Trial Outcomes & Findings for A Problem Solving Intervention for Hospice Caregivers (NCT NCT03712410)

NCT ID: NCT03712410

Last Updated: 2023-02-16

Results Overview

Comparison of 4 groups Generalised Anxiety Disorder Assessment (GAD-7) minimum 0 maximum 21 higher scores mean a worse outcome (more anxiety) Patient Health Questionnaire 9 (PHQ9) minimum 0 maximum 37 higher scores mean a worse outcome (more distress) Caregiver Quality of Life Index (CQLI-R) minimum 0 maximum 40 higher scores mean a better outcome (better quality of life)

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

523 participants

Primary outcome timeframe

from baseline to follow-up (prior to intervention-day 1 to post intervention-approx. day 30)

Results posted on

2023-02-16

Participant Flow

Participant milestones

Participant milestones
Measure
Group 1 (PISCES-f2f)
Family caregivers will receive three sessions of the PISCES intervention in person. The agenda for the first face to face visit for caregivers (suggested timeline 5-7 days after hospice admission) includes an explanation of the purpose of the visit/call. During the first session, the interventionist works on steps one and two of the ADAPT model, namely "Attitude" and "Defining the Problem and Setting Realistic Goals." During the second visit (suggested timeline 11-13 days after hospice admission) the interventionist covers steps three and four of the ADAPT model. Step three encourages caregivers in being creative and generating alternative solutions. Step four focuses on predicting the consequences and developing a solution plan. The third visit (suggested timeline 16-18 days after hospice admission) focuses on step five, namely trying out the solution plan and determining if it works. PISCES: The intervention is based on Problem Solving Therapy and is a coping skills intervention designed for family caregivers of hospice patients.
Group 2 (PISCES Video)
In this group, participants will receive the PISCES intervention in three sessions; however, the first session will be delivered face to face and the other two via video or phone. The three intervention sessions will be scheduled with a suggested timeline between days 5 and 18 of the hospice admission. The first session will take place in person (suggested timeline 5-7 days after hospice admission). After the first session where the in-person encounter will allow for the establishment of rapport between the interventionist and the caregiver, the second session (suggested timeline 11-13 days after hospice admission) and the third session (suggested timeline 16-18 days after hospice admissions) will be conducted via live videoconferencing. If the caregiver already has access to a computer and Internet, they will utilize the videoconferencing solution. If videoconferencing is not feasible, the sessions will be delivered over the regular phone. PISCES: The intervention is based on Problem Solving Therapy and is a coping skills intervention designed for family caregivers of hospice patients.
Group 3 (PISCESplus)
PISCESplus is meant to be an enhanced version of the PISCES intervention including the original problem solving therapy modules with the addition of positive reappraisal elements. The suggested timeline for the first session which will be in person is 5-7 days after hospice admission. At the end of the first session, the interventionist will ask the caregiver to take the time to think about and identify some positive aspects of caregiving. At the end of the second session (which is scheduled to take place via video approx. 11-13 days after admission) the interventionist will ask the caregiver to go over the benefits or positive aspects of caregiving that they had identified and ask them to comment as to why they perceive these as positive or beneficial. The third session will also take place via video. PISCES: The intervention is based on Problem Solving Therapy and is a coping skills intervention designed for family caregivers of hospice patients.
Group 4 PISCESplus Online
In this group, participants receive the entire intervention (PISCES plus-so the PISCES intervention with the positive reappraisal enhancements) online and complete all surveys electronically. All pre-and post assessments are conducted online and the PISCES sessions are carried out online as well.
Overall Study
STARTED
154
152
154
63
Overall Study
COMPLETED
115
106
101
46
Overall Study
NOT COMPLETED
39
46
53
17

