Problem Solving Therapy for Home-Hospice Caregivers: A Pilot Study

Area of Science:

• Gerontology
• Psychology
• Hospice and Palliative Care

Background:

• Family caregivers of hospice patients face significant challenges impacting their quality of life and mental health.
• Problem-solving deficits can exacerbate caregiver burden and distress.
• Existing interventions may not adequately address the specific needs of home-based hospice caregivers.

Purpose of the Study:

• To evaluate the efficacy of Brief Problem-Solving Therapy (PST-Hospice) in improving quality of life, reducing depression, and enhancing problem-solving skills in family caregivers of hospice patients.
• To assess the feasibility and acceptability of PST-Hospice delivered by hospice social workers in a home-hospice setting.

Main Methods:

• A pilot randomized controlled trial involving 37 family caregivers of home-based hospice patients.
• Participants were randomized to either PST-Hospice (45 minutes/week for 5 weeks) or usual care plus caregiver education (UC + CE).
• Assessments included caregiver quality of life, depressive symptoms, and problem-solving functioning (Social Problem Solving Inventory-Revised Short Form) at baseline and follow-up.

Main Results:

• The PST-Hospice group reported significantly higher caregiver quality of life scores post-intervention compared to the UC + CE group.
• PST-Hospice participants showed clinical improvements in Positive Problem Orientation and Rational Problem-Solving subscales of the SPSI-R.
• No significant differences were reported for depressive symptoms.

Conclusions:

• Brief Problem-Solving Therapy is a potentially effective intervention for enhancing quality of life and problem-solving skills in family caregivers of hospice patients.
• The intervention appears feasible and acceptable for routine implementation by hospice social workers in home-hospice care.
• Further research with larger sample sizes is warranted to confirm these findings and explore effects on depressive symptoms.