A Computer-Based Intervention for Distance Caregivers of Parents With Advanced Cancer

Case Comprehensive Cancer Center7 enrolled

Overview

This pilot clinical trial studies the feasibility and effectiveness of a new computer-based communication intervention in supporting distance caregivers of patients with advanced lung or brain cancer. Unlike local caregivers, distance caregivers often receive little, if any, professional support and have limited communication with the oncology team. Using a computer-based communication intervention to allow distance caregivers the opportunity to participate in a physician visit, have questions and concerns addressed, and meet members of the oncology team may help reduce stress.

PRIMARY OBJECTIVES: I. What is the relationship of primary stressors (type and stage/grade of cancer, and patient quality of life \[QOL\]) and structural factors/stressors (age, gender, race, and education) with patient and caregiver psychological outcomes at baseline? II. What are the effects of the Communication with Long Distance Caregivers Offering a Supportive Electronic Resource (CLOSER) intervention on distance caregiver psychological outcomes (anxiety and distress), controlling for primary stressors (type and stage/grade of cancer, and patient quality of life), distance caregiver structural factors/stressors (caregiver age, gender, race, and employment), and baseline anxiety and distress? III. What are the effects of the CLOSER intervention on patient psychological outcomes (anxiety and distress), controlling for primary stressors (type and stage/grade of cancer, and patient quality of life), distance caregiver structural factors/stressors (caregiver age, gender, race, and employment), and baseline anxiety and distress? IV. What is the feasibility (time, cost, resources and acceptability to patients, caregivers and clinicians) of using Adobe Connect, a computer-based web communication system, with the distance caregiver, the parent with advanced cancer, and the health care providers together in a routine follow-up oncology office visit? V. What is the experience of being a distance caregiver participating in the CLOSER intervention? OUTLINE: Participants are assigned to 1 of 2 arms. ARM I: Participants receive usual care for 5 weeks. During the week 5 office visit, distance caregivers are not present. ARM II: Participants receive usual care for 5 weeks. During the week 5 visit, distance caregivers virtually attend using the CLOSER intervention with computer video and audio connection. After completion of study, participants are followed up within 48-96 hours.

Study Type

INTERVENTIONAL

Allocation

Interventions

Usual carePROCEDURE

Health care provided by physician, physician's nurse, and social worker

computer-assisted interventionOTHER

Caregiver will virtually attend visit using the CLOSER intervention

Distress ThermometerOTHER

Average score of a one item scale (range 0-10) where higher scores indicate more distress

Profile of Mood States (POMS-B)OTHER

average score of five items scored 0-4 which describe how someone is feeling. Higher scores indicate increased discomfort

Quality of Life: Functional Assessment in Cancer Therapy - (FACT)OTHER

Average score of FACT which quantitatively assesses brain cancer patient's physiological functional and quality of life. FACT questions are scored 0-4 with higher numbers indicating more functionality

Tension-Anxiety SubscaleOTHER

six item scale which asks to qualitatively describe which areas in you life are causing stress

Eligibility

Sex: ALLMin age: 18 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: INCLUSION CRITERIA FOR PATIENTS: * Having a diagnosis of advanced lung cancer or malignant brain tumor for two to six months * Receiving on-going care from the medical oncologist at the Seidman Cancer Center * Having a primary and distance caregiver involved in their care, support, and/or care planning * English as a primary language * Capacity to provide informed consent, as validated by the oncologist INCLUSION CRITERIA FOR DISTANCE CAREGIVERS: * Family caregiver of a patient with advanced lung cancer or malignant brain tumor * Patient and distance caregiver perception that this caregiver's geographic location is such that precludes routine participation in medical appointments * English as primary language * Capable of providing informed consent * Computer ownership with internet access Exclusion Criteria: EXCLUSION CRITERIA FOR PATIENTS: * No primary caregiver * Enrolled in hospice EXCLUSION CRITERIA FOR DISTANCE CAREGIVERS: * Those who routinely participate in most of the patient's medical appointments (once or more per month)

Outcomes

Primary Outcomes

Primary stressors (type and stage/grade of cancer, and patient QOL)

Regression analysis will be run to explore the influence of primary stressors and structural factors on patient and caregiver outcomes (anxiety and distress).

Time frame: Baseline

effect of CLOSER intervention on caregiver anxiety

A two sample t-test will be conducted to compare differences in baseline to post-treatment POMS-B scores between the usual care and intervention caregiver groups