(Press-News.org) Stem cell transplant is essential in the care of many blood cancers, but leaves patients requiring in-home care for months after. Frequently the role of caregiver falls to family or other committed members of the patient's support network. Previous work shows dramatically increased stress in cancer caregivers, directly impacting the caregiver and indirectly impacting the cancer patient via reduced quality of care. A randomized control trial funded by the National Cancer Institute by members of the University of Colorado Cancer Center, published in the journal Bone Marrow Transplantation, demonstrates an intervention that successfully reduces the stress of caregivers in the context of cancer patients treated with stem cell transplantation.
"The first 100 days after a stem cell transplant is a critical period for patients in which caregivers are called upon to deliver around-the-clock care, providing support for patients' everyday needs and also patients' emotional health. But who takes care of the caregivers?" says Mark Laudenslager, PhD, investigator at the CU Cancer Center, director of the Behavioral and Endocrinology Laboratory at the CU School of Medicine, and the paper's first author.
The study enrolled 148 caregivers of allogeneic hematopoietic stem cell (Allo-HSCT) patients, randomizing 74 into a group that was offered the study's psychosocial intervention and 74 into a group that received treatment as usual (which included the availability but not the requirement of mental health support services). In the experimental group, caregivers received eight, one-on-one stress management sessions focused on understanding stress and its physical consequences, changing roles as caregivers, cognitive behavioral stress management, pacing respiration and identifying social support.
The group calls the intervention PsychoEducation, Paced Respiration and Relaxation, or PEPRR.
"We wanted to make sure PEPRR didn't add any additional caregiver stress, for example by asking caregivers to schedule additional appointments. For that reason, we were pleased to be able to offer our intervention during cancer patients' follow-up visits. By delivering care to the caregivers at the same time cancer patients were being seen by their doctors, we hoped to minimize the stress of the intervention itself," Laudenslager says.
After the patient received stem cell transplant, Laudenslager and colleagues used a questionnaire known as the Perceived Stress Scale (PSS) to follow the trajectory of caregiver stress over time. (The 14-item scale had been used previously to show elevated levels of stress in allo-HSCT caregivers.) Researchers also measured caregivers' depression and anxiety using similar, validated questionnaires.
"Of course, even as caregivers entered the hospital and were offered our study, their stress levels were already elevated," Laudenslager says.
As seen in study results, at the one-month point, the stress of caregivers in the treatment as usual group started to rise, whereas stress in the group that received PEPRR continued to decline. Results of the PSS questionnaire administered 3 months after a patient's stem cell transplant (near the end of the critical 100-day period) showed that the experienced stress of caregivers who had followed the PEPRR measured even below the average of the general population. At the end of the study period, mean stress in the PEPRR group was significantly lower than in he treatment-as-usual group. Measures of depression and anxiety were also lower in the PEPRR group.
"We see this as a promising intervention for cancer caregivers in these high-stress situations of home care after acute treatment," Laudenslager says.
He also points out that the cost of the intervention is only about $500 per caregiver, compared with over $200,000 for an Allo-HSCT.
"Rescuing distress has the potential benefit of improving caregiver well-being and thus may permit the caregiver to be more effective in fulfilling their caregiver tasks," the group writes.
INFORMATION:
This group is currently recruiting for a follow up study (NCT02037568) funded by Patient-Centered Outcomes Research Institute focused on evaluating improved quality of life in Allo-HSCT patients whose caregivers participate programs similar to the PEPRR intervention studied in the current trial.
New York, NY - NYU Langone Medical Center and its Laura and Isaac Perlmutter Cancer Center will have a high profile at the 51st Annual Meeting of the American Society for Clinical Oncology (ASCO), with researchers presenting close to 30 abstracts accepted for oral, poster and publication presentations.
Leading the way are eight oral abstract and poster presentations on melanoma for which an NYU Langone researcher is either a senior, lead or contributing author. While many of these studies are multi-institutional, five poster presentations are led by the Perlmutter ...
