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Lee KC, Hsieh YL, Lin PC, Lin YP. Sleep Pattern and Predictors of Sleep Disturbance Among Family Caregivers of Terminal Ill Patients With Cancer in Taiwan: A Longitudinal Study. Am J Hosp Palliat Care 2018; 35:1109-1117. [PMID: 29390869 DOI: 10.1177/1049909118755453] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Background: Sleep disturbance commonly has a negative impact on the well-being of family caregivers (FCs) of terminally ill patients with cancer. The effect of sleep disturbance on FCs has not been explored through long-term follow-up studies in Taiwan. Objective: The purposes of this study were to (1) identify the trajectory of sleep quality of FCs of terminally ill patients with cancer in Taiwan and (2) examine the determinants of sleep disturbance through a longitudinal follow-up until patient death. Methods: A prospective, longitudinal study was conducted among 95 FCs of terminally ill patients with cancer. The FCs’ sleep quality was measured subjectively by using the Pittsburgh Sleep Quality Index and objectively by wearing a wrist actigraphy for 48 hours each month during the 6-month follow-up assessments. The trajectory and determinants of sleep quality were identified using a generalized estimation equation approach. Results: The FCs’ sleep quality significantly decreased as the patient’s death approached. Family caregivers who were women or older, had a relative with a longer survival period after diagnosis, reported higher levels of depression and fatigue, and provided lower levels of assistance to their relatives experienced more sleep disturbance. Conclusion: The sleep quality of Taiwanese FCs significantly deteriorated as the death of the terminally ill patients with cancer approached. Early detection of the FCs’ sleep disturbance, increasing their self-awareness of sleep problems, and providing nonpharmacological interventions and psychosocial support may be helpful for FCs to improve their quantity and quality of sleep.
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Affiliation(s)
- Kwo-Chen Lee
- School of Nursing, China Medical University, Taichung, Taiwan
- Department of Nursing, China Medical University Hospital, Taichung, Taiwan
| | - Ya-Ling Hsieh
- School of Nursing, China Medical University, Taichung, Taiwan
- Department of Nursing, Chi Mei Medical Center, Tainan, Taiwan
| | - Pi-Chu Lin
- Master program in Long-Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Yun-Ping Lin
- School of Nursing, China Medical University, Taichung, Taiwan
- Department of Nursing, China Medical University Hospital, Taichung, Taiwan
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302
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Cuthbert CA, King-Shier KM, Ruether JD, Tapp DM, Wytsma-Fisher K, Fung TS, Culos-Reed SN. The Effects of Exercise on Physical and Psychological Outcomes in Cancer Caregivers: Results From the RECHARGE Randomized Controlled Trial. Ann Behav Med 2018; 52:645-661. [DOI: 10.1093/abm/kax040] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
- Colleen A Cuthbert
- Department of Oncology, Cumming School of Medicine, University of Calgary, University Drive Northwest, Calgary, Alberta, Canada
- Alberta Health Services, 1331, 29th Street Northwest, Calgary, Alberta, Canada
| | - Kathryn M King-Shier
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - J Dean Ruether
- Department of Oncology, Cumming School of Medicine, University of Calgary, University Drive Northwest, Calgary, Alberta, Canada
- Alberta Health Services, 1331, 29th Street Northwest, Calgary, Alberta, Canada
| | - Dianne M Tapp
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
| | | | - Tak S Fung
- Department of Oncology, Cumming School of Medicine, University of Calgary, University Drive Northwest, Calgary, Alberta, Canada
- Information Technologies, University of Calgary, Calgary, Alberta, Canada
| | - S Nicole Culos-Reed
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Division of Medical Oncology, Department of Psychosocial Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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303
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Köhle N, Drossaert CHC, Van Uden-Kraan CF, Schreurs KMG, Hagedoorn M, Verdonck-de Leeuw IM, Bohlmeijer ET. Intent to use a web-based psychological intervention for partners of cancer patients: Associated factors and preferences. J Psychosoc Oncol 2018; 36:203-221. [PMID: 29336704 DOI: 10.1080/07347332.2017.1397831] [Citation(s) in RCA: 8] [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
This study examined partners of cancer patients intention to use a web-based psychological intervention, their preferences regarding its preconditions, functionalities and topics, and factors related to their intention. One hundred and sixty-eight partners completed a questionnaire about these aspects. Forty-eight percent of the partners would (maybe) make use of a web-based intervention. Partners who intended to participate were significantly younger, used the Internet more often, and perceived more caregiver strain. Most partners preferred an intervention that takes less than 1 hour/week, lasts five weeks or more, and contains information and peer support. Half of the partners would like to receive online guidance.
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Affiliation(s)
- Nadine Köhle
- a Department of Psychology , Health & Technology, University of Twente , AE Enschede , The Netherlands
| | - Constance H C Drossaert
- a Department of Psychology , Health & Technology, University of Twente , AE Enschede , The Netherlands
| | - Cornelia F Van Uden-Kraan
- b Department of Clinical Psychology , VU University, VdBoechorststraat 1 , 1082 BT Amsterdam , The Netherlands
| | - Karlein M G Schreurs
- a Department of Psychology , Health & Technology, University of Twente , AE Enschede , The Netherlands.,c Roessingh Research & Development , AH Enschede , The Netherlands
| | - Mariët Hagedoorn
- d Department of Health Psychology , University Medical Center Groningen , RB Groningen , The Netherlands
| | - Irma M Verdonck-de Leeuw
- b Department of Clinical Psychology , VU University, VdBoechorststraat 1 , 1082 BT Amsterdam , The Netherlands.,e Department of Otolaryngology/Head and Neck Surgery , VU University Medical Center ; MB Amsterdam , The Netherlands
| | - Ernst T Bohlmeijer
- a Department of Psychology , Health & Technology, University of Twente , AE Enschede , The Netherlands
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304
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Nayak MG, George A, Vidyasagar MS. Perceived Barriers to Symptoms Management among Family Caregivers of Cancer Patients. Indian J Palliat Care 2018; 24:202-206. [PMID: 29736126 PMCID: PMC5915890 DOI: 10.4103/ijpc.ijpc_27_18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Introduction Caring for patients with advanced disease involves many concerns for caregivers. All aspects of health of the caregiver is compromised in the process of caring for the cancer patients. Usually, most of the terminally ill cancer patients live with their caregivers at home. Objectives The aims of the present study was to identify the barriers to symptom management among caregivers of cancer patients and to find the association between perceived barriers to symptom management of caregivers' with their demographic variables and their patients' disease-related variables. Materials and Methods A descriptive study was conducted among 768 family caregivers (FCGs) of cancer patients, and they were selected using convenient sampling technique. Data was collected from caregivers who were caring for their beloved one at least 2-3 h/day and who were above 20 years of age. Data was collected through a structured interview using barriers questionnaire and demographic pro forma after obtaining the consent from the caregivers. Results The result shows that among 768 FCGs, 216 (28.1%) of them were in the age group between 31 and 40 years and most of them were spouses (45.6%). The perceived barriers of caregivers were less confidence on the management of symptoms. A total of 423 (55.1%) had lack of awareness about pain assessment and management of cancer by 681 (88.6%). Majority, i.e., 654 (85.1%) of them had financial problems in the family. Conclusion FCGs take the major responsibilities both at the hospital and at home in caring for the cancer patients. Since FCGs had lack of knowledge on caring of cancer patients, there is a need for awareness program on the assessment and management of symptoms among cancer patients.
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Affiliation(s)
- Malathi G Nayak
- Department of Community Health Nursing, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Anice George
- Department of Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - M S Vidyasagar
- Department of Radiotherapy and Oncology, Kasturba Medical College Hospital, Manipal Academy of Higher Education, Manipal, Karnataka, India
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305
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Khanjari S, Damghanifar M, Haqqani H. Investigating the relationship between the quality of life and religious coping in mothers of children with recurrence leukemia. J Family Med Prim Care 2018; 7:213-219. [PMID: 29915762 PMCID: PMC5958572 DOI: 10.4103/jfmpc.jfmpc_236_17] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Background: Leukemia is a life-threatening chronic disease for children. The recurrence of the disease causes tension and reduces the quality of life for the family, especially for mothers. Religion is an important humanitarian aspect of holistic care that can be very effective in determining the health level of the patient and the family members. The present study aims at investigating the role of religious coping (RCOPE) in the quality of life for mothers of children with recurrent leukemia. Methods: This is a cross-sectional study of the descriptive-correlational type. Two-hundred mothers with children aging 1–15 years suffering from leukemia were selected using a continuous sampling method. The data were collected using questionnaires eliciting information about personal information, Persian version of the Caregiver Quality of Life Index-Cancer, and RCOPE. The collected data were analyzed in SPSS using descriptive tests and independent samples t-test. Results: The result of examining the relation between life quality and demographic features of mothers showed that education level, income, and occupation had a significant statistical relationship with general quality of life mothers. The results of examining the relationship between quality of life and RCOPE of mothers showed that RCOPE was positively correlated only with the positive coping dimension quality of life (P < 0/001). Negative RCOPE had a significant reverse statistical correlation with general quality of life and all its aspects. Conclusion: The quality of life for the participants in this study was significantly related to RCOPE. Mothers with negative RCOPE faced low scores for quality of life, and religious support can improve their life quality. Further longitudinal studies are required to investigate the effects of establishing support communities.
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Affiliation(s)
- Sedigheh Khanjari
- Deptartment of Pediatric Nursing, Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.,MS in Pediatric Nursing, School of Nursing and Midwifery, University of Medical Sciences, Tehran, Iran
| | - Marjan Damghanifar
- MS in Pediatric Nursing, School of Nursing and Midwifery, University of Medical Sciences, Tehran, Iran
| | - Hamid Haqqani
- Department of Biostatistics, School of Health Management and Information Sciences, University of Medical Sciences, Tehran, Iran
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306
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Aguiló S, García E, Arza A, Garzón-Rey JM, Aguiló J. Evaluation of chronic stress indicators in geriatric and oncologic caregivers: a cross-sectional study. Stress 2018; 21:36-42. [PMID: 29063803 DOI: 10.1080/10253890.2017.1391211] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Caregiving induces chronic stress with physical and psychological impact on informal caregivers health. Therefore, subjective and objective indicators are needed for the early diagnosis of pathologic stress to prevent the risk of developing stress-related diseases in caregivers. Our aim was to assess the self-perceived stress, that is, how and how much the stressor affects the individual, through endocrine, metabolic, and immunologic biomarkers levels in geriatric and oncologic informal caregivers. Informal caregivers and non-caregivers were invited to participate in a cross-sectional study at the Clinic Hospital of Barcelona. Demographic and lifestyle characteristics, self-perceived stress (Perceived Stress Scale, State-Trait Anxiety Inventory and Stress Visual Analogue Scale), and biomarkers (copeptin, glucose, glycated hemoglobin, low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), cholesterol, triglycerides, α-amylase, cortisol, tumor necrosis factor (TNF-α), and Interleukins (IL-6 and IL-10)) were evaluated. Descriptive and non-parametric statistical data analysis were performed. Fifty-six subjects (19 non-caregivers, 17 geriatric caregivers, and 20 oncologic caregivers) participated. Median age (IQR) was 57 years (47-66) and 71.46% were women. Self-perceived stress was higher in oncologic caregivers than geriatric caregivers in all psychometric test analyzed (Wilcoxon Rank Sum test, p value < .05). Glucose concentrations and glycated hemoglobin levels differed statistically among groups (Kruskal-Wallis test (K-W tests), p value < .05), even though the median levels were not clinically relevant. Levels of other biomarkers did not differ significantly (K-W tests, p value > .05). These findings suggest that perceived stress is not homogeneous in the caregivers community and thus these two groups could be differentiated. These results provide the baseline information to initiate social actions addressed to each group of caregivers to increase their wellbeing.
