Symptoms such as pain, fatigue, paroxysmal coughing, and dyspnea are major concerns of lung cancer patients and their caregivers. The focus in management of such symptoms traditionally has been on the patient. Studies of caregivers, however, have documented that the psychosocial impact of providing care to family members with lung cancer is profound. The ultimate goal of this research is to develop more effective ways to help patients and caregivers cope more effectively with problematic symptoms experienced by lung cancer patients. The proposed study seeks to evaluate the efficacy of a new, caregiver assisted coping skills training protocol. 500 early stage lung cancer patients (Stages I to IIIA) and their caregivers will be randomly assigned to one of two conditions: 1) Caregiver-assisted coping skills training-systematically trains caregivers in methods for guiding the patient in use of coping skills for symptom management (i.e. relaxation training, imagery, activity pacing, and communication skills), or 2) Cancer education and support-a comparison condition that provides patients and caregivers with information on the nature of lung cancer and treatment methods and controls for attention and contact. Assessment measures to be collected before and after treatment and at 4- and 14-months follow-up will include patient reports of major symptoms (pain, fatigue, coughing, and dyspnea), quality of life, depression, anxiety, self efficacy and quality of relationship with the caregiver and caregivers' ratings of mood, strain, and quality of relationship with the patient. If caregiver-assisted CST is effective, future studies could evaluate this training in other cancer populations (e.g. breast cancer, prostate cancer). Future studies could also identify the particular caregiver-assisted CST components (e.g. relaxation training, imagery training, or activity pacing methods) that contribute most to treatment effects. By isolating the active ingredients of training, one can streamline it, making it more cost-effective and more readily available to the larger population of patients having lung cancer. The proposed study rigorously evaluations methods for enhancing the effects of caregiver-assisted coping skills training in cancer patients and their caregivers.
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