Efficacy of problem‐solving therapy for spouses of men with prostate cancer: A randomized controlled trial

Abstract

Objective Prostate cancer can have a significant negative impact on patients and their spouses. Problem‐solving therapy (PST) has been shown to help reduce distress and improve quality of life among cancer and caregiver populations. This study tested the efficacy of PST for spouses of men with prostate cancer. Methods Spouses of men diagnosed with prostate cancer within the past 18 months (N = 164) were randomly assigned to PST (n = 78) or usual psychosocial care (UPC; n = 86). Spouses completed measures of constructive and dysfunctional problem solving, cancer‐related distress, mood, physical and mental health, and dyadic adjustment at preintervention and post‐intervention and 3‐month post‐intervention follow‐up. Results Constructive problem solving increased from pre‐intervention to post‐intervention among spouses receiving PST but not for spouses receiving UPC; this was maintained at follow‐up. There was no decrease in dysfunctional problem solving. Spouses receiving PST versus UPC reported less cancer‐related distress post‐intervention and at follow‐up. There were no significant changes in mood or physical and mental health. Dyadic adjustment was significantly better for spouses receiving PST versus UPC at post‐intervention but not at follow‐up. Improvements in constructive problem solving mediated better mood and dyadic adjustment post‐intervention. Conclusions Results support the efficacy of PST for improving spouses' constructive problem solving. There was evidence of both direct and mediated positive effects of PST for both individual and dyadic adjustment. PST may be useful for improving individual and dyadic outcomes for spouses of men with prostate cancer.

The effectiveness of psychoeducational interventions on caregiver‐oriented outcomes in caregivers of adult cancer patients: A systematic review and meta‐analysis

“…Twenty‐four of the included articles reported RCTs while four studies used a quasi‐experimental design to assess the effect of PEIs on caregiver outcomes 15,34–36 . The majority of the trials were conducted in the United States of America 37–46 with just one trial from France, 47 Nigeria, 36 and Taiwan 35 …”

“…Other interventions were facilitated by social workers, 34,37,44,46,50 psychologists, 15,34,56,58 oncology experts 38 and three studies were facilitated by trained researchers 55,57,60 . The PEIs in 14 of the included trials was guided by a conceptual framework, 35,37,39,41,45,46,50,53,55,60,62,63 the most common being the Transactional Model of Stress and Coping 35,36,46,53 …”

“…Various caregiver‐reported outcomes were measured across studies such as QoL, depression, anxiety, caregiver burden, caregiving preparedness, supportive care needs and perceived stress. Fourteen studies reported a high Cronbach's alpha as an indicator for internal consistency for various measures for caregiver outcomes 15,35,38,41,42,44,46,48,54,56,57,59,61 . For instance, a Cronbach's alpha of 0.84 and 0.88 was reported for caregiver QoL cancer scale (CQOLC) 38 and Center for Epidemiological Studies‐Depression (CES‐D) 44 respectively.…”

Problem-Solving Based Intervention for Informal Caregivers: A Scoping Review

“…Therefore, the quality of studies is not available. [36] problem-solving [47] problem solving [22] [48] problem solving [49]- [53] problem-solving ability [56] problem solving [39] coping [18] coping [37] improved problem solving [17] improved problem solving [24] [28] [46] less negative problem orientation [47] improved problem solving [56] better problem-solving 11/16 Burden [37] Cancer-related distress [35] subjective and objective burden [23] [24] [25] caregiver reaction [26] burden [13] [43] burden [30] [32] distress, burden [18] perceived stress, burden [33] burden [15] distress [36] burden [47] distress [37] reduced distress [35] reduced burden; Remained low level distress [26] lower burden [42] reduced burden [30] [32] lower leverl of distress and burden [33] reduced burden [15] decreased distress [36]…”

Female partner experiences of prostate cancer patients’ engagement with a community-based football intervention: a qualitative study

“…Limited research has investigated e cacy of psychosocial interventions for partners, and mixed ndings have been reported [7]. Speci cally, partnered exercise (i.e., collaborative engagement in nonsexual physical activities for couples) has potential to be effective, as it can increase engagement in affectionate behaviors [8], whereas intimacy-enhancing therapy [9] and problem-solving therapy [10] may increase relationship satisfaction and constructive problem solving, respectively. Also, research indicates that partners' distress may be relieved by emotional support from a health care provider enhancing their capability to support the patient [11].…”