Jones, J.M., Lewis, F.M., Griffith, K., Cheng, T., Secord, S., Walton, T., . . . Catton, P. (2013). Helping Her Heal-Group: A pilot study to evaluate a group delivered educational intervention for male spouses of women with breast cancer. Psycho-Oncology, 22, 2102–2109.

To determine the acceptability and feasibility of HHH-G and the study methods to evaluate its impact on participating men’s skill, self confidence, and self care and to assess the impact of intervention on the participating husbands' ratings of marital quality and depressed mood

HHH-G is a group intervention program with five sessions. Intervention was delivered by two trained educational counselors over five separate 1.5-hour sessions delivered at one week intervals. The five sessions included

• Anchoring yourself to be strong for her
• Listening and not fixing
• Gaining a deeper understanding of her
• Connecting with her
• Putting the pieces together.

Each session included a short group presentation by the education counselors and skill building and efficacy enhancing group exercises. Participants were also provided with spouses' workbooks with session specific activities at home and home assignments that focused on enhancing behavioral capabilities including knowledge and skill. Data were collected at baseline, immediately after the last session, and three months later.

• The sample included 54 couples.
• Couples included women undergoing breast cancer treatment at Princess Margaret Hospital at Toronto and their husbands.
• Mean age of the women was 50.6 years.
• Mean age of the men was 53.1 years.

• Single site
• Inpatient setting      
• Princess Margaret Hospital at Toronto, Canada

Phase of care: active antitumor treatment

A mixed method (one-arm, qualitative, pre-post intervention design) was used.

• Demo/clinical data
• Participation retention and treatment compliance
• Spouse skill checklist
• CASE-S
• CES-D
• Revised Didactic Adjustment Scale (RDAS)
• Mutuality and Interpersonal Sensitivity Scale (MIS)

A moderate to favorable increase in skills was noted as measured by the spouse skill checklist (p < 0.001), including the self care and support subscale (p < 0.001) and the wife support scale (p < 0.003). A significant time effect on self efficacy was measured by CASE-S. No significant changes in depressed mood or marital functioning was noted for the husbands, but a significant reduction in depressed mood (p < 0.003) was noted for the wives.

The feasibility and acceptability of HHH-G were supported. No significant reduction in depression scores were noted for male spouses, which might have been caused by the floor effect because baseline CES-D scores were low in male spouses. A large sample size with a control group woul dneed to be studied to truly examine the effectiveness of this intervention program.

• The study had a small sample size, with fewer than 100 participants.
• There was a risk of bias because there was no control group and no random assignment.
• Findings were not generalizable.

Study demonstrated promising findings on feasibility and reduction in depressed mood for the women with breast cancer. This sounds like a cost-effective approach that could be used by nurses and social workers to improve patient and caregiver outcomes, such as increasing self efficacy and marital functioning.