Problem Solving Therapy (PST) has been found effective when delivered to informal caregivers of patients with various conditions. In hospice however its translation to practice is impeded by the increased resources needed for its delivery.
We designed a randomized non-inferiority trial with two groups, Group 1 in which caregivers received PST face to face, and Group 2 via videophone. Family hospice caregivers were recruited from two urban hospice agencies and received the PST intervention (in 3 visits for Group 1 or 3 video-calls in Group 2) in an approximate period of 20 days after hospice admission. Standard caregiver demographic data were collected. We also measured caregiver anxiety, quality of life and problem solving skills at baseline and at completion of the study. 126 caregivers were recruited in the study. PST delivered via video was not inferior to face to face delivery.
The observed changes in scores were similar for each group. Caregiver quality of life improved and state anxiety decreased under both conditions. Audiovisual feedback captured by technology may be sufficient, providing a solution to the geographic barriers that often inhibit the delivery of these types of interventions to older adults in hospice. This study demonstrated that the use of telehealth tools for the delivery of a cognitive behavioral intervention can be as effective as the face to face delivery.
Conclusions: The delivery of PST via videophone was not inferior to face-to-face. Audiovisual feedback captured by technology may be sufficient, providing a solution to the geographic barriers that often inhibit the delivery of these types of interventions to older adults in hospice.
George Demiris, PhD
University of Washington.
Demiris G, Parker Oliver D, Wittenberg-Lyles E, et al: A Noninferiority Trial of a Problem-Solving Intervention for Hospice Caregivers: In Person versus Videophone. J Palliat Med. 2012 Jun;15(6):653-60. Epub 2012 Apr 26.