Michelle Guo, MD

Caregivers play a vital role throughout the treatment and recovery of patients undergoing hematopoietic stem cell transplantation (HSCT). Maintaining caregiver psychological well-being improves both patient and caregiver outcomes. Positive psychology interventions (PPIs), which involve the performance of intentional activities to enhance positive behaviors, feelings, and cognitions, are lacking for HSCT caregivers. We performed a proof-of-concept trial of a phone-delivered PPI, PATH-C, for HSCT caregivers and used semi-structured qualitative interviews to explore the utility and feasibility of PATH-C. Interviews were audio-recorded, transcribed, and coded verbatim. We interviewed 15 caregivers (average age [SD]: 63 [5.2] years). Themes that emerged from rapid qualitative analysis of the data were barriers, facilitators, and preferences for PATH-C. Barriers included lack of time and stress related to caregiving. Facilitators included accountability through regular meetings with the interventionist and the structured PPI format. Caregiver preferences included starting PATH-C within the first 100 days post-transplant and phone delivery. Caregivers expressed motivation to continue using positive psychological skills from in PATH-C after study completion. Overall, caregivers reported PATH-C encouraged them to practice self-care and reclaim their identity outside of caregiving responsibilities. Findings from this study will inform further refinement of PATH-C for larger randomized clinical trials.