title: A preliminary study to develop an intervention to facilitate communication between couples in advanced cancer.
abstract: OBJECTIVE
  Psychosocial interventions directed to couples where one has advanced cancer can reduce distress, enhance communication, and provide an opportunity for relational growth. The present study aimed to develop an intervention to facilitate communication about living with advanced cancer using the Patient Dignity Inventory (PDI) as the focus of a clinical interview with couples toward the end of life.
  
  
  METHODS
  Couples were recruited from oncology and palliative care services at a Sydney hospital. After the PDI was developed and manualized as an intervention for couples, the PDI-Couple Interview (PDI-CI) was delivered by a clinical psychologist and comprised the following: (1) the patient completed the PDI; (2) the patient's identified partner completed the PDI about how they thought the patient was feeling; and (3) the clinician reviewed the results with the couple, summarizing areas of concurrence and discordance and facilitating discussion.
  
  
  RESULTS
  Some 34 couples were referred, of which 12 consented, 9 of whom completed the clinical interview. Reported benefits included enabling couples to express their concerns together, identifying differences in understanding, and giving "permission to speak" with each other. The focus of the interview around the PDI provided a structure that was particularly acceptable for men. Most couples confirmed that they were "on the same page," and where differences were identified, it provided a forum for discussion and a mutual understanding of the challenges in managing advanced cancer within a supportive context.
  
  
  CONCLUSIONS
  Participant couples' experiences of the PDI-CI provide valuable insight into the benefits of this intervention. This preliminary study indicates that the intervention is a relatively simple means of enhancing closer communication and connection between couples where one has advanced cancer and may be an important adjunct in helping prepare couples for the challenges inherent toward the end of life. Further investigation of feasibility with a larger sample is recommended.
authors: The School of Medicine, University of Notre Dame,Darlinghurst,New South Wales,Australia.
authors: Jane
authors: J
authors: Mowll
authors: The School of Medicine, University of Notre Dame,Darlinghurst,New South Wales,Australia.
authors: Elizabeth A
authors: EA
authors: Lobb
authors: Illawarra Cancer Care Centre,Wollongong,New South Wales,Australia.
authors: Lisbeth
authors: L
authors: Lane
authors: Calvary Health Care Sydney,Kogarah,New South Wales,Australia.
authors: Judith
authors: J
authors: Lacey
authors: Cancer Care Manitoba, Manitoba Palliative Care Research Unit,Winnipeg,Canada.
authors: Harvey M
authors: HM
authors: Chochinov
authors: The School of Medicine and Public Health, University of Newcastle,New South Wales,Australia.
authors: Brian
authors: B
authors: Kelly
authors: HammondCare, Braeside Hospital,Wetherill Park,New South Wales,Australia.
authors: Meera
authors: M
authors: Agar
authors: Cancer Care Centre, St. George Hospital,Kogarah,New South Wales,Australia.
authors: Matthew
authors: M
authors: Links
authors: Cancer Care Centre, St. George Hospital,Kogarah,New South Wales,Australia.
authors: John H
authors: JH
authors: Kearsley
mesh_terms: D000368:Aged; D002173:Cancer Care Facilities; D017028:Caregivers / Q000523:psychology*; D003142:Communication; D019546:Couples Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D009517:New South Wales; D028723:Personhood; D010865:Pilot Projects; D011594:Psychometrics; D012944:Social Support; D018454:Spouses / Q000523:psychology*; D013315:Stress, Psychological / Q000209:etiology / Q000517:prevention & control*; D011795:Surveys and Questionnaires; D019452:Terminally Ill / Q000523:psychology*
keywords: Advanced cancer; Couple communication; Intervention; Patient dignity inventory