An integrated intervention programme for couples facing colorectal cancer: A randomized controlled trial

A feasibility study of a coping-focused, couple-based family resilience intervention (CCFRI) in supporting couples experiencing colorectal cancer

PURPOSE

Colorectal cancer patients and their spousal caregivers possess the potential to build family resilience and navigate the challenges of the cancer journey. However, few intervention studies have focused on enhancing family resilience among colorectal cancer couples. This study aimed to evaluate the feasibility, acceptability, and preliminary effects of a coping-focused, couple-based family resilience intervention guided by the Walsh Family Resilience Model.

METHODS

A one-group, six-week pre- and post-intervention study was conducted. Six intervention sessions were delivered either face-to-face or by telephone. Quantitative data were collected using self-report questionnaires assessing family resilience, hope, family sense of coherence, spiritual well-being, perceived social support, and couple communication quality. Qualitative data were gathered through semi-structured interviews with open-ended questions and note-taking.

RESULTS

A total of 24 colorectal cancer patient-spousal caregiver dyads were initially recruited for the intervention, but only 19 couples completed all six intervention sessions. Feasibility outcomes indicated a couple recruitment rate of 68.6% and a retention rate of 79.2%. Small to moderate improvements were identified in family resilience, hope, family sense of coherence, perceived social support, and couple communication quality, though spiritual well-being showed limited change. The majority of participants were satisfied with the intervention and provided valuable suggestions for future improvements.

CONCLUSIONS

This study showed that the coping-focused, couple-based family resilience intervention may effectively support colorectal cancer couples, improving adaptation and coping. Future research with larger samples is needed to confirm long-term effects and further refine intervention components.

A randomized controlled trial of an intervention for unmet supportive care needs addressing colorectal cancer couples

PURPOSE

Supported by the Supportive Care Needs Framework (SCNF), we developed a colorectal cancer (CRC) couple-based unmet supportive care needs (USCNs) intervention program, which has been proven to be feasible. The intention was to assess what the clinical efficacy of this intervention would be in CRC couples.

METHODS

One hundred and sixty-eight CRC couples were randomly assigned to one of two groups: a control group (receiving normal care) or an intervention group (receiving normal care plus a five-week USCNs intervention). Information on USCNs, mutual communication, quality of life, and psychological adjustment was gathered from CRC couples both at baseline and right after the intervention. The collected data were examined using repeated measures analysis of variance (ANOVA).

RESULTS

There were 135 CRC couples who completed the five-week intervention and post-intervention outcome measures (retention rate: 80.4%). Combining with the ANOVA results (p < 0.001 for both couples) and the intervention effect sizes Cohen's d (d = 0.33-0.60 for patients, d = 0.22-0.59 for spousal caregivers), the USCNs intervention is effective in improving USCNs, mutual communication, mental health, positive emotions, and negative emotions in CRC couples.

CONCLUSION

The CRC couple-based USCNs intervention effectively reduces USCNs and promotes cancer adjustment among CRC couples. This intervention can assist clinical staff in refining routine care components to enable couples to manage CRC more effectively. In the future, it will be essential to lengthen the follow-up duration to assess the efficacy of the intervention in the long term.

Design of Digital Mental Health Platforms for Family Member Cocompletion: Scoping Review

BACKGROUND

The COVID-19 pandemic placed an additional mental health burden on individuals and families, resulting in widespread service access problems. Digital mental health interventions suggest promise for improved accessibility. Recent reviews have shown emerging evidence for individual use and early evidence for multiusers. However, attrition rates remain high for digital mental health interventions, and additional complexities exist when engaging multiple family members together.

OBJECTIVE

As such, this scoping review aims to detail the reported evidence for digital mental health interventions designed for family use with a focus on the build and design characteristics that promote accessibility and engagement and enable cocompletion by families.

METHODS

A systematic literature search of MEDLINE, Embase, PsycINFO, Web of Science, and CINAHL databases was conducted for articles published in the English language from January 2002 to March 2024. Eligible records included empirical studies of digital platforms containing some elements designed for cocompletion by related people as well as some components intended to be completed without therapist engagement. Platforms were included in cases in which clinical evidence had been documented.

RESULTS

Of the 9527 papers reviewed, 85 (0.89%) met the eligibility criteria. A total of 24 unique platforms designed for co-use by related parties were identified. Relationships between participants included couples, parent-child dyads, family caregiver-care recipient dyads, and families. Common platform features included the delivery of content via structured interventions with no to minimal tailoring or personalization offered. Some interventions provided live contact with therapists. User engagement indicators and findings varied and included user experience, satisfaction, completion rates, and feasibility. Our findings are more remarkable for what was absent in the literature than what was present. Contrary to expectations, few studies reported any design and build characteristics that enabled coparticipation. No studies reported on platform features for enabling cocompletion or considerations for ensuring individual privacy and safety. None examined platform build or design characteristics as moderators of intervention effect, and none offered a formative evaluation of the platform itself.

CONCLUSIONS

In this early era of digital mental health platform design, this novel review demonstrates a striking absence of information about design elements associated with the successful engagement of multiple related users in any aspect of a therapeutic process. There remains a large gap in the literature detailing and evaluating platform design, highlighting a significant opportunity for future cross-disciplinary research. This review details the incentive for undertaking such research; suggests design considerations when building digital mental health platforms for use by families; and offers recommendations for future development, including platform co-design and formative evaluation.

A couple-based dyadic coping intervention for colorectal cancer patient-spousal caregiver dyads: A randomized controlled study

PURPOSE

To evaluate the clinical effects of a couple-focused dyadic coping intervention in colorectal cancer (CRC) couples.

METHODS

The study was a single-blinded randomized controlled study which 226 CRC couples were recruited and randomized to either the intervention (N = 113) or the control (N = 113) group. All couples received usual care while the six-week dyadic coping intervention was provided to the intervened couples in psycho-education and skill training methods through face-to-face combined with telephone formats. Measurement data, including dyadic coping, marital satisfaction, quality of life and psychological well-being were collected at pre- and post-intervention periods. And multilevel model (MLM) was applied to analyze the effects of the intervention and the role tendency.

RESULTS

A total of 173 couples completed the program and post-intervention evaluation. The retention rate was 76.5%. Results from MLM showed that the dyadic coping intervention is effective in promoting levels of dyadic coping (P < 0.001), marital satisfaction (P = 0.042), mental health (P = 0.006), and positive psychological well-being (P < 0.001), and alleviating depression (P = 0.015) in CRC couples. For role tendency, the intervention found to be more effective in CRC spousal caregivers' positive psychological well-being compared to the patients (P = 0.037).

CONCLUSION

The couple-based dyadic coping intervention is effective in promoting dyadic coping and improving psychological adjustment in CRC couples. More studies were needed to further evaluate the program and its long-term efficacy in the future. In addition, given the positive effects of the intervention, clinical nursing stuffs may consider implementing such intervention in their routine work while caring for CRC couples.