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

Published online by Cambridge University Press:  30 March 2017

Annika B. von Heymann-Horan ,
Louise B. Puggaard ,
Kathrine G. Nissen ,
Kirstine Skov Benthien ,
Pernille Bidstrup ,
James Coyne ,
Christoffer Johansen ,
Jakob Kjellberg ,
Mie Nordly  and
Per Sjøgren
...Show all authors
Annika B. von Heymann-Horan*
Affiliation:
Danish Cancer Society Research Center, Copenhagen, Denmark
Louise B. Puggaard
Affiliation:
Department of Psychology, University of Copenhagen, Copenhagen, Denmark
Kathrine G. Nissen
Affiliation:
Department of Psychology, University of Copenhagen, Copenhagen, Denmark
Kirstine Skov Benthien
Affiliation:
Palliative Research Group, Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Pernille Bidstrup
Affiliation:
Danish Cancer Society Research Center, Copenhagen, Denmark
James Coyne
Affiliation:
Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA University Medical Centre Groningen, University of Groningen, The Netherlands
Christoffer Johansen
Affiliation:
Danish Cancer Society Research Center, Copenhagen, Denmark Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Denmark
Jakob Kjellberg
Affiliation:
KORA, The Danish Institute for Local and Regional Government Research, Copenhagen, Denmark
Mie Nordly
Affiliation:
Palliative Research Group, Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Per Sjøgren
Affiliation:
Palliative Research Group, Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
Helle Timm
Affiliation:
Knowledge Center for Rehabilitation and Palliative Care, University of Southern Denmark, Copenhagen, Denmark
Hans von der Maase
Affiliation:
Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Denmark
Mai-Britt Guldin
Affiliation:
Research Unit for General Practice, Aarhus University, Aarhus, Denmark
*
Address correspondence and reprint requests to: Annika B. von Heymann-Horan, Danish Cancer Society Research Center, Strandboulevarden 49, 2100 København Ø, Copenhagen, Denmark. E-mail: heymann@cancer.dk.
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Abstract

Objective:

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.

Method:

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.

Results:

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.

Significance of Results:

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.

Keywords

Psychological interventionPalliative careExistential therapyFamily caregiverCancer
Type
Original Article
Information
Palliative & Supportive Care , Volume 16 , Issue 2 , April 2018 , pp. 189 - 197
Copyright
Copyright © Cambridge University Press 2017 

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