United we stand? The effects of a couple-coping intervention on adjustment to early stage breast or gynecological cancer. Cancer Distress Reduction with a Couple-Based Skills Training: A Randomized Controlled Trial Helping patients with localized prostate carcinoma manage uncertainty and treatment side effects Facilitating research participation and improving quality of life for African American prostate cancer survivors and their intimate partners Feasibility of a dyadic intervention for management of osteoarthritis: A pilot study with older patients and their spousal caregivers Couple-focused group intervention for women with early stage breast cancer. Promoting Adaptive Coping by Persons With HIV Disease: Evaluation of a Patient/Partner Intervention Model Couple-focused support to improve HIV medication adherence: a randomized controlled trial Dyads affected by chronic heart failure: a randomized study evaluating effects of education and psychosocial support to patients with heart failure and their partners. Randomized clinical trial of a family intervention for prostate cancer patients and their spouses Effects of spouse-assisted coping skills training and exercise training in patients with osteoarthritic knee pain: a randomized controlled study Depression and Anxiety in Women With Breast Cancer and Their Partners A randomized pilot trial of a telephone-based couples intervention for physical intimacy and sexual concerns in colorectal cancer. Promoting couples collaboration in type 2 diabetes: the diabetes support project pilot data. Spouse-assisted training in pain coping skills and the outcome of multidisciplinary pain management for chronic low back pain treatment: a 1-year randomized controlled trial. Project Genesis: assessing the efficacy of problem-solving therapy for distressed adult cancer patients. Intervention to influence behaviors linked to risk of chronic diseases: a multisite randomized controlled trial with African-American HIV-serodiscordant heterosexual couples. A randomized trial of a representational intervention for cancer pain: does targeting the dyad make a difference? A couple-based intervention for patients and caregivers facing end-stage cancer: outcomes of a randomized controlled trial. Coronary artery bypass graft surgery patients and their family member caregivers: outcomes of a family-focused staged psychoeducational intervention. Effects of a brief intervention program for patients with cancer and their partners on feelings of inequity, relationship quality and psychological distress. A randomized controlled trial to evaluate the effectiveness of CouPLES: a spouse-assisted lifestyle change intervention to improve low-density lipoprotein cholesterol. Intimacy-enhancing psychological intervention for men diagnosed with prostate cancer and their partners: a pilot study. Partner participation in cognitive-behavioral self-management group treatment for patients with rheumatoid arthritis. Improving the quality of life of patients with prostate carcinoma Mechanisms of patient health behavior change in a randomized controlled trial of a spouse-assisted intervention Partner-guided cancer pain management at the end of life: a preliminary study. A couple-based intervention for female breast cancer.
Cancer diagnosis affects the psychological well-being of both patients and their partners , and effective coping has been suggested to be a conjoint process of mutual support . Ninety-four married women with early stage cancer and their partners were r and omly assigned to couples-based coping training ( CanCOPE ) , individual coping training for the woman , or a medical education control . Couples ' observed support communication and self-reported psychological distress , coping effort , and sexual adjustment were assessed at diagnosis , after cancer surgery , and at 6- and 12-month follow-ups . CanCOPE produced significant improvements in couples ' supportive communication , reduced psychological distress and coping effort , and improved sexual adjustment . Training in couples rather than individual coping was more effective in facilitating adaptation to cancer Background There are few interventions for couples facing cancer . Purpose This study aims to investigate the utility of providing dyadic skills to these couples . Methods Woman recently diagnosed with breast or gynecological cancer and their partners were r and omly assigned to either a couple-skills intervention ( Side by Side ) or to cancer education ( Couples Control Program ) . Assessment s with self-report and behavioral observation of both partners were conducted four times over 16 months . Results Multilevel analyses of data from 72 participating couples suggest that females receiving Side by Side showed larger reductions in fear of progression , and couples reported less avoidance in dealing with the cancer , more posttraumatic growth , and better relationship skills relative to the Couples Control Program . All differences favoring Side by Side disappeared by 16 months after the diagnosis . ConclusionS hort-term changes in functioning