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Rashid NSA, Mohamad Marzuki MF, Abdullah NN, Mohamad M, Takshe AA, Mohd Yunus R, Chen XW. Supporting caregivers of people with dementia: insights from Demensia KITA mobile application online content development. Sci Rep 2024; 14:19302. [PMID: 39164373 PMCID: PMC11336210 DOI: 10.1038/s41598-024-69947-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 08/12/2024] [Indexed: 08/22/2024] Open
Abstract
Dementia significantly impacts caregivers, particularly in low and middle-income countries where support is often inadequate. Given the gap in affordable and culturally relevant digital resources for Malaysian dementia caregivers, we developed "Demensia KITA," a mobile application (app) specifically tailored to their needs. This study utilized a theoretical framework proposed from existing literature and the "Model of Carer Stress and Burden". This paper discusses our app content development, highlighting key findings and challenges. To assess caregivers' needs, the Nominal Group Technique (NGT) with five dementia caregivers was conducted, followed by a Focus Group Discussion (FGD) with eight medical professionals. Both sessions were conducted online via Google Meet. In the NGT, ideas were generated, organized, prioritized, reviewed, and refined by medical professionals in the FGD. Content relevant to addressing the complexities of dementia caregiving was then discussed. Topics were either adapted from established modules or newly developed from credible sources. Subsequently, these were organized into modules and themes, and subsequently underwent expert validation. From the NGT, three key domains emerged: Knowledge, Services, and Support. These were further organized into two modules: 'Patient Care for Caregivers' and 'Caregiver Wellbeing'. Within these, twelve sub-modules were identified, covering a range of topics including basic knowledge on dementia, patient care, nutritional management, oral and dental care, simple exercises, daily activity and memory rehabilitation, service directories, support groups, emotional and stress management, welfare assistance, and daily motivation. This framework was developed to address the specific needs of dementia caregivers in terms of psychoeducation, psychosocial and caregiving skills, incorporating expert opinions in the field. This study corroborates the feasibility of online methods for mobile health app content development and encourages similar research. Future studies should evaluate Demensia KITA's effectiveness in alleviating caregiver burden across all regions, assess users' acceptance, and ensure it meets the evolving needs of Malaysian caregivers with regular updates.
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Affiliation(s)
- Nurul Syaireen A Rashid
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA Sungai Buloh, 47000, Shah Alam, Selangor Darul Ehsan, Malaysia
- Training Management Division, Ministry of Health, Menara Prisma Aras 6, Persiaran Perdana, Persint 3, 62675, Wilayah Persekutuan Putrajaya, Malaysia
| | - Muhamad Fadhil Mohamad Marzuki
- Kedah State Health Department, Ministry of Health Malaysia, Simpang Kuala, Jalan Kuala Kedah, 05400, Alor Setar, Kedah, Malaysia
| | - Nik Nairan Abdullah
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA Sungai Buloh, 47000, Shah Alam, Selangor Darul Ehsan, Malaysia
| | - Mariam Mohamad
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA Sungai Buloh, 47000, Shah Alam, Selangor Darul Ehsan, Malaysia
| | - Aseel A Takshe
- Department Public Health, Faculty of Communication, Arts and Sciences, Canadian University Dubai, Al Safa Street-Al Wasi City Walk Mall, P.O. Box 17781, Dubai, United Arab Emirates
| | - Raudah Mohd Yunus
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA Sungai Buloh, 47000, Shah Alam, Selangor Darul Ehsan, Malaysia
| | - Xin Wee Chen
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA Sungai Buloh, 47000, Shah Alam, Selangor Darul Ehsan, Malaysia.
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Badger T, Segrin C, Crane TE, Chalasani P, Arslan W, Hadeed M, Given CW, Sikorskii A. A sequential multiple assignment randomized trial of symptom management for cancer survivors during treatment and their informal caregivers. Support Care Cancer 2024; 32:523. [PMID: 39023547 DOI: 10.1007/s00520-024-08734-6] [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: 06/02/2023] [Accepted: 07/11/2024] [Indexed: 07/20/2024]
Abstract
CONTEXT Many cancer survivors and their informal caregivers experience multiple symptoms during the survivor's treatment. OBJECTIVE Test relative effectiveness and optimal sequencing of two evidence-based interventions for symptom management. METHODS In this sequential multiple assignment randomized trial (SMART), survivors of solid tumors with elevated depression or anxiety and their caregivers as dyads were initially randomized after baseline assessment in a 3:1 ratio to the Symptom Management and Survivorship Handbook (SMSH, N = 277 dyads) intervention or SMSH plus 8 weeks of telephone interpersonal counseling (TIPC, N = 97 dyads). After 4 weeks, survivors who were not responding (no improvement or worsening score on depression and/or anxiety item) to SMSH only and their caregivers were re-randomized to continue with SMSH alone (N = 44 dyads) to give it more time or to SMSH + TIPC (N = 44 dyads). Mixed effects and generalized linear models compared severity of depression, anxiety, and a summed index of 16 other symptoms over weeks 1-13 and week 17 between randomized groups and among three dynamic treatment regimes (DTRs). Dyads received SMSH only for 12 weeks (DTR1); SMSH for 12 weeks with 8 weeks of TIPC added from week 1 (DTR2); and SMSH for 4 weeks followed by the combined SMSH + TIPC for 8 weeks if no response at 4 weeks (DTR3). RESULTS Survivors randomized initially to SMSH alone had significantly lower anxiety over weeks 1-13 compared to those randomized to the combined SMSH + TIPC. In comparing DTRs, survivor's anxiety was significantly lower at week 13 for DTR1 compared to DTR2 with no other main effects for survivors or caregivers. Exploratory moderation analyses indicated a potential benefit of adding TIPC for caregivers of non-responders with elevated baseline symptoms. CONCLUSION SMSH + TIPC did not result in better symptom outcomes at week 17 than SMSH alone. Lower intensity SMSH may improve depression and anxiety symptoms for most survivors and their caregivers. TRIAL REGISTRATION Clinicaltrails.gov ID number, NCT03743415; approved and posted on 11/16/2018.
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Affiliation(s)
- Terry Badger
- College of Nursing, University of Arizona, 1305 N. Martin Avenue, Tucson, AZ, 85721, USA.
| | - Chris Segrin
- Department of Communication, University of Arizona, Tucson, AZ, 85721, USA
| | - Tracy E Crane
- Division of Medical Oncology, Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Pavani Chalasani
- Division of Hematology-Oncology, George Washington University, Washington, DC, USA
| | - Waqas Arslan
- College of Medicine, University of Arizona, Phoenix, AZ, USA
| | - Mary Hadeed
- College of Nursing, University of Arizona, 1305 N. Martin Avenue, Tucson, AZ, 85721, USA
| | - Charles W Given
- College of Nursing, Michigan State University, East Lansing, MI, USA
| | - Alla Sikorskii
- Department of Psychiatry, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, USA
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Shaffer KM, Perepezko K, Glazer JV, Mattos MK, Klinger J, Buysse DJ, Ritterband LM, Donovan H. Caregiver Experiences With an Internet-Delivered Insomnia Intervention: SHUTi-CARE Trial Primary Qualitative Analysis. Ann Behav Med 2024:kaae041. [PMID: 38990523 DOI: 10.1093/abm/kaae041] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2024] Open
Abstract
BACKGROUND Digital health interventions show potential to increase caregivers' access to psychosocial care; however, it is unclear to what extent existing interventions may need to be tailored to meet caregivers' unique needs. PURPOSE This study aimed to determine whether-and if so, how-an efficacious Internet-delivered insomnia program should be modified for caregivers. The generalizability of these findings beyond the tested program was also examined. METHODS Higher-intensity family caregivers (N = 100; age M = 52.82 [SD = 13.10], 75% non-Hispanic White, 66% ≥college degree) received access to an Internet-based cognitive-behavioral therapy for insomnia (CBT-I) program. Participants who completed one or more intervention "Cores" provided open-ended feedback on their experience; nonusers (completed no Cores) shared their barriers. RESULTS Most caregivers who used the program (n = 82, 82%) found it feasible, citing its user-friendly, fully automated online format. Many reported that CBT-I strategies were helpful, although some faced challenges in implementing these strategies due to the unpredictability of their caregiving responsibilities. Opinions were divided on the utility of tailoring the program for caregivers. Nonusers (n = 18, 18%) primarily cited concerns about time burden and lifestyle compatibility as usage barriers. CONCLUSIONS Delivering fully automated behavioral interventions through the Internet appears suitable for many caregivers. Extensive tailoring may not be required for most caregivers to benefit from an existing online CBT-I program, although additional guidance on integrating CBT-I strategies in the context of challenging sleep schedules and environments may help a subset of caregivers. Future research should explore how such tailoring may enhance digital health intervention uptake and effectiveness for caregivers.
