Skip to main content
SpringerLink
Log in

Couple-based communication intervention for head and neck cancer: a randomized pilot trial

  • Original Article
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Objective

To test feasibility and preliminary efficacy of a couple-based supportive communication (CSC) intervention for head and neck cancer (HNC) delivered during patients’ oncology treatment.

Methods

Twenty couples were randomly assigned to either a four-session CSC or a treatment-as-usual (TAU) condition. The CSC intervention primarily focused on increasing couple emotional disclosure, supportive listening, and social support. Patients and partners completed measures of individual and relationship functioning at baseline, post-intervention, and 6-month follow-up.

Results

Ninety-eight percent of CSC sessions were completed and couples reported high levels of satisfaction with the intervention. Between-group effect sizes indicated that patients and partners in CSC reported improvements in individual and relationship functioning, relative to those in the TAU condition.

Conclusions

A couple-based communication intervention delivered during oncology treatment is feasible and acceptable in the context of HNC and may lead to improvements in individual and relationship functioning. Preliminary efficacy results are interpreted in the context of social-cognitive processing and intimacy theories.

Trial registration

The trial was registered on www.clinicaltrials.gov (NCT01785576) first posted on February 7, 2013.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

References

  1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A Global cancer statistics (2018) GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 68:394–424. doi: https://doi.org/10.3322/caac.21492

  2. Chaturvedi AK, Engels EA, Pfeiffer RM, Hernandez BY, Xiao W, Jiang B et al (2011) Human papillomavirus and rising oropharyngeal cancer incidence in the United States. J Clin Oncol 29:4294–4301. https://doi.org/10.1200/JCO.2011.36.4596

    Article  PubMed  PubMed Central  Google Scholar 

  3. Brockstein B, Masters G (eds) (2003) Head and neck cancer. Kluwer Academic, Norwell

    Google Scholar 

  4. Howren MB, Christensen AJ, Karnell LH, Funk GF (2013) Psychological factors associated with head and neck cancer treatment and survivorship: evidence and opportunities for behavioral medicine. J Consult Clin Psychol 81:299–317. https://doi.org/10.1037/a0029940

    Article  PubMed  Google Scholar 

  5. Bjorklund M, Sarvimaki A, Berg A (2010) Living with head and neck cancer: a profile of captivity. J Nurs Healthc Chronic Illn 2:22–31

    Article  Google Scholar 

  6. Fang, CY, Heckman, CJ (2016) Informational and support needs of patients with head and neck cancer: current status and emerging issues. Cancers Head Neck. 1. doi: https://doi.org/10.1186/s41199-016-0017-6

  7. Longacre ML, Ridge JA, Burtness BA, Galloway TJ, Fang CY (2012) Psychological functioning of caregivers for head and neck cancer patients. Oral Oncol 48:18–25. https://doi.org/10.1016/j.oraloncology.2011.11.012

    Article  PubMed  Google Scholar 

  8. Badr H, Gupta V, Sikora A, Posner M (2014) Psychological distress in patients and caregivers over the course of radiotherapy for head and neck cancer. Oral Oncol 50:1005–1011. https://doi.org/10.1016/j.oraloncology.2014.07.003

    Article  PubMed  PubMed Central  Google Scholar 

  9. Posluszny DM, Dougall AL, Johnson JT, Argiris A, Ferris RL, Baum A, Bovbjerg DH, Dew MA (2015) Posttraumatic stress disorder symptoms in newly diagnosed head and neck cancer patients and their partners. Head Neck 37:1282–1289. https://doi.org/10.1002/hed.23760

    Article  PubMed  Google Scholar 

  10. Pistrang N, Barker C (1995) The partner relationship in psychological response to breast cancer. Soc Sci Med 40:789–797

    Article  CAS  PubMed  Google Scholar 

  11. Porter LS, Keefe FJ, Hurwitz H, Faber M (2005) Disclosure between patients with gastrointestinal cancer and their spouses. Psychooncology. 14:1030–1042

    Article  PubMed  Google Scholar 

  12. Reese JB, Shelby RA, Keefe FJ, Porter LS, Abernethy AP (2010) Sexual concerns in cancer patients: a comparison of GI and breast cancer patients. Support Care Cancer 18:1179–1189. https://doi.org/10.1007/s00520-009-0738-8

    Article  PubMed  Google Scholar 

  13. Yu Y, Sherman KA (2015) Communication avoidance, coping and psychological distress of women with breast cancer. J Behav Med 38:565–577. https://doi.org/10.1007/s10865-015-9636-3

    Article  PubMed  Google Scholar 

  14. Manne S, Kashy DA, Siegel S, Myers Virtue S, Heckman C, Ryan D (2014) Unsupportive partner behaviors, social-cognitive processing, and psychological outcomes in couples coping with early stage breast cancer. J Fam Psychol 28:214–224. https://doi.org/10.1037/a0036053

    Article  PubMed  PubMed Central  Google Scholar 

  15. Porter LS, Keefe FJ, Baucom DH, Hurwitz H, Moser B, Patterson E, Kim HJ (2012) Partner-assisted emotional disclosure for patients with GI cancer: 8 week follow up processes associated with change. Support Care Cancer 20:1755–1762. https://doi.org/10.1007/s00520-011-1272-z