may be improved by enhancing couples ’ dyadic skills during acute medical treatment of the disease The objective of this study was to test the efficacy of an  individualized uncertainty management intervention delivered by telephone to Caucasian and African‐American men with localized prostate carcinoma and directed at managing the uncertainties of their disease and treatment African American men experience worse prostate cancer outcomes compared with those of Caucasian men , not only in incidence and mortality rates , but also in coping with the side effects of treatment . Unfortunately , African American men have been significantly under‐represented in research evaluating the efficacy of psychosocial interventions for improving coping in prostate cancer survivors . This pilot study explored the feasibility and efficacy of coping skills training ( CST ) , an intervention developed to enhance coping with treatment side effects in a sample of African American prostate cancer survivors and their intimate partners . The intervention was delivered in a telephone‐based format design ed to facilitate research participation . A total of 40 couples were r and omized to either 6 sessions of CST or usual care . Survivors completed measures of disease‐specific quality of life ( QOL ) related to urinary , sexual , bowel , and hormonal symptom domains , as well as measures of global QOL ( i.e. , physical functioning and mental health ) . Partners completed measures of caregiver strain , mood , and vigor . Analysis of data from 30 couples ( 12 couples in CST , 18 couples in usual care ) indicated that CST produced moderate to large treatment effects for QOL related to bowel , urinary , sexual , and hormonal symptoms .  Partners who underwent CST  reported less caregiver strain , depression , and fatigue , and more vigor , with moderate effect sizes observed that approached conventional levels of statistical significance . These preliminary findings suggest that telephone‐based CST is a feasible approach that can successfully enhance coping inAfrican American prostate cancer survivors and their intimate partners . Cancer 2007 . © 2006 American Cancer Society This study evaluated a novel intervention for older osteoarthritis ( OA ) patients and their spousal caregivers that consisted of st and ard patient education supplemented by information related to effectively managing arthritis as a couple . Twenty-four female OA patients and their husb and s were r and omly assigned to either an educational intervention that was targeted at both patient and spouse or to a patient education intervention that was targeted at only the patient . Findings revealed that both interventions were evaluated favorably but the couple intervention was better attended than the patient intervention . In addition , patients in the couple intervention experienced greater increased efficacy in managing arthritis pain and other symptoms . The findings of this pilot study point to the utility of a dyadic intervention approach to management of OA in late life This study examined the efficacy of a couple-focused group intervention on psychological adaptation of women with early stage breast cancer and evaluated whether perceived partner unsupportive behavior or patient functional impairment moderated intervention effects . Two hundred thirty-eight women were r and omly assigned to receive either 6 sessions of a couple-focused group intervention or usual care . Intent-to-treat growth curve analyses indicated that participants assigned to the couples ' group reported lower depressive symptoms . Women rating their partners as more unsupportive benefited more from the intervention than did women with less unsupportive partners , and women with more physical impairment benefited more from the intervention group than did women with less impairment . Subgroup analyses comparing women attending the couple-focused group intervention with women not attending groups and with usual care participants indicated that women attending sessions reported significantly less distress than did women receiving usual care and women who dropped out of the intervention This study evaluated an intervention to facilitate adaptive coping by persons living with HIV ( PLWH ) , with the participation of their cohabiting partners as a dimension of the intervention . An experimental design with r and omization was used , and 84 PLWH and their partners were recruited . The intervention was based on a psychosocial educational model that incorporated four 2-hour sessions focused on communication , stress appraisal , adaptive coping strategies , and building social support . Both members of the dyad were included in each session . The comparison control included four supportive phone calls to the PLWH alone . Data were collected from both the PLWH and their partner in each of the two groups at baseline , immediately following the intervention , and 3 months and 6 months posttreatment . Data were analyzed using repeated measures analysis of variance , with change scores from the partner data being