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Zimami S, Darwish H. Preparedness for caregiving among informal caregivers of people with dementia: A scoping review. Geriatr Nurs 2024; 60:191-206. [PMID: 39265381 DOI: 10.1016/j.gerinurse.2024.08.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 07/26/2024] [Accepted: 08/19/2024] [Indexed: 09/14/2024]
Abstract
INTRODUCTION Dementia is a global health concern, and informal caregivers often provide care for those affected. Caregiver preparedness is crucial for optimizing quality of life. However, knowledge about the determinants of caregiver preparedness is limited. PURPOSE The aim of this scoping review was to identify the factors associated with preparedness for caregiving among informal caregivers of people with dementia. METHODOLOGY The review adhered to the methods from the Joanna Briggs Institute. Studies exploring the preparedness of informal caregivers of people with dementia were included in this review. Data were extracted from studies found in five major databases: PubMed, PsycINFO, Scopus, CINAHL, and Embase. RESULTS The final review included twenty-three studies. Self-efficacy and confidence, resilience and self-conduct, knowledge, education and training, mutuality, mental health, less caregiving conflict, and mindfulness were associated with caregiver preparedness. CONCLUSION This review identified a significant research gap in preparedness among caregivers of people with dementia. More research is essential to understand the factors associated with caregivers' preparedness. Recognizing these elements can inform tailored interventions, assisting informal caregivers in their caregiving transition and journey.
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Affiliation(s)
- Sumiyyah Zimami
- University of Michigan School of Nursing, 400 N Ingalls St, Ann Arbor, MI 48109, United States; University College in Darb, Department of Nursing, Jazan University, Jizan, Saudi Arabia.
| | - Hala Darwish
- University of Michigan School of Nursing, 400 N Ingalls St, Ann Arbor, MI 48109, United States
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Zhao Q, Zhao X, Zhang J, Xu X, Kong H, Lin S, Zhao H, Li M. The mediating roles of caregiver needs and caregiver readiness in the relation between family resilience and benefit finding in family caregivers of patients with stroke in China. Top Stroke Rehabil 2024:1-10. [PMID: 39140651 DOI: 10.1080/10749357.2024.2387482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 07/28/2024] [Indexed: 08/15/2024]
Abstract
OBJECTIVES The purpose of this study was to assess the effects of family resilience, caregiver needs, and caregiver readiness on benefit finding for family caregivers of patients with stroke and to examine the mediating role of caregiver needs and caregiver readiness between family resilience and benefit finding. METHODS In this cross-sectional study, convenience sampling was designed and used to recruit participants from three general hospitals in Jinan, Shandong Province, China, from February to September 2022, in which 340 participants completed the General Information Questionnaire, Chinese version of the Family Resilience Assessment Scale (C-FRAS), Caregiver Needs Assessment Scale (CNAS) Chinese version of the Caregiver Preparedness Scale (C-CPS), and Caregiver Benefit Finding Scale (CBFS). Model 6 in process version 4.0 was used to test the chain mediation model between family resilience and benefit finding for caregiver needs and caregiver readiness. RESULTS Correlation analysis showed that benefit finding in family caregivers was positively associated with family resilience and caregiver readiness and negatively associated with caregiver needs; mediation model tests showed that the total indirect effect of family resilience on benefit finding was 0.163, with the specific mediating effects of caregiver needs and caregiver readiness accounting for 33.74% and 59.51%, and the chain mediating effect of both accounting for 6.75%. CONCLUSIONS Family resilience not only directly influences benefit finding for family caregivers but also indirectly affects benefit finding through caregiver needs and caregiver readiness. Caregiver needs and caregiver readiness have a mediating role between family resilience and benefit finding in family caregivers.
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Affiliation(s)
- Qitong Zhao
- Nursing school, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Xinyue Zhao
- Nursing school, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Jingwei Zhang
- Department of Nursing, Zibo City Central Hospital, Zibo, Shandong, China
| | - Xiangmin Xu
- Nursing school, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Haoxin Kong
- Nursing school, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Shuhao Lin
- Nursing school, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Haijun Zhao
- Traditional Chinese Medicine School, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Mingxia Li
- Nursing school, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
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Clarke JJ, Halkett GKB, McDougall E, Dhillon HM, Lobb E, Phillips JL, Hudson P, Nowak AK. What do carers of people with high-grade glioma perceive could improve their preparedness to care, and what additional support do they require? Neurooncol Pract 2024; 11:296-306. [PMID: 38737602 PMCID: PMC11085844 DOI: 10.1093/nop/npae015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024] Open
Abstract
Background Concerning levels of stress, strain, and poorer mental health are observed in family carers of patients diagnosed with high-grade glioma (HGG). Understanding the reported unmet needs of these carers will enable future interventions to address such needs to improve their preparedness for care and well-being. In this secondary analysis, we aimed to explore: (i) what carers of people with HGG perceive could improve their preparedness to care; and (ii) what needs carers reported they required additional support with. Methods Responses from 188 carers of patients with HGG participating in a randomized controlled trial of the Care-IS intervention were analyzed to identify reported unmet needs. Of this larger sample, 92 participants answered a qualitative question seeking to identify perceived unmet needs in carer preparedness over 12 months. These responses comprised the data for the current secondary analysis. Content analysis was used to analyze the qualitative data and observe trends across participant responses. Results Five overarching themes were identified: carer needs, providing emotional and practical care, coping with uncertainty, coping with the consequences of illness progression, and processing and supporting end-of-life care. Notably, the content analysis identified differences in response numbers between groups in the Care-IS trial, particularly with the control group having more needs regarding illness progression and end-of-life care. Conclusions Future interventions aimed at improving the well-being and preparedness of carers of people with HGG should consider providing better support centered on carer needs, their changed circumstances, living with uncertainty, and care transition.
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Affiliation(s)
- James J Clarke
- Faculty of Health Sciences, Curtin School of Nursing/Curtin Health Innovation Research Institute, Curtin University, Bentley, Western Australia, Australia
- Faculty of Health Sciences, Curtin School of Population Health/Curtin EnAble Institute, Curtin University, Bentley, Western Australia, Australia
| | - Georgia K B Halkett
- Faculty of Health Sciences, Curtin School of Nursing/Curtin Health Innovation Research Institute, Curtin University, Bentley, Western Australia, Australia
| | - Emma McDougall
- Faculty of Health Sciences, Curtin School of Nursing/Curtin Health Innovation Research Institute, Curtin University, Bentley, Western Australia, Australia
| | - Haryana M Dhillon
- Faculty of Science, Psycho-Oncology Cooperative Research Group, School of Psychology, University of Sydney, Sydney, Australia
- Centre for Medical Psychology & Evidence-based Decision-making, Sydney, Australia
| | - Elizabeth Lobb
- Faculty of Health, ImPACCT, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Jane L Phillips
- Faculty of Health, ImPACCT, University of Technology Sydney, Ultimo, New South Wales, Australia
- Faculty of Health, School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Peter Hudson
- Centre for Palliative Care, St Vincent’s Hospital Melbourne, Melbourne, Victoria, Australia
- Department of Nursing, University of Melbourne, Melbourne, Victoria, Australia
- End of LIfe Research Department, Vrije University Brussels, Brussels, Belgium
| | - Anna K Nowak
- University of Western Australia, Crawley, Western Australia, Australia
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Hughes I, Lavery J. Contemporary challenges for SCPDNs in the provision of end-of-life care. Br J Community Nurs 2024; 29:26-31. [PMID: 38147447 DOI: 10.12968/bjcn.2024.29.1.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Abstract
The advancement in the knowledge and skills required by the Specialist Community Practitioner District Nurse (SCPDN) is integral in supporting end-of-life care. An integrated and multi-disciplinary team approach is pivotal for high quality patient care delivery, which involves individuals and their significant others in decision-making at a sensitive time. Advanced care planning and the use of therapeutic communication by the SCPDN can help to support autonomy in individuals during uncertain times, enabling them to express their end-of-life wishes. The SCPDN, guided by the evidence base, must provide holistic care and manage palliation while ensuring the patient is at the centre of all decisions.
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Affiliation(s)
- Irene Hughes
- Lecturer, Nursing and Advanced Practice, Liverpool John Moores University
| | - Joanna Lavery
- Senior Lecturer, Nursing and Advanced Practice, Liverpool John Moores University
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Turner RL, Reese-Melancon C, Harrington EE, Andreo M. Caregiving During the COVID-19 Pandemic: Factors Associated With Feelings of Caregiver Preparedness. J Appl Gerontol 2023; 42:2089-2099. [PMID: 37395127 PMCID: PMC10333559 DOI: 10.1177/07334648231182242] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2023] Open
Abstract
Examination of caregiver preparedness for the COVID-19 pandemic can inform efforts to support caregivers in future times of global crisis. Informal caregivers of adults with dementia or severe disabilities (n = 72, Mage = 62.82 years, 90.28% female) were recruited through Adult Day Centers across the United States. Caregivers responding to an online survey regarding their experiences and preparedness reported an increase in burden, stress, and time spent caregiving since the onset of the pandemic. Caregivers reported feeling prepared for typical caregiving responsibilities but felt less prepared for someone else to assume the role of primary caregiver. Multiple regression modeling indicated that resilience accounted for significant variance in primary caregiver preparedness, over and above burden, but only caregiver age accounted for significant variability in a component representing feeling prepared to delegate caregiving to another person. These findings have implications for research and applied efforts to promote caregiver well-being and preparedness.
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Affiliation(s)
- Rachael L. Turner
- Department of Psychology, Oklahoma State University, Stillwater, OK, USA
| | | | - Erin E. Harrington
- Department of Biobehavioral Health, Pennsylvania State University, University Park, PA, USA
| | - Micaela Andreo
- Department of Psychology, University of Texas at Dallas, Richardson, TX, USA
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Paulson D, McClure N, Wharton T, Gendron E, Allen Q, Irfan H. Caregiver Preparedness: A Therapeutic Mechanism and Moderating Factor on Outcomes for the Savvy Caregiver Program. Clin Gerontol 2023:1-15. [PMID: 37530457 PMCID: PMC10834848 DOI: 10.1080/07317115.2023.2242357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/03/2023]
Abstract
OBJECTIVES Evidence-based interventions for dementia caregivers, such as the Savvy Caregiver Program (SC), seek to address skills and knowledge deficits, caregiver burden, depressive symptoms, and grief. Little research has examined mechanisms by which these interventions accomplish their goals. Caregiver preparedness may be a possible mechanism by which caregiver interventions may confer benefits. METHODS The sample included 76 dementia caregivers who completed the 6-session SC. Participants completed the Anticipatory Grief Scale, Center for Epidemiological Studies-Depression Scale, the Preparedness for Caregiving Scale, and the Zarit Burden Interview-Short Form. RESULTS A repeated measures ANOVA was utilized to determine the interaction between baseline scores and pre-post change in caregiver preparedness. Analysis significantly predicted caregiver burden, (F(1) = 6.68, p=.012, partial η2=.10), depressive symptom endorsement, (F(1) = 6.41, p=.014, partial η2=.09, and anticipatory grief, (F(1) = 6.22, p=.02, partial η2=.1), post-treatment. CONCLUSIONS Pre-post change in caregiver preparedness significantly predicted pre-post change across measures of caregiver burden, depressive symptom endorsement, and anticipatory grief. Findings suggest that caregiver preparedness may be one mechanism by which the SC confers positive outcomes. These findings provide an empirical and theoretical basis for tailoring future dementia caregiver interventions. CLINICAL IMPLICATIONS Clinical Interventions may seek to improve caregiver preparedness and subsequent outcomes through utilization of programs like SC.
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Affiliation(s)
- Daniel Paulson
- Department of Psychology, University of Central Florida, Alzheimer's and Dementia Resource Center, Orlando, Florida, USA
| | - Nicole McClure
- Department of Psychology, University of Central Florida, Orlando, Florida, USA
| | - Tracy Wharton
- Principal Research Scientist, National Network of Public Health Institutes, Washington, USA
| | - Edith Gendron
- Chief Operating Officer of ADRC, Winter Park, Florida, USA
| | - Quinn Allen
- Psychology, University of Central Florida, Orlando, USA
| | - Hanya Irfan
- Health Sciences, University of Central Florida, Orlando, USA
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Uhm KE, Jung H, Woo MW, Kwon HE, Oh-Park M, Lee BR, Kim EJ, Kim JH, Lee SA, Lee J. Influence of preparedness on caregiver burden, depression, and quality of life in caregivers of people with disabilities. Front Public Health 2023; 11:1153588. [PMID: 37564425 PMCID: PMC10409988 DOI: 10.3389/fpubh.2023.1153588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 07/14/2023] [Indexed: 08/12/2023] Open
Abstract
Introduction Caregiver preparedness is defined as the perceived preparation of caregivers to care for the physical and emotional needs of the patient. Purpose This study investigated caregiver preparedness and its influences on caregiver burden, depression, and quality of life (QoL) in caregivers of individuals with disabilities. Methods We conducted a multicenter cross-sectional survey study on caregivers caring for patients with disabilities. Sociodemographic characteristics were collected via questionnaires. The Preparedness for Caregiving Scale (PCS), Burden Interview (BI), Center for Epidemiologic Studies Depression Scale (CES-D), and EuroQol-Visual Analogue Scale (EQ-VAS) were administered. Results A total of 151 caregivers were enrolled. The mean age of caregivers was 53.7 ± 12.4 years, and 80.8% were female. The majority of participants were the main caregivers of patients with stroke, spinal cord injury, or traumatic brain injury. The mean PCS score was 2.1 ± 0.9, demonstrating significant relationships with BI (r = -0.512, p < 0.001), CES-D (r = -0.622, p < 0.001), and EQ-VAS (r = 0.441, p < 0.001). The CES-D was significantly associated with the PCS after controlling other variables. However, PCS did not show any correlation with the duration of caregiving or amount of time spent per day on caregiving. Discussion The clinical implications of this study are that higher caregiver preparedness is a predictor of less caregiver burden and depression, and better QoL. However, preparedness did not increase as the duration or time spent on caregiving was extended. Therefore, efforts to enhance the caregivers' preparedness are required to reduce caregiver burden and improve health outcomes for both caregivers and patients.
