Donald E Bailey1, Cristina C Hendrix2, Karen E Steinhauser3, Karen M Stechuchak4, Laura S Porter5, Julie Hudson6, Maren K Olsen7, Andrew Muir8, Sarah Lowman9, Andrea DiMartini10, Laurel Williams Salonen11, James A Tulsky12. 1. Duke University School of Nursing, Durham NC, USA; Duke Center for the Study of Aging and Human Development, Durham, USA. Electronic address: chip.bailey@duke.edu. 2. Duke University School of Nursing, Durham NC, USA; Durham Veterans Affairs Medical Center Geriatric Research, Education, and Clinical Center, Durham, USA; Duke Center for the Study of Aging and Human Development, Durham, USA. Electronic address: cristina.hendrix@duke.edu. 3. Division of General Medicine, Department of Medicine, Duke University School of Medicine, Durham, USA; Duke Palliative Care, Duke University Health System, Durham, USA; Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, USA. Electronic address: karen.steinhauser@duke.edu. 4. Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, USA. Electronic address: karen.stechuchak@duke.edu. 5. Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, USA. Electronic address: laura.porter@duke.edu. 6. Duke Transplant Center, Duke University School of Medicine, Durham, USA. Electronic address: julie.hudson@duke.edu. 7. Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, USA; Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, USA. Electronic address: maren.olsen@duke.edu. 8. Division of Gastroenterology, Department of Medicine, Duke University School of Medicine, Durham, USA. Electronic address: andrew.muir@duke.edu. 9. Duke Palliative Care, Duke University Health System, Durham, USA. Electronic address: slowman@email.unc.edu. 10. University of Pittsburgh Medical Center, Departments of Psychiatry and Surgery, Starzl Transplant Institute Pittsburgh, USA. Electronic address: DiMartiniAF@upmc.edu. 11. Organ Transplantation Program, The University of Nebraska Medical Center, 983285 Nebraska Medical Center, Omaha, USA. Electronic address: lsalonen@nebraskamed.com. 12. Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, USA; Division of Palliative Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, USA; Center for Palliative Care, Harvard Medical School, Boston, USA. Electronic address: jamesa_tulsky@dfci.harvard.edu.
Abstract
OBJECTIVE: We tested an uncertainty self-management telephone intervention (SMI) with patients awaiting liver transplant and their caregivers. METHODS: Participants were recruited from four transplant centers and completed questionnaires at baseline, 10, and 12 weeks from baseline (generally two and four weeks after intervention delivery, respectively). Dyads were randomized to either SMI (n=56) or liver disease education (LDE; n=59), both of which involved six weekly telephone sessions. SMI participants were taught coping skills and uncertainty management strategies while LDE participants learned about liver function and how to stay healthy. Outcomes included illness uncertainty, uncertainty management, depression, anxiety, self-efficacy, and quality of life. General linear models were used to test for group differences. RESULTS: No differences were found between the SMI and LDE groups for study outcomes. CONCLUSION: This trial offers insight regarding design for future interventions that may allow greater flexibility in length of delivery beyond our study's 12-week timeframe. PRACTICE IMPLICATIONS: Our study was designed for the time constraints of today's clinical practice setting. This trial is a beginning point to address the unmet needs of these patients and their caregivers as they wait for transplants that could save their lives.
RCT Entities:
OBJECTIVE: We tested an uncertainty self-management telephone intervention (SMI) with patients awaiting liver transplant and their caregivers. METHODS:Participants were recruited from four transplant centers and completed questionnaires at baseline, 10, and 12 weeks from baseline (generally two and four weeks after intervention delivery, respectively). Dyads were randomized to either SMI (n=56) or liver disease education (LDE; n=59), both of which involved six weekly telephone sessions. SMIparticipants were taught coping skills and uncertainty management strategies while LDEparticipants learned about liver function and how to stay healthy. Outcomes included illness uncertainty, uncertainty management, depression, anxiety, self-efficacy, and quality of life. General linear models were used to test for group differences. RESULTS:No differences were found between the SMI and LDE groups for study outcomes. CONCLUSION: This trial offers insight regarding design for future interventions that may allow greater flexibility in length of delivery beyond our study's 12-week timeframe. PRACTICE IMPLICATIONS: Our study was designed for the time constraints of today's clinical practice setting. This trial is a beginning point to address the unmet needs of these patients and their caregivers as they wait for transplants that could save their lives.
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