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Self‐management intervention for head and neck cancer couples: Results of a randomized pilot trial
Author(s) -
Badr Hoda,
Herbert Krista,
Chhabria Karishma,
Sandulache Vlad C.,
Chiao Elizabeth Y.,
Wagner Timothy
Publication year - 2019
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.31906
Subject(s) - spouse , medicine , distress , randomized controlled trial , head and neck cancer , coping (psychology) , patient satisfaction , physical therapy , quality of life (healthcare) , clinical psychology , cancer , nursing , surgery , sociology , anthropology
Background Patients with head and neck cancer (HNC) experience significant physical and psychological morbidity during radiotherapy (RT) that contributes to treatment interruptions and a poor quality of life. Although spouses/partners can help by encouraging patient self‐management (eg, self‐care) during RT, they often experience high psychological distress rates, lack basic health care knowledge and skills, and report increased marital conflict regarding patient self‐management. The current pilot study examined the feasibility and acceptability of a 6‐session telephone‐based intervention called S pouses coping with the H ead A nd neck R adiation E xperience (SHARE), which teaches self‐management, communication, and coping skills to patients with HNC and their spouses. The treatment effects of SHARE compared with usual medical care (UMC) in controlling patient physical symptoms and improving patient/spouse psychological and marital functioning also were examined. Methods Thirty patients who initiated RT and their spouses (60 participants; 40% of whom were racial/ethnic minorities) were randomized to SHARE or UMC, and preintervention and postintervention assessments were completed. Results Solid recruitment (70%) and low attrition rates (7%) demonstrated feasibility. Strong program evaluations and homework completion rates (72%) supported acceptability. Significant treatment effects (medium in magnitude) were observed for SHARE compared with UMC with regard to HNC‐specific physical symptom burden (Cohen’s d , ‐0.89) and symptom interference (Cohen’s d , ‐0.86). Medium to large effects favoring SHARE also were found for patient and spouse depressive symptoms (Cohen’s d , ‐0.84) and cancer‐specific distress (Cohen’s d , ‐1.05). Conclusions The findings of the current study support the feasibility, acceptability, and preliminary efficacy of SHARE. They also suggest that programs that empower HNC couples with the necessary skills to coordinate care and manage the challenges of RT together hold great promise for controlling a patient’s physical symptoms and improving the psychological functioning of both partners.