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Nic Giolla Easpaig B, Newman B, Johnson J, Laidsaar-Powell R, Sansom-Daly UM, Jones L, Hofstätter L, Robertson EG, Mears S, Sattarshetty K, Harrison R. Supporting Carers: Study Protocol of a Meta-Review of Psychosocial Interventions for Carers of People With Cancer. JMIR Res Protoc 2024; 13:e56403. [PMID: 39269748 PMCID: PMC11437216 DOI: 10.2196/56403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 06/26/2024] [Accepted: 06/30/2024] [Indexed: 09/15/2024] Open
Abstract
BACKGROUND While there is a clear need for psychosocial interventions that promote the well-being of carers of patients with cancer, the corresponding evidence base is disparate, complex, and difficult for end users to navigate and interpret. Carers remain undersupported with a lack of dedicated, effective, evidence-based programs. We will conduct a meta-review to synthesize this evidence and determine the state of science in this field. OBJECTIVE This study aims to address the question, "what psychosocial interventions are available to promote the well-being of carers for people with cancer?" METHODS A meta-review will synthesize the relevant reviews of psychosocial interventions that have been developed and evaluated with carers for people with cancer. A total of 4 electronic databases (PsycInfo, MEDLINE, CINAHL, and Cochrane Database of Systematic Reviews) will be searched for reviews published between January 2013 and December 2023. A team-based approach will be taken for screening and assessment of the returned records against the eligibility criteria to determine inclusion. Included reviews will be critically appraised using the Joanna Briggs Institute Critical Appraisal Checklist for Systematic Reviews and Research Syntheses. Relevant data on study characteristics, carer and patient populations, intervention details, and psychosocial outcomes will be extracted, synthesized, and the findings will be presented in a narrative format. RESULTS It is anticipated that the study will be completed by October 2024. CONCLUSIONS Ensuring that carers have access to evidence-based programs that promote their well-being as they care for loved ones is critical. This meta-review will contribute to program development and translation efforts by providing a clear picture of the intervention evidence base of carers of patients with cancer and identifying notable strengths, weaknesses, and gaps across the literature. The findings are anticipated to offer future directions to advance research in the field. TRIAL REGISTRATION PROSPERO (CRD42023403219); https://tinyurl.com/4tnzv49s. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/56403.
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Affiliation(s)
- Brona Nic Giolla Easpaig
- School of Nursing, Charles Darwin University, Sydney, Australia
- Australian Institute for Health Innovation, Macquarie University, Sydney, Australia
| | - Bronwyn Newman
- Australian Institute for Health Innovation, Macquarie University, Sydney, Australia
| | - Judith Johnson
- School of Psychology, University of Leeds, Leeds, United Kingdom
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester, Manchester, United Kingdom
| | - Rebekah Laidsaar-Powell
- Psycho-Oncology Co-Operative Group (PoCoG), School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
| | - Ursula M Sansom-Daly
- School of Clinical Medicine, Discipline of Paediatrics & Child Health, UNSW Medicine and Health, University of New South Wales, Sydney, Australia
- Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia
- Sydney Youth Cancer Service, Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Sydney, Australia
| | - Lucy Jones
- Neuroblastoma Australia, Sydney, Australia
| | | | - Eden G Robertson
- School of Clinical Medicine, Discipline of Paediatrics & Child Health, UNSW Medicine and Health, University of New South Wales, Sydney, Australia
- Redkite, Sydney, Australia
| | - Stephen Mears
- Australian Institute for Health Innovation, Macquarie University, Sydney, Australia
| | | | - Reema Harrison
- Australian Institute for Health Innovation, Macquarie University, Sydney, Australia
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Wang Z. COGNITIVE BEHAVIORAL THERAPY MAY ALLEVIATE ANXIETY AND DEPRESSIVE SYMPTOMS IN ADVANCED CANCER PATIENTS. J Evid Based Dent Pract 2024; 24:102009. [PMID: 39174172 DOI: 10.1016/j.jebdp.2024.102009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/24/2024]
Abstract
ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION Tian L. Effects of cognitive behavioral therapy on anxiety and depressive symptoms in advanced cancer patients: A meta-analysis. Gen Hosp Psychiatry. 2024 Jan 20;87:20-32. doi:10.1016/j.genhosppsych.2024.01.006. Epub ahead of print. PMID: 38280276. SOURCE OF FUNDING This research was funded by the National College Students Innovation and Entrepreneurship Training Program (Grant No. 202310343044), and the Zhejiang University Student Science and Technology Innovation Activity Plan (Grant No. 2023R413038). CONFLICT OF INTEREST The authors have no actual or potential conflicts of interest. TYPE OF STUDY/DESIGN Systematic review with meta-analysis of data.
