Milbury Kathrin, Ann-Yi Sujin, Whisenant Meagan S, Jones Morgan, Li Yisheng, Necroto Victoria, Yousuf Sania D, Chavez-MacGregor Mariana, Meyers Larrisa, Bruera Eduardo
Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, United States.
Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, United States.
Oncologist. 2025 Jul 4;30(7). doi: 10.1093/oncolo/oyae351.
Patients with advanced cancer and their spousal caregivers who parent minor children report unmet parenting concerns and increased psychological distress. Seeking to address these important supportive care needs, this RCT examined the feasibility, acceptability, and initial evidence for the efficacy of a novel psychosocial intervention.
Patients with a metastatic solid malignancy and their spouses completed self-reported validated assessments of psychological symptoms and cancer-related parenting outcomes and were then randomized to the parent support intervention or a usual care (UC) group. Both groups were reassessed 6 and 12 weeks later. Dyads randomized to the counselor-led intervention attended the first 2 sessions jointly addressing illness communication and family routines. Spouses individually attended the last 2 sessions focusing on caregiver support and family death preparedness.
Fifty patients and their spouses were randomized. All a priori feasibility benchmarks were met. Attendance in the intervention arm was high with 84% of caregivers attending all 4 sessions (mean = 3.48). The program was evaluated favorably by all patients and spouses deeming the intervention as beneficial. Caregivers rated the individual-level sessions as particularly helpful. Multilevel analyses revealed a significant reduction in anxiety symptoms (P = .05) and improvement in parenting efficacy (P = .03) at 6-week follow-up in the intervention group compared with UC.
The initial testing of our parent support intervention yielded promising results regarding feasibility and preliminary evidence for efficacy for reduced anxiety symptoms and improved parenting efficacy. This program may meet a frequent and distressing psychosocial need that is typically unaddressed by multidisciplinary oncology teams.
患有晚期癌症的患者及其抚养未成年子女的配偶护理人员表示，他们在育儿方面存在未得到满足的担忧，且心理困扰加剧。为了满足这些重要的支持性护理需求，这项随机对照试验（RCT）研究了一种新型心理社会干预措施的可行性、可接受性以及疗效的初步证据。
患有转移性实体恶性肿瘤的患者及其配偶完成了关于心理症状和与癌症相关的育儿结果的自我报告验证评估，然后被随机分配到父母支持干预组或常规护理（UC）组。两组在6周和12周后重新进行评估。随机分配到由咨询师主导的干预组的二元组共同参加了前两节课，内容涉及疾病沟通和家庭日常事务。配偶们单独参加了最后两节课，重点是护理人员支持和家庭死亡准备。
50名患者及其配偶被随机分组。所有先验可行性基准均得到满足。干预组的出勤率很高，84%的护理人员参加了所有4节课（平均=3.48）。所有患者和配偶都对该项目给予了积极评价，认为该干预有益。护理人员认为个人层面的课程特别有帮助。多层次分析显示，与常规护理组相比，干预组在6周随访时焦虑症状显著减轻（P=0.05），育儿效能有所提高（P=0.03）。
我们的父母支持干预措施的初步测试在可行性以及减轻焦虑症状和提高育儿效能的疗效初步证据方面产生了有希望的结果。该项目可能满足了一种常见且令人痛苦的心理社会需求，而多学科肿瘤团队通常未对此加以解决。
