BACKGROUND: Approximately 10% of the individuals experiencing the death of a loved one develop prolonged grief disorder (PGD) after bereavement. Family members of haematological cancer patients might be particularly burdened since their loss experience is preceded by a very strenuous time of disease and aggressive treatment. However, support needs of relatives of cancer patients often remain unmet, also after the death of the patient. Therapeutic possibilities are enhanced by providing easily available and accessible Internet-based therapies. This study will adapt and evaluate an Internet-based grief therapy for bereaved individuals after the loss of a significant other due to haematological cancer.
METHODS: The efficacy of the Internet-based grief therapy is evaluated in a randomized controlled trial with a wait-list control group. Inclusion criteria are bereavement due to hematological cancer and meeting the diagnostic criteria for PGD. Exclusion criteria are severe depression, suicidality, dissociative tendency, psychosis, posttraumatic stress disorder, substance use disorder, and current psychotherapeutic or psychopharmacological treatment. The main outcome is PGD severity. Secondary outcomes are depression, anxiety, somatization, posttraumatic stress, quality of life, sleep quality, and posttraumatic growth. Data is collected pre- and posttreatment. Follow-up assessments will be conducted 3, 6, and 12 months after completion of the intervention. The Internet-based grief therapy is assumed to have at least moderate effects regarding PGD and other bereavement-related mental health outcomes. Predictors and moderators of the treatment outcome and PGD will be determined.
DISCUSSION: Individuals bereaved due to haematological cancer are at high risk for psychological distress. Tailored treatment for this particularly burdened target group is missing. Our study results will contribute to a closing of this healthcare gap.
TRIAL REGISTRATION: German Clinical Trial Register UTN: U1111-1186-6255 . Registered 1 December 2016.
BACKGROUND: Although caregiver burden may continue to influence the mental health of cancer patients' caregivers long after bereavement few studies have examined this issue.
METHODS: A systematic review was conducted to provide a summary of (1) operationalizations of caregiver burden used in this field and (2) the effect of caregiver burden on post-bereavement mental health of adult caregivers of cancer patients. A systematic search of the electronic databases PubMed, Web of Science, and PsycINFO was conducted across empirical studies published in a peer-reviewed journal up until April 2017.
RESULTS: Caregiver burden was rarely defined and it was operationalized in multiple and diverging ways. The 20 included papers present varying results but generally indicate that caregiver burden (especially emotional) has an adverse effect on post-bereavement mental health.
CONCLUSIONS: In future studies, researchers seeking to ascertain which aspects of caregiver burden may prove an appropriate target for prevention and intervention should first employ a precise operational definition of the concept.