{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T20:07:10Z","timestamp":1767902830197,"version":"3.49.0"},"reference-count":37,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2019,4,4]],"date-time":"2019-04-04T00:00:00Z","timestamp":1554336000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVES<\/jats:title>\n                    <jats:p>Family caregivers of hospice patients have multiple needs as they try to cope during a stressful time. Translatable interventions effective in improving caregiver outcomes are greatly needed. Our objective was to assess the impact of a problem\u2010solving intervention (called Problem\u2010Solving Intervention to Support Caregivers in End\u2010of\u2010Life Care Settings [PISCES]) to support hospice caregivers on caregiver quality of life and anxiety, and compare its effectiveness delivered face to face and via videoconferencing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DESIGN<\/jats:title>\n                    <jats:p>In this 4\u2010year randomized clinical trial, caregivers were randomly assigned to a group receiving standard care with added \u201cfriendly calls\u201d (attention control [AC] group), a group receiving standard care and PISCES delivered face to face (F2F), or a group receiving standard care and PISCES delivered via videoconferencing (VC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>SETTING<\/jats:title>\n                    <jats:p>Home hospice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PARTICIPANTS<\/jats:title>\n                    <jats:p>A total of 514 caregivers participated (172 in AC, 171 in F2F, and 171 in VC). Caregivers were predominantly female (75%); mean age was 60.3 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>INTERVENTION<\/jats:title>\n                    <jats:p>PISCES includes a structured curriculum delivered in three sessions and motivates caregivers to adopt a positive attitude, define problems by obtaining facts, set goals, and generate and evaluate solutions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>MEASUREMENTS<\/jats:title>\n                    <jats:p>Quality of life was measured by the Caregiver Quality of Life Index\u2010Revised; anxiety was measured by the Generalized Anxiety Disorder 7\u2010Item. Other measures included the Caregiver Reaction Assessment scale, demographic data, and an exit interview.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Compared with AC, caregivers in the F2F condition had postintervention reduced anxiety (\u22121.31 [95% confidence interval [CI]\u2009=\u2009\u22122.11 to .50];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.004) and improved social (.57 [95% CI\u2009=\u2009.19\u2010.95];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.01), financial (.57 [95% CI\u2009=\u2009.21\u2010.93];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.004), and physical quality of life (.53 [95% CI\u2009=\u2009.19\u2010.87];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.01). There were no differences in caregivers in the VC condition compared with the AC condition.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>The PISCES intervention improves caregiver outcomes and is effective when delivered in person. How to integrate technology to reduce the intervention delivery cost warrants further investigation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.15894","type":"journal-article","created":{"date-parts":[[2019,4,4]],"date-time":"2019-04-04T10:23:46Z","timestamp":1554373426000},"page":"1345-1352","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["A Problem\u2010Solving Intervention for Hospice Family Caregivers: A Randomized Clinical Trial"],"prefix":"10.1111","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6318-5829","authenticated-orcid":false,"given":"George","family":"Demiris","sequence":"first","affiliation":[{"name":"School of Nursing University of Pennsylvania  Philadelphia Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Debra Parker","family":"Oliver","sequence":"additional","affiliation":[{"name":"School of Medicine University of Missouri  Columbia Missouri"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karla","family":"Washington","sequence":"additional","affiliation":[{"name":"School of Medicine University of Missouri  Columbia Missouri"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth","family":"Pike","sequence":"additional","affiliation":[{"name":"School of Nursing University of Washington  Seattle Washington"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,4,4]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1037\/0882-7974.18.2.250"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/geronj\/45.5.P192"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02883327"},{"key":"e_1_2_6_5_1","volume-title":"Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life","author":"Institute of Medicine","year":"2015"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1191\/026921699673763725"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.291.1.88"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1191\/0269216303pm667oa"},{"key":"e_1_2_6_9_1","doi-asserted-by":"crossref","DOI":"10.1093\/oso\/9780198528425.001.0001","volume-title":"Problem Solving Treatment for Anxiety and Depression: A Practical Guide","author":"Mynors\u2010Wallis L","year":"2005"},{"key":"e_1_2_6_10_1","volume-title":"Problem Solving Therapy. 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