Posttraumatic Growth Intervention Improved Psychological, Physical Health in Patients With CRC and Spouses

A posttraumatic growth (PTG) intervention was found to improve depressive symptoms and physical health in couples coping with colorectal cancer (CRC), according to a study published in Psycho-Oncology.

PTG refers to positive changes in an individual after they have experienced a traumatic event. This can include cancer diagnoses, which can be traumatic for both the patient and their spouse. Spousal caregivers (SC) have been shown to experience negative effects following the news of their spouse’s CRC diagnosis, but previous studies on an intervention to address PTG only focused on the patients. This study aimed to evaluate a PTG intervention on couples experiencing CRC to see if there were positive changes in quality of life and depressive symptoms.

Colorectal cancer | Image credit: Dr_Microbe - stock.adobe.com

A single-blind randomized controlled study design was conducted with only the evaluators blinded. Eligibility criteria included being part of a couple, being aged 18 years or older, and having at least 1 partner diagnosed with non-metastatic CRC that was being treated with chemotherapy. In eligible couples, both members aware of the diagnosis, the spouse was the primary caregiver, neither spouse had any physical or mental illness that was severe, and at least 1 spouse used a cell phone.

All researchers were trained before the start of the study, and all participants were screened by clinical nurses prior to inclusion in the study. Recruitment began in February 2023, and all participants in the intervention group took part in a 5-week intervention for PTG alongside their usual care; the control group only received their usual care. The PTG intervention was delivered to each couple individually. Outcomes and demographics were assessed using questionnaires, with primary outcomes being positive changes. Secondary outcomes included relationship satisfaction, quality of life, and depressive symptoms. Benefit finding (BF) was also used to evaluate positive changes.

There were 151 couples included in the study, with 77 in the intervention group and 74 in the control group. The patients were primarily male (67.8%) and most participants had less than a primary school education (60.3% in patients, 63.8% for SC). The patient and SC were well-informed of the condition in most cases (66.7% in patients, 60.3% in SC). A total of 87.9% of families cited the condition as an economic burden.

Patients and SCs had no differences in outcome measures at baseline compared with the control group. However, post-intervention, patients had higher PTG (t, 2.348; difference, 0.23), physical components summary (t, 3.760; difference, 0.29), and mental components summary (t, 5.631; difference, 0.46) compared with the control group. They also had lower anxiety (t, –3.009; difference, 0.31) and depression (t, –3.470; difference, 0.37). SCs in the intervention group also had higher PTG (t, 2.853; difference, 0.29) and BF (t, 5.300; difference, 0.44) compared with the control group.

There were some limitations to this study. Long-term effects of the intervention could not be assessed when only evaluating patients and SCs at baseline and post-intervention. Follow-up assessments would be needed in future studies. A blank control group was used rather than an active control group. Generalizability is limited due to all participants being of the same cultural background.

The researchers concluded that PTG interventions would be able to help couples where 1 member has been diagnosed with CRC. The researchers suggested that long-term effects of the intervention should be the subject of future research.

Reference

Wang Z, Chen X, Zhou J, Lin C, Zhao J, Li Q. The effect of a couple-based posttraumatic growth intervention in supporting couples coping with colorectal cancer: a randomized controlled study. Psychooncology. Published online March 18, 2024. doi:10.1002/pon.6326