Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2018 May;55(5):1341-1349.e4.
doi: 10.1016/j.jpainsymman.2018.01.005. Epub 2018 Jan 31.

Coping Skills Practice and Symptom Change: A Secondary Analysis of a Pilot Telephone Symptom Management Intervention for Lung Cancer Patients and Their Family Caregivers

Joseph G Winger  1 , Kevin L Rand  2 , Nasser Hanna  3 , Shadia I Jalal  4 , Lawrence H Einhorn  3 , Thomas J Birdas  5 , DuyKhanh P Ceppa  5 , Kenneth A Kesler  5 , Victoria L Champion  6 , Catherine E Mosher  2
Affiliations
Randomized Controlled Trial

Coping Skills Practice and Symptom Change: A Secondary Analysis of a Pilot Telephone Symptom Management Intervention for Lung Cancer Patients and Their Family Caregivers

Joseph G Winger et al. J Pain Symptom Manage. 2018 May.

Abstract

Context: Little research has explored coping skills practice in relation to symptom outcomes in psychosocial interventions for cancer patients and their family caregivers.

Objectives: To examine associations of coping skills practice to symptom change in a telephone symptom management (TSM) intervention delivered concurrently to lung cancer patients and their caregivers.

Methods: This study was a secondary analysis of a randomized pilot trial. Data were examined from patient-caregiver dyads (n = 51 dyads) that were randomized to the TSM intervention. Guided by social cognitive theory, TSM involved four weekly sessions where dyads were taught coping skills including a mindfulness exercise, guided imagery, pursed lips breathing, cognitive restructuring, problem solving, emotion-focused coping, and assertive communication. Symptoms were assessed, including patients' and caregivers' psychological distress and patients' pain interference, fatigue interference, and distress related to breathlessness. Multiple regression analyses examined associations of coping skills practice during the intervention to symptoms at six weeks after the intervention.

Results: For patients, greater practice of assertive communication was associated with less pain interference (β = -0.45, P = 0.02) and psychological distress (β = -0.36, P = 0.047); for caregivers, greater practice of guided imagery was associated with less psychological distress (β = -0.30, P = 0.01). Unexpectedly, for patients, greater practice of a mindfulness exercise was associated with higher pain (β = 0.47, P = 0.07) and fatigue interference (β = 0.49, P = 0.04); greater practice of problem solving was associated with higher distress related to breathlessness (β = 0.56, P = 0.01) and psychological distress (β = 0.36, P = 0.08).

Conclusion: Findings suggest that the effectiveness of TSM may have been reduced by competing effects of certain coping skills. Future interventions should consider focusing on assertive communication training for patients and guided imagery for caregivers.

Trial registration: ClinicalTrials.gov NCT01993550.

Keywords: Lung cancer; cognitive-behavioral; family caregivers; intervention components; psychosocial interventions; symptom management.

PubMed Disclaimer

Conflict of interest statement

Disclosures

The authors declare no conflicts of interest.

References

    1. Badr H, Krebs P. A systematic review and meta-analysis of psychosocial interventions for couples coping with cancer. Psychooncology. 2013;22:1688–1704. - PMC - PubMed
    1. Hagedoorn M, Sanderman R, Bolks HN, Tuinstra J, Coyne JC. Distress in couples coping with cancer: A meta-analysis and critical review of role and gender effects. Psychol Bull. 2008;134:1–30. - PubMed
    1. Li Q, Loke AY. A systematic review of spousal couple-based intervention studies for couples coping with cancer: Direction for the development of interventions. Psychooncology. 2014;23:731–739. - PubMed
    1. Northouse LL, Katapodi MC, Song L, Zhang L, Mood DW. Interventions with family caregivers of cancer patients: Meta-analysis of randomized trials. CA Cancer J Clin. 2010;60:317–339. - PMC - PubMed
    1. Lin C-C, Chou P-L, Wu S-L, Chang Y-C, Lai Y-L. Long-term effectiveness of a patient and family pain education program on overcoming barriers to management of cancer pain. Pain. 2006;122:271–281. - PubMed

Publication types

Associated data