0
No votes yet
Open Access Article
Evidence-Based Practice

Putting Evidence Into Practice®: Nursing Assessment and Interventions to Reduce Family Caregiver Strain and Burden

Norissa J. Honea
RuthAnn Brintnall
Barbara Given
Paula Sherwood
Deirdre B. Colao
Susan C. Somers
Laurel L. Northouse
CJON 2008, 12(3), 507-516 DOI: 10.1188/08.CJON.507-516

Family caregiving often is associated with multiple rewards, yet the diversity and intensity of caregiving roles also can result in caregiver strain and burden. Using interventions to reduce the strain and burden on caregivers of patients with cancer is an important role nurses play. This article is a critical review and synthesis of the evidence regarding assessment tools and interventions aimed at reducing caregiver strain and burden in the oncology population. Although the striking finding is the limited number of interventions targeted toward oncology caregivers, suggestions from the literature are offered to support and promote healthy outcomes for family caregivers.

References 

Beach, S. R., Schulz, R., Yee, J. L., & Jackson, S. (2000). Negative and positive health effects of caring for a disabled spouse: Longitudinal findings from the caregiver health effects study. <i>Psychology and Aging</i>, 15(2), 259-271.

Bookwala, J., & Schulz, R. (2000). A comparison of primary stressors, secondary stressors, and depressive symptoms between elderly caregiving husbands and wives. <i>Psychology and Aging</i>, 15(4), 607-616.

Cooper, H. (1998). <i>Synthesizing research</i> (3rd ed.). Thousand Oaks, CA: Sage.

Ferrell, B., Grant, M., Chan, J., Ahn, C., & Ferrell, B. (1995). The impact of cancer pain education on family caregivers of elderly patients. <i>Oncology Nursing Forum</i>, 22(8), 1211-1218.

Gaugler, J. E., Hanna, N., Linder, J., Given, C. W., Tolbert, V., Kataria, R., et al. (2005). Cancer caregiving and subjective stress: A multi-site, multi-dimensional analysis. <i>Psycho-Oncology</i>, 14(9), 771-785.

Given, C., Given, B., Stommel, M., Collins, C., King, S., & Franklin, S. (1992). The Caregiver Reaction Assessment (CRA) for caregivers to persons with chronic physical and mental impairments. <i>Research in Nursing and Health</i>, 15(4), 271-283.

Goode, K. T., Haley, W. E., Roth, D. L., & Ford, G. R. (1998). Predicting longitudinal changes in caregiver physical and mental health: A stress process model. <i>Health Psychology</i>, 17(2), 190-198.

Harding, R., Higginson, I. J., Leam, C., Donaldson, N., Pearce, A., George, R., et al. (2004). Evaluation of a short-term group intervention for informal carers of patients attending a home palliative care service. <i>Journal of Pain and Symptom Management</i>, 27(5), 396-408.

Jepson, C., McCorkle, R., Adler, D., Nuamah, I., & Lusk, E. (1999). Effects of home care on caregivers' psychosocial status. <i>Image—Journal of Nursing Scholarship</i>, 31(2), 115-120.

Keefe, F. J., Ahles, T. A., Sutton, L., Dalton, J., Baucom, D., Pope, M. S., et al. (2005). Partner-guided cancer pain management at the end of life: A preliminary study. <i>Journal of Pain and Symptom Management</i>, 29(3), 263-272.

Martire, L. M., Lustig, A. P., Schulz, R., Miller, G. E., & Helgeson, V. S. (2004). Is it beneficial to involve a family member? A metaanalysis of psychosocial interventions for chronic illness. <i>Health Psychology</i>, 23(6), 599-611.

McMillan, S., Small, B., Weitzner, M., Schonwetter, R., Tittle, M., Moody, L., et al. (2006). Impact of coping skills intervention with family caregivers of hospice patients with cancer: A randomized clinical trial. <i>Cancer</i>, 106(1), 214-222.

Mitchell, S. A., & Friese, C. R. (n.d.). Weight of evidence. Retrieved September 6, 2007, from <a target="_blank" href='http://www.ons.org/outcomes/tables/sleep/woe.shtml'>http://www.ons.org/o...

Oberst, M., Thomas, S., Gass, K., & Ward, S. (1989). Caregiving demands and appraisal of stress among family caregivers. <i>Cancer Nursing</i>, 12(4), 209-215.