Despite early promise of benefits, soy doesn't help lung function
Lifestyle and diet may also affect asthma control
Study highlights importance of placebo-controlled studies
CHICAGO --- Despite previous findings suggesting a link between soy intake and decreased asthma severity, a new study from Northwestern Medicine and the American Lung Association Asthma Clinical Research Network shows soy supplements do not improve lung function for patients with asthma.
The paper, published May 26 in the Journal of the American Medical Association (JAMA), highlights the ...
While most surviving spouses had more depression symptoms following the death of their partner regardless of hospice use, researchers found a modest reduction in depressive symptoms among some surviving spouses of hospice users compared with nonhospice users, according to an article published online by JAMA Internal Medicine.
The Institute of Medicine's report on improving the quality of care near the end of life highlights the need for supporting family caregivers. Core components of high-quality hospice care include counseling services for family members before and ...
Delayed clamping of the umbilical cord to help prevent iron deficiency in infancy was associated with improved scores in fine-motor and social skills in children at age 4, particularly in boys, although it was not associated with any effect on overall IQ or behavior compared with children whose cords were clamped seconds after delivery, according to an article published online by JAMA Pediatrics.
Iron deficiency is a global health issue among preschool children associated with impaired neurodevelopment that can affect cognitive, motor and behavioral abilities. Delaying ...
In an analysis that included more than 70,000 participants from 13 studies, subclinical hyperthyroidism was associated with an increased risk for hip and other fractures including spine, according to a study in the May 26 issue of JAMA. Subclinical hyperthyroidism is a low serum thyroid-stimulating hormone concentration in a person without clinical symptoms and normal thyroid hormone concentrations on blood tests.
Overt hyperthyroidism is an established risk factor for osteoporosis and fractures. Associations between subclinical thyroid dysfunction and fractures are unclear ...
Although some data have suggested that supplementation with soy isoflavone may be an effective treatment for patients with poor asthma control, a randomized trial that included nearly 400 children and adults found that use of the supplement did not result in improved lung function or clinical outcomes, including asthma symptoms and episodes of poor asthma control, according to a study in the May 26 issue of JAMA. Soy isoflavones are plant (soybean) derived chemicals that have anti-oxidant effects.
Increases in asthma prevalence and severity over the last several decades ...
Individually rare but collectively common intermediate-size copy number variations may be negatively associated with educational attainment, according to a study in the May 26 issue of JAMA. Copy number variations (CNVs) are regions of the genome that differ in the number of segments of DNA.
The Database of Genomic Variants catalogs approximately 2.4 million DNA CNVs. Some of them have been previously implicated as causal of a wide variety of traits and conditions. According to background information in the article large (defined as larger than 500 kb), recurrent CNVs ...
In a small study in Chile that included patients with gallbladder cancer, exposure to aflatoxin (a toxin produced by mold) was associated with an increased risk of gallbladder cancer, according to a study in the May 26 issue of JAMA.
In Chile, gallbladder cancer is a leading cause of cancer death in women. Exposure to aflatoxin, a liver carcinogen, is associated with gallbladder cancer in primates. Aflatoxin contamination has been identified in Chile, including in aji rojo (red chili peppers). Aji rojo is associated with gallbladder cancer; however, the association of ...
(NEW YORK -- May 26, 2015) Spouses of patients receiving hospice for three or more days more frequently reported reduced depression symptoms, compared to surviving spouses of patients who did not receive hospice, according to a study led by researchers at the Icahn School of Medicine at Mount Sinai published online today in JAMA Internal Medicine.
This is the first national study to examine depressive symptoms as an outcome for spouses of people with all types of serious illnesses that used hospice care, which is designed to improve quality of life as opposed to offering ...
A typical characteristic of the brain of an Alzheimer sufferer is the presence of insoluble Tau protein aggregates. Scientists at VIB, KU Leuven and Janssen Pharmaceutica have demonstrated that the distribution of these aggregates through the brain is facilitated by synaptic connections between brain cells. This news is highly significant because the focus is increasingly on repairing synaptic connections as a therapeutic strategy in neurodegenerative diseases such as Alzheimer's. In fact, it is generally accepted that a loss of synaptic connections leads to a loss in cognitive ...
