Regan, T.W., Lambert, S.D., Girgis, A., Kelly, B., Kayser, K., & Turner, J. (2012). Do couple-based interventions make a difference for couples affected by cancer?: A systematic review. BMC Cancer, 12, 279.

DOI Link

Purpose

STUDY PURPOSE: To explore the efficacy of interventions provided to couples 

TYPE OF STUDY: Systematic review

Search Strategy

DATABASES USED: CINAHL, PsycINFO, MEDLINE, EMBASE, ISI Web of Science
 
KEYWORDS: couple; partner; support; caregiver; carer; family; spouse; wife; close relatives; significant other; family; relatives; cancer
 
INCLUSION CRITERIA: Evaluated a psychosocial intervention for patients with cancer and their caregivers; experimental or quasi-experimental design; included depression, anxiety, distress, or quality of life as an outcome measure
 
EXCLUSION CRITERIA: Compared similar interventions; included pharmacologic, exercise, or dietary elements in the intervention; focused on sexuality

Literature Evaluated

TOTAL REFERENCES RETRIEVED = 1,279
 
EVALUATION METHOD AND COMMENTS ON LITERATURE USED: Criteria of the Effective Public Health Practice Project and the National Health and Medical Research Council guidelines for assessing levels of evidence

Sample Characteristics

  • FINAL NUMBER STUDIES INCLUDED = 23
  • SAMPLE RANGE ACROSS STUDIES, TOTAL PATIENTS INCLUDED IN REVIEW: Not provided
  • KEY SAMPLE CHARACTERISTICS: Various tumor sites; more than 80% of patients and caregivers were Caucasian; 86% of caregivers were spouses; more than 62% of patients and caregivers had at least some college education.

Results

Six studies evaluated social adjustment for patients and partners. All showed greater improvement in adjustment for intervention partners at various study time points. Nine studies evaluated relationship functioning and the quality of the patient-partner relationship. All of these showed improvement with the intervention at various time points in the study. Five studies evaluated coping strategies, and all showed greater improvement in coping with the intervention. Of four studies that looked at self-efficacy, two showed improvement with the intervention and two showed no significant effect. Two studies assessed partner communication, and both showed improvement with the intervention. Interventions in early-stage cancer appeared to result in greater improvement compared to those targeting late- or advanced-stage cancer. No significant differences were found comparing face-to-face and telephone delivery of interventions. In eight of the studies, the interventions were provided by nurses. Other providers were social workers, psychologists and therapists, or counselors (no experience or qualifications provided).

Conclusions

Couple-based psychosocial and psychoeducational interventions are shown to be effective in improving caregiver coping and self-efficacy, as well as couple relationship and communications. Face-to-face and telephonic delivery of the interventions were effective.

Limitations

Samples were all well-educated Caucasian individuals in heterosexual relationships, so these findings may not be applicable to other groups.

Nursing Implications

Findings show clear benefits of psychoeducational types of interventions delivered to couples for caregivers and patients, and that these have been effectively provided by nurses. Findings also suggest that delivery in formats other than face-to-face situations can be beneficial. Additional research in the efficacy of various modes of delivery would be useful, so that clinicians can determine the most cost-effective and practical approaches that are helpful to patients and caregivers.

Legacy ID

4383