title: A randomized pilot trial of a telephone-based couples intervention for physical intimacy and sexual concerns in colorectal cancer.
abstract: BACKGROUND
  We previously developed and piloted a telephone-based intimacy enhancement (IE) intervention addressing sexual concerns of colorectal cancer patients and their partners in an uncontrolled study. The current study tested the feasibility, acceptability, and preliminary efficacy of the IE intervention in a randomized, controlled trial.
  
  
  METHODS
  Twenty-three couples were randomized to either the four-session IE condition or to a wait list control condition and completed sexual and relationship outcomes measures. The IE intervention teaches skills for coping with sexual concerns and improving intimacy. Feasibility and acceptability were assessed through enrollment and post-treatment program evaluations, respectively. Effect sizes were calculated by comparing differences in average pre/post change scores across completers in the two groups (n = 18 couples).
  
  
  RESULTS
  Recruitment and attrition data supported feasibility. Program evaluations for process (e.g., ease of participation) and content (e.g., relevance) demonstrated acceptability. Engaging in intimacy-building activities and communication were the skills rated as most commonly practiced and most helpful. For patients, positive effects of the IE intervention were found for female and male sexual function, medical impact on sexual function, and self-efficacy for enjoying intimacy (≥.58); no effects were found on sexual distress or intimacy and small negative effects for sexual communication, and two self-efficacy items. For partners, positive IE effects were found for all outcomes; the largest were for sexual distress (.69), male sexual function (1.76), communication (.97), and two self-efficacy items (≥.87).
  
  
  CONCLUSIONS
  The telephone-based IE intervention shows promise for couples facing colorectal cancer. Larger multi-site intervention studies are necessary to replicate findings.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Barsky Reese
authors.forename: Laura S
authors.initials: LS
authors.lastname: Porter
authors.forename: Katelyn R
authors.initials: KR
authors.lastname: Regan
authors.forename: Francis J
authors.initials: FJ
authors.lastname: Keefe
authors.forename: Nilofer S
authors.initials: NS
authors.lastname: Azad
authors.forename: Luis A
authors.initials: LA
authors.lastname: Diaz
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Herman
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Haythornthwaite
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D015179:Colorectal Neoplasms / Q000523:psychology* / Q000534:rehabilitation; D003142:Communication; D005191:Family Characteristics; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D010865:Pilot Projects; D015397:Program Evaluation; D011788:Quality of Life / Q000523:psychology; D012731:Sex Counseling / Q000379:methods*; D020018:Sexual Dysfunctions, Psychological / Q000517:prevention & control*; D012747:Sexual Partners / Q000523:psychology*; D018454:Spouses; D017741:Survivors / Q000523:psychology*; D013689:Telephone; D016896:Treatment Outcome
keywords: colorectal cancer; couple therapy; feasibility studies; sexual dysfunctions; sexuality