Abstract: 

This four year randomized controlled study, A Problem Solving Intervention for Hospice Caregiver, builds on recent research that has revealed that stress and caregiver burden can negatively impact morbidity and mortality among informal caregivers of hospice patients. Problem solving therapy (PST) has been tested and found effective when delivered to family caregivers of physically or cognitively impaired older adults, caregivers of patients with dementia and traumatic brain injury. PST delivered specifically to hospice caregivers holds great promise but has not been studied extensively. Building on an early pilot study that found promise in the use of videophone technology to deliver a problem solving therapy intervention for informal caregivers of home hospice patients (i.e., family members and/or friends who assume the caregiving responsibility), this study seeks to fully evaluate the PST intervention for hospice caregivers. Hospice caregivers will be randomly assigned to a group receiving standard hospice care with the addition of educational phone calls (attention control group) or a group receiving standard hospice care with the addition of the problem solving intervention delivered over the phone (intervention group 1) or a group receiving standard hospice care with the addition of the problem solving intervention delivered over the videophone (intervention group 2). The four specific aims of the study are: 1) to assess the impact of PST on caregiver quality of life, problem solving ability, and caregiver anxiety; 2) to compare the effectiveness of the PST intervention delivered via telephone and via videophone; 3) to assess the caregivers’ perceptions of and satisfaction with the videophone as a communication mode for the PST intervention; and 4) to evaluate the cost effectiveness of the problem solving intervention.