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Development and preliminary evaluation of a telephone-based coping skills training intervention for survivors of acute lung injury and their informal caregivers

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Abstract

Purpose

Survivors of acute lung injury (ALI) and their informal caregivers have difficulty coping with the physical and emotional challenges of recovery from critical illness. We aimed to develop and pilot test a telephone-based coping skills training intervention for this population.

Methods

Fifty-eight participants were enrolled overall. A total of 21 patients and 23 caregivers participated in a cross-sectional study to assess coping and its association with psychological distress. This also informed the development of an ALI coping skills training intervention in an iterative process involving content and methodological experts. The intervention was then evaluated in seven patients and seven caregivers in an uncontrolled, prospective, pre-post study. Outcomes included acceptability, feasibility, and symptoms of psychological distress measured with the Hospital Anxiety and Depression Scale (HADS) and Post-Traumatic Symptom Scale (PTSS).

Results

Survivors and their caregivers used adaptive coping infrequently, a pattern that was strongly associated with psychological distress. These findings informed the development of a 12-session intervention for acquiring, applying, and maintaining coping skills. In the evaluation phase, participants completed 77 (92 %) of a possible 84 telephone sessions and all (100 %) reported the intervention’s usefulness in their daily routine. Mean change scores reflecting improvements in the HADS (7.8 U) and PTSS (10.3 U) were associated with adaptive coping (r = 0.50–0.70) and high self-efficacy (r = 0.67–0.79).

Conclusions

A novel telephone-based coping skills training intervention was acceptable, feasible, and may have been associated with a reduction in psychological distress among survivors of ALI and their informal caregivers. A randomized trial is needed to evaluate the intervention.

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Acknowledgments

Salary support was provided by National Institutes of Health awards K23 HL081048 (C.E.C.), K23 AG032875 (D.B.W.), K23 HL082650 (J.M.K.), and K23 HL067068 (S.S.C.). The authors wish to thank Verena Knowles, RN for conducting the coping skills training telephone sessions and Brenda Walton, M.Div. for conducting interviews.

Author information

Authors and Affiliations

  1. Duke University Medical Center, Division of Pulmonary and Critical Care Medicine, Department of Medicine, Duke University, Box 102043, Durham, NC, 27710, USA

    Christopher E. Cox

  2. Department of Psychology and Neuroscience, Duke University, Durham, NC, USA

    Laura S. Porter & Francis J. Keefe

  3. Division of Pulmonary and Critical Care, Department of Medicine, University of Washington, Seattle, WA, USA

    Catherine L. Hough

  4. Department of Critical Care, University of Pittsburgh, Pittsburgh, PA, USA

    Douglas B. White & Jeremy M. Kahn

  5. Program on Ethics and Decision Making in Critical Illness, University of Pittsburgh, Pittsburgh, PA, USA

    Douglas B. White & Jeremy M. Kahn

  6. Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of North Carolina, Chapel Hill, NC, USA

    Shannon S. Carson

  7. Department of Medicine, Center for Palliative Care, Duke University, Durham, NC, USA

    James A. Tulsky

  8. Center for Health Services Research in Primary Care, VA Medical Center, Durham, NC, USA

    James A. Tulsky

Authors
  1. Christopher E. Cox
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  2. Laura S. Porter
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  3. Catherine L. Hough
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  4. Douglas B. White
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  6. Shannon S. Carson
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  7. James A. Tulsky
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  8. Francis J. Keefe
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Correspondence to Christopher E. Cox.

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Cox, C.E., Porter, L.S., Hough, C.L. et al. Development and preliminary evaluation of a telephone-based coping skills training intervention for survivors of acute lung injury and their informal caregivers. Intensive Care Med 38, 1289–1297 (2012). https://doi.org/10.1007/s00134-012-2567-3

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  • DOI: https://doi.org/10.1007/s00134-012-2567-3

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