Using the COPE intervention for family caregivers to improve symptoms of hospice homecare patients: a clinical trial

Abstract

Purpose/objectives: To test an intervention for hospice caregivers designed to help them better manage symptoms experienced by patients with cancer.

Design: A three-group comparative design with repeated measures.

Setting: A large nonprofit hospice that primarily provides home care.

Sample: 329 hospice homecare patients with cancer and their caregivers were randomized into three groups: a control group (n = 109) receiving standard care, a group (n = 109) receiving standard care plus friendly visits, and a group (n = 111) receiving standard care plus the COPE intervention.

Methods: Caregivers received experimental training in the COPE intervention (creativity, optimism, planning, expert information) over nine days to assist with symptom management.

Main research variables: Intensity of pain, dyspnea, and constipation, overall symptom distress, and quality of life (QOL). Data were collected on admission and days 16 and 30.

Findings: Although symptom intensity for three target symptoms did not decrease, symptom distress was significantly improved (p = 0.009) in the COPE intervention group. QOL was not significantly different.

Conclusions: Symptom distress, a measure that encompasses patient suffering along with intensity, was significantly decreased in the group in which caregivers were trained to better manage patient symptoms.

Implications for nursing: The COPE intervention is effective and immediately translatable to the bedside for hospice homecare patients with advanced cancer.