Supporting patients with advanced cancer and their spouses in parenting minor children: results of a randomized controlled trial

Introduction Patients with advanced cancer and their spousal caregivers who parent minor children report unmet parenting concerns and increased psychological distress. Seeking to address these important supportive care needs, this RCT examined the feasibility, acceptability, and initial evidence for the efficacy of a novel psychosocial intervention. Patients and Methods Patients with a metastatic solid malignancy and their spouses completed self-reported validated assessments of psychological symptoms and cancer-related parenting outcomes and were then randomized to the parent support intervention or a usual care (UC) group. Both groups were reassessed 6 and 12 weeks later. Dyads randomized to the counselor-led intervention attended the first 2 sessions jointly addressing illness communication and family routines. Spouses individually attended the last 2 sessions focusing on caregiver support and family death preparedness. Results Fifty patients and their spouses were randomized. All a priori feasibility benchmarks were met. Attendance in the intervention arm was high with 84% of caregivers attending all 4 sessions (mean = 3.48). The program was evaluated favorably by all patients and spouses deeming the intervention as beneficial. Caregivers rated the individual-level sessions as particularly helpful. Multilevel analyses revealed a significant reduction in anxiety symptoms (P = .05) and improvement in parenting efficacy (P = .03) at 6-week follow-up in the intervention group compared with UC. Conclusions The initial testing of our parent support intervention yielded promising results regarding feasibility and preliminary evidence for efficacy for reduced anxiety symptoms and improved parenting efficacy. This program may meet a frequent and distressing psychosocial need that is typically unaddressed by multidisciplinary oncology teams.