A couple-based intervention for patients and caregivers facing end-stage cancer: outcomes of a randomized controlled trial
Article first published online: 14 SEP 2011
Copyright © 2011 John Wiley & Sons, Ltd.
Volume 22, Issue 1, pages 28–38, January 2013
How to Cite
McLean, L. M., Walton, T., Rodin, G., Esplen, M. J. and Jones, J. M. (2013), A couple-based intervention for patients and caregivers facing end-stage cancer: outcomes of a randomized controlled trial. Psycho-Oncology, 22: 28–38. doi: 10.1002/pon.2046
- Issue published online: 4 JAN 2013
- Article first published online: 14 SEP 2011
- Manuscript Accepted: 9 JUL 2011
- Manuscript Revised: 29 JUN 2011
- Manuscript Received: 28 APR 2011
- terminal metastatic cancer;
- marital distress;
- psychosocial distress;
- patient experience of empathic care;
- caregiver burden;
- couple-based intervention
We evaluated the effect of Emotionally Focused Therapy (EFT) [intervention (INT)], modified for the advanced cancer population versus standard care [control (CTL)], on marital functioning and psychosocial outcomes among distressed couples. EFT examines the ways couples process patterns of interaction, facilitating change.
Forty-two patients with metastatic cancer and their caregivers were assigned randomly to receive eight sessions of EFT delivered by one EFT-trained psychologist or standard care provided by multidisciplinary clinicians. Partners completed measures of marital functioning, depression, hopelessness, empathic caregiving (patient), and caregiver burden (caregiver) before randomization at baseline (T0), post-intervention (T1), and 3-month post-intervention (T2). Data were analyzed using three-way analyses of covariance; main effects were treatment, patient status, and sex. Multilevel modeling was also employed.
At T1, INT group led to significant improvement in marital functioning (p ≤ 0.0001) and patients' experience of caregiver empathic care (p = 0.02) versus CTL group. Effect sizes for these differences were in the large range (d = 1.00). In both groups, patients showed a marginally higher mean score for marital functioning compared with caregivers [INT: M = 56.3, standard deviation (SD) = 4.6 vs M = 54.3, SD = 4.5; CTL group: M = 43.4, SD = 10.3 vs M = 42.4, SD = 6.8, respectively]. At T2, results were maintained.
The effectiveness of and adherence to the EFT couple intervention for patients facing advanced cancer were demonstrated in this study. Larger randomized control trials are needed to confirm these findings. Qualitative studies may help to further understand the mechanism by which such an intervention may act. Copyright © 2011 John Wiley & Sons, Ltd.