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

A Problem Solving Intervention for Hospice Caregivers

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Group 1 (PISCES-f2f)
n=154 Participants
Family caregivers will receive three sessions of the PISCES intervention in person. The agenda for the first face to face visit for caregivers (suggested timeline 5-7 days after hospice admission) includes an explanation of the purpose of the visit/call. During the first session, the interventionist works on steps one and two of the ADAPT model, namely "Attitude" and "Defining the Problem and Setting Realistic Goals." During the second visit (suggested timeline 11-13 days after hospice admission) the interventionist covers steps three and four of the ADAPT model. Step three encourages caregivers in being creative and generating alternative solutions. Step four focuses on predicting the consequences and developing a solution plan. The third visit (suggested timeline 16-18 days after hospice admission) focuses on step five, namely trying out the solution plan and determining if it works. PISCES: The intervention is based on Problem Solving Therapy and is a coping skills intervention designed for family caregivers of hospice patients.
Group 2 (PISCES Video)
n=152 Participants
In this group, participants will receive the PISCES intervention in three sessions; however, the first session will be delivered face to face and the other two via video or phone. The three intervention sessions will be scheduled with a suggested timeline between days 5 and 18 of the hospice admission. The first session will take place in person (suggested timeline 5-7 days after hospice admission). After the first session where the in-person encounter will allow for the establishment of rapport between the interventionist and the caregiver, the second session (suggested timeline 11-13 days after hospice admission) and the third session (suggested timeline 16-18 days after hospice admissions) will be conducted via live videoconferencing. If the caregiver already has access to a computer and Internet, they will utilize the videoconferencing solution. If videoconferencing is not feasible, the sessions will be delivered over the regular phone. PISCES: The intervention is based on Problem Solving Therapy and is a coping skills intervention designed for family caregivers of hospice patients.
Group 3 (PISCESplus)
n=154 Participants
PISCESplus is meant to be an enhanced version of the PISCES intervention including the original problem solving therapy modules with the addition of positive reappraisal elements. The suggested timeline for the first session which will be in person is 5-7 days after hospice admission. At the end of the first session, the interventionist will ask the caregiver to take the time to think about and identify some positive aspects of caregiving. At the end of the second session (which is scheduled to take place via video approx. 11-13 days after admission) the interventionist will ask the caregiver to go over the benefits or positive aspects of caregiving that they had identified and ask them to comment as to why they perceive these as positive or beneficial. The third session will also take place via video. PISCES: The intervention is based on Problem Solving Therapy and is a coping skills intervention designed for family caregivers of hospice patients.
Group 4 PISCESplus Online
n=63 Participants
In this group, participants receive the entire intervention (PISCES plus-so the PISCES intervention with the positive reappraisal enhancements) online and complete all surveys electronically. All pre-and post assessments are conducted online and the PISCES sessions are carried out online as well.
Total
n=523 Participants
Total of all reporting groups
Age, Continuous
56.8 years
STANDARD_DEVIATION 12.7 • n=99 Participants
58.8 years
STANDARD_DEVIATION 12.8 • n=107 Participants
57.4 years
STANDARD_DEVIATION 12.2 • n=206 Participants
56.1 years
STANDARD_DEVIATION 17.2 • n=7 Participants
57.4 years
STANDARD_DEVIATION 13.2 • n=31 Participants
Sex/Gender, Customized
Male
23 Participants
n=99 Participants
34 Participants
n=107 Participants
20 Participants
n=206 Participants
12 Participants
n=7 Participants
89 Participants
n=31 Participants
Sex/Gender, Customized
Female
129 Participants
n=99 Participants
113 Participants
n=107 Participants
130 Participants
n=206 Participants
51 Participants
n=7 Participants
423 Participants
n=31 Participants
Sex/Gender, Customized
Unknown or Decline to Answer
2 Participants
n=99 Participants
5 Participants
n=107 Participants
4 Participants
n=206 Participants
0 Participants
n=7 Participants
11 Participants
n=31 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
7 Participants
n=99 Participants
8 Participants
n=107 Participants
11 Participants
n=206 Participants
9 Participants
n=7 Participants
35 Participants
n=31 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
138 Participants
n=99 Participants
136 Participants
n=107 Participants
134 Participants
n=206 Participants
51 Participants
n=7 Participants
459 Participants
n=31 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
