Development of Intervention Program for Pain Palliation of Family With Outpatients Under Cancer Chemotherapy Treatment

Monday, 30 October 2017

Nahoko Saita, PhD
Faculty of Health Sciences, Yamaguchi University Graduate School of Medicine, Ube, Japan

[Purpose] The locus of cancer treatment has been moving from inpatient to outpatient in Japan. Family members face manifold problems through the patient’s struggle with cancer and the stresses they experience negatively affect their capacity to support the patient. Yet only a few hospitals provide group support for family members.

We developed an intervention program to empower the family, relieve distress, and enable them to face the disease together with the patient.

[Methods] There were 13 participant family members (Male: 2, Female: 11, mean age: 52.5±12.8) recruited from outpatients undergoing chemotherapy in a university hospital. We divided the participants into groups of four to seven and conducted a once weekly five-week program comprising a 120-minute session including 30-minute educational lecture, 60-minute discussion, and 20-minute relaxation. Educational sessions comprised content on the side effects of chemotherapy; the psychology of people with cancer; stress (symptoms associated with the psychological process and coping strategies as a family member); relaxation; how to build a relationship with medical professionals; cancer and daily life; and social support. Group members selected discussion themes based on the educational lectures, and nurses facilitated the discussion. Relaxation employed the progressive muscle relaxation method.

We measured and assessed social support (JMS-SSS), psychosocial function (self-efficacy scale, IES-R), family functioning (FACEⅢ), and satisfaction level (contents of discussion, feedback) before and after each intervention to measure program effectiveness.

[Results] Level of social support and self-efficacy in psychosocial function increased. In family functioning, there were seven participants categorized into “extreme” family type and those in “intermediate” type were six before the intervention, while they shifted to “balanced” type after the intervention.

Feedback from program participants indicated that they were able to obtain peer support, learned new ways to deal with patients, and had a positive influence on patients. The satisfaction rate was more than 4.5 on a five-point scale. They said that they wished they had known about this kind of program sooner. All participants wanted to practice the relaxation at home.

[Discussion] Family members valued the intervention and wanted ongoing contact and stated that they had obtained peer support and new coping strategies. These findings suggest the importance of medical professionals providing education and an outlet for families of people with cancer to express their emotion. This family support program was considered a useful method as it empowered family members and triggered positive changes in their attitude, way of thinking, and psychosocial functioning which would enable them to provide much needed support to their family member.