covariates . Results indicated that the design was a feasible model , which demonstrated potential for the management of stress and possibly problems such as adherence in PLWH . A manual was developed as a part of this intervention and is currently available Objective : To assess the efficacy of a couple-based intervention to improve medication-taking behavior in a clinic population with demonstrated adherence problems . Design : A r and omized controlled trial ( SMART Couples Study ) conducted between August 2000 and January 2004 . Setting : Two HIV/AIDS outpatient clinics in New York City . Participants : Heterosexual and homosexual HIV-serodiscordant couples ( n = 215 ) in which the HIV-seropositive partner had < 80 % adherence at baseline . The sample was predominantly lower-income racial/ethnic minorities . Intervention : Participants were r and omly assigned to a four-session couple-focused adherence intervention or usual care . The intervention consisted of education about treatment and adherence , identifying adherence barriers , developing communication and problem-solving strategies , optimizing partner support , and building confidence for optimal adherence . Outcome measures : Medication adherence at week 8 ( 2 weeks after the intervention ) compared with baseline , assessed with a Medication Event Monitoring System cap . Results : Intervention participants showed higher mean medication adherence at post-intervention when compared with controls whether adherence was defined as proportion of prescribed doses taken ( 76 % versus 60 % ) or doses taken within specified time parameters ( 58 % versus 35 % ) . Also , participants in the intervention arm were significantly more likely to achieve high levels of adherence ( > 80 % , > 90 % , or > 95 % ) when compared with controls . However , in most cases , effects diminished with time , as seen at follow-up at 3 and 6 months . Conclusion : The SMART Couples program significantly improved medication adherence over usual care , although the level of improved adherence , for many participants , was still suboptimal and the effect was attenuated over time BACKGROUND Chronic heart failure ( CHF ) causes great suffering for both patients and their partners . The aim of this study was to evaluate the effects of an integrated dyad care program with education and psychosocial support to patients with CHF and their partners during a postdischarge period after acute deterioration of CHF . METHODS One hundred fifty-five patient-caregiver dyads were r and omized to usual care ( n = 71 ) or a psychoeducation intervention ( n = 84 ) delivered in 3 modules through nurse-led face-to-face counseling , computer-based education , and other written teaching material s to assist dyads to develop problem-solving skills . Follow-up assessment s were completed after 3 and 12 months to assess perceived control , perceived health , depressive symptoms , self-care , and caregiver burden . RESULTS Baseline sociodemographic and clinical characteristics of dyads in the experimental and control groups were similar at baseline . Significant differences were observed in patients ' perceived control over the cardiac condition after 3 ( P < .05 ) but not after 12 months , and no effect was seen for the caregivers . No group differences were observed over time in dyads ' health-related quality of life and depressive symptoms , patients ' self-care behaviors , and partners ' experiences of caregiver burden . CONCLUSIONS Integrated dyad care focusing on skill-building and problem-solving education and psychosocial support was effective in initially enhancing patients ' levels of perceived control . More frequent professional contact and ongoing skills training may be necessary to have a higher impact on dyad outcomes and warrants further research Few intervention studies have been conducted to help couples manage the effects of prostate cancer and maintain their quality of life . The objective of this study was to determine whether a family‐based intervention could improve appraisal variables ( appraisal of illness or caregiving , uncertainty , hopelessness ) , coping re sources ( coping strategies , self‐efficacy , communication ) , symptom distress , and quality of life in men with prostate cancer and their spouses & NA ; This study tested the separate and combined effects of spouse‐assisted pain coping skills training ( SA‐CST ) and exercise training ( ET ) in a sample of patients having persistent osteoarthritic knee pain . Seventy‐two married osteoarthritis ( OA ) patients with persistent knee pain and their spouses were r and omly assigned to : SA‐CST alone , SA‐CST plus ET , ET alone , or st and ard care ( SC ) . Patients in SA‐CST alone , together with their spouses , attended 12 weekly , 2‐h group sessions for training in pain coping and couples skills . Patients in SA‐CST+ET received spouse‐assisted coping skills training and attended 12‐weeks supervised ET . Patients in the ET alone condition received just an exercise program . Data analyses revealed : ( 1 ) physical fitness and strength :  