Interrelationship Between Patient and Family Caregiver Outcomes Following Lung Cancer Surgery: A Secondary Analysis of a Randomized Controlled Trial

INTRODUCTION: While surgery is considered a standard treatment for patients diagnosed with early-stage lung cancer, it often brings significant challenges for patients including functional limitations and post-operative symptoms. Family caregivers play a critical role in care coordination, post-operative management, and addressing emotional distress often with limited preparation and support. Despite their importance, few studies have assessed the interrelationship between patient and caregiver outcomes during the peri-operative period. METHODS: This study is a secondary analysis of data from a randomized controlled trial involving 190 patient-caregiver dyads who participated in a dyadic multimedia self-management intervention. Structural equation modeling (SEM) was used to evaluate the impact of various sociodemographic variables and psychosocial mediators on dyadic outcomes. RESULTS: Self-efficacy was a consistent predictor, with positive effects on preparedness and quality of life (QOL) and negative effects on psychological distress. While activation and knowledge were positively associated with self-efficacy and preparedness, they showed minimal effects on caregiver burden and distress. When evaluating the interdependent relationship, higher patient QOL was associated with improved caregiver preparedness and reduced burden. Caregiver distress significantly predicted greater patient distress and lower patient QOL. CONCLUSIONS: The results of this study support the interdependent, bi-directional associations of patient and caregiver well-being. Further multi-media interventions in the peri-operative period focused on self-efficacy and promoting emotional resilience among caregivers may substantially improve post-operative outcomes for both members of the dyad.