Grant Details
Grant Number: |
5R01CA276035-02 Interpret this number |
Primary Investigator: |
Milbury, Kathrin |
Organization: |
University Of Tx Md Anderson Can Ctr |
Project Title: |
Psycho-Spiritual Management for Patients with Advanced Cancer and Their Family Caregivers |
Fiscal Year: |
2024 |
Abstract
PROJECT SUMMARY/ABSTRACT
Given the generally incurable nature of metastatic cancer, patients and their family caregivers are at high risk of
experiencing depressive symptoms and spiritual distress (e.g., lack of meaning and peace, despair, alienation).
As caregivers struggle with their own fears and stressors, providing quality support and care to the patient may
be difficult. Moreover, psychospiritual distress is interdependent in families coping with cancer suggesting the
need for a dyadic approach to psychospiritual supportive care. Despite accumulating evidence that highlights
the value of positive psychology interventions in improving depressive symptoms and spiritual wellbeing,
evidence-based dyadic interventions are limited in the palliative care setting. To address critical knowledge gaps
and build upon our pilot work, we propose an adequately powered efficacy trial of a 4-session family-focused
meditation (FFM) intervention targeting psychospiritual outcomes. Patient-family caregiver dyads will be
randomized to either the FFM intervention, a usual care (UC) control group or a dose-matched attention control
(AC) group receiving a social support intervention. To enhance accessibility and scalability for future
dissemination, the FFM and AC interventions will be delivered via videoconferencing. To increase generalizability
of our findings, we will use a multi-site enrollment strategy and recruit families from a community hospital caring
for a diverse including underserved patient population. We will administer all study procedures including the
Patients and caregivers will complete
assessments at baseline (prior to randomization) and then again 6, 12, and 24 weeks later. Guided by our
exciting pilot findings, we propose a multi-method assessment strategy to uncover a priori intervention
mechanisms. In addition to self-reports, at baseline and the 6-week follow-up, patients and caregivers will wear
a device called the Electronically Activated Recorder (EAR), an innovative, in vivo naturalistic observation tool
that will allow us to objectively assess changes in observed behaviors in daily life as a function of group
assignment to evaluate mechanisms of intervention efficacy. We propose depressive symptoms as the primary
outcome given the prognostic value of depression in the survival of metastatic cancer patients and family
caregivers; and spiritual wellbeing as the secondary outcome as it protects against the desire for a hastened
death, hopelessness, and suicidal ideation independent of depression in patients with metastatic cancer. For
families who transition to end of life care over the course of the study, we seek to explore their experiences with
this transition and if the FFM program improves patient and caregiver psychospiritual adjustment at this crucial
timepoint. The knowledge gained from this randomized controlled trial will advance the science of behavioral
medicine, and, ultimately, inform the clinical care of a vulnerable and understudied patient-caregiver population.
intervention in English or Spanish based on participant preference.
Publications
None