Leveraging the Dyad: Mechanisms of an Intervention for Psychological Distress in Chronic Lung Disease (SERENE)

Patients with chronic obstructive pulmonary disease (COPD), a serious lung disease impacting over 16 million Americans, face a lot of long-term symptoms. Those with COPD and their caregivers see emotional strain, like feelings of depression and anxiety, as a major concern. This emotional strain is also closely linked with worse health results in COPD. However, many patients with COPD do not get the needed care for this distress. Family caregivers, because of their ongoing relationship with patients, are in a good position to help. This is especially true since close personal relationships can have direct health benefits and offer protection against stressors.

But there’s a gap in our knowledge: How can palliative care best use these close relationships to support both the patient and caregiver? This study aims to compare the effects of two methods: a Coping Skills Training (CST) program and a minimally enhanced usual care attention control group. In a series of 12 remote weekly sessions, patients and their caregivers will learn coping skills specific to COPD. The CST program aims to (1) boost patients’ ability to manage stress and illness and (2) guide caregivers on coping and being effective support coaches. Past research showed CST improved patient’s mental well-being and their ability to function. However, it’s not clear how it achieves these improvements, and earlier research did not fully represent the groups most affected by COPD.

The main goal of this study is to use behavioral science to uncover how CST helps patients through caregiver support. This project will also determine how well CST works for different patient groups. It will identify what encourages or deters people from joining and completing the program. This includes understanding barriers that might make participation harder. A community advisory board will work with the research team throughout the study to help create materials for participants and ensure that the final results are communicated to patients with COPD and their caregivers. The study will include 375 patient-caregiver pairs from outpatient clinics at the University of Pennsylvania and Henry Ford Health System. These clinics mainly serve Black, low-income, or rural patients.

The knowledge from this project will help (1) create better palliative care interventions that make the best use of patients’ current relationships and social support and (2) find ways to address and overcome the specific challenges some groups face in getting palliative care, helping ensure more equal care access for everyone.

Henry Ford Health System
Thomas Jefferson University

National Institute of Nursing Research