BACKGROUND: For family caregivers, lung cancer surgery is an episodic and stressful event. Some family caregivers frequently lack the necessary skills for their roles, and they may experience psychological distress, which reduce their own quality of life whilst affecting the health outcomes of patients. However, research on perioperative support programs that focus on caregivers of patients with early-stage lung cancer is limited. Thus, this study aimed to assess the feasibility, acceptability and preliminary efficacy of a perioperative support program for family caregivers of patients with early-stage lung cancer. METHODS: A single-blinded, parallel-group, pilot randomised controlled trial was conducted. Seventy family caregivers of patients with stage I or II lung cancer were recruited from March to May 2022 in the thoracic surgery department of a university-affiliated hospital in Changsha, China. The participants were randomised into the intervention group (n = 35) or control group (n = 35). The intervention consisted of four face-to-face intervention sessions during the hospital stay and two weekly telephone follow-up sessions after discharge, which aimed to improve caregivers' perioperative care knowledge and coping skills to reduce psychological distress and caregiver burden and to improve their quality of life. Feasibility was assessed by the rates of recruitment, attrition, time spent on completing the questionnaire and the duration of each session. Acceptability was evaluated using the Client Satisfaction Questionnaire. Preliminary intervention effects were evaluated on primary (psychological distress) and secondary (caregiver burden, quality of life, coping style and social support) outcomes. RESULTS: The feasibility of the program was established at a high recruitment rate of 89.7% and a low attrition rate of 10.0%. The participants were highly satisfied with the program. Although the psychological distress was reduced in the intervention group, the results were not statistically significant (P = 0.106, Cohen's d = - 0.28). No significant differences in caregiver burden, active coping, negative coping, social support and quality of life (P >
0.05 for all) were found between the two groups at 4 weeks after the intervention. CONCLUSIONS: The perioperative support program may be feasible and acceptable for family caregivers of patients with early-stage lung cancer. The program provides caregivers with coping and communication skill training and psychoeducational strategies to help them face the perioperative challenges of caring for patients with early-stage lung cancer. Based on the promising results of this pilot study, we have conducted a large-scale randomised controlled trial to evaluate the intervention's effectiveness. TRIAL REGISTRATION: This study was retrospectively registered at the Chinese Clinical Trial Registry. Registration Date: February 25, 2022. REGISTRATION NUMBER: ChiCTR2200056965.