9 Participants
n=99 Participants
8 Participants
n=107 Participants
9 Participants
n=206 Participants
3 Participants
n=7 Participants
29 Participants
n=31 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=99 Participants
0 Participants
n=107 Participants
1 Participants
n=206 Participants
1 Participants
n=7 Participants
2 Participants
n=31 Participants
Race (NIH/OMB)
Asian
3 Participants
n=99 Participants
1 Participants
n=107 Participants
3 Participants
n=206 Participants
2 Participants
n=7 Participants
9 Participants
n=31 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
0 Participants
n=7 Participants
0 Participants
n=31 Participants
Race (NIH/OMB)
Black or African American
64 Participants
n=99 Participants
56 Participants
n=107 Participants
53 Participants
n=206 Participants
23 Participants
n=7 Participants
196 Participants
n=31 Participants
Race (NIH/OMB)
White
72 Participants
n=99 Participants
82 Participants
n=107 Participants
79 Participants
n=206 Participants
28 Participants
n=7 Participants
261 Participants
n=31 Participants
Race (NIH/OMB)
More than one race
12 Participants
n=99 Participants
8 Participants
n=107 Participants
14 Participants
n=206 Participants
8 Participants
n=7 Participants
42 Participants
n=31 Participants
Race (NIH/OMB)
Unknown or Not Reported
3 Participants
n=99 Participants
5 Participants
n=107 Participants
4 Participants
n=206 Participants
1 Participants
n=7 Participants
13 Participants
n=31 Participants
Caregiver Generalized Anxiety Disorder (GAD-7) Score
6.69 units on a scale
STANDARD_DEVIATION 5.4 • n=99 Participants
5.74 units on a scale
STANDARD_DEVIATION 4.9 • n=107 Participants
6.32 units on a scale
STANDARD_DEVIATION 4.9 • n=206 Participants
5.85 units on a scale
STANDARD_DEVIATION 5.2 • n=7 Participants
6.2 units on a scale
STANDARD_DEVIATION 5.1 • n=31 Participants
Caregiver PHQ-9 Score
7.54 units on a scale
STANDARD_DEVIATION 5.7 • n=99 Participants
6.6 units on a scale
STANDARD_DEVIATION 5.4 • n=107 Participants
6.99 units on a scale
STANDARD_DEVIATION 5.3 • n=206 Participants
6.78 units on a scale
STANDARD_DEVIATION 5.36 • n=7 Participants
7.0 units on a scale
STANDARD_DEVIATION 5.5 • n=31 Participants
Caregiver Quality of Life Index (CQLI-R)
27.7 units on a scale
STANDARD_DEVIATION 8.0 • n=99 Participants
28.5 units on a scale
STANDARD_DEVIATION 8.4 • n=107 Participants
29.32 units on a scale
STANDARD_DEVIATION 7.2 • n=206 Participants
28.31 units on a scale
STANDARD_DEVIATION 7.7 • n=7 Participants
28.5 units on a scale
STANDARD_DEVIATION 7.9 • n=31 Participants
Caregiver Status
Bereaved
43 Participants
n=99 Participants
47 Participants
n=107 Participants
46 Participants
n=206 Participants
4 Participants
n=7 Participants
140 Participants
n=31 Participants
Caregiver Status
Active
107 Participants
n=99 Participants
102 Participants
n=107 Participants
103 Participants
n=206 Participants
59 Participants
n=7 Participants
371 Participants
n=31 Participants
Caregiver Status
Unknown or Not Reported
4 Participants
n=99 Participants
3 Participants
n=107 Participants
5 Participants
n=206 Participants
0 Participants
n=7 Participants
12 Participants
n=31 Participants
Caregiver Diagnosis
Cancer
11 Participants
n=99 Participants
6 Participants
n=107 Participants
10 Participants
n=206 Participants
5 Participants
n=7 Participants
32 Participants
n=31 Participants
Caregiver Diagnosis
Dementia
2 Participants
n=99 Participants
3 Participants
n=107 Participants
2 Participants
n=206 Participants
13 Participants
n=7 Participants
20 Participants
n=31 Participants
Caregiver Diagnosis
Other
38 Participants
n=99 Participants
35 Participants
n=107 Participants
33 Participants
n=206 Participants
5 Participants
n=7 Participants
111 Participants
n=31 Participants
Caregiver Diagnosis
Unknown or Not Reported
103 Participants
n=99 Participants
108 Participants
n=107 Participants
109 Participants
n=206 Participants
40 Participants
n=7 Participants
360 Participants
n=31 Participants
Caregiver Dementia
No
14 Participants
n=99 Participants
8 Participants
n=107 Participants
9 Participants
n=206 Participants
1 Participants
n=7 Participants
32 Participants
n=31 Participants
Caregiver Dementia
Yes
6 Participants
n=99 Participants
4 Participants
n=107 Participants
5 Participants
n=206 Participants
21 Participants
n=7 Participants
36 Participants
n=31 Participants
Caregiver Dementia
Don't Know
35 Participants
n=99 Participants
35 Participants
n=107 Participants
35 Participants
n=206 Participants
5 Participants
n=7 Participants
110 Participants
n=31 Participants
Caregiver Dementia
Unknown or Not Reported
99 Participants
n=99 Participants
105 Participants
n=107 Participants
105 Participants
n=206 Participants
36 Participants
n=7 Participants
345 Participants
n=31 Participants
Caregiver Marital Status
Single/Never Married/Partnered
37 Participants
n=99 Participants
38 Participants
n=107 Participants
25 Participants
n=206 Participants
20 Participants
n=7 Participants
120 Participants
n=31 Participants
Caregiver Marital Status
Married/Partnered
67 Participants
n=99 Participants
69 Participants
n=107 Participants
76 Participants
n=206 Participants
33 Participants
n=7 Participants
