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Does problem-solving training for family caregivers benefit their care recipients with severe disabilities? A latent growth model of the Project CLUES randomized clinical trial.

ABSTRACT: To examine whether an individualized problem-solving intervention provided to family caregivers of persons with severe disabilities provides benefits to both caregivers and their care recipients.Family caregivers were randomly assigned to an education-only control group or a problem-solving training (PST) intervention group. Participants received monthly contacts for 1 year.Family caregivers (129 women, 18 men) and their care recipients (81 women, 66 men) consented to participate.Caregivers completed the Social Problem-Solving Inventory-Revised, the Center for Epidemiological Studies-Depression scale, the Satisfaction with Life scale, and a measure of health complaints at baseline and in 3 additional assessments throughout the year. Care recipient depression was assessed with a short form of the Hamilton Depression Scale.Latent growth modeling was used to analyze data from the dyads. Caregivers who received PST reported a significant decrease in depression over time, and they also displayed gains in constructive problem-solving abilities and decreases in dysfunctional problem-solving abilities. Care recipients displayed significant decreases in depression over time, and these decreases were significantly associated with decreases in caregiver depression in response to training.PST significantly improved the problem-solving skills of community-residing caregivers and also lessened their depressive symptoms. Care recipients in the PST group also had reductions in depression over time, and it appears that decreases in caregiver depression may account for this effect.

SUBMITTER: Berry JW

PROVIDER: S-EPMC3401541 | biostudies-other | 2012 May

REPOSITORIES: biostudies-other

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Does problem-solving training for family caregivers benefit their care recipients with severe disabilities? A latent growth model of the Project CLUES randomized clinical trial.

Berry Jack W JW Elliott Timothy R TR Grant Joan S JS Edwards Gary G Fine Philip R PR

Rehabilitation psychology 20120501 2

<h4>Objective</h4>To examine whether an individualized problem-solving intervention provided to family caregivers of persons with severe disabilities provides benefits to both caregivers and their care recipients.<h4>Design</h4>Family caregivers were randomly assigned to an education-only control group or a problem-solving training (PST) intervention group. Participants received monthly contacts for 1 year.<h4>Participants</h4>Family caregivers (129 women, 18 men) and their care recipients (81 w ...[more]

PMID: 22686549

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Project description:The main goal of the present study was to explore the role of sleep in the process of ill-defined problem solving. The results of previous studies indicate that various cognitive processes are largely dependent on the quality and quantity of sleep. However, while sleep-related memory consolidation seems to be well-grounded, with regard to the impact of sleep on problem solving, existing research yields mixed and rather inconclusive results. Moreover, this effect has been mainly tested using simple and well-defined, common laboratory problems, such as the remote associate test (RAT), crossword and anagram puzzles, numeric and logic problems, etc. What is lacking is research on the effect of sleep on solving more complex and more real-life oriented ill-defined problems. In the present study, we hypothesized that sleep can improve performance in solving this kind of problems. The study involved 40 participants, randomly assigned to two experimental conditions: sleep group and waking group. The experimental protocol comprised three stages: problem presentation, retention interval, and testing stage. The problem was presented to the participants in the form of an interactive computer game concerning a complex, elaborate crime story. During the retention interval, the participants-depending on the condition-took a nap or stayed awake; sleeping participants underwent polysomnography recording, while waking participants performed activities not related to the experimental problem. In the testing stage, participants tried to solve the presented problem. The solutions generated were assessed both for quality (reasonableness, consistency, and story recall) and creativity (fluency, flexibility, originality, and elaboration). Contrary to expectations, we found no effect of sleep on ill-defined problem solving. Neither quality nor creativity of the solutions generated by the participants was higher in the nap group than in the waking group. There were also no performance improvements with regard to any sleep stage or incidence of dreams. Our study adds to a growing body of evidence that sleep probably might provide an incubation gap, but not a facilitating environment serving the purpose of problem solving, at least with regard to ill-defined problems.

