Couples and Cancer: Building Partner Efficacy in Caring

DESCRIPTION (provided by applicant): Current estimates are that one in three Americans - and therefore two in three couples - are likely to face the experience of cancer. This Phase I SBIR proposal is to test the feasibility of improving the efficacy of caregiving provided by the partners of cancer patients. Partners will be trained in selected complementary therapy techniques that show promise for improving quality of life and well-being in cancer. Outcomes will be evaluated over three months. Aim 1: Determine the longitudinal within-subject effects of the intervention on emotional adjustment, functional quality of life, and quality of relationship in a sample of patients and their intimate partners, assessed as individuals. Aim 2: Stratify the sample into subgroups to identify markers predicting who is most likely and who is least likely to be helped by the intervention. Aim 3: Identify barriers and facilitators of utilization of the caregiving techniques taught in the intervention. Achieving the above aims will support testing of the following hypotheses: Hypothesis 1: There will be significant improvements in emotional adjustment, functional quality of life, and quality of relationship during the intervention phase compared to the control phase, for both patients and partners. Hypothesis 2: The partner's frequency of use of the intervention techniques will predict levels of emotional adjustment, functional quality of life, and quality of relationship in both the patient and the partner. Sample: 48 couples, mixed types, stages and durations of cancer. Method: We will use a longitudinal, within-subjects, control and intervention phases design employing statistical methodologies that provide insights into the data that are not afforded by traditional methods (N-of-1 "pre-processing" of single-case longitudinal data; screening the data prior to combining individual subjects into composite groups to assess and circumvent paradoxical confounding; and hierarchically optimal classification tree analysis to provide sample stratification in regard to outcome variables for theoretical maximum accuracy and parsimony). Focus groups will provide qualitative data on barriers and facilitators of utilization, phenomenology of the intervention, and critique for future refinement. Long-term goal: Based on the findings, a Phase II study would develop and test a multimedia approach to the training. The goal is an educational series that is evidence-based, inspirational, and accessible to the mass market of couples facing cancer.