Stronger together in advanced cancer: the added value of dyadic care

A diagnosis of advanced cancer affects not only the patient, but also the informal caregiver. Both are confronted with emotional, physical, and existential challenges that are deeply intertwined. This is why dyadic care, support that focuses not on the individual but on the patient–caregiver pair, is receiving growing attention.

A large-scale international study conducted in six European countries examined the effectiveness of such dyadic psycho-educational interventions. In total, 431 patient–caregiver dyads took part in a three-arm randomized study. They received either a face-to-face intervention with nursing guidance (FOCUS+), a web-based version (iFOCUS), or standard care. The interventions focused on coping, communication, dealing with uncertainty, and strengthening self-efficacy.

After twelve weeks, neither intervention significantly improved the emotional functioning of patients or caregivers. However, the face-to-face FOCUS+ intervention showed clear positive effects. Patients reported higher self-efficacy and evaluated their joint coping more positively. Caregivers also demonstrated more problem-focused coping. These improvements were not observed in the digital iFOCUS intervention, which also showed lower adherence.

Dyadic coping refers to how patients and caregivers manage stress and uncertainty together, through open communication, mutual understanding, and joint problem-solving. The study confirms that personal, relationship-based support plays a crucial role in this process. Digital tools currently appear less capable of addressing this complexity.

According to first author Aline De Vleminck, the results highlight both how difficult it is to strengthen emotional resilience in advanced cancer and how valuable human-guided care remains. The study therefore calls for continued investment in face-to-face dyadic interventions, while digital support needs further refinement to have real impact in vulnerable care contexts.

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