245 Participants
n=31 Participants
Caregiver Marital Status
Widowed
23 Participants
n=99 Participants
16 Participants
n=107 Participants
20 Participants
n=206 Participants
2 Participants
n=7 Participants
61 Participants
n=31 Participants
Caregiver Marital Status
Separated/Divorced
18 Participants
n=99 Participants
18 Participants
n=107 Participants
14 Participants
n=206 Participants
7 Participants
n=7 Participants
57 Participants
n=31 Participants
Caregiver Marital Status
Decline to Answer
0 Participants
n=99 Participants
1 Participants
n=107 Participants
0 Participants
n=206 Participants
0 Participants
n=7 Participants
1 Participants
n=31 Participants
Caregiver Marital Status
Unknown or Not Reported
9 Participants
n=99 Participants
10 Participants
n=107 Participants
19 Participants
n=206 Participants
1 Participants
n=7 Participants
39 Participants
n=31 Participants
Caregiver Education
Less than High School
2 Participants
n=99 Participants
1 Participants
n=107 Participants
2 Participants
n=206 Participants
0 Participants
n=7 Participants
5 Participants
n=31 Participants
Caregiver Education
High School/GED
24 Participants
n=99 Participants
27 Participants
n=107 Participants
25 Participants
n=206 Participants
6 Participants
n=7 Participants
82 Participants
n=31 Participants
Caregiver Education
Some College/Associate Degree
38 Participants
n=99 Participants
42 Participants
n=107 Participants
43 Participants
n=206 Participants
17 Participants
n=7 Participants
140 Participants
n=31 Participants
Caregiver Education
Bachelor's Degree
40 Participants
n=99 Participants
27 Participants
n=107 Participants
37 Participants
n=206 Participants
17 Participants
n=7 Participants
121 Participants
n=31 Participants
Caregiver Education
Graduate/Professional Degree
41 Participants
n=99 Participants
45 Participants
n=107 Participants
28 Participants
n=206 Participants
22 Participants
n=7 Participants
136 Participants
n=31 Participants
Caregiver Education
Unknown or Not Reported
9 Participants
n=99 Participants
10 Participants
n=107 Participants
19 Participants
n=206 Participants
1 Participants
n=7 Participants
39 Participants
n=31 Participants
Caregiver Relation
Spouse/Partner
41 Participants
n=99 Participants
42 Participants
n=107 Participants
41 Participants
n=206 Participants
15 Participants
n=7 Participants
139 Participants
n=31 Participants
Caregiver Relation
Adult Child
70 Participants
n=99 Participants
69 Participants
n=107 Participants
74 Participants
n=206 Participants
38 Participants
n=7 Participants
251 Participants
n=31 Participants
Caregiver Relation
Parent
7 Participants
n=99 Participants
7 Participants
n=107 Participants
5 Participants
n=206 Participants
1 Participants
n=7 Participants
20 Participants
n=31 Participants
Caregiver Relation
Sibling
6 Participants
n=99 Participants
4 Participants
n=107 Participants
3 Participants
n=206 Participants
1 Participants
n=7 Participants
14 Participants
n=31 Participants
Caregiver Relation
Other
20 Participants
n=99 Participants
20 Participants
n=107 Participants
12 Participants
n=206 Participants
7 Participants
n=7 Participants
59 Participants
n=31 Participants
Caregiver Relation
Decline to Answer
1 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
0 Participants
n=7 Participants
1 Participants
n=31 Participants
Caregiver Relation
Unknown or Not Reported
9 Participants
n=99 Participants
10 Participants
n=107 Participants
19 Participants
n=206 Participants
1 Participants
n=7 Participants
39 Participants
n=31 Participants
Care Receiver Gender
Male
69 Participants
n=99 Participants
59 Participants
n=107 Participants
69 Participants
n=206 Participants
15 Participants
n=7 Participants
212 Participants
n=31 Participants
Care Receiver Gender
Female
75 Participants
n=99 Participants
83 Participants
n=107 Participants
64 Participants
n=206 Participants
47 Participants
n=7 Participants
269 Participants
n=31 Participants
Care Receiver Gender
Unknown or Not Reported
10 Participants
n=99 Participants
10 Participants
n=107 Participants
21 Participants
n=206 Participants
1 Participants
n=7 Participants
42 Participants
n=31 Participants
Care Receiver Ethnicity
Hispanic
6 Participants
n=99 Participants
8 Participants
n=107 Participants
11 Participants
n=206 Participants
5 Participants
n=7 Participants
30 Participants
n=31 Participants
Care Receiver Ethnicity
Non-Hispanic
136 Participants
n=99 Participants
133 Participants
n=107 Participants
120 Participants
n=206 Participants
55 Participants
n=7 Participants
444 Participants
n=31 Participants
Care Receiver Ethnicity
Decline to Answer
2 Participants
n=99 Participants
1 Participants
n=107 Participants
2 Participants
n=206 Participants
2 Participants
n=7 Participants
7 Participants
n=31 Participants
Care Receiver Ethnicity
Unknown or Not Reported
10 Participants
n=99 Participants
10 Participants
n=107 Participants
21 Participants
n=206 Participants
1 Participants
n=7 Participants
42 Participants
n=31 Participants
Care Receiver Race
American Indian or Alaska Native
0 Participants
n=99 Participants
0 Participants
n=107 Participants
1 Participants
n=206 Participants
0 Participants
n=7 Participants
1 Participants
n=31 Participants