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Affiliation(s)
- Kelly M Shaffer
- Center for Behavioral Health and Technology, University of Virginia, Charlottesville, VA, USA
- School of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Kate Perepezko
- National Center on Family Support, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jillian V Glazer
- Center for Behavioral Health and Technology, University of Virginia, Charlottesville, VA, USA
| | - Meghan K Mattos
- Center for Behavioral Health and Technology, University of Virginia, Charlottesville, VA, USA
- School of Nursing, University of Virginia, Charlottesville, VA, USA
| | - Julie Klinger
- National Center on Family Support, University of Pittsburgh, Pittsburgh, PA, USA
| | - Daniel J Buysse
- School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Lee M Ritterband
- Center for Behavioral Health and Technology, University of Virginia, Charlottesville, VA, USA
- School of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Heidi Donovan
- National Center on Family Support, University of Pittsburgh, Pittsburgh, PA, USA
- School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
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Wang Y, Seplaki CL, Norton SA, Williams AM, Kadambi S, Loh KP. Communication between Caregivers of Adults with Cancer and Healthcare Professionals: a Review of Communication Experiences, Associated Factors, Outcomes, and Interventions. Curr Oncol Rep 2024; 26:773-783. [PMID: 38777979 DOI: 10.1007/s11912-024-01550-5] [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] [Accepted: 05/13/2024] [Indexed: 05/25/2024]
Abstract
PURPOSE OF REVIEW Family/unpaid caregivers play an important role in cancer care. This review aims to summarize caregiver communication experiences with healthcare professionals (HCPs). RECENT FINDINGS The Caregiver-Centered Communication model defines five core functions that HCPs should achieve when interacting with caregivers, including fostering relationships, exchanging information, recognizing and responding to caregiver emotions, aiding in decision making, and assisting in patient care management. The literature shows that caregivers have both positive and negative communication experiences with HCPs with respect to these five core functions. Factors at the caregiver (e.g., demographic characteristics, information sources, caregiving duration, health status), patient (e.g., demographic and clinical characteristics), and HCP levels (e.g., time constraints in clinical settings, communication skills) are associated with caregiver-HCP communication quality. Studies further show that these communication experiences may affect caregiver outcomes, including quality of life, mental health, resilience, and satisfaction with cancer care. Moreover, poor quality caregiver-HCP communication is associated with patient readmission to the hospital and unmet care needs. Interventions for caregivers or patient-caregiver dyads have been shown to enhance caregiver confidence and increase their engagement in communication with HCPs. Interventions for HCPs have shown efficacy in improving their communication skills, particularly in involving caregivers in decision-making discussions. Given time constraints during medical visits, we suggest conducting a caregiver assessment by navigators prior to visits to understand their communication needs. Additionally, reimbursing HCPs for time spent communicating with caregivers during visits could be beneficial. More research is needed to better understand how to enhance caregiver-HCP communication quality.
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Affiliation(s)
- Ying Wang
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Christopher L Seplaki
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Sally A Norton
- School of Nursing, University of Rochester Medical Center, Rochester, NY, USA
| | - AnnaLynn M Williams
- Division of Supportive Care in Cancer, Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA
| | - Sindhuja Kadambi
- Division of Hematology/Oncology, Department of Medicine, James P Wilmot Cancer Institute, University of Rochester Medical Center, 601 Elmwood Avenue, Box 704, Rochester, NY, 14642, USA
| | - Kah Poh Loh
- Division of Hematology/Oncology, Department of Medicine, James P Wilmot Cancer Institute, University of Rochester Medical Center, 601 Elmwood Avenue, Box 704, Rochester, NY, 14642, USA.
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Zeng Z, Holtmaat K, Koole SL. Psychological care for cancer survivors: a 2 × 2 model of interpersonal emotion regulation by caregivers. Front Psychol 2024; 15:1390692. [PMID: 38979076 PMCID: PMC11228138 DOI: 10.3389/fpsyg.2024.1390692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 06/05/2024] [Indexed: 07/10/2024] Open
Affiliation(s)
- Zihao Zeng
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam Public Health, Mental Health, Amsterdam, Netherlands
- School of Educational Science, Hunan Normal University, Changsha, China
| | - Karen Holtmaat
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam Public Health, Mental Health, Amsterdam, Netherlands
| | - Sander L Koole
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam Public Health, Mental Health, Amsterdam, Netherlands
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Fenton ATHR, Ornstein KA, Kent EE, Miller-Sonet E, Wright AA, Dionne-Odom JN. A comparison of adult-child and spousal cancer caregivers' participation in medical decisions. PLoS One 2024; 19:e0300450. [PMID: 38870142 PMCID: PMC11175391 DOI: 10.1371/journal.pone.0300450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 02/28/2024] [Indexed: 06/15/2024] Open
Abstract
BACKGROUND Family caregivers often play a key role in medical decision-making for patients with cancer. Adult-children account for nearly half of caregivers, but often have less experience with serious illness care and decision-making and face unique relational challenges as the patient's child. Yet little research explores the potentially distinctive decision-making, involvement in decisions, and support needs of adult-child caregivers. METHODS Analysis of survey data of U.S. cancer caregivers conducted by CancerCare® in 2021. Chi-square tests and multivariable regression models assessed whether adult-child and spousal caregivers differed on the type of medical decisions they participated in (e.g., treatment planning, medication management), who made the decision (e.g., caregiver or joint decision), and the resources that informed decisions (e.g., friends and family, education materials). RESULTS Adult-children (N = 892) were less likely than spouses (N = 314) to participate in treatment planning (beta = -0.41; 95%CI = -0.81,-0.01), but more likely to be involved in decisions about whether to challenge medical authority (e.g., seeking alternative treatment, second opinion) (beta = 0.50; 95%CI = 0.22,0.78). Compared to spouses, adult-children made joint decisions with patients less often (-13.2-percentage points; 95%CI = -19.64,-6.67) and acted as primary decision-maker more frequently (5.60-percentage points; 95%CI = 0.01,10.43). More adult-children than spouses sought help and information regarding decisions from the oncology team (8.42-percentage points; 95%CI = 1.98,14.87) and friends and family (7.91-percentage points; 95%CI = 1.34,14.48). CONCLUSIONS How cancer caregivers and patients are related to each other shapes caregivers' medical decision-making. Adult-children's and spouses' probabilities of participating in and influencing decisions differed for certain types of decisions while adult-children were more likely to seek information and social support regarding decisions. These findings highlight the importance of the patient's and caregiver's relationship type in medical decision-making, suggesting that decision support programs may be more effective if they tailor programs by relationship type.
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Affiliation(s)
- Anny T. H. R. Fenton
- Division of Population Sciences, Dana Farber Cancer Institute, Boston, MA, United States of America
| | - Katherine A. Ornstein
- Center for Equity in Aging, Johns Hopkins University School of Nursing, Baltimore, MD, United States of America
| | - Erin E. Kent
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, NC, United States of America
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, Chapel Hill, NC, United States of America
| | | | - Alexi A. Wright
- Division of Population Sciences, Dana Farber Cancer Institute, Boston, MA, United States of America
- Harvard Medical School, Boston, MA, United States of America
| | - J. Nicholas Dionne-Odom
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, United States of America
- Division of Gerontology, Geriatrics and Palliative Care, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States of America
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Henderson NL, Padalkar T, Bourne G, Hendrix EK, Williams CP, Odom JN, Triebel K, Rocque GB. Assessing the association between quantity and quality of family caregiver participation in decision-making clinical encounters on patient activation in the metastatic breast cancer setting. Support Care Cancer 2024; 32:422. [PMID: 38858225 PMCID: PMC11164765 DOI: 10.1007/s00520-024-08593-1] [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: 11/28/2023] [Accepted: 05/20/2024] [Indexed: 06/12/2024]
Abstract
OBJECTIVE Caregivers support individuals undergoing cancer treatment by assisting with activities, managing care, navigating healthcare systems, and communicating with care teams. We explored the quality and quantity of caregiver participation during recorded decision-making clinical appointments in women with metastatic breast cancer. METHODS This was a convergent parallel mixed methods study that utilized qualitative and quantitative data collection and analysis. Caregiver participation quality was operationalized using a summative thematic content analysis to identify and sum caregiver actions performed during appointments. Performance of a greater number of actions was considered greater quality of participation. Caregiver participation quantity was measured by calculating the proportion of speaking time. Participation quality and quantity were compared to patient activation, assessed using the Patient Activation Measure 1-month post decision-making appointment. RESULTS Fifty-three clinical encounters between patients with MBC, their caregivers, and oncologists were recorded. Identified caregiver actions included: General Support; Management of Treatment or Medication; Treatment History; Decision-Making; Insurance or Money; Pharmacy; Scheduling; Travel Concerns; General Cancer Understanding; Patient Specific Cancer Understanding; Caregiver-Initiated or Emphasis on Symptom Severity; and Caregiver Back-Up of Patient Symptom Description. Caregivers averaged 5 actions (SD 3): 48% of patient's caregivers had low quality (< 5 actions) and 52% had high quality (> 6 actions) participation. Regarding quantity, caregivers spoke on average for 4% of the encounter, with 60% of caregivers speaking less than 4% of the encounter (low quantity) and 40% of caregivers speaking more than 4% (high quantity). Greater quality and quantity of caregiver participation was associated with greater patient activation. CONCLUSIONS Caregivers perform a variety of actions during oncological decision-making visits aiding both patient and provider. Greater participation in terms of quantity and quality by the caregiver was associated with greater patient activism, indicating a need for better integration of the caregiver in clinical decision-making environments.
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Affiliation(s)
- Nicole L Henderson
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Tanvi Padalkar
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Garrett Bourne
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Emma K Hendrix
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Courtney P Williams
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - J Nicholas Odom
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kristen Triebel
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Gabrielle B Rocque
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
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Livaudais-Toman J, Kaplan CP, Karliner LS. Who do patients depend on as they age and for what medical needs? An exploratory study of Chinese and Latino primary care patients. BMC PRIMARY CARE 2024; 25:204. [PMID: 38851670 PMCID: PMC11161952 DOI: 10.1186/s12875-024-02411-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 04/29/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND As the U.S. population ages, family members increasingly act as informal caregivers, particularly for minority patients and those with limited English proficiency (LEP). However, physicians often do not identify or engage caregivers until there is a health crisis. This study aims to further our understanding of characteristics associated with having a caregiver present at a primary care visit, and better understand the specific roles family caregivers engage in to support older Chinese and Latino primary care patients. METHODS Primary care patients were surveyed by telephone in a study of language access and communication. Participants included Chinese and Latino primary care patients (≥ 65 years old) from an academic general medicine practice. We asked patients if anyone was in the room with them during their most recent primary care visit (yes = caregiver accompanied). We asked about caregiving support for various needs, and examined associations of patient and visit characteristics with being accompanied, and frequency of caregiver support roles overall and by caregiver accompaniment. RESULTS Among 906 participants, 80% preferred a non-English language, 64% were women, 88% had Medicare, and mean age was 76 years (range 65-97). 43% were accompanied to their most recent visit. Speaking English 'not at all' vs. 'very well' was associated with being caregiver accompanied (OR 3.5; 95% CI 1.3-9.7), as was older age ≥ 75 vs. 65-74 (OR 2.7; 95% CI 2.0-3.7). The most common roles being supported by caregivers included: transportation to medical appointments (63%), helping with medical decisions (60%), and talking with the doctor about the patient's medical care (54%). Even among unaccompanied patients, substantial proportions reported caregiver support with medical decisions (45%), talking with the doctor (33%), and medical needs at home (26%). CONCLUSIONS Opportunities for physicians to engage caregivers who have active support roles may be missed, especially if those caregivers are not present at the visit. Future interventions should aim to help physicians identify which patients have caregivers and for what needs, so they may effectively engage caregivers before a health crisis occurs.
