Keefe, F.J., Ahles, T.A., Sutton, L., Dalton, J., Baucom, D., Pope, M.S., . . . Scipio, C. (2005). Partner-guided cancer pain management at the end of life: A preliminary study. Journal of Pain and Symptom Management, 29, 263–272.

Intervention goals were to

1. Educate patient/partner dyads about cancer pain and management.
2. Teach dyads a variety of pain coping strategies.
3. Teach partners how to help patients acquire and maintain coping skills.

Three 45- to 60-minute face-to-face sessions with an RN educator for training in pain management strategies were delivered over one to two weeks. Educators were knowledgeable about cancer pain and skilled in coping skills training interventions. Four educators were used, and quality assurance plans were described.

• In session 1, the training program and materials were explained, a videotape was shown, and a book was given regarding barriers, treatments, side effects, and healthcare provider communication.
• In session 2, participants received relaxation training and guided imagery.
• In session 3, an activity pacing method was introduced.

For sessions 2 and 3, the educator guided participants through skills, partners were asked to serve as coach, and the educator provided feedback.

Following completion of the three sessions, the educator reviewed the coping skills found most useful and developed a maintenance plan.

• The sample (N = 78) was comprised of patient/partner dyads.
• Participants were assigned to the intervention group (n = 41) or a control group (n = 37) receiving standard care through their medical outpatient or hospice program.
• Patients had advanced cancer diagnoses and were experiencing disease-related pain (worst pain rating of > 3 on the Brief Pain Inventory), a life expectancy of less than six months, and no change in their disease treatment planned.
• Patients were older than 18 years of age and met Medicare hospice benefit eligibility criteria (regardless of enrollment).

Home setting

A properly randomized, controlled trial design was used (with small sample size). Power analysis was not reported.

• Caregiver Strain Index
• Chronic Pain Self-Efficacy Scale (for caregivers)
• Profile of Mood States–Brief

A trend toward reporting lower levels of caregiver strain (p = 0.06) existed.

Partners receiving the intervention reported significantly higher levels of self-efficacy for helping patients control pain and significantly higher levels of self-efficacy for helping patients control other symptoms.

No significant difference was found in positive or negative mood.

• The sample size was small.
• The study had high attrition rates (31.7% in the intervention group and 24.3% in the control group).