Care Receiver Race
Asian
5 Participants
n=99 Participants
2 Participants
n=107 Participants
3 Participants
n=206 Participants
3 Participants
n=7 Participants
13 Participants
n=31 Participants
Care Receiver Race
Native Hawaiian or Other Pacific Islander
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
0 Participants
n=7 Participants
0 Participants
n=31 Participants
Care Receiver Race
Black or African American
63 Participants
n=99 Participants
55 Participants
n=107 Participants
50 Participants
n=206 Participants
25 Participants
n=7 Participants
193 Participants
n=31 Participants
Care Receiver Race
White
75 Participants
n=99 Participants
84 Participants
n=107 Participants
87 Participants
n=206 Participants
33 Participants
n=7 Participants
279 Participants
n=31 Participants
Care Receiver Race
More than one race
9 Participants
n=99 Participants
8 Participants
n=107 Participants
10 Participants
n=206 Participants
2 Participants
n=7 Participants
29 Participants
n=31 Participants
Care Receiver Race
Unknown or Not Reported
2 Participants
n=99 Participants
3 Participants
n=107 Participants
3 Participants
n=206 Participants
0 Participants
n=7 Participants
8 Participants
n=31 Participants
Care Receiver Marital Status
Single/Never Married/Partnered
19 Participants
n=99 Participants
18 Participants
n=107 Participants
12 Participants
n=206 Participants
10 Participants
n=7 Participants
59 Participants
n=31 Participants
Care Receiver Marital Status
Married/Partnered
57 Participants
n=99 Participants
59 Participants
n=107 Participants
58 Participants
n=206 Participants
24 Participants
n=7 Participants
198 Participants
n=31 Participants
Care Receiver Marital Status
Widowed
47 Participants
n=99 Participants
45 Participants
n=107 Participants
49 Participants
n=206 Participants
19 Participants
n=7 Participants
160 Participants
n=31 Participants
Care Receiver Marital Status
Separated/Divorced
21 Participants
n=99 Participants
20 Participants
n=107 Participants
15 Participants
n=206 Participants
9 Participants
n=7 Participants
65 Participants
n=31 Participants
Care Receiver Marital Status
Unknown or Not Reported
10 Participants
n=99 Participants
10 Participants
n=107 Participants
20 Participants
n=206 Participants
1 Participants
n=7 Participants
41 Participants
n=31 Participants
Care Receiver Residence
Private Home Residence/Adult Group Home
123 Participants
n=99 Participants
115 Participants
n=107 Participants
117 Participants
n=206 Participants
54 Participants
n=7 Participants
409 Participants
n=31 Participants
Care Receiver Residence
Assisted Living Facility/Nursing Home/Skilled Nursing Facility
18 Participants
n=99 Participants
22 Participants
n=107 Participants
13 Participants
n=206 Participants
2 Participants
n=7 Participants
55 Participants
n=31 Participants
Care Receiver Residence
Other
4 Participants
n=99 Participants
5 Participants
n=107 Participants
4 Participants
n=206 Participants
6 Participants
n=7 Participants
19 Participants
n=31 Participants
Care Receiver Residence
Unknown or Not Reported
9 Participants
n=99 Participants
10 Participants
n=107 Participants
20 Participants
n=206 Participants
1 Participants
n=7 Participants
40 Participants
n=31 Participants
Caregiver Distance from Receiver
With you
90 Participants
n=99 Participants
72 Participants
n=107 Participants
81 Participants
n=206 Participants
37 Participants
n=7 Participants
280 Participants
n=31 Participants
Caregiver Distance from Receiver
Less than 1 hour away
49 Participants
n=99 Participants
61 Participants
n=107 Participants
42 Participants
n=206 Participants
19 Participants
n=7 Participants
171 Participants
n=31 Participants
Caregiver Distance from Receiver
More than 1 hour away
4 Participants
n=99 Participants
8 Participants
n=107 Participants
10 Participants
n=206 Participants
6 Participants
n=7 Participants
28 Participants
n=31 Participants
Caregiver Distance from Receiver
Decline to Answer
2 Participants
n=99 Participants
0 Participants
n=107 Participants
1 Participants
n=206 Participants
0 Participants
n=7 Participants
3 Participants
n=31 Participants
Caregiver Distance from Receiver
Unknown or Not Reported
9 Participants
n=99 Participants
11 Participants
n=107 Participants
20 Participants
n=206 Participants
1 Participants
n=7 Participants
41 Participants
n=31 Participants
Caregiver Time Caring
Less than 1 year
42 Participants
n=99 Participants
46 Participants
n=107 Participants
40 Participants
n=206 Participants
13 Participants
n=7 Participants
141 Participants
n=31 Participants
Caregiver Time Caring
1-3 years
32 Participants
n=99 Participants
31 Participants
n=107 Participants
28 Participants
n=206 Participants
26 Participants
n=7 Participants
117 Participants
n=31 Participants
Caregiver Time Caring
3 years or more
69 Participants
n=99 Participants
62 Participants
n=107 Participants
65 Participants
n=206 Participants
22 Participants
n=7 Participants
218 Participants
n=31 Participants
Caregiver Time Caring
Decline to Answer
2 Participants
n=99 Participants
2 Participants
n=107 Participants
1 Participants
n=206 Participants
1 Participants
n=7 Participants
6 Participants
n=31 Participants
Caregiver Time Caring
