The proposed study will test the efficacy of a dual component psychoeducational intervention with family caregivers of terminally ill cancer patients. First, the intervention will teach caregivers pain management techniques because pain is a common symptom among terminally ill cancer patients and its managements is the primary concern of caregivers and patients. Proper training of caregivers facilitates their ability to manage patient pain, and good pain management improves the patient's quality of life. Second, the intervention will teach caregivers coping skills they can use to mitigate the stress associated with caregiving. The use of adaptive coping skills with caregiving stressors will improve caregiver well-being and potentially ease their bereavement process. Approximately 81 terminally ill cancer patients and their primary family caregiver will be recruited for the study through three home-care hospice organizations. Participants will be randomly assigned to an intervention group or a usual care group. The initial assessment will occur within two weeks of participants entering the hospice program, and assessment procedures will gather demographic, patient quality of life, patient pain, caregiver well-being, caregiver coping, and satisfaction with medical care data. A one-hour intervention will occur within 24 hours of the first assessment for those caregivers randomized to the intervention group. Follow up assessment will occur two weeks later for all caregivers and patients. Finally, caregivers will be assessed two months after the patient dies. All assessments will occur in the home of the caregiver and patient. This study is the first to test the efficacy of a psychoeducational intervention with caregivers of the terminally ill. It will provide us with an understanding of how caregivers' capacity to provide adequate pain management and to cope with caregiver stressors is related to caregiver well-being and patient quality of life. Furthermore, empirical evaluation of this cost-effective intervention will initiate clinical research programs aimed at assuaging the end of life process for patients and their family caregivers.
