Examining the effect of peer helping in a coping skills intervention: a randomized controlled trial for advanced gastrointestinal cancer patients and their family caregivers

• Published in: Quality of life research 2018-02, Vol.27 (2), p.515-528
• Main Authors: Mosher, Catherine E., Secinti, Ekin, Johns, Shelley A., O'Neil, Bert H., Helft, Paul R., Shahda, Safi, Jalal, Shadia I., Champion, Victoria L.
• Format: Article
• Language: English
• Subjects: Adaptation, Psychological - physiology; Cancer; Caregivers; Caregivers - psychology; CLINICAL AND POLICY APPLICATIONS; Coping; Families & family life; Female; Gastrointestinal cancer; Gastrointestinal Neoplasms - psychology; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Palliative care; Patients; Peer Group; Peers; Public Health; Quality of life; Quality of Life - psychology; Quality of Life Research; Sociology; Spirituality; Well being
• ISSN: 0962-9343; 1573-2649
• DOI: 10.1007/s11136-017-1620-7

Purpose At the end of life, spiritual well-being is a central aspect of quality of life for many patients and their family caregivers. A prevalent spiritual value in advanced cancer patients is the need to actively give. To address this need, the current randomized trial examined whether adding a peer helping component to a coping skills intervention leads to improved meaning in life and peace for advanced gastrointestinal cancer patients and their caregivers. Feasibility and acceptability outcomes were also assessed. Methods Advanced gastrointestinal cancer patients and caregivers (n = 50 dyads) were randomly assigned to a 5-session, telephone-based coping skills intervention or a peer helping + coping skills intervention. One or both dyad members had moderate-severe distress. Peer helping involved contributing to handouts on coping skills for other families coping with cancer. Patients and caregivers completed measures of meaning in life/peace, fatigue, psychological symptoms, coping self-efficacy, and emotional support. Patient pain and caregiver burden were also assessed. Results Small effects in favor of the coping skills group were found regarding meaning in life/peace at 1 and 5 weeks post-intervention. Other outcomes did not vary as a function of group assignment, with both groups showing small decreases in patient and caregiver fatigue and caregiver distress and burden. High recruitment and retention rates supported feasibility, and high participant satisfaction ratings supported acceptability. Conclusions Although a telephone-based intervention is feasible and acceptable for this population, peer helping in the context of a coping skills intervention does not enhance spiritual well-being relative to coping skills alone.