Pasacreta, J. V., Barg, F., Nuamah, I., & McCorkle, R. (2000). Participant characteristics before and 4 months after attendance at a family caregiver cancer education program. <i>Cancer Nursing</i>, 23(4), 295-303.

Pasacreta, J. V., & McCorkle, R. (2000). Cancer care: Impact of interventions on caregiver outcomes. <i>Annual Review of Nursing Research</i>, 18, 127-148.

Picot, S. J. (1996). Family care givers. Windows into their worlds. <i>Reflections</i>, 22(4), 13-14.

Pinquart, M., & Sorenson, S. (2003). Associations of stressors and uplifts of caregiving with caregiver burden and depressive mood: A meta-analysis. <i>Journals of Gerontology Series B: Psychological Sciences and Social Sciences</i>, 58(2), P112-P128.

Portenoy, R. K., Thaler, H. T., Kornblith, A. B., Lepore, J. M., Friedlander-Klar, H., Coyle, N., et al. (1994). Symptom prevalence, characteristics and distress in a cancer population. <i>Quality of Life Research</i>, 3(3), 183-189.

Porter, L., Keefe, F., McBride, C., Pollak, K., Fish, L., & Garst, J. (2002). Perceptions of patients' self-efficacy for managing pain and lung cancer symptoms: Correspondence between patients and family caregivers. <i>Pain</i>, 98(1-2), 169-178.

Rexilius, S. J., Mundt, C., Erickson Megel, M., & Agrawal, S. (2002). Therapeutic effects of massage therapy and healing touch on caregivers of patients undergoing autologous hematopoietic stem cell transplant [Online exclusive]. <i>Oncology Nursing Forum</i>, 29(3), E35-E44. Retrieved April 15, 2008, from http://ons.metapress.com/context/n32p3381648866h8/fulltext.pdf <a target="_blank" href='http://ons.metapress.com/context/n32p3381648866h8/fulltext.pdf'>http://o...

Robinson, B. (1983). Validation of a Caregiver Strain Index. <i>Journals of Gerontology</i>, 38(3), 344-348.

Ropka, M. E., & Spencer-Cisek, P. (2001). PRISM: Priority Symptom Management Project phase I: Assessment. <i>Oncology Nursing Forum</i>, 28(10), 1585-1594.

Schulz, R., & Beach, S. R. (2000). Negative and positive health effects of caring for a disabled spouse: Longitudinal findings from the Caregiver Health Effects Study. <i>Psychology and Aging</i>, 15(4), 607-616.

Sherwood, P. R., Given, B. A., Given, C. W., Schiffman, R. F., Murman, D. L., Lovely, M., et al. (2006). Predictors of distress in caregivers of persons with a primary malignant brain tumor. <i>Research in Nursing and Health</i>, 29(2), 105-120.

Sherwood, P. R., Given, C. W., Given, B. A., & von Eye, A. (2005), Caregiver burden and depressive symptoms: Analysis of common outcomes in caregivers of elderly patients. <i>Journal of Aging and Health</i>, 17(2), 125-147.

Sorenson, S., Pinquart, M., & Duberstein, P. (2002). How effective are interventions with caregivers? An updated meta-analysis. <i>Gerontologist</i>, 42(3), 356-372.

Stetz, K. (1987). Caregiving demands during advanced cancer: The spouse's needs. <i>Cancer Nursing</i>, 10(5), 260-268.

Stommel, M., Wang, S., Given, C., & Given, B. (1992). Confirmatory factor analysis (CFA) as a method to assess measurement equivalence. <i>Research in Nursing and Health</i>, 15(5), 399-405.

Toseland, R., Blanchard, C., & McCallion, P. (1995). A problem solving intervention for caregivers of cancer patients. <i>Social Science and Medicine</i>, 40(4), 517-528.

Townsend, P. (1957). <i>The family life of old people: An inquiry in East London.</i> London, England: Eoutledge and Kegan Paul.

Vitaliano, P. P., Zhang, J., & Scanlan, J. M. (2003). Is caregiving hazardous to one's physical health? A meta-analysis. <i>Psychological Bulletin</i>, 129(6), 946-972.

Yin, T., Zhou, Q., & Bashford, C. (2002). Burden on family members: Caring for frail elderly: A meta-analysis of interventions. <i>Nursing Research</i>, 51(3), 199-208.

