In spite of the detrimental effects that advanced cancer has on patients and their family caregivers, there are few programs of care to assist them. The purpose of this study is to determine if a brief or extensive family-based program of care (The FOCUS Program) can improve the proximal and distal outcomes of patients with advanced cancer and their family caregivers. There are two specific aims.
Aim one is to determine if family dyads randomly assigned to either a brief or extensive family-based program of care have better proximal and distal outcomes from both a clinical and economic perspective than dyads randomly assigned to usual care. Proximal outcomes are less negative appraisal of illness or caregiving, less uncertainty, less hopelessness, more active coping, better family illness communication, and higher self-efficacy. Distal outcomes are higher quality of life, greater satisfaction with care, and similar or lower health care resource utilization.
Aim two is to determine if the brief or extensive program of care has a differential effect on patient and caregiver outcomes depending on the patient's risk for distress. A longitudinal randomized clinical trial will be used in which a cohort of patients with advanced cancer (breast, colon, lung, prostate) and a family caregiver (N=324 dyads) will be followed over 6 months. Patients will be assessed for risk for distress at baseline and designated as either high or low risk. Following assessment, patients and caregivers (as a dyad) will be stratified by patients' type of cancer and treatment and randomly assigned to one of three arms: 1) Usual care, 2) Brief FOCUS-three sessions, or 3) Extensive FOCUS-six sessions. Data will be collected at baseline, prior to intervention (Time 1); at three months (Time 2); and at six months (Time 3) with established instruments. Analyses will use ANCOVA with planned contrasts with three levels of care (Usual, Brief, Extensive) and two levels of risk (high and low). Overall, this study will examine intervention effects in dyads facing advanced cancer, in conjunction with program dose and patients' baseline risk for distress.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Project (R01)
Project #
5R01CA107383-04
Application #
7268828
Study Section
Nursing Science: Adults and Older Adults Study Section (NSAA)
Program Officer
Aziz, Noreen M
Project Start
2004-09-28
Project End
2009-05-31
Budget Start
2007-06-01
Budget End
2008-05-31
Support Year
4
Fiscal Year
2007
Total Cost
$509,674
Indirect Cost
Name
University of Michigan Ann Arbor
Department
Type
Schools of Nursing
DUNS #
073133571
City
Ann Arbor
State
MI
Country
United States
Zip Code
48109
Ellis, Katrina R; Janevic, Mary R; Kershaw, Trace et al. (2017) Meaning-based coping, chronic conditions and quality of life in advanced cancer & caregiving. Psychooncology 26:1316-1323
Ellis, Katrina R; Janevic, Mary R; Kershaw, Trace et al. (2017) The influence of dyadic symptom distress on threat appraisals and self-efficacy in advanced cancer and caregiving. Support Care Cancer 25:185-194
Song, Lixin; Rini, Christine; Ellis, Katrina R et al. (2016) Appraisals, perceived dyadic communication, and quality of life over time among couples coping with prostate cancer. Support Care Cancer 24:3757-65
Lambert, Sylvie D; Yoon, Hyojin; Ellis, Katrina R et al. (2015) Measuring appraisal during advanced cancer: psychometric testing of the appraisal of caregiving scale. Patient Educ Couns 98:633-9
Kershaw, Trace; Ellis, Katrina R; Yoon, Hyojin et al. (2015) The Interdependence of Advanced Cancer Patients' and Their Family Caregivers' Mental Health, Physical Health, and Self-Efficacy over Time. Ann Behav Med 49:901-11
Martinez, Kathryn A; Friese, Christopher; Kershaw, Trace et al. (2015) Effect of a Nurse-Led Psychoeducational Intervention on Healthcare Service Utilization Among Adults With Advanced Cancer. Oncol Nurs Forum 42:E310-8
Northouse, Laurel L; Mood, Darlene W; Schafenacker, Ann et al. (2013) Randomized clinical trial of a brief and extensive dyadic intervention for advanced cancer patients and their family caregivers. Psychooncology 22:555-63