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Zhang M, Liu X, Huang Y. Are Art-Based Interventions Effective in Improving Psychological Well-Being Among Informal Caregivers of Cancer Patients? A Systematic Review. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2024. [PMID: 39093932 DOI: 10.1089/jicm.2023.0741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/04/2024]
Abstract
Objectives: To systematically synthesize the current evidence on the effects of art-based interventions on improving anxiety, depression, stress, sleep, and well-being of cancer caregivers. Design: A systematic review. Methods: We searched PubMed, EMBASE, Web of Science, CINAHL, PsycINFO, and Cochrane Central Register of Controlled Trials databases from their inception up to April 2024. Studies exploring the effects of art-based interventions on the psychological symptoms of cancer caregivers were included. We did not restrict the publication to the particular study designs, including randomized controlled trials, quasiexperimental studies, and qualitative studies. Results: Fifteen studies of 607 participants were identified in this systematic review. Overall, the existing studies provided preliminary evidence to suggest that art-based interventions may benefit cancer caregivers in improving anxiety, depression, stress, caregiver burden, and quality of life. However, the relatively low quality of the current evidence limits the efficacy of these findings. Conclusions: According to the existing evidence, the therapeutic benefits of using art-based interventions for improving the psychological well-being of cancer caregivers are uncertain. More high-quality and well-designed studies are still required to confirm the psychological effectiveness of art-based interventions for cancer caregivers in the future.
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Affiliation(s)
- Mengqin Zhang
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, Sichuan, China
| | - Xing Liu
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, Sichuan, China
| | - Yan Huang
- Department of Gynecological Nursing, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, Sichuan, China
- Department of Nursing, West China Second University Hospital, Sichuan University, Chengdu, China
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Poco LC, Malhotra C. More competent informal caregivers reduce advanced cancer patients' unplanned healthcare use and costs. Cancer Med 2024; 13:e7366. [PMID: 38872395 PMCID: PMC11176569 DOI: 10.1002/cam4.7366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 01/15/2024] [Accepted: 05/27/2024] [Indexed: 06/15/2024] Open
Abstract
BACKGROUND Patients with metastatic cancer experience high healthcare use and costs, most of which are unplanned. We aimed to assess whether patients with more competent informal caregivers have lower unplanned healthcare use and costs. METHODS This study used data from a prospective cohort of patients with solid metastatic cancer. Patients and their informal family caregivers were surveyed every 3 months until patients' death. Patients' unplanned healthcare use/costs were examined through hospital records. Caregivers responded to the 4-item Caregiver Competence Scale. First, in a deceased subsample of patients and their caregivers, we used patients' last 2 years of data (226 dyads) to assess the association between caregivers' competency (independent variable) and patients' unplanned healthcare use/costs (outcomes). Next, in a prospective sample of patient-caregiver dyads (up to 15 surveys), we assessed whether patients' functional well-being and psychological distress moderated the association between caregivers' competency and unplanned healthcare use/costs (311 dyads). RESULTS In the deceased subsample, during last 2 years of patients' life, caregivers' higher competency lowered the odds of patients' unplanned healthcare use [OR (CI) = 0.86 (0.75, 0.98), p = 0.03], and was associated with a significant reduction in unplanned healthcare costs [Coeff (CI) = -0.19 (-0.36, -0.01), p = 0.03]. In the prospective sample, patients' functional well-being and psychological distress moderated the association between caregivers' competency and patients' unplanned healthcare use/costs. CONCLUSION With deterioration in patients' condition and an increase in caregiving demands, improving caregivers' competency can reduce patients' unplanned healthcare use and costs. This should be further tested in future trials.