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Affiliation(s)
- Jennifer Livaudais-Toman
- Department of Medicine, Division of General Internal Medicine, University of California, San Francisco (UCSF), San Francisco, CA, USA.
| | - Celia P Kaplan
- Department of Medicine, Division of General Internal Medicine, University of California, San Francisco (UCSF), San Francisco, CA, USA
- Multi-Ethnic Health Equity Research Center, UCSF, San Francisco, CA, USA
- Helen Diller Family Comprehensive Cancer Center, UCSF, San Francisco, CA, USA
| | - Leah S Karliner
- Department of Medicine, Division of General Internal Medicine, University of California, San Francisco (UCSF), San Francisco, CA, USA
- Multi-Ethnic Health Equity Research Center, UCSF, San Francisco, CA, USA
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Atsu FS, Botha NN, Segbedzi CE, Ogum MA, Apaak D, Tsedze IS, Akoto LA, Ansah EW. Care for the cerebrovascular accident survivors: experiences of family caregivers. BMC Palliat Care 2024; 23:138. [PMID: 38824599 PMCID: PMC11143680 DOI: 10.1186/s12904-024-01468-6] [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: 08/11/2023] [Accepted: 05/22/2024] [Indexed: 06/03/2024] Open
Abstract
BACKGROUND The role of family caregivers in the management of cerebrovascular accident survivors is invaluable. So far, there is a strong evidence affirming the effectiveness of family support for cerebrovascular accident survivors. Meanwhile, caring for cerebrovascular survivors can be labour and time intensive and pretty stressful for caregivers. The purpose of the study was to examine the lived experiences of family caregivers of cerebrovascular accident survivors in the Ho Municipality in the Volta Region of Ghana. This aims are to establish their caregivers' knowledge, preparedness, and impact of caregiving on the caregiver, and coping strategies caregivers adopted. METHODS Using a four-item (with 14 prompts) interview guide and descriptive phenomenological approach, we gathered and analysed data from 37 family caregivers in the Ho Municipality of Ghana. RESULTS We found that caregivers had limited knowledge about cerebrovascular disease-risk factors and were ill-prepared for their caregiving roles. Additionally, we found limited knowledge about coping strategies among the caregivers. We further report that some caregivers lost close relationships, and their jobs because of the caregiving, they also used fasting and prayer as coping strategies. CONCLUSIONS Caregivers suffered broken relationship, loss their jobs and incomes due to their caregiving roles. Moreover, some engaged in fasting and prayers, and alcohol use to cope with the stress associated with caring for the cerebrovascular accident survivors. We discussed the potential implications of our findings on the realisation of the Sustainable Development Goal 3.4. The aim of this goal is to reduce by 75% premature deaths due to cerebrovascular and other non-communicable diseases by 2030.
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Affiliation(s)
| | - Nkosi Nkosi Botha
- Department of Health, Physical Education and Recreation (HPER), University of Cape Coast, Cape Coast, Ghana.
- Air Force Medical Centre, Air Force Base, Takoradi, Ghana.
| | - Cynthia Esinam Segbedzi
- Department of Health, Physical Education and Recreation (HPER), University of Cape Coast, Cape Coast, Ghana
| | - Mary Aku Ogum
- Department of Health, Physical Education and Recreation (HPER), University of Cape Coast, Cape Coast, Ghana
| | - Daniel Apaak
- Department of Health, Physical Education and Recreation (HPER), University of Cape Coast, Cape Coast, Ghana
| | - Ivy Selorm Tsedze
- Department of Adult Health, School of Nursing and Midwifery, University of Cape Coast, Cape Coast, Ghana
| | | | - Edward Wilson Ansah
- Department of Health, Physical Education and Recreation (HPER), University of Cape Coast, Cape Coast, Ghana
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Cubukcu M, Sahin B, Kiymaz D, Simsek Yurt N. Effect of Education on Symptom Management and Control in Cancer Patients Receiving Palliative Care. Pain Manag Nurs 2024; 25:e243-e249. [PMID: 38480085 DOI: 10.1016/j.pmn.2024.02.009] [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: 07/06/2023] [Revised: 02/12/2024] [Accepted: 02/12/2024] [Indexed: 06/04/2024]
Abstract
OBJECTIVE This study aims to investigate the effect of an educational intervention on cancer patients receiving palliative care and their caregivers concerning symptom management and family needs. METHODS This study involved 120 participants-60 cancer patients and their respective caregivers-divided into intervention and control groups. Over a 2-week period, the intervention group received a comprehensive educational program focusing on symptom management, while the control group did not receive any educational intervention. The Edmonton Symptom Assessment System (ESAS) and Palliative Performance Scale (PPS) were used to assess patients' symptoms, their intensity, and performance, while the Family Need Scale (FNS) was utilized to evaluate caregivers' needs. These assessments were conducted at the beginning and end of the study. Primary outcomes focused on symptom assessment using ESAS and PPS, along with evaluating caregivers' needs through FNS. Secondary outcomes involved assessing participant satisfaction with the intervention. RESULTS At the end of the study, comparing initial and second evaluations, both ESAS and PPS scores significantly increased in the intervention and control groups (p = .003, p = .002, respectively). Additionally, a statistically significant decrease in the severity of symptoms, except for lethargy/hypokinesis, was observed in the intervention group compared to the control group. The FNS scale indicated that family needs satisfaction was higher in the intervention group compared to the control group. The data obtained demonstrated that there was a reduction the pain, fatigue, depression, anxiety, drowsiness, and shortness of breath levels in the intervention group compared to the control group, but there was no significant difference other than these symptoms. CONCLUSIONS The educational intervention positively impacted symptom management and family needs. Optimizing symptom control would greatly benefit palliative care patients and their caregivers.
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Affiliation(s)
- Mahcube Cubukcu
- Samsun University Faculty of Medicine, Department of Family Medicine, Samsun, Turkey
| | - Bekir Sahin
- Gazi State Hospital, Clinic of Internal Medicine, Samsun, Turkey
| | - Dilek Kiymaz
- Samsun Training and Research Hospital, Education Unit, Samsun, Turkey
| | - Nur Simsek Yurt
- Samsun University Faculty of Medicine, Department of Family Medicine, Samsun, Turkey; Samsun Training and Research Hospital, Clinic of Family Medicine, Samsun, Turkey.
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McConnell KM, Shen MJ. The need for multilevel supportive care infrastructure for cancer caregivers. Cancer 2024; 130:1913-1915. [PMID: 38567689 DOI: 10.1002/cncr.35303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Communication with cancer caregivers occurs in the broader multilevel context of oncology care. Improving communication with caregivers requires changes across multiple levels of this context.
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Affiliation(s)
- Kelly M McConnell
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Megan J Shen
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
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12
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Fong ZV, Teinor J, Engineer L, Yeo TP, Rinaldi D, Greer JB, Lavu H, Qadan M, Johnston FM, Ferrone CR, Chang DC, Yeo CJ, Wolfgang CL, Warshaw AL, Lillemoe KD, Fernandez-del Castillo C, Weiss MJ, Wu AW, Wolff JL. Caregiver-reported quality of communication in pancreatic and periampullary cancer. Cancer 2024; 130:2051-2059. [PMID: 38146683 PMCID: PMC11102340 DOI: 10.1002/cncr.35154] [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: 06/05/2023] [Revised: 10/05/2023] [Accepted: 10/25/2023] [Indexed: 12/27/2023]
Abstract
BACKGROUND Communication between caregivers and clinical team members is critical for transitional care, but its quality and potential impact on outcomes are not well understood. This study reports on caregiver-reported quality of communication with clinical team members in the postpancreatectomy period and examines associations of these reports with patient and caregiver outcomes. METHODS Caregivers of patients with pancreatic and periampullary malignancies who had undergone pancreatectomy were surveyed. Instrument measures assessed care experiences using the Caregiver Perceptions About Communication with Clinical Team Members (CAPACITY) instrument. The instrument has two main subscales: communication, assessing the extent to which providers helped caregivers comprehend details of clinical visits, and capacity, defined as the extent to which providers assessed whether caregivers were able to care for patients. RESULTS Of 265 caregivers who were approached, 240 (90.6%) enrolled in the study. The mean communication and capacity subscale scores were 2.7 ± 0.6 and 1.5 ± 0.6, respectively (range, 0-4 [higher = better]). Communication subscale scores were lower among caregivers of patients who experienced (vs. those who did not experience) a 30-day readmission (2.6 ± 0.5 vs. 2.8 ± 0.6, respectively; p = .047). Capacity subscale scores were inversely associated with restriction in patient daily activities (a 0.04 decrement in the capacity score for every 1 point in daily activity restriction; p = .008). CONCLUSIONS After pancreatectomy, patients with pancreatic and periampullary cancer whose caregivers reported worse communication with care providers were more likely to experience readmission. Caregivers of patients with greater daily activity restrictions were less likely to report being asked about the caregiver's skill and capacity by clinicians. PLAIN LANGUAGE SUMMARY This prospective study used a validated survey instrument and reports on the quality of communication between health care providers and caregivers as reported by caregivers of patients with pancreatic and periampullary cancer after pancreatectomy. In an analysis of 240 caregivers enrolled in the study, lower communication scores (the extent to which providers helped caregivers understand clinical details) were associated with higher odds of 30-day patient readmission to the hospital. In addition, lower capacity scores (the extent to which providers assessed caregivers' ability to care for patients) were associated with greater impairment in caregivers. The strikingly low communication quality and capacity assessment scores suggest substantial room for improvement, with the potential to improve both caregiver and patient outcomes.