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Affiliation(s)
- Kyeong Eun Uhm
- Department of Rehabilitation Medicine, Konkuk University Medical Center, Seoul, Republic of Korea
| | - Heeyoune Jung
- Department of Rehabilitation Medicine, National Traffic Injury Rehabilitation Hospital, Yangpyeong, Republic of Korea
| | - Min Woo Woo
- Department of Rehabilitation Medicine, Konkuk University Medical Center, Seoul, Republic of Korea
| | - Hyo Eun Kwon
- Department of Rehabilitation Medicine, Konkuk University Medical Center, Seoul, Republic of Korea
| | - Mooyeon Oh-Park
- Burke Rehabilitation Hospital, Montefiore Health System, White Plains, NY, United States
| | - Bo Ram Lee
- Department of Psychiatry, Cheil Hospital, Seoul, Republic of Korea
| | - Eun Joo Kim
- Department of Rehabilitation Medicine, National Rehabilitation Center, Seoul, Republic of Korea
| | - Jung Hwan Kim
- Department of Rehabilitation Medicine, National Rehabilitation Center, Seoul, Republic of Korea
| | - Seung Ah Lee
- Department of Physical Medicine and Rehabilitation, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Jongmin Lee
- Department of Rehabilitation Medicine, Konkuk University Medical Center, Seoul, Republic of Korea
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Häger Tibell L, Årestedt K, Holm M, Wallin V, Steineck G, Hudson P, Kreicbergs U, Alvariza A. Preparedness for caregiving and preparedness for death: Associations and modifiable thereafter factors among family caregivers of patients with advanced cancer in specialized home care. DEATH STUDIES 2023; 48:407-416. [PMID: 37441803 DOI: 10.1080/07481187.2023.2231388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/15/2023]
Abstract
The purpose of this study was to (1) explore associations between preparedness for caregiving and preparedness for death among family caregivers of patients with advanced cancer and (2) explore modifiable preparedness factors, such as communication and support. Data was derived from a baseline questionnaire collected in specialized home care. The questionnaire included socio-demographics, the Preparedness for Caregiving Scale, and single items addressing preparedness for death, received support and communication about incurable illness. Data was analyzed using descriptive statistics and Spearman correlations. Altogether 39 family caregivers participated. A significant association was found between preparedness for caregiving and preparedness for death. Received support and communication about the illness was associated with higher levels of preparedness for caregiving and death. This study contributes to evidence on the association between preparedness for caregiving and death, but also that communication and support employed by healthcare professionals could improve family caregiver preparedness and wellbeing.
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Affiliation(s)
- Louise Häger Tibell
- The Department of Health Care Science/Palliative Research Centre, Marie Cederschiöld University, Stockholm, Sweden
- Tema Cancer, BES: Breast-Endocrine Tumours and Sarcoma, Karolinska University Hospital, Stockholm, Sweden
| | - Kristofer Årestedt
- Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden
- Department of Research, Region Kalmar County, Kalmar, Sweden
| | - Maja Holm
- The Department of Health Care Science/Palliative Research Centre, Marie Cederschiöld University, Stockholm, Sweden
- Department of Nursing Science, Sophiahemmet University, Stockholm, Sweden
| | - Viktoria Wallin
- The Department of Health Care Science/Palliative Research Centre, Marie Cederschiöld University, Stockholm, Sweden
| | - Gunnar Steineck
- Department of Clinical Cancer Epidemiology, Karolinska Institutet, Stockholm, Sweden
- Division of Clinical Cancer Epidemiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Peter Hudson
- Centre for Palliative Care, St Vincent´s Hospital and The University of Melbourne, Melbourne, Australia
- Vrije University Brussels, Brussels, Belgium
| | - Ulrika Kreicbergs
- The Department of Health Care Science/Palliative Research Centre, Marie Cederschiöld University, Stockholm, Sweden
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Anette Alvariza
- Research and Development-Unit/Palliative Care, Stockholms Sjukhem, Stockholm, Sweden
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Bierman A, Lee Y, Penning MJ. Mental Health Benefits and Detriments of Caregiving Demands: A Nonlinear Association in the Canadian Longitudinal Study on Aging. J Aging Health 2022; 35:392-404. [PMID: 36112750 PMCID: PMC10150259 DOI: 10.1177/08982643221125258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives This study examines whether the association between caregiving demands and mental health is non-linear and also, whether this non-linear association is contingent on the marital status of the caregiver. Methods We analyze the data from the Canadian Longitudinal Study on Aging, applying OLS regression and quadratic interaction terms. Results A lower level of demands is salubriously associated with symptoms of depression and life satisfaction, but this association becomes deleterious at higher levels of demands. Moreover, a connection to a marital partner extends the benefits of caregiving demands and stems the adverse consequences. Discussion This research shows that acts of caregiving may not themselves be detrimental. Instead, the degree and way in which caregiving relates to mental health may vary by both the extent of the demands of the caregiving role and familial relationships in which caregivers are embedded.
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Affiliation(s)
| | - Yeonjung Lee
- University of Calgary, Calgary, AB, Canada
- Chung-Ang University, Seoul, Korea
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Abstract
OBJECTIVES The purpose of this pilot study is to examine the efficacy of a theoretically based, 6-week dementia caregiver support group in a primary care setting. METHODS Using a quasi-experimental design, 22 participants completed the caregiver support group. Participants were mostly in their mid-60 s (M = 63 years old), female (n = 19), Caucasian (n = 14), and identified as either the care recipient's child or spouse (n = 19). At baseline and 6 weeks, participants completed self-report measures related to demographic information, caregiver preparedness, strain, and depressive symptoms, and care recipient's neuropsychiatric symptoms. Participants also completed a satisfaction survey. Within-subjects t-tests were run to determine if participants' scores changed over time. RESULTS Results revealed that participants demonstrated a significant increase in mean caregiver preparedness scores. No significant effects were found for caregiver strain, depressive symptoms, and distress related to neuropsychiatric symptoms. Participants rated being largely satisfied with the program. CONCLUSIONS Results suggest that this 6-week caregiver support group may be a promising caregiver intervention in primary care clinics. CLINICAL IMPLICATIONS Findings support the importance of caregiver support for persons with dementia in primary care.
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Affiliation(s)
- Mona Shah Barman
- Department of Psychology, University of Central Florida, Orlando, Florida, USA
| | - Daniel Paulson
- Department of Psychology, University of Central Florida, Orlando, Florida, USA
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Doyle C. The importance of supportive relationships with general practitioners, hospitals and pharmacists for mothers who 'give medicines' to children with severe and profound intellectual disabilities. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2022; 26:29-49. [PMID: 32815761 DOI: 10.1177/1744629520951003] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
A purposeful sample of 15 mothers of children with severe and profound intellectual disabilities participated in this hermeneutic phenomenological study through interviews and completion of a diary. The aim of the study was to explore mothers' lived experience of 'giving medicines' to children with severe and profound intellectual disabilities. Findings yielded multiple themes, one of which gave insight into the importance of supportive relationships with health professionals. The general practitioner (GP), hospital and pharmacist are key in providing supportive elements to mothers' daily role. Having the support of a helpful GP was key in helping mothers cope on a daily basis for child related queries on illness, getting prescriptions or seeking advice. Accessibility to the hospital and avoiding the emergency department with their child was recommended. The pharmacist was central to the daily activities relating to 'giving medicines' and a good relationship resulted in a happier mother.
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Affiliation(s)
- Carmel Doyle
- School of Nursing and Midwifery, 214057Trinity College, Dublin, Ireland
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Hancock DW, Czaja S, Schulz R. The Role of Preparedness for Caregiving on the Relationship Between Caregiver Distress and Potentially Harmful Behaviors. Am J Alzheimers Dis Other Demen 2022; 37:15333175221141552. [PMID: 36427169 PMCID: PMC10581146 DOI: 10.1177/15333175221141552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
This work extends research suggesting a link between indicators of distress among informal caregivers (CG) (e.g., depression and burden), and potentially harmful behaviors (PHB), including feeling like yelling or screaming at the care recipient (CR). We tested three hypotheses regarding the role of a novel predictor, CG preparedness for caregiving, which were: 1) a direct effect between CG preparedness and PHB, 2) CG distress mediates the relationship between the direct effect of CG preparedness on PHB, and finally, 3) CG preparedness is only related to PHB through their shared associations with indicators of caregiver distress, an indirect effects model. Examining two indicators of PHB and CG depression and CG burden, results supported the indirect effects model. Higher CG preparedness was associated with lower CG distress, which in turn was associated with lower risk of PHB. These findings highlight the importance of CG preparedness as a target for caregiver intervention research.
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Affiliation(s)
- David W. Hancock
- Department of Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Sara Czaja
- Department of Medicine, Weill Cornell Medical College, New York, NY, USA
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Ris I, Volken T, Schnepp W, Mahrer-Imhof R. Exploring Factors Associated With Family Caregivers' Preparedness to Care for an Older Family Member Together With Home Care Nurses: An Analysis in a Swiss Urban Area. J Prim Care Community Health 2022; 13:21501319221103961. [PMID: 35670066 PMCID: PMC9178975 DOI: 10.1177/21501319221103961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Introduction: Home-dwelling older people with chronic diseases often need the support of informal and formal caregivers in order to continue living at home. Family members, however, need to be willing and prepared for caregiving together with home care nurses. Objectives: The purpose of this study was to explore factors associated with family caregivers’ preparedness to care for older home-dwelling adults who also receive home care nursing services. Methods: For this cross-sectional correlational study, a structured questionnaire was sent to family caregivers of adults aged 65 years or older receiving services from a community care agency. A total of 243 participants returned the questionnaire, of which 199 could be analyzed. Results: The stepwise backward regression model explained 29.1% of the variance of family caregivers’ preparedness. Mutuality was the most strongly associated factor with family caregivers’ preparedness whereas professional involvement of family caregiver in care process was important as well. Care intensity showed no significant impact. Conclusion: Nurses should support the whole family emotionally, and appreciate, admire, reinforce, and respect the caregivers’ situation. Home care nurses need to invest in helping families to find solutions, to strengthen their relationships between family members and the older person dwelling at home.
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Affiliation(s)
- Irène Ris
- ZHAW Zürcher Hochschule für Angewandte Wissenschaften, Winterthur Schweiz, Switzerland.,Universität Witten/Herdecke, Fakultät für Gesundheit, Witten, Deutschland
| | - Thomas Volken
- ZHAW Zürcher Hochschule für Angewandte Wissenschaften, Winterthur Schweiz, Switzerland
| | - Wilfried Schnepp
- Universität Witten/Herdecke, Fakultät für Gesundheit, Witten, Deutschland
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Zauszniewski JA, Burant CJ, Martin RJ, Sweetko JS, DiFranco E. Caregivers' Use of Personal and Social Resourcefulness: Differences by Care Recipient Condition. West J Nurs Res 2021; 44:288-295. [PMID: 34622720 DOI: 10.1177/01939459211050951] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Although family caregivers who use both the personal and social resourcefulness skills have the best health outcomes, it is unknown whether their tendency toward personal or social resourcefulness varies by their care recipient's condition. This cross-sectional study of existing data from 234 caregivers of persons with various conditions examined five item pairs from the Resourcefulness Scale© with responses capturing personal and social resourcefulness in relation to anxiety, anger, sadness, indecision, and financial distress. Caregivers were categorized by the recipient's condition (amyotrophic lateral sclerosis, cancer, dementia, mental illness, Parkinson's disease, stroke, traumatic brain injury, other, or multiple conditions). Findings showed that across most groups, caregivers used both personal and social resourcefulness when angry, sad, or indecisive and personal resourcefulness when anxious or managing money. Caregivers of persons with cancer, traumatic brain injury, stroke, and mental illness differed. The findings provide a basis for future clinical trials across diverse caregiver groups.
