Dyadic psychological intervention for patients with cancer and caregivers in home-based, specialized palliative care.: The Domus model

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DOI

    Annika Berglind von Heymann-Horan, Danish Cancer Society Research Center, The Danish Cancer Society, Copenhagen, Louise Berg Puggaard, Institut for psykologi, Københavns Universitet, DanmarkKathrine Grovn Nissen, Institut for Psykologi, Københavns Universitet, DanmarkKirstine Skov Benthien, Department of Onkology, University Hospital of Copenhagen, Rigshospitalet, Det Sundhedsvidenskabelige Fakultet, Københavns Universitet, Pernille E Bidstrup, Danish Cancer Society Research Center, The Danish Cancer Society, Copenhagen, James Coyne, Department of Psychiatry,University of Pennsylvania,Philadelphia,PA,USA., the University of Groningen, University Medical Centre Groningen, European Research Institute for the Biology of Aging, 9700 AD Groningen, The Netherlands., USAChristoffer Johansen, Danish Cancer Society Research Centre, Danish Cancer Society, Copenhagen, Denmark., Department of Onkology, University Hospital of Copenhagen, Rigshospitalet, DanmarkJakob Kjellberg, KORA Det Nationale Institut for Kommuners og Regioners Analyse og Forskning , DanmarkMie Nordly, Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Københavns Universitet, Det Sundhedsvidenskabelige Fakultet, Per Sjøgren, Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Helle Timm, Videnscenter for Rehabilitering og Palliation - Syddansk Universitet, Hans von der Maase, Department of Oncology, Rigshospitalet, Copenhagen University Hospital,
  • Mai-Britt Guldin

Patients with incurable cancer and their informal caregivers have numerous psychological and psychosocial needs. Many of these patients wish to receive their care and die at home. Few home-based specialized palliative care (SPC) interventions systematically integrate psychological support. We present a psychological intervention for patient–caregiver dyads developed for an ongoing randomized controlled trial (RCT) of home-based SPC, known as Domus, as well as the results of an assessment of its acceptability and feasibility.
The Domus model of SPC for patients with incurable cancer and their caregivers offered systematic psychological assessment and dyadic intervention as part of interdisciplinary care. Through accelerated transition to SPC, the aim of the model was to enhance patients' chances of receiving care and dying at home. Integration of psychological support sought to facilitate this goal by alleviating distress in patients and caregivers. Psychologists provided needs-based sessions based on existential-phenomenological therapy. Feasibility and acceptability were investigated by examining enrollment, nonparticipation, and completion of psychological sessions.
Enrollment in the RCT and uptake of the psychological intervention indicated that it was feasible and acceptable to patients and caregivers. The strengths of the intervention included its focus on dyads, psychological distress, and existential concerns, as well as interdisciplinary collaboration and psychological interventions offered according to need. Its main limitation was a lack of an intervention for other family members.
Our results show that psychological intervention can be systematically integrated into SPC and that it appears feasible to provide dyadic needs-based sessions with an existential therapeutic approach. The Domus RCT will provide evidence of the efficacy of a novel model of multidisciplinary SPC.
OriginalsprogEngelsk
TidsskriftPalliative & Supportive Care
Sider (fra-til)9
ISSN1478-9515
DOI
StatusUdgivet - 2017

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