TY - JOUR
T1 - Self-management intervention for head and neck cancer couples
T2 - Results of a randomized pilot trial
AU - Badr, Hoda
AU - Herbert, Krista
AU - Chhabria, Karishma
AU - Sandulache, Vlad C.
AU - Chiao, Elizabeth Y.
AU - Wagner, Timothy
N1 - Publisher Copyright:
© 2018 American Cancer Society
PY - 2019/4/1
Y1 - 2019/4/1
N2 - 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 Spouses coping with the Head And neck Radiation Experience (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.
AB - 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 Spouses coping with the Head And neck Radiation Experience (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.
KW - M.D. Anderson Symptom Inventory Head and Neck survey (MDASI-HN)
KW - couple-based intervention
KW - head and neck cancer
KW - psychological distress
KW - supportive care
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U2 - 10.1002/cncr.31906
DO - 10.1002/cncr.31906
M3 - Article
C2 - 30521075
AN - SCOPUS:85058017264
SN - 0008-543X
VL - 125
SP - 1176
EP - 1184
JO - Cancer
JF - Cancer
IS - 7
ER -