Hudson, P.L., Trauer, T., Lobb, E., Zordan, R., Williams, A., Quinn, K., . . . Thomas, K. (2012). Supporting family caregivers of hospitalised palliative care patients: A psychoeducational group intervention. BMJ Supportive and Palliative Care, 2, 115–120. 

To examine the effectiveness of an inpatient group psychoeducational intervention for caregivers of patients receiving inpatient palliative care

Five education group sessions were delivered using a standardized method, the components and conduct of which were developed by authors in the pilot study that preceded the current study. Each was 90 minutes, and they focused on five topics: what palliative care is, the typical role of family caregivers (CGs), available support services to help CGs, preparing for the future, and self-care strategies for CGs. Caregivers were also given the opportunity to arrange individual meetings with designated multidisciplinary team members based on their needs. CGs were referred formally to family meetings if needed.

• N = 126 in T1, 107 in T2   
• AGE = 57 years
• MALES: 33.3%, FEMALES: 66.7%
• CURRENT TREATMENT: Other
• KEY DISEASE CHARACTERISTICS: Adults receiving palliative care, patients with various advanced cancers
• OTHER KEY SAMPLE CHARACTERISTICS: Adults aged older than 18 years, CGs of adults with cancer receiving palliative care, English speakers, adults willing to be recognized as a patient's primary CG. Those with significant emotional distress were excluded.

• SITE: Multi-site   
• SETTING TYPE: Inpatient    
• LOCATION: Australia

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

Pre-/postdesign

• Family CGs’ needs measured with the Family Inventory of Needs (FIN)
• Preparedness for CG role measured by the Preparedness for Caregiving Scale (PREP)
• Competence for the CG role measured by the Caregiver Competence Scale (COMP)
• General Health Questionnaire (GHQ) to determine if CGs were emotionally eligible to participate.
• All measures had an alpha greater than 0.87.
• Measurement occurred before the educational intervention and after three days.

• Significant (p = 0.028) but small effect (0.22) on FIN, indicating improvement in met needs
• Significant (< 0.001), moderate effect (0.43) on preparedness
• No significant change in general health or competence
• A significant difference between those who declared a religious affiliation (improved GHQ scores) and those who had no religion

The educational intervention showed a small to moderate effect on reducing CGs' unmet needs and improved their sense of preparedness. The intervention did not affect CGs’ competence, although a trend of improvement was observed. The intervention did not improve CGs’ psychological well-being (secondary outcome—intervention was not geared to improve psychological well-being).

• Risk of bias (no control group)
• Risk of bias (no blinding)
• Risk of bias (no random assignment)
• Unintended interventions or applicable interventions not described that would influence results
• Questionable protocol fidelity
• Subject withdrawals ≥ 10%
• Thirteen of the 52 educational sessions 1:1 rather than group

Educational interventions improved CGs' sense of preparedness and decreased their sense of unmet needs. They may help improve CGs’ competence.