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Affiliation(s)
| | - Esther García
- b Centro de Investigación Biomédica en Red de Bioingeniería , Biomateriales y Nanomedicina (CIBER-BBN) , Madrid , Spain
| | - Adriana Arza
- b Centro de Investigación Biomédica en Red de Bioingeniería , Biomateriales y Nanomedicina (CIBER-BBN) , Madrid , Spain
- c Microelectronics and Electronic Systems Department , Universitat Autònoma de Barcelona , Barcelona , Spain
| | - Jorge M Garzón-Rey
- b Centro de Investigación Biomédica en Red de Bioingeniería , Biomateriales y Nanomedicina (CIBER-BBN) , Madrid , Spain
- c Microelectronics and Electronic Systems Department , Universitat Autònoma de Barcelona , Barcelona , Spain
| | - Jordi Aguiló
- b Centro de Investigación Biomédica en Red de Bioingeniería , Biomateriales y Nanomedicina (CIBER-BBN) , Madrid , Spain
- c Microelectronics and Electronic Systems Department , Universitat Autònoma de Barcelona , Barcelona , Spain
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307
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Abstract
OBJECTIVE To discuss lesbian, gay, bisexual, and transgender (LGBT)-specific survivorship issues including: integrating sexual and gender minority identities with cancer survivor identities; coordinating medical care and disclosing identities to health care providers; dealing with late effects of treatment; and addressing LGBT family and relationship issues. DATA SOURCES Published articles, quotes from an online survey of 311 LGBT survivors. CONCLUSION The transition from active cancer treatment to survivorship presents challenges, and LGBT cancer survivors may face additional challenges as they enter the survivorship phase. IMPLICATIONS FOR NURSING PRACTICE Oncology nurses can improve the quality of survivorship care delivered to LGBT survivors and their caregivers by addressing the disparities and gaps in health care.
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308
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Stafford L, Sinclair M, Turner J, Newman L, Wakefield C, Krishnasamy M, Mann GB, Gilham L, Mason K, Rauch P, Cannell J, Schofield P. Study protocol for Enhancing Parenting In Cancer (EPIC): development and evaluation of a brief psycho-educational intervention to support parents with cancer who have young children. Pilot Feasibility Stud 2017; 3:72. [PMID: 29238608 PMCID: PMC5725968 DOI: 10.1186/s40814-017-0215-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 12/01/2017] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Parents with cancer have high rates of psychological morbidity, and their children are at risk of poor psychosocial outcomes, particularly in the context of parental distress and poor family communication. Parents express concerns about the impact of cancer on their children and report a lack of professional guidance in meeting their children's needs. Few parenting interventions exist and current interventions have extensive infrastructure demands making them unsuitable for routine use in most health settings. The aims of this study are to develop and establish the feasibility and acceptability of a novel and accessible psycho-educational intervention to improve parenting efficacy and decrease parental stress among adults with cancer who have children aged 3-12 years. The intervention will be suitable for parents with cancer who are receiving treatment with a view to longer term survival, irrespective of cancer diagnosis, and their respective co-parents. METHODS/DESIGN This study comprises two phases using the UK Medical Research Council framework for developing complex interventions. In the development phase, intervention content will be iteratively developed and evaluated in consultation with consumers, and in the piloting phase, feasibility will be tested in a clinical sample of 20 parents with cancer and their co-parents using a single arm, pre-test post-test design. The intervention will comprise an audiovisual resource (DVD), a question prompt list, and a telephone call with a clinical psychologist. Questionnaires administered pre- and 1 month post-intervention will assess parental stress, psychological morbidity, quality of life, self-efficacy and perceptions of child adjustment, and family functioning. Intervention feasibility will be determined by mixed-method participant evaluation of perceived usefulness, benefits, and acceptability. DISCUSSION This new initiative will translate existing descriptive evidence into an accessible intervention that supports parenting during cancer treatment and meets the information needs of parents with cancer and their families. This is an important advance: despite increasing recognition of the impact of parental cancer on the family, intervention research lags behind the descriptive literature. This low-intensity, accessible, and targeted intervention places minimal burden on infrastructure and promotes patient autonomy and self-management. If feasible, this style of intervention may be a template for future interventions with similar populations.
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Affiliation(s)
- Lesley Stafford
- Centre for Women's Mental Health, Royal Women's Hospital, Parkville, Victoria Australia
- School of Psychological Sciences, University of Melbourne, Melbourne, Victoria Australia
| | - Michelle Sinclair
- Centre for Women's Mental Health, Royal Women's Hospital, Parkville, Victoria Australia
| | - Jane Turner
- Discipline of Psychiatry, University of Queensland, Herston, Queensland Australia
- Royal Brisbane and Women's Hospital, Brisbane, Queensland Australia
| | - Louise Newman
- Centre for Women's Mental Health, Royal Women's Hospital, Parkville, Victoria Australia
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria Australia
| | - Claire Wakefield
- School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales Australia
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales Australia
| | - Mei Krishnasamy
- Department of Nursing, University of Melbourne, Melbourne, Victoria Australia
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Parkville, Victoria Australia
| | - G Bruce Mann
- Breast Service, Victorian Comprehensive Cancer Centre, Parkville, Victoria Australia
- Department of Surgery, University of Melbourne, Melbourne, Victoria Australia
| | - Leslie Gilham
- Centre for Women's Mental Health, Royal Women's Hospital, Parkville, Victoria Australia
| | - Kylie Mason
- Parkville Integrated Haematology Service, Victorian Comprehensive Cancer Centre, Parkville, Victoria Australia
- Department of Medicine, University of Melbourne, Melbourne, Victoria Australia
| | - Paula Rauch
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA USA
| | - Julia Cannell
- Centre for Women's Mental Health, Royal Women's Hospital, Parkville, Victoria Australia
| | - Penelope Schofield
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Parkville, Victoria Australia
- Department of Psychology, Swinburne University, Hawthorn, Victoria Australia
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309
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Mishra SI, Rishel Brakey H, Kano M, Nedjat-Haiem FR, Sussman AL. Health related quality of life during cancer treatment: Perspectives of young adult (23-39 years) cancer survivors and primary informal caregivers. Eur J Oncol Nurs 2017; 32:48-54. [PMID: 29353632 DOI: 10.1016/j.ejon.2017.11.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 11/20/2017] [Accepted: 11/26/2017] [Indexed: 12/24/2022]
Abstract
PURPOSE There is a paucity of information regarding health related quality of life (HRQoL) of young adults (YAs) with cancer and caregivers. Therefore, we characterize YA and caregiver perspectives on the impact of cancer and its treatment on HRQoL. METHODS We conducted descriptive qualitative in-depth, semi-structured interviews with YAs receiving cancer care at an academic health center in Albuquerque, New Mexico (USA) and primary informal caregivers. The interviews, conducted from September through December 2015, focused on perspectives on the impact of the disease and its treatment in terms of physical and emotional effects, coping, and strategies to enhance HRQoL. We used an iterative thematic analysis approach to identify emergent themes and create a coding structure. RESULTS We reached thematic saturation after interviewing 8 YAs and 8 caregivers. YAs and caregivers discussed cancer triggered challenges such as anxiety, depression, isolation, fear, and financial hardships. YAs and caregivers coped by maintaining positive perspectives, relying on friends and family, and prayer. Caregivers discussed how expectations for and experiences of a "good day" changed depending on their loved ones' stage of cancer treatment. YAs navigated challenges by focusing on activities and thoughts that provided meaning to their lives. YAs and caregivers suggested strategies to enhance HRQoL through patient/provider communication, support services, and decision making tools as potential mechanisms for grounding patient-centered interventions to improve cancer care. CONCLUSIONS Implications include the development and evaluation of informational and behavioral interventions tailored and targeted to address the pragmatic needs of YAs undergoing cancer treatment and informal caregivers.
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Affiliation(s)
- Shiraz I Mishra
- Department of Pediatrics, University of New Mexico Health Sciences Center, 1 University of New Mexico, MSC 10 5590, Albuquerque, NM 87131, USA; Department of Family and Community Medicine, University of New Mexico Health Sciences Center, 1 University of New Mexico, MSC 09 5040, Albuquerque, NM 87131, USA; University of New Mexico Comprehensive Cancer Center, University of New Mexico Health Sciences Center, 1201 Camino de Salud, Albuquerque, NM 87131, USA.
| | - Heidi Rishel Brakey
- University of New Mexico Clinical and Translational Science Center, University of New Mexico Health Sciences Center, 1 University of New Mexico, Albuquerque, NM 87131, USA
| | - Miria Kano
- Department of Family and Community Medicine, University of New Mexico Health Sciences Center, 1 University of New Mexico, MSC 09 5040, Albuquerque, NM 87131, USA; University of New Mexico Comprehensive Cancer Center, University of New Mexico Health Sciences Center, 1201 Camino de Salud, Albuquerque, NM 87131, USA
| | - Frances R Nedjat-Haiem
- New Mexico State University, School of Social Work, 1335 International Mall, Las Cruces, NM 88003, USA
| | - Andrew L Sussman
- Department of Family and Community Medicine, University of New Mexico Health Sciences Center, 1 University of New Mexico, MSC 09 5040, Albuquerque, NM 87131, USA; University of New Mexico Comprehensive Cancer Center, University of New Mexico Health Sciences Center, 1201 Camino de Salud, Albuquerque, NM 87131, USA
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310
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Holst-Hansson A, Idvall E, Bolmsjö I, Wennick A. Hoping to reach a safe haven - Swedish families' lived experience when a family member is diagnosed with breast cancer. Eur J Oncol Nurs 2017; 31:52-58. [DOI: 10.1016/j.ejon.2017.10.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 10/08/2017] [Accepted: 10/09/2017] [Indexed: 11/30/2022]
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311
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Segrin C, Badger TA, Sikorskii A, Crane TE, Pace TWW. A dyadic analysis of stress processes in Latinas with breast cancer and their family caregivers. Psychooncology 2017; 27:838-846. [PMID: 29125677 DOI: 10.1002/pon.4580] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2017] [Revised: 10/20/2017] [Accepted: 10/31/2017] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Breast cancer diagnosis and treatment negatively affect quality of life for survivors and their family caregivers. The stress process model has been useful for describing the cascade of social and psychological experiences that culminate in degraded quality of life for both survivors and their family caregivers. This study is designed to test theoretically specified predictors of negative psychosocial outcomes in a dyadic context. METHODS Participants were 230 dyads composed of Latinas recently diagnosed with breast cancer and their primary family caregiver, who completed measures of socioeconomic status, stress, family conflict, depression, and anxiety. Data were analyzed following the Actor-Partner Interdependence Mediation Model in structural equation modeling. RESULTS For both survivors and caregivers, there were significant direct and indirect actor effects (through family conflict) of perceived stress on depression and anxiety. Several indirect partner effects were also evident in this sample. Specifically, caregivers' stress was predictive of survivors' depression and anxiety through survivors' increased perceptions of family conflict. CONCLUSIONS As predicted by the stress process model, stress and family conflict were predictive of psychological distress in breast cancer survivors and their family caregivers. Significant partner effects in the Actor-Partner Interdependence Mediation Model suggest that there are some dyadic influences, particularly from caregivers' stress to survivors' perceptions of exacerbated family conflict. These findings show how strained family relationships can aggravate the well-being of cancer survivors and their family caregivers through this challenging experience.
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Affiliation(s)
- Chris Segrin
- Department of Communication, University of Arizona, Tucson, AZ, USA
| | - Terry A Badger
- College of Nursing, University of Arizona, Tucson, AZ, USA
| | - Alla Sikorskii
- Department of Psychiatry, Michigan State University, East Lansing, MI, USA
| | - Tracy E Crane
- College of Nursing, University of Arizona, Tucson, AZ, USA
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312
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Heckel M, Hoser B, Stiel S. Caring for patients with brain tumors compared to patients with non-brain tumors: Experiences and needs of informal caregivers in home care settings. J Psychosoc Oncol 2017; 36:189-202. [PMID: 28902576 DOI: 10.1080/07347332.2017.1379046] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND/OBJECTIVE Informal caregivers of patients with advanced cancer experience a challenging time, especially while caring for the patient at home. The aim of this study is to compare experiences, perceived burdens, and needs during home care of informal caregivers of brain tumor patients and informal caregivers of non-brain tumor patients. METHODS 28 informal caregivers (17 brain tumor group, 11 non-brain tumor group) participated in this study. Semi-structured interviews were conducted to gather information retrospectively. Data was analyzed using principles of thematic analysis method. RESULTS The results support existing evidence that the themes assessment of the situation, dealing with the situation, effects of the situation, and support by others are of importance to all informal caregivers. Caregivers in the brain tumor group put more emphasis on information and perception of the situation by others than caregivers in the non-brain tumor group. CONCLUSION The emerging need for information of caregivers and the effects for caregivers of changes in the perception of the situation by others should be addressed to better support informal caregivers of brain tumor patients.