Unknown or Not Reported
9 Participants
n=99 Participants
11 Participants
n=107 Participants
20 Participants
n=206 Participants
1 Participants
n=7 Participants
41 Participants
n=31 Participants
Caregiver Time Spent Caring per week
Less than 5 hours
6 Participants
n=99 Participants
10 Participants
n=107 Participants
7 Participants
n=206 Participants
4 Participants
n=7 Participants
27 Participants
n=31 Participants
Caregiver Time Spent Caring per week
5-10 hours
16 Participants
n=99 Participants
20 Participants
n=107 Participants
12 Participants
n=206 Participants
11 Participants
n=7 Participants
59 Participants
n=31 Participants
Caregiver Time Spent Caring per week
11-20 hours
22 Participants
n=99 Participants
13 Participants
n=107 Participants
20 Participants
n=206 Participants
9 Participants
n=7 Participants
64 Participants
n=31 Participants
Caregiver Time Spent Caring per week
More than 20 hours
100 Participants
n=99 Participants
96 Participants
n=107 Participants
93 Participants
n=206 Participants
37 Participants
n=7 Participants
326 Participants
n=31 Participants
Caregiver Time Spent Caring per week
Decline to Answer
1 Participants
n=99 Participants
2 Participants
n=107 Participants
2 Participants
n=206 Participants
1 Participants
n=7 Participants
6 Participants
n=31 Participants
Caregiver Time Spent Caring per week
Unknown or Not Reported
9 Participants
n=99 Participants
11 Participants
n=107 Participants
20 Participants
n=206 Participants
1 Participants
n=7 Participants
41 Participants
n=31 Participants
Caregiver Added Expense
Yes
112 Participants
n=99 Participants
104 Participants
n=107 Participants
100 Participants
n=206 Participants
43 Participants
n=7 Participants
359 Participants
n=31 Participants
Caregiver Added Expense
No
32 Participants
n=99 Participants
36 Participants
n=107 Participants
33 Participants
n=206 Participants
19 Participants
n=7 Participants
120 Participants
n=31 Participants
Caregiver Added Expense
Decline to Answer
1 Participants
n=99 Participants
1 Participants
n=107 Participants
1 Participants
n=206 Participants
0 Participants
n=7 Participants
3 Participants
n=31 Participants
Caregiver Added Expense
Unknown or Not Reported
9 Participants
n=99 Participants
11 Participants
n=107 Participants
20 Participants
n=206 Participants
1 Participants
n=7 Participants
41 Participants
n=31 Participants
Caregiver Work Status
Yes
61 Participants
n=99 Participants
66 Participants
n=107 Participants
61 Participants
n=206 Participants
27 Participants
n=7 Participants
215 Participants
n=31 Participants
Caregiver Work Status
No
83 Participants
n=99 Participants
75 Participants
n=107 Participants
73 Participants
n=206 Participants
35 Participants
n=7 Participants
266 Participants
n=31 Participants
Caregiver Work Status
Decline to Answer
1 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
0 Participants
n=7 Participants
1 Participants
n=31 Participants
Caregiver Work Status
Unknown or Not Reported
9 Participants
n=99 Participants
11 Participants
n=107 Participants
20 Participants
n=206 Participants
1 Participants
n=7 Participants
41 Participants
n=31 Participants
Caregiver Work Support
Cut back on hours or quit work entirely
18 Participants
n=99 Participants
15 Participants
n=107 Participants
16 Participants
n=206 Participants
4 Participants
n=7 Participants
53 Participants
n=31 Participants
Caregiver Work Support
Taken an unpaid leave or any leave under Family Medical Leave Act
5 Participants
n=99 Participants
4 Participants
n=107 Participants
6 Participants
n=206 Participants
1 Participants
n=7 Participants
16 Participants
n=31 Participants
Caregiver Work Support
Left one job for a different one
1 Participants
n=99 Participants
3 Participants
n=107 Participants
1 Participants
n=206 Participants
2 Participants
n=7 Participants
7 Participants
n=31 Participants
Caregiver Work Support
Used your own sick leave or vacation time
20 Participants
n=99 Participants
13 Participants
n=107 Participants
15 Participants
n=206 Participants
9 Participants
n=7 Participants
57 Participants
n=31 Participants
Caregiver Work Support
Taken a job or worked additional hours to earn more money
1 Participants
n=99 Participants
0 Participants
n=107 Participants
2 Participants
n=206 Participants
2 Participants
n=7 Participants
5 Participants
n=31 Participants
Caregiver Work Support
None of these apply
8 Participants
n=99 Participants
4 Participants
n=107 Participants
6 Participants
n=206 Participants
9 Participants
n=7 Participants
27 Participants
n=31 Participants
Caregiver Work Support
Decline to Answer
4 Participants
n=99 Participants
8 Participants
n=107 Participants
5 Participants
n=206 Participants
0 Participants
n=7 Participants
17 Participants
n=31 Participants
Caregiver Work Support
Selected More than 1 option
25 Participants
n=99 Participants
29 Participants
n=107 Participants
29 Participants
n=206 Participants
8 Participants
n=7 Participants
91 Participants
n=31 Participants
Caregiver Work Support
Unknown or Not Reported
72 Participants
n=99 Participants
76 Participants
n=107 Participants
74 Participants
n=206 Participants
28 Participants
n=7 Participants
250 Participants
n=31 Participants

