Effectiveness of implementing a dyadic psychoeducational intervention for cancer patients and family caregivers

Abstract

PurposeThis study examined the effectiveness, feasibility, and satisfaction with implementation of the FOCUS program in two US Cancer Support Community affiliates in Ohio and California as well as the cost to deliver the program. FOCUS is an evidence-based psychoeducational intervention for dyads (cancer patients and caregivers).MethodsA pre-post-intervention design was employed. Eleven, five-session Focus programs were delivered by licensed professionals in a small group format (three–four dyads/group) to 36 patient-caregiver dyads. An Implementation Training Manual, a FOCUS Intervention Protocol Manual, and weekly conference calls were used to foster implementation. Participants completed questionnaires prior to and following completion of each five-session FOCUS program to measure primary (emotional distress, quality of life) and secondary outcomes (benefits of illness, self-efficacy, and dyadic communication). Enrollment and retention rates and fidelity to FOCUS were used to measure feasibility. Cost estimates were based on time and median hourly wages. Repeated analysis of variance was used to analyze the effect of FOCUS on outcomes for dyads. Descriptive statistics were used to examine feasibility, satisfaction, and cost estimates.ResultsFOCUS had positive effects on QOL (p = .014), emotional (p = .012), and functional (p = .049) well-being, emotional distress (p = .002), benefits of illness (p = .013), and self-efficacy (p = .001). Intervention fidelity was 85% with enrollment and retention rates of 71.4 and 90%, respectively. Participants were highly satisfied. Cost for oversight and delivery of the five-session FOCUS program was $168.00 per dyad.ConclusionsFOCUS is an economic and effective intervention to decrease distress and improve the quality of life for dyads.

A critical literature review of dyadic web‐based interventions to support cancer patients and their caregivers, and directions for future research

“…They are usually restricted by space‐time or delivered in a single audio format instead of in a combination of diverse formats, such as pictures, text, audio, and video. For instance, a traditional FOCUS psychoeducational programme targeting patient‐caregiver pairs and delivered via face‐to‐face sessions showed significant positive effects on dyads' QOL and emotional distress . Campbell et al explored the efficacy of telephone‐based coping skills training for patients with prostate cancer and their partners to cope with treatment side effects.…”

“…The results showed that it benefited both QOL and psychological health. Notwithstanding the effectiveness of these interventions, low recruitment or high attrition rates are common . Various reasons for this have been reported, including long‐distance travel, scheduling conflicts, and illness severity …”

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“…The teaching materials used in the program focus on the theoretical level, which are difficult to understand, even for some informal caregivers. A previous study showed using picture books as intervention tools was helpful to improve the attention and executive function in community-dwelling older adults [56]. Another reason might be that the length of the intervention was too limited to improve the psychological parameters significantly [55].…”

The ‘Charter of Rights for Family Caregivers’. The role and importance of the caregiver: an Italian proposal

“…At the same time, the programme managed to improve the benefits gained from the cancer experience and the level of self-efficacy. 14 …”