BACKGROUND Caregivers of patients undergoing hematopoietic stem cell transplantation (HCT) experience an immense caregiving burden before, during, and after HCT. METHODS We conducted an unblinded, randomized trial of a psychosocial intervention (BMT-CARE) for caregivers of patients undergoing autologous and allogeneic HCT at Massachusetts General Hospital. Caregivers were randomly assigned to BMT-CARE or usual care. BMT-CARE was tailored to the HCT trajectory and integrated treatment-related education and self-care with cognitive-behavioral skills to promote coping. Caregivers assigned to BMT-CARE met with a trained interventionist (a psychologist or a social worker) in person, via telephone, or via videoconferencing for 6 sessions starting before HCT and continuing up to day +60 after HCT. The primary endpoint was feasibility, which was defined as at least 60% of eligible caregivers enrolling and completing 50% or more of the intervention sessions. We assesed caregiver quality of life (QOL; Caregiver Oncology Quality of Life Questionnaire), caregiving burden (Caregiver Reaction Assessment), psychological distress (Hospital Anxiety and Depression Scale), self-efficacy (Cancer Self-Efficacy Scale-Transplant), and coping (Measures of Current Status) at baseline and 30 and 60 days after HCT. We used mixed linear effect models to assess the effect of BMT-CARE on outcomes longitudinally. RESULTS We enrolled 72.5% of eligible caregivers (100 of 138), and 80% attended 50% or more of the intervention sessions. Caregivers randomized to BMT-CARE reported improved QOL (B = 6.11; 95% CI, 3.50-8.71; P < .001), reduced caregiving burden (B = -6.02; 95% CI, -8.49 to -3.55; P < .001), lower anxiety (B = -2.18; 95% CI, -3.07 to -1.28; P < .001) and depression symptoms (B = -1.23; 95% CI, -1.92 to -0.54; P < .001), and improved self-efficacy (B = 7.22; 95% CI, 2.40-12.03; P = .003) and coping skills (B = 4.83; 95% CI, 3.04-6.94; P < .001) in comparison with the usual-care group. CONCLUSIONS A brief multimodal psychosocial intervention tailored for caregivers of HCT recipients is feasible and may improve QOL, mood, coping, and self-efficacy while reducing the caregiving burden during the acute HCT period.

中文翻译：

---

对接受造血干细胞移植患者的家庭护理人员进行多模式心理社会干预：一项随机临床试验。

背景技术接受造血干细胞移植（HCT）的患者的护理人员在HCT之前、期间和之后经历巨大的护理负担。方法 我们对在马萨诸塞州总医院接受自体和同种异体 HCT 的患者的护理人员进行了一项非盲、随机心理干预试验 (BMT-CARE)。护理人员被随机分配接受 BMT-CARE 或常规护理。BMT-CARE 针对 HCT 轨迹量身定制，将治疗相关教育和自我护理与认知行为技能相结合，以促进应对。分配到 BMT-CARE 的护理人员会面、通过电话或通过视频会议与经过培训的干预专家（心理学家或社会工作者）进行 6 次会议，从 HCT 之前开始，一直持续到 HCT 后 +60 天。主要终点是可行性，其定义为至少 60% 的合格护理人员参加并完成 50% 或更多的干预课程。我们评估了护理人员的生活质量（QOL；护理人员肿瘤学生活质量问卷）、护理负担（护理人员反应评估）、心理困扰（医院焦虑和抑郁量表）、自我效能（癌症自我效能量表-移植）和应对方式（现状衡量）基线以及 HCT 后 30 天和 60 天。我们使用混合线性效应模型来纵向评估 BMT-CARE 对结果的影响。结果 我们招募了 72.5% 的合格护理人员（138 名护理人员中的 100 名），其中 80% 的护理人员参加了 50% 或更多的干预课程。随机接受 BMT-CARE 的护理人员报告生活质量改善（B = 6.11；95% CI，3.50-8.71；P < .001），护理负担减轻（B = -6.02；95% CI，-8.49 至 -3.55；P < . 001）、较低的焦虑（B = -2.18；95% CI，-3.07 至 -1.28；P < .001）和抑郁症状（B = -1.23；95% CI，-1.92 至 -0.54；P < .001） ，与平常相比，自我效能感（B = 7.22；95% CI，2.40-12.03；P = .003）和应对技能（B = 4.83；95% CI，3.04-6.94；P < .001）有所提高- 护理小组。结论 为 HCT 接受者的护理人员量身定制的简短的多模式心理社会干预是可行的，可以改善生活质量、情绪、应对和自我效能，同时减轻急性 HCT 期间的护理负担。