the SA‐CST+ET and ET alone groups had significant improvements in physical fitness compared to SA‐CST alone and patients in SA‐CST+ET and ET alone had significant improvements in leg flexion and extension compared to SA‐CST alone and SC , ( 2 ) pain coping : patients in SA‐CST+ET and SA‐CST alone groups had significant improvements in coping attempts compared to ET alone or SC and spouses in SA‐CST+ET rated their partners as showing significant improvements in coping attempts compared to ET alone or SC , and ( 3 ) self‐efficacy : patients in SA‐CST+ET reported significant improvements in self‐efficacy and their spouses rated them as showing significant improvements in self‐efficacy compared to ET alone or SC . Patients receiving SA‐CST+ET who showed increased self‐efficacy were more likely to have improvements in psychological disability . An intervention that combines spouse‐assisted coping skills training and exercise training  can improve physical fitness , strength , pain coping , and self‐efficacy in patients suffering from pain due to osteoarthritis Background : Psychosocial interventions can improve psychological quality of life ( symptoms of depression and anxiety ) of both women with breast cancer and their partners , but are not offered routinely to women and their partners . Objective : To test the hypotheses that telephone-delivered psychosocial interventions decrease depression and anxiety in women with breast cancer and their partners . Methods : The design of the study was a three-wave repeated measures with a between-subjects factor ( treatment group ) . Ninety-six women and their 96 partners were assigned r and omly to participate in one of three different 6-week programs : ( a ) telephone interpersonal counseling ( TIP-C ) ; ( b ) self-managed exercise ; or ( c ) attention control ( AC ) . Results : The mixed-model analysis of variance for symptoms of depression among women with breast cancer revealed  women 's depressive symptom scores decreased over time in all groups . For anxiety , women 's symptoms of anxiety decreased in the TIP-C and exercise groups over time , but not in the AC group . A parallel set of analyses was conducted on  partners ' depression and anxiety data . Symptoms of depression and anxiety among the partners decreased substantially over the course of the investigation . Similar to the women , partners '  symptoms of anxiety decreased significantly in the TIP-C and exercise groups , but not in the AC group . Discussion : Findings from this study support that these telephone-delivered psychosocial interventions were effective for decreasing symptoms of depression and anxiety to improve psychological quality of life when compared to an AC group BACKGROUND We previously developed and piloted a telephone-based intimacy enhancement ( IE ) intervention addressing sexual concerns of colorectal cancer patients and their partners in an uncontrolled study . The current study tested the feasibility , acceptability , and preliminary efficacy of the IE intervention in a r and omized , controlled trial . METHODS Twenty-three couples were r and omized to either the four-session IE condition or to a wait list control condition and completed sexual and relationship outcomes measures . The IE intervention teaches skills for coping with sexual concerns and improving intimacy . Feasibility and acceptability were assessed through enrollment and post-treatment program evaluations , respectively . Effect sizes were calculated by comparing differences in average pre/post change scores across completers in the two groups ( n = 18 couples ) . RESULTS Recruitment and attrition data supported feasibility . Program evaluations for process ( e.g. , ease of participation ) and content ( e.g. , relevance ) demonstrated acceptability . Engaging in intimacy-building activities and communication were the skills rated as most commonly practice d and most helpful . For patients , positive effects of the IE intervention were found for female and male sexual function , medical impact on sexual function , and self-efficacy for enjoying intimacy ( ≥.58 ) ; no effects were found on sexual distress or intimacy and small negative effects for sexual communication , and two self-efficacy items . For partners ,  positive IE effects were found for all outcomes ; the largest were for sexual distress ( .69 ) , male sexual function ( 1.76 ) , communication ( .97 ) , and two self-efficacy items ( ≥.87 ) . CONCLUSIONS The telephone-based IE intervention shows promise for couples facing colorectal cancer . Larger multi-site intervention studies are necessary to replicate findings A pilot study was conducted to assess the feasibility and potential efficacy of a couples focused diabetes intervention in which a collaborative problem-solving approach to diabetes self-care was promoted . Couples ( N = 44 ) , in which one partner had Type 2 diabetes and was in poor blood glucose control were r and omly assigned to one of three groups : a couples intervention , an individual intervention , or individual diabetes education . The intervention