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Affiliation(s)
- Maria Heckel
- a Department of Palliative Medicine , University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) , Germany
| | - Bettina Hoser
- a Department of Palliative Medicine , University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) , Germany
| | - Stephanie Stiel
- b Institute for General Practice, Hannover Medical School , Hannover , Germany
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313
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Lambert SD, Bowe SJ, Livingston PM, Heckel L, Cook S, Kowal P, Orellana L. Impact of informal caregiving on older adults' physical and mental health in low-income and middle-income countries: a cross-sectional, secondary analysis based on the WHO's Study on global AGEing and adult health (SAGE). BMJ Open 2017; 7:e017236. [PMID: 29146639 PMCID: PMC5695345 DOI: 10.1136/bmjopen-2017-017236] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Revised: 07/15/2017] [Accepted: 08/17/2017] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES A high proportion of care stemming from chronic disease or disability in low-income and middle-income countries is provided by informal caregivers. The goal of this study was to determine the level of burden experienced by these caregivers, explore associated factors and assess whether caregivers' and non-caregivers' health differed. DESIGN AND SETTING This cross-sectional study was a secondary analysis of data on caregivers' burden, health and health risk factors in Ghana, India and the Russian Federation collected as part of the WHO's Study on global AGEing and adult health (SAGE) Wave 1. PARTICIPANTS Caregivers in Ghana (n=143), India (n=490) and Russia (n=270) completed the measures. OUTCOME MEASURES Factors associated (ie, demographics and caregiving profile variables) with burden were explored among caregivers. Then, quality of life (QOL), perceived stress, depression, self-rated health (SRH) and health risk factors were compared between caregivers and matched non-caregivers (1:2). RESULTS The largest caregiving subgroups were spouses and adult children. Caregivers mostly cared for one person and provided financial, social/emotional and/or physical support, but received little support themselves. Burden level ranged from 17.37 to 20.03. Variables associated with burden were mostly country-specific; however, some commonality for wealth, type of care and caregiving duration was noted. Caregivers with a moderate or high level of burden reported lower QOL and higher perceived stress than those experiencing low burden. Caregivers reported lower QOL and SRH than non-caregivers. CONCLUSION Given the lack of support received and consequences of the burden endured by caregivers, policy and programme initiatives are needed to ensure that caregivers in low- and middle-income countries can fulfil their role without compromising their own health.
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Affiliation(s)
- Sylvie D Lambert
- Ingram School of Nursing, McGill University, Montreal, Quebec, Canada
- St. Mary's Research Centre, St. Mary's Research Centre, Montreal, Quebec, Canada
| | - Steven J Bowe
- Faculty of Health, Deakin University, Geelong, Australia
| | | | - Leila Heckel
- Faculty of Health, Deakin University, Geelong, Australia
| | - Selina Cook
- Faculty of Health, Deakin University, Geelong, Australia
| | - Paul Kowal
- Department of Anthropology, University of Oregon, Geneva, Switzerland
- Research Centre for Generational Health and Ageing, University of Newcastle, Newcastle, New South Wales, Australia
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314
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Favez N, Cairo Notari S, Antonini T, Charvoz L. Expressed emotion in couples facing breast cancer in women is associated with psychological distress in the first year after surgery. J Health Psychol 2017; 25:830-839. [PMID: 29090603 DOI: 10.1177/1359105317736575] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to assess the links between partners' and women's expressed emotion with the distress of one another during the first year after surgery for breast cancer in women. The design was longitudinal. A sample of 61 couples participated in the study at 2 weeks, 3 months, and 12 months after the surgery. Expressed emotion was assessed with the Five-Minute Speech Sample. Psychological distress was assessed with a self-reported questionnaire. Mixed-model analyses showed that partners' expressed emotion is associated with heightened psychological distress in women during the first year after surgery, even after medical data were controlled for.
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Affiliation(s)
| | | | | | - Linda Charvoz
- University of Applied Sciences and Arts Western Switzerland, Switzerland
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315
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Wyatt G, Sikorskii A, Tesnjak I, Frambes D, Holmstrom A, Luo Z, Victorson D, Tamkus D. A Randomized Clinical Trial of Caregiver-Delivered Reflexology for Symptom Management During Breast Cancer Treatment. J Pain Symptom Manage 2017; 54:670-679. [PMID: 28743659 PMCID: PMC5650941 DOI: 10.1016/j.jpainsymman.2017.07.037] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 07/13/2017] [Accepted: 07/18/2017] [Indexed: 11/22/2022]
Abstract
PURPOSE The objective of this study was to determine the effects of a home-based reflexology intervention delivered by a friend/family caregiver compared with attention control on health-related quality of life of women with advanced breast cancer undergoing chemotherapy, targeted and/or hormonal therapy. METHODS Patient-caregiver dyads (N = 256) were randomized to four weekly reflexology sessions or attention control. Caregivers in the intervention group were trained in a 30-minute protocol. During the four weeks, both groups had telephone symptom assessments, and intervention group had fidelity assessments. The intervention effects were assessed using linear mixed-effects models at weeks 5 and 11 for symptom severity and interference with daily activities, functioning, social support, quality of patient-caregiver relationship, and satisfaction with life. RESULTS Significant reductions in average symptom severity (P = 0.02) and interference (P < 0.01) over 11 weeks were found in the reflexology group compared with control, with no group differences in functioning, social support, quality of relationship, or satisfaction with life at weeks 5 and 11. Stronger quality of relationship was associated with lower symptom interference in the entire sample (P = 0.02), but controlling for it did not diminish the effect of intervention on symptoms. Significant reductions in symptom severity in the reflexology group compared with attention control were seen during weeks 2-5 but were reduced at Week 11. DISCUSSION Efficacy findings of caregiver-delivered reflexology with respect to symptom reduction open a new evidence-based avenue for home-based symptom management.
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Affiliation(s)
- Gwen Wyatt
- College of Nursing, Michigan State University, East Lansing, Michigan, USA.
| | - Alla Sikorskii
- College of Nursing, University of Arizona, Tucson, Arizona, USA
| | - Irena Tesnjak
- Department of Statistics and Probability, Michigan State University, East Lansing, Michigan, USA
| | - Dawn Frambes
- College of Nursing, Michigan State University, East Lansing, Michigan, USA
| | - Amanda Holmstrom
- Department of Communication, Michigan State University, East Lansing, Michigan, USA
| | - Zhehui Luo
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, Michigan, USA
| | - David Victorson
- Feinberg School of Medicine, Northwestern University, Evanston, Illinois, USA
| | - Deimante Tamkus
- College of Human Medicine, Michigan State University, East Lansing, Michigan, USA
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316
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Große J, Treml J, Kersting A. Impact of caregiver burden on mental health in bereaved caregivers of cancer patients: A systematic review. Psychooncology 2017; 27:757-767. [DOI: 10.1002/pon.4529] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 08/07/2017] [Accepted: 08/08/2017] [Indexed: 12/25/2022]
Affiliation(s)
- Julia Große
- Department für Psychische Gesundheit; Universität Leipzig Medizinische Fakultät; Leipzig Germany
| | - Julia Treml
- Department für Psychische Gesundheit; Universität Leipzig Medizinische Fakultät; Leipzig Germany
| | - Anette Kersting
- Department für Psychische Gesundheit; Universität Leipzig Medizinische Fakultät; Leipzig Germany
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317
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Frambes D, Sikorskii A, Tesnjak I, Wyatt G, Lehto R, Given B. Caregiver-Reported Health Outcomes: Effects of Providing Reflexology for Symptom Management to Women With Advanced Breast Cancer. Oncol Nurs Forum 2017; 44:596-605. [DOI: 10.1188/17.onf.596-605] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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318
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Rand S, Forder J, Malley J. A study of dyadic interdependence of control, social participation and occupation of adults who use long-term care services and their carers. Qual Life Res 2017; 26:3307-3321. [PMID: 28786019 PMCID: PMC5681980 DOI: 10.1007/s11136-017-1669-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2017] [Indexed: 10/25/2022]
Abstract
PURPOSE Unpaid care is an important source of support of people with long-term conditions. Interdependence of carers' and care recipients' quality of life would be expected due to the relational nature of caregiving. This study aims to explore interdependence of quality of life in carer/care-recipient dyads, especially in relation to mutual interdependence due to social feedback in the caregiving relationship and also the partner effects of one partner's experience of long-term care support on the other's outcomes. METHODS Using data collected in an interview survey of 264 adults with care support needs and their unpaid carers in England, we employed regression analysis to explore whether there is mutual interdependence of care-related quality of life within carer/care-recipient dyads for three quality of life attributes: Control over daily life, Social participation and Occupation. The influence of factors, including satisfaction with long-term care, were also considered on individuals' and dyad partners' care-related quality of life. RESULTS We found mutual interdependence of quality of life at the dyad-level for Control over daily life, but not Occupation or Social participation. A partner effect of care recipients' satisfaction with long-term care on carers' Control over daily life was also observed. Higher care recipient satisfaction with care services was associated with higher Control over daily life. By contrast, for Social participation and Occupation, there were only significant effects of care recipients' satisfaction with long-term care and their own quality of life. CONCLUSIONS These findings highlight the importance of considering the wider impact beyond the individual of long-term care on quality of life in the evaluation of long-term care policy and practice.
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Affiliation(s)
- Stacey Rand
- Personal Social Services Research Unit (PSSRU), University of Kent, Cornwallis Building, Canterbury, CT2 7NF, UK.
| | - Julien Forder
- Personal Social Services Research Unit (PSSRU), University of Kent, Cornwallis Building, Canterbury, CT2 7NF, UK
| | - Juliette Malley
- Personal Social Services Research Unit (PSSRU), London School of Economics and Political Science, Cowdray House, Houghton Street, London, WC2A 2AE, UK
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319
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Unmet Needs and Caregiver Burden Among Family Caregivers of Hospice Patients in South Korea. J Hosp Palliat Nurs 2017. [DOI: 10.1097/njh.0000000000000350] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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320
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Worry in Head and Neck Cancer Caregivers: The Role of Survivor Factors, Care-Related Stressors, and Loneliness in Predicting Fear of Recurrence. Nurs Res 2017; 66:295-303. [PMID: 28654567 DOI: 10.1097/nnr.0000000000000223] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Fear of recurrence (FOR) is a primary concern for both cancer survivors and their caregivers, yet little is known about what care-related factors exacerbate this worry. OBJECTIVES This study aimed to establish the role of care-related stressors-as distinct from survivor characteristics-in predicting FOR in head and neck cancer caregivers. METHODS HNC survivor-caregiver dyads took part in a mailed survey. Survivors provided information on health and quality of life (using the Functional Assessment of Cancer Therapy Questionnaire). Caregivers provided sociodemographic information, impact of caring on their time and finances, as well as their level of social support (Oslo Support Scale), loneliness (3-point loneliness scale), and completed the Worry of Cancer Scale (to measure FOR). RESULTS Data from 180 dyads were available for analysis. Multiple regression analysis was used to examine the role of caregiver stressors, social support, and loneliness while controlling for caregiver and survivor characteristics. The model explained 28% of the variance in Worry of Cancer scores (FOR). Caregivers who reported more loneliness, spent more time caring, and had greater financial stress from caring had higher scores on Worry of Cancer (FOR). Female caregivers, those caring for younger survivors, and those with survivors who had undergone less extensive forms of surgery also reported higher FOR. DISCUSSION A combination of factors place caregivers at greater risk of cancer-related worry, paving the way for designing interventions aimed at reducing FOR in caregivers of patients with head and neck cancers.
