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Using the COPE Intervention for Family Caregivers to Improve Symptoms of Hospice Homecare Patients: A Clinical Trial

Susan C. McMillan
Brent J. Small
ONF 2007, 34(2), 313-321 DOI: 10.1188/07.ONF.313-321

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.

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