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The unmet supportive care needs-what advanced lung cancer patients' caregivers need and related factors. Support Care Cancer 2016; 24:2999-3009. [PMID: 26872793 DOI: 10.1007/s00520-016-3096-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 01/24/2016] [Indexed: 10/22/2022]
Abstract
PURPOSE To identify the unmet supportive care needs and related factors in caregivers of patients with advanced lung cancer. METHODS A cross-sectional study of 166 lung cancer patient-caregivers dyads was recruited at a medical center. The supportive care needs, fatigue, and sleep disturbance of caregivers were collected. Patients were assessed for symptom severity, anxiety, and depression. Logistic regression was used to reveal the related factors of unmet supportive care needs. RESULTS Of the 166 dyads surveyed, the top unmet needs were information needs, health care professional/health care service needs, and daily living needs. Patients' anxiety was positively correlated to overall caregiving needs, health care professional/health care service needs, interpersonal communication needs, and psychological/emotional needs of caregivers. The information needs and health care professional/health care service needs were related to the caregivers' fatigue. The sleep disturbance of caregivers was associated with their overall caregiving needs, daily living needs, and psychological/emotional needs. CONCLUSIONS Future interventions to meet the needs of caregivers should include specific needs assessment and continuing education in caregiving.
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Family caregiving challenges in advanced colorectal cancer: patient and caregiver perspectives. Support Care Cancer 2015; 24:2017-2024. [PMID: 26530227 DOI: 10.1007/s00520-015-2995-z] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 10/26/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE Family caregivers of advanced colorectal cancer patients may be at increased risk for psychological distress. Yet their key challenges in coping with the patient's illness are not well understood. Soliciting both patient and caregiver perspectives on these challenges would broaden our understanding of the caregiving experience. Thus, the purpose of this research was to identify caregivers' key challenges in coping with their family member's advanced colorectal cancer from the perspective of patients and caregivers. METHODS Individual, semi-structured qualitative interviews were conducted with 23 advanced colorectal cancer patients and 23 primary family caregivers. Interview data were analyzed via thematic analysis. RESULTS In nearly all cases, patient and caregiver reports of the caregiver's key challenge were discrepant. Across patient and caregiver reports, caregivers' key challenges included processing emotions surrounding the patient's initial diagnosis or recurrence and addressing the patient's practical and emotional needs. Other challenges included coping with continual uncertainty regarding the patient's potential functional decline and prognosis and observing the patient suffer from various physical symptoms. CONCLUSIONS Findings suggest that eliciting the perspectives of both patients and caregivers regarding caregivers' challenges provides a more comprehensive understanding of their experience. Results also point to the need to assist caregivers with the emotional and practical aspects of caregiving.
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White MN, King AC, Sallis JF, Frank LD, Saelens BE, Conway TL, Cain KL, Kerr J. Caregiving, Transport-Related, and Demographic Correlates of Sedentary Behavior in Older Adults. J Aging Health 2015; 28:812-33. [DOI: 10.1177/0898264315611668] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: Excess sedentary time predicts negative health outcomes independent of physical activity. The present investigation examined informal caregiving duties and transportation-related factors as potential correlates of sedentary behavior in older adults. Method: Average daily sedentary time was measured via accelerometer in adults ages 66 years and older ( N = 861). Caregiving variables included dog ownership and informal family caregiving status. Transportation variables included driver status, walking distance to public transit, and reported presence of pedestrians and bicyclists in one’s neighborhood. Results: In multivariate models, owning a dog and being a driver were associated with less sedentary time ( p ≤ .01). Educational status and geographic region modified the association between dog ownership and sedentary time, and age modified the association between driver status and sedentary time. Discussion: This study identified that older adult dog owners and drivers were less sedentary. Both factors may create opportunities for older adults to get out of their homes.