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Affiliation(s)
- Jaclene A Zauszniewski
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Christopher J Burant
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Richard J Martin
- The Breen School of Nursing and Health Professions, Ursuline College, Cleveland, OH, USA
| | - John S Sweetko
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Evelina DiFranco
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
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Onu DU, Orjiakor CT, Onyedire NG, Amazue LO, Allison TJ. Preparedness for caregiving moderates the association between burden and health-related quality of life among family caregivers of stroke patients in Nigeria. SOUTH AFRICAN JOURNAL OF PSYCHOLOGY 2021. [DOI: 10.1177/00812463211048755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Studies on improving the health-related quality of life of stroke patients are abundant, but less attention has been given to the factors influencing the wellbeing of their family caregivers, especially in low- to middle-income countries such as Nigeria where the burden of stroke is expected to increase. In this study, we examined the moderating role of preparedness for caregiving in the connection between the burden of caregiving and health-related quality of life of family caregivers of stroke patients in Nigeria. Family caregivers of stroke patients (140 females and 60 males; aged between 18 and 57 years) were purposively sampled from a Federal Medical Center in Southeastern Nigeria. Participants completed measures of caregiver’s strain (burden), health-related quality of life, and preparedness to give care. Results showed that burden negatively predicted physical health (β = –.61, CI: [–.89, –.34]) and mental health (β = –.76, CI: [−1.07, –.45]) dimensions of the health-related quality of life, respectively. Results also showed that preparedness moderated the relationship between burden and physical health (β = .21, CI: [.11, .32]), as well as mental health (β = .24, CI: [.12, .35]) dimensions. Ensuring that caregivers of stroke patients are adequately prepared to give care could ameliorate the negative impacts of caregiving on health of family caregivers of stroke patients.
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Affiliation(s)
- Desmond U Onu
- Department of Psychology, University of Nigeria, Nsukka, Nigeria
| | - Charles Tochukwu Orjiakor
- Department of Psychology, University of Nigeria, Nsukka, Nigeria
- ThinkScope Consulting, Nigeria
- Health Policy Research Group, Department of Pharmacology and Therapeutics, College of Medicine, University of Nigeria, Enugu, Nigeria
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Waters AR, Gren LH, Rogers CR, Kirchhoff AC, Warner EL. Qualitative inquiry of cancer caregiving during young adulthood: responsibilities, challenges, teamwork, and social support. JOURNAL OF PSYCHOSOCIAL ONCOLOGY RESEARCH AND PRACTICE 2021; 3:e062. [PMID: 34746795 PMCID: PMC8570566 DOI: 10.1097/or9.0000000000000062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Young adult cancer caregivers (YACC) may experience heightened caregiver burden because they take on caregiving during a dynamic time of life. The purpose of this study was to describe YACC experiences, burden, and social support while caregiving. METHODS Grounded by the Cancer Family Caregiving Experience Model and the Stress and Coping Social Support theory, semi-structured interviews were conducted with YACC. Inductive analysis was applied to YACC perceptions of caregiving, and deductive analysis to YACC social networks and social support. RESULTS YACC (N=34) were primarily between 25 to 29 years of age (38.2%), primarily female (70.6%), non-Hispanic White (91.2%), employed (85.3%), college graduates or higher (53.0%), and caring for a spouse/partner (52.9%). Qualitative analysis of interviews with YACC resulted in 2 themes: cancer caregiving during young adulthood and young adult cancer caregiver social support. In the first theme YACC often did not perceive themselves as caregivers, rather their caregiving responsibilities were viewed as an extension of their relationship with the patient. Further YACC reported developmental-specific responsibilities (eg, caring for young children, being unable to take time off while solidifying careers) which often conflicted with their caregiving responsibilities (eg, managing patient's medication, attending appointments) and heightened burden. In response, YACC often formed caregiver teams consisting of family, friends, and community members to care for their loved one. In the second theme YACC most commonly reported receiving emotional and instrumental support from their social network. YACC specifically mentioned their appreciation for emotional support provided by other young adults and instrumental support in the form of financial support. CONCLUSIONS YACC faced developmentally specific challenges during caregiving that older adult caregivers may not encounter. The conflict of young adult and caregiving responsibilities resulted in YACC forming caregiver teams. Thus, theoretical approaches to understand and improve caregiver health would benefit from the inclusion of the developmental context of young adulthood. Furthermore, it is crucial that cancer centers tailor supportive services to YACC as the number of young caregivers increases.
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Affiliation(s)
- Austin R. Waters
- Cancer Control and Population Sciences Research Program, Huntsman Cancer Institute, Salt Lake City, UT
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT
| | - Lisa H. Gren
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT
| | - Charles R. Rogers
- Cancer Control and Population Sciences Research Program, Huntsman Cancer Institute, Salt Lake City, UT
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT
| | - Anne C. Kirchhoff
- Cancer Control and Population Sciences Research Program, Huntsman Cancer Institute, Salt Lake City, UT
- Department of Pediatrics, University of Utah, Salt Lake City, UT
| | - Echo L. Warner
- University of Arizona Cancer Center, Tucson, AZ
- College of Nursing, University of Arizona, Tucson, AZ
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Ross A, Jumin Lee L, Wehrlen L, Cox R, Yang L, Perez A, Bevans M, Ding A, Wallen G. Factors That Influence Health-Promoting Behaviors in Cancer Caregivers. Oncol Nurs Forum 2021; 47:692-702. [PMID: 33063787 DOI: 10.1188/20.onf.692-702] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To describe cancer caregivers' participation in health-promoting behaviors and to identify factors influencing participation. SAMPLE & SETTING 129 informal cancer caregivers at the National Institutes of Health Clinical Center. METHODS & VARIABLES Cross-sectional survey methodology using Health-Promoting Lifestyle Profile-II (HPLP-II), PROMIS® Global Physical Health, NIH Toolbox Stress and Self-Efficacy, Caregiver Reaction Assessment, and Family Care Inventory Mutuality subscale. RESULTS Caregivers reported the highest HPLP-II subscale scores for spirituality and interpersonal relationships and the lowest for physical activity. Caregivers who were older, with lower body mass indices, in better physical health, and with higher self-efficacy and mutuality participated in more health-promoting behaviors. Sixty percent of the caregivers reported that they exercised less since becoming a caregiver, and 47% reported that their diet was worse. IMPLICATIONS FOR NURSING Future research is needed to examine novel interventions to increase health-promoting activities in cancer caregivers, and these interventions might be strengthened by including components that focus on increasing self-efficacy and/or improving the strength of the relationship between the caregiver and care recipient.
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Affiliation(s)
- Alyson Ross
- National Institutes of Health Clinical Center
| | | | | | - Robert Cox
- National Institutes of Health Clinical Center
| | - Li Yang
- National Institutes of Health Clinical Center
| | - Avery Perez
- Philadelphia College of Osteopathic Medicine
| | | | - Alice Ding
- National Institutes of Health Clinical Center
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Camicia ME, Ann Laslo M, Lutz BJ. Implementing a Caregiver Assessment and Tailored Plan: An Emerging Case Management Competency. Prof Case Manag 2021; 26:205-213. [PMID: 34021107 DOI: 10.1097/ncm.0000000000000513] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Michelle E Camicia
- Michelle E. Camicia, PhD, RN, CRRN, CCM, NEA-BC, FARN, FAHA, FAAN , is the Director of Operations for Kaiser Foundation Rehabilitation Center. She is an international leader in rehabilitation and nursing, with expertise in care transitions for individuals with chronic and disabling conditions. Dr. Camicia received her PhD from the Betty Irene Moore School of Nursing at the University of California Davis. Her research focuses on health service delivery and assessing and addressing the needs of family caregivers
- Mary Ann Laslo, MSN, RN, CRRN, CCM, CNL, has expertise in care transitions for individuals with chronic and disabling conditions. Her research focuses on health service delivery and assessing and addressing the needs of family caregivers. She is a Clinical Practice Consultant at the Kaiser Foundation Rehabilitation Center in Vallejo, California. She has extensive experience in rehabilitation nursing, case management, and quality, including extensive managerial, organizational, and education/program development capabilities in acute and postacute rehabilitation
- Barbara J. Lutz, PhD, RN, CRRN, PHNA-BC, FAHA, FAAN, is the McNeill Distinguished Professor at the University of North Carolina-Wilmington School of Nursing. Her research focuses on understanding the needs and experiences of patients with chronic disabling illnesses and their family caregivers as they move through the continuum of care, from acute care to home
| | - Mary Ann Laslo
- Michelle E. Camicia, PhD, RN, CRRN, CCM, NEA-BC, FARN, FAHA, FAAN , is the Director of Operations for Kaiser Foundation Rehabilitation Center. She is an international leader in rehabilitation and nursing, with expertise in care transitions for individuals with chronic and disabling conditions. Dr. Camicia received her PhD from the Betty Irene Moore School of Nursing at the University of California Davis. Her research focuses on health service delivery and assessing and addressing the needs of family caregivers
- Mary Ann Laslo, MSN, RN, CRRN, CCM, CNL, has expertise in care transitions for individuals with chronic and disabling conditions. Her research focuses on health service delivery and assessing and addressing the needs of family caregivers. She is a Clinical Practice Consultant at the Kaiser Foundation Rehabilitation Center in Vallejo, California. She has extensive experience in rehabilitation nursing, case management, and quality, including extensive managerial, organizational, and education/program development capabilities in acute and postacute rehabilitation
- Barbara J. Lutz, PhD, RN, CRRN, PHNA-BC, FAHA, FAAN, is the McNeill Distinguished Professor at the University of North Carolina-Wilmington School of Nursing. Her research focuses on understanding the needs and experiences of patients with chronic disabling illnesses and their family caregivers as they move through the continuum of care, from acute care to home
| | - Barbara J Lutz
- Michelle E. Camicia, PhD, RN, CRRN, CCM, NEA-BC, FARN, FAHA, FAAN , is the Director of Operations for Kaiser Foundation Rehabilitation Center. She is an international leader in rehabilitation and nursing, with expertise in care transitions for individuals with chronic and disabling conditions. Dr. Camicia received her PhD from the Betty Irene Moore School of Nursing at the University of California Davis. Her research focuses on health service delivery and assessing and addressing the needs of family caregivers
- Mary Ann Laslo, MSN, RN, CRRN, CCM, CNL, has expertise in care transitions for individuals with chronic and disabling conditions. Her research focuses on health service delivery and assessing and addressing the needs of family caregivers. She is a Clinical Practice Consultant at the Kaiser Foundation Rehabilitation Center in Vallejo, California. She has extensive experience in rehabilitation nursing, case management, and quality, including extensive managerial, organizational, and education/program development capabilities in acute and postacute rehabilitation
- Barbara J. Lutz, PhD, RN, CRRN, PHNA-BC, FAHA, FAAN, is the McNeill Distinguished Professor at the University of North Carolina-Wilmington School of Nursing. Her research focuses on understanding the needs and experiences of patients with chronic disabling illnesses and their family caregivers as they move through the continuum of care, from acute care to home
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19
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Hill AM, Moorin R, Slatyer S, Bryant C, Hill K, Waldron N, Aoun S, Kamdar A, Grealish L, Reberger C, Jones C, Bronson M, Bulsara MK, Maher S, Claverie T, Moyle W. Evaluating the provision of Further Enabling Care at Home (FECH+) for informal caregivers of older adults discharged home from hospital: protocol for a multicentre randomised controlled trial. BMJ Open 2021; 11:e046600. [PMID: 34155075 PMCID: PMC8217916 DOI: 10.1136/bmjopen-2020-046600] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION There are personal and societal benefits from caregiving; however, caregiving can jeopardise caregivers' health. The Further Enabling Care at Home (FECH+) programme provides structured nurse support, through telephone outreach, to informal caregivers of older adults following discharge from acute hospital care to home. The trial aims to evaluate the efficacy of the FECH+ programme on caregivers' health-related quality of life (HRQOL) after care recipients' hospital discharge. METHODS AND ANALYSIS A multisite, parallel-group, randomised controlled trial with blinded baseline and outcome assessment and intention-to-treat analysis, adhering to Consolidated Standards of Reporting Trials guidelines will be conducted. Participants (N=925 dyads) comprising informal home caregiver (18 years or older) and care recipient (70 years or older) will be recruited when the care recipient is discharged from hospital. Caregivers of patients discharged from wards in three hospitals in Australia (one in Western Australia and two in Queensland) are eligible for inclusion. Participants will be randomly assigned to one of the two groups. The intervention group receive the FECH+ programme, which provides structured support and problem-solving for the caregiver after the care recipient's discharge, in addition to usual care. The control group receives usual care. The programme is delivered by a registered nurse and comprises six 30-45 min telephone support sessions over 6 months. The primary outcome is caregivers' HRQOL measured using the Assessment of Quality of Life-eight dimensions. Secondary outcomes include caregiver preparedness, strain and distress and use of healthcare services. Changes in HRQOL between groups will be compared using a mixed regression model that accounts for the correlation between repeated measurements. ETHICS AND DISSEMINATION Participants will provide written informed consent. Ethics approvals have been obtained from Sir Charles Gairdner and Osborne Park Health Care Group, Curtin University, Griffith University, Gold Coast Health Service and government health data linkage services. Findings will be disseminated through presentations, peer-reviewed journals and conferences. TRIAL REGISTRATION NUMBER ACTRN12620000060943.