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Affiliation(s)
| | - Jonathan Teinor
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD
| | - Lilly Engineer
- Johns Hopkins University School of Medicine, Baltimore, MD
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | | | - Dee Rinaldi
- Thomas Jefferson University, Philadelphia, PA
| | | | - Harish Lavu
- Thomas Jefferson University, Philadelphia, PA
| | | | | | | | | | | | | | | | | | | | | | - Albert W Wu
- Johns Hopkins University School of Medicine, Baltimore, MD
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Jennifer L Wolff
- Johns Hopkins University School of Medicine, Baltimore, MD
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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13
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Albright L, Ko W, Buvanesh M, Haraldsson H, Polubriaginof F, Kuperman GJ, Levy M, Sterling MR, Dell N, Estrin D. Opportunities and Challenges for Augmented Reality in Family Caregiving: Qualitative Video Elicitation Study. JMIR Form Res 2024; 8:e56916. [PMID: 38814705 PMCID: PMC11176885 DOI: 10.2196/56916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/27/2024] [Accepted: 04/26/2024] [Indexed: 05/31/2024] Open
Abstract
BACKGROUND Although family caregivers play a critical role in care delivery, research has shown that they face significant physical, emotional, and informational challenges. One promising avenue to address some of caregivers' unmet needs is via the design of digital technologies that support caregivers' complex portfolio of responsibilities. Augmented reality (AR) applications, specifically, offer new affordances to aid caregivers as they perform care tasks in the home. OBJECTIVE This study explored how AR might assist family caregivers with the delivery of home-based cancer care. The specific objectives were to shed light on challenges caregivers face where AR might help, investigate opportunities for AR to support caregivers, and understand the risks of AR exacerbating caregiver burdens. METHODS We conducted a qualitative video elicitation study with clinicians and caregivers. We created 3 video elicitations that offer ways in which AR might support caregivers as they perform often high-stakes, unfamiliar, and anxiety-inducing tasks in postsurgical cancer care: wound care, drain care, and rehabilitative exercise. The elicitations show functional AR applications built using Unity Technologies software and Microsoft Hololens2. Using elicitations enabled us to avoid rediscovering known usability issues with current AR technologies, allowing us to focus on high-level, substantive feedback on potential future roles for AR in caregiving. Moreover, it enabled nonintrusive exploration of the inherently sensitive in-home cancer care context. RESULTS We recruited 22 participants for our study: 15 clinicians (eg, oncologists and nurses) and 7 family caregivers. Our findings shed light on clinicians' and caregivers' perceptions of current information and communication challenges caregivers face as they perform important physical care tasks as part of cancer treatment plans. Most significant was the need to provide better and ongoing support for execution of caregiving tasks in situ, when and where the tasks need to be performed. Such support needs to be tailored to the specific needs of the patient, to the stress-impaired capacities of the caregiver, and to the time-constrained communication availability of clinicians. We uncover opportunities for AR technologies to potentially increase caregiver confidence and reduce anxiety by supporting the capture and review of images and videos and by improving communication with clinicians. However, our findings also suggest ways in which, if not deployed carefully, AR technologies might exacerbate caregivers' already significant burdens. CONCLUSIONS These findings can inform both the design of future AR devices, software, and applications and the design of caregiver support interventions based on already available technology and processes. Our study suggests that AR technologies and the affordances they provide (eg, tailored support, enhanced monitoring and task accuracy, and improved communications) should be considered as a part of an integrated care journey involving multiple stakeholders, changing information needs, and different communication channels that blend in-person and internet-based synchronous and asynchronous care, illness, and recovery.
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Affiliation(s)
- Liam Albright
- Department of Information Science, Cornell University, New York, NY, United States
| | - Woojin Ko
- Department of Computer Science, Cornell Tech, New York, NY, United States
| | - Meyhaa Buvanesh
- Department of Information Science, Jacobs Technion-Cornell Institute, Cornell Tech, New York, NY, United States
| | | | - Fernanda Polubriaginof
- Digital Informatics and Technology Solutions (DigITS), Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Gilad J Kuperman
- Digital Informatics and Technology Solutions (DigITS), Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Michelle Levy
- Digital Informatics and Technology Solutions (DigITS), Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Madeline R Sterling
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, NY, United States
| | - Nicola Dell
- Department of Information Science, Jacobs Technion-Cornell Institute, Cornell Tech, New York, NY, United States
| | - Deborah Estrin
- Department of Computer Science, Cornell Tech, New York, NY, United States
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Coschi CH, Dodbiba L, Guerry D. Oncology: What You May Have Missed in 2023. Ann Intern Med 2024; 177:S57-S70. [PMID: 38621244 DOI: 10.7326/m24-0520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/17/2024] Open
Abstract
Advances in oncology treatment methods have improved outcomes and quality of life for patients with cancer. However, care of these patients can be complex, and the contribution of physicians from different specialties is crucial. This article highlights important publications from 2023 on topics across a wide spectrum relating to the management of oncology patients. The literature was screened for significant new evidence that is relevant to internal medicine specialists and subspecialists whose focus is not oncology. Two articles address the importance of social interventions targeting end-of-life care for low-income and minority patients and the well-being of caregivers. Two additional articles address screening considerations in patients at risk for colorectal and lung cancer. Two more articles address safe use of hormone-related therapies to treat symptoms of menopause and prevent disease recurrence or progression in patients diagnosed with noninvasive breast neoplasia. Finally, several articles were included on topics related to COVID-19 vaccination in patients with cancer, use of cannabinoids for cancer pain control, chronic autoimmune adverse effects related to use of immune checkpoint inhibitors, and the incidence of second primary neoplasms.
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Affiliation(s)
- Courtney H Coschi
- Division of Medical Oncology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada (C.H.C., L.D.)
| | - Lorin Dodbiba
- Division of Medical Oncology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada (C.H.C., L.D.)
| | - DuPont Guerry
- Associate Editor, Annals of Internal Medicine, and Emeritus Professor of Medicine, Perelman School of Medicine, Philadelphia, Pennsylvania (D.G.)
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Yuen EYN, Hale M, Wilson C. The role of social support among caregivers of people with cancer from Chinese and Arabic communities: a qualitative study. Support Care Cancer 2024; 32:310. [PMID: 38668869 PMCID: PMC11052886 DOI: 10.1007/s00520-024-08502-6] [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: 09/06/2023] [Accepted: 04/13/2024] [Indexed: 04/29/2024]
Abstract
PURPOSE Cancer caregivers from culturally and linguistically diverse (CALD) communities have reported significant unmet emotional support needs. This study aimed explore the role of social support to manage emotional wellbeing among cancer caregivers from Arabic and Chinese communities in Australia. METHODS Semi-structured interviews were conducted with Chinese (n = 12) and Arabic (n = 12) speaking cancer caregivers. Participants' mean age was 40.6 years; majority were female (83%) and providing care to a parent (41.67%). RESULTS Using thematic analysis to analyse interview data, five overarching themes emerged describing caregivers' perspectives on social support. Themes were related to the following: (1) receiving emotional support from social networks, (2) barriers to accessing emotional support from social networks, (3) isolation and loss of connection following the cancer diagnosis, (4) faith as a source of support, and (5) utility of support groups and caregiver advocates. Several caregivers relied on social networks for emotional support; however, caregivers identified key cultural and generational barriers to seeking support from their social networks which prevented caregivers from disclosing their emotions and caregiving situation. Caregivers also reported being isolated from their support system. CONCLUSION Empirical testing of culturally appropriate strategies that improve social support seeking among caregivers from CALD communities is recommended.
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Affiliation(s)
- Eva Y N Yuen
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Melbourne, Australia.
- Centre for Quality and Patient Safety, Monash Health, Melbourne, Australia.
- School of Psychology and Public Health, La Trobe University, Bundoora, VIC, Australia.
