• Susan C McMillan and Brent J Small.
• College of Nursing, University of South Florida, Tampa, FL, USA. smcmilla@health.usf.edu
• Oncol Nurs Forum. 2007 Mar 1;34(2):313-21.

Purpose/ObjectivesTo test an intervention for hospice caregivers designed to help them better manage symptoms experienced by patients with cancer.DesignA three-group comparative design with repeated measures.SettingA large nonprofit hospice that primarily provides home care.Sample329 hospice homecare patients with cancer and their caregivers were randomized into three groups: a control group (n = 109) receiving standard care, a group (n = 109) receiving standard care plus friendly visits, and a group (n = 111) receiving standard care plus the COPE intervention.MethodsCaregivers received experimental training in the COPE intervention (creativity, optimism, planning, expert information) over nine days to assist with symptom management.Main Research VariablesIntensity of pain, dyspnea, and constipation, overall symptom distress, and quality of life (QOL). Data were collected on admission and days 16 and 30.FindingsAlthough symptom intensity for three target symptoms did not decrease, symptom distress was significantly improved (p = 0.009) in the COPE intervention group. QOL was not significantly different.ConclusionsSymptom distress, a measure that encompasses patient suffering along with intensity, was significantly decreased in the group in which caregivers were trained to better manage patient symptoms.Implications For NursingThe COPE intervention is effective and immediately translatable to the bedside for hospice homecare patients with advanced cancer.

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