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Affiliation(s)
- Anne-Marie Hill
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
- School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Western Australia, Australia
| | - Rachael Moorin
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Susan Slatyer
- Discipline of School of Nursing, Murdoch University, Murdoch, Western Australia, Australia
| | - Christina Bryant
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Keith Hill
- Rehabilitation Ageing and Independent Living (RAIL) Research Centre, Monash University, Melbourne, Victoria, Australia
| | | | - Samar Aoun
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
- Perron Institute for Neurological and Translational Science, Perth, Western Australia, Australia
| | - Ami Kamdar
- Department of General Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Laurie Grealish
- Gold Coast Hospital and Health Services, Gold Coast, Queensland, Australia
- School of Nursing and Midwifery Nathan and Gold Coast, Griffith University, Brisbane, Queensland, Australia
| | - Caroline Reberger
- Department of Rehabilitation and Aged Care, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Cindy Jones
- Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Mary Bronson
- Medical Division, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Max K Bulsara
- Institute for Health Research, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Sean Maher
- Department of Rehabilitation and Aged Care, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Tracey Claverie
- Gold Coast Hospital and Health Services, Gold Coast, Queensland, Australia
| | - Wendy Moyle
- School of Nursing and Midwifery Nathan and Gold Coast, Griffith University, Brisbane, Queensland, Australia
- Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
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20
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La IS, Johantgen M, Storr CL, Zhu S, Cagle JG, Ross A. Caregiver burden and related factors during active cancer treatment: A latent growth curve analysis. Eur J Oncol Nurs 2021; 52:101962. [PMID: 33962232 DOI: 10.1016/j.ejon.2021.101962] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 03/06/2021] [Accepted: 04/11/2021] [Indexed: 02/05/2023]
Abstract
PURPOSE Caregiver burden is frequently studied cross-sectionally, but longitudinal studies on family caregiver burden during active cancer treatment are lacking. The goals of this study were to characterize trajectories of caregivers' burden during a 6-month active treatment period, and to examine which predictors are associated with their burden. METHOD This study was a secondary analysis of data from a prospective study. A sample of 112 family caregivers of patients receiving cancer treatment were assessed at three time points (the initiation of new treatment regimen, 3-, and 6-month follow-up). Caregivers completed measures: Caregiver Reaction Assessment and Mutuality Scale of the Family Care Inventory. Data were analyzed using latent growth curve modeling. RESULTS The two highest burdens were subdomains related to disrupted schedule and financial problems. Models showed a decline in schedule burden over time, yet total burden and other subscales (financial problems, health problems, and lack of family support and self-esteem) remained relatively stable. In multivariate analysis, mutuality, the relationship quality between patients and caregivers was inversely related to burden at baseline. Being a spouse, a sole caregiver and lower income were related to higher burden over time. CONCLUSIONS Our findings confirmed significant determinants of caregiver burden over the course of active treatment. It is important for health care providers to be attentive to vulnerable caregivers who are at higher risk of elevated burden over time. Considering the multidimensional nature of caregiver burden, early assessment and tailored support programs may be effective by focusing on patient-caregiver relationships, caregiving roles, and income.
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Affiliation(s)
- In Seo La
- College of Nursing Science, Kyung Hee University, Seoul, South Korea; University of Maryland School of Nursing, Baltimore, MD, USA.
| | - Meg Johantgen
- University of Maryland School of Nursing, Baltimore, MD, USA
| | - Carla L Storr
- University of Maryland School of Nursing, Baltimore, MD, USA
| | - Shijun Zhu
- University of Maryland School of Nursing, Baltimore, MD, USA
| | - John G Cagle
- University of Maryland School of Social Work, Baltimore, MD, USA
| | - Alyson Ross
- National Institutes of Health, Clinical Center, Bethesda, MD, USA
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21
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Abstract
ABSTRACT BACKGROUND: Mutuality, a positive relationship between caregiver and care receiver that affects patient's health and caregiver's burden, stress, and well-being, has never been investigated in motor neuron disease. METHOD: We conducted a mixed-method study with convergent parallel design. Quantitative data were collected with the Mutuality Scale, and qualitative data were collected using deep interviews. The sample was composed of 30 people with motor neuron diseases and 24 family caregivers. RESULTS: Deductive, qualitative content analysis of the interviews confirmed the presence of mutuality and its 4 dimensions. The average score of patients' Mutuality Scale was 3.07 (SD, 0.79; range, 1.3-4), and that of the caregivers was 3.16 (SD, 0.53; range, 2.2-3.9). The dimensions "love" and "shared values" had the highest scores, whereas the dimension "shared pleasurable activities" had the lowest score. Patients' and caregivers' answers correlated. CONCLUSION: Mutuality concept and its 4 dimensions had content validity in motor neuron disease people. Nurses should consider the level of mutuality and adopt strategies to increase and preserve it.
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Niu A, Guo C, Zhong D, He G, Zhong W, Wang L, Chen Y, Shang L, Fu J. Identifying the Unmet Supportive Care Needs, with Concomitant Influencing Factors, in Family Caregivers of Cancer Patients in China. Asia Pac J Oncol Nurs 2021; 8:276-286. [PMID: 33850961 PMCID: PMC8030597 DOI: 10.4103/apjon.apjon_52_20] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 08/19/2020] [Indexed: 12/24/2022] Open
Abstract
Objective The objective of the study is to assess the unmet needs of cancer caregivers and to identify the possible predictors of their supportive care needs in China. Methods This multicenter, cross-sectional study enrolled 449 cancer patients' family caregivers' dyads. Patients provided general information and Karnofsky performance status (KPS); caregivers provided general information and completed a survey of Chinese version of the Supportive Care Needs Survey-Partners and Caregivers Scale. The independent samples t-test, one-way analysis of variance, and multiple stepwise regression were used to analyze the factors that influence the needs of caregivers. Results A proportion of caregivers who had no needs were 5.6%. A proportion of caregivers with ≥ 5 moderate or high unmet needs and with ≥ 10 moderate or high unmet needs were 77.7% and 63.2%, respectively. Healthcare services and information needs and communication and relationship needs were the most prominent areas of caregivers' unmet needs. The item "Finding out about financial support and government benefits for you and/or the person with cancer" was the highest level of unmet needs at 78.6%. The level of unmet needs was related to the patient's physical function (KPS score), caregiver's educational levels, financial burden of healthcare, as well as the level of burden related to caregiving (working status, caring for others, caregiving experience, and total caregiving time). Conclusions The level of unmet needs of family caregivers of cancer patients in China was higher. In clinical practice, more attention should be paid to family caregivers who take care of the patient with poor physical function, those who are highly educated, faced with higher financial burden of healthcare, and are currently working, as well as those who need to take care of others, spend more time caregiving, and have no caregiving experience.
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Affiliation(s)
- Aifang Niu
- Department of Internal Medicine, 947 Army Hospital, Kashgar, China
| | - Chunyong Guo
- Department of Internal Medicine, 947 Army Hospital, Kashgar, China
| | - Daozhu Zhong
- Department of Internal Medicine, 947 Army Hospital, Kashgar, China
| | - Guirong He
- Department of Internal Medicine, 947 Army Hospital, Kashgar, China
| | - Wenbo Zhong
- Department of Internal Medicine, Xinjiang Military District General Hospital, Urumqi, Xinjiang, China
| | - Lanmei Wang
- Department of Internal Medicine, 947 Army Hospital, Kashgar, China
| | - Yu Chen
- Department of Internal Medicine, 947 Army Hospital, Kashgar, China
| | - Lei Shang
- Department of Preventive Medicine, Air Force Medical University, Xi'an, Shaanxi, China
| | - Jufang Fu
- Nursing Department, Shenzhen University General Hospital, Shenzhen, Guangdong, China
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Koenig Kellas J, Castle KM, Johnson AZ, Cohen MZ. Cancer as Communal: Understanding Communication and Relationships from the Perspectives of Survivors, Family Caregivers, and Health Care Providers. HEALTH COMMUNICATION 2021; 36:280-292. [PMID: 31665940 DOI: 10.1080/10410236.2019.1683952] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
With cancer increasing in prevalence and high priorities placed on concurrent oncological and palliative care to help meet the familial, spiritual, and individual needs of stakeholders in cancer, research is needed that assesses the factors that facilitate coping across stakeholders in cancer care. We were interested in synthesizing our understanding of communication and relationships among patients, caregivers, and providers based on the reasoning that illness is relational, but often conceptualized and researched from the individual perspectives of various stakeholders. The current study examined the experiences of relational and communication opportunities and challenges during cancer for current and former family caregivers, cancer survivors, and palliative and oncology health care practitioners. The thematic analysis of 30 semi-structured interviews revealed an overarching theme on the benefits of orienting toward cancer as communal, which was, in turn, facilitated or impeded by four additional themes/sets of behaviors: support, presence, perspective-taking, and reframing hope. Results of a cross-case data matrix analysis reveal that stakeholders in different roles experience qualitative differences in their experience of cancer as communal, isolated, or ambivalent. Implications for education, palliative care, and interventions are discussed.
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Affiliation(s)
| | | | - Alexis Z Johnson
- Department of Communication and Journalism, Arkansas Tech University
| | - Marlene Z Cohen
- Department of Nursing, VA Nebraska Western Iowa Healthcare System, College of Nursing, University of Nebraska Medical Center
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Douglas SL, Mazanec P, Lipson AR, Day K, Blackstone E, Bajor DL, Saltzman J, Krishnamurthi S. Videoconference Intervention for Distance Caregivers of Patients With Cancer: A Randomized Controlled Trial. JCO Oncol Pract 2021; 17:e26-e35. [PMID: 33434451 DOI: 10.1200/op.20.00576] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
PURPOSE Approximately 20% of caregivers (CGs) live > 1 hour away from the patient and are considered distance caregivers (DCGs) who often report higher distress and anxiety than local CGs. The purpose of this study was to test the effectiveness of an intervention aimed at reducing anxiety and distress in DCGs of patients with cancer. METHODS This randomized controlled trial enrolled DCGs of patients with all cancer types who were being seen monthly by oncologists in outpatient clinics. There were three arms of the intervention delivered over a 4-month period: arm 1 (a) received 4 monthly videoconference-tailored coaching sessions with an advanced practice nurse or social worker focused on information and support, (b) participated in patient's appointments with the oncologist via videoconference over the 4-month study period, and (c) had access to a website designed for DCGs. Arm 2 did not receive the coaching sessions but received the other two components, and arm 3 received access to the DCG website only. RESULTS There were 302 DCGs who provided pre- and postintervention data. There were significant anxiety by group (P = .028 and r = 0.16) and distress by group interactions (P = .014 and r = 0.17). Arm 1 had the greatest percentage of DCGs who demonstrated improvement in anxiety (18.6%) and distress (25.2%). CONCLUSION Coaching and use of videoconference technology (to join the DCG into the patient-oncologist office visit) were effective in reducing both anxiety and distress for DCGs. These components could be considered for local CGs who-with COVID-19-are unable to accompany the patient to oncologist visits.
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Affiliation(s)
- Sara L Douglas
- School of Nursing and Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH
| | - Polly Mazanec
- Case Western Reserve University, School of Nursing, Cleveland, OH
| | - Amy R Lipson
- Case Western Reserve University, School of Nursing, Cleveland, OH
| | - Kim Day
- Independent Contractor, Cleveland, OH
| | - Eric Blackstone
- Case Western Reserve University, School of Nursing, Cleveland, OH
| | - David L Bajor
- Seidman Cancer Center and Case Comprehensive Cancer Center, Cleveland, OH
| | - Joel Saltzman
- Lake Health UH Seidman Cancer Center and Case Comprehensive Cancer Center, Mentor, OH
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Decadt I, Laenen A, Celus J, Geyskens S, Vansteenlandt H, Coolbrandt A. Caregiver distress and quality of life in primary caregivers of oncology patients in active treatment and follow-up. Eur J Cancer Care (Engl) 2021; 30:e13399. [PMID: 33393137 DOI: 10.1111/ecc.13399] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 12/12/2020] [Accepted: 12/15/2020] [Indexed: 02/01/2023]
Abstract
OBJECTIVE As the number of informal caregivers and their caregiving responsibilities increase, this study aims at evaluating caregiver distress, quality of life (QoL) and their predictors in informal caregivers of cancer patients during active treatment and follow-up. METHODS This cross-sectional descriptive study targeted primary caregivers of patients with different cancer diagnoses. Caregiver-reported outcomes were measured by the Caregiver Risk Screen (CRS), Distress Thermometer (DT) and Caregiver Quality of Life Index-Cancer (CQOLC). RESULTS Caregivers (n = 1580) experienced a low-to-moderate risk of caregiver distress and a moderate QoL during both treatment and follow-up. About 13% reported a high caregiver risk and 20% reported severe distress. There was a strong and significant correlation between caregiver distress and caregivers' QoL (0.793). Predictive factors for higher distress and poorer QoL were: fewer emotional and practical resources, being female, non-spousal relationship or not living together (p < 0.05). Caregivers of patients with head-and-neck, skin, lung and brain cancers reported the highest distress and lowest QoL. CONCLUSION Caregiver distress is highly variable, but a minority of caregivers is at high risk for caregiver distress. Professional caregivers play an important role at supporting caregivers and detecting high-risk caregivers.