- Psycho-Oncology Research Unit, Olivia Newton John Centre, Austin Health, Heidelberg, VIC, Australia.
| | - Megan Hale
- School of Psychology and Public Health, La Trobe University, Bundoora, VIC, Australia
- Psycho-Oncology Research Unit, Olivia Newton John Centre, Austin Health, Heidelberg, VIC, Australia
| | - Carlene Wilson
- School of Psychology and Public Health, La Trobe University, Bundoora, VIC, Australia
- Psycho-Oncology Research Unit, Olivia Newton John Centre, Austin Health, Heidelberg, VIC, Australia
- Centre for Epidemiology and Biostatistics, University of Melbourne, Parkville, VIC, Australia
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16
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Johansson B, Cajander Å, Ahmad A, Ohlsson-Nevo E, Fransson P, Granström B, von Essen L, Langegård U, Pettersson M, Henriksson A, Ehrsson YT. The effect of internet-administered support (carer eSupport) on preparedness for caregiving in informal caregivers of patients with head and neck cancer compared with support as usual: a study protocol for a randomized controlled trial. BMC Cancer 2024; 24:494. [PMID: 38637744 PMCID: PMC11025201 DOI: 10.1186/s12885-024-12273-y] [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: 03/30/2024] [Accepted: 04/16/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Informal caregivers (ICs) of patients with cancer provide essential and mainly uncompensated care. A self-perceived preparedness to care for the patient is associated with a lower caregiver burden, described as the extent to which caregiving is perceived as having adverse effects on IC functioning and well-being. ICs' well-being is associated with patient-perceived quality of care, suggesting that interventions to optimize ICs' health are essential in order to improve patient care. Head and neck cancer (HNC) is the seventh most common malignant disease in the world. The disease and its treatment have a significant negative impact on the patient's health and quality of life. Symptoms usually interfere with swallowing, food and fluid intake, breathing, speaking, and communication. ICs frequently manage patients' symptoms and side effects, especially problems related to nutrition and oral pain, without being properly prepared. Carer eSupport is an Internet-administered intervention, based on focus group discussions with ICs, developed in collaboration with ICs and healthcare professionals, tested for feasibility, and deemed feasible. This study protocol outlines the methods of investigating the effects of Carer eSupport plus support as usual (SAU) on self-reported preparedness for caregiving, caregiver burden, and well-being in the ICs of patients with HNC, compared with ICs receiving SAU only. METHODS AND ANALYSIS In this randomized controlled trial, 110 ICs of patients with HNC, undergoing radiotherapy combined with surgery and/or medical oncological treatment, will be randomized (1:1) to Carer eSupport plus SAU or SAU only. Data will be collected at baseline (before randomization), post-intervention (after 18 weeks), and 3 months after post-intervention. The primary outcome is self-reported preparedness for caregiving. Secondary outcomes are self-reported caregiver burden, anxiety, depression, and health-related quality of life. The effect of Carer eSupport plus SAU on preparedness for caregiving and secondary outcomes, compared with SAU only, will be evaluated by intention to treat analyses using linear regression models, mixed-model regression, or analysis of covariance. DISCUSSION If proven effective, Carer eSupport has the potential to significantly improve ICs' preparedness for caregiving and their wellbeing, thereby improving patient-perceived quality of care and patient wellbeing. TRIAL REGISTRATION ClinicalTrials.gov; NCT06307418, registered 12.03.2024 (https://clinicaltrials.gov/search? term=NCT06307418).
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Affiliation(s)
- Birgitta Johansson
- Department of Immunology, Genetics, and Pathology, Uppsala University, Rudbecklaboratoriet, 75185, Uppsala, Sweden.
| | - Åsa Cajander
- Division of Visual Information and Interaction, Department of Information Technology, Uppsala University, 751 05, Uppsala, Box 337, Sweden
| | - Awais Ahmad
- Division of Visual Information and Interaction, Department of Information Technology, Uppsala University, 751 05, Uppsala, Box 337, Sweden
| | - Emma Ohlsson-Nevo
- Department of Surgery, Faculty of Medicine and Health, Örebro University, 701 82, Örebro, Sweden
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, 701 82, Örebro, Sweden
| | - Per Fransson
- Department of Nursing, Umeå University, 901 87, Umeå, Sweden
| | - Brith Granström
- Department of Diagnostics and Intervention, Umeå University, 901 87, Umeå, Sweden
| | - Louise von Essen
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Dag Hammarskjölds väg 14B, 751 85, Uppsala, Sweden
| | - Ulrica Langegård
- Department of Immunology, Genetics, and Pathology, Uppsala University, Rudbecklaboratoriet, 75185, Uppsala, Sweden
- Department of Oncology, Sahlgrenska University Hospital, 413 45, Gothenburg, Sweden
| | - Mona Pettersson
- Department of Public Health and Caring Sciences, Uppsala University, 751 22, Uppsala, Box 564, Sweden
| | - Anna Henriksson
- Physiotherapy and behavioral medicine, Department of Women's and Children's Health, Uppsala University, 751 22, Uppsala, Box 564, Sweden
- The School of Health, Care and Social Welfare, Mälardalen University, 721 23, Västerås, Box 883, Sweden
| | - Ylva Tiblom Ehrsson
- Department of Surgical Sciences, Section of Otorhinolaryngology and Head & Neck Surgery, Uppsala University, Akademiska sjukhuset, ingång 70, bv, Rudbecklaboratoriet, 75185, Uppsala, Sweden
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Le Roux E, Meunier-Beillard N, Simonel C, Omorou A, Lejeune C. Spouses of patients treated for colon cancer: identification of key caregiver skills using the Delphi method. Support Care Cancer 2024; 32:263. [PMID: 38564042 DOI: 10.1007/s00520-024-08456-9] [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: 11/13/2023] [Accepted: 03/25/2024] [Indexed: 04/04/2024]
Abstract
PURPOSE Spouses are often the front-line caregivers for colon cancer patients. Providing this support requires a particular set of coping skills. Our objective was to identify key skills that healthcare and medico-social sector professionals could assess in routine practice that would allow them to propose appropriate support to spouses who are accompanying colon cancer patients in their care pathway. METHODS An online two-round Delphi study was conducted among French colon cancer patients, spouses and professionals. The content of the Delphi study was developed from a previously published qualitative study. RESULTS In the first round of the study, 63% of the participants were professionals (n = 40), 19% spouses (n = 12) and 17% patients (n = 11). In the second round, they were respectively 55% (n = 22), 22% (n = 9) and 22% (n = 9). Twenty-seven of the 75 proposed skills were consensually identified as key skills. Nine were related to emotional and psychological well-being, six to social relations, four to organisation, five to health and three to domestic domains. The three most consensual skills (≥ 90% agreement) for spouses were (1) helping the tired patient in everyday life, (2) stimulating the patient to prevent him/her from giving up and (3) limiting one's amount of personal time to care for the patient. CONCLUSION The study identified the key skills needed by spouses of patients being treated for colon cancer. Better awareness of these skills among professionals would enable them to offer tailored support to help patients and spouses maintain their physical and emotional well-being.
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Affiliation(s)
- Enora Le Roux
- Université Paris Cité, Inserm, ECEVE, F-75010, Paris, France
- AP-HP Nord-Université de Paris, Hôpital Universitaire Robert Debré, Unité d'épidémiologie clinique, Inserm, CIC 1426, Paris, France
| | - Nicolas Meunier-Beillard
- CHU Dijon Bourgogne, Inserm, Université de Bourgogne, CIC 1432, Module Épidémiologie Clinique, Dijon, France
- CHU Dijon Bourgogne, Délégation à la Recherche Clinique et à l'Innovation, USMR, Dijon, France
| | - Caroline Simonel
- CHU Dijon Bourgogne, Inserm, Université de Bourgogne, CIC 1432, Module Épidémiologie Clinique, Dijon, France
| | - Abdou Omorou
- Université de Lorraine, CHRU Nancy, Inserm CIC 1433 Clinical Epidemiology, Nancy, France
- 1319 UMR INSPIIRE, Inserm, Université de Lorraine, Nancy, France
- The French National Platform Quality of Life and Cancer, Nancy, France
| | - Catherine Lejeune
- CHU Dijon Bourgogne, Inserm, Université de Bourgogne, CIC 1432, Module Épidémiologie Clinique, Dijon, France.
- Inserm, Université Bourgogne-Franche-Comté, UMR 1231, EPICAD, Dijon, France.
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Park YS, Kim H, Jang SY, Park EC. Trends in private caregiving cost after implementing a comprehensive nursing service covered by national health insurance: Interrupted time series. Int J Nurs Stud 2024; 152:104689. [PMID: 38308934 DOI: 10.1016/j.ijnurstu.2024.104689] [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: 02/15/2023] [Revised: 01/01/2024] [Accepted: 01/01/2024] [Indexed: 02/05/2024]
Abstract
BACKGROUND The Korean government has implemented a comprehensive nursing care service system (CNS) to mitigate the stress faced by caregivers. OBJECTIVE This study aimed to assess trends in the estimated average costs of private caregiving and determine the difference in costs between those using CNS and those not using it. DESIGN A comparative interrupted time series analysis with a 2-year lag period verified total private caregiving cost trends; biannual differences in costs were evaluated based on using CNS. PARTICIPANTS The main unit of analysis was episode. We extracted a total of 6418 episodes of hospitalization in acute care settings that included the use of caregiving services (formal, informal caregiving and CNS). METHODS We conducted segmented regression to assess the impact of CNS on total private caregiving costs using data from 2012 to 2018, excluding the years 2015 and 2016 of the Korean Health Panel dataset. RESULTS We presented that the immediate mean difference in total private caregiving costs between CNS users and non-users was -444.7 USD two years after the implementation of the CNS policy (95 % CI -714.5 to -174.5, p-value 0.001). Among individuals living in rural areas, two years after the implementation of the CNS policy, there was a significant immediate mean cost difference of -476.9 USD in total private caregiving costs between CNS users and non-users (p-value 0.011). Similarly, for episodes with a Charlson Comorbidity Index (CCI) score of 0 to 1, there was a substantial immediate mean cost difference in total private caregiving costs between CNS users and non-users, amounting to -399.9 USD two years after the CNS policy (p-value 0.008). CONCLUSIONS This study evaluated the trend of total private caregiving costs between groups using and not using CNS. After two years of being covered by CNS health insurance, those who utilized CNS paid $433 less for their total private caregiving cost over a 6-month period, compared to those who did not use CNS. The adoption of CNS may be an effective system for relieving the financial burden on inpatients in need of private caregiving services. TWEETABLE ABSTRACT Korean Comprehensive Nursing Service reduces private caregiving costs.
