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"Lung Cancer Fighter Programme"preliminary results and second phase recruitment

08 Sep 2016

 

Co-organized by Department of Social Work and Social Administration, HKU and The Hong Kong Cancer Fund

Lung cancer is the second most common cancer in Hong Kong, with more than 4,000 new diagnoses every year. Sponsored by the Research Grants Council and co-organized by the Department of Social Work and Social Administration of the University of Hong Kong (HKU) and the Hong Kong Cancer Fund, the first phase "Lung Cancer Fighter Programme" was launched in April, 2016, which was also the first ever programme launched in Hong Kong for lung cancer patients and their caregivers.  

Ninety-seven pairs of lung cancer patients and family caregivers were recruited to the programme, among the patients, 58 patients (60%) were diagnosed with stage IV cancer. The participants took part in an eight-session psychosocial intervention programme. In a questionnaire filled in by them before the programme, about 50% of both the patient and family caregiver participants were found to be at-risk of developing anxiety and depression problems. Some preliminary findings of the first phase "Lung Cancer Fighter Programme" are as follows:  

1. Family caregivers experienced higher levels of anxiety and bodily irritability when compared to the patients; while cancer patients reported more insomnia and lower levels of general vitality compared with their caregivers.
2. The levels of depression of patients and those of their family caregivers were found to be positively associated. Similar findings were identified for the levels of anxiety, insomnia and quality of life, which aligned with our recently published research in Psycho-oncology in July.
3. Both patients and caregivers have shown improvements in multiple domains of quality of life after partaking in the intervention programme. Over 80% of the patients reported improvement in general vitality and daily functioning, and nearly 80% of the caregivers and 70% of the patients experienced improvements in their overall quality of life. One-third of patients, and more than a quarter of caregivers who were at-risk of having depression and anxiety problems have fallen below the clinical cut off in mental health functioning after the intervention.

To enable more families of lung cancer patients to benefit from the programme, we are now recruiting both patient and family caregiver participants for the 2nd phase of the programme.

Course commencement date: October 21 to December 16, 2016

Both patients and caregivers are distressed by lung cancer
Despite the advancements in medical treatment for lung cancer that remarkably improved survival rate and recovery, lung cancer patients have to face a multitude of challenges including cancer-related physical symptoms (notably coughing, shortness of breath, pain), side effects of treatments (such as radiotherapy, chemotherapy and targeted therapies), and psychosocial distresses associated with the life-threatening diagnosis. Relative to patients with other cancers, lung cancer patients often report higher levels of helplessness and depression. Likewise, family caregivers also suffer from elevated levels of psychological distresses. In July, our team published a model illustrating the inter-relatedness of distresses in cancer patients and those in their spouses in Psycho-oncology (a peer-reviewed academic journal). Our findings suggest that patients and their spouses experienced significant interaction and reciprocal reinforcement on their mutual levels of anxiety, depression, and quality of sleep, with depression being the factor sustaining poor quality of sleep among the couples. To conclude, these results signified the importance of receiving psychosocial intervention for both cancer patients and their family caregivers.

Lung Cancer Fighter Programme –
Hong Kong’s first psychosocial group intervention for lung cancer patients and family caregivers
Psychosocial intervention refers to a range of non-pharmacological therapies including counselling, communication training, positive psychological therapy, and behavioural therapy. International and local literatures support the effectiveness of psychosocial interventions on improving the quality of life of cancer patients. The HKU team has been co-organizing ‘Cancer Fighter Programme’ with the Hong Kong Cancer Fund, benefiting thousands of cancer patients (notably breast, colorectal or mixed cancer patients). However, to date, none has been conducted specifically for lung cancer patients and their family caregivers.

In the light of the sizable lung cancer patient population, the higher levels of patient and caregiver distress relative to that of other cancers, the reciprocal nature of patients’ and caregivers’ well-being, and the benefits of previous “Cancer Fighter Programme” for patients and caregivers, the current “Lung Cancer Fighter Programme” is dedicated to providing psychosocial intervention for both lung cancer patients and their family caregivers. This programme will be the first large-scale, systematic integrative service model in Hong Kong, and in the world, to provide 8 sessions of psychosocial intervention including tips on active coping with cancer treatment, better communication among family members, symptom relief techniques, and psychoeducation. The programme will also assist participants in identifying and modifying their dysfunctional thoughts and values, and fostering their resilience.

The first phase of the programme was held in April to June this year. 97 patient-caregiver dyads completed baseline questionnaires, 60 of which completed follow-up questionnaires after course completion. Of the patient participants, over 70% were in active treatment.

Preliminary findings: (i) Interconnectedness of patient and caregiver well-being
Our preliminary findings show that prior to the programme, caregivers reported higher levels of anxiety and bodily irritability than their family members with lung cancer; while cancer patients had more insomnia and lower levels of general vitality compared with their caregivers. Furthermore, well-being of lung cancer patients and that of their caregivers were found to be positively associated, with strongest relationships found on quality of life, depression, anxiety and insomnia. The current findings are in line with our recently published research in Psycho-oncology, and reaffirm the need for psychosocial care for both lung cancer patients and the family caregivers.

Preliminary findings: (ii) Mutual benefits on patients and caregivers
Both patients and caregivers have shown improvements in multiple domains of quality of life after partaking in the intervention programme. Over 80% of the patients reported improvement in general vitality and daily functioning, and nearly 80% of the caregivers and 70% of the patients experienced improvements in their overall quality of life. One-third of patients, and more than a quarter of caregivers who were at-risk of having depression and anxiety problems have fallen back into the normal range of mental health functioning after the intervention programme.

For equiries about the programme: The University of Hong Kong Hotline: 3917 5582/ The Hong Kong Cancer Fund Hotline: 3919 7000.