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321
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Morris M, Marshall-Lucette S. The Experience of Myeloma Caregivers During Home-Based Oral Chemotherapy Treatment: A Qualitative Study. Semin Oncol Nurs 2017; 33:362-371. [PMID: 28751188 DOI: 10.1016/j.soncn.2017.05.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The primary aim of this qualitative study was to explore myeloma carers/caregivers experience during outpatient-based oral treatment for patients with multiple myeloma (MM). DATA SOURCES Literature review. In-depth, open-ended interviews of seven purposively selected caregivers of MM patients in the United Kingdom. CONCLUSION Findings showed that carers were involved in practical and emotional caregiving activities, assisting the patient with managing complex oral combination treatments, and monitoring side effects. Care-giving activities continued after treatment, and experiences were described within the context of the MM journey and fear and uncertainty about the future. Caregivers also experienced a range of emotions, which they often kept hidden from the MM patients and other family members. Difficulties balancing caring responsibilities, particularly for those with jobs, were expressed. IMPLICATIONS FOR NURSING PRACTICE Nurses need to understand the importance of considering carers' involvement when assessing patients, and the need to address caregivers' continuing support and information needs. Problems navigating health and social care processes should be anticipated, and nurses can direct the carers to appropriate resources to meet their needs.
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322
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Zeng F, Xu Q, Liu D, Luo H, Zhou YO, Ning W, Chen J, Zhang H, Liu H, Li Y, Zuo X. Relatives’ quality of life and psychological disturbance: a new concern of SLE management. Clin Rheumatol 2017; 37:67-73. [DOI: 10.1007/s10067-017-3743-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 06/12/2017] [Accepted: 06/27/2017] [Indexed: 11/29/2022]
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323
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Aubin M, Vézina L, Verreault R, Simard S, Desbiens JF, Tremblay L, Dumont S, Fillion L, Dogba MJ, Gagnon P. Effectiveness of an intervention to improve supportive care for family caregivers of patients with lung cancer: study protocol for a randomized controlled trial. Trials 2017; 18:304. [PMID: 28676071 PMCID: PMC5496252 DOI: 10.1186/s13063-017-2044-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 06/05/2017] [Indexed: 11/25/2022] Open
Abstract
Background Family caregivers (FC) often experience higher distress levels than their relative with cancer. Many cancer centers have implemented distress screening programs, but most of them concentrate their efforts on patients, with little attention to their FC. To fill this gap, a pragmatic intervention has been designed to improve supportive care for FC of patients with lung cancer. This article describes the study protocol of a single-center randomized controlled trial to assess its effectiveness. Methods/design A total of 120 lung cancer patients and their FC are randomly assigned to the experimental group (exposed to intervention, N = 60) or to the control group (usual care, N = 60). The intervention includes: (1) systematic FC distress screening and problem assessment near their relative’s cancer diagnosis, and every 2 months, (2) privileged contact with an oncology nurse (ON) away from the patient to address FC problems and (3) liaison by the ON with the family physician of FC reporting high distress (thermometer score ≥5/10), or problems relying on FP expertise. In both groups, FC, patient and process-of-care outcomes are measured at baseline and every 3 months, up to 9 months. The primary endpoint is FC distress measured by the Hospital Anxiety and Depression Scale (HADS) and the Psychological Distress Index used in the Quebec Health Survey (PDQHS). Individual interviews with 10 FC and a focus group with the oncology team will be conducted at the study end to further document the effectiveness of the intervention and its impact on quality of life (for FC) and practice organization (for the oncology team). Discussion This trial will assess the effectiveness of an innovative intervention based on interprofessional collaboration between primary care and oncology care. It targets a population in great need, yet often neglected, and has the potential to clearly improve patient and caregiver experience of cancer care, and reduce the burden of disease. Trial registration ClinicalTrials.gov, ID: NCT02531464. Registered on 15 July 2015. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-2044-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Michèle Aubin
- Research Centre of the Institut Universitaire de Cardiologie et de Pneumologie de Quebec (IUCPQ), Quebec, QC, Canada. .,Research Centre of Primary Care and Services-Université Laval (CERSSPL-UL), Quebec, QC, Canada. .,Research Centre of the CHU de Quebec, Quebec, QC, Canada. .,Department of Family Medicine and Emergency Medicine, Université Laval, Quebec, QC, Canada. .,Maison Michel-Sarrazin Research Team in Palliative Care and Psychosocial Oncology (ERMOS), Quebec, QC, Canada. .,Laval Family Medicine Unit, Université Laval, Quebec, QC, Canada. .,CIUSSS Capitale-Nationale , 2690, Chemin des Quatre-Bourgeois, Quebec, QC, G1V 0B7, Canada.
| | - Lucie Vézina
- Research Centre of the Institut Universitaire de Cardiologie et de Pneumologie de Quebec (IUCPQ), Quebec, QC, Canada.,Laval Family Medicine Unit, Université Laval, Quebec, QC, Canada
| | - René Verreault
- Research Centre of Primary Care and Services-Université Laval (CERSSPL-UL), Quebec, QC, Canada.,Department of Social and Preventive Medicine, Université Laval, Quebec, QC, Canada
| | - Sébastien Simard
- Research Centre of the Institut Universitaire de Cardiologie et de Pneumologie de Quebec (IUCPQ), Quebec, QC, Canada.,Maison Michel-Sarrazin Research Team in Palliative Care and Psychosocial Oncology (ERMOS), Quebec, QC, Canada.,Pulmonary Oncology Centre, IUCPQ, Quebec, QC, Canada
| | - Jean-François Desbiens
- Research Centre of the CHU de Quebec, Quebec, QC, Canada.,Maison Michel-Sarrazin Research Team in Palliative Care and Psychosocial Oncology (ERMOS), Quebec, QC, Canada.,Faculty of Nursing, Université Laval, Quebec, QC, Canada
| | - Lise Tremblay
- Research Centre of the Institut Universitaire de Cardiologie et de Pneumologie de Quebec (IUCPQ), Quebec, QC, Canada.,Pulmonary Oncology Centre, IUCPQ, Quebec, QC, Canada.,Department of Medicine, Université Laval, Quebec, QC, Canada
| | - Serge Dumont
- Research Centre of Primary Care and Services-Université Laval (CERSSPL-UL), Quebec, QC, Canada.,Research Centre of the CHU de Quebec, Quebec, QC, Canada.,Maison Michel-Sarrazin Research Team in Palliative Care and Psychosocial Oncology (ERMOS), Quebec, QC, Canada.,Faculty of Social Sciences, Université Laval, Quebec, QC, Canada
| | - Lise Fillion
- Research Centre of the CHU de Quebec, Quebec, QC, Canada.,Maison Michel-Sarrazin Research Team in Palliative Care and Psychosocial Oncology (ERMOS), Quebec, QC, Canada.,Faculty of Nursing, Université Laval, Quebec, QC, Canada
| | - Maman Joyce Dogba
- Research Centre of Primary Care and Services-Université Laval (CERSSPL-UL), Quebec, QC, Canada.,Research Centre of the CHU de Quebec, Quebec, QC, Canada.,Department of Family Medicine and Emergency Medicine, Université Laval, Quebec, QC, Canada
| | - Pierre Gagnon
- Research Centre of Primary Care and Services-Université Laval (CERSSPL-UL), Quebec, QC, Canada.,Research Centre of the CHU de Quebec, Quebec, QC, Canada.,Maison Michel-Sarrazin Research Team in Palliative Care and Psychosocial Oncology (ERMOS), Quebec, QC, Canada.,Department of Psychiatry, Université Laval, Quebec, QC, Canada
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324
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Cuthbert CA, King-Shier K, Tapp D, Ruether D, Culos-Reed SN. Exploring Gender Differences in Self-Reported Physical Activity and Health Among Older Caregivers. Oncol Nurs Forum 2017. [PMID: 28632242 DOI: 10.1188/17.onf.435-445] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To document self-reported physical health and activity levels of older caregivers. Gender differences in physical health, physical activity levels, and predictors of physical activity were also examined.
. DESIGN A cross-sectional study.
. SETTING Tom Baker Cancer Centre in Calgary, Alberta, Canada.
. SAMPLE 130 caregivers aged 60 years or older caring for individuals with breast, prostate, or colorectal cancer.
. METHODS Self-report survey including validated questionnaires on physical and mental health and physical activity levels. Convenience sampling was used. Data were analyzed using descriptive statistics, correlations, and multiple regression.
. MAIN RESEARCH VARIABLES The physical component score of the SF-36v2® was the main research variable. Other variables included the mental component score of the SF-36v2, sleep quality, depression, social support, physical activity levels, and anxiety.
. FINDINGS The mean age of caregivers was 70 years. Physical health and physical activity levels were higher than population norms. A significant difference in physical health (p = 0.015) existed between men and women but not in physical activity levels (p = 0.079). Predictors of physical activity levels were age (β = -0.291), physical health (β = 0.307), and caregiving hours per week (β = -0.221).
. CONCLUSIONS The findings suggest that gender had a minimal effect on physical health and no effect on physical activity levels in older caregivers. Depression and poor sleep quality were high in some caregivers but did not predict physical activity levels.
. IMPLICATIONS FOR NURSING The negative effects of caregiving on physical health and physical activity levels in older caregivers are not universal. Nurses should be aware of the caregiving situation and promote health based on the individual.
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325
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Duggleby W, Tycholiz J, Holtslander L, Hudson P, Nekolaichuk C, Mirhosseini M, Parmar J, Chambers T, Alook A, Swindle J. A metasynthesis study of family caregivers' transition experiences caring for community-dwelling persons with advanced cancer at the end of life. Palliat Med 2017; 31:602-616. [PMID: 28618898 DOI: 10.1177/0269216316673548] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Family caregivers (broadly defined as family and friends) experience multiple concurrent transitions when caring for a person with advanced cancer. AIMS To (a) explore the transition experience of family caregivers caring for persons with advanced cancer living in the community, (b) describe potential triggers for transitions, (c) identify what influences this experience, and (d) develop a conceptual framework of their transition experience. DESIGN Sandelowski and Barroso's methodology for synthesizing qualitative research included (a) a comprehensive search of empirical literature, (b) quality appraisal of qualitative studies, (c) classification of studies, and (d) synthesis of the findings. DATA SOURCES Literature was sourced from six electronic data bases. Inclusion criteria were as follows: (a) published qualitative studies (and mixed-method designs) of the caregiving experience of family caregivers of community-living persons with advanced cancer at the end of life, (b) participants (caregivers and care recipients) of 18 years of age and above, (c) studies published in English in any country, and (d) studies published between 2004 and 2014. RESULTS A total of 72 studies were included in the metasynthesis. Family caregivers experience a "life transition" whereby their lives are permanently altered. The participants described the process of redefining normal which consisted of coming to terms with their situation and connecting with others. Outcomes of these processes were as follows: (a) maintaining a sense of personhood, (b) reframing hope, (c) maintaining self-efficacy, (d) finding meaning, and (e) preparing for the death of their care recipient. CONCLUSION The findings provide a framework to guide the development of supportive programs and future research.