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Affiliation(s)
- Louisa Camille Poco
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore
| | - Chetna Malhotra
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
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Teo I, Paramasivam K, Chee WY, Ng C, Neo PSH, Lee GL. Deathbed experiences and meaning-making: Perspectives of family caregivers of patients who received cancer palliative care. Palliat Support Care 2024; 22:444-450. [PMID: 38053407 DOI: 10.1017/s1478951523001670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
OBJECTIVES The deathbed symbolizes a time when the patient is dangerously ill and where death is imminent. The memories of family caregivers during this time can potentially shape their meaning-making of the patient's death and bereavement adjustment. We aimed to understand the experiences of family caregivers at the deathbed of patients receiving palliative care. We also examined caregiver's meaning-making that occurred after the patient's death. METHODS In this retrospective qualitative study, family caregivers of cancer patients who received palliative care in Singapore were recruited through purposive sampling. In-person, semi-structured interviews were individually conducted with study participants to understand their experiences from a caregiver's perspective before and after the death of the patient. Thematic content analysis method was conducted. RESULTS A total of 25 bereaved family caregivers were interviewed, with spouses, adult children, and others comprising one-third each of the sample. Six themes emerged from caregivers' recollected experiences around the patient deathbed: Lasting image of the patient, A time of intense emotions, Healthcare providers prepare caregivers, A time for saying goodbye, Rituals provide comfort, and Impact on family ties. Four themes emerged surrounding post-loss meaning-making: An end to the pain and suffering, "Have I done enough?," Significance in the timing of events, and Gaining strength and personal growth. SIGNIFICANCE OF RESULTS The deathbed is a salient time for family caregivers as they prepare for patient's death. There are opportunities to provide support to the family based on the study findings.
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Affiliation(s)
- Irene Teo
- Department of Psychosocial Oncology, National Cancer Centre Singapore, Singapore
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
| | | | | | - Carolyn Ng
- Portland Institute for Loss and Transition, Portland, OR, USA
| | | | - Geok Ling Lee
- Department of Social Work, National University of Singapore, Singapore
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Cui P, Cheng C, An H, Chen X, Chen C, Hu H. A chain mediation model reveals the association between family sense of coherence and quality of life in caregivers of advanced cancer patients. Sci Rep 2024; 14:10701. [PMID: 38730003 PMCID: PMC11087510 DOI: 10.1038/s41598-024-61344-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 05/05/2024] [Indexed: 05/12/2024] Open
Abstract
Caregivers of advanced cancer patients face challenges impacting their quality of life (QoL). While evidence suggests that family sense of coherence (FSOC) can enhance individual psychological well-being and reduce distress symptoms, the precise mechanism through which FSOC improves caregivers' QoL remains unclear. This study aimed to explore the relationships among FSOC, psychological resilience, psychological distress, and QoL in primary caregivers of advanced cancer patients. A cross-sectional observational study was undertaken from June 2020 to March 2021 across five tertiary hospitals in China. Instruments included a general characteristic questionnaire, the Family Sense of Coherence Scale, the Patient Health Questionnaire-4, the 10-item Connor-Davidson Resilience Scale, and the 8-item SF-8 health survey. Pearson's correlation and chain mediation analyses were performed using IBM SPSS (version 21) and PROCESS macro (version 3.4). Out of 290 valid questionnaires, results demonstrated that FSOC directly and positively influences caregivers' QoL. Psychological distress partially mediated the FSOC-QoL association, with paths "FSOC-psychological distress-QoL" and "FSOC-psychological resilience-psychological distress-QoL" contributing 43.08% and 6.72% of the total effect, respectively. Furthermore, this study distinguished physical and mental aspects of QoL, confirming both conform to the chain mediation model. FSOC impacts caregivers' QoL directly and indirectly through the mediation of psychological distress and the chain mediation effect of "psychological resilience-psychological distress". These insights enhance our understanding of the complex interplay between FSOC and QoL, underscoring the potential benefits of bolstering FSOC to strengthen caregiver resilience, alleviate distress, and ultimately elevate their QoL.
