Results from the family and coping oriented palliative homecare intervention study (FamCope)—A randomized controlled trial

ABSTRACT

We tested if a family-and-coping-oriented basic palliative homecare intervention (six visits within 15 weeks) could improve quality-of-life and reduce anxiety and depression of advanced cancer patients and their closest relative, and reduce acute hospital admissions of patients. Fifty-seven families were randomized, but patient enrollment was terminated before reaching target sample due to a low recruitment rate.

We found no evidence of effect of the FamCope-intervention, but further investigation of effective methods to support how families cope with advanced cancer at home is needed as levels of distress is as high in relatives as it is in patients. However, duration of interventions to support family-coping may need a considerable time-span to show effect on quality-of-life.

We recommend that recruitment is undertaken in close collaboration with the hospital clinics, and that complexity of problems is used as inclusion criterion to decide when a family-coping intervention is needed based on the level of problems and distress in the family.

KEYWORDS:

• advanced cancer
• coping
• family
• homecare
• intervention
• palliative care
• quality-of-life

Acknowledgments

We are grateful to patients and relatives who contributed to the study and to the project nurses Helle Hesager, Lisbeth Egebjerg Olsen, Pia Marcher, and Liv Frich, who delivered the intervention. We thank healthcare staff at the recruitment sites at Rigshospitalet (Department of Urology, Department of Gynecology, and Departments of Oncology: Lung, Head and Neck, Gastrointestinal, Urological, Gynecological) and at Bispebjerg and Frederiksberg University Hospital (Departments of Gastrointestinal Surgery, the Pulmonary Medical Department, Department of Endocrinology, Department of Neurology, Department of Urology, and the Medical Department) for contributing to the recruitment of patients. We also thank statisticians Ditte Sæbye and Morten Aagaard Pedersen, Bispebjerg and Frederiksberg University Hospital, for statistical advice, and scientific assistant Maria Rudkjær Mikkelsen for undertaking the randomization.

Additional information

Funding

The study was supported by grants from The Danish Cancer Society, Lundbeck Foundation, The Health Foundation (Helsefonden), Novo Nordic Foundation, Danish Nurses Organization, and Danish Regions.