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Affiliation(s)
- Yu Shin Park
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea; Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Hyunkyu Kim
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea; Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Suk-Yong Jang
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea; Department of Healthcare Management, Graduate School of Public Health, Yonsei University, Seoul, South Korea
| | - Eun-Cheol Park
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea; Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
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Hastert TA, Kyko JM, Ruterbusch JJ, Robinson JRM, Kamen CS, Beebe-Dimmer JL, Nair M, Thompson HS, Schwartz AG. Caregiver costs and financial burden in caregivers of African American cancer survivors. J Cancer Surviv 2024; 18:565-574. [PMID: 36274101 DOI: 10.1007/s11764-022-01271-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 10/06/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE People with cancer commonly rely on loved ones as informal caregivers during and after treatment. Costs related to caregiving and their association with caregiver financial burden are not well understood. METHODS Results include data from 964 caregivers of African American cancer survivors in the Detroit Research on Cancer Survivors (ROCS) cohort. Caregiving costs include those related to medications, logistics (e.g., transportation), and medical bills. Financial burden measures included caregiver financial resources, strain, and difficulty paying caregiving costs. Prevalence ratios (PR) and 95% confidence intervals (CI) of associations between costs and high financial burden were calculated using modified Poisson models controlling for caregiver characteristics. RESULTS Caregivers included spouses (36%), non-married partners (8%), family members (48%), and friends (9%). Nearly two-thirds (64%) of caregivers reported costs related to caregiving. Logistical costs were the most common (58%), followed by medication costs (35%) and medical bills (17%). High financial hardship was reported by 38% of caregivers. Prevalence of high financial hardship was 52% (95% CI: 24%, 86%) higher among caregivers who reported any versus no caregiver costs. Associations between caregiver costs and high financial burden were evident for costs related to medications (PR: 1.33, 95% CI: 1.12, 1.58), logistics (PR: 1.57, 95% CI: 1.29, 1.92), and medical bills (PR: 1.57, 95% CI: 1.28, 1.92). CONCLUSIONS Most caregivers experienced costs related to caregiving, and these costs were associated with higher prevalence of high caregiver financial burden. IMPLICATIONS FOR CANCER SURVIVORS Informal caregivers experience financial hardship related to cancer along with cancer survivors.
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Affiliation(s)
- Theresa A Hastert
- Department of Oncology, Wayne State University School of Medicine, Detroit, MI, USA.
- Population Studies and Disparities Research Program, Karmanos Cancer Institute, Detroit, MI, 48201, USA.
| | - Jaclyn M Kyko
- Department of Oncology, Wayne State University School of Medicine, Detroit, MI, USA
- Population Studies and Disparities Research Program, Karmanos Cancer Institute, Detroit, MI, 48201, USA
| | - Julie J Ruterbusch
- Department of Oncology, Wayne State University School of Medicine, Detroit, MI, USA
- Population Studies and Disparities Research Program, Karmanos Cancer Institute, Detroit, MI, 48201, USA
| | - Jamaica R M Robinson
- Center for Research On End-of-Life Care, Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Charles S Kamen
- Department of Surgery, University of Rochester, Rochester, NY, USA
| | - Jennifer L Beebe-Dimmer
- Department of Oncology, Wayne State University School of Medicine, Detroit, MI, USA
- Population Studies and Disparities Research Program, Karmanos Cancer Institute, Detroit, MI, 48201, USA
| | - Mrudula Nair
- Department of Oncology, Wayne State University School of Medicine, Detroit, MI, USA
- Population Studies and Disparities Research Program, Karmanos Cancer Institute, Detroit, MI, 48201, USA
| | - Hayley S Thompson
- Department of Oncology, Wayne State University School of Medicine, Detroit, MI, USA
- Population Studies and Disparities Research Program, Karmanos Cancer Institute, Detroit, MI, 48201, USA
| | - Ann G Schwartz
- Department of Oncology, Wayne State University School of Medicine, Detroit, MI, USA
- Population Studies and Disparities Research Program, Karmanos Cancer Institute, Detroit, MI, 48201, USA
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20
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Arthur EK, Ridgway-Limle EA, Krok-Schoen JL, Boehmer U, Battle-Fisher M, Lee CN. Scoping review of experiences of sexual minority women treated for breast cancer. J Psychosoc Oncol 2024; 42:709-732. [PMID: 38501984 DOI: 10.1080/07347332.2024.2323471] [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: 03/20/2024]
Abstract
PURPOSE To summarize and critique research on the experiences and outcomes of sexual minority women (SMW) treated with surgery for breast cancer through systematic literature review. METHODS A comprehensive literature search identified studies from the last 20 years addressing surgical experiences and outcomes of SMW breast cancer survivors. Authors performed a quality assessment and thematic content analysis to identify emergent themes. RESULTS The search yielded 121 records; eight qualitative studies were included in the final critical appraisal. Quality scores for included studies ranged 6-8 out of 10. Experiences and outcomes of SMW breast cancer survivors were organized by major themes: 1) Individual, 2) Interpersonal, 3) Healthcare System, and 4) Sociocultural and Discursive. CONCLUSIONS SMW breast cancer survivors have unique experiences of treatment access, decision-making, and quality of life in survivorship. SMW breast cancer survivors' personal values, preferences, and support network are critical considerations for researchers and clinicians.
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Affiliation(s)
- Elizabeth K Arthur
- Nursing Research, The James Comprehensive Cancer Center, The Ohio State Wexner Medical Center, Columbus, Ohio, USA
| | - Emily A Ridgway-Limle
- Nursing Research, The James Comprehensive Cancer Center, The Ohio State Wexner Medical Center, Columbus, Ohio, USA
| | - Jessica L Krok-Schoen
- School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Ulrike Boehmer
- Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts, USA
| | | | - Clara N Lee
- Department of Plastic and Reconstructive Surgery, College of Medicine, The Ohio State University, Columbus, Ohio, USA
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21
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Yuen EYN, Hale M, Wilson C. Experiences with health information among caregivers of people with cancer from culturally and linguistically diverse backgrounds: A qualitative study. Palliat Support Care 2024:1-9. [PMID: 38450449 DOI: 10.1017/s1478951524000166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
OBJECTIVES Although some research suggests that caregivers from culturally and linguistically diverse (CALD) communities have higher unmet information needs compared to their English-speaking counterparts, few studies have examined determinants of information needs among CALD cancer caregivers and their satisfaction with received information. This study aimed to explore experiences with cancer-related information among caregivers of people with cancer from CALD communities. METHODS Semi-structured interviews were conducted with 24 caregivers from Arabic and Chinese backgrounds (12 in each group). Thematic analysis was used to analyze data. RESULTS Participants' mean age was 40.6 years, and most were female (83%). Six themes were identified: (a) lack of information to meet their needs; (b) challenges understanding cancer- and care-related information; (c) proactivity to make sense of, and understand information; (d) interpreting information: the role formal and informal services; and (e) engaging with health providers to access information. CONCLUSIONS Caregivers identified significant language and communication barriers impacting their capacity to understand cancer-related information given by providers and they invested personal effort clarifying information. The importance of access to formal interpreter services, even when caregivers and care recipients seem proficient in English, was highlighted. Cultural sensitivity of providers when discussing a cancer diagnosis and treatment was also identified as an important consideration. SIGNIFICANCE OF RESULTS Culturally tailored outreach programs designed to provide key cancer-related information which are accessible to CALD caregivers have the potential to improve the health outcomes of both caregivers and care recipients.
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Affiliation(s)
- Eva Y N Yuen
- School of Nursing and Midwifery, Faculty of Health, Deakin university, Burwood, VIC, Australia
- Centre for Quality and Patient Safety-Monash Health Partnership, Institute for Health Transformation, Deakin University, Burwood, VIC, Australia
- School of Psychology and Public Health, La Trobe University, Bundoora, VIC, Australia
- Psycho-Oncology Research Unit, ONJ Centre, Austin Health, Heidelberg, VIC, Australia
| | - Megan Hale
- School of Psychology and Public Health, La Trobe University, Bundoora, VIC, Australia
- Psycho-Oncology Research Unit, ONJ Centre, Austin Health, Heidelberg, VIC, Australia
| | - Carlene Wilson
- School of Psychology and Public Health, La Trobe University, Bundoora, VIC, Australia
- Psycho-Oncology Research Unit, ONJ Centre, Austin Health, Heidelberg, VIC, Australia
- Centre for Epidemiology and Biostatistics, University of Melbourne, Parkville, VIC, Australia
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22
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Gudenkauf LM, Li X, Hoogland AI, Oswald LB, Lmanirad I, Permuth JB, Small BJ, Jim HSL, Rodriguez Y, Bryant CA, Zambrano KN, Walters KO, Reblin M, Gonzalez BD. Feasibility and acceptability of C-PRIME: A health promotion intervention for family caregivers of patients with colorectal cancer. Support Care Cancer 2024; 32:198. [PMID: 38416143 DOI: 10.1007/s00520-024-08395-5] [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: 05/10/2023] [Accepted: 02/18/2024] [Indexed: 02/29/2024]
Abstract
PURPOSE This study aimed to test the feasibility and acceptability of a digital health promotion intervention for family caregivers of patients with advanced colorectal cancer and explore the intervention's preliminary efficacy for mitigating the impact of caregiving on health and well-being. METHODS We conducted a single-arm pilot feasibility trial of C-PRIME (Caregiver Protocol for Remotely Improving, Monitoring, and Extending Quality of Life), an 8-week digital health-promotion behavioral intervention involving monitoring and visualizing health-promoting behaviors (e.g., objective sleep and physical activity data) and health coaching (NCT05379933). A priori benchmarks were established for feasibility (≥ 50% recruitment and objective data collection; ≥ 75% session engagement, measure completion, and retention) and patient satisfaction (> 3 on a 1-5 scale). Preliminary efficacy was explored with pre- to post-intervention changes in quality of life (QOL), sleep quality, social engagement, and self-efficacy. RESULTS Participants (N = 13) were M = 52 years old (SD = 14). Rates of recruitment (72%), session attendance (87%), assessment completion (87%), objective data collection (80%), and retention (100%) all indicated feasibility. All participants rated the intervention as acceptable (M = 4.7; SD = 0.8). Most participants showed improvement or maintenance of QOL (15% and 62%), sleep quality (23% and 62%), social engagement (23% and 69%), and general self-efficacy (23% and 62%). CONCLUSION The C-PRIME digital health promotion intervention demonstrated feasibility and acceptability among family caregivers of patients with advanced colorectal cancer. A fully powered randomized controlled trial is needed to test C-PRIME efficacy, mechanisms, and implementation outcomes, barriers, and facilitators in a divserse sample of family caregivers. TRIAL REGISTRATION The Caregiver Protocol for Remotely Improving, Monitoring, and Extending Quality of Life (C-PRIME) study was registered on clinicaltrials.gov, NCT05379933, in May 2022.
