Education, Counseling on Caregiving Role for Spouses Improves Outcomes for Women With Breast Cancer

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Educational counseling for spouses of those with breast cancer can help improve support-related communication.
Educational counseling for spouses of those with breast cancer can help improve support-related communication.

DENVER, CO — An educational counseling intervention delivered directly to spouses of women with breast cancer has a positive effect on outcomes for spouse/caregivers and patients, according to a presentation at the 2017 Oncology Nursing Society Annual Congress.

An estimated 307,660 cases of in situ or invasive breast cancer were diagnosed in 2016. Of those cases, 153,830 involved women whose spouses took on the role of caregiver. Spouse/caregivers are at increased risk for elevated depressed mood and anxiety as a result of their wife's diagnosis. In addition, the disease can have a significant negative impact on marital relationships and the woman's appraisal of spouse's interpersonal support.

Because a breast cancer diagnosis causes ripple effects in the family and can have as significant an impact on a patient's spouse as it does on the patient, Frances Lewis, RN, MN, PhD, FAAN, and colleagues at the University of Washington in Seattle sought to determine the efficacy of an in-person educational counseling intervention, Helping Her Heal (R01-CA-114-561), for the spouse/caregivers of women with breast cancer.

For the study, 322 women with newly diagnosed stage 0-III breast cancer and their spouse/caregivers were randomized to an intervention group or a control group.

The spouses in the intervention group attended in-person fully scripted skill-building and efficacy-enhancing sessions, each session 30 to 60 minutes long, in 2-week intervals for 5 sessions. The spouses in the control group received a booklet, “What's Happening to the Woman I Love?” in the mail.

Outcomes measured were improvement in caregivers' and wives' depressed mood, anxiety, and marital communication; behavioral skills and confidence of spouses in supporting their wives and in managing their own cancer-related distress; and increase in wives' positive appraisal of their spouses' support. Using Linear Mixed Models with an intent to treat analysis, participants were assessed at 3, 6, and 9 months.

Three-month assessments revealed significant improvements in depressed mood, anxiety, marital communication, interpersonal support, self-care, and self-efficacy in the spouse/caregivers in the intervention group compared with those in the control group. The wives' appraisal of spouses' interpersonal support was also significantly improved in the intervention group. All of these differences, except anxiety and depressed mood, were sustained at the 9-month assessment.

In addition, marital communication was improved in intervention-group patients. However, the intervention did not have a significant effect on the patients' anxiety or depressed mood.

Dr Lewis and colleagues conclude that the Helping Her Heal program was beneficial for the spouse/caregivers on most of the measured outcomes. Furthermore, results demonstrated a diffused benefit on the patients' view of the quality of communication with their spouses and their spouses' interpersonal support. However, the researchers note that future studies are needed to help informal caregivers and couples thrive.

Reference

1. Lewis F, Griffith K, Zahlis E, Shands ME, Dawson P. Helping her heal: enhancing marital communication and interpersonal support in spouse caregivers of women with breast cancer. Oral presentation at: Oncology Nursing Society 42nd Annual Congress; May 4-7, 2017; Denver, CO.

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