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Affiliation(s)
- Wendy Duggleby
- 1 Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Jamie Tycholiz
- 2 Strategic Planning and Policy Development, Alberta Health, Edmonton, AB, Canada
| | - Lorraine Holtslander
- 3 College of Nursing, University of Saskatchewan, Saskatoon, SK, Canada.,4 University of the Witwatersrand, Johannesburg, South Africa
| | - Peter Hudson
- 5 Centre for Palliative Care, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia.,6 The University of Melbourne, Melbourne, VIC, Australia.,7 Palliative Care, Queen's University Belfast, Belfast, UK
| | - Cheryl Nekolaichuk
- 8 Division of Palliative Care Medicine, Department of Oncology, University of Alberta, Edmonton, AB, Canada
| | - Mehrnoush Mirhosseini
- 8 Division of Palliative Care Medicine, Department of Oncology, University of Alberta, Edmonton, AB, Canada
| | - Jasneet Parmar
- 9 Department of Family Medicine, University of Alberta, Edmonton, AB, Canada.,10 Network of Excellence in Seniors' Health and Wellness, Covenant Health, Knoxville, TN, USA
| | - Thane Chambers
- 11 University of Alberta Libraries, Edmonton, AB, Canada
| | - Angele Alook
- 12 Alberta Union of Provincial Employees, Edmonton, AB, Canada
| | - Jennifer Swindle
- 1 Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
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326
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The effects of oncology massage on symptom self-report for cancer patients and their caregivers. Support Care Cancer 2017; 25:3645-3650. [PMID: 28660350 DOI: 10.1007/s00520-017-3784-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 06/07/2017] [Indexed: 01/15/2023]
Abstract
BACKGROUND Massage has shown benefit for symptomatic relief in cancer patients and their caregivers. We explored the effects of a single massage session on self-reported symptoms in an outpatient clinic at a comprehensive cancer center. METHODS Patients and caregivers receiving oncology massage treatments (30 or 60-min duration) at our Integrative Medicine Center outpatient clinic from September 2012 to January 2015 completed the Edmonton Symptom Assessment Scale (ESAS; 0-10 scale, 10 most severe) pre and post massage. ESAS individual items and subscales of physical distress (PHS), psychological distress (PSS), and global distress (GDS) were analyzed. We used paired t tests with a p value correction (i.e., p < .001) to examine symptoms pre/post massage. RESULTS Initial massage visits for 343 patients and 87 caregivers were analyzed. The highest symptom burdens (means) at baseline for patients were sleep 4.22, fatigue 3.57, and pain 2.94; for caregivers, sleep 3.77, well-being 3.01, and pain 2.59. Although patients reported significantly greater global distress and physical symptoms (p < .0001) compared to caregivers at baseline, groups did not differ in regard to psychological symptom burden (p = .66) and individual symptom scores (e.g., pain, sleep, spiritual pain). Massage therapy was associated with statistically (p < .0001) and clinically significant improvements in symptoms of pain, fatigue, anxiety, well-being, and sleep and ESAS subscales for both patients and caregivers. Greater massage duration (30 vs 60 min) did not lead to greater symptom reduction. CONCLUSIONS Patients and caregivers reported a moderately high symptom burden. A single massage treatment resulted in acute relief of self-reported symptoms in both groups. Further study is warranted regarding optimal massage dose and frequency.
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327
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Partner's survivorship care needs: An analysis in head and neck cancer patients. Oral Oncol 2017; 71:113-121. [PMID: 28688678 DOI: 10.1016/j.oraloncology.2017.06.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 06/05/2017] [Accepted: 06/15/2017] [Indexed: 11/22/2022]
Abstract
PURPOSE To determine the number, type and predictors of unmet needs for head and neck cancer (HNC) survivors' partner's. METHODS Partners of HNC patients were invited to complete the Cancer Survivors' Partners Unmet Needs Survey (CaSPUN). Analysis determined number, proportion and factors associated with greater unmet needs using linear regression. Agreement between the unmet needs of patients and their partners was determined. RESULTS Among the 44 partners participated 29 reported ≥1 unmet need and 4 had a very high number of needs (31-35). The most common unmet needs were related to concerns about cancer returning, coping with supporting someone with cancer, and the changes cancer has caused. The highest reported needs were in the Relationships domain. Increasing patient unmet needs was significantly associated with increasing partner unmet needs (p<0.01). CONCLUSIONS A significant proportion of head and neck cancer partners experience unmet needs, which often differ from the patient's needs.
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328
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Demographic characteristics, call details and psychosocial support needs of the family/friends of someone diagnosed with cancer who access Australian Cancer Council telephone information and support services. Eur J Oncol Nurs 2017; 28:86-91. [DOI: 10.1016/j.ejon.2017.03.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 03/21/2017] [Accepted: 03/29/2017] [Indexed: 11/23/2022]
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329
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Lambert S, Girgis A, Descallar J, Levesque JV, Jones B. Trajectories of mental and physical functioning among spouse caregivers of cancer survivors over the first five years following the diagnosis. PATIENT EDUCATION AND COUNSELING 2017; 100:1213-1221. [PMID: 28089132 DOI: 10.1016/j.pec.2016.12.031] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 11/30/2016] [Accepted: 12/29/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Identify the trajectories of physical and mental functioning among spouse caregivers of patients with cancer over the first five years post-diagnosis and variables associated with low or deteriorating functioning. METHODS Caregivers completed a survey at 6 months and 1, 2, 3.5, and 5 years post-patient diagnosis, including the SF-12 for quality of life (QOL). SF-12 Mental Component Summary (MCS, n=299) and Physical Component Summary (PCS, n=300) scores were analyzed using SAS. RESULTS Five trajectories for PCS were identified, the top three were: (a) high PCS (53.0%); (b) steady decline in PCS (17.0%); and (c) steady increase, but remaining below population norm (16.7%). Five trajectories for MCS were also identified, the top two being: (a) high MCS (45.8%) and (b) MCS comparable to population norm (27.8%). Variables associated with low or deteriorating QOL included depression, social support, coping, burden, and/or unmet needs. CONCLUSIONS This is the first study to document spouse caregivers' QOL over the first five years post-patient diagnosis. Although many participants experienced high functioning, almost a third reported low or deteriorating mental or physical functioning. PRACTICE IMPLICATIONS Variables associated with low or deteriorating mental and physical functioning can be targeted in future interventions.
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Affiliation(s)
- Sylvie Lambert
- Ingram School of Nursing, McGill University, Montreal, Canada; St. Mary's Research Centre, Montreal, Canada; Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, UNSW Medicine, University of New South Wales, Australia.
| | - Afaf Girgis
- Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, UNSW Medicine, University of New South Wales, Australia
| | - Joseph Descallar
- Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, The University of New South Wales, Liverpool, Australia
| | - Janelle V Levesque
- Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, UNSW Medicine, University of New South Wales, Australia
| | - Bobby Jones
- Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, USA
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330
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‘It’s not just the word care, it’s the meaning of the word…(they) actually care': caregivers’ perceptions of home-based primary care in Toronto, Ontario. AGEING & SOCIETY 2017. [DOI: 10.1017/s0144686x1700040x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
ABSTRACTThe frail and homebound older adult populations currently experience difficulties accessing primary care in the medical office. Given this fundamental access to care problem, and the questionable care quality that arises when navigating a labyrinthine health-care system, these populations have typically been subject to inadequate primary care. To meet their needs better, growing research stresses the importance of providing comprehensive home-based primary care (HBPC), delivered by an inter-professional team of health-care providers. Family care-givers typically provide the majority of care within the home, yet their perceptions of HBPC remain under-researched. The purpose of this study was to explore unpaid care-givers' perceptions of and experiences with HBPC programmes in Toronto, Canada. We conducted qualitative inductive content analysis, using analytic procedures informed by grounded theory, to discover a number of themes regarding unpaid care-givers' understandings of HBPC. Findings suggest that, compared to the standard office-based care model, HBPC may better support unpaid care-givers, providing them assistance with system navigation and offering them the peace of mind that they are not alone, but have someone to call should the need arise. The implications of this research suggest that HBPC could be a model to help mitigate the discontinuities in care that patients with comorbid chronic conditions and their attendant unpaid care-givers experience when accessing fragmented health, home and social care systems.
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331
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Saria MG, Nyamathi A, Phillips LR, Stanton AL, Evangelista L, Kesari S, Maliski S. The Hidden Morbidity of Cancer: Burden in Caregivers of Patients with Brain Metastases. Nurs Clin North Am 2017; 52:159-178. [PMID: 28189161 DOI: 10.1016/j.cnur.2016.10.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Caregiving is a highly individualized experience. Although numerous articles have been published on caregiver burden from a variety of diagnoses and conditions, this article presents the unique features of caregiving in patients with brain metastases. Improved long-term survival, concerns about disease recurrence or progression, the cancer experience (initial diagnosis, treatment, survivorship, recurrence, progression, and end of life), and the increasing complexity of cancer treatments add to the demands placed on the caregivers of patients with brain metastases. Health care professionals must identify caregiver burden and administer the appropriate interventions, which must be as unique and individualized as the caregivers' experiences.
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Affiliation(s)
- Marlon Garzo Saria
- Clinical Trials and Research, John Wayne Cancer Institute, Providence Saint John's Health Center, University of California, Los Angeles, School of Nursing, 2200 Santa Monica Boulevard, Santa Monica, CA 90404, USA.
| | - Adeline Nyamathi
- University of California, Los Angeles, School of Nursing, 700 Tiverton Avenue, Los Angeles, CA 90095, USA
| | - Linda R Phillips
- University of California, Los Angeles, School of Nursing, 700 Tiverton Avenue, Los Angeles, CA 90095, USA
| | - Annette L Stanton
- Department of Psychology, University of California, Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA 90095-1563, USA
| | - Lorraine Evangelista
- Nursing Science, University of California, Irvine, 106 Berk Hall, Irvine, CA 92697-3959, USA
| | - Santosh Kesari
- Department of Translational Neuro-Oncology and Neurotherapeutics, John Wayne Cancer Institute, Providence Saint John's Health Center, 2200 Santa Monica Boulevard, Santa Monica, CA 90404, USA
| | - Sally Maliski
- University of California, Los Angeles, School of Nursing, 700 Tiverton Avenue, Los Angeles, CA 90095, USA; University of Kansas Medical Center, University of Kansas School of Nursing, Mail Stop 2029, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA
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332
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Ross A, Shamburek R, Wehrlen L, Klagholz SD, Yang L, Stoops E, Flynn SL, Remaley AT, Pacak K, Shelburne N, Bevans MF. Cardiometabolic risk factors and health behaviors in family caregivers. PLoS One 2017; 12:e0176408. [PMID: 28472106 PMCID: PMC5417518 DOI: 10.1371/journal.pone.0176408] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 04/09/2017] [Indexed: 11/30/2022] Open
Abstract
The purpose of this study was to compare components of cardiometabolic risk and health behaviors of 20 family caregivers of allogeneic hematopoietic stem cell transplant patients to those of age, gender, and race/ethnicity-matched controls. A prospective, repeated measures design was used to compare cardiometabolic risk and health behaviors in caregivers and controls at three time-points: pre-transplantation, discharge, and six weeks post-discharge. Measures included components of metabolic syndrome, Reynolds Risk Score, NMR serum lipoprotein particle analyses, and the Health-Promoting Lifestyle Profile II (HPLP-II). Mixed-model repeated measure analyses were used. There were no between or within group differences in LDL cholesterol, HDL cholesterol, and triglycerides. There was a significant interaction effect between time and role in large VLDL concentration (VLDL-P) (F (2, 76) = 4.36, p = .016), with the trajectory of large VLDL-P increasing over time in caregivers while remaining stable in controls. Within caregivers, VLDL particle size (VLDL-Z) was significantly larger at time-point three compared to time-points one (p = .015) and two (p = .048), and VLDL-Z was significantly larger in caregivers than in controls at time point three (p = .012). HPLP-II scores were lower in caregivers than controls at all time-points (p < .01). These findings suggest that caregiving may have a bigger impact on triglycerides than on other lipids, and it is through this pathway that caregivers may be at increased cardiometabolic risk. More sensitive measurement methods, such as NMR lipoprotein particle analyses, may be able to detect early changes in cardiometabolic risk.
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Affiliation(s)
- Alyson Ross
- Nursing Department, Clinical Center, National Institutes of Health, Bethesda, Maryland, United States of America
- * E-mail:
| | - Robert Shamburek
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Leslie Wehrlen
- Nursing Department, Clinical Center, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Stephen D. Klagholz
- Nursing Department, Clinical Center, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Li Yang
- Nursing Department, Clinical Center, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Elyssa Stoops
- Nursing Department, Clinical Center, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Sharon L. Flynn
- Nursing Department, Clinical Center, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Alan T. Remaley
- Department of Laboratory Medicine, Clinical Center, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Karel Pacak
- National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Nonniekaye Shelburne
- National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Margaret F. Bevans
- Nursing Department, Clinical Center, National Institutes of Health, Bethesda, Maryland, United States of America
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333
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Association between family satisfaction and caregiver burden in cancer patients receiving outreach palliative care at home. Palliat Support Care 2017; 16:260-268. [DOI: 10.1017/s1478951517000232] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
ABSTRACTObjective:Little is known about the associations between family satisfaction with end-of-life care and caregiver burden. We conducted a researcher-assisted questionnaire survey to clarify the impact of caregiver burden on family satisfaction and to determine the types of burden that decrease family satisfaction.Method:Bereaved family caregivers of patients with advanced cancer who received our outreach palliative care service were retrospectively identified. Family satisfaction with the end-of-life care provided by the palliative care service and caregiver burden were quantified using the Japanese versions of the FAMCARE Scale and the Zarit Burden Interview (ZBI), respectively.Results:Our study subjects included 23 family caregivers. The mean scores on the FAMCARE Scale and the ZBI for the total population were 72.8 ± 11.2 and 22.8 ± 17.3, respectively, indicating moderate-to-high satisfaction and low-to-moderate burden. Caregiver burden had a strong negative correlation to family satisfaction with end-of-life care (Spearman's rho [ρ] = −0.560, p = 0.005), which remained after adjustment for potential confounders (standardized beta [β] = −0.563, p = 0.01). Several burden items—including loss of control, personal time, social engagement with others, feeling angry with the patient, feeling that the patient wants more help than he/she needs, and a wish to leave the care to someone else—were associated with decreased satisfaction. The major cause of dissatisfaction for family members included the information provided regarding prognosis, family conferences with medical professionals, and the method of involvement of family members in care decisions.Significance of results:Caregiver burden can be a barrier to family satisfaction with end-of-life care at home. A home care model focused on caregiver burden could improve end-of-life experiences for patients and family caregivers.