included goal - setting , dietary behavior change , and a focus on emotions . For those in the couples arm , this was done within the framework of promoting collaborative communication between the partners . All intervention contacts were over the telephone to increase reach . Results showed that both the individual and couples interventions yielded meaningful clinical improvements in medical outcomes . Diabetes education also result ed in improved blood glucose control . Despite the small number , mixed-model regression analyses found statistically significant treatment effects for total cholesterol . This pilot demonstrates the feasibility and potential efficacy of a telephone intervention for Type 2 diabetes patients and their partners . Information from implementing this pilot led to refinement and further development of the intervention , which is being assessed in a larger , more comprehensive trial This study examined the comparative efficacy of three interventions : a spouse-assisted coping skills training protocol for patients undergoing a multidisciplinary pain management programme ( SA-MPMP ) , conventional patient-oriented multidisciplinary pain management programme ( P-MPMP ) and st and ard medical care ( SMC ) .  Thirty-six chronic low back pain ( CLBP ) patients and their spouses were r and omly assigned to one of the three conditions . The SA-MPMP condition consisted of seven , weekly , 2-h , group sessions of training in dyadic pain coping and couple skills , delivered by a clinical psychologist with support of a multidisciplinary team of specialists , to patients together with their spouses . P-MPMP consisted of the SA-MPMP training delivered to the patient only ( i.e. , no spouse participation and assistance ) . The SMC condition entailed continuation of routine treatment , entailing medical care only . Data analysis revealed that , at the 12-month follow-up time point , patients receiving SA-MPMP had significant improvements in kinesiophobia and rumination about pain compared to those receiving P-MPMP and SMC . In patients suffering from CLBP , an intervention that combines spouse-assisted coping skills training with a multidisciplinary pain management programme can improve fear of movement and rumination about low back pain The efficacy of problem-solving therapy ( PST ) to reduce psychological distress was assessed among a sample of 132 adult cancer patients . A second condition provided PST for both the patient and a significant other . At posttreatment , all participants receiving PST fared significantly better than waiting list control patients . Further , improvements in problem solving were found to correlate significantly with improvements in psychological distress and overall quality of life . No differences in symptom reduction were identified between the 2 treatment protocol s. At a 6-month follow-up , however , patients who received PST along with their significant other reported lower levels of psychological distress as compared with members of the PST-alone condition on approximately half of the outcome measures . These effects were further maintained 1-year posttreatment BACKGROUND The high morbidity and mortality in African Americans associated with behavior-linked chronic diseases are well documented . METHODS We tested the efficacy of an intervention to increase multiple health-related behaviors in African Americans . In a multisite cluster-r and omized controlled trial , groups of African American human immunodeficiency virus (HIV)-serodiscordant heterosexual couples in Atlanta ( Georgia ) , Los Angeles ( California ) , New York ( New York ) , and Philadelphia ( Pennsylvania ) were allocated to an individual-focused health promotion that addressed multiple health-related behaviors or to a couple-focused HIV/sexually transmitted disease ( STD ) risk reduction intervention . Primary outcomes were adherence to fruit and vegetable consumption and physical activity guidelines assessed preintervention , immediately postintervention , and 6 and 12 months postintervention . Secondary outcomes included fatty food consumption , prostate and breast cancer screening , and alcohol use . Generalized estimating equations tested the efficacy of the health promotion intervention over the postintervention assessment s. RESULTS Health promotion intervention participants were more likely to report consuming 5 or more servings of fruits and vegetables daily ( rate ratio [ RR ] , 1.38 ; 95 % confidence interval [ CI ] , 1.18 to 1.62 ) and adhering to physical activity guidelines ( 1.39 ; 1.22 to 1.59 ) compared with HIV/STD intervention participants . In the health promotion intervention compared with the HIV/STD intervention , participants consumed fatty foods less frequently ( mean difference , -0.18 ; 95 % CI , -0.30 to -0.07 ) , more men received prostate cancer screening ( RR , 1.51 ; 95 % CI , 1.21 to 1.88 ) , and more women received a mammogram ( RR , 1.26 ; 95 % CI , 1.06 to 1.50 ) . Alcohol use did not differ between the intervention groups . CONCLUSION This trial demonstrates the efficacy