Over half of new lung cancer cases are diagnosed with already distant metastases. Given the incurable nature of metastatic lung cancer, quality of life (QOL) is a primary concern. Patients commonly experience fatigue, sleep disturbances, depression, and shortness of breath as well as spiritual/existential distress compromising their QOL. Moreover, in light of these symptoms, patients have a high need for care and support and are often dependent on their caregivers. Patients report that their spouses/romantic partners are their most important and valued source of support and care; yet, caregiving exerts physical and emotional toll. Partners often report high rates of psychological distress, fatigue, and sleep disturbances, often as high as patients' rates, which may compromise the quality of care they are able to provide to the patient. Given the interdependent nature of QOL in couples, poor caregiver QOL may undermine patient QOL and vice versa. Additionally, although couples frequently report cancer-related concerns, they may not be able to disclose these concerns to each other. This holding back of concerns further exacerbates couples' distress. Therefore, there is a high need to develop supportive care programs that help patients and their partners to manage symptoms together as well as disclose their concerns to facilitate psychological adjustment. Meditation training has been shown to improve the QOL of cancer patients, but little is known whether this type of intervention is feasible and efficacious for patients with metastatic disease. Even less is known about a couple-based meditation approach that incorporates partner-assisted emotional disclosure techniques. Thus, this investigation will examine if a meditation training that integrates emotional disclosure improves QOL in couples affected by metastatic lung cancer. The proposed research will randomly assign couples to either the couple-based meditation program, an attention control group or a waitlist control group receiving usual care. Prior to randomization, patients and partners will complete standard QOL self-report measures. Feasibility data will be documented (e.g., consent, attrition, and adherence). We will incorporate the 4-session intervention (60-75 min. each) into patients' cancer treatment plans, as it may be especially useful at this time to alleviate physical symptoms and psychological distress. Couples will be re-assessed at the end of the intervention and three months later. These data will address two fundamental questions: 1) is it feasible to implement a couple-based meditation program in patients with metastatic lung cancer receiving treatment (radiotherapy and/or chemotherapy) and their partners? And, 2) is there preliminary evidence of treatment efficacy in regard to QOL outcomes? We will use these findings to design a future, larger study to further test the efficacy of this intervention. This project represents a major ste towards managing QOL in patients with metastatic lung cancer and their partners, a vulnerable yet understudied population.
This project will demonstrate the feasibility and initial effectiveness of a couple-based meditation intervention to improve quality of life and symptom burden in patients with metastatic lung cancer. Because informal caregiving has been related to poor quality of life, this intervention includes also patients' spouses/partners to improve quality of life in both members of the couple.
