Annika B von Heymann-Horan1, Louise B Puggaard2, Kathrine G Nissen2, Kirstine Skov Benthien3, Pernille Bidstrup1, James Coyne4, Christoffer Johansen1, Jakob Kjellberg5, Mie Nordly3, Per Sjøgren3, Helle Timm6, Hans von der Maase7, Mai-Britt Guldin8. 1. Danish Cancer Society Research Center,Copenhagen,Denmark. 2. Department of Psychology,University of Copenhagen,Copenhagen,Denmark. 3. Palliative Research Group,Department of Oncology,Rigshospitalet, Copenhagen University Hospital,Copenhagen,Denmark. 4. Department of Psychiatry,University of Pennsylvania School of Medicine,Philadelphia,Pennsylvania,USA. 5. KORA,The Danish Institute for Local and Regional Government Research,Copenhagen,Denmark. 6. Knowledge Center for Rehabilitation and Palliative Care, University of Southern Denmark,Copenhagen,Denmark. 7. Department of Oncology,Rigshospitalet, Copenhagen University Hospital,Denmark. 8. Research Unit for General Practice, Aarhus University,Aarhus,Denmark.
Abstract
ABSTRACTObjective:Patients with incurable cancer and their informal caregivers have numerous psychological and psychosocial needs. Many of these patients wish to receive their care and die at home. Few home-based specialized palliative care (SPC) interventions systematically integrate psychological support. We present a psychological intervention for patient-caregiver dyads developed for an ongoing randomized controlled trial (RCT) of home-based SPC, known as Domus, as well as the results of an assessment of its acceptability and feasibility. METHOD: The Domus model of SPC for patients with incurable cancer and their caregivers offered systematic psychological assessment and dyadic intervention as part of interdisciplinary care. Through accelerated transition to SPC, the aim of the model was to enhance patients' chances of receiving care and dying at home. Integration of psychological support sought to facilitate this goal by alleviating distress in patients and caregivers. Psychologists provided needs-based sessions based on existential-phenomenological therapy. Feasibility and acceptability were investigated by examining enrollment, nonparticipation, and completion of psychological sessions. RESULTS: Enrollment in the RCT and uptake of the psychological intervention indicated that it was feasible and acceptable to patients and caregivers. The strengths of the intervention included its focus on dyads, psychological distress, and existential concerns, as well as interdisciplinary collaboration and psychological interventions offered according to need. Its main limitation was a lack of an intervention for other family members. SIGNIFICANCE OF RESULTS: Our results show that psychological intervention can be systematically integrated into SPC and that it appears feasible to provide dyadic needs-based sessions with an existential therapeutic approach. The Domus RCT will provide evidence of the efficacy of a novel model of multidisciplinary SPC.
RCT Entities:
ABSTRACTObjective:Patients with incurable cancer and their informal caregivers have numerous psychological and psychosocial needs. Many of these patients wish to receive their care and die at home. Few home-based specialized palliative care (SPC) interventions systematically integrate psychological support. We present a psychological intervention for patient-caregiver dyads developed for an ongoing randomized controlled trial (RCT) of home-based SPC, known as Domus, as well as the results of an assessment of its acceptability and feasibility. METHOD: The Domus model of SPC for patients with incurable cancer and their caregivers offered systematic psychological assessment and dyadic intervention as part of interdisciplinary care. Through accelerated transition to SPC, the aim of the model was to enhance patients' chances of receiving care and dying at home. Integration of psychological support sought to facilitate this goal by alleviating distress in patients and caregivers. Psychologists provided needs-based sessions based on existential-phenomenological therapy. Feasibility and acceptability were investigated by examining enrollment, nonparticipation, and completion of psychological sessions. RESULTS: Enrollment in the RCT and uptake of the psychological intervention indicated that it was feasible and acceptable to patients and caregivers. The strengths of the intervention included its focus on dyads, psychological distress, and existential concerns, as well as interdisciplinary collaboration and psychological interventions offered according to need. Its main limitation was a lack of an intervention for other family members. SIGNIFICANCE OF RESULTS: Our results show that psychological intervention can be systematically integrated into SPC and that it appears feasible to provide dyadic needs-based sessions with an existential therapeutic approach. The Domus RCT will provide evidence of the efficacy of a novel model of multidisciplinary SPC.
Entities:
Keywords:
Cancer; Existential therapy; Family caregiver; Palliative care; Psychological intervention
Authors: Annika von Heymann-Horan; Pernille Bidstrup; Mai-Britt Guldin; Per Sjøgren; Elisabeth Anne Wreford Andersen; Hans von der Maase; Jakob Kjellberg; Helle Timm; Christoffer Johansen Journal: Br J Cancer Date: 2018-11-14 Impact factor: 7.640
Authors: Pinky Shani; Kristin Raeesi; Eli Walter; Kai Lewis; Wanyi Wang; Lorenzo Cohen; Gloria Y Yeh; Cecile A Lengacher; Peter M Wayne Journal: Pilot Feasibility Stud Date: 2021-03-19
Authors: Lea J Jabbarian; Ida J Korfage; Branka Červ; Johannes J M van Delden; Luc Deliens; Guido Miccinesi; Sheila Payne; Anna Thit Johnsen; Mariëtte N Verkissen; Andrew Wilcock; Agnes van der Heide; Judith A C Rietjens Journal: Psychooncology Date: 2019-11-20 Impact factor: 3.894
Authors: Christine Marie Bækø Halling; Rasmus Trap Wolf; Per Sjøgren; Hans Von Der Maase; Helle Timm; Christoffer Johansen; Jakob Kjellberg Journal: BMC Palliat Care Date: 2020-09-15 Impact factor: 3.234