Mosher, C.E., Winger, J.G., Hanna, N., Jalal, S.I., Einhorn, L.H., Birdas, T.J., . . . Champion, V.L. (2016). Randomized pilot trial of a telephone symptom management intervention for symptomatic lung cancer patients and their family caregivers. Journal of Pain and Symptom Management, 52, 469–482.
To test a telephone-based symptom management (TSM) intervention based on social cognitive theory with patients with lung cancer and their caregivers
The control group received education/support. The goal was to test the effect of TSM on the following patient symptoms: anxiety, pain, breathlessness, fatigue, and depressive symptoms. In caregivers, the focus was on anxiety and depressive symptoms. The intervention group dyads received TSM sessions (each was 45 minutes) for four weeks from a licensed social worker who was trained by a psychologist. The intervention involved giving participants instructions on symptom management, problem solving, cognitive restructuring, emotion focused/self-soothing, communication skills, pleasant activity scheduling, and activity pacing. Participants received identical handouts detailing the points discussed and practice assignment and a CD with instructions for relaxation exercises. The teaching was based on various EB cognitive behavioral and emotion-focused strategies. The sessions focused on both the patient and caregiver.
Primary outcomes for the caregivers were:
Secondary outcomes:
No significant main effects were found for primary outcomes for either patients or caregivers. Small effect size improvement in self-efficacy of caregivers managing their own emotions was observed in the TSM group, while it declined slightly in the education/support group. Also, caregivers in the TSM group reported less perceived social constraints compared to the education/support group. No main effects were noticed in caregivers' self-efficacy in relation to managing patients’ symptoms.
The intervention did not demonstrate a significant effect.
The effect of a nonpharmacological (psychosocial) intervention on the symptoms of patients with lung cancer and their caregivers is inconclusive. Psychosocial interventions improved caregivers’ self-efficacy in managing their emotions and perception of social constraints.