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Affiliation(s)
| | | | | | | | - Brian E. Saelens
- Seattle Children’s Institute Center for Child Health, Behavior, and Development, WA, USA
- University of Washington, Seattle, USA
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Eggenberger SK, Krumwiede NK, Young PK. Using Simulation Pedagogy in the Formation of Family-Focused Generalist Nurses. J Nurs Educ 2015; 54:588-93. [DOI: 10.3928/01484834-20150916-08] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 06/11/2015] [Indexed: 11/20/2022]
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Rha SY, Park Y, Song SK, Lee CE, Lee J. Caregiving burden and the quality of life of family caregivers of cancer patients: the relationship and correlates. Eur J Oncol Nurs 2015; 19:376-82. [DOI: 10.1016/j.ejon.2015.01.004] [Citation(s) in RCA: 99] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 01/06/2015] [Accepted: 01/15/2015] [Indexed: 01/20/2023]
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Sun V, Grant M, Koczywas M, Freeman B, Zachariah F, Fujinami R, Del Ferraro C, Uman G, Ferrell B. Effectiveness of an interdisciplinary palliative care intervention for family caregivers in lung cancer. Cancer 2015; 121:3737-45. [PMID: 26150131 DOI: 10.1002/cncr.29567] [Citation(s) in RCA: 95] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Revised: 06/03/2015] [Accepted: 06/17/2015] [Indexed: 12/22/2022]
Abstract
BACKGROUND Family caregivers (FCGs) experience significant deteriorations in quality of life while caring for patients with lung cancer. In this study, the authors tested the effectiveness of an interdisciplinary palliative care intervention for FCGs of patients diagnosed with stage I through IV nonsmall cell lung cancer. METHODS FCGs who were identified by patients as their primary caregivers were enrolled in a prospective, quasi-experimental study in which the usual care group was accrued first followed by the intervention group. FCGs in the intervention group were presented at interdisciplinary care meetings, and they also received 4 educational sessions organized in the physical, psychological, social, and spiritual domains. The sessions included self-care plans to support the FCG's own needs. Caregiver burden, caregiving skills preparedness, psychological distress, and FCG quality of life were assessed at baseline and after 12 weeks using validated measures. RESULTS In total, 366 FCGs were included in the primary analysis. FCGs who received the interdisciplinary palliative care intervention had significantly better scores for social well being (5.84 vs 6.86; P < .001) and had lower psychological distress scores (4.61 vs 4.20; P = .010) at 12 weeks compared with FCGs in the usual care group. FCGs in the intervention group also had significantly less caregiver burden compared with FCGs in the usual care group (P = .008). CONCLUSIONS An interdisciplinary approach to palliative care in lung cancer resulted in statistically significant improvements in FCG's social well being and psychological distress and in less caregiver burden.
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Affiliation(s)
- Virginia Sun
- Division of Nursing Research and Education, Department of Population Sciences, City of Hope, Duarte, California
| | - Marcia Grant
- Division of Nursing Research and Education, Department of Population Sciences, City of Hope, Duarte, California
| | - Marianna Koczywas
- Medical Oncology and Therapeutics Research, City of Hope, Duarte, California
| | - Bonnie Freeman
- Supportive Care Medicine, City of Hope, Duarte, California
| | | | - Rebecca Fujinami
- Division of Nursing Research and Education, Department of Population Sciences, City of Hope, Duarte, California
| | - Catherine Del Ferraro
- Division of Nursing Research and Education, Department of Population Sciences, City of Hope, Duarte, California
| | - Gwen Uman
- Vital Research, LLC, Los Angeles, California
| | - Betty Ferrell
- Division of Nursing Research and Education, Department of Population Sciences, City of Hope, Duarte, California
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van den Hurk DGM, Schellekens MPJ, Molema J, Speckens AEM, van der Drift MA. Mindfulness-Based Stress Reduction for lung cancer patients and their partners: Results of a mixed methods pilot study. Palliat Med 2015; 29:652-60. [PMID: 25701663 PMCID: PMC4457793 DOI: 10.1177/0269216315572720] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Lung cancer patients and partners show high rates of impaired quality of life and heightened distress levels. Mindfulness-Based Stress Reduction has proven to be effective in reducing psychological distress in cancer patients. However, studies barely included lung cancer patients. AIM We examined whether Mindfulness-Based Stress Reduction might be a feasible and effective intervention for patients with lung cancer and partners. DESIGN Mindfulness-Based Stress Reduction is a training in which mindfulness practices are combined with psycho-education to help participants cope with distress. In this mixed methods pilot study, questionnaires on psychological distress and quality of life were administered before, directly after and 3 months after the Mindfulness-Based Stress Reduction training, in combination with semi-structured interviews. SETTING/PARTICIPANTS Patients with lung cancer and partners were recruited at one tertiary care academic medical centre. A total of 19 lung cancer patients and 16 partners participated in the Mindfulness-Based Stress Reduction training. RESULTS Most patients were diagnosed with advanced stage lung cancer. Vast majority completed the training. Those receiving anti-cancer treatment did not miss more sessions than patients who were not currently treated. Patients and partners felt positive about participating in a peer group and with their partner. Among participants no significant changes were found in psychological distress. Caregiver burden in partners decreased significantly after following Mindfulness-Based Stress Reduction. The qualitative analysis showed that the training seemed to instigate a process of change in participants. CONCLUSION The Mindfulness-Based Stress Reduction training seemed to be feasible for patients with lung cancer and their partners. A randomized controlled trial is needed to examine the effectiveness of Mindfulness-Based Stress Reduction in reducing psychological distress in lung cancer patients and partners.