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Affiliation(s)
- Panpan Cui
- Department of Nursing, Henan Provincial Key Medicine Laboratory of Nursing, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, No. 7 Weiwu Road, Zhengzhou, China
- School of Nursing, Zhengzhou University, Zhengzhou, China
| | - Chunyan Cheng
- Hematology Department, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Huiying An
- Gastroenterology, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Xinyi Chen
- Medical Oncology, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Changying Chen
- The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe Dong Road, Zhengzhou, China.
- Institute for Hospital Management of Henan Province, Zhengzhou, China.
| | - Hengyu Hu
- Department of Nursing, Henan Provincial Key Medicine Laboratory of Nursing, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, No. 7 Weiwu Road, Zhengzhou, China.
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Xia W, Zheng Y, Guo D, Zhu Y, Tian L. Effects of cognitive behavioral therapy on anxiety and depressive symptoms in advanced cancer patients: A meta-analysis. Gen Hosp Psychiatry 2024; 87:20-32. [PMID: 38280276 DOI: 10.1016/j.genhosppsych.2024.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 12/09/2023] [Accepted: 01/19/2024] [Indexed: 01/29/2024]
Abstract
OBJECTIVE To evaluate the effects of cognitive behavioral therapy on anxiety and depressive symptoms in patients with advanced cancer. METHODS A systematical search was conducted on Embase, PubMed, Web of Science, Cochrane Library, PsycINFO, Chinese Biomedical Database, CNKI, VIP Database, and Wanfang database, and the search time was from the inception to May 26, 2023. Randomized controlled trials focusing on the effects of cognitive behavioral therapy on anxiety and depressive symptoms in patients with advanced cancer were collected using relevant terms such as advanced stage, cancer, anxiety, depression, and cognitive behavioral therapy. The quality of included studies was evaluated using the Cochrane risk of bias (ROB 2.0) tool, and meta-analysis was performed using RevMan5.4 software. RESULTS 15 articles, including 1,597 patients, were included. Twelve of the studies reported the effect of CBT on anxiety symptoms in 1,485 advanced cancer patients; Fifteen studies reported the effect of CBT on depressive symptoms in 1,861 advanced cancer patients. The results of meta-analysis showed that CBT was effective in decreasing anxiety [SMD = -0.55, 95% CI (-0.82, -0.27), P < 0.001, I2 = 84%] and depressive symptoms [SMD = -0.38, 95% CI (-0.58, -0.17), P < 0.001, I2 = 78%] in patients with advanced cancer compared to controls, especially the interventions that were delivered lasted for 2-8 weeks. CONCLUSION Cognitive behavioral therapy lasting for 2-8 weeks is effective for anxiety and depressive symptoms in advanced cancer patients to a moderate degree, but more rigorous research is needed to guide the choice between online and face-to-face delivery mode and the priority of self-guided versus therapist-guided interventions still needs to be studied.
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Affiliation(s)
- Wangjie Xia
- The First Affiliated Hospital of Soochow University, Suzhou 215006, China; School of Nursing, Medical College of Soochow University, Suzhou 215006, China
| | - Yanping Zheng
- Suzhou hospital of Traditional Chinese Medicine, Suzhou 215007, China
| | - Daoxia Guo
- School of Nursing, Medical College of Soochow University, Suzhou 215006, China
| | - Yuelan Zhu
- The First People's Hospital of Kunshan, Suzhou 215000, China.
| | - Li Tian
- The First Affiliated Hospital of Soochow University, Suzhou 215006, China; School of Nursing, Medical College of Soochow University, Suzhou 215006, China.
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