Zarit, S., Reever, K., & Bach-Peterson, J. (1980). Relatives of the impaired elderly: Correlates of feelings of burden. <i>Gerontologist</i>, 20(6), 649-655.

Martire, L. M., Lustig, A. P., Schulz, R., Miller, G. E., & Helgeson, V. S. (2004). Is it beneficial to involve a family member? A meta-analysis of psychosocial interventions for chronic illness. <i>Health Psychology</i>, 23(6), 599-611.

Sorenson, S., Pinquart, M., & Duberstein, P. (2002). How effective are interventions with caregivers? An updated meta-analysis. <i>Gerontologist</i>, 42(3), 356-372.

Harding, R., Higginson, I. J., Leam, C., Donaldson, N., Pearce, A., George, R., et al. (2004). Evaluation of a short-term group intervention for informal carers of patients attending a home palliative care service. <i>Journal of Pain and Symptom Management</i>, 27(5), 396-408.

Jepson, C., McCorkle, R., Adler, D., Nuamah, I., & Lusk, E. (1999). Effects of home care on caregivers' psychosocial status. <i>Image—Journal of Nursing Scholarship</i>, 31(2), 115-120.

Rexilius, S. J., Mundt, C., Erickson Megel, M., & Agrawal, S. (2002). Therapeutic effects of massage therapy and healing touch on caregivers of patients undergoing autologous hematopoietic stem cell transplant [Online exclusive]. <i>Oncology Nursing Forum</i>, 29(3), E35-E44. Retrieved April 15, 2008, from http://ons.metapress.com/context/n32p3381648866h8/fulltext.pdf <a target="_blank" href='http://ons.metapress.com/context/n32p3381648866h8/fulltext.pdf'>http://o...

Ferrell, B. R., Grant, M., Chan, J., Ahn, C., & Ferrell, B. A. (1995). The impact of cancer pain education on family caregivers of elderly patients. <i>Oncology Nursing Forum</i>, 22(8), 1211-1218.

Keefe, F. J., Ahles, T. A., Sutton, L., Dalton, J., Baucom, D., Pope, M. S., et al. (2005). Partner-guided cancer pain management at the end of life: A preliminary study. <i>Journal of Pain and Symptom Management</i>, 29(3), 263-272.

Alecxih, L. M., Zeruld, S., & Olearczyk, B. (2001). <i>Characteristics of caregivers based on the survey of income and program participation.</i> Retrieved September 5, 2007, from <a target="_blank" href='http://www.lewin.com/NR/rdonlyres/249B1D52-EFCC-48D8-B9C7-86BB4A34E0C9/0...

American Cancer Society. (2008). <i>Cancer facts and figures 2008.</i> Atlanta, GA: Author.

Archbold, P. G., Stewart, B. J., Greenlick, M. R., & Harvath, T. (1990). Mutuality and preparedness as predictors of caregiver role strain. <i>Research in Nursing and Health</i>, 13(6), 375-384.

Arno, P. S. (2006). <i>Economic value and informal caregiving.</i> Paper presented at the Care Coordination and Caregiving Forum, Department of Veterans Affairs, Bethesda, MD.

Guyatt, G. H., Sackett, D. L., & Cook, D. J. (1993). Users guide to medical literature. <i>JAMA</i>, 270(21), 2598-2601.

Guyatt, G. H., Sackett, D. L., & Cook, D. J. (1994). How to use an article about therapy or prevention. <i>JAMA</i>, 271(1), 59-63.

Harding, R., & Higginson, I. J. (2003). What is the best way to help caregivers in cancer and palliative care? A systematic literature review of interventions and their effectiveness. <i>Palliative Medicine</i>, 17(1), 63-74.

McMillan, S. C., Small, B. J., Weitzner, M., Schonwetter, R., Tittle, M., Moody, L., et al. (2006). Impact of coping skills intervention with family caregivers of hospice patients with cancer: A randomized clinical trial. <i>Cancer</i>, 106(1), 214-222.

Toseland, R. W., Blanchard, C. G., & McCallion, P. (1995). A problem solving intervention for caregivers of cancer patients. <i>Social Science and Medicine</i>, 40(4), 517-528.

Pasacreta, J. V., Barg, F., Nuamah, I., & McCorkle, R. (2000). Participant characteristics before and 4 months after attendance at a family caregiver cancer education program. <i>Cancer Nursing</i>, 23(4), 295-303.