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Caregiver-guided pain coping skills training for patients with advanced cancer: Results from a randomized clinical trial.

Authors
  • Porter, Laura S1
  • Steel, Jennifer L2
  • Fairclough, Diane L3
  • LeBlanc, Thomas W1
  • Bull, Janet4
  • Hanson, Laura C5
  • Fischer, Stacy6
  • Keefe, Francis J1
  • 1 Duke University School of Medicine, Durham, NC, USA.
  • 2 University of Pittsburgh, Pittsburgh, PA, USA.
  • 3 Colorado School of Public Health, Arora, CO, USA.
  • 4 Four Seasons Compassion for Life, Hendersonville, NC, USA.
  • 5 Division of Geriatric Medicine & Palliative Care Program, University of North Carolina, Chapel Hill, NC, USA.
  • 6 University of Colorado, Denver, CO, USA.
Type
Published Article
Journal
Palliative medicine
Publication Date
May 01, 2021
Volume
35
Issue
5
Pages
952–961
Identifiers
DOI: 10.1177/02692163211004216
PMID: 33775175
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Pain is a major concern among patients with advanced cancer and their family caregivers. Evidence suggests that pain coping skills training interventions can improve outcomes, however they have rarely been tested in this population. To test the efficacy of a caregiver-guided pain coping skills training intervention. The primary outcome was caregiver self-efficacy for helping the patient manage pain. A randomized controlled trial compared the intervention to an enhanced treatment-as-usual control. Dyads in both conditions received pain education, and those in the intervention received three sessions of pain coping skills training. Caregiver outcomes (self-efficacy; caregiver strain, caregiving satisfaction, psychological distress) and patient outcomes (self-efficacy, pain intensity and interference, psychological distress) were collected at baseline and post-intervention. Two hundred two patients with stage III-IV cancer and pain and their family caregivers were enrolled from four outpatient oncology clinics and a free-standing hospice/palliative care organization. Compared to those in the control arm, caregivers in the intervention reported significant increases in caregiving satisfaction (p < 0.01) and decreased anxiety (p = 0.04). In both conditions, caregivers reported improvements in self-efficacy, and patients reported improvements in self-efficacy, pain severity and interference, and psychological distress. This is the first study to test a pain coping skills intervention targeted to patients and caregivers facing advanced cancer. Findings suggest that pain education provides benefits for patients and caregivers, and coping skills training may be beneficial for caregivers. Further research is needed to optimize the benefits of education and pain coping skills training for improving cancer pain outcomes.Trial registration: ClinicalTrials.gov NCT02430467, Caregiver-Guided Pain Management Training in Palliative Care.

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