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Affiliation(s)
- Ine Decadt
- Department of Oncology Nursing, University Hospitals Leuven, Leuven, Belgium
| | - Annouschka Laenen
- Leuven Biostatistics and Statistical Bioinformatics Centre, KU Leuven, Leuven, Belgium
| | - Janne Celus
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium
| | - Shelly Geyskens
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium
| | - Hannah Vansteenlandt
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium
| | - Annemarie Coolbrandt
- Department of Oncology Nursing, University Hospitals Leuven, Leuven, Belgium.,Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium
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Martí-García C, Fernández-Alcántara M, Suárez López P, Romero Ruiz C, Muñoz Martín R, Garcia-Caro MP. Experiences of family caregivers of patients with terminal disease and the quality of end-of-life care received: a mixed methods study. PeerJ 2020; 8:e10516. [PMID: 33362972 PMCID: PMC7745673 DOI: 10.7717/peerj.10516] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 11/17/2020] [Indexed: 11/20/2022] Open
Abstract
The aim of this study was to analyze the perceptions and experiences of relatives of patients dying from a terminal disease with regard to the care they received during the dying process, considering the oncological or non-oncological nature of the terminal disease, and the place where care was provided (at home, emergency department, hospital room, or palliative care unit). For this purpose, we conducted a mixed-methods observational study in which two studies were triangulated, one qualitative using semi-structured interviews (n = 30) and the other quantitative, using questionnaires (n = 129). The results showed that the perception of relatives on the quality of care was highly positive in the quantitative evaluation but more critical and negative in the qualitative interview. Experience of the support received and palliative measures was more positive for patients attended in hospital in the case of oncological patients but more positive for those attended at home in the case of non-oncological patients.
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Affiliation(s)
- Celia Martí-García
- Department of Nursing, University of Málaga, Málaga, Spain
- Mind, Brain and Behaviour Research Center (CIMCYC), University of Granada, Granada, Spain
| | | | | | | | - Rocío Muñoz Martín
- Distrito sanitario Granada-Metropolitano de Atención Primaria, Granada, Spain
| | - Mᵃ Paz Garcia-Caro
- Mind, Brain and Behaviour Research Center (CIMCYC), University of Granada, Granada, Spain
- Department of Nursing, University of Granada, Granada, Spain
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Knobloch LK, Nichols LO, Martindale-Adams J. Applying Relational Turbulence Theory to Adult Caregiving Relationships. THE GERONTOLOGIST 2020; 60:598-606. [PMID: 31228192 DOI: 10.1093/geront/gnz090] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Indexed: 01/06/2023] Open
Abstract
Although the quality of the relationship between caregivers and care recipients predicts the well-being of both people, gaps exist in understanding the interpersonal dynamics of adult caregiving. We introduce relational turbulence theory as a conceptual framework for understanding how caregivers and care recipients relate to each other. We searched for research on relational turbulence theory as well as research on the relationships of adult care partners. Then, we integrated the two bodies of work. Our review suggests initial support for the theory's three central tenets: (a) transitions, including the transition to caregiving, are key periods within relationships; (b) relational uncertainty and interdependence are relationship parameters that complicate relating during transitions; and (c) relational turbulence predicts outcomes. Recommendations for practice include (a) helping care partners focus on relationship continuity, (b) gearing clinical services toward both people, (c) educating them about relational uncertainty and interdependence, and (d) teaching them communication strategies for diminishing relational turbulence. Making care partners aware of interpersonal challenges may bolster relationship satisfaction.
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Affiliation(s)
| | - Linda O Nichols
- Veterans Affairs Medical Center Memphis and Departments of Preventive Medicine and Internal Medicine, University of Tennessee Health Science Center, Memphis
| | - Jennifer Martindale-Adams
- Department of Preventive Medicine, University of Tennessee Health Science Center and Veterans Affairs Medical Center Memphis, Memphis
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Holland DE, Vanderboom CE, Mandrekar J, Borah BJ, Dose AM, Ingram CJ, Griffin JM. A technology-enhanced model of care for transitional palliative care versus attention control for adult family caregivers in rural or medically underserved areas: study protocol for a randomized controlled trial. Trials 2020; 21:895. [PMID: 33115524 PMCID: PMC7594268 DOI: 10.1186/s13063-020-04806-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 10/16/2020] [Indexed: 11/30/2022] Open
Abstract
Background Transitioning care from hospital to home is associated with risks of adverse events and poor continuity of care. These transitions are even more challenging when new approaches to care, such as palliative care, are introduced before discharge. Family caregivers (FCGs) are expected to navigate these transitions while also managing care. In addition to extensive caregiving responsibilities, FCGs often have their own health needs that can inhibit their ability to provide care. Those living in rural areas have even fewer resources to meet their self-care and caregiving needs. The purpose of this study is to test the efficacy and cost-effectiveness of an intervention to improve FCGs’ health and well-being. The intervention uses video visits to teach, guide, and counsel FCGs in rural areas during hospital-to-home transitions. The intervention is based on evidence of transitional and palliative care principles, which are individualized to improve continuity of care, provide caregiver support, enhance knowledge and skills, and attend to caregivers’ health needs. It aims to test whether usual care practices are similar to this technology-enhanced intervention in (1) caregiving skills (e.g., caregiving preparedness, communication with clinicians, and satisfaction with care), (2) FCG health outcomes (e.g., quality of life, burden, coping skills, depression), and (3) cost. We describe the rationale for targeting rural caregivers, the methods for the study and intervention, and the analysis plan to test the intervention’s effect. Methods The study uses a randomized controlled trial design, with FCGs assigned to the control condition or the caregiver intervention by computer-generated lists. The intervention period continues for 8 weeks after care recipients are discharged from the hospital. Data are collected at baseline, 2 weeks, 8 weeks, and 6 months. Time and monetary costs from a societal perspective are captured monthly. Discussion This study addresses 2 independent yet interrelated health care foci—transitional care and palliative care—by testing an intervention to extend palliative care practice and improve transition management for caregivers of seriously ill patients in rural areas. The comprehensive cost assessment will quantify the commitment and financial burden of FCGs. Trial registration ClinicalTrials.gov NCT03339271. Registered on 13 November 2017. Protocol version: 11. Supplementary information Supplementary information accompanies this paper at 10.1186/s13063-020-04806-0.
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Affiliation(s)
- Diane E Holland
- Department of Health Sciences Research, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Catherine E Vanderboom
- Department of Health Sciences Research, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Jay Mandrekar
- Department of Health Sciences Research, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Bijan J Borah
- Department of Health Sciences Research, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.,The Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
| | - Ann Marie Dose
- Department of Health Sciences Research, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Cory J Ingram
- Center for Palliative Medicine, Mayo Clinic, Rochester, MN, USA
| | - Joan M Griffin
- Department of Health Sciences Research, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA. .,The Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA.
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Axelsson L, Alvariza A, Holm M, Årestedt K. Intensity of Predeath Grief and Postdeath Grief of Family Caregivers in Palliative Care in Relation to Preparedness for Caregiving, Caregiver Burden, and Social Support. Palliat Med Rep 2020; 1:191-200. [PMID: 34223476 PMCID: PMC8241336 DOI: 10.1089/pmr.2020.0033] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2020] [Indexed: 11/13/2022] Open
Abstract
Background: The intensity of predeath grief is associated with postdeath grief in family caregivers of patients in palliative care. Different factors during caregiving may influence this association. Objective: To examine (1) the intensity of grief in relation to preparedness for caregiving, caregiver burden, and social support, and (2) if these variables moderate associations between predeath and postdeath grief. Methods: This prospective correlational study used unpaired t-test to compare grief in relation to preparedness for caregiving, caregiver burden, and social support. Hierarchical multiple linear regression analysis investigated moderation effects. Family caregivers were recruited from 10 palliative homecare facilities. The Anticipatory Grief Scale, Texas Revised Inventory of Grief, Preparedness for Caregiving Scale, Caregiver Burden Scale, and Multidimensional Scale of Perceived Social Support were used. Ethical approval for the study was granted by the Regional Ethical Review Board in Stockholm, Sweden. Results: In total, 128 family caregivers participated. Those with high caregiver burden scored significantly higher intensity of predeath but not postdeath grief. Caregiver burden and social support moderated the association between intensity of predeath grief and postdeath grief. There was a stronger association between predeath and postdeath grief among caregivers with low caregiver burden or low social support. Preparedness for caregiving had no moderating effect. Discussion: Attention should be directed to caregiver burden and social support during family caregiving, as these variables seem to be significant for the intensity of grief before and after the patient's death. Acknowledging predeath grief during caregiving and recognizing pre- and postdeath grief as parts of the same process are of importance in clinical practice and when designing supportive interventions.
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Affiliation(s)
- Lena Axelsson
- Department of Nursing Science, Sophiahemmet University, Stockholm, Sweden
| | - Anette Alvariza
- Department of Health Care Sciences/Palliative Research Centre, Ersta Sköndal Bräcke University College, Stockholm, Sweden.,Capio Palliative Care, Dalen Hospital, Stockholm, Sweden
| | - Maja Holm
- Department of Nursing Science, Sophiahemmet University, Stockholm, Sweden
| | - Kristofer Årestedt
- Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden.,The Research Section, Region Kalmar County, Kalmar, Sweden
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Burden and Preparedness amongst Informal Caregivers of Adults with Moderate to Severe Traumatic Brain Injury. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176386. [PMID: 32887272 PMCID: PMC7503757 DOI: 10.3390/ijerph17176386] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 08/21/2020] [Accepted: 08/24/2020] [Indexed: 01/23/2023]
Abstract
This study examined the patterns of informal (unpaid) caregiving provided to people after moderate to severe traumatic brain injury (TBI), explore the self-reported burden and preparedness for the caregiving role, and identify factors predictive of caregiver burden and preparedness. A cross-sectional cohort design was used. Informal caregivers completed the Demand and Difficulty subscales of the Caregiving Burden Scale; and the Mutuality, Preparedness, and Global Strain subscales of the Family Care Inventory. Chi-square tests and logistic regression were used to examine the relationships between caregiver and care recipient variables and preparedness for caregiving. Twenty-nine informal caregivers who reported data on themselves and people with a moderate to severe TBI were recruited (referred to as a dyad). Most caregivers were female (n = 21, 72%), lived with the care recipient (n = 20, 69%), and reported high levels of burden on both scales. While most caregivers (n = 21, 72%) felt “pretty well” or “very well” prepared for caregiving, they were least prepared to get help or information from the health system, and to deal with the stress of caregiving. No significant relationships or predictors for caregiver burden or preparedness were identified. While caregivers reported the provision of care as both highly difficult and demanding, further research is required to better understand the reasons for the variability in caregiver experience, and ultimately how to best prepare caregivers for this long-term role.
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31
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Gbolahan OO, Amiede OS, Samuel OA. The Burden and Perceived Stress on Family Caregivers of Patients With Orofacial Cleft Deformities in The Perioperative Period of Cleft Repair. J Patient Exp 2020; 7:1602-1609. [PMID: 33457620 PMCID: PMC7786686 DOI: 10.1177/2374373520948650] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Different stages along the trajectory of cleft care may present with different and peculiar challenges that may negatively impact family caregivers, leading to considerable stress and burden. This study aims to evaluate the family caregiver burden and perceived stress of caring for patients with cleft deformities. Contributing factors to family caregivers’ burden in the perioperative period of cleft repair was also identified. A cross-sectional design that included 90 adult caregiver–patient pairs was employed. Semi-structured questionnaire was used to collect necessary information. The level of caregiver’s burden was assessed using the Zarit burden interview score. The results demonstrated the levels of caregiver burden as severe (4.4%), moderate to severe (21.1%), mild to moderate (40%), and little or none (34.5%). The only significant and independent predictor of caregiver burden was earning less than US$50/month (odds ratio = 2.30, 95% CI = 0.95-5.61, P = .066). Coping strategy was mainly family support (98.9%), while the greatest need expressed was financial assistance (66.7%). Our findings suggests that efforts geared at reducing direct and indirect cost of cleft care may help in reducing caregivers’ burden.