of interventions targeting multiple health-related behaviors in African American HIV-seropositive and HIV-seronegative men and women . Trial Registration clinical trials.gov Identifier : NCT00644163 OBJECTIVE To determine the efficacy in overcoming attitudinal barriers to reporting cancer pain and using analgesics of an educational intervention presented to patients accompanied by a significant other ( SO ) as compared with patients alone . DESIGN Patient-SO pairs ( N = 161 ) were r and omized to the dyad condition ( patient and SO received the intervention ) , solo condition ( patient received the intervention ) , or care as usual . Dyad and solo conditions received the intervention at baseline ( T1 ) and 2 and 4 weeks later . MAIN OUTCOME MEASURES Patients ' and SOs ' attitudes about analgesic use and patients ' pain outcomes ( pain severity , pain relief , interference with life , negative mood , and global quality of life [ QOL ] ) at T1 , 5 weeks later ( T2 ) , and 9 weeks later ( T3 ) . RESULTS Completers ' analyses revealed no significant differences between groups at T2 . At T3 , patients in the dyad and the solo groups showed greater decreases in attitudinal barriers as compared with controls . T1-T3 changes in patients ' barriers mediated between the dyad and solo interventions and pain severity , pain relief , pain interference , negative mood , and global QOL . CONCLUSION The intervention was no more efficacious when it was presented to dyads than to patients alone . Conditions under which SOs should be included in interventions need to be determined BACKGROUND We evaluated the effect of Emotionally Focused Therapy ( EFT ) [ intervention ( INT ) ] , modified for the advanced cancer population versus st and ard care [ control ( CTL ) ] , on marital functioning and psychosocial outcomes among distressed couples .  EFT examines the ways couples process patterns of interaction , facilitating change . METHODS Forty-two patients with metastatic cancer and their caregivers were assigned r and omly to receive eight sessions of EFT delivered by one EFT-trained psychologist or st and ard care provided by multidisciplinary clinicians . Partners completed measures of marital functioning , depression , hopelessness , empathic caregiving ( patient ) , and caregiver burden ( caregiver ) before r and omization at baseline ( T0 ) , post-intervention ( T1 ) , and 3-month post-intervention ( T2 ) . Data were analyzed using three-way analyses of covariance ; main effects were treatment , patient status , and sex . Multilevel modeling was also employed . RESULTS At T1 , INT group led to significant improvement in marital functioning ( p ≤ 0.0001 ) and patients ' experience of caregiver empathic care ( p = 0.02 ) versus CTL group . Effect sizes for these differences were in the large range ( d = 1.00 ) . In both groups , patients showed a marginally higher mean score for marital functioning compared with caregivers [ INT : M = 56.3 , st and ard deviation ( SD ) = 4.6 vs M = 54.3 , SD = 4.5 ; CTL group : M = 43.4 , SD = 10.3 vs M = 42.4 , SD = 6.8 , respectively ] . At T2 , results were maintained . CONCLUSIONS The effectiveness of and adherence to the EFT couple intervention for patients facing advanced cancer were demonstrated in this study . Larger r and omized control trials are needed to confirm these findings . Qualitative studies may help to further underst and the mechanism by which such an intervention may act This experimental study examined the effectiveness of a psychoeducational intervention delivered over 12 weeks . The sample was comprised of 38 coronary artery bypass graft ( CABG ) surgery patient-family member caregiver dyads who completed all six data collection points . Experimental and control groups did not differ in emotional health , functional health status , or satisfaction . Differences in the number of self-reported complications/symptoms were not in the predicted direction . Improvement occurred in clinical , functional , and emotional outcomes ; however , several symptoms , such as fatigue and pain , persisted . Family caregivers reported more depressive symptoms than patients preoperatively and at later stages of recovery . Implication s include the need for instruction about the recovery trajectory and adequate preparation and support of home health nurses and family caregivers When one member of a couple develops a serious illness , the lives of both partners are likely to be affected . Interventions directed at both partners are generally lacking , however . In the present study , a brief counseling program directed at couples confronted with cancer was evaluated . The intervention focused mainly on the exchange of social support and help between both partners and was aim ed at restoring perceptions of equity . Couples were r and omly assigned to an experimental group or a waiting-list group . After the intervention , both patients and their partners reported lower levels of perceptions of underinvestment and overbenefit , and higher levels of relationship quality . Moreover , among patients psychological distress decreased after the intervention . These effects were generally maintained until follow-up three months later . Associations between perceptions of equity and relationship quality and psychological distress were also examined OBJECTIVE This r and omized controlled trial evaluated the effectiveness of a telephone-delivered , spouse-assisted lifestyle intervention to reduce patient LDL-C.  