A review of distress and its management in couples facing end-of-life cancer.

The aim of this review paper is to (1) provide an overview of the impact of cancer on the couple, (2) to identify potential outcomes for couple's interventions targeted specifically when one spouse is facing end of life, (3) to review and critique the empirical literature on psychosocial interventions for couple's facing end of life to date, and (4) to provide direction for research in this area. Based on our review, we found that there is clear evidence of significant distress arising from the impact of terminal illness on the marital relationship, which can result in greater suffering in the last months and weeks of life. Currently, there is a very small body of evidence on the effectiveness of couple interventions for those where one is in palliative care. Future randomized controlled trials are needed to examine the impact of couple therapy adapted for couples facing the end of life, and to guide in providing information on the number of sessions and format required for this population. Outcomes, such as more effective communication, reduction in the experience of hopelessness, uncertainty, isolation, depression, anxiety, and more adaptive coping strategies should be considered. Copyright 2007 John Wiley & Sons, Ltd.