Videoconferencing Can Boost Mental Health of Distance Cancer Caregivers
NEW YORK (Reuters Health) - Videoconferencing can significantly reduce levels of anxiety and distress among remote caregivers who live more than an hour away from the patients with cancer they support, according to a randomized controlled trial.
"In this time of COVID-19 and distancing, this intervention has the potential to benefit not only the true distance caregivers but other caregivers who may no longer be able to be with their loved one with cancer," lead investigator Dr. Sara Douglas of Case Western Reserve University School of Nursing in Cleveland reported at the American Society of Clinical Oncology (ASCO) virtual annual meeting.
Cancer caregivers are essential to the healthcare team and are crucial to providing quality care to patients, Dr. Douglas explained. Yet, about 20% of cancer caregivers live more than one hour away from the patient.
These "distance caregivers" may experience high levels of anxiety and distress, "which has a negative impact not only on their own health but upon their ability to provide high-quality care to the patient," she said.
The researchers tested the effectiveness of a videoconferencing intervention aimed at reducing anxiety and distress in 441 distance caregivers. Their mean age was 47 years, 71% were women, and 63% were children of the patient. More than 80% were employed and new to the distance caregiver role.
There were three arms to the intervention "each representing a different level of intensity of information and support for the distance caregiver," Dr. Douglas said.
Over the four-month study period, distance caregivers in the full-intervention arm (arm 1) received monthly videoconference coaching sessions with a nurse practitioner or social worker, focused on providing information and support; were able to participate in patient-oncologist visits via videoconference; and had access to a website with information specifically designed for distance caregivers. Arm-2 participants participated in virtual patient-oncologist visits and had access to the same website, while arm-3 participants had access to the website only (control arm).
Changes in levels of distress and anxiety were measured before and after the interventions using a questionnaire.
At baseline, all distance caregivers met or exceeded the threshold for concern for both distress and anxiety. The full intervention appeared to be most effective in reducing caregiver distress and anxiety.
Of the distance caregivers who received the full intervention, 19.2% reported significantly reduced anxiety and 24.8% reported reduced distress - a "moderate to large" effect, according to Dr. Douglas.
Corresponding numbers were 17.3% and 19.8%, respectively, for arm 2 and 13.1% and 18% for arm 3. "It's worth noting that videoconference office visits alone were found to be of some benefit in improving distress and anxiety distance cancer caregivers," Dr. Douglas said.
"Anecdotally, oncologists reported that there were fewer phone calls and emails at the end of the day for them to answer for patients whose distance caregiver participated in the videoconference office visit. Distance caregivers reported liking to hear first-hand from the oncologist and being able to ask their question in real time," Dr. Douglas said.
Dr. Cardinale B. Smith, chief quality officer of Cancer Services at the Mount Sinai Health System in New York City, said, "Caregivers play an important role in cancer care delivery and literature demonstrates that they often have increased anxiety, depression and poorer health outcomes when caring for a loved one with serious illness."
"The intervention described in this abstract is important in that it provides clear and concrete activities (videoconference and coaching) caregivers can participate in to decrease anxiety and stress," Dr. Smith, who was not involved in the research, told Reuters Health by email.
The study was funded by the National Institute of Nursing Research, part of the National Institutes of Health. The authors have no relevant disclosures.
SOURCE: https://bit.ly/2Tl7UXr American Society of Clinical Oncology (ASCO) Annual Meeting 2020.