METHOD From 2007 to 2010 , 255 out patients with LDL-C>76 mg/dL and their spouses from the Durham Veterans Affairs Medical Center were r and omized to intervention or usual care .  The intervention comprised nine monthly goal - setting telephone calls to patients and support planning calls to spouses . Outcomes were assessed at 11 months . RESULTS Patients were 95 % male and 65 % White .  LDL-C did not differ between groups ( mean difference = 2.3 mg/dL , 95 % CI = -3.6 , 8.3 , p = 0.44 ) , nor did the odds of meeting goal LDL-C ( OR = 0.95 , 95 % CI = 0.6 , 1.7 ; p = 0.87 ) . Intakes of calories ( p = 0.03 ) , total fat ( p = 0.02 ) , and saturated fat ( p = 0.02 ) were lower for the intervention group . Cholesterol and fiber intake did not differ between groups ( p = 0.11 and 0.26 , respectively ) . The estimated rate of moderate intensity physical activity per week was 20 % higher in the intervention group ( IRR = 1.2 , 95 % CI = 1.0 , 1.5 , p = 0.06 ) . Most participants did not experience a change in cholesterol medication usage during the study period in the intervention ( 71.7 % ) and usual care ( 78.9 % ) groups . CONCLUSION This intervention might be an adjunct to usual primary care to improve adherence to lifestyle behaviors INTRODUCTION Few couple-focused interventions have been developed to improve distress and relationship outcomes among men diagnosed with localized prostate cancer and their partners . AIMS We examined the effects of a five-session Intimacy-Enhancing Therapy ( IET ) vs. Usual Care ( UC ) on the psychological and relationship functioning of men diagnosed with localized prostate cancer and their partners . Pre-intervention levels of psychological and relationship functioning were evaluated as moderators of intervention effects . METHODS Seventy-one survivors and their partners completed a baseline survey and were subsequently r and omly assigned to receive five sessions of IET or UC ( no treatment ) . Eight weeks after the baseline assessment , a follow-up survey was administered to survivor and partner . MAIN OUTCOME MEASURES Distress , well-being , relationship satisfaction , relationship intimacy , and communication were investigated as the main outcomes . RESULTS IET effects were largely moderated by pre-intervention psychosocial and relationship factors . Those survivors who had higher levels of cancer concerns at pretreatment had significantly reduced concerns following IET . Similar moderating effects for pre-intervention levels were reported for the effects of IET on self-disclosure , perceived partner disclosure , and perceived partner responsiveness . Among partners beginning the intervention with higher cancer-specific distress , lower marital satisfaction , lower intimacy , and poorer communication , IET improved these outcomes . CONCLUSIONS IET had a marginally significant main effect upon survivor well-being but was effective among couples with fewer personal and relationship re sources . Subsequent research is needed to replicate these findings with a larger sample and a longer follow-up OBJECTIVE To determine if participation of the spouse of patients with rheumatoid arthritis in cognitive-behavioral oriented self-management training aim ed at improving disease related cognitions and coping with pain has additional benefits for the patients . METHODS A total of 59 couples were r and omly assigned to 2 conditions . In the experimental condition the couples participated in a group program aim ed at restructuring disease related cognitions and decreasing passive coping . In the control condition , only the patient participated . Disease status , self-reported physical and psychological functioning , coping , disease related cognitions , and marriage characteristics were assessed prior to the intervention and 2 weeks and 6 months postintervention . A general linear model with repeated measures was used to test for differences between conditions . RESULTS In both conditions , similar positive changes in disease activity , cognitions , coping , and physical and psychological functioning were observed . Patients reported a decrease in potential support . There were no differences between conditions . However , at the followup assessment patients in the experimental condition reported more improvement of disease related communication with their spouse . CONCLUSION No evidence was found for additional beneficial effects of spouse participation in the cognitive-behavioral oriented self-management group treatment Treatments for clinical ly localized prostate carcinoma are accompanied by sexual , urinary , and bowel dysfunction and other sequelae that can result in significant distress and reduced well being . Methods capable of improving quality of life are needed that can be integrated into clinical practice . To address this need , a nurse‐driven , cancer care intervention was developed and tested Spouse-assisted interventions can improve health behaviors , but mechanisms of action are unknown . This study evaluated mediators of dietary and physical activity outcomes during a  spouse-assisted intervention to improve  low-density lipoprotein cholesterol .  