A couple-based complex intervention for Chinese spousal caregivers and their partners with advanced cancer: An intervention study

Background Guided by the Preliminary Live with Love Conceptual Framework (P-LLCF) for Cancer Couple Dyads, a Caring for Couples Coping with Cancer (4Cs) program was developed to support couples coping with cancer as a unit. This study examined the acceptability, feasibility, and the preliminary effect of the 4Cs program. Methods A pre- and post-intervention study design with no control group was conducted among Chinese cancer patients and their spousal caregivers. Among the 135 couples approached, a total of 117 dyads were successfully recruited at baseline, with 92 dyads successfully followed-up at 6 weeks. Outcome measures, including dyadic mediators (self-efficacy), dyadic appraisal (Cancer Related Communication Problem, CRCP), dyadic coping (Dyadic Coping Inventory, DCI), and dyadic outcomes (physical and mental health, negative and positive emotions, and marital satisfaction), were assessed at T0 (pre-intervention) and T1 (post-intervention). Repeated measures analysis of variance was applied in testing the outcomes of the 4Cs program. Results The recruitment and retention rates were 86.7% and 78.6%, respectively. Significant improvements were seen in the couples' scores on overall (total) self-efficacy (P < 0.01), CRCP (P < 0.05), DCI (P < 0.05), the physical component summary (PCS) of SF-12 (P < 0.05), anxiety (P < 0.01), and benefit findings (P < 0.05) from T0 to T1. Spousal caregivers scored significantly higher on self-efficacy (P < 0.05), the PCS (P < 0.01), and anxiety (P < 0.05) than the patients. The overall effect sizes calculated in this study ranged from medium to small. Conclusions This study provides evidence suggesting that the 4Cs program is acceptable, feasible, and improved outcomes in supporting Chinese couples coping with cancer as dyads.