Given, B., Given, C.W., Sikorski, A., Jeon, S., Sherwood, P., & Rahbar, M. (2006). The impact of providing symptom management assistance on caregiver reaction: Results of a randomized trial. Journal of Pain and Symptom Management, 32(5), 433–443.

Dyads in the experimental group received four contacts over a 10-week intervention. (Two in-person contacts coinciding with regular visits to the oncology center; alternated with two telephone contacts approximately two weeks following each in-person contact.)

Cognitive behavioral intervention was directed toward the patient and caregiver dyad. Patients received information on self-care, cognitive reframing, coping strategies, and techniques for communicating needs for assistance with family members. Interventions for caregivers focused on etiology and strategies for managing symptoms, how to integrate into everyday activities, and how to better communicate with the patient and healthcare providers about symptom management. The intervention nurse assessed the caregivers’ perception of their involvement in and reaction to assisting the patient with symptom management; collaboratively selected strategies to implement; and evaulated the success of strategies to either continue or be revised.

• The sample included caregivers of patients with a solid tumor within their first two cycles of chemotherapy for treatment of new tumor (N = 125)—intervention (n = 59) versus standard of care (n = 66).

A properly designed randomized clinical trial was used.

• Center for Epidemiologic Studies Depression Scale (CES-D)
• Caregiver (burden) reaction to assisting with symptoms was measured by the following.
  • Total number of symptoms for which caregiver provided assistance
  • Total level of distress reported because of assisting with symptom management
  • Reaction (level of distress) score per symptom

Caregivers in the experimental intervention group reported significantly lower total negative reactions and fewer assistances at 10 weeks than caregivers in the standard of care arm (p < 0.01).

Patients of caregivers in the experimental group reported significantly lower levels of symptom severity for which caregivers provided assistance.

Female caregivers in the experimental group reported less negative reactions to providing assistance than female caregivers in the control group (p < 0.01). Males in the control group reported less negative reactions per assistance than males in the experimental group (p = 0.08).

Caregivers who were younger than their patients reported less negative reactions to assisting with symptom management than caregivers who were the same age or older than their patients (p = 0.06).

• Demographic information about race and ethnicity of the sample was not described.
• No description exists of the qualifications or training required for the intervention nurse nor do evidence-based guidelines exist for strategies used in symptom management.