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

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• 作者：Catherine E. Mosher ; PhD^a ; ^{cemosher@iupui.edu" class="auth_mail" title="E-mail the corresponding author} ; Joseph G. Winger ; MS^a ; Nasser Hanna ; MD^b ; Shadia I. Jalal ; MD^b ; ^d ; Lawrence H. Einhorn ; MD^b ; Thomas J. Birdas ; MD^c ; DuyKhanh P. Ceppa ; MD^c ; Kenneth A. Kesler ; MD^c ; Jordan Schmitt ; MD^b ; ^d ; Deborah A. Kashy ; PhD^e ; Victoria L. Champion ; PhD ; RN ; FAAN^f
• 关键词：Lung cancer ; family caregivers ; psychosocial interventions ; cognitive-behavioral ; symptom management ; distress
• 刊名：Journal of Pain and Symptom Management
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：52
• 期：4
• 页码：469-482
• 全文大小：347 K

文摘

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 four 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 two- and six-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.