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Affiliation(s)
- Olalere Omoyosola Gbolahan
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Ibadan/UCH, Ibadan, Nigeria
| | - Ogunmuyiwa Stella Amiede
- Oral and Maxillofacial Surgery Unit, Federal Medical Centre Abeokuta, Abeokuta, Ogun State, Nigeria
| | - Olowookere Anu Samuel
- Department of Community Health, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
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Ross A, Perez A, Wehrlen L, Lee LJ, Yang L, Cox R, Bevans M, Ding A, Wiener L, Wallen GR. Factors influencing loneliness in cancer caregivers: A longitudinal study. Psychooncology 2020; 29:1794-1801. [PMID: 32672866 DOI: 10.1002/pon.5477] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 06/29/2020] [Accepted: 07/07/2020] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To describe levels of loneliness in cancer caregivers over a 6 month time period, and to examine factors that influence changes in loneliness in caregivers over time. METHODS Prospective, repeated measures design was utilized to examine levels of loneliness and factors that influence loneliness in 129 family caregivers of individuals undergoing cancer treatment at three time points over a 6 month period. Measures included: PROMIS global health and sleep disturbance; NIH Toolbox loneliness, self-efficacy and perceived stress; Family Care Inventory mutuality scale; and Caregiver Reaction Assessment. RESULTS Approximately one third (30.2%, n = 39) of the caregivers had high levels of loneliness, and levels of loneliness did not change over the three time points (P = .985). For any given time point, caregivers who were not married (P = .008), not working (P = .027), with worse mental health (P = .015), more perceived-stress (P < .0001), and more caregiver burden (P = .003) reported higher levels of loneliness. CONCLUSION This study provides guidance for clinicians attempting to identify at-risk caregivers by confirming the findings of previous research that caregivers with higher burden, stress and in poor mental health are at increased risk for loneliness. This study provides preliminary evidence that continuing to work during the caregiving trajectory may be beneficial to caregivers by reducing levels of loneliness. Future research is needed to confirm these findings and to examine novel interventions to reduce loneliness in cancer caregivers.
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Affiliation(s)
- Alyson Ross
- National Institutes of Health (NIH) Clinical Center, Bethesda, Maryland, USA
| | - Avery Perez
- Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania, USA
| | - Leslie Wehrlen
- National Institutes of Health (NIH) Clinical Center, Bethesda, Maryland, USA
| | - Lena J Lee
- National Institutes of Health (NIH) Clinical Center, Bethesda, Maryland, USA
| | - Li Yang
- National Institutes of Health (NIH) Clinical Center, Bethesda, Maryland, USA
| | - Robert Cox
- National Institutes of Health (NIH) Clinical Center, Bethesda, Maryland, USA
| | - Margaret Bevans
- National Institutes of Health (NIH) Clinical Center, Bethesda, Maryland, USA
| | - Alice Ding
- National Institutes of Health (NIH) Clinical Center, Bethesda, Maryland, USA
| | - Lori Wiener
- National Cancer Institute Center for Cancer Research Pediatric Oncology Branch, Bethesda, Maryland, USA
| | - Gwenyth R Wallen
- National Institutes of Health (NIH) Clinical Center, Bethesda, Maryland, USA
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Roles of Family Caregivers and Perceived Burden When Caring for Hospitalized Adult Cancer Patients: Perspective From a Low-Income Country. Cancer Nurs 2020; 42:208-217. [PMID: 29601362 DOI: 10.1097/ncc.0000000000000591] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Family caregivers (FCGs) of adult cancer patients (ACPs) are typically involved in the entire trajectory of cancer disease, from diagnosis to survivorship or end of life. In developing countries, FCGs are more intensely involved in the process of providing care to the hospitalized ACPs because of lack of adequate cancer care resources. Active performance of tasks to meet the needs of ACPs in the hospital setting is likely to elicit significant caregiver burden. OBJECTIVE The aim of this study was to explore the tasks performed and the caregiver burden experienced by FCGs of hospitalized ACPs in a sub-Saharan country. METHODS A cross-sectional descriptive design was used to collect data from 168 FCGs of ACPs. The Caregiver Burden Scale was used to measure burden. RESULTS The most common cancer diagnosis in male and female ACPs was Kaposi's sarcoma (32.1%) and breast cancer (37.9%), respectively. The tasks regularly performed by most FCGs for the ACPs were providing emotional support (79.8%), feeding (68.5%), transporting to other appointments (62.5%), preparing meals (55%), and giving medications (46.4%). Most FCGs (75%) were experiencing severe or very severe general caregiver burden. The dimensions of caregiver burden that were most severely impacted were general strain (70.6%), disappointment (85.8%), and isolation (72%). Predictors of caregiver burden are reported. CONCLUSION Family caregivers of hospitalized ACPs experience severe caregiver burden. The main forms of burden experienced were general strain, disappointment, and isolation. IMPLICATIONS FOR PRACTICE Cancer care services in developing countries should be strengthened with services that address FCGs' emotional needs and human resources to curtail the strain imposed on FCGs.
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Fowler NR, Head KJ, Perkins AJ, Gao S, Callahan CM, Bakas T, Suarez SD, Boustani MA. Examining the benefits and harms of Alzheimer's disease screening for family members of older adults: study protocol for a randomized controlled trial. Trials 2020; 21:202. [PMID: 32075686 PMCID: PMC7031904 DOI: 10.1186/s13063-019-4029-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 12/23/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Multiple national expert panels have identified early detection of Alzheimer's disease and related dementias (ADRD) as a national priority. However, the United States Preventive Services Task Force (USPSTF) does not currently support screening for ADRD in primary care given that the risks and benefits are unknown. The USPSTF stresses the need for research examining the impact of ADRD screening on family caregiver outcomes. METHODS The Caregiver Outcomes of Alzheimer's Disease Screening (COADS) is a randomized controlled trial that will examine the potential benefits or harms of ADRD screening on family caregivers. It will also compare the effectiveness of two strategies for diagnostic evaluation and management after ADRD screening. COADS will enroll 1800 dyads who will be randomized into three groups (n = 600/group): the 'Screening Only' group will receive ADRD screening at baseline and disclosure of the screening results, with positive-screen participants receiving a list of local resources for diagnostic follow-up; the 'Screening Plus' group will receive ADRD screening at baseline coupled with disclosure of the screening results, with positive-screen participants referred to a dementia collaborative care program for diagnostic evaluation and potential care; and the control group will receive no screening. The COADS trial will measure the quality of life of the family member (the primary outcome) and family member mood, anxiety, preparedness and self-efficacy (the secondary outcomes) at baseline and at 6, 12, 18 and 24 months. Additionally, the trial will examine the congruence of depressive and anxiety symptoms between older adults and family members at 6, 12, 18 and 24 months and compare the effectiveness of two strategies for diagnostic evaluation and management after ADRD screening between the two groups randomized to screening (Screening Only versus Screening Plus). DISCUSSION We hypothesize that caregivers in the screening arms will express higher levels of health-related quality of life, lower depressive and anxiety symptoms, and better preparation for caregiving with higher self-efficacy at 24 months. Results from this study will directly inform the National Plan to Address Alzheimer's Disease, the USPSTF and other organizations regarding ADRD screening and early detection policies. TRIAL REGISTRATION ClinicalTrials.gov, NCT03300180. Registered on 3 October.
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Affiliation(s)
- Nicole R. Fowler
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202 USA
- Indiana University Center for Aging Research, Indianapolis, IN 46202 USA
- Regenstrief Institute, Inc., Indianapolis, IN 46202 USA
- Center for Health Innovation and Implementation Science, Indiana Clinical and Translational Science Institute, Indianapolis, IN 46202 USA
| | - Katharine J. Head
- Department of Communication Studies, Indiana University-Purdue University Indianapolis, Indianapolis, IN 46202 USA
| | - Anthony J. Perkins
- Department of Biostatistics, Indiana University School of Medicine & Richard M. Fairbanks School of Public Health, Indianapolis, IN 46202 USA
| | - Sujuan Gao
- Department of Biostatistics, Indiana University School of Medicine & Richard M. Fairbanks School of Public Health, Indianapolis, IN 46202 USA
| | - Christopher M. Callahan
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202 USA
- Indiana University Center for Aging Research, Indianapolis, IN 46202 USA
- Regenstrief Institute, Inc., Indianapolis, IN 46202 USA
- Eskenazi Health, Indianapolis, IN 46202 USA
| | - Tamilyn Bakas
- College of Nursing, University of Cincinnati, Cincinnati, OH 45219 USA
| | - Shelley D. Suarez
- Indiana University Center for Aging Research, Indianapolis, IN 46202 USA
- Regenstrief Institute, Inc., Indianapolis, IN 46202 USA
| | - Malaz A. Boustani
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202 USA
- Indiana University Center for Aging Research, Indianapolis, IN 46202 USA
- Regenstrief Institute, Inc., Indianapolis, IN 46202 USA
- Center for Health Innovation and Implementation Science, Indiana Clinical and Translational Science Institute, Indianapolis, IN 46202 USA
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Jeong A, Shin D, Park JH, Park K. Attributes of caregivers' quality of life: A perspective comparison between spousal and non-spousal caregivers of older patients with cancer. J Geriatr Oncol 2020; 11:82-87. [DOI: 10.1016/j.jgo.2019.05.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Revised: 02/13/2019] [Accepted: 05/22/2019] [Indexed: 11/16/2022]
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36
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Loh KWJ, Ng T, Choo SP, Saw HM, Mahendran R, Tan C, Chang GCY, Ong YJ, Yee ACP, Chan A, Soo KC. Cancer Supportive and Survivorship Care in Singapore: Current Challenges and Future Outlook. J Glob Oncol 2019; 4:1-8. [PMID: 30241247 PMCID: PMC6223422 DOI: 10.1200/jgo.17.00117] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Despite being a relatively young nation, Singapore has established itself as a leading multifaceted medical hub, both regionally and globally. Although Singapore continues to pursue excellence in oncology care, cancer supportive care and survivorship care remain in the infancy stage. In an effort to advance this important aspect of oncology care in Singapore, the first cancer supportive and survivorship care forum was held in December 2016, involving 74 oncology practitioners. The primary goals of this forum were to raise awareness of the importance of cancer supportive and survivorship care and to provide a platform for oncology practitioners of diverse backgrounds to converge and address the challenges associated with the delivery of cancer supportive and survivorship care in Singapore. Key challenges identified during this forum included, but were not limited to, care fragmentation in an oncologist-centric model of care, poor integration of allied health and rehabilitation services, passive engagement of community partners, lack of specialized skill sets and knowledge in supportive and survivorship care, and patient-related barriers such as poor health literacy. The survivorship care model commonly used in Singapore places an imbalanced emphasis on surveillance for cancer recurrence and second primary cancers, with little attention given to the supportive and survivorship needs of the survivors. In summary, these challenges set the stage for the development and use of a more survivor-centric model, one that focuses not only on cancer surveillance, but also on the broad and unique physical and psychosocial needs of survivors of cancer in Singapore.
