Group Meaning-Centered Psychotherapy for the Improvement of Wellbeing in Caregivers of Patients With Serious Illness

Feasibility will be measured by numbers and percentages of participant recruitment, enrollment, accrual, and retention of participants in the MCP-C intervention. Findings will be summarized using estimates and corresponding 95% confidence intervals.

Acceptability will be measured by the Was It Worth It (WIWI) Questionnaire. The WIWI consists of 7 questions, 3 answered with yes/no/uncertain, two answered on a 3-point scale (i.e., improved, stayed the same, or got worse), one open-ended/fill-in-the-blank question, and one yes/no question.

The Life Attitude Profile-Revised (LAP-R) is a 48-item scale that measures a person's life attitude and meaning in life. The LAP-R is scored on a 7-point Likert scale, with a minimum score of 30 and a maximum score of 210. A higher score indicates a greater sense of meaning in life and a more positive attitude towards life.

Spiritual well-being will be assessed using the Functional Assessment of Chronic Illness Therapy Spiritual Well-Being Scale (FACIT-Sp-12), a 12-item self-report measure with a total score range of 0-48, with higher scores indicating a greater level of spiritual well-being. items are answered on a scale of 0-4 where 0=Not at all, 1=A little bit, 2=Somewhat, 3=Quite a bit, and 4=Very much.

Change in anxiety and depression will be assessed using the Hospital Anxiety and Depression Scale (HADS). The HADS is a 14-item self-rated questionnaire with depression and anxiety subscales both ranging from 0 to 21, categorized as: normal 0-7, mild 8-10, moderate 11-14, and severe 15-21. Items are answered on a scale of 0-3 with varying responses for each question (e.g., very much/quite a lot/not very much/not at all or often/sometimes/not often/very seldom).

Change in attitude toward caregiving will be assessed using the Attitudes Towards Caregiving Scale ( ATCS), a 43-item 5-point Likert-type measure of ways caregivers find meaning through caregiving. The ATCS yields an overall (range 43-215) and three subscale [loss/powerlessness (range 19-96), provisional meaning (range 19-96), and ultimate meaning (range 5-25)] scores, with higher scores indicating higher overall meaning. Items are answered with one of 5 responses: strongly agree, agree, undecided, disagree, or strongly disagree.

Change in perception of social support will be assessed using the Duke/University of North Caroling (UNC) Functional Social Support Questionnaire (FSSQ), an 8-item measure of social support that generates a total score (range 0-44). Higher scores generally indicate a higher degree of satisfaction related to social support. Items are answered on a scale of 5-1 where 5=as much as I would like; 4=almost as much as I would like; 3=some, but would like more; 2=less than i would like, and 1=much less than I would like.

Change in perception of benefit will be assessed using the Benefit Finding Scale (BFS), a 17-item measure of perceived benefits adapted from Behr's Positive Contributions Scale for breast cancer, modified for caregiving. It yields a total score (range 17-85) with higher scores indicating greater benefit finding. Items are answered with one of 5 responses: not at all, a little bit, somewhat, quite a bit, or very much.

The Cancer Support Source-Caregiver (CSS-Caregiver) is an 18-item questionnaire used to assess demands of cancer caregiving. Participants rate items of concern on a scale of 0 (not at all) to 4 (very seriously). A higher score indicates an item is of greater concern. Higher overall scores indicate higher levels of stress.