    Article  PubMed  Google Scholar 

  16. Badr H, Milbury K, Majeed N, Carmack CL, Ahmad Z, Gritz ER (2016) Natural language use and couples’ adjustment to head and neck cancer. Health Psychol 35:1069–1080. https://doi.org/10.1037/hea0000377

    Article  PubMed  PubMed Central  Google Scholar 

  17. Manne S, Badr H (2008) Intimacy and relationship processes in couples’ psychosocial adaptation to cancer. Cancer. 112:2541–2555. https://doi.org/10.1002/cncr.23450

    Article  PubMed  Google Scholar 

  18. Foa EB, Kozak MJ (1986) Emotional processing of fear: exposure to corrective information. Psychol Bull 99:20–35

    Article  CAS  PubMed  Google Scholar 

  19. Foa EB, Stektes G, Rothbaum BO (1989) Behavioral/cognitive conceptualizations of post-traumatic stress disorder. Beh Therapy 20:155–176. https://doi.org/10.1016/S0005-7894(89)80067-X

    Article  Google Scholar 

  20. Porter LS, Keefe FJ, Baucom DH, Hurwitz H, Moser B, Patterson E, Kim HJ (2012) Partner-assisted emotional disclosure for patients with gastrointestinal cancer: results from a randomized control trial. Support Care Cancer 20:1755–1762. https://doi.org/10.1007/s00520-011-1272-z

    Article  PubMed  Google Scholar 

  21. Porter LS, Keefe FJ, Baucom DH, Olsen M, Zafar SY, Uronis H (2017) A randomized pilot trial of a videoconference couples communication intervention for advanced GI cancer. Psychooncology. 26:1027–1035. https://doi.org/10.1002/pon.4121

    Article  PubMed  Google Scholar 

  22. Manne S, Ostroff J, Rini C, Fox K, Goldstein L, Grana G (2004) The interpersonal process of intimacy: the role of self-disclosure, partner disclosure, and partner responsiveness in interactions between breast cancer patients and their partners. J Fam Psychol 18:589–599

    Article  PubMed  Google Scholar 

  23. Badr H, Krebs P (2013) A systematic review and meta-analysis of psychosocial interventions for couples coping with cancer. Psychooncology. 22:1688–1704. https://doi.org/10.1002/pon.3200

    Article  PubMed  Google Scholar 

  24. Badr H, Herbert K, Chhabria K, Sandulache VC, Chiao E, Wagner T (2019) Self-management intervention for head and neck cancer couples: results of a randomized pilot trial. Cancer. 125:1176–1184. https://doi.org/10.1002/cncr.31906

    Article  PubMed  Google Scholar 

  25. Nguyen TD, Attkisson CC, Stegner BL (1983) Assessment of patient satisfaction: development and refinement of a service evaluation questionnaire. Eval Program Plann 6:299–313

    Article  CAS  PubMed  Google Scholar 

  26. Spanier GB (1976) Measuring dyadic adjustment: new scales for assessing the quality of marriage and similar dyads. Journal of Marriage and the Family Journal of Marriage and Family 38:15–28

    Article  Google Scholar 

  27. Graham JH, Yenling JL, Jerziorski JL (2006) The dyadic adjustment scale: a reliability generalization meta-analysis. J Marriage Fam 68:701–717

    Article  Google Scholar 

  28. Miller RS, Lefcourt HM (1982) The assessment of social intimacy. J Pers Assess 46:514–518

    Article  CAS  PubMed  Google Scholar 

  29. Miller RS, Lefcourt HM (2000) Miller social intimacy scale. In: Corcoran K, Fischer J (eds) Measures for clinical practice: a sourcebook, 3rd edn. Free Press, New York, NY

    Google Scholar 

  30. Weiss DS (2007) The impact of event scale: revised. In: Wilson JP, Tang CS (eds) Cross-cultural assessment of psychological trauma and PTSD. Springer, New York, pp 219–238

    Chapter  Google Scholar 

  31. Radloff LS (1977) The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas 1:385–401

    Article  Google Scholar 

  32. Chhabriaa KS, Carnabyb GD (2017) Psychometric validation of the Center for Epidemiological Studies Depression Scale in head and neck Cancer patients. Oral Oncol 75:158–162

    Article  Google Scholar 

  33. Pilkonis PA, Choi SW, Reise SP, Stover AM, Riley WT, Cella D (2011) Item banks for measuring emotional distress from the patient-reported outcomes measurement information system (PROMIS): depression, anxiety, and anger. Assessment. 18:263–283. https://doi.org/10.1177/1073191111411667

    Article  PubMed  PubMed Central  Google Scholar 

  34. Schalet BD, Pilkonis PA, Yu L, Dodds N, Johnston KL, Yount S, Riley W, Cella D (2016) Clinical validity of PROMIS® depression, anxiety, and anger across diverse clinical samples. J Clin Epidemiol 73:119–127. https://doi.org/10.1016/j.jclinepi.2015.08.036