Project description:OBJECTIVES:Family caregivers of hospice patients have multiple needs as they try to cope during a stressful time. Translatable interventions effective in improving caregiver outcomes are greatly needed. Our objective was to assess the impact of a problem-solving intervention (called Problem-Solving Intervention to Support Caregivers in End-of-Life Care Settings [PISCES]) to support hospice caregivers on caregiver quality of life and anxiety, and compare its effectiveness delivered face to face and via videoconferencing. DESIGN:In this 4-year randomized clinical trial, caregivers were randomly assigned to a group receiving standard care with added "friendly calls" (attention control [AC] group), a group receiving standard care and PISCES delivered face to face (F2F), or a group receiving standard care and PISCES delivered via videoconferencing (VC). SETTING:Home hospice. PARTICIPANTS:A total of 514 caregivers participated (172 in AC, 171 in F2F, and 171 in VC). Caregivers were predominantly female (75%); mean age was 60.3 years. INTERVENTION:PISCES includes a structured curriculum delivered in three sessions and motivates caregivers to adopt a positive attitude, define problems by obtaining facts, set goals, and generate and evaluate solutions. MEASUREMENTS:Quality of life was measured by the Caregiver Quality of Life Index-Revised; anxiety was measured by the Generalized Anxiety Disorder 7-Item. Other measures included the Caregiver Reaction Assessment scale, demographic data, and an exit interview. RESULTS:Compared with AC, caregivers in the F2F condition had postintervention reduced anxiety (-1.31 [95% confidence interval [CI]?=?-2.11 to .50]; p?=?.004) and improved social (.57 [95% CI?=?.19-.95]; p?=?.01), financial (.57 [95% CI?=?.21-.93]; p?=?.004), and physical quality of life (.53 [95% CI?=?.19-.87]; p?=?.01). There were no differences in caregivers in the VC condition compared with the AC condition. CONCLUSION:The PISCES intervention improves caregiver outcomes and is effective when delivered in person. How to integrate technology to reduce the intervention delivery cost warrants further investigation.

Project description:ObjectivesProblem-solving skills training is adaptable, inexpensive and simple to deliver. However, its application with prisoners who self-harm is unknown. The study assessed the feasibility and acceptability of a problem-solving training (PST) intervention for prison staff and prisoners who self-harm, to inform the design of a large-scale study.Design and settingA mixed-methods design used routinely collected data, individual outcome measures, an economic protocol and qualitative interviews at four prisons in Yorkshire and Humber, UK.Participants(i) Front-line prison staff, (ii) male and female prisoners with an episode of self-harm in the previous 2 weeks.InterventionThe intervention comprised a 1 hour staff training session and a 30 min prisoner session using adapted workbooks and case studies.OutcomesWe assessed the study processes-coverage of training; recruitment and retention rates and adequacy of intervention delivery-and available data (completeness of outcome data, integrity of routinely collected data and access to the National Health Service (NHS) resource information). Prisoner outcomes assessed incidence of self-harm, quality of life and depression at baseline and at follow-up. Qualitative findings are presented elsewhere.ResultsRecruitment was higher than anticipated for staff n=280, but lower for prisoners, n=48. Retention was good with 43/48 (89%) prisoners completing the intervention, at follow-up we collected individual outcome data for 34/48 (71%) of prisoners. Access to routinely collected data was inconsistent. Prisoners were frequent users of NHS healthcare. The additional cost of training and intervention delivery was deemed minimal in comparison to 'treatment as usual'. Outcome measures of self-harm, quality of life and depression were found to be acceptable.ConclusionsThe intervention proved feasible to adapt. Staff training was delivered but on the whole it was not deemed feasible for staff to deliver the intervention. A large-scale study is warranted, but modifications to the implementation of the intervention are required.

Dataset Information

Does problem-solving training for family caregivers benefit their care recipients with severe disabilities? A latent growth model of the Project CLUES randomized clinical trial.

Publications

Does problem-solving training for family caregivers benefit their care recipients with severe disabilities? A latent growth model of the Project CLUES randomized clinical trial.

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