Patients with advanced cancer experience higher rates of physical and emotional distress relative to those with early stage disease, adding to the suffering of their families who play a key role in providing care and emotional support. Despite the input of palliative and respite care services, many advanced cancer patients and their caregivers lack the skills to engage in self-care/caregiving, report poor communication and relationship problems, and experience high rates of emotional distress. Only a handful of randomized controlled trials of psychosocial interventions in advanced cancer 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 multifaceted needs of advanced cancer patients and their caregivers. Programs that address these gaps may not only improve patient and caregiver quality of life, but also their satisfaction with care. The name of the program, NexTSTEPS, is an acronym for six skills that are important for successful symptom management and adjustment to cancer. They represent the next steps to take, so to speak, following the diagnosis of advanced cancer. The next steps are: 1) Taking care of yourself; 2) Stress management; 3) Taking control of symptoms and side effects; 4) Effective communication; 5) Problem solving and coping as a team; and 6) Social support. NexTSTEPS provides skills training in all six areas through a home-based manualized treatment protocol.
Primary aims of the study are to: 1) Determine the effects of NexTSTEPS on patient physical and emotional QOL, palliative care utilization, and satisfaction with care relative to usual medical care; and 2) Determine the effects of NexTSTEPS on caregiver self-care, physical and emotional quality of life, and satisfaction with care relative to usual medical care.
This study is supported by the ACS: RSG 15-058-01 PCSM