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Affiliation(s)
| | | | - Johan Molema
- Radboud University Medical Centre, Nijmegen, The Netherlands
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Applying the evidence to help caregivers torn in two. Nursing 2015; 45:30-7; quiz 37-8. [PMID: 25973758 DOI: 10.1097/01.nurse.0000464983.54444.80] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Caregiving burden and health-promoting behaviors among the family caregivers of cancer patients. Eur J Oncol Nurs 2015; 19:174-81. [DOI: 10.1016/j.ejon.2014.09.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Revised: 08/27/2014] [Accepted: 09/23/2014] [Indexed: 10/24/2022]
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Matson M, Song L, Mayer DK. Putting Together the Pieces of the Puzzle: Identifying Existing Evidence-Based Resources to Support the Cancer Caregiver. Clin J Oncol Nurs 2014; 18:619-21. [DOI: 10.1188/14.cjon.619-621] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Schellekens MPJ, van den Hurk DGM, Prins JB, Molema J, Donders ART, Woertman WH, van der Drift MA, Speckens AEM. Study protocol of a randomized controlled trial comparing Mindfulness-Based Stress Reduction with treatment as usual in reducing psychological distress in patients with lung cancer and their partners: the MILON study. BMC Cancer 2014; 14:3. [PMID: 24386906 PMCID: PMC3893473 DOI: 10.1186/1471-2407-14-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Accepted: 12/19/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Lung cancer is the leading cause of cancer death worldwide and characterized by a poor prognosis. It has a major impact on the psychological wellbeing of patients and their partners. Recently, it has been shown that Mindfulness-Based Stress Reduction (MBSR) is effective in reducing anxiety and depressive symptoms in cancer patients. The generalization of these results is limited since most participants were female patients with breast cancer. Moreover, only one study examined the effectiveness of MBSR in partners of cancer patients. Therefore, in the present trial we study the effectiveness of MBSR versus treatment as usual (TAU) in patients with lung cancer and their partners. METHODS/DESIGN A parallel group, randomized controlled trial is conducted to compare MBSR with TAU. Lung cancer patients who have received or are still under treatment, and their partners are recruited. Assessments will take place at baseline, post intervention and at three-month follow-up. The primary outcome is psychological distress (i.e. anxiety and depressive symptoms). Secondary outcomes are quality of life (only for patients), caregiver appraisal (only for partners), relationship quality and spirituality. In addition, cost-effectiveness ratio (only in patients) and several process variables are assessed. DISCUSSION This trial will provide information about the clinical and cost-effectiveness of MBSR compared to TAU in patients with lung cancer and their partners.
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Affiliation(s)
- Melanie P J Schellekens
- Department of Psychiatry, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
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Lee YJ, Kang H. Nursing Needs and Burden of Family Caregivers of Middle-Aged Hepatocellular Carcinoma Patients. ASIAN ONCOLOGY NURSING 2014. [DOI: 10.5388/aon.2014.14.4.227] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Yu Jin Lee
- Cancer Center, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Hyunwook Kang
- Department of Nursing, Chung-Ang University, Seoul, Korea
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Wittenberg-Lyles E, Kruse RL, Oliver DP, Demiris G, Petroski G. Exploring the collective hospice caregiving experience. J Palliat Med 2013; 17:50-5. [PMID: 24351126 DOI: 10.1089/jpm.2013.0289] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Collective caregiving, performed by caregivers working in pairs (informal primary and secondary caregivers working together), is common in the hospice setting. Research suggests that caregiving pairs may experience different caregiver outcomes. However, little is known about how caregiving pairs differ from solo caregivers (informal primary caregivers) on outcome measures. OBJECTIVE The goal of this study was to determine whether being in a caregiver pair affected caregiver anxiety and depression and how outcomes changed over time. DESIGN A mixed model analysis was used. SETTING/SUBJECTS Hospice caregivers (260 solo caregivers and 44 caregivers in 22 pairs) who participated in a larger, randomized controlled trial completed caregiver measures upon hospice admission and periodically until the death of the patient or hospice decertification. MEASUREMENTS Measured were caregiver quality of life, social support, anxiety, and depression. RESULTS Caregiver pairs had higher anxiety and depression scores than solo caregivers. Emotional, financial, and physical quality of life were associated with decreased depression, whereas only emotional and financial quality of life were correlated with lower levels of anxiety. Social support was associated with lower levels of depression and anxiety. CONCLUSIONS Despite assumptions that social support is positively facilitated vis-a-vis collective caregiving, caregiving pairs may be at higher risk for anxiety and depression. Future research is needed to address why individuals become anxious and/or depressed when working as part of a caregiving pair.
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