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Affiliation(s)
- Lisa M Gudenkauf
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, USA.
| | - Xiaoyin Li
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, USA
| | - Aasha I Hoogland
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, USA
| | - Laura B Oswald
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, USA
| | - Iman Lmanirad
- Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Jennifer B Permuth
- Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, FL, USA
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA
| | - Brent J Small
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Heather S L Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, USA
| | - Yvelise Rodriguez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, USA
| | - Crystal A Bryant
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, USA
| | - Kellie N Zambrano
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, USA
| | - Kerie O Walters
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, USA
| | - Maija Reblin
- Department of Family Medicine, University of Vermont, Burlington, VT, USA
| | - Brian D Gonzalez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, USA
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23
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Bell-Brown A, Hopkins T, Watabayashi K, Overstreet K, Leahy A, Bradshaw E, Gallagher K, Obenchain J, Padron A, Scott B, Flores B, Shankaran V. A proactive financial navigation intervention in patients with newly diagnosed gastric and gastroesophageal junction adenocarcinoma. Support Care Cancer 2024; 32:189. [PMID: 38400905 PMCID: PMC10894103 DOI: 10.1007/s00520-024-08399-1] [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: 05/02/2023] [Accepted: 02/19/2024] [Indexed: 02/26/2024]
Abstract
PURPOSE Many cancer patients and caregivers experience financial hardship, leading to poor outcomes. Gastric and gastroesophageal junction (GEJ) cancer patients are particularly at risk for financial hardship given the intensity of treatment. This pilot randomized study among gastric/GEJ cancer patients and caregivers tested a proactive financial navigation (FN) intervention to obtain a signal of efficacy to inform a larger, more rigorous randomized study. METHODS We tested a 3-month proactive FN intervention among gastric/GEJ cancer patients and caregivers compared to usual care. Caregiver participation was optional. The primary endpoint was incidence of financial hardship, defined as follows: accrual of debt, income decline of ≥ 20%, or taking loans to pay for treatment. Data from participant surveys and documentation by partner organizations delivering the FN intervention was analyzed and outcomes were compared between study arms. RESULTS Nineteen patients and 12 caregivers consented. Primary FN resources provided included insurance navigation, budget planning, and help with out-of-pocket medical expenses. Usual care patients were more likely to experience financial hardship (50% vs 40%) and declines in quality of life (37.5% vs 0%) compared to intervention patients. Caregivers in both arms reported increased financial stress and poorer quality of life over the study period. CONCLUSIONS Proactive financial navigation has potentially positive impacts on financial hardship and quality of life for cancer patients and more large-scale randomized interventions should be conducted to rigorously explore the impact of similar interventions. Interventions that have the potential to lessen caregiver financial stress and burden need further exploration. TRIAL REGISTRATION TRN: NCT03986502, June 14, 2019.
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Affiliation(s)
- Ari Bell-Brown
- Hutchinson Institute for Cancer Outcomes Research, Fred Hutchinson Cancer Center, 1100 Fairview Ave N., Mailstop M3-B232, Seattle, WA, 98109, USA.
| | - Talor Hopkins
- Hutchinson Institute for Cancer Outcomes Research, Fred Hutchinson Cancer Center, 1100 Fairview Ave N., Mailstop M3-B232, Seattle, WA, 98109, USA
| | - Kate Watabayashi
- Hutchinson Institute for Cancer Outcomes Research, Fred Hutchinson Cancer Center, 1100 Fairview Ave N., Mailstop M3-B232, Seattle, WA, 98109, USA
| | | | - Anthony Leahy
- Consumer Education and Training Services, Seattle, WA, USA
| | | | | | | | - Amber Padron
- Patient Advocate Foundation, Washington, DC, USA
| | - Beth Scott
- Patient Advocate Foundation, Washington, DC, USA
| | | | - Veena Shankaran
- Hutchinson Institute for Cancer Outcomes Research, Fred Hutchinson Cancer Center, 1100 Fairview Ave N., Mailstop M3-B232, Seattle, WA, 98109, USA
- Division of Medical Oncology, University of Washington School of Medicine, Seattle, WA, USA
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24
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Moore C, Gallagher P, Dunne S. Health literacy, eHealth literacy and their association with burden, distress, and self-efficacy among cancer caregivers. Front Psychol 2024; 15:1283227. [PMID: 38434952 PMCID: PMC10904647 DOI: 10.3389/fpsyg.2024.1283227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 02/05/2024] [Indexed: 03/05/2024] Open
Abstract
Purpose Health literacy skills are vital for cancer caregivers in helping cancer survivors to navigate their diagnosis, treatment, and recovery but little is known. This study explored health literacy and eHealth literacy among cancer caregivers and the relationship between health literacy/eHealth literacy and potential associated factors. Methods Informal caregivers who had cared for an individual with cancer completed a survey which collected demographic data and measured caregiver health literacy, eHealth literacy, self-efficacy, burden, and distress. Results Seven percent of caregivers had inadequate health literacy. Caregivers scored lowest on health literacy domains related to caregiver social support, information seeking and understanding care recipient preferences. eHealth literacy was associated with self-efficacy and burden while, different health literacy domains were associated with burden ('Understanding care recipient needs and preferences'), self-efficacy ('Cancer-related communication with the care recipient' and 'Understanding care recipients needs and preferences') and distress ('Proactivity and determination to seek information', 'Understanding care recipient needs and preferences', 'Understanding the healthcare system'). Conclusion Findings highlight key areas of need regarding cancer caregiver health literacy which future research can target. Given the observed relationship between aspects of health literacy and burden, distress and self-efficacy future work could be carried out on how to alleviate high levels of burden and distress and how to enhance self-efficacy among cancer caregivers by addressing health literacy skills. Implications for cancer survivors Findings from this study will inform the development of health literacy interventions to support caregivers to build their health literacy skills and enable this group to better support cancer survivors as a result.
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Affiliation(s)
- Chloe Moore
- School of Psychology, Dublin City University, Dublin, Ireland
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25
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Shi Y, Gao Y, Huai Q, Du Z, Yang L. Experiences of financial toxicity among caregivers of cancer patients: a meta-synthesis of qualitative studies. Support Care Cancer 2024; 32:146. [PMID: 38326575 DOI: 10.1007/s00520-024-08349-x] [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: 07/23/2023] [Accepted: 01/30/2024] [Indexed: 02/09/2024]
Abstract
OBJECTIVES The purpose of this study was to explore the experience of financial toxicity among caregivers of cancer patients and to provide recommendations for subsequent intervention strategies. METHODS Computer searches of PubMed, EmBase, The Cochrane Library, Web of Science, CINAHL (EBSCO), CNKI, Wanfang database, and SinoMed for qualitative studies experience of financial toxicity among caregivers cancer patients. The search time frame was from the establishment of the database to May 2023. The quality of included studies was assessed using the Qualitative Research Checklist from the Joanna Briggs Institute (JBI) Reviewer's Manual. The meta-synthesis was integrated following the meta-aggregation method proposed by the Joanna Briggs Institute (JBI) and reported following the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guidelines. RESULTS A total of nine studies were included, distilling 25 qualitative findings into nine new categories and synthesizing three synthesized findings: caregivers have strong negative experiences that affect their family relationships, daily work and life; caregivers use different strategies to cope with financial toxicity; needs and expectations of caregivers coping with financial toxicity. CONCLUSIONS Financial toxicity among caregivers of cancer patients affects their daily lives. Receiving timely recognition of this financial burden and providing assistance to enhance their coping skills are crucial in mitigating its impact. Healthcare professionals should focus on the financial toxicity experienced by caregivers of people with cancer, address their supportive needs, and develop a comprehensive support system to improve caregivers' coping abilities and quality of life.
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Affiliation(s)
- Yanan Shi
- School of Nursing, Weifang Medical University, 7166 Baotong West Street, Weifang, 261053, China
| | - Ying Gao
- School of Nursing, Weifang Medical University, 7166 Baotong West Street, Weifang, 261053, China
| | - Qiyang Huai
- School of Nursing, Weifang Medical University, 7166 Baotong West Street, Weifang, 261053, China
| | - Zhongyan Du
- School of Nursing and Rehabilitation, Shandong University, 44 West Culture Road, Jinan, 250000, China
| | - Lijuan Yang
- Department of Nursing, Shandong Provincial Hospital, Jingwuweiqi Road, Jinan, 250000, China.
