Abstract
BackgroundGiven the generally incurable nature of metastatic non-small cell lung cancer (mNSCLC), patients and their romantic partners are at risk for existential/spiritual distress. Although a handful of dyadic psychosocial interventions for lung cancer patients and their caregivers exist, none of them target spiritual well-being. Informed by the mindfulness-based intervention literature and our pilot work in couples affected by lung cancer, we developed a brief couple-based mind-body (CBMB) intervention. The primary aim of this research protocol is to determine the feasibility of implementing the CBMB intervention versus an active control (AC) or wait list control (WLC) group in patients with mNSCLC and their partners using a randomized controlled trial design.MethodsSeventy-five patients with mNSCLC receiving treatment and their partners are randomized to the CBMB intervention, an AC or a WLC group. Those in the CBMB intervention and AC groups receive four intervention sessions of 60 min each over 4 weeks and complete weekly homework assignments. The first session is delivered in person, and the remaining sessions are delivered via videoconference. The dyads in the AC group discuss cancer-related and personal growth concerns with the interventionist but are not taught coping skills. Patients and partners in all groups complete baseline assessments of quality of life (QOL) prior to randomization. Follow-up assessments are performed 4 weeks and then again 3 months later. The primary outcome is feasibility (i.e., ≥ 30% of eligible couples consent, ≥ 70% of enrolled couples are retained, and ≥ 50% of all CBMB and AC sessions are attended). We will also perform primarily descriptive analyses of the self-reported outcomes (e.g., spiritual well-being and psychological distress) and explore potential intervention mediators (i.e., compassion, communication, mindfulness, and closeness) to inform a larger, future trial.DiscussionThis trial will provide important information regarding the feasibility of a behavioral intervention in a vulnerable yet understudied population using videoconferencing and descriptive data regarding spiritual well-being and other indices of QOL in both mNSCLC patients and their partners.Trial registrationClinicalTrials.gov NCT02596490
Highlights
Given the generally incurable nature of metastatic non-small cell lung cancer, patients and their romantic partners are at risk for existential/spiritual distress
To address the gaps in the literature regarding dyadic psychosocial interventions for lung cancer patients and their romantic partners, we developed a mindfulness-based intervention designed to target the psychospiritual needs of couples affected by metastatic non-small cell lung cancer (mNSCLC)
Informed by the mindfulness-based intervention literature for cancer and our previous work suggesting that a meditation program increases spiritual well-being and reduces distress outcomes in patients with stage I–III lung cancer and their partners [10, 11], we developed a brief couple-based mind-body (CBMB) intervention
Summary
Given the generally incurable nature of metastatic non-small cell lung cancer (mNSCLC), patients and their romantic partners are at risk for existential/spiritual distress. A handful of dyadic psychosocial interventions for lung cancer patients and their caregivers exist, none of them target spiritual well-being. Given the high symptom burden and generally incurable nature of metastatic non-small cell lung cancer (mNSCLC), spiritual distress (e.g., lack of meaning and hopelessness) is common in patients and their families [1]. Spiritual pain (described as “pain deep in the soul or being that is not physical”), endorsed by 44% of patients with advanced cancer, is adversely related to physical and emotional symptoms [1]. Spiritual well-being is an important aspect of QOL management in this patient population
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