Does Caregiver Participation in Advance Care Planning Using a Decision Support Tool Together With Patients Reduce Caregiver Strain, Burden and Anxiety Over Time? A Post-Hoc Analysis of a Randomized Controlled Trial.
Bronson R Kunzler, Andrew J Foy, Benjamin H Levi and 4 others
PMID 34414808WHAT IT FOUND
Family caregivers who completed advance care planning together with patients using a decision aid did not have less strain, burden, or anxiety over time than caregivers in other planning groups.
Key findings
01Caregiver strain increased from baseline in all study arms, and the MYWK together group had the largest increase, but differences between groups were not significant.
02Caregiver burden increased from baseline in two of the four groups, with the MYWK together group showing the largest increase, but group differences were not significant.
03Anxiety increased from baseline in all study groups, and the Standard alone group had the largest increase, but the MYWK together group did not differ significantly from other groups.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
This was a post-hoc analysis, and the parent trial was powered to detect changes in caregiver self-efficacy, not differences over time in strain, burden, or anxiety. Of 285 dyads enrolled, 246 completed both visits and all measures, and only the first 24 months of interview data were analysed because of attrition. The caregivers were 75% female and 57.3% spouses or domestic partners of patients with specified advanced illnesses, so results may not apply to other caregiver groups. The authors suggest standard scales may not fully capture complex caregiver distress, and the numerical increases were not significant.
Declared interests
Two authors have intellectual property and copyright interests in the MYWK decision aid. MYWK has been made available free of charge for research and education. The other authors declared no conflicts.
The easy way to misread this
Do not conclude that MYWK together with patients worsens caregiver strain, burden, or anxiety. The largest increases were numerical and not significantly different between groups, and strain and anxiety rose over time in all groups.