Lung cancer is the leading cause of cancer mortality in the United States. Patients with advanced LC experience higher rates of physical and emotional distress relative to those with other cancers and this adds to the suffering of their families who play a key role in providing care and emotional support. Despite the input of outpatient palliative and respite care services, LC families are often unprepared and lack the resources for caregiving, have low self-efficacy for managing symptoms at home, report high rates of emotional distress, and receive very little psychosocial care. Only a handful of randomized controlled trials (RCTs) of psychosocial interventions for the caregivers of advanced cancer patients have been conducted. Most have targeted the families of hospice patients (not undergoing treatment), have not been well-integrated into routine palliative care, and have not addressed the specific needs of LC caregivers. Programs that address these gaps may not only improve family caregiver QOL, but also patient QOL and the quality of palliative and supportive care services that are offered to cancer patients and their families.
This study seeks to test the efficacy of a psychosocial intervention to empower lung cancer caregivers and improve their quality of life. The program, called CareSTEPS, provides skills training in six domains that are central to the caregiving role: self-Care, Stress management, sympTom management, Effective communication, Problem-solving, and Social support.
Two hundred advanced LC patients who are within one month of treatment initiation (baseline) and their caregivers will complete baseline surveys and be randomized to either CareSTEPS or a usual medical care (UMC) condition. In addition to UMC, caregivers in the CareSTEPS condition will receive an intervention manual and six weekly 45-minute telephone counseling sessions with a trained interventionist. Patients and caregivers in both the CareSTEPS and UMC conditions will complete follow-up surveys at eight weeks and six months post-baseline.
The primary aim is to determine the impact of the CareSTEPS intervention on caregiver self-care behaviors, physical and emotional QOL, and satisfaction with care. We hypothesize that at the 8 week and 6 month follow-ups, caregivers in the CareSTEPS group will engage in more self-care behaviors, and report better physical QOL, less emotional distress, less caregiver burden, and greater satisfaction with care relative to caregivers in the UMC group.
By empowering families with the skills they need to provide care and meet the challenges of LC, CareSTEPS holds great promise for improving caregiver QOL, patient QOL, and the quality of palliative and supportive care services offered to patients with advanced cancer and their families.
Funded by R01CA187143. ClinicalTrials.gov Identifier: NCT02414672