We propose to implement and evaluate the efficacy of a short-term problem-solving skills training program for familial caregivers to lower income older (60+) post-treatment cancer patients. The goal of the intervention is to equip family caregivers with problem-solving skills and knowledge that will provide them with a more adaptive means of attending to any symptoms their elderly relative may be experience during the cancer survivorship period. By focusing attention on families' potential role in palliative care efforts during the post-treatment period, we propose that we will be able to impact patients' health related quality of life, by fostering enhanced symptom recognition, improved symptom control, advocacy with health professionals, and adherence to symptom management options. Familial caregivers to older cancer patients who have completed active treatment will be accrued from Community/Migrant Health Centers (C/MHCs). Caregivers and patients will be followed for ten months.
The specific aims are to: (1) Deliver a brief problem-solving training program with regard to symptom management ('Problem-solving') to enhance caregiver skills (i.e., perceived self-efficacy, social problem-solving and communication) of familial caregivers to older post-treatment cancer patients. (2) Evaluate the efficacy of problem-solving in enhancing caregiver skills, relative to participating in a caregiver support group ('Support'): (a) Assess short- and long-term change in caregiver skills reported by caregivers assigned to either the Problem-solving condition or the Support condition; and, (b) Compare change reported by caregivers in the Problem-solving condition, relative to reports by those in the Support condition; (3) Assess the impact of change in caregiver skills on: (a) Change in patients' symptomology and physical functioning, depressive symptomology, anxiety, quality of life, perceptions of and satisfaction with care ('patient outcomes'); (b) Change in caregivers' depressive symptomology, anxiety, quality of life, perceptions of and satisfaction with patient care ('caregiver outcomes'). (4) Disseminate information that informs family training in palliation and symptom control to participating C/MHCs and other C/MHCs serving these populations, contingent on demonstrating beneficial program outcomes.