PRIMARY outcome

Timeframe: from baseline to follow-up (prior to intervention-day 1 to post intervention-approx. day 30)

Comparison of 4 groups Generalised Anxiety Disorder Assessment (GAD-7) minimum 0 maximum 21 higher scores mean a worse outcome (more anxiety) Patient Health Questionnaire 9 (PHQ9) minimum 0 maximum 37 higher scores mean a worse outcome (more distress) Caregiver Quality of Life Index (CQLI-R) minimum 0 maximum 40 higher scores mean a better outcome (better quality of life)

Outcome measures

Outcome measures
Measure
Group 1 (PISCES Face to Face)
n=154 Participants
Family caregivers will receive three sessions of the PISCES intervention in person. The agenda for the first face to face visit for caregivers (suggested timeline 5-7 days after hospice admission) includes an explanation of the purpose of the visit/call. During the first session, the interventionist works on steps one and two of the ADAPT model, namely "Attitude" and "Defining the Problem and Setting Realistic Goals." During the second visit (suggested timeline 11-13 days after hospice admission) the interventionist covers steps three and four of the ADAPT model. Step three encourages caregivers in being creative and generating alternative solutions. Step four focuses on predicting the consequences and developing a solution plan. The third visit (suggested timeline 16-18 days after hospice admission) focuses on step five, namely trying out the solution plan and determining if it works. PISCES: The intervention is based on Problem Solving Therapy and is a coping skills intervention designed for family caregivers of hospice patients.
Group 2 (PISCES Delivered in a Hybrid Format)
n=152 Participants
In this group, participants will receive the PISCES intervention in three sessions; however, the first session will be delivered face to face and the other two via video. The three intervention sessions will be scheduled with a suggested timeline between days 5 and 18 of the hospice admission. The first session will take place in person (suggested timeline 5-7 days after hospice admission). After the first session where the in-person encounter will allow for the establishment of rapport between the interventionist and the caregiver, the second session (suggested timeline 11-13 days after hospice admission) and the third session (suggested timeline 16-18 days after hospice admissions) will be conducted via live videoconferencing. If the caregiver already has access to a computer and Internet, they will utilize the videoconferencing solution. If videoconferencing is not feasible, the sessions will be delivered over the regular phone. PISCES: The intervention is based on Problem Solving Therapy and is a coping skills intervention designed for family caregivers of hospice patients.
Group 3 (PISCESplus)
n=154 Participants
PISCESplus is meant to be an enhanced version of the PISCES intervention including the original problem solving therapy modules with the addition of positive reappraisal elements. The suggested timeline for the first session which will be in person is 5-7 days after hospice admission. At the end of the first session, the interventionist will ask the caregiver to take the time to think about and identify some positive aspects of caregiving. At the end of the second session (which is scheduled to take place via video approx. 11-13 days after admission) the interventionist will ask the caregiver to go over the benefits or positive aspects of caregiving that they had identified and ask them to comment as to why they perceive these as positive or beneficial. The third session will also take place via video. PISCES: The intervention is based on Problem Solving Therapy and is a coping skills intervention designed for family caregivers of hospice patients.
Group 4 (PISCESplus Online)
n=63 Participants
Participants in this group receive the PISCES plus intervention (the PISCES intervention with the enhancement of the positive reappraisal elements) delivered fully online. All assessments and sessions take place online. PISCES: The intervention is based on Problem Solving Therapy and is a coping skills intervention designed for family caregivers of hospice patients.
Table 2. Comparison of 4 Groups
Difference (FollowUp-Baseline) Generalised Anxiety Disorder Assessment (GAD-7)
-2.54 units on a scale
Standard Deviation 4.25
-1.49 units on a scale
Standard Deviation 4.06
-2.27 units on a scale
Standard Deviation 4.56
-1.52 units on a scale
Standard Deviation 5.12
Table 2. Comparison of 4 Groups
Difference (FollowUp-Baseline) Patient Health Questionnaire 9 (PHQ9)
-2.69 units on a scale
Standard Deviation 4.29
-1.56 units on a scale
Standard Deviation 4.19
-1.87 units on a scale
Standard Deviation 4.59
-2.02 units on a scale
Standard Deviation 4.14
Table 2. Comparison of 4 Groups
Difference (FollowUp-Baseline) Caregiver Quality of Life Index (CQLI-R)
1.14 units on a scale
Standard Deviation 6.42
0.77 units on a scale
Standard Deviation 4.82
0.27 units on a scale
Standard Deviation 7.17
1.15 units on a scale
Standard Deviation 5.80

PRIMARY outcome

Timeframe: from baseline to follow-up (time point 1 is pre-intervention, i.e., day 0 and time point 2 is post-intervention, approx. day 30)

Comparison of Traditional PISCES vs. Online PISCES Generalised Anxiety Disorder Assessment (GAD-7) minimum 0 maximum 21 higher scores mean a worse outcome (more problems) Patient Health Questionnaire 9 (PHQ9) minimum 0 maximum 37 higher scores mean a worse outcome Caregiver Quality of Life Index (CQLI-R) minimum 0 maximum 40 higher scores mean a better outcome

Outcome measures

Outcome measures
Measure
Group 1 (PISCES Face to Face)
n=306 Participants
Family caregivers will receive three sessions of the PISCES intervention in person. The agenda for the first face to face visit for caregivers (suggested timeline 5-7 days after hospice admission) includes an explanation of the purpose of the visit/call. During the first session, the interventionist works on steps one and two of the ADAPT model, namely "Attitude" and "Defining the Problem and Setting Realistic Goals." During the second visit (suggested timeline 11-13 days after hospice admission) the interventionist covers steps three and four of the ADAPT model. Step three encourages caregivers in being creative and generating alternative solutions. Step four focuses on predicting the consequences and developing a solution plan. The third visit (suggested timeline 16-18 days after hospice admission) focuses on step five, namely trying out the solution plan and determining if it works. PISCES: The intervention is based on Problem Solving Therapy and is a coping skills intervention designed for family caregivers of hospice patients.
Group 2 (PISCES Delivered in a Hybrid Format)
n=217 Participants
In this group, participants will receive the PISCES intervention in three sessions; however, the first session will be delivered face to face and the other two via video. The three intervention sessions will be scheduled with a suggested timeline between days 5 and 18 of the hospice admission. The first session will take place in person (suggested timeline 5-7 days after hospice admission). After the first session where the in-person encounter will allow for the establishment of rapport between the interventionist and the caregiver, the second session (suggested timeline 11-13 days after hospice admission) and the third session (suggested timeline 16-18 days after hospice admissions) will be conducted via live videoconferencing. If the caregiver already has access to a computer and Internet, they will utilize the videoconferencing solution. If videoconferencing is not feasible, the sessions will be delivered over the regular phone. PISCES: The intervention is based on Problem Solving Therapy and is a coping skills intervention designed for family caregivers of hospice patients.
Group 3 (PISCESplus)
PISCESplus is meant to be an enhanced version of the PISCES intervention including the original problem solving therapy modules with the addition of positive reappraisal elements. The suggested timeline for the first session which will be in person is 5-7 days after hospice admission. At the end of the first session, the interventionist will ask the caregiver to take the time to think about and identify some positive aspects of caregiving. At the end of the second session (which is scheduled to take place via video approx. 11-13 days after admission) the interventionist will ask the caregiver to go over the benefits or positive aspects of caregiving that they had identified and ask them to comment as to why they perceive these as positive or beneficial. The third session will also take place via video. PISCES: The intervention is based on Problem Solving Therapy and is a coping skills intervention designed for family caregivers of hospice patients.
Group 4 (PISCESplus Online)
Participants in this group receive the PISCES plus intervention (the PISCES intervention with the enhancement of the positive reappraisal elements) delivered fully online. All assessments and sessions take place online. PISCES: The intervention is based on Problem Solving Therapy and is a coping skills intervention designed for family caregivers of hospice patients.
Table 3. Comparison of Traditional PISCES vs. Online PISCES
Difference (FollowUp-Baseline) Generalised Anxiety Disorder Assessment (GAD-7)
-2.04 units on a scale
Standard Deviation 4.18
-2.03 units on a scale
Standard Deviation 4.74
Table 3. Comparison of Traditional PISCES vs. Online PISCES
Difference (FollowUp-Baseline) Patient Health Questionnaire 9 (PHQ9)
-2.15 units on a scale
Standard Deviation 4.27
-1.91 units on a scale
Standard Deviation 4.44
Table 3. Comparison of Traditional PISCES vs. Online PISCES
Difference (FollowUp-Baseline) Caregiver Quality of Life Index (CQLI-R)
0.96 units on a scale
Standard Deviation 5.70
0.54 units on a scale
Standard Deviation 6.76

