 41.0%. Data of 157 caregivers were available (63.1% females; mean age: 54.6 years, standard deviation (SD): 14.1); 127 participants were included in the main analysis. Participation in sEBT or active control was not significantly associated with post-treatment depression. Outcomes showed prevailingly significant association with time of investigation. Self-efficacy, scepticism of benefit of the intervention, belief of better coping alone and support by family and friends were significant factors in declining participation in the randomised controlled trial. Inclusion rate was tripled compared with a previously evaluated longer EBT group intervention. By shortening the intervention, inclusion rate was traded for effectiveness and the intervention could not impact caregivers' psychological state. Early integration of sEBT and combination of individual and group setting and further study of the optimal length for caregiver interventions are suggested.
Sections du résumé
BACKGROUND
Informal caregivers of palliative patients show higher levels of depression and distress compared with the general population. Fegg's (2013) existential behavioural therapy was shortened to two individual 1-h sessions (short-term existential behavioural therapy).
AIM
Testing the effectiveness of sEBT on psychological symptoms of informal caregivers in comparison with active control.
DESIGN
Randomised controlled trial.
SETTING/PARTICIPANTS
Informal caregivers of palliative in-patients.
METHODS
The primary outcome was depression; secondary outcomes were anxiety, subjective distress and minor mental disorders, positive and negative affect, satisfaction with life, quality of life and direct health care costs. General linear mixed models allow several measurements per participant and change over time. Reasons for declining the intervention were investigated by Rosenstock's Health Belief Model.
RESULTS
Overall inclusion rate was 41.0%. Data of 157 caregivers were available (63.1% females; mean age: 54.6 years, standard deviation (SD): 14.1); 127 participants were included in the main analysis. Participation in sEBT or active control was not significantly associated with post-treatment depression. Outcomes showed prevailingly significant association with time of investigation. Self-efficacy, scepticism of benefit of the intervention, belief of better coping alone and support by family and friends were significant factors in declining participation in the randomised controlled trial.
CONCLUSION
Inclusion rate was tripled compared with a previously evaluated longer EBT group intervention. By shortening the intervention, inclusion rate was traded for effectiveness and the intervention could not impact caregivers' psychological state. Early integration of sEBT and combination of individual and group setting and further study of the optimal length for caregiver interventions are suggested.
Identifiants
pubmed: 32348699
doi: 10.1177/0269216320911595
pmc: PMC7243077
doi:
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
806-816Références
Arch Intern Med. 2006 May 22;166(10):1092-7
pubmed: 16717171
Gerontologist. 2002 Jun;42(3):356-72
pubmed: 12040138
J Pain Symptom Manage. 2008 Apr;35(4):356-64
pubmed: 18222629
J Pers Soc Psychol. 1988 Jun;54(6):1063-70
pubmed: 3397865
Control Clin Trials. 1990 Apr;11(2):116-28
pubmed: 2161310
J Clin Psychol. 2009 Jun;65(6):627-38
pubmed: 19309694
Health Psychol Rev. 2014;8(3):253-69
pubmed: 25053213
Int J Group Psychother. 2008 Oct;58(4):455-542
pubmed: 18837662
Palliat Med. 2009 Jun;23(4):339-44
pubmed: 19304804
Acta Psychiatr Scand. 1999 Dec;100(6):462-8
pubmed: 10626926
Psychooncology. 2013 Sep;22(9):2079-86
pubmed: 23532835
J Gen Intern Med. 2001 Sep;16(9):606-13
pubmed: 11556941
BMC Palliat Care. 2016 Oct 24;15(1):88
pubmed: 27776501
Psychol Med. 1998 May;28(3):551-8
pubmed: 9626712
Health Educ Behav. 2009 Jun;36(3):601-14
pubmed: 18469160
J Pain Symptom Manage. 2005 Oct;30(4):329-41
pubmed: 16256897
J Pers Assess. 1985 Feb;49(1):71-5
pubmed: 16367493
Lancet. 2014 May 17;383(9930):1721-30
pubmed: 24559581
Gesundheitswesen. 2015 Jan;77(1):46-52
pubmed: 24806594
Clin Psychol Rev. 2010 Mar;30(2):238-47
pubmed: 20006414
J Affect Disord. 2017 Mar 01;210:338-344
pubmed: 28088111
Am Psychol. 1993 Dec;48(12):1181-209
pubmed: 8297057
Eur J Cancer. 2003 Jul;39(11):1517-24
pubmed: 12855257
Gesundheitswesen. 2015 Jan;77(1):53-61
pubmed: 25025287
J Palliat Med. 2013 Nov;16(11):1410-6
pubmed: 24215249
Gerontologist. 1993 Apr;33(2):240-8
pubmed: 8468017
J Oncol Pract. 2017 Feb;13(2):119-121
pubmed: 28972832
Stat Med. 1999 Aug 15;18(15):1903-42
pubmed: 10440877
Palliat Med. 2016 Feb;30(2):117-31
pubmed: 26281853