Randomized clinical trial of a family intervention for prostate cancer patients and their spouses.
BACKGROUND
Few intervention studies have been conducted to help couples manage the effects of prostate cancer and maintain their quality of life. The objective of this study was to determine whether a family-based intervention could improve appraisal variables (appraisal of illness or caregiving, uncertainty, hopelessness), coping resources (coping strategies, self-efficacy, communication), symptom distress, and quality of life in men with prostate cancer and their spouses.


METHODS
For this clinical trial, 263 patient-spouse dyads were stratified by research site, phase of illness, and treatment; then, they were randomized to the control group (standard care) or the experimental group (standard care plus a 5-session family intervention). The intervention targeted couples' communication, hope, coping, uncertainty, and symptom management. The final sample consisted of 235 couples: 123 couples in the control group and 112 couples in the experimental group. Data collection occurred at baseline before randomization and at 4 months, 8 months, and 12 months.


RESULTS
At 4-month follow-up, intervention patients reported less uncertainty and better communication with spouses than control patients, but they reported no other effects. Intervention spouses reported higher quality of life, more self-efficacy, better communication, and less negative appraisal of caregiving, uncertainty, hopelessness, and symptom distress at 4 months compared with controls, and some effects were sustained to 8 months and 12 months.


CONCLUSIONS
Men with prostate cancer and their spouses reported positive outcomes from a family intervention that offered them information and support. Programs of care need to be extended to spouses who likely will experience multiple benefits from intervention.
Northouse
Laurel L
LL
School of Nursing, University of Michigan, Ann Arbor, Michigan 48109-5482, USA. lnortho@umich.edu
Mood
Darlene W
DW
Schafenacker
Ann
A
Montie
James E
JE
Sandler
Howard M
HM
Forman
Jeffrey D
JD
Hussain
Maha
M
Pienta
Kenneth J
KJ
Smith
David C
DC
Kershaw
Trace
T
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D011471:Prostatic Neoplasms / Q000523:psychology*; D011788:Quality of Life; D012944:Social Support; D018454:Spouses / Q000193:education / Q000523:psychology*; D016896:Treatment Outcome