Let’s chat: Piloting an approach to patient-caregiver goal discussions in a neuro-oncology clinic.

Abstract

28 Background: Communication is important to fostering joint coping in patients with advanced cancer and their family caregivers. Joint goal setting has been shown to enhance relationship quality for dyads and increase interpersonal ease and connection. Often patients and caregivers indicate they wish to discuss issues together but have difficulty doing so, which can inhibit dyadic coping and achievement of treatment goals and interpersonal plans. The aim of this study was to determine the feasibility and describe the methods of a short, one-time goal communication intervention for neuro-oncology patients and their primary family caregivers. Methods: Participants were recruited from a neuro-oncology clinic at an NCI-Designated Comprehensive Cancer Center. After informed consent from both patient and caregiver, the dyad was taken to a private room to complete a demographic questionnaire, eight-minute self-directed dyadic discussion of goals, and post-discussion questionnaire. For the discussion, dyads were asked to create and discuss three goals they had for themselves, and three goals they thought their partner would list, with at least one non-cancer related goal. Results: 10 dyads (n=20) were recruited for this study. Participants were mostly white, non-Hispanic, and married spouses. Only one patient participant was unable to list three goals. Dyads reported that the discussion was not stressful and they found high levels of benefit. Analysis of questionnaire and open-ended feedback overwhelmingly indicated the discussion task was useful to participants and that the study environment encouraged open, non-confrontational communication. Conclusions: Our brief prompted dyadic discussion intervention was feasible to implement and participants reported it was useful. Communication between advanced cancer patients and caregivers is vitally important to facilitate dyadic coping and ensure dyads are better able to achieve their goals. This pilot could be easily adapted to facilitate dyadic communication longitudinally to help facilitate communication between patients and caregivers along the cancer care continuum.