Abstract
BackgroundAs the primary informal caregiver for cancer patients, spousal caregivers are a population at a high risk of hidden morbidity. The factors impacting couples coping with cancer are complex, and within spousal caregiver-patient dyads the impact is mutual. The aim of this study is to explain the process that led to the development of an acceptable, feasible, and potentially effective ‘Caring for Couples Coping with Cancer “4Cs” Programme’ to support couples coping with cancer as the unit of intervention in China.MethodsThe Medical Research Council’s (MRC) framework for developing and evaluating complex interventions was adopted to develop an intervention for couples coping with cancer. Three steps were taken in the process of developing the 4Cs programme, namely: (1) identifying the evidence base by conducting a series of extensive reviews of the relevant literature and conducting a focus group study; (2) identifying/developing a theory by proposing a preliminary Live with Love Conceptual Framework ‘P-LLCF’ for cancer couple dyads; and (3) modelling the process and outcomes of the 4Cs programme.ResultsThe programme that was developed is comprised of six individual sessions to be delivered by the researcher/therapists over 6 weeks. The main contents of the sessions of the 4Cs programme are: primary stressors (section 1); secondary stressors (section 2); dyadic mediator (section 3); dyadic appraisal (section 4); dyadic coping (section 5); and a programme overview (section 6). The emphasis of the programme is on supporting couples coping with cancer. A booklet was developed to provide the participants with easy access to written information about their common concerns in caring for loved ones with cancer.ConclusionsGuided by the MRC guidelines, a potentially effective, feasible, and acceptable 4Cs programme aimed at supporting couples coping with cancer as a dyad was developed. Future research is needed to pilot and evaluate the feasibility, modelling, and outcomes of this 4Cs programme.Electronic supplementary materialThe online version of this article (doi:10.1186/s12904-015-0062-7) contains supplementary material, which is available to authorized users.
Highlights
As the primary informal caregiver for cancer patients, spousal caregivers are a population at a high risk of hidden morbidity
The aim of this paper is to explain the process that led to the development of a complex intervention, the ‘Caring for Couples Coping with Cancer “4Cs” Programme’ to support couples coping with cancer as the unit of intervention in China, based on the studies that were undertaken
This section presents the steps that we took in developing a complex intervention, the 4Cs programme, according to the Medical Research Council (MRC) framework, namely: (1) identifying evidence: evidence was identified from reviews of the literature and a focus group interview study; (2) identifying or developing a theory: a preliminary Live with Love Conceptual Framework (P-LLCF) was proposed; and (3) modelling the process and outcomes of the 4Cs programme
Summary
As the primary informal caregiver for cancer patients, spousal caregivers are a population at a high risk of hidden morbidity. A complex intervention is an intervention that consists of various components that act independently or interdependently [1, 2], and whose function and process are standardised [3]. It is considered beneficial and, crucial to include both qualitative and quantitative studies in the lengthy process of developing, piloting, evaluating, reporting, and implementing a complex intervention [1]. Spousal caregivers are said to experience levels of distress as high as or even higher than those felt by the patients themselves [11, 12]
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