Randomized Pilot Trial of a Telephone Symptom Management Intervention for Symptomatic Lung Cancer Patients and Their Family Caregivers

Abstract

Context Lung cancer is one of the most common cancers affecting both men and women and is associated with high symptom burden and psychological distress. Lung cancer patients’ family caregivers also show high rates of distress. However, few interventions have been tested to alleviate significant problems of this population. Objectives This study examined the preliminary efficacy of telephone-based symptom management (TSM) for symptomatic lung cancer patients and their family caregivers. Methods Symptomatic lung cancer patients and caregivers (N=106 dyads) were randomly assigned to 4 sessions of TSM consisting of cognitive-behavioral and emotion-focused therapy or an education/support condition. Patients completed measures of physical and psychological symptoms, self-efficacy for managing symptoms, and perceived social constraints from the caregiver; caregivers completed measures of psychological symptoms, self-efficacy for helping the patient manage symptoms and managing their own emotions, perceived social constraints from the patient, and caregiving burden. Results No significant group differences were found for all patient outcomes and caregiver self-efficacy for helping the patient manage symptoms and caregiving burden at 2 and 6-weeks post-intervention. Small effects in favor of TSM were found regarding caregiver self-efficacy for managing their own emotions and perceived social constraints from the patient. Study outcomes did not significantly change over time in either group. Conclusion Findings suggest that our brief telephone-based psychosocial intervention is not efficacious for symptomatic lung cancer patients and their family caregivers. Next steps include examining specific intervention components in relation to study outcomes, mechanisms of change, and differing intervention doses and modalities.

Telemedicine Use Among Caregivers of Cancer Patients: Systematic Review (Preprint)

“…On the other hand, the second cluster concerning carer's relationship with the patient evaluated perceived support such as difficulties encountered in communicating with the patient about the disease, and caregiver's perception of patient's symptom management [51,55,70]. The Edmonton Symptom Assessment Scale (ESAS) was the main tool used to assess these variables.…”

“…These improved outcomes were: caregiver self-efficacy, Quality of Life, distress, depression, appraisal of caregiving, and perceived social support. Caregiver self-efficacy both in managing own emotions and in helping the patients to control symptoms was measured in five studies [52,59,61,67,70] and was always statistically significant. Five studies reported significant differences in Quality of Life aspects: three of them showed significant effects in all dimensions of Quality of Life [52,65,67]; Two studies showed significant effects in spiritual and social well-being [59,65], while one study [60] showed significant outcomes in social well-being.…”

“…In twelve papers an intervention was developed an intervention for a unique type of cancer patients [49,[51][52][53][54]58,60,61,65,66,68,70], while the others implemented telemedicine tools for a multifaceted sample including patients with different cancer diagnoses [48,50,[55][56][57]59,[62][63][64]67,71].…”

“…Eight of them were conducted by prepared nurses [48,52,54,56,59,61,62,71]; four were carried out by social workers [60,65,68,70]; three were operated at a distance by carers distance using web-based platforms [51,55,58]. In three randomized trials the intervention was delivered by clinical psychologists [53,62,69], while in another trial a genetic counsellor conducted the telehealth risk communication to motivate colonoscopy [49].…”

Mediating Roles of Resilience and Optimism between Work Demand and Psychological Distress among Pre-School Pupils’ Caregivers

“…Studies have also been conducted on psychological distress among nursing students [87] and drug users [88][89]. Psychological distress have also been investigated among caregivers particularly of people with chronic obstructive pulmonary disease [90], patients with psychosis [91][92], patients with schizophrenia [93], cancer patients [94], symptomatic lung cancer patients [95], women with ovarian cancer [96], patients with lung cancer [97][98], and individuals with affective disorders [99]. Studies on psychological distress have also been done on caregivers of children with autism spectrum disorder [100][101][102][103] and children with asthma [104], children with a disorder of sex development [105][106].…”