Informal Caregiver Training on Home Care and Cancer Symptom Management Prior to Hospital Discharge: A Feasibility Study

Cristina C. Hendrix

Charlene Ray

ONF 2006, 33(4), 793-798. DOI: 10.1188/06.ONF.793-798

Purpose/Objectives: To determine the feasibility of individualized caregiver training for home care and symptom management conducted at the bedside of older patients with cancer prior to hospital discharge.

Design: Pilot study.

Setting: The Extended Care Rehabilitation Center at the Durham Veterans Affairs Medical Center in North Carolina.

Sample: 7 female informal caregivers with a mean age of 56 (range = 26-76). More than half were African American. Most commonly, caregivers were spouses of the patients with cancer.

Methods: Individualized and experiential training on home care and cancer symptom management was conducted at the bedside of patients before hospital discharge. Caregiver demographic data were collected. An informal interview at the end of the training asked about the usefulness of the training in preparing for home caregiving.

Main Research Variables: Feasibility of the training.

Findings: Individualized bedside training to caregivers prior to hospital discharge is feasible. All caregivers noted the relevance of the content as well as the approach to the training.

Conclusions: When given an opportunity for training on symptom management and home care, informal caregivers were very interested in participating. The individualized approach gave caregivers an opportunity to have their particular needs met. The flexibility of when to conduct the training proved to be crucial when soliciting attendance. The biggest challenge was in recruiting caregiver subjects through patients with cancer.

Implications for Nursing: The impetus now is to look at the effects of the training on caregiver-patient variables as well as the cost-effectiveness and sustainability of such an approach to caregiver training.

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    Albert, S.M., & Levine, C. (2005). Family caregiver research and the HIPAA factor. Gerontologist, 45, 432-437.

    Andrews, S.C. (2001). Caregiver burden and symptom distress in people with cancer receiving hospice care. Oncology Nursing Forum, 28, 1469-1474.

    Aranda, S.K., & Hayman-White, K. (2001). Home caregivers of the person with advanced cancer: An Australian perspective. Cancer Nursing, 24, 300-307.

    Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice-Hall.

    Bandura, A. (1997). Self-efficacy: The exercise of control. New York: W.H. Freeman and Company.

    Bandura, A., Adams, N.E., & Beyer, J. (1977). Cognitive processes mediating behavioral change. Journal of Personality and Social Psychology, 35(3), 125-139.

    Chorley, J.N. (2005). Ankle sprain discharge instructions from the emergency department. Pediatric Emergency Care, 21, 498-501.

    Edwards, B.K., Howe, H.L., Ries, L.A., Thun, M.J., Rosenberg, H.M., Yancik, R., et al. (2002). Annual report to the nation on the status of cancer, 1973-1999, featuring implications of age and aging on U.S. cancer burden. Cancer, 94, 2766-2792.

    Ferrari, R., Rowe, B.H., Majumdar, S.R., Cassidy, J.D., Blitz, S., Wright, S.C., et al. (2005). Simple educational intervention to improve the recovery from acute whiplash: Results of a randomized, controlled trial. Academic Emergency Medicine, 12, 699-706.

    Flesch, R. (1974). The art of readable writing. New York: Harper and Row.

    Giarelli, E., McCorkle, R., & Monturo, C. (2003). Caring for a spouse after prostate surgery: The preparedness needs of wives. Journal of Family Nursing, 9, 453-485.

    Hendrix, C.C. (2004). A manual for informal caregivers on cancer symptom management. Unpublished manuscript.

    Hodges, L.J., Humphris, G.M., & Macfarlane, G. (2005). A meta-analytic investigation of the relationship between the psychological distress of cancer patients and their carers. Social Science and Medicine, 60(1), 1-12.

    Hudson, P., Aranda, S., & McMurray, N. (2002). Intervention development for enhanced lay palliative caregiver support—The use of focus groups. European Journal of Cancer Care, 11, 262-270.

    Kurtin, D., Elting, L., Martin, C., DeFord, L., Rubenstein, E., Lam, T., et al. (1999, June). Risk, outcomes and cost of emergency center visits in cancer patients [Abstract]. Paper presented at the annual meeting of the American Society of Clinical Oncology, Atlanta, GA.

    Laizner, A.M., Yost, L.M., Barg, F.K., & McCorkle, R. (1993). Needs of family caregivers of persons with cancer: A review. Seminars in Oncology Nursing, 9, 114-120.

    Lee, T.L., & Bokovoy, J. (2005). Understanding discharge instructions after vascular surgery: An observational study. Journal of Vascular Nursing, 23(1), 25-29.

    Morris, S.M., & Thomas, C. (2001). The carer's place in the cancer situation: Where does the carer stand in the medical setting? European Journal of Cancer Care, 10, 87-95.

    National Alliance for Caregiving & AARP. (2004). Family caregiving in the US: Findings from a national survey. Washington, DC: Authors.

    Pasacreta, J.V., & McCorkle, R. (2000). Cancer care: Impact of interventions on caregiver outcomes. Annual Review of Nursing Research, 18, 127-148.

    Reynolds, M.A.H. (2002, Spring). Post-surgical pain management discharge teaching—A pilot study [Abstract]. Communicating Nursing Research, 35, 360.

    Rose, K.E. (1999). A qualitative analysis of the information needs of informal caregivers of terminally ill cancer patients. Journal of Clinical Nursing, 8, 81-88.

    Schulz, R., & Beach, S.R. (1999). Caregiving as a risk factor for mortality: The Caregiver Health Effects Study. JAMA, 282, 2215-2219.

    Schulz, R., Visintainer, P., & Williamson, G.M. (1990). Psychiatric and physical morbidity effects of caregiving. Journal of Gerontology: Psychological Sciences, 45(5), P181-P194.

    Schumacher, K.L., Koresawa, S., West, C., Hawkins, C., Johnson, C., Wais, E., et al. (2002). Putting cancer pain management regimens into practice at home. Journal of Pain and Symptom Management, 23, 369-382.

    Steele, R.G., & Fitch, M.I. (1996). Needs of family caregivers of patients receiving home hospice care for cancer. Oncology Nursing Forum, 23, 823-828.

    Steinhauser, K.E., Clipp, E.C., McNeilly, M., Christakis, N.A., McIntyre, L.M., & Tulsky, J.A. (2000). In search of a good death: Observations of patients, families, and providers. Annals of Internal Medicine, 132, 825-832.

    Sutton, L.M., Clipp, E.C., & Winer, E.P. (2000). Management of the terminally ill patient. In C.P. Hunter, K.A. Johnson, & H.B. Muss (Eds.), Cancer in the elderly (pp. 543-572). New York: Marcel Dekker.

    Sutton, L.M., Demark-Wahnefried, W., & Clipp, E.C. (2003). Management of terminal cancer in elderly patients. Lancet Oncology, 4, 149-157.

    Weitzner, M.A., Jacobsen, P.B., Wagner, H., Friedland, J., & Cox, C. (1999). The Caregiver Quality of Life Index-Cancer (CQOLC) scale: Development and validation of an instrument to measure quality of life of the family caregiver of patients with cancer. Quality of Life Research, 8, 55-63.