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Affiliation(s)
- Kiley Wei-Jen Loh
- Wei-Jen Kiley Loh, Terence Ng, Su Pin Choo, Alethea Chung Pheng Yee, Alexandre Chan, and Khee Chee Soo, National Cancer Centre Singapore; Hay Mar Saw, Singapore General Hospital; Rathi Mahendran, National University Hospital; Celia Tan, Allied Health, Singhealth Services; Gail Chia Yang Chang, KK Women's and Children's Hospital; Yew Jin Ong, Singapore Cancer Society; and Alexandre Chan, National University of Singapore (NUS) and Duke-NUS Graduate Medical School, Singapore
| | - Terence Ng
- Wei-Jen Kiley Loh, Terence Ng, Su Pin Choo, Alethea Chung Pheng Yee, Alexandre Chan, and Khee Chee Soo, National Cancer Centre Singapore; Hay Mar Saw, Singapore General Hospital; Rathi Mahendran, National University Hospital; Celia Tan, Allied Health, Singhealth Services; Gail Chia Yang Chang, KK Women's and Children's Hospital; Yew Jin Ong, Singapore Cancer Society; and Alexandre Chan, National University of Singapore (NUS) and Duke-NUS Graduate Medical School, Singapore
| | - Su Pin Choo
- Wei-Jen Kiley Loh, Terence Ng, Su Pin Choo, Alethea Chung Pheng Yee, Alexandre Chan, and Khee Chee Soo, National Cancer Centre Singapore; Hay Mar Saw, Singapore General Hospital; Rathi Mahendran, National University Hospital; Celia Tan, Allied Health, Singhealth Services; Gail Chia Yang Chang, KK Women's and Children's Hospital; Yew Jin Ong, Singapore Cancer Society; and Alexandre Chan, National University of Singapore (NUS) and Duke-NUS Graduate Medical School, Singapore
| | - Hay Mar Saw
- Wei-Jen Kiley Loh, Terence Ng, Su Pin Choo, Alethea Chung Pheng Yee, Alexandre Chan, and Khee Chee Soo, National Cancer Centre Singapore; Hay Mar Saw, Singapore General Hospital; Rathi Mahendran, National University Hospital; Celia Tan, Allied Health, Singhealth Services; Gail Chia Yang Chang, KK Women's and Children's Hospital; Yew Jin Ong, Singapore Cancer Society; and Alexandre Chan, National University of Singapore (NUS) and Duke-NUS Graduate Medical School, Singapore
| | - Rathi Mahendran
- Wei-Jen Kiley Loh, Terence Ng, Su Pin Choo, Alethea Chung Pheng Yee, Alexandre Chan, and Khee Chee Soo, National Cancer Centre Singapore; Hay Mar Saw, Singapore General Hospital; Rathi Mahendran, National University Hospital; Celia Tan, Allied Health, Singhealth Services; Gail Chia Yang Chang, KK Women's and Children's Hospital; Yew Jin Ong, Singapore Cancer Society; and Alexandre Chan, National University of Singapore (NUS) and Duke-NUS Graduate Medical School, Singapore
| | - Celia Tan
- Wei-Jen Kiley Loh, Terence Ng, Su Pin Choo, Alethea Chung Pheng Yee, Alexandre Chan, and Khee Chee Soo, National Cancer Centre Singapore; Hay Mar Saw, Singapore General Hospital; Rathi Mahendran, National University Hospital; Celia Tan, Allied Health, Singhealth Services; Gail Chia Yang Chang, KK Women's and Children's Hospital; Yew Jin Ong, Singapore Cancer Society; and Alexandre Chan, National University of Singapore (NUS) and Duke-NUS Graduate Medical School, Singapore
| | - Gail Chia Yang Chang
- Wei-Jen Kiley Loh, Terence Ng, Su Pin Choo, Alethea Chung Pheng Yee, Alexandre Chan, and Khee Chee Soo, National Cancer Centre Singapore; Hay Mar Saw, Singapore General Hospital; Rathi Mahendran, National University Hospital; Celia Tan, Allied Health, Singhealth Services; Gail Chia Yang Chang, KK Women's and Children's Hospital; Yew Jin Ong, Singapore Cancer Society; and Alexandre Chan, National University of Singapore (NUS) and Duke-NUS Graduate Medical School, Singapore
| | - Yew Jin Ong
- Wei-Jen Kiley Loh, Terence Ng, Su Pin Choo, Alethea Chung Pheng Yee, Alexandre Chan, and Khee Chee Soo, National Cancer Centre Singapore; Hay Mar Saw, Singapore General Hospital; Rathi Mahendran, National University Hospital; Celia Tan, Allied Health, Singhealth Services; Gail Chia Yang Chang, KK Women's and Children's Hospital; Yew Jin Ong, Singapore Cancer Society; and Alexandre Chan, National University of Singapore (NUS) and Duke-NUS Graduate Medical School, Singapore
| | - Alethea Chung Pheng Yee
- Wei-Jen Kiley Loh, Terence Ng, Su Pin Choo, Alethea Chung Pheng Yee, Alexandre Chan, and Khee Chee Soo, National Cancer Centre Singapore; Hay Mar Saw, Singapore General Hospital; Rathi Mahendran, National University Hospital; Celia Tan, Allied Health, Singhealth Services; Gail Chia Yang Chang, KK Women's and Children's Hospital; Yew Jin Ong, Singapore Cancer Society; and Alexandre Chan, National University of Singapore (NUS) and Duke-NUS Graduate Medical School, Singapore
| | - Alexandre Chan
- Wei-Jen Kiley Loh, Terence Ng, Su Pin Choo, Alethea Chung Pheng Yee, Alexandre Chan, and Khee Chee Soo, National Cancer Centre Singapore; Hay Mar Saw, Singapore General Hospital; Rathi Mahendran, National University Hospital; Celia Tan, Allied Health, Singhealth Services; Gail Chia Yang Chang, KK Women's and Children's Hospital; Yew Jin Ong, Singapore Cancer Society; and Alexandre Chan, National University of Singapore (NUS) and Duke-NUS Graduate Medical School, Singapore
| | - Khee Chee Soo
- Wei-Jen Kiley Loh, Terence Ng, Su Pin Choo, Alethea Chung Pheng Yee, Alexandre Chan, and Khee Chee Soo, National Cancer Centre Singapore; Hay Mar Saw, Singapore General Hospital; Rathi Mahendran, National University Hospital; Celia Tan, Allied Health, Singhealth Services; Gail Chia Yang Chang, KK Women's and Children's Hospital; Yew Jin Ong, Singapore Cancer Society; and Alexandre Chan, National University of Singapore (NUS) and Duke-NUS Graduate Medical School, Singapore
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Mason N, Hodgkin S. Preparedness for caregiving: A phenomenological study of the experiences of rural Australian family palliative carers. HEALTH & SOCIAL CARE IN THE COMMUNITY 2019; 27:926-935. [PMID: 30810249 DOI: 10.1111/hsc.12710] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 12/09/2018] [Accepted: 12/11/2018] [Indexed: 06/09/2023]
Abstract
The care of people with life-limiting illnesses is increasingly moving away from an acute setting into the community. Thus, the caregiver role is growing in significance and complexity. The importance of preparing and supporting family caregivers is well established; however, less is known about the impact of rurality on preparedness and how preparedness shapes the caregiving continuum including bereavement. The aim of this study, conducted in 2017, was to explore how bereaved rural family palliative carers described their preparedness for caregiving. Interpretative phenomenological analysis was employed following semi-structured interviews with four women and six men (N = 10, aged 55-87 years). Participants were recruited voluntarily through past engagement with a Regional Specialist Palliative Care Consultancy Service in Australia. The experiences of caregivers illustrated a lack of preparedness for the role and were characterised by four major themes: Into the unknown, Into the battle, Into the void and Into the good. The unknown was associated with a lack of knowledge and skills, fear, prognostic communication, exclusion, emotional distress and grief experience. Battles were experienced in a number of ways: intrapsychically (existing within the mind), through role conflict and identity; interpersonally with the patient, clinician and family; and systematically (against health, financial and legal systems). The void was felt during isolation in caregiving, in relinquishing the role, in bereavement and in feeling abandoned by service providers. Positive experiences, such as being valued, included and connected to supports, and the fostering of closer relationships and deeper meaning, occurred less frequently but temporarily buffered against negative aspects. Implications from this study for policy and practice centre on the frequent, purposeful and genuine engagement of caregivers. Services and clinicians are encouraged to enhance communication practices, promote meaningful inclusion, address access issues and enhance support at role relinquishment.
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Affiliation(s)
- Naomi Mason
- Albury Wodonga Health, Albury Wodonga, Vic., Australia
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Mazanec SR, Reichlin D, Gittleman H, Daly BJ. Perceived Needs, Preparedness, and Emotional Distress of Male Caregivers of Postsurgical Women With Gynecologic Cancer. Oncol Nurs Forum 2019; 45:197-205. [PMID: 29466348 DOI: 10.1188/18.onf.197-205] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To describe the perceived needs, preparedness, and emotional distress of male caregivers of postsurgical patients with gynecologic cancer during the transition from hospital to home.
. SAMPLE & SETTING 50 male caregivers of patients with gynecologic cancer on an inpatient unit at University Hospitals Seidman Cancer Center in Cleveland, OH.
. METHODS & VARIABLES Caregiver needs, perceived preparedness, and emotional distress were measured at admission and at one week postdischarge. Instruments included the Comprehensive Needs Assessment Tool for Cancer Caregivers, Preparedness for Caregiving Scale, and National Comprehensive Cancer Network Distress Thermometer. The analysis consisted of descriptive statistics, Spearman's correlations, and univariate linear regressions.
. RESULTS At both time points, male caregivers' greatest needs were interaction with the healthcare staff and information. Perceived preparedness was not associated with emotional distress. Male caregivers who were young, were employed, were unmarried, and had a lower income had greater needs.
. IMPLICATIONS FOR NURSING A relational nursing care approach that maintains effective communication with male caregivers is essential. Nurses should broaden the caregiver assessment beyond the practical care of the patient.
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Affiliation(s)
- Susan R Mazanec
- Frances Payne Bolton School of Nursing, Case Western Reserve University (CWRU)
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Petruzzo A, Biagioli V, Durante A, Emberti Gialloreti L, D'Agostino F, Alvaro R, Vellone E. Influence of preparedness on anxiety, depression, and quality of life in caregivers of heart failure patients: Testing a model of path analysis. PATIENT EDUCATION AND COUNSELING 2019; 102:1021-1028. [PMID: 30611564 DOI: 10.1016/j.pec.2018.12.027] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Revised: 12/23/2018] [Accepted: 12/27/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVES Testing the influence of heart failure (HF) caregiver preparedness on anxiety and depression, and the influence of HF caregiver anxiety and depression on caregiver physical and mental QOL. METHODS In this cross-sectional study, we used the Caregiver Preparedness Scale (CPS), the Hospital Anxiety and Depression Scale (HADS) with the anxiety (HADS-A) and depression (HADS-D) subscales, and the Short-Form 12 (SF-12) measuring the physical component summary (PCS) and the mental component summary (MCS) of QOL. Socio-demographic data and patients' clinic data were also collected. Data analysis was conducted with descriptive statistics, correlations, and path analysis. RESULTS A total of 366 HF caregiver and patient dyads were enrolled. Caregivers were mostly females (73.3%) with a mean age of 58.61 (SD = 15.66) years. The tested model showed excellent fit indices with the following significant paths: CPS scores predicted HADS-D scores; HADS-A scores predicted MCS scores; and HADS-D scores predicted both PCS and MCS scores. Also, HADS-D mediated the relationship between CPS and MCS scores. CONCLUSION Preparedness influences HF caregiver depression and depression influences caregiver physical and mental QOL. Depression mediates between preparedness and HF caregiver mental QOL. PRACTICE IMPLICATIONS Interventions focused on improving HF caregiver preparedness may improve caregivers' depression and QOL.
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Affiliation(s)
- Antonio Petruzzo
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", via Montpellier, 1, 00133 Rome, Italy.
| | - Valentina Biagioli
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", via Montpellier, 1, 00133 Rome, Italy.
| | - Angela Durante
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", via Montpellier, 1, 00133 Rome, Italy.
| | - Leonardo Emberti Gialloreti
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", via Montpellier, 1, 00133 Rome, Italy.
| | - Fabio D'Agostino
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", via Montpellier, 1, 00133 Rome, Italy; Saint Camillus International University of Health and Medical Sciences, via di S. Alessandro, 8, 00131 Rome, Italy.
| | - Rosaria Alvaro
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", via Montpellier, 1, 00133 Rome, Italy.
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", via Montpellier, 1, 00133 Rome, Italy.
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Refinement of a Conceptual Model for Adolescent Readiness to Engage in End-of-Life Discussions. Cancer Nurs 2019; 41:E21-E39. [PMID: 28114261 DOI: 10.1097/ncc.0000000000000465] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Adolescents living with incurable cancer require ongoing support to process grief, emotions, and information as disease progresses including treatment options (phase 1 clinical trials and/or hospice/palliative care). Little is known about how adolescents become ready for such discussions. OBJECTIVE The purpose of this study was to explore the process of adolescent readiness for end-of-life preparedness discussions, generating a theoretical understanding for guiding clinical conversations when curative options are limited. METHODS We explored 2 in-depth cases across time using case-study methodology. An à priori conceptual model based on current end-of-life research guided data collection and analysis. Multiple sources including in-depth adolescent interviews generated data collection on model constructs. Analysis followed a logical sequence establishing a chain of evidence linking raw data to study conclusions. Synthesis and data triangulation across cases and time led to theoretical generalizations. Initially, we proposed a linear process of readiness with 3 domains: a cognitive domain (awareness), an emotional domain (acceptance), and a behavioral domain (willingness), which preceded preparedness. RESULTS Findings led to conceptual model refinement showing readiness is a dynamic internal process that interacts with preparedness. Current awareness context facilitates the type of preparedness discussions (cognitive or emotional). Furthermore, social constraint inhibits discussions. CONCLUSIONS Data support theoretical understanding of the dynamism of readiness. Future research that validates adolescent conceptualization will ensure age-appropriate readiness representation. IMPLICATIONS FOR PRACTICE Understanding the dynamic process of readiness for engaging in end-of-life preparedness provides clinician insight for guiding discussions that facilitate shared decision making and promote quality of life for adolescents and their families.
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Castellanos EH, Dietrich MS, Bond SM, Wells N, Schumacher K, Ganti AK, Murphy BA. Impact of patient symptoms and caregiving tasks on psychological distress in caregivers for head and neck cancer (HNC). Psychooncology 2019; 28:511-517. [PMID: 30578599 DOI: 10.1002/pon.4968] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 11/15/2018] [Accepted: 11/23/2018] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To determine the association of caregiving task burden and patient symptom burden with psychological distress among caregivers of head and neck cancer (HNC) patients. METHODS Adults with HNC and their primary caregivers were included. Patient symptom burden was assessed with the Vanderbilt Head and Neck Symptom Survey-2.0. Caregiving task burden was quantified as task number and task difficulty/distress using the HNC Caregiving Task Inventory. Psychological distress was measured with the Profile of Mood States-Short Form. Two-step clustering analysis was conducted for patient symptom burden, caregiving task burden, and psychological distress. Associations of the resultant clusters of task burden and patient symptoms with caregiver distress were tested using logistic regressions. RESULTS Eighty-nine HNC caregivers and 84 patients were included. Among patients, two clusters of symptom burden were found (51% mod-high, 49% low). Among caregivers, two clusters of caregiving task burden (40% mod-high, 60% low) and caregiver psychological distress (40% mod-high, 60% low) were found. Caregivers with mod-high task numbers and task difficulty/distress reported higher levels of psychological distress. After controlling for caregiver number of tasks, respective difficulty/distress, and patient symptom burden, caregiver perceived task difficulty/distress had the strongest association with caregiver psychological distress (adjusted OR = 3.83; 95% CI, 1.0-14.64; P = 0.049). CONCLUSIONS Psychological distress in HNC caregivers is associated with caregiving task burden, with caregivers experiencing high task difficulty/distress at greatest risk. Further study of the caregiver and task characteristics leading to psychological distress should inform supportive interventions for HNC patients and caregivers.