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334
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Tan JY, Molassiotis A, Lloyd-Williams M, Yorke J. Burden, emotional distress and quality of life among informal caregivers of lung cancer patients: An exploratory study. Eur J Cancer Care (Engl) 2017; 27. [PMID: 28417550 DOI: 10.1111/ecc.12691] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2017] [Indexed: 12/15/2022]
Abstract
This study was conducted to explore the interrelationships among caregiver burden, emotional status and quality of life (QoL) in caregivers of lung cancer patients, and to identify whether caregiver burden and health status are associated with patient emotional status and QoL. Forty-three dyads of lung cancer patients and their caregivers were included for analysis. Caregiver-reported outcomes were measured by Caregiver Burden Scale (CBS), Caregivers Quality of Life Index-Cancer (CQOLC) and Hospital Anxiety and Depression Scale (HADS), while patient-reported outcomes were collected by HADS and Lung Cancer Symptom Scale (LCSS). The majority of the CBS and CQOLC scores were significantly higher in anxious and depressed caregivers than non-anxious and non-depressed caregivers (p < .01 or .05). Caregivers of depressed patients experienced significantly greater emotional distress than those of non-depressed patients (p < .01). Significantly positive associations were identified among most of the CBS, CQOLC and caregiver HADS scores. Patient LCSS scores were positively correlated with the CBS and caregiver HADS scores, and patient HADS scores were also positively related to caregiver HADS scores. The close interrelationships between caregiver and patient health outcomes provide evidence that lung cancer patients and their caregivers should be viewed as a unit in future supportive service models.
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Affiliation(s)
- J-Y Tan
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong.,School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK
| | - A Molassiotis
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong.,School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK
| | - M Lloyd-Williams
- Institute of Psychology Health and Society, University of Liverpool, Liverpool, UK
| | - J Yorke
- School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK.,The Christie NHS Foundation Trust, Manchester, UK
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335
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Thomsen KT, Guldin MB, Nielsen MK, Ollars CL, Jensen AB. A process evaluation of systematic risk and needs assessment for caregivers in specialised palliative care. BMC Palliat Care 2017; 16:23. [PMID: 28390401 PMCID: PMC5385034 DOI: 10.1186/s12904-017-0196-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 03/23/2017] [Indexed: 11/29/2022] Open
Abstract
Background Caregiving is strenuous and it may be associated with adverse psychological outcomes. During the palliative care trajectory, there are unique opportunities for providing support and preventing poor bereavement outcome. However, the tasks of palliative care staff in relation to caregivers are often unclear in the daily practice. Assessment is recommended to establish risk and needs and standards for caregiver support are available. Still, the feasibility of applying these standards among caregivers in everyday clinical practice has not been tested so far. Methods This study tested the feasibility of an intervention based on key elements of the “Bereavement support standards for specialist palliative care services” in a Danish specialised palliative home care team. We followed the UK Medical Research Council’s guidelines for the process evaluation of complex interventions. The intervention consisted of: 1. Systematic risk and needs assessment for caregivers at care entry; 2. Interdisciplinary conference to prepare a support plan; 3. Targeted support; 4. The establishment of an electronic medical record for caregivers to document targeted support. Outcomes included the reach, fidelity and acceptability of the intervention as well as the assessment of contextual factors. Results The intervention reached 76 of 164 caregivers (46%). The interdisciplinary risk assessment and documentation of a support plan was conducted in 57 (75%) of the enrolled caregivers. Finally, a separate medical record was established according to the intervention blueprint for 62% of caregivers receiving targeted support. After managing initial challenges, palliative care staff reported that the intervention was useful and acceptable. Conclusion The intervention proved feasible and useful. Still, we identified barriers to the implementation which should be taken into consideration when planning implementation of a systematic risk and needs assessment and in the establishment of medical records for caregivers.
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Affiliation(s)
- Kia Toft Thomsen
- Department of Oncology, Aarhus University Hospital, Noerrebrogade 44, Aarhus C, 8000, Denmark.
| | - Mai-Britt Guldin
- Research Unit for General Practice, Department of Public Health, Aarhus University, Bartholins Allé 2, Aarhus C, 8000, Denmark.,The Palliative Team, Department of Oncology, Aarhus University Hospital, Noerrebrogade 44, Aarhus C, 8000, Denmark
| | - Mette Kjærgaard Nielsen
- Research Unit for General Practice, Department of Public Health, Aarhus University, Bartholins Allé 2, Aarhus C, 8000, Denmark
| | - Chaitali Laura Ollars
- Department of Oncology, Aarhus University Hospital, Noerrebrogade 44, Aarhus C, 8000, Denmark
| | - Anders Bonde Jensen
- Department of Oncology, Aarhus University Hospital, Noerrebrogade 44, Aarhus C, 8000, Denmark
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336
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Cuthbert CA, Culos-Reed SN, King-Shier K, Ruether JD, Bischoff MB, Tapp DM. Creating an upward spiral: A qualitative study of caregivers' experience of participating in a structured physical activity programme. Eur J Cancer Care (Engl) 2017; 26. [PMID: 28382645 DOI: 10.1111/ecc.12684] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2017] [Indexed: 11/30/2022]
Abstract
Family caregivers' physical and emotional well-being may be negatively impacted while in the caregiver role. Interventions to support caregiver health have largely focused on psychological support, with only a few studies to date evaluating the role of exercise. Of the exercise studies conducted, there has been one qualitative study examining caregivers' perspectives on the value and impact of this type of intervention. This qualitative study was part of a larger mixed methods investigation including a randomised controlled trial investigating the effects of a 24-week exercise programme for cancer caregivers conducted in western Canada. We aimed to explore cancer family caregivers' experience of participating in a structured exercise programme. We conducted face-to-face interviews with 20 of the participants from the exercise intervention and analysed transcribed data using Thorne's interpretive description as a guiding framework. Two main patterns characterised the experiences of the caregivers. The metaphor of a downward spiral represented the experience of being in the caregiver role, while the metaphor of an upward spiral represented the experience of participating in the exercise programme. Our findings highlight that caregivers valued the exercise programme, experienced positivity through exercise and the group-based format, and noticed improvements to their physical and emotional well-being.
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Affiliation(s)
- C A Cuthbert
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada.,Alberta Health Services, Cancer Care, Tom Baker Cancer Center, Calgary, AB, Canada
| | - S N Culos-Reed
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada.,Cumming School of Medicine, Division of Medical Oncology, Department of Psychosocial Oncology, University of Calgary, Calgary, AB, Canada
| | - K King-Shier
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada.,Cumming School of Medicine, Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - J D Ruether
- Alberta Health Services, Cancer Care, Tom Baker Cancer Center, Calgary, AB, Canada.,Cumming School of Medicine, Division of Medical Oncology, University of Calgary, Calgary, AB, Canada
| | - M B Bischoff
- Faculty of Communication, Media and Film, University of Calgary, Calgary, AB, Canada
| | - D M Tapp
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
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337
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Frambes D, Given B, Lehto R, Sikorskii A, Wyatt G. Informal Caregivers of Cancer Patients: Review of Interventions, Care Activities, and Outcomes. West J Nurs Res 2017; 40:1069-1097. [PMID: 28381113 DOI: 10.1177/0193945917699364] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Family and friends are important resources for patients during cancer treatment and warrant an expanded review of not only what they contribute to patient care but also the support they need and the personal consequences of caregiving. A review of 14 randomized controlled trials published between 2009 and 2016 was completed utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The results of this review expand the scope of what is known regarding relationships among supportive interventions for caregivers, activities performed to care for cancer patients, caregiver characteristics, and health outcomes of caregivers. Specific results include (a) updated synthesis of literature associated with variables important to caregiving, (b) attention to interventions designed to support caregivers,
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Affiliation(s)
- Dawn Frambes
- 1 Michigan State University, East Lansing, MI, USA.,2 Calvin College, Grand Rapids, MI, USA
| | | | | | | | - Gwen Wyatt
- 1 Michigan State University, East Lansing, MI, USA
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338
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Screening for symptom burden and supportive needs of patients with glioblastoma and brain metastases and their caregivers in relation to their use of specialized palliative care. Support Care Cancer 2017; 25:2761-2770. [PMID: 28357650 DOI: 10.1007/s00520-017-3687-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 03/21/2017] [Indexed: 12/25/2022]
Abstract
PURPOSE Patients with brain tumors have a high symptom burden and multiple supportive needs. Needs of caregivers are often unattended. This study aims to determine screening-based symptom burden and supportive needs of patients and caregivers with regard to the use of specialized palliative care (SPC). METHODS Seventy-nine patients with glioblastoma and brain metastases and 46 caregivers were screened with standardized questionnaires following diagnosis and 2 months later. The screening assessed symptom burden, quality of life (QoL), distress, and supportive needs. RESULTS The most relevant symptoms were drowsiness, tiredness, and low well-being (53-58%). The most prevalent patient supportive needs were the need for information about available resources, the illness, and possible lifestyle changes (50-56%). The most prevalent caregiver needs were information about the illness, lifestyle changes, and about available resources (56-74%). Patients who received SCP and their caregivers had higher symptom burden and supportive needs than those without SPC. They reported moderate improvement in pain, distress, and QoL, while patients without SPC also improved their QoL, but had small to moderate deteriorations in pain, drowsiness, nauseas, well-being, and other problems. Distress of caregivers with SPC improved with moderate to large effect sizes but still was on a high level and remained stable for those without SPC. CONCLUSIONS Symptom burden and supportive needs were high, but even more caregivers than patients expressed high distress and supportive needs. SPC appears to reach the target group, both patients and caregivers with elevated symptom burden. Targeted interventions are needed to improve tiredness and drowsiness.
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339
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Yu H, Li L, Liu C, Huang W, Zhou J, Fu W, Ma Y, Li S, Chang Y, Liu G, Wu Q. Factors associated with the quality of life of family caregivers for leukemia patients in China. Health Qual Life Outcomes 2017; 15:55. [PMID: 28330476 PMCID: PMC5363014 DOI: 10.1186/s12955-017-0628-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 03/14/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The leukemia affects not only the quality of life (QOL) of patients with the disease but also that of their family caregivers (FCs). The research studies on QOL of FCs for leukemia patients are limited. This study aimed to evaluate the QOL of FCs for leukemia patients in Heilongjiang province, China. METHODS A cross-sectional questionnaire survey was undertaken with 309 FCs for leukemia patients recruited from three hospitals in Heilongjiang province. The QOL of the participants was assessed using the Chinese version of WHOQOL-BREF. Multivariate regression models were established to determine the predictors of the QOL of FCs, including the socio-economic characteristics of patients and FCs, and the emotional distress, social support and family functions of FCs. RESULTS The FCs had low QOL scores in all four domains: 12.7 ± 2.8 for physical, 12.2 ± 2.5 for psychological, 13.2 ± 2.9 for social and 11.3 ± 2.5 for environment. Social support is a major predictor of the QOL of FCs, with a standardized β coefficient of "high support" ranging from 0.41 to 0.58 for the four domains, followed by family function (β = 0.37 ~ 0.44 for psychological, social and environmental domains). The FCs who were older, highly educated, had no religious belief, suffered from a higher level of emotional distress, and provided care to younger patients and the patients without insurance coverage had lower QOL than the others. CONCLUSION The study provides some important insights into the QOL of FCs for leukemia patients. The QOL of FCs for leukemia patients is low and low levels of support to FCs are a major predictor of low QOL of FCs.
