Demiris, G., Oliver, D.P., Wittenberg-Lyles, E., & Washington, K. (2011). Use of videophones to deliver a cognitive-behavioural therapy to hospice caregivers. Journal of Telemedicine and Telecare, 17, 142–145.

 

To test the feasibility of delivering problem-solving therapy via videophones

Videophones were installed for caregivers, and in an initial visit, caregivers were asked to review and prioritize common concerns. Three follow-up intervention calls were scheduled from days 5–16 of the hospice admission. Counseling via the videocalls was done to encourage caregivers to be creative and identify alternative solutions to stated problems, predicting consequences and developing an action plan, and trying out and evaluating the effect of the actions implemented. A final call was done to assess caregiver perceptions of the intervention. Calls were supervised to assure treatment fidelity.

• N = 42   
• MEAN AGE = 62 years
• MALES: 19%, FEMALES: 81%
• CURRENT TREATMENT: Not applicable
• KEY DISEASE CHARACTERISTICS: All were in hospice; no disease characteristics were reported.

• SITE: Single site   
• SETTING TYPE: Home    
• LOCATION: Washington

• PHASE OF CARE: End-of-life care
• APPLICATIONS: Palliative care

Quasiexperimental

• Caregiver Quality of Life Index (CQLI)
• Problem Solving Inventory (PSI)
• State-Trait Anxiety Inventory (STAI)
• Technical quality of video calls instrument

Caregivers reported lower anxiety scores after the intervention (p = 0.04). No significant changes occurred in other measures. Eighty-nine percent of attempted calls were successful, and the average technical quality was 48 out of a possible score of 50. Average call duration was 38 minutes (range = 18–84 minutes). Average usefulness of the intervention was rated as 4.8 by caregivers out of a possible score of 5.

The use of video calls to deliver psychoeducational interventions was generally feasible and well received by caregivers. The intervention was associated with a reduction in anxiety levels.

• Small sample (< 100)
• Risk of bias (no control group)
• Risk of bias (no blinding)
• Risk of bias (no random assignment)
• Measurement/methods not well described
• Intervention expensive, impractical, or training needs
• Unclear how measurement instruments were completed
• Equipment for video calls may not be readily available.
• Type of patients and disease characteristics were not provided.

This study showed that the delivery of an intervention via video call was feasible and had benefit in terms of anxiety reduction for caregivers. Since the time of this study, technology has advanced, and it is more likely that video conferencing can be provided via the Internet. This can be a practical method for providing interventions to caregivers.