Coping Skills Practice and Symptom Change: A Secondary Analysis of a Pilot Telephone Symptom Management Intervention for Lung Cancer Patients and Their Family Caregivers.
Study Goal
The researchers aimed to examine associations between coping skills practice (including mindfulness) and symptom changes in lung cancer patients and their caregivers.
Results Summary
Greater practice of mindfulness exercises was unexpectedly associated with higher pain and fatigue interference in patients, suggesting potential negative effects. The study found mixed results for other coping skills, with assertive communication and guided imagery showing benefits for patients and caregivers, respectively.
Population
Lung cancer patients and their family caregivers (51 dyads).
Effective Dosage
Not specified (mindfulness was one of several coping skills taught in weekly sessions).
Duration
Four weeks.
Interactions
None mentioned.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
greater practice of assertive communication | decrease | pain interference | patients | - | was associated with less | #1 |
greater practice of assertive communication | decrease | psychological distress | patients | - | was associated with less | #2 |
greater practice of guided imagery | decrease | psychological distress | caregivers | - | was associated with less | #3 |
greater practice of a mindfulness exercise | increase | pain interference | patients | - | was associated with higher | #4 |
greater practice of a mindfulness exercise | increase | fatigue interference | patients | - | was associated with higher | #5 |
greater practice of problem solving | increase | distress related to breathlessness | patients | - | was associated with higher | #6 |
greater practice of problem solving | increase | psychological distress | patients | - | was associated with higher | #7 |
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.