This is a secondary analysis of data from a r and omized controlled trial comparing usual care ( n = 128 ) to a spouse-assisted lifestyle change intervention ( n = 127 ) comprising nine monthly goal setting telephone calls to participants and support planning calls to spouses over 11 months .  Structural equation modeling was used to examine if the intervention influenced the putative mediators of participant self-efficacy and perceived spousal support at 6 months ( i.e. action test ) ; if changes in putative mediators at 6 months were associated with changes in diet and physical activity outcomes at 11 months ( i.e. conceptual test ) ; and if treatment condition effects on outcomes at 11 months were mediated by its effects on the 6-month putative mediators ( i.e. indirect effects test ) . Participants were 94.9 % male , 64.9 % white and were 61.3 years old on average . The action test showed that the intervention increased dietary self-efficacy ( p < .001 ) and perceived spousal support for diet ( p < .001 ) and physical activity ( p < .01 ) at 6 months . The conceptual test showed that increases in participant physical activity self-efficacy at 6 months were associated with increases in physical activity frequency ( p = .01 ) and duration ( p = .04 ) at 11 months ; other putative mediators were not associated with changes in outcomes at 11 months . The indirect effects tests did not support a mediating role for self-efficacy or perceived spousal support . Intervention-induced changes in spousal support and dietary self-efficacy did not translate into behavior change . Other mechanisms may be driving behavior change . Trial registration : Clinical Trials.gov identifier : NCT00321789 This preliminary study tested the efficacy of a partner-guided cancer pain management protocol for patients who are at the end of life . Seventy-eight advanced cancer patients meeting criteria for hospice eligibility and their partners were r and omly assigned to a partner-guided pain management training intervention , or usual care control condition . The partner-guided pain management training protocol was a three-session intervention conducted in patients ' homes that integrated educational information about cancer pain with systematic training of patients and partners in cognitive and behavioral pain coping skills . Data analyses revealed that the partner-guided pain management protocol produced significant increases in partners ' ratings of their self-efficacy for helping the patient control pain and self-efficacy for controlling other symptoms . Partners receiving this training also showed a trend to report improvements in their levels of caregiver strain . Overall , the results of this preliminary study suggest that a partner-guided pain management protocol may have benefits in the context of cancer pain at the end of life . Given the significance of pain at the end of life , future research in this area appears warranted OBJECTIVE Although women 's breast cancer affects both women and their male partners , as well as their relationships , few interventions have been developed to work with couples confronting breast cancer . The current investigation presents the pilot results from a new couple-based intervention program for breast cancer that teaches couples how to minimize negative effects and maximize positive functioning during this difficult time . METHOD In this pilot study , 14 couples in which the wife had early stage breast cancer were r and omly assigned to one of the two treatment conditions : Couple-based relationship enhancement ( RE ) or treatment-as-usual ( TAU ) . RESULTS The results from this study suggest that compared with couples receiving treatment-as-usual , both women and men in the RE condition experienced improved functioning on individual psychological variables as well as relationship functioning at posttest and 1-year follow-up . In addition , women in RE show fewer medical symptoms at both time periods . CONCLUSIONS In this pilot study , the couple-based intervention , RE , has shown promise in improving individual , medical , and relationship functioning for couples in which the woman is facing breast cancer , and therefore merits further investigation on a larger scale
OBJECTIVE Partners have a significant role in a person 's ability to adjust to a chronic physical illness , which warrants their inclusion in couples interventions .
However to deliver more specific , tailored support it is necessary to explore which types of couples interventions are most effective across certain chronic illness population s and outcomes .