Psychosocial interventions for couples coping with cancer: A systematic review

This chapter systematically reviews the efficacy of existing psychosocial interventions in cancer involving couples on patients' and their partners' quality of life (QOL). We conducted a systematic review of randomized controlled studies of psychosocial interventions conducted with cancer patients and their partners published between 1980 and 2011 that were aimed at improving the patient's and/or the partner's QOL. Using bibliographic software and manual review, two independent raters reviewed 744 articles and identified 19 articles for inclusion. Owing to the varied or sometimes absent theoretical basis, the varied intervention approaches used, and the diversity in outcomes reported, it is difficult to discern a clear pattern of results. Studies that were aimed at improving communication, reciprocal understanding, and intimacy appeared effective in reducing distress and improving relationship functioning in one or both partners. However, such interventions appear to benefit only a subset of couples-particularly those who have poorer functioning relationships, greater cancer-related distress, or poor communication skills at the outset. Questions also remain regarding at what point in the illness and treatment trajectory couples' interventions should be delivered, and how long they should continue. Two areas that appear to be fruitful for future intervention include expanding choice of outcomes to include health behaviors and designing sexual interventions that include both patients and their partners. More research is also needed to determine whether intervention modality affects intervention efficacy and whether technologically based interventions are easier to disseminate and are cost-effective.