    Article  PubMed  PubMed Central  Google Scholar 

  35. Weitzner MA, Jacobsen PB, Wagner H Jr, Friedland J, Cox C (1999) The caregiver quality of life index- Cancer (CQOLC) scale: development and validation of an instrument to measure quality of life of the family caregiver of patients with cancer. Qual Life Res 8:55–63

    Article  CAS  PubMed  Google Scholar 

  36. Cella DF, Tulsky DS, Gray G, Sarafian B, Linn E, Bonami A et al (1993) The functional assessment of Cancer therapy scale: development and validation of the general measure. J Clin Oncol 11:570–579

    Article  CAS  PubMed  Google Scholar 

  37. List M, DAntonio L, Cella D et al (1996) The performance status scale for head and neck cancer patients and the functional assessment of cancer therapy head and neck scale– a study of utility and validity. Cancer. 77:2294–2301

    Article  CAS  PubMed  Google Scholar 

  38. Mendoza T, Wang XS, Cleeland CS, Morrissey M, Johnson BA, Wendt JK et al (1999) The rapid assessment of fatigue severity in cancer patients: use of the brief fatigue inventory. Cancer. 85:1186–1196

    Article  CAS  PubMed  Google Scholar 

  39. Cleeland CS, Ryan KM (1994) Pain assessment: global use of the brief pain inventory. Ann Acad Med Singap 23:129–138

    CAS  PubMed  Google Scholar 

  40. Baucom DH, Epstein N (1990) Cognitive behavioral marital therapy. Brunner/Mazel, New York

    Google Scholar 

  41. Dehle C, Larsen D, Landers JE (2001) Social support in marriage. Am J Fam Ther 29:307–324

    Article  Google Scholar 

  42. Cutrona CE, Suhr JA (1994) An analysis of couples’ supportive interactions. In: Burleson BR, Albrecht TL, Goldsmith DJ, Sarason IG (eds) Communication of social support: messages, interactions, and community. Sage, Thousand Oaks, pp 113–135

    Google Scholar 

  43. Fredman SJ, Baucom DH, Gremore TM, Castellani AM, Kallman TA, Porter LS, Kirby JS, Claire Dees E, Klauber-Demore N, Peppercorn J, Carey LA (2009) Quantifying the recruitment challenges with couple-based interventions for cancer: applications to early-stage breast cancer. Psychooncology. 18:667–673

    Article  PubMed  PubMed Central  Google Scholar 

  44. Porter LS, Keefe FJ (2018) Couple-based communication interventions for cancer: moving beyond a ‘one size fits all’ approach. Acta Oncol 57:693–695. https://doi.org/10.1080/0284186X.2017.1400687

    Article  PubMed  Google Scholar 

  45. Mesters I, van der Borne H, McCormick L, Pruyn J, de Boer M, Imbos T (1997) Openness to discuss cancer in the nuclear family: scale, development, and validation. Psychosom Med 59:269–279

    Article  CAS  PubMed  Google Scholar 

Download references

Funding

This study was funded by a philanthropic grant provided by an anonymous donor.

Author information

Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, 2200 W. Main St, Ste 340, Durham, NC, 27705, USA

    Tina M. Gremore & Laura S. Porter

  2. NorthShore University HealthSystem, Evanston, IL, USA

    Bruce Brockstein, Stephanie Brenner & Tiffany Benfield

  3. University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Donald H. Baucom

  4. Northwestern University, Evanston, IL, USA

    Tamara Golden Sher

  5. University of Washington, Seattle, WA, USA

    David Atkins

Authors
  1. Tina M. Gremore
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bruce Brockstein
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Laura S. Porter
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Stephanie Brenner
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Tiffany Benfield
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Donald H. Baucom
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Tamara Golden Sher
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. David Atkins
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Tina Gremore, Bruce Brockstein, Laura Porter, Stephanie Brenner, and Tiffany Benfield. The first draft of the manuscript was written by Tina Gremore and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript

Corresponding author

Correspondence to Tina M. Gremore.

Ethics declarations

Conflict of interest

Tina Gremore, Bruce Brockstein, Laura Porter, Stephanie Brenner, Tiffany Benefield, Donald Baucom, and Tamara Golden Sher declare that they have no conflict of interest. David Atkins reports grants from NIAA, NIMH, NIDA, PCORI, and Lyssn.io, Inc., outside the submitted work. He reports that he is the cofounder and equity stakeholder in Lyssn.io, Inc., which is a start-up that focuses on technology to support training, supervision, and quality assurance of evidence-based counseling.

Ethics approval

Approval was obtained from the ethics committee of NorthShore University HealthSystem. The procedures used in this study adhere to the tenets of the Declaration of Helsinki.

Consent to participation

Written informed consent was obtained from all individual participants included in the study.

Consent for publication

Written consent to publish was obtained from all individual participants included in the study.

Code availability

Not applicable.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gremore, T.M., Brockstein, B., Porter, L.S. et al. Couple-based communication intervention for head and neck cancer: a randomized pilot trial. Support Care Cancer 29, 3267–3275 (2021). https://doi.org/10.1007/s00520-020-05848-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-020-05848-5

Keywords

Search

Navigation