Milbury K, et al. Oncologist 2020.
BACKGROUND: Although mindfulness-based interventions have been widely examined in patients with non-metastatic cancer, the feasibility and efficacy of these types of programs are largely unknown for those with advanced disease. We pilot-tested a couple-based mediation (CBM) relative to a supportive-expressive (SE) and a usual care (UC) arm targeting psycho-spiritual distress in patients with metastatic lung cancer and their spousal caregivers.
PATIENTS AND METHODS: Seventy-five patient-caregiver dyads completed baseline self-report measures and were then randomized to one of the three arms. Couples in the CBM and SE groups attended four, 60 min. sessions that were delivered via videoconference. All dyads were reassessed 1 and 3 months later.
RESULTS: A priori feasibility benchmarks were met. Although attendance was high in both groups, dyads in the CBM group indicated greater benefit of the sessions than those in the SE group (patients, CBM mean=2.63, SE mean=2.20, P=.003; spouse, CBM mean=2.71, SE mean=2.00, P=.005). Compared with the UC group, patients in the CBM group reported significantly lower depressive symptoms (P=.05; d=.53) and marginally reduced cancer-related stress (P=.07; d=.68). Medium effect sizes in favor of the CBM compared with the SE group for depressive symptoms (d=.59) and cancer-related stress (d=.54) were found. Spouses in the CBM group reported significantly lower depressive symptoms (P<.01; d=.74) compared with those in the UC group.
CONCLUSION: It seems feasible and possibly efficacious to deliver dyadic interventions via videoconference to couples coping with metastatic lung cancer. Mindfulness-based interventions may be of value to managing psychological symptoms in the palliative care setting.