Background: As the primary informal caregiver for cancer patients, spousal caregivers are the population at a high risk of hidden morbidity. The factors impacting couples coping with cancer are complex, and within spousal caregiver-patient dyads the impact is mutual.

Aim: To develop and examine the feasibility and effects of a ‘Caring for Couples Coping with Cancer “4Cs” Programme’ to support couples coping with cancer as the unit of intervention in China.

Methods: The Medical Research Council’s (MRC) framework in developing and evaluating complex interventions was adopted in developing and piloting this ‘Caring for Couples Coping with Cancer “4Cs” Programme’.

 In phase = 1 \* ROMAN I of the development of the 4Cs programme, three steps were conducted: (1) identifying evidence: evidence identified from extensive reviews of the literature and a focus group interview study; (2) identifying or developing a theory: a preliminary Live with Love Conceptual Framework (P-LLCF) was proposed, and the P-LLCF was tested using mixed methods design; and (3) modelling the process and outcomes: the 4Cs programme was developed based on the P-LLCF.

In phase = 2 \* ROMAN II of determination of feasibility/piloting: the 4Cs programme was piloted by a pre-intervention and post-intervention study design. Outcome measures, including dyadic mediators (self-efficacy), dyadic appraisal (Cancer Related Communication Problem, CRCP), dyadic coping (Dyadic Coping Inventory, DCI), and dyadic outcomes (physical and mental health, negative and positive emotions, and marital satisfaction), were assessed at T0 (pre-intervention) and T1 (post-intervention). Repeated measures analysis of variance and structural equation modeling (SEM) were applied in testing the outcomes of the 4Cs program.

 Results: The recruitment and retention rates were 86.7% and 78.6%, respectively. The overall effect sizes calculated in this study ranged from medium to small. The SEM of all six models resulted in convergence and showed goodness of fit to the data and variables, supportive of the constructs in the P-LLCF.

Li Qiuping,  Ph. D and M. D, professor, supervisor in master degree. Her research interests comprise nursing education, digestive system diseases and cancer care. The major research contents mainly focus on the development and evaluation of supportive psychological intervention model for cancer patients and their family caregivers. She has accomplished 11 research projects. More than 100 articles were published by the first author or corresponding author, among which 26 were included in SCI journals. She has edited 16 textbooks and 5 Monographs, and secured research funding from National Natural Science Foundation of China (NSFC) as principal investigator.