Bahrami, M., & Farzi, S. (2014). The effect of a supportive educational program based on COPE model on caring burden and quality of life in family caregivers of women with breast cancer. Iranian Journal of Nursing and Midwifery Research, 19, 119–126.

To determine the effects of a supportive educational program based on the COPE model on caring burden and quality of life in family caregivers of women with breast cancer

Caregivers randomly were assigned to the experimental or control group. The experimental group had two educational sessions within the first nine days of caregiving and had a follow-up phone call between these two sessions. The education included problem solving, goal setting, learning how to get help for problem solving, and review and discussion of problems faced and actions taken. Study assessments were completed at baseline and at 30 days after study entry. Instruments were completed by questioning.

• N = 64
• MEAN AGE = 38 years
• MALES: 36%, FEMALES: 64%
• KEY DISEASE CHARACTERISTICS: All patients had breast cancer.
• OTHER KEY SAMPLE CHARACTERISTICS: The majority of caregivers were spouses or children of the patient. None had healthcare training. Most had limited formal education and low income.

• SITE: Single site  
• SETTING TYPE: Multiple settings  
• LOCATION: Iran

• RCT

• Caregiver quality-of-life questionnaire 
• World Health Organization quality-of-life questionnaire
• Caregiving burden questionnaire (Ziret et al.)

Quality-of-life scores after the intervention were higher in the experimental group in physical (p = .001), psychological (p = .017), and environmental (p -.047) domains, and overall (p < .001). Burden was significantly lower after the intervention in the experimental group (p < .001). In the experimental group, burden declined and scores in all quality-of-life measures improved, while burden scores increased and quality-of-life scores declined in the control group.

Findings showed that the program implemented was associated with improved quality of life and reduced caregiver burden.

• Small sample (less than 100)
• Risk of bias (no blinding)
• Risk of bias (no appropriate attentional control condition)
• Measurement validity/reliability questionable
• Questionable protocol fidelity
• Other limitations/explanation: Tools used are not well-known instruments, and as these appeared to be directly administered by researchers. If bias may have been introduced is not clear. Internal consistency of instruments ranged from 0.59–0.92. No description of approaches to ensure treatment fidelity was provided. Usual care in the control group is not described. If sessions were provided individually or in a group setting is not clear.

Findings suggest that a supportive, psychoeducational intervention was beneficial to caregivers with improvement in quality of life and reduction in caregiver burden. Nurses can assist caregivers in working with them around problem solving, goal setting, and provision of supportive interactions. The intervention consisted of two educational sessions and one phone call in a one-month period.