Improved coping and self-efficacy drive improvements in mood among caregivers of patients with primary malignant brain tumors: Results from an RCT

Background: In a recent randomized controlled trial, caregivers of patients diagnosed with primary malignant brain tumors (PMBT) who received NeuroCARE-a six-session, cognitive-behavioral, telehealth intervention-demonstrated improved anxiety and depression symptoms at 11 weeks post-randomization compared to caregivers assigned to usual care (UC). We explored whether these intervention effects were mediated by improvements in coping and self-efficacy. Methods: We examined data from caregivers of patients with PMBT randomized to receive either NeuroCARE or UC (N = 120). Participants completed assessments of anxiety and depression symptoms (Hospital Anxiety and Depression Scale), coping (Measure of Current Status), and self-efficacy (Lewis Cancer Self-Efficacy Scale) at baseline, 11 weeks, and 16 weeks. We conducted four simple mediation regression models using the Preacher & Hayes bootstrapping method to examine whether improvements in coping or self-efficacy from baseline to 11 weeks mediated intervention effects on 11-week anxiety or depression symptoms. Results: The sample (N = 120; Mage=53 years) predominantly consisted of participants who self-identified as female (82.5%), White (91.7%), and spouses/partners (70.0%) caring for a patient with glioblastoma (84%). Improvements in 11-week anxiety symptoms in caregivers assigned to NeuroCARE were mediated by improved coping (indirect effect=-1.44, SE = 0.49, 95% CI [-2.50, -0.54]) and self-efficacy (indirect effect=-1.29, SE = 0.42, 95% CI [-2.16, -0.52]). Similarly, improvements in 11-week depression symptoms were mediated by improved coping (indirect effect=-1.43, SE = 0.38, 95% CI [-2.21, -0.74]) and self-efficacy (indirect effect=-0.95, SE = 0.32, 95% CI [-1.60, -0.36]). Conclusion: The NeuroCARE intervention improves mood by enhancing coping skills and improving caregivers' self-efficacy in caregivers of patients with PMBT.