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Affiliation(s)
- Emily H Castellanos
- Division of Hematology/Oncology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Mary S Dietrich
- Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.,Department of Biostatistics, Vanderbilt University School of Nursing, Nashville, Tennessee, USA
| | - Stewart M Bond
- William F. Connell School of Nursing, Boston College, Boston, Massachusetts, USA
| | - Nancy Wells
- Department of Biostatistics, Vanderbilt University School of Nursing, Nashville, Tennessee, USA
| | - Karen Schumacher
- Department of Physiological Nursing, UCSF School of Nursing, San Francisco, California, USA
| | - Apar Kishor Ganti
- Division of Oncology-Hematology, Department of Internal Medicine, VA Nebraska Western Iowa Health Care System, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Barbara A Murphy
- Division of Hematology/Oncology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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Marzorati C, Bailo L, Mazzocco K, Pravettoni G. Empowerment from patient's and caregiver's perspective in cancer care. Health Psychol Open 2018; 5:2055102918815318. [PMID: 30619617 PMCID: PMC6299910 DOI: 10.1177/2055102918815318] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
The caregivers’ perceptions of the patients’ health condition may be biased and induce them to perceive higher needs than patients actually disclose. Our aim was to assess if the level of knowledge and awareness about cancer disease and treatment, and patient participation and assistance differs between caregivers and patients. A descriptive, cross-sectional study was conducted across five countries (Italy, United Kingdom, Spain, France and Germany) on a total of 510 participants who directly (patient) or indirectly (caregiver) faced a cancer diagnosis. Investigating this divergence could help to identify possible difficulties in patient–caregiver relationship, eventually improving patient empowerment.
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Affiliation(s)
- Chiara Marzorati
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.,Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan, Italy
| | - Luca Bailo
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan, Italy
| | - Ketti Mazzocco
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.,Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan, Italy
| | - Gabriella Pravettoni
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.,Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan, Italy
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43
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Davidson PM, Abshire MA, Paull G, Szanton SL. Family caregivers: Important but often poorly understood. J Clin Nurs 2018; 27:4242-4244. [DOI: 10.1111/jocn.14654] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | | | - Glenn Paull
- St George Hospital; Kogarah NSW Australia
- Faculty of Health; University of Technology Sydney; Sydney NSW Australia
| | - Sarah L. Szanton
- Center on Innovative Care in Aging; Johns Hopkins School of Nursing; Baltimore Maryland
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Distress is Interdependent in Patients and Caregivers with Newly Diagnosed Incurable Cancers. Ann Behav Med 2018; 51:519-531. [PMID: 28097515 DOI: 10.1007/s12160-017-9875-3] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Individuals with advanced, incurable cancer often experience high physical and psychological symptom burden. Family and friend caregivers are at risk for emotional distress. PURPOSE The aim of the study is to investigate the interrelationship of distress in patient-caregiver dyads at the time of newly diagnosed incurable cancer. METHODS From May 2011 to July 2015, within 8 weeks of diagnosis of advanced lung or noncolorectal gastrointestinal cancer, 350 patients and 275 family caregivers were enrolled in a randomized controlled trial of early palliative care. Actor-partner interdependence modeling was used to examine relationships between dyad's self-reported anxiety and depressive symptoms on the Hospital Anxiety and Depression Scale at baseline. RESULTS Comparing patients with caregivers, patients reported more depressive symptoms (M diff = .84; t[274] = 3.17, p = .002, d = .22) and caregivers reported more anxiety symptoms (M diff =1.62, t[274] = 4.91, p < .001, d = .39). Dyads' anxiety symptoms were positively associated, as were depressive symptoms (rs = .21, ps ≤ .001). Actor-partner interdependence modeling showed that patients' anxiety symptoms were positively associated with their own depressive symptoms, with an equal effect for caregivers (actor effect βs = 0.52, ps < .001). Patients' own anxiety was concurrently positively associated with their caregivers' depressive symptoms, with an equal effect for caregivers to patients (partner effect βs=0.08, ps=.008). CONCLUSIONS In the context of newly diagnosed incurable cancer, caregivers experience more pronounced anxiety, while patients report greater depressive symptoms. Findings indicate that anxiety and depressive symptoms are interrelated among dyads facing newly diagnosed incurable disease. Results emphasize the importance of addressing distress in both patients and caregivers. Future research should discern when dyadic versus individual psychosocial interventions would be optimal. TRIAL REGISTRATION NUMBER The trial was registered with the ClinicalTrials.gov database (NCT02349412) https://clinicaltrials.gov/ct2/show/NCT02349412 .
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45
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Zale EL, Heinhuis TJ, Tehan T, Salgueiro D, Rosand J, Vranceanu AM. Resiliency is independently associated with greater quality of life among informal caregivers to neuroscience intensive care unit patients. Gen Hosp Psychiatry 2018; 52:27-33. [PMID: 29549820 DOI: 10.1016/j.genhosppsych.2018.02.012] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 02/22/2018] [Accepted: 02/27/2018] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Every year, millions of Americans become informal caregivers to loved ones admitted to Neuroscience Intensive Care Units (Neuro-ICU), and face challenges to Quality of Life (QoL). This study sought to identify associations between resiliency, distress, and caregiver QoL at time of Neuro-ICU admission. METHODS Informal caregivers (N = 79, Mage = 53, 64% female) of Neuro-ICU patients were recruited and completed self-report questionnaires during the hospitalization. We used hierarchical regression to test relative contributions of caregiver mindfulness, perceived coping abilities, and preparedness for caregiving to caregiver QoL, above-and-beyond non-modifiable patient and caregiver factors (e.g., gender) and caregiver psychological distress (i.e., anxiety, depression, history of mental health conditions). RESULTS Preparedness for caregiving was uniquely and positively associated with Physical Health QoL (sr2 = 0.07, p = 0.001), Social QoL (sr2 = 0.05, p = 0.021), and Environmental QoL (sr2 = 0.14, p < 0.001), even after accounting for psychological distress. Mindfulness was uniquely and positively associated with Physical Health QoL (sr2 = 0.12, p < 0.001) and Psychological QoL (sr2 = 0.07, p = 0.004), above-and-beyond variance accounted for by psychological distress. CONCLUSIONS Mindfulness and preparedness for caregiving emerged as consistent, unique resiliency factors associated with greater caregiver QoL across QoL dimensions. Results highlight the importance of resiliency factors in QoL among Neuro-ICU caregivers and the need for early interventions to support resiliency.
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Affiliation(s)
- Emily L Zale
- Department of Psychiatry, Integrated Brain Health Clinical and Research Program, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Tessa J Heinhuis
- Psychology Department, University of Amsterdam, Amsterdam, Netherlands
| | - Tara Tehan
- Neuroscience Intensive Care Unit, Institute for Brain Health, Massachusetts General Hospital, Boston, MA, USA
| | - Danielle Salgueiro
- Neuroscience Intensive Care Unit, Institute for Brain Health, Massachusetts General Hospital, Boston, MA, USA
| | - Jonathan Rosand
- Neuroscience Intensive Care Unit, Institute for Brain Health, Massachusetts General Hospital, Boston, MA, USA
| | - Ana-Maria Vranceanu
- Department of Psychiatry, Integrated Brain Health Clinical and Research Program, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
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Finley J. Caregiver Café: Providing Education and Support to Family Caregivers of Patients With Cancer. Clin J Oncol Nurs 2018; 22:91-96. [DOI: 10.1188/18.cjon.91-96] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Goldsmith J, Young AJ, Dale L, Powell MP. Plain Language and Health Literacy for the Oncology Family Caregiver: Examining an English/Spanish mHealth Resource. Semin Oncol Nurs 2017; 33:498-506. [PMID: 29110915 DOI: 10.1016/j.soncn.2017.09.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To explore an mHealth resource to support the limited-English-proficient cancer family caregiver. DATA SOURCES Structured interviews with oncology clinic providers to assess a nurse-delivered resource to support health literacy and decision-making along the cancer trajectory. CONCLUSION Limitations in communicating about oncology care with limited-English caregivers is evident. The mHealth resource examined here shows promise to improve relational health literacy between the oncology nurse and family caregiver. IMPLICATIONS FOR NURSING PRACTICE Communicating with limited-English-proficient family caregivers invites oncology nurses to seek out resources to create shared understanding.
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48
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Glajchen M, Goehring A. The Family Meeting in Palliative Care: Role of the Oncology Nurse. Semin Oncol Nurs 2017; 33:489-497. [PMID: 29107531 DOI: 10.1016/j.soncn.2017.09.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To describe the family meeting in palliative and end-of-life care, highlighting the role of the oncology nurse. Specific strategies will be provided for pre-meeting preparation, communication, and follow-up activities. DATA SOURCES A conceptual framework drawn from family and communication theory, and best practices from the clinical, research, nursing, and palliative care literature. CONCLUSION Working with patients and families is complex, but the family meeting is a promising tool and a potential quality indicator in palliative care. IMPLICATIONS FOR NURSING PRACTICE The nurse is well positioned to participate fully in every aspect of the family meeting.
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49
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Petruzzo A, Paturzo M, Buck HG, Barbaranelli C, D'Agostino F, Ausili D, Alvaro R, Vellone E. Psychometric evaluation of the Caregiver Preparedness Scale in caregivers of adults with heart failure. Res Nurs Health 2017; 40:470-478. [DOI: 10.1002/nur.21811] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Accepted: 06/23/2017] [Indexed: 01/10/2023]
Affiliation(s)
- Antonio Petruzzo
- Department of Biomedicine and Prevention; University of Rome Tor Vergata; Rome Italy
| | - Marco Paturzo
- Department of Biomedicine and Prevention; University of Rome Tor Vergata; Rome Italy
| | - Harleah G. Buck
- College of Nursing; University of South Florida; Tampa Florida
| | | | - Fabio D'Agostino
- Department of Biomedicine and Prevention; University of Rome Tor Vergata; Rome Italy
| | - Davide Ausili
- Department of Medicine and Surgery; University of Milan-Bicocca; Milan Italy
| | - Rosaria Alvaro
- Department of Biomedicine and Prevention; University of Rome Tor Vergata; Rome Italy
| | - Ercole Vellone
- Department of Biomedicine and Prevention; University of Rome Tor Vergata; Rome Italy
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50
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Altschuler A, Liljestrand P, Grant M, Hornbrook MC, Krouse RS, McMullen CK. Caregiving and mutuality among long-term colorectal cancer survivors with ostomies: qualitative study. Support Care Cancer 2017; 26:529-537. [PMID: 28844086 DOI: 10.1007/s00520-017-3862-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 08/16/2017] [Indexed: 11/25/2022]
Abstract
PURPOSE The cancer caregiving literature focuses on the early phases of survivorship, but caregiving can continue for decades when cancer creates disability. Survivors with an ostomy following colorectal cancer (CRC) have caregiving needs that may last decades. Mutuality has been identified as a relationship component that can affect caregiving. This paper discusses how mutuality may affect long-term ostomy caregiving. METHODS We conducted semi-structured, in-depth interviews with 31 long-term CRC survivors with ostomies and their primary informal caregivers. Interviewees were members of an integrated health care delivery system in the USA. We used inductive theme analysis techniques to analyze the interviews. RESULTS Most survivors were 71 years of age or older (67%), female (55%), and with some college education (54%). Two thirds lived with and received care from spouses. Caregiving ranged from minimal support to intimate assistance with daily ostomy care. While some survivors received caregiving far beyond what was needed, others did not receive adequate caregiving for their health care needs. Low mutuality created challenges for ostomy caregiving. CONCLUSIONS Mutuality impacts the quality of caregiving, and this quality may change over time, depending on various factors. Emotional feedback and amplification is the proposed mechanism by which mutuality may shift over time. Survivorship care should include assessment and support of mutuality as a resource to enhance health outcomes and quality of life for survivors with long-term caregiving needs and their caregivers. Appropriate questionnaires can be identified or developed to assess mutuality over the survivorship trajectory.
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Affiliation(s)
- Andrea Altschuler
- Kaiser Permanente Division of Research, 2000 Broadway, Oakland, CA, 94612, USA.
| | - Petra Liljestrand
- Kaiser Permanente Division of Research, 2000 Broadway, Oakland, CA, 94612, USA
| | - Marcia Grant
- City of Hope, 1500 E Duarte Rd, Duarte, CA, 91010, USA
| | - Mark C Hornbrook
- Kaiser Permanente Center for Health Research, 3800 N. Interstate Avenue, Portland, OR, 97227, USA
| | - Robert S Krouse
- Perelman School of Medicine, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA
- Leonard Davis Institute of Health Economics, University of Pennsylvania, 3641 Locust Walk #210, Philadelphia, PA, 19104, USA
- Cpl. Michael J. Crescenz Veterans Affairs Medical Center, 3900 Woodland Ave., Philadelphia, PA, 19104, USA
| | - Carmit K McMullen
- Kaiser Permanente Center for Health Research, 3800 N. Interstate Avenue, Portland, OR, 97227, USA
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