A self-management programme Building Better Caregivers in a Cancer Context in Ireland

The Building Better Caregivers (BBC) is a 6-week self - management programme aimed at enhancing caregiving skills and reducing caregivers’ stress (Lorig et al., 2012, 2019). No study to date investigated the suitability of BBC in Ireland for the population of caregivers of people with cancer. This project was developed in collaboration of a research team from Munster Technological University in Ireland and representatives of Recovery Haven Kerry Cancer Support House, which delivers caring and therapeutic services to those who have experienced cancer, their families and carers. The overall aim of this project was to implement and evaluate the BBC intervention in the population of caregivers of people with cancer in Ireland. Two data collections waves were completed. Both waves were conducted fully online (an introductory session was followed by 6 weekly 2.5-hour intervention sessions). A total of 15 participants took part. The project employed sequential mixed methods design. Data were collected using multiple qualitative and quantitative methods, including individual interviews, reflective diaries, focus groups, observations, and six quantitative surveys. There were three data collection points for each wave: prior to, during and after the BBC programme. Qualitative data were analysed using thematic analysis, and quantitative data were analysed statistically. The qualitative data analysis relieved three main themes: 1) BBC in the context of cancer in an Irish setting, 2) The power of the group, and 3) Self-management skills. Participants provided a range of experiences related to the intervention and suggested potential modifications for the future BBC programmes. Overall, the BBC intervention was perceived as helpful and applicable to the caregivers of people living with cancer in Ireland. Some suggestions for change included the inclusion of follow-up sessions and scheduling modifications (for example, shorter sessions delivered over 8 rather than 6 weeks). The BBC intervention provided an opportunity for participants to meet other caregivers, which was perceived as very beneficial. Participants reported gaining better self-management skills on completion of the intervention. The quantitative data revealed a statistically significant effect for depression (PHQ-8), caregiving self-efficacy (CSES) and exercise behaviour (cycling). There was a downward trend in means in shortness of breath, stress, sleeping problems, and fatigue, meaning the intervention had a positive effect on these measures. Similarly, there was an upwards trend to all exercise behaviour means, which indicates the BBC intervention was effective in increasing participants engagement in exercise. There was a slight increase in stress measured by the Caregiver Strain Index and in the scale pain in some participants. The individual qualitative data provided insight and reasoning to this (one participant had an acute medical issue leading to pain at the time of the BBC intervention). Overall, the BBC intervention had a positive effect on the majority of outcomes measured. Data collected provided promising insights into the usefulness of BBC in the context of cancer in Ireland. BBC seems to have a promising potential to caregivers of people living with cancer in Ireland. There is potential for BBC intervention to be applicable to other settings, such as palliative care.