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The feasibility and acceptability of a chaplain-led intervention for caregivers of seriously ill patients: A Caregiver Outlook pilot study

Published online by Cambridge University Press:  29 October 2015

Karen E. Steinhauser ,
Annette Olsen ,
Kimberly S. Johnson ,
Linda L. Sanders ,
Maren Olsen ,
Natalie Ammarell  and
Daniel Grossoehme
Karen E. Steinhauser*
Affiliation:
Duke Palliative Care, Department of Medicine, Duke University School of Medicine, Durham, North Carolina Division of General Internal Medicine, Duke University School of Medicine, Durham, North Carolina Center for the Study of Aging and Human Development, Department of Geriatrics, Duke University School of Medicine, Durham, North Carolina Center for Health Services Research in Primary Care, Duke University School of Medicine, Durham, North Carolina
Annette Olsen
Affiliation:
Pastoral Services, Duke University Hospital, Durham, North Carolina
Kimberly S. Johnson
Affiliation:
Duke Palliative Care, Department of Medicine, Duke University School of Medicine, Durham, North Carolina Division of General Internal Medicine, Duke University School of Medicine, Durham, North Carolina Center for the Study of Aging and Human Development, Department of Geriatrics, Duke University School of Medicine, Durham, North Carolina Department of Geriatrics, Duke University School of Medicine, Durham, North Carolina
Linda L. Sanders
Affiliation:
Division of General Internal Medicine, Duke University School of Medicine, Durham, North Carolina
Maren Olsen
Affiliation:
Department of Biostatistics and Informatics, Duke University School of Medicine, Durham, North Carolina Center for Health Services Research in Primary Care, Duke University School of Medicine, Durham, North Carolina
Natalie Ammarell
Affiliation:
School of Nursing, Duke University School of Medicine, Durham, North Carolina
Daniel Grossoehme
Affiliation:
Durham VA Medical Center, Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
*
Address correspondence and reprint requests to: Karen Steinhauser, Center for Palliative Care, VA and Duke Medical Centers, 411 West Chapel Hill Street, Suite 500, Durham, North Carolina 27701. E-mail: karen.steinhauser@duke.edu.
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Abstract

Objective:

When caring for a loved one with a life-limiting illness, a caregiver's own physical, emotional, and spiritual suffering can be profound. While many interventions focus on physical and emotional well-being, few caregiver interventions address existential and spiritual needs and the meaning that caregivers ascribe to their role. To evaluate the feasibility and acceptability of the process and content of Caregiver Outlook, we employed a manualized chaplain-led intervention to improve well-being by exploring role-related meaning among caregivers of patients with a life-limiting illness.

Method:

We conducted a single-arm pre–post pilot evaluation among caregivers of patients with advanced cancer or amyotrophic lateral sclerosis (ALS). Caregivers completed three chaplain-led intervention sessions focusing on (1) a relationship review, (2) forgiveness, and (3) legacy. Outcomes administered at baseline and at 1 and 2 weeks after the intervention included quality of life, anxiety, depression, spiritual well-being, religious coping, caregiver burden, and grief.

Results:

The sample (N = 31) included a range of socioeconomic status groups, and the average age was approximately 60 years. A third of them worked full-time. Some 74% of our participants cared for a spouse or partner, and the other quarter of the sample cared for a parent (13%), child (10%), or other close family member (3%). At baseline, participants did not demonstrate clinical threshold levels of anxiety, depression, or other indicators of distress. Outcomes were stable over time. The qualitative results showed the ways in which Caregiver Outlook was assistive: stepping back from day-to-day tasks, the opportunity to process emotions, reflecting on support received, provoking thoughts and emotions between sessions, discussing role changes, stimulating communication with others, and the anonymity of a phone conversation. Both religious and nonreligious participants were pleased with administration of the chaplain intervention.

Significance of results:

The acceptability and feasibility of Caregiver Outlook were demonstrated among caregivers of patients with an advanced illness. Our pilot findings suggest minor modifications to study participant screening, interventionist guidance, and the study measures.

Keywords

InterventionQuality of LifeSpirituality
Type
Original Articles
Information
Palliative & Supportive Care , Volume 14 , Issue 5 , October 2016 , pp. 456 - 467
Copyright
Copyright © Cambridge University Press 2015 

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