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Affiliation(s)
- Hongjuan Yu
- Department of Hematology, the First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, 150001, China
| | - Limin Li
- Department of Hematology, the First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, 150001, China
| | - Chaojie Liu
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, 3086, Australia
| | - Weidong Huang
- School of Health Management, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin, 150086, China.
| | - Jin Zhou
- Department of Hematology, the First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, 150001, China
| | - Wenqi Fu
- School of Health Management, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin, 150086, China
| | - Yi Ma
- School of Health Management, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin, 150086, China
| | - Si Li
- Department of Hematology, the First Hospital of Harbin, Harbin, Heilongjiang, 100730, China
| | - Yuying Chang
- Department of Hematology, the Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, 150081, China
| | - Guoxiang Liu
- School of Health Management, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin, 150086, China.
| | - Qunhong Wu
- School of Health Management, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin, 150086, China.
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340
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Simoneau TL, Kilbourn K, Spradley J, Laudenslager ML. An evidence-based stress management intervention for allogeneic hematopoietic stem cell transplant caregivers: development, feasibility and acceptability. Support Care Cancer 2017; 25:2515-2523. [PMID: 28283805 DOI: 10.1007/s00520-017-3660-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 03/06/2017] [Indexed: 01/05/2023]
Abstract
PURPOSE Caregivers of cancer patients face challenges impacting their physical, psychological and social well-being that need attention in the form of well-designed and tested interventions. We created an eight-session individual stress management intervention for caregivers of allogeneic hematopoietic stem cell transplant (Allo-HSCT) recipients. This intervention, tested by randomized control trial, proved effective in decreasing distress. Herein, we describe the intervention including theoretical framework, development, and elements of fidelity. Implementation challenges along with recommendations for refinement in future studies are discussed with the goal of replication and dissemination. METHODS Seventy-four of 148 caregivers received stress management training following randomization. The intervention occurred during the 100-day post-transplant period when caregivers are required. The training provided integrated cognitive behavioral strategies, psychoeducation, and problem-solving skills building as well as use of a biofeedback device. RESULTS Seventy percent of caregivers completed all eight sessions indicating good acceptability for the in-person intervention; however, most caregivers did not reliably use the biofeedback device. The most common reason for drop-out was their patient becoming gravely ill or patient death. Few caregivers dropped out because of study demands. The need for flexibility in providing intervention sessions was key to retention. CONCLUSION Our evidence-based stress management intervention for Allo-HSCT caregivers was feasible. Variability in acceptability and challenges in implementation are discussed and suggestions for refinement of the intervention are outlined. Dissemination efforts could improve by using alternative methods for providing caregiver support such as telephone or video chat to accommodate caregivers who are unable to attend in-person sessions.
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Affiliation(s)
- Teresa L Simoneau
- VA Eastern Colorado Healthcare System, 1020 Johnson Rd., Golden, CO, 80401, USA.
| | - Kristin Kilbourn
- Department of Psychology, University of Colorado Denver, Denver, CO, USA
| | - Janet Spradley
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Mark L Laudenslager
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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341
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Köhle N, Drossaert CHC, Jaran J, Schreurs KMG, Verdonck-de Leeuw IM, Bohlmeijer ET. User-experiences with a web-based self-help intervention for partners of cancer patients based on acceptance and commitment therapy and self-compassion: a qualitative study. BMC Public Health 2017; 17:225. [PMID: 28245794 PMCID: PMC5331662 DOI: 10.1186/s12889-017-4121-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2016] [Accepted: 02/08/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Partners of cancer patients are the cornerstone of supportive cancer care. They assume different roles and responsibilities that optimally support the patient. Such support is highly demanding, and many partners report (mental) health problems. However, many of them do not use professional supportive care themselves. Offering a Web-based self-help intervention based on Acceptance and Commitment Therapy (ACT) and self-compassion could be an important resource to support this group. This qualitative study aimed to examine user-experiences with a Web-based self-help intervention based on ACT and self-compassion among partners of cancer patients. METHODS Individual in-depth interviews, about partners' appreciation of the intervention and lessons learned, were conducted with 14 partners of cancer patients who used the Web-based self-help intervention. Interviews were audio-recorded, transcribed verbatim and analyzed by three independent coders both deductively and inductively. RESULTS In general, partners appreciated the intervention, however, they also expressed ambivalent feelings towards peer support, the content of the feedback of their counselor, and the 'tunneled' structure of the intervention. The majority of the partners reported being more self-compassionate accepting that they experienced negative thoughts and feelings, they reported that they learned to increase the distance between their thoughts and themselves, they indicated being more aware of their personal values, and they thought that they were better able to commit to those values. They also reported other (non-specific) helpful processes such as insight and acknowledgement, positivity, the possibility to tell their story, time for themselves, and feeling closer and more connected with their partner (the patient). CONCLUSIONS Partners of cancer patients indicated to appreciate the Web-based self-help intervention based on ACT and self-compassion. They felt that the intervention helped them to cope with negative emotions, thoughts, and one's suffering; to practice self-kindness; and to clarify values based on difficult recent experiences. In addition, they felt that the intervention supported them to obtain insight and acknowledgement, positivity, to tell their story, make time for themselves, and feeling closer and more connected with the patient. We think that a Web-based psychological intervention based on ACT and self-compassion may be a valuable contribution in supporting partners of cancer patients.
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Affiliation(s)
- Nadine Köhle
- Department of Psychology, Health & Technology, University of Twente, P.O. Box 217, 7500 AE, Enschede, The Netherlands.
| | - Constance H C Drossaert
- Department of Psychology, Health & Technology, University of Twente, P.O. Box 217, 7500 AE, Enschede, The Netherlands
| | - Jasmijn Jaran
- Department of Psychology, Health & Technology, University of Twente, P.O. Box 217, 7500 AE, Enschede, The Netherlands
| | - Karlein M G Schreurs
- Department of Psychology, Health & Technology, University of Twente, P.O. Box 217, 7500 AE, Enschede, The Netherlands.,Roessingh Research & Development, P.O. Box 310, 7500 AH, Enschede, The Netherlands
| | - Irma M Verdonck-de Leeuw
- Department of Clinical, Neuro-& Developmental Psychology, Section Clinical Psychology, VU University, van der Boechorststraat 1, 1082 BT, Amsterdam, The Netherlands.,Department of Otolaryngology/Head and Neck Surgery, VU University Medical Center, P.O Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - Ernst T Bohlmeijer
- Department of Psychology, Health & Technology, University of Twente, P.O. Box 217, 7500 AE, Enschede, The Netherlands
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342
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Frambes D, Lehto R, Sikorskii A, Tesnjak I, Given B, Wyatt G. Fidelity scorecard: evaluation of a caregiver-delivered symptom management intervention. J Adv Nurs 2017; 73:2012-2021. [PMID: 28122157 DOI: 10.1111/jan.13266] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2017] [Indexed: 11/27/2022]
Abstract
AIM To evaluate and quantify the intervention fidelity of a symptom management protocol through implementation of a scorecard, using an exemplar study of caregiver-delivered reflexology for people with breast cancer. BACKGROUND Studies on caregiver-delivered symptom management interventions seldom include adequate information on protocol fidelity, contributing to potentially suboptimal provision of the therapeutic intervention, hindering reproducibility and generalizability of the results. DESIGN Fidelity assessment of a 4-week intervention protocol in a randomized controlled trial (RCT) with data collection between 2012 - 2016. METHODS The National Institutes of Health Behaviour Change Consortium (NIH-BCC) conceptual model for intervention fidelity guided the study. The five NIH-BCC fidelity elements are: (1) dose; (2) provider training; (3) intervention delivery; (4) intervention receipt; and (5) enactment. To illustrate the elements, an intervention protocol was deconstructed and each element quantified using a newly developed fidelity scorecard. RESULTS Mean scores and frequency distributions were derived for the scorecard elements. For dose, the mean number of sessions was 4·4, 96% used the correct intervention duration and 29% had 4 weeks with at least one session. Provider training was achieved at 80% of the maximum score, intervention delivery was 96%, intervention receipt was 99% and enactment indicated moderate adoption at 3·8 sessions per patient. The sample mean score was 15·4 out of 16, indicating the high overall fidelity. CONCLUSION Research findings that include description of how fidelity is both addressed and evaluated are necessary for clinical translation. Clinicians can confidently recommend symptom management strategies to patients and caregivers when fidelity standards are explicitly reported and measured.
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Affiliation(s)
- Dawn Frambes
- Department of Nursing, Calvin College, Grand Rapids, MI, USA
| | - Rebecca Lehto
- College of Nursing, Michigan State University, East Lansing, MI, USA
| | - Alla Sikorskii
- College of Nursing, University of Arizona, Tucson, AR, USA
| | - Irena Tesnjak
- Department of Statistics and Probability, Michigan State University, East Lansing, MI, USA
| | - Barbara Given
- College of Nursing, Michigan State University, East Lansing, MI, USA
| | - Gwen Wyatt
- College of Nursing, Michigan State University, East Lansing, MI, USA
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343
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Ito E, Tadaka E. Quality of life among the family caregivers of patients with terminal cancer at home in Japan. Jpn J Nurs Sci 2017; 14:341-352. [DOI: 10.1111/jjns.12164] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 09/15/2016] [Accepted: 11/16/2016] [Indexed: 12/31/2022]
Affiliation(s)
- Eriko Ito
- Faculty of Medicine, Department of Community Health Nursing; Yokohama City University; Yokohama Japan
| | - Etsuko Tadaka
- Faculty of Medicine, Department of Community Health Nursing; Yokohama City University; Yokohama Japan
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344
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de Moor JS, Dowling EC, Ekwueme DU, Guy GP, Rodriguez J, Virgo KS, Han X, Kent EE, Li C, Litzelman K, McNeel TS, Liu B, Yabroff KR. Employment implications of informal cancer caregiving. J Cancer Surviv 2017; 11:48-57. [PMID: 27423439 PMCID: PMC5239760 DOI: 10.1007/s11764-016-0560-5] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 06/25/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE Previous research describing how informal cancer caregiving impacts employment has been conducted in small samples or a single disease site. This paper provides population-based estimates of the effect of informal cancer caregiving on employment and characterizes employment changes made by caregivers. METHODS The samples included cancer survivors with a friend or family caregiver, participating in either the Medical Expenditure Panel Survey Experiences with Cancer Survivorship Survey (ECSS) (n = 458) or the LIVESTRONG 2012 Survey for People Affected by Cancer (SPAC) (n = 4706). Descriptive statistics characterized the sample of survivors and their caregivers' employment changes. Multivariable logistic regression identified predictors of caregivers' extended employment changes, comprising time off and changes to hours, duties, or employment status. RESULTS Among survivors with an informal caregiver, 25 % from the ECSS and 29 % from the SPAC reported that their caregivers made extended employment changes. Approximately 8 % of survivors had caregivers who took time off from work lasting ≥2 months. Caregivers who made extended employment changes were more likely to care for survivors: treated with chemotherapy or transplant; closer to diagnosis or end of treatment; who experienced functional limitations; and made work changes due to cancer themselves compared to caregivers who did not make extended employment changes. CONCLUSIONS Many informal cancer caregivers make employment changes to provide care during survivors' treatment and recovery. IMPLICATIONS FOR CANCER SURVIVORS This study describes cancer caregiving in a prevalent sample of cancer survivors, thereby reflecting the experiences of individuals with many different cancer types and places in the cancer treatment trajectory.
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Affiliation(s)
- Janet S de Moor
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA.
