Brief Psychosocial Intervention for Head and Neck Cancer Patients and Partners

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The proposed pilot research is in response to one of NCI's goals of this program announcement, which is to examine both adverse and positive effects of cancer diagnosis and treatment on patients and families, and to develop and evaluate interventions to improve quality of life and decrease negative outcomes. This prospective, longitudinal project seeks to further our understanding of the psychosocial sequelae of head and neck cancer for both patients and their partners or spouses, using both quantitative and qualitative methods, and to develop and test the feasibility of a brief couples intervention designed to improve the couples' well-being, quality of life, and relationship. The uncertainty and life threatening nature of cancer diagnoses can lead to anxiety, depression, and traumatic stress. Further, head and neck cancer is a physically and emotionally devastating disease that can cause facial disfigurement, as well as difficulties with speech, eating, and mobility. This results in poor quality of life. Spouses of patients also experience distress, caregiver burden, and decreases in their own quality of life. Although behavioral medicine interventions designed to improve psychological adjustment and quality of life in cancer patients have shown promising outcomes, head and neck cancer has been understudied in this context and there has been little research on including spouses in the intervention, or targeting the relationship for intervention. The specific aims of the proposed research are to (1) characterize both negative and positive symptoms of adjustment to head and neck cancer in patients and their partners over time, and to examine the psychosocial pathways in which relationship-focused coping and relationship quality may affect these symptoms. Negative symptoms include traumatic stress, depression, and anxiety and positive symptoms include enhanced growth and quality of life; (2) qualitatively examine the impact of head and neck cancer on patients, partners, and their relationship; and (3) to evaluate the feasibility of a brief two-session couples intervention to improve quality of life and relationship quality. Eighty couples (n=160) will be recruited. Distress, traumatic stress, positive outcomes, coping, relationship quality, and quality of life will be assessed in both patients and partners at one and six months after cancer diagnosis. Twenty of these couples will also participate in a qualitative interview. Ten additional couples will be recruited to test the feasibilty of the psychosocial intervention.