Caregiver/partner interventions refer to provision of a specific intervention to a patient’s informal caregiver, spouse, or partner in an attempt to affect the patient's symptoms. Caregiver/partner interventions involving education and enhancing partner adjustment to the patient’s illness have been studied in patients with cancer in an attempt to manage patient anxiety.
Cochrane, B.B., Lewis, F.M., & Griffith, K.A. (2011). Exploring a diffusion of benefit: Does a woman with breast cancer derive benefit from an intervention delivered to her partner? Oncology Nursing Forum, 38, 207–214.
To provide preliminary data on the diffusion of psychosocial benefit (anxiety, depressed mood, and marital quality) for women diagnosed with breast cancer when only their partners received a psychoeducational intervention focused on the breast cancer experience
Five group sessions focusing on stress-reduction and interpersonal communication were delivered to the patient’s partner. The program focused on enhancing partner adjustment to the breast cancer experience and skill training to enhance the diagnosed woman’s perceived support. Sessions focused on stress-reduction strategies, enhancing listening skills, and resisting a tendency to fix or reassure prematurely, along with nonverbal strategies to enhance their interpersonal connection.
Patients were undergoing the diagnosis phase of care.
A pre/post-test design was used.
Average patient state anxiety score improved from 44.1 preintervention to 31 postintervention (p = 0.01).
There is preliminary support for a diffusion of benefit to the diagnosed woman when a psychoeducational intervention is delivered to her partner in terms of depression and anxiety.
Findings may not be applicable to other socioeconomic or education level groups.
Manne, S.L., Ostroff, J.S., Winkel, G., Fox, K., Grana, G., Miller, E., . . . Frazier, T. (2005). Couple-focused group intervention for women with early stage breast cancer. Journal of Consulting and Clinical Psychology, 73, 634–646.
The intervention was a couple-focused support group intervention (90-minute group session over six weeks). The intervention consisted of enhanced support exchanges and coping skills between women with cancer and their partners. One group received the intervention and one group received usual care, which included social work consultations for all women and referral to a psychiatrist or psychologist if indicated. Assessments occurred initially, after the first group session, at the end of group session 6, and at six months for follow-up.
A longitudinal, randomized controlled trial design was used.
Analysis evaluated subgroups of data using growth curves models approach with three-step procedure. For first step, time was considered the only explanatory variable. For second step, demographic, medical, site, treatment, and psychological covariates were examined. Third step examined moderator effects by crossing the intervention group main effect with time and the proposed mean-centered moderators. All multiple mean comparisons were adjusted with Tukey.
Women attending sessions reported significantly less distress and anxiety levels than did women receiving usual care or those who dropped out of the intervention (p = 0.0171). Findings suggest that women who rated their partners as more unsupportive and those who had greater physical impairment had an increased response to the intervention compared to women in the control group. Thirty-five percent dropped out of the intervention. Results via ITT analysis: First step (time) indicated significant decline in anxiety over time ([t344] = -2.21, p = 0.0280) and significant differences among participants both in preintervention anxiety (z = 8.02, p < 0.0001) and in the rates at which anxiety changed over time (z = 2.38, p = 0.0085). Second and third steps steps indicated that interactions involving the intervention group were not significant for anxiety. Effect sizes of intervention were small, ranging from 0.2 to 0.7.
Effect sizes were relatively small (0.2–0.7).