Abstract
OBJECTIVES: This study evaluated the effectiveness of a social media-based life review intervention on happiness in advanced cancer patient-caregiver dyads and explored participants' subjective experiences. METHODS: A mixed-methods design was employed in oncology wards of a medical center in northern Taiwan between September 2024 and January 2025. Sixty patient-caregiver dyads were recruited through convenience sampling and randomly assigned to an experimental (social media-based life review) or control group (standard care). Final analysis included 28 dyads in the experimental group and 29 in the control group. Quantitative data were collected at baseline and post-intervention using the Subjective Happiness Scale and analyzed with descriptive statistics, t-tests, chi-square tests, and generalized estimating equations (GEE). Qualitative data were collected through two consecutive semi-structured interviews and were analyzed thematically to explore participants' experiences of happiness. RESULTS: Patients in the experimental group maintained stable happiness, whereas those in the control group decline significantly (p = 0.023). Between-group differences were non-significant. Caregivers in the experimental group demonstrated a significant improvement in happiness (p = 0.025), with no change in control group. Patient happiness was positively associated with family support and self-acceptance, whereas caregiver happiness was influenced by age, family support, and patient educational. Qualitative themes were "Always being there is happiness" and "Rediscovering us through memories." CONCLUSION: Social media-based life review intervention enhanced caregiver happiness and prevented decline in patient happiness, highlighting the potential of digitally mediated, family-centered interventions in advanced cancer care. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT06559917.