Title : Impact of the family cohesion-centered frailty intervention on older gastric cancer patients: A non-randomized controlled trial
Abstract:
Background: Frailty is highly prevalent among older gastric cancer patients and strongly associated with adverse postoperative outcomes. While frailty interventions have been implemented, few have focused on family cohesion as a pivotal aspect. This study aims to evaluate the effectiveness of a family cohesion-centered frailty intervention grounded in the Satir Family Therapy Model among for high-risk frailty older patients with gastric cancer.
Methods: A non-randomized, time-based controlled trial was conducted in a tertiary hospital in China, with 79 participants and their family caregivers allocated according to sequential admission periods into an experimental group (n = 40) or a control group (n = 39). The intervention focused on enhancing family communication and cohesion. Frailty, family cohesion, self-efficacy, anxiety, depression, and quality of life were assessed on the day of hospital admission (T0), immediate post-intervention (T1), and 1 month after intervention completion (T2). Analyses used generalized estimating equations with multiple imputation under an intention-to-treat framework, adjusting for demographic and clinical covariates. Moderation analyses tested three-way interactions.
Results: Significant group by time interactions were observed for frailty, family cohesion, self-efficacy, anxiety, depression, and quality of life (all P<0.05). Compared with usual care, the intervention group demonstrated greater reductions in frailty, anxiety, and depression and was associated with improvement in family cohesion, self-efficacy, and quality of life, with effects strengthening at T2. Sensitivity analyses yielded consistent results. Limited moderating effects were identified for age, education, and TNM stage.
Conclusions: The family cohesion-centered intervention produced multidimensional, sustained benefits for older gastric cancer patients at high risk of frailty. By integrating the Satir Family Therapy Model into perioperative care, this program offers a feasible and effective family-based approach to optimizing frailty management and postoperative recovery.
Clinical trial number: ChiCTR2400082744
Keywords: Gastric Cancer; Frailty Intervention; Family Cohesion; Satir Family Therapy Model.
