The Added Value of Family Caregivers' Level of Mastery in Predicting Survival of Glioblastoma Patients: A Validation Study.
Florien W Boele, Jason Weimer, Amir H Zamanipoor Najafabadi and 7 others
PMID 34608049WHAT IT FOUND
In glioblastoma patients, caregivers who felt more control over care shortly after diagnosis had patients who survived longer, even after age, function, surgery and MGMT status were considered.
This is not proof that caregiver mastery changes survival.
Key findings
01In the model adjusted for age, KPS, extent of resection and MGMT status, the caregiver mastery result (HR=0.843, 95%CI=0.755-0.940) was consistent with the earlier finding that higher mastery was linked to a lower probability of the patient dying sooner (HR=0.839, 95%CI=0.771-0.913).
02The model's ability to separate patients who survived to 15 months from those who did not was better when mastery was included (C-index 0.737 compared with 0.659 without mastery).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 41 of 120 dyads (34.2%) met the analysis criteria, so confidence intervals were larger than in the first report. Caregivers had to have depressive symptoms to enter the parent trial, so the sample may not represent all glioblastoma caregivers. IDH mutation could not be included because 14.6% of data were missing and only 2 mutations were recorded. Postsurgical treatment could not be modeled because all participants received postoperative chemotherapy and radiotherapy, and because of multicollinearity with KPS. The analysis used baseline data and tested association, not causality.
Declared interests
The authors declared no conflicts of interest. The parent trial was associated with NCI R01-NR013170.
The easy way to misread this
Do not conclude that caregiver mastery causes longer survival or that an intervention to improve mastery will extend life. The study used baseline data from 41 dyads and tested association, not a randomized caregiver intervention.