Psychosocial Outcomes in Patients Who Participated in a Hospital-Based Family Involvement Program After Major Abdominal Oncological Surgery: A Preplanned Secondary Analysis of a Prospective Cohort Study.
Kreca S, Musters S, et al. • Psycho-oncology • 2026
Family caregiver involvement during hospital admission for major abdominal cancer surgery improved sleep quality and satisfaction with care, but did not significantly affect patients' anxiety, depression, or self-perceived health.
Key Findings
Results
Patients in the Family Involvement Program (FIP) reported significantly higher sleep quality compared to those receiving usual care.
Sleep quality was assessed as a psychosocial outcome alongside anxiety, depression, self-perceived health, and health-related quality of life.
Analysis was conducted using linear mixed-effects models with stepwise backward selection.
The study design was a patient-preferred prospective cohort study comparing FIP participants to usual care recipients.
The improvement in sleep quality was one of only two statistically significant psychosocial outcomes favoring the FIP group.
Results
Patients in the FIP group reported significantly higher satisfaction with healthcare than those receiving usual care.
Satisfaction with care was analyzed using linear regression, a different analytic approach from the other psychosocial outcomes.
This was one of two statistically significant findings favoring the FIP group.
The FIP involved family caregivers participating alongside patients during hospitalization for major abdominal cancer surgery.
Results
No significant differences were found between FIP and usual care groups in anxiety, depression, or self-perceived health.
Anxiety and depression were measured using the Hospital Anxiety and Depression Scale (HADS).
Self-perceived health was measured using the EQ-VAS.
Health-related quality of life was also assessed using the EQ-5D-5L index score, with no significant between-group differences reported.
All these outcomes were analyzed using linear mixed-effects models with stepwise backward selection.
Results
A high proportion of family caregivers stayed overnight during the patient's hospitalization, with 80%–90% of caregivers doing so.
Overnight stays were tracked as a fidelity metric for the Family Involvement Program.
Fidelity metrics also included completion rates of fundamental and optional care activities.
Engagement in fundamental and optional care activities by family caregivers varied across activities and postoperative days.
These fidelity metrics were used to characterize the level of caregiver involvement achieved in the program.
Methods
The study was designed as a preplanned secondary analysis of a patient-preferred prospective cohort study comparing a Family Involvement Program to usual care for major abdominal cancer surgery.
Patients who participated in the FIP alongside a family caregiver were compared to those who received usual care.
The patient-preferred design means patients self-selected into groups based on their preference, which is a key methodological consideration.
Psychosocial outcomes assessed included sleep quality, anxiety and depression (HADS), self-perceived health (EQ-VAS), and health-related quality of life (EQ-5D-5L) index score.
The FIP was a hospital-based program specifically designed to involve family caregivers during the inpatient period following major abdominal oncological surgery.
What This Means
This research suggests that having family members actively involved in a patient's hospital care after major abdominal cancer surgery can improve certain aspects of how patients feel during their recovery. Specifically, patients who participated in a structured Family Involvement Program — where a family caregiver stayed with them and helped with care activities, including frequently staying overnight — reported sleeping better and feeling more satisfied with their healthcare compared to patients who received standard care without this structured family involvement.
However, the program did not appear to make a measurable difference in patients' levels of anxiety, depression, or their overall sense of their own health. This suggests that while having a family caregiver present and engaged may help with day-to-day comfort and feelings about the care experience, it may not be sufficient on its own to address the emotional and psychological challenges that come with a serious cancer diagnosis and major surgery.
This research matters because it provides evidence that formalizing and structuring family caregiver involvement during hospitalization — rather than leaving it to chance — may offer real benefits to patients. The finding that 80–90% of caregivers stayed overnight highlights that families are often willing to be deeply involved when given a clear framework. These findings could inform how hospitals design care programs that better integrate family members as part of the recovery team, particularly for cancer patients undergoing complex surgery.
Kreca S, Musters S, van Dieren S, van der Wal-Huisman H, Romijn J, Nieveen van Dijkum E, et al.. (2026). Psychosocial Outcomes in Patients Who Participated in a Hospital-Based Family Involvement Program After Major Abdominal Oncological Surgery: A Preplanned Secondary Analysis of a Prospective Cohort Study.. Psycho-oncology. https://doi.org/10.1002/pon.70373