# A Problem Solving Intervention for Hospice Caregivers

> **NIH NIH R01** · UNIVERSITY OF PENNSYLVANIA · 2020 · $511,339

## Abstract

Abstract
Hospice care is conceptualized as quality compassionate care for people facing a life-limiting
illness, with services that cover clinical care, pain management, and emotional and spiritual
support tailored to patients' and families' needs and preferences. Family members, spouses,
friends or others who assume the unpaid or informal caregiving role are essential to the delivery
of hospice services; however, stress and caregiver burden can negatively affect caregivers'
morbidity and mortality. The emotional needs of individuals caring for dying persons at home
are not well attended, and interventions aiming to provide support to hospice caregivers are
notably lacking. Our team recently completed a randomized clinical trial (Grant Nr.
R01NR012213) with 514 hospice caregivers to test a problem-solving therapy (PST)
intervention we tailored specifically for the hospice setting, entitled PISCES (Problem-solving
Intervention to Support Caregivers in End of Life care Settings). Our findings demonstrate that
the PISCES intervention when delivered face to face was effective leading to statistically
significant decrease in anxiety and increase in quality of life when compared to the other groups
(video group and attention control). An additional lesson learned from our RCT study is that
caregivers wanted to focus not only on specific problems or challenges, but also on recognizing
the positive aspects of caregiving. This approach of positive reappraisal has been found to
enhance problem solving interventions in other settings. The specific aims of this renewal
application are: 1) to compare the effectiveness of the PISCES intervention when delivered face
to face and when delivered in a hybrid platform (with the first session in person and remaining
sessions via video) to hospice caregivers; 2) to compare the effectiveness of the PISCES
intervention to the refined PISCES intervention (PISCESplus) that integrates positive
reappraisal elements; 3) to assess caregivers' perceptions of and satisfaction with the
PISCESplus intervention; and 4) to conduct a cost analysis of the three intervention groups.

## Key facts

- **NIH application ID:** 9712962
- **Project number:** 5R01NR012213-07
- **Recipient organization:** UNIVERSITY OF PENNSYLVANIA
- **Principal Investigator:** George Demiris
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $511,339
- **Award type:** 5
- **Project period:** 2011-04-11 → 2022-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9712962

## Citation

> US National Institutes of Health, RePORTER application 9712962, A Problem Solving Intervention for Hospice Caregivers (5R01NR012213-07). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9712962. Licensed CC0.

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