- Healthcare Assessment Research Branch, Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, 3E438, MSC 9764, Bethesda, MD, 20892-9764, USA.
| | - Emily C Dowling
- Institute for Technology Assessment, Massachusetts General Hospital, Boston, MA, USA
| | - Donatus U Ekwueme
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Gery P Guy
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Juan Rodriguez
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Katherine S Virgo
- Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Xuesong Han
- Surveillance and Health Services Research Program, American Cancer Society, Atlanta, GA, USA
| | - Erin E Kent
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
| | - Chunyu Li
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kristen Litzelman
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
| | | | - Benmei Liu
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
| | - K Robin Yabroff
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
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345
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Janda M, Neale RE, Klein K, O'Connell DL, Gooden H, Goldstein D, Merrett ND, Wyld DK, Rowlands IJ, Beesley VL. Anxiety, depression and quality of life in people with pancreatic cancer and their carers. Pancreatology 2017; 17:321-327. [PMID: 28153446 DOI: 10.1016/j.pan.2017.01.008] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Revised: 01/19/2017] [Accepted: 01/19/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND People with pancreatic cancer have high levels of anxiety and depression and reduced quality of life (QoL), but few studies have assessed these outcomes for patient-carer dyads. We therefore investigated these issues in an Australian population-based study. METHODS Patients with pancreatic cancer (n = 136) and many of their carers (n = 84) completed the Hospital Anxiety and Depression Scale (HADS) and Functional Assessment of Cancer Therapy QoL questionnaire at a median of three months after diagnosis. Overall QoL and well-being subscales (physical, social, emotional, functional) were compared with general population norms. Intraclass correlation coefficients were used to compare anxiety, depression and QoL scores of patients and their respective carers. RESULTS Fifteen percent of patients and 39% of carers had HADS scores indicative of anxiety and 15% of patients and 14% of carers of depression, respectively. Overall, 70% of patients and 58% of carers had QoL scores below the Queensland population average. Patients' anxiety, depression, overall QoL, social, emotional and functional wellbeing scores were significantly related to those scores in their carers. Among patients and carers, accessing psychological help was associated with elevated anxiety. Not receiving chemotherapy was associated with elevated depression among patients and younger age was associated with poorer outcomes in carers. CONCLUSIONS More carers had symptoms of anxiety than patients with pancreatic cancer, but symptoms of depression were similarly common in patients and carers. Further research is needed to assess whether interventions to reduce patients' distress could also improve QoL among carers, or whether carer-focussed interventions are required.
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Affiliation(s)
- Monika Janda
- Institute for Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Rachel E Neale
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Kerenaftali Klein
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | | | - Helen Gooden
- Cancer Nursing Research Unit, University of Sydney, Sydney, Australia
| | - David Goldstein
- University of New South Wales, Sydney, Australia; Department of Medical Oncology, Prince of Wales Hospital, Sydney, Australia
| | - Neil D Merrett
- South Western Sydney Upper GI Surgical Unit, Bankstown Hospital, Sydney, Australia; Discipline of Surgery, University of Western Sydney, Sydney, Australia
| | - David K Wyld
- Department of Medical Oncology, Royal Brisbane and Women's Hospital, Brisbane, Australia; School of Medicine, University of Queensland, Brisbane, Australia
| | - Ingrid J Rowlands
- School of Public Health, University of Queensland, Brisbane, Australia
| | - Vanessa L Beesley
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia.
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346
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Sleep disturbances in caregivers of patients with advanced cancer: A systematic review. Palliat Support Care 2017; 15:125-140. [PMID: 28095943 DOI: 10.1017/s1478951516001024] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Sleep disturbances are a common issue for those who provide informal care to someone with a life-limiting condition. The negative consequences of poor sleep are well documented. The purpose of the present study was to determine the sleep patterns of caregivers of patients with advanced cancer. METHOD An extensive systematic review of studies reporting empirical sleep data was undertaken in 2015 in accordance with the PRISMA Statement. A total of eight electronic databases were searched, with no date restrictions imposed. Additionally, a search of the bibliographies of the studies identified during the electronic search was conducted. Search terms included: "sleep," "insomnia," "sleep disturbance," "circadian rhythm," "caregiver," "carer," "advanced cancer," "palliative cancer," and MESH suggestions. The inclusion criteria required studies to be in English and to report primary qualitative and/or quantitative research that examined sleep in caregivers of patients with advanced cancer. Unpublished studies, conference papers, and dissertations were excluded. RESULTS Overall, 10 studies met the inclusion criteria and were included in the review. Two major findings emerged from the data synthesis. First, at least 72% of caregivers reported moderate to severe sleep disturbance as measured by the Pittsburgh Sleep Quality Index. Second, objective measurement of caregivers' sleep identified that some caregivers experienced up to a 44% reduction in their total sleep time compared to the recommended eight hours. SIGNIFICANCE OF RESULTS Reduction in total sleep time appears to be the biggest issue facing caregivers' sleep. Future studies need to explore the specific factors that cause these sleep disturbances and thus help to identify interventions to optimize sleep.
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347
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The Perceptions of Important Elements of Caregiving for a Left Ventricular Assist Device Patient: A Qualitative Meta-Synthesis. J Cardiovasc Nurs 2017; 31:215-25. [PMID: 25882647 DOI: 10.1097/jcn.0000000000000242] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND The use of a left ventricular assist device (LVAD) is becoming increasingly common in patients with end-stage heart failure. Many LVAD programs require patients to have a caregiver before receiving a device. There are few studies exploring the experience, burden, and impacts on caregivers of patients with LVADs. OBJECTIVES The aim of this study was to synthesize the qualitative literature regarding caregiver's perceptions about caring for an adult LVAD patient. METHODS We searched MEDLINE, CINAHL, PsychInfo, and Web of Science to find English articles on the topic of LVAD caregiver's perceptions. The articles were then synthesized using a formal process of qualitative meta-synthesis. RESULTS Eight articles met criteria for inclusion. The meta-synthesis across the articles resulted in 8 themes categorized under 3 domains. Many of the articles suggested a longitudinal process of caregiving with perceptions largely dependent upon the time of interview in relation to the LVAD. The first domain of caregiving is the "early" stage, covering the life before the LVAD through the procedure. This phase is characterized by the pre-LVAD "emotional rollercoaster," the decision seen as "no option," and the thought of "leave it [the LVAD] at the hospital." The second domain is the "middle" stage, covering the time frame after discharge from the hospital. This phase is characterized by fragility of the patient, recognition of a need to adapt, and a transformed life. The final domain is "late LVAD" and describes how late in the LVAD process the LVAD indication (bridge to transplant or destination therapy) brings in to focus what is important to caregivers. CONCLUSIONS Existing literature indicates that the LVAD caregiver experience is intense as well as burdensome and entails the need to adapt to a new life. Given the burdens caregivers experience, clinicians and future research should explore strategies to support these important individuals.
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348
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Lee KC, Yiin JJ, Lu SH, Chao YF. The Burden of Caregiving and Sleep Disturbance Among Family Caregivers of Advanced Cancer Patients. Cancer Nurs 2017; 38:E10-8. [PMID: 24978619 DOI: 10.1097/ncc.0000000000000166] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Sleep disturbance may cause physical and psychological problems. The relationship between sleep disturbance and the burden of caregiving among family caregivers (FCs) has not previously been investigated. OBJECTIVE The purposes of this study were to (1) assess subjective and objective information on the sleep patterns of FCs of advanced cancer patients and (2) identify the components of caregiving burden that are risk factors for sleep disturbance among these FCs. METHODS A prospective, cross-sectional study of 176 FCs was conducted. Subjective and objective tools measuring sleep quality and caregiver burden were used. A hierarchical regression model was applied to identify the predictive factors for sleep disturbance among FCs. RESULTS Approximately 72.2% of FCs experienced sleep disturbance. The major sleep disturbance was frequent "wake after sleep onset" to provide patient care; a nap during the day was necessary. Correlations were strong between caregiver burden and sleep quality. The final regression model, which included subjective and objective burden, predicted 56.6% of the variance in sleep disturbance. CONCLUSIONS Sleep disturbance was common in FCs of advanced cancer patient, and our results demonstrated the relationship between sleep disturbance and caregiving burden. IMPLICATIONS FOR PRACTICE Family caregivers with risk factors for sleep disturbance should be identified and be provided resources for sleep quality improvement.
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Affiliation(s)
- Kwo-Chen Lee
- Author Affiliations: School of Nursing, China Medical University, and Department of Nursing, China Medical University Hospital, Taichung (Drs Lee and Lu); Neurosurgery, Veteran General Hospital, Taichung, and Graduate Institute of Medical Science, National Defense Medical Center, Taipei (Dr Yiin); and Department of Nursing, Mackay Medical College, New Taipei, Taiwan (Dr Chao)
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349
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Taleghani F, Ashouri E, Saburi M. Empathy, Burnout, Demographic Variables and their Relationships in Oncology Nurses. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2017; 22:41-45. [PMID: 28382057 PMCID: PMC5364751 DOI: 10.4103/ijnmr.ijnmr_66_16] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Development of nurse-patient empathic communication in the oncology ward is of great importance for the patients to relieve their psychological stress, however, nursing care of cancer patients is accompanied with high stress and burnout. The present study aimed to define the level of empathy and its association with burnout and some demographic characteristics of oncology nurses. MATERIALS AND METHODS This descriptive/correlation study was conducted in a professional cancer treatment center in Isfahan. Through census sampling, 67 oncology nurses were selected. The data collection tools were Jefferson Scale of Nursing Empathy, Maslach Burnout Inventory, and demographic characteristics questionnaire. RESULTS Mean nurses' empathy and overall burnout scores were 62.28 out of 100 and 38.8 out of 100, respectively. Score of empathy showed an inverse correlation with overall burnout score (r = -0.189, P = 0.04), depersonalization (r = -0.218, P = 0.02), and personal accomplishment (r = -0.265, P = 0.01). Multiple regression test was used to detect which dimension of burnout was a better predictor for the reduction of empathy score. Results showed that the best predictors were lack of personal accomplishment (P = 0.02), depersonalization (P = 0.04), and emotional exhaustion (P = 0.14), respectively. The most influential demographic factor on empathy was work experience (r = 0.304, P = 0.004). One-way analysis of variance showed that official staff had a higher empathy score (f = 2.39, P = 0.045) and their burnout was lower (f = 2.56, P = 0.04). CONCLUSIONS Results showed a negative relationship between empathy and burnout in oncology nurses. Therefore, nursing support from managers to reduce burnout increases empathic behavior of nurses.
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Affiliation(s)
- Fariba Taleghani
- Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Elaheh Ashouri
- Students Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Morteza Saburi
- Department of Nursing, Cancer Hospital, University of Medical Science, Isfahan, Iran
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350
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Cruz J, Marques A, Figueiredo D. Impacts of COPD on family carers and supportive interventions: a narrative review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2017; 25:11-25. [PMID: 26499310 DOI: 10.1111/hsc.12292] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/02/2015] [Indexed: 06/05/2023]
Abstract
Caring for a relative with chronic disease influences multiple dimensions of family carers' lives. This study aimed to provide an overview of the impacts of chronic obstructive pulmonary disease (COPD) on family carers and identify interventions aimed at supporting them. A narrative review was conducted. Searches were performed in electronic databases using a combination of keywords. Articles were screened for relevance and selected articles were analysed in two groups considering the study aims. Eighteen articles were selected. Fifteen studies evaluated the impacts of COPD on family carers and three studies presented interventions aimed at supporting them. Carers reported negative impacts of caring on physical health, emotional, social, relational and financial/employment life dimensions. Positive aspects of care-giving were reported in four studies and were related to carers' personal growth and satisfaction in being able to do something useful for their relatives. The existing interventions were directed at both patients and carers; however, studies provided limited information on how carers were involved, hindering the interpretation of findings. In conclusion, COPD poses several unique challenges to family carers related to the specificities of the disease. Further research with appropriate intervention studies is needed to promote carers' healthy adjustment to the disease.
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Affiliation(s)
- Joana Cruz
- Department of Health Sciences (SACS), University of Aveiro, Aveiro, Portugal
- School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal
| | - Alda Marques
- School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal
- Center for Health Technology and Services Research (CINTESIS), School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal
| | - Daniela Figueiredo
- School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal
- Center for Health Technology and Services Research (CINTESIS), School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal
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