PRIMARY outcome

Timeframe: from baseline to follow-up (time point 1 is pre-intervention-day 0 and time point 2 is post-intervention-approx. day 30)

Within-Group Comparison Baseline vs. Follow-up Generalised Anxiety Disorder Assessment (GAD-7) minimum 0 maximum 21 higher scores mean a worse outcome (more problems) Patient Health Questionnaire 9 (PHQ9) minimum 0 maximum 37 higher scores mean a worse outcome Caregiver Quality of Life Index (CQLI-R) minimum 0 maximum 40 higher scores mean a better outcome

Outcome measures

Outcome measures
Measure
Group 1 (PISCES Face to Face)
n=306 Participants
Family caregivers will receive three sessions of the PISCES intervention in person. The agenda for the first face to face visit for caregivers (suggested timeline 5-7 days after hospice admission) includes an explanation of the purpose of the visit/call. During the first session, the interventionist works on steps one and two of the ADAPT model, namely "Attitude" and "Defining the Problem and Setting Realistic Goals." During the second visit (suggested timeline 11-13 days after hospice admission) the interventionist covers steps three and four of the ADAPT model. Step three encourages caregivers in being creative and generating alternative solutions. Step four focuses on predicting the consequences and developing a solution plan. The third visit (suggested timeline 16-18 days after hospice admission) focuses on step five, namely trying out the solution plan and determining if it works. PISCES: The intervention is based on Problem Solving Therapy and is a coping skills intervention designed for family caregivers of hospice patients.
Group 2 (PISCES Delivered in a Hybrid Format)
n=217 Participants
In this group, participants will receive the PISCES intervention in three sessions; however, the first session will be delivered face to face and the other two via video. The three intervention sessions will be scheduled with a suggested timeline between days 5 and 18 of the hospice admission. The first session will take place in person (suggested timeline 5-7 days after hospice admission). After the first session where the in-person encounter will allow for the establishment of rapport between the interventionist and the caregiver, the second session (suggested timeline 11-13 days after hospice admission) and the third session (suggested timeline 16-18 days after hospice admissions) will be conducted via live videoconferencing. If the caregiver already has access to a computer and Internet, they will utilize the videoconferencing solution. If videoconferencing is not feasible, the sessions will be delivered over the regular phone. PISCES: The intervention is based on Problem Solving Therapy and is a coping skills intervention designed for family caregivers of hospice patients.
Group 3 (PISCESplus)
PISCESplus is meant to be an enhanced version of the PISCES intervention including the original problem solving therapy modules with the addition of positive reappraisal elements. The suggested timeline for the first session which will be in person is 5-7 days after hospice admission. At the end of the first session, the interventionist will ask the caregiver to take the time to think about and identify some positive aspects of caregiving. At the end of the second session (which is scheduled to take place via video approx. 11-13 days after admission) the interventionist will ask the caregiver to go over the benefits or positive aspects of caregiving that they had identified and ask them to comment as to why they perceive these as positive or beneficial. The third session will also take place via video. PISCES: The intervention is based on Problem Solving Therapy and is a coping skills intervention designed for family caregivers of hospice patients.
Group 4 (PISCESplus Online)
Participants in this group receive the PISCES plus intervention (the PISCES intervention with the enhancement of the positive reappraisal elements) delivered fully online. All assessments and sessions take place online. PISCES: The intervention is based on Problem Solving Therapy and is a coping skills intervention designed for family caregivers of hospice patients.
Table 4. Within-Group Comparison Baseline vs. Follow-up
Generalised Anxiety Disorder Assessment (GAD-7)
-2.04 units on a scale
Standard Deviation 4.18
-2.03 units on a scale
Standard Deviation 4.74
Table 4. Within-Group Comparison Baseline vs. Follow-up
Patient Health Questionnaire 9 (PHQ9)
-2.15 units on a scale
Standard Deviation 4.27
-1.91 units on a scale
Standard Deviation 4.44
Table 4. Within-Group Comparison Baseline vs. Follow-up
Caregiver Quality of Life Index (CQLI-R)
0.96 units on a scale
Standard Deviation 5.70
0.54 units on a scale
Standard Deviation 6.76

Adverse Events

Group 1 (PISCES-f2f)

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Group 2 (PISCES Video)

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Group 3 (PISCESplus)

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Group 4 PISCESplus Online

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

George Demiris

University of Pennsylvania

Phone: 2158988559

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place