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26
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Nightingale CL, Snavely AC, McLouth LE, Dressler EV, Kent EE, Adonizio CS, Danhauer SC, Cannady R, Hopkins JO, Kehn H, Weaver KE, Sterba KR. Processes for identifying caregivers and screening for caregiver and patient distress in community oncology: results from WF-1803CD. J Natl Cancer Inst 2024; 116:324-333. [PMID: 37738445 PMCID: PMC10852602 DOI: 10.1093/jnci/djad198] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 08/13/2023] [Accepted: 09/11/2023] [Indexed: 09/24/2023] Open
Abstract
BACKGROUND Despite their vital roles, informal caregivers of adult cancer patients are commonly overlooked in cancer care. This study describes processes for identifying cancer caregivers and processes for distress screening and management among caregivers and patients in the understudied community oncology setting. METHODS Supportive care leaders from the National Cancer Institute Community Oncology Research Program practices completed online survey questions regarding caregiver identification, caregiver and patient distress screening, and distress management strategies. We described practice group characteristics and prevalence of study outcomes. Multivariable logistic regression explored associations between practice group characteristics and caregiver identification in the electronic health record (EHR). RESULTS Most (64.9%, 72 of 111) supportive care leaders reported routine identification and documentation of informal caregivers; 63.8% record this information in the EHR. Only 16% routinely screen caregivers for distress, though 92.5% screen patients. Distress management strategies for caregivers and patients are widely available, yet only 12.6% are routinely identified and screened and had at least 1 referral strategy for caregivers with distress; 90.6% are routinely screened and had at least 1 referral strategy for patients. Practices with a free-standing outpatient clinic (odds ratio [OR] = 0.29, P = .0106) and academic affiliation (OR = 0.01, P = .04) were less likely to identify and document caregivers in the EHR. However, higher oncologist volume was associated with an increased likelihood of recording caregiver information in the EHR (OR = 1.04, P = .02). CONCLUSIONS Despite high levels of patient distress screening and management, few practices provide comprehensive caregiver engagement practices. Existing patient engagement protocols may provide a promising platform to build capacity to better address caregiver needs.
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Affiliation(s)
- Chandylen L Nightingale
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Anna C Snavely
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Laurie E McLouth
- Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, KY, USA
| | - Emily V Dressler
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Erin E Kent
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina Chapel Hill, Chapel Hill, NC, USA
| | - Christian S Adonizio
- Center for Oncology Research and Innovation, Geisinger Health, Danville, PA, USA
| | - Suzanne C Danhauer
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Rachel Cannady
- Cancer Caregiver Support, American Cancer Society, Atlanta, GA, USA
| | - Judith O Hopkins
- Hematology and Oncology, Novant Health Cancer Institute, Southeast Clinical Oncology Research Consortium National Cancer Institute Community Oncology Research Program, Winston-Salem, NC, USA
| | - Heather Kehn
- Metro Minnesota Community Oncology Research Consortium, Minneapolis, MN, USA
| | - Kathryn E Weaver
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Katherine R Sterba
- Department of Public Health Sciences, Medical University of South Carolina College of Medicine, Charleston, SC, USA
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27
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Gül İ, Toygar İ, Usta Yeşilbalkan Ö. Support needs of carers of cancer patients and the effects of the patient's age and cancer type on their needs. Eur J Oncol Nurs 2024; 68:102468. [PMID: 37988773 DOI: 10.1016/j.ejon.2023.102468] [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: 01/19/2023] [Revised: 10/18/2023] [Accepted: 11/09/2023] [Indexed: 11/23/2023]
Abstract
PURPOSE This study aimed to investigate support needs of carers of cancer patients and the effects of the patient's age and cancer type on their needs. METHODS In this descriptive and comparative study, the data were collected from the carers (n = 120) of the patient admitted to inpatient and outpatient clinics of a university hospital between June 2021 and October 2022. Patient identification form, carer identification form, and Carer Support Needs Assessment Tool (CSNAT) were used for data collection. The comparisons of the support needs were done for the carers according to the patient's age (<65 versus ≥65 years) and cancer type (hematological malignancies versus solid tumors). RESULTS Caring duration (19.78 ± 29.64 vs 10.33 ± 18.77 months) and caring hours per week (47.58 ± 26.90 vs 32.75 ± 25.75 h) were high in those caring for older adults. Carers of older adults need more support in providing personal care for their relatives (eg dressing, washing, toileting) (X2 = 8.000, p = 0.005). Carers of patients with hematological malignancies need more support in understanding their relative's illness (X2 = 6.136, p = 0.013), having time themselves in the day (X2 = 4.089, p = 0.043), managing their relative's symptoms, including giving medicines? (X2 = 5.263, p = 0.022), and their beliefs or spiritual concerns (X2 = 4.728, p = 0.030) compared to the carers of the patients with solid tumors. CONCLUSION The support needs of the carers vary depending on the patient's age and cancer type. Carers of older adults and patients with hematological malignancies need more support.
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Affiliation(s)
- İrem Gül
- Ege University Faculty of Nursing, Medical Nursin Department, İzmir, Turkey.
| | - İsmail Toygar
- Muğla Sıtkı Koçman University, Fethiye Faculty of Health Sciences, Muğla, Turkey.
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28
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Low NJH, Leow DGW, Klainin-Yobas P. Effectiveness of Technology-Based Psychosocial Interventions on Psychological Outcomes Among Adult Cancer Patients and Caregivers: A Systematic Review and Meta-Analysis. Semin Oncol Nurs 2024; 40:151533. [PMID: 37977974 DOI: 10.1016/j.soncn.2023.151533] [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: 05/11/2023] [Revised: 10/12/2023] [Accepted: 10/16/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVE Technology-based psychosocial interventions (TBPIs) have increasingly gained intention. However, the effectiveness of TBPIs on psychological outcomes remains inconclusive. This review aimed to evaluate the effectiveness of TBPIs on health-related quality of life (HRQOL), coping, self-efficacy, and depression among adult cancer patients and caregivers. DATA SOURCES Randomised controlled trials (RCTs) evaluating the effectiveness of TBPIs targeting adult cancer patients, caregivers, or patient-caregiver dyads were included. English articles dated from 2012 to 2022 were retrieved from eight electronic databases, three clinical trial registries, and six grey literature databases. Two reviewers independently screened, appraised, and extracted data. The Cochrane risk of bias assessment tool and GRADE were used to appraise the methodological quality of included studies. Meta-analyses and subgroup analyses were undertaken with statistical pooling of standardized mean differences based on the random-effects model. CONCLUSION Totally, 37 RCTs were included in the review, with 35 trials for meta-analysis. Results demonstrated improvements in HRQOL, self-efficacy, and depression among cancer patients and caregivers with varying pooled effect sizes. Subgroup analyses suggested that dyadic TBPIs were more effective in improving HRQOL among cancer patients and caregivers, compared with those solely targeted at cancer patients or caregivers. IMPLICATION FOR NURSING PRACTICE Findings value-added to the existing evidence base on TBPIs. An interactive patient-caregiver dyadic program integrating TBPIs into routine oncology care is recommended to improve health outcomes for cancer patients and caregivers. Well-designed future RCTs are required to further evaluate the effectiveness of dyadic TBPIs, with emphasis on coping and self-efficacy outcomes among cancer patients and caregivers.
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Affiliation(s)
| | - Darryl Ge Wei Leow
- Staff Nurse, Woodlands Health Campus, Yishun Community Hospital, Singapore
| | - Piyanee Klainin-Yobas
- Associate Professor, Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore
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29
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Applebaum AJ, Schofield E, Kastrinos A, Gebert R, Behrens M, Loschiavo M, Shaffer KM, Levine M, Dannaoui A, Bellantoni C, Miller MF, Zaleta AK. A randomized controlled trial of a distress screening, consultation, and targeted referral system for family caregivers in oncologic care. Psychooncology 2024; 33:e6301. [PMID: 38363002 PMCID: PMC11250988 DOI: 10.1002/pon.6301] [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: 12/18/2023] [Revised: 01/16/2024] [Accepted: 01/27/2024] [Indexed: 02/17/2024]
Abstract
OBJECTIVE Distress screening is standard practice among oncology patients, yet few routine distress screening programs exist for cancer caregivers. The objective of this study was to demonstrate the feasibility, acceptability, and preliminary efficacy of Cancer Support Source-CaregiverTM (CSS-CG, 33-item), an electronic distress screening and automated referral program with a consultation (S + C) to improve caregiver unmet needs, quality of life, anxiety, depression, and distress relative to Enhanced Usual Care (EUC; access to educational materials). METHOD 150 caregivers of patients with varying sites/stages of cancer were randomized to S + C or EUC and completed assessments at baseline, 3-months post-baseline, and 6-months post-baseline. A subset of participants (n = 10) completed in-depth qualitative interviews. RESULTS S + C was feasible: among 75 caregivers randomized to S + C, 66 (88%) completed CSS-CG and consultation. Top concerns reported were: (1) patient's pain and/or physical discomfort; (2) patient's cancer progressing/recurring; and (3) feeling nervous or afraid. Differences between groups in improvements on outcomes by T2 and T3 were modest (ds < 0.53) in favor of S + C. Qualitative data underscored the helpfulness of S + C in connecting caregivers to support and helping them feel cared for and integrated into cancer care. CONCLUSIONS S + C is feasible, acceptable, and yields more positive impact on emotional well-being than usual care. Future studies will examine programmatic impact among caregivers experiencing higher acuity of needs, and benefits of earlier integration of S + C on caregiver, patient, and healthcare system outcomes.
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Affiliation(s)
- Allison J. Applebaum
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center
| | - Elizabeth Schofield
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center
| | - Amanda Kastrinos
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center
| | - Rebecca Gebert
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center
| | - Mia Behrens
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center
| | - Morgan Loschiavo
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center
| | - Kelly M. Shaffer
- Center for Behavioral Health and Technology, University of Virginia
| | - Marcia Levine
- Department of Nursing, Memorial Sloan Kettering Cancer Center
| | - Aimee Dannaoui
- Department of Nursing, Memorial Sloan Kettering Cancer Center
| | | | - Melissa F. Miller
- Research and Training Institute, Cancer Support Community, Philadelphia, PA
| | - Alexandra K. Zaleta
- Research and Training Institute, Cancer Support Community, Philadelphia, PA
- Current affiliation: CancerCare, New York, NY
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30
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Hur Y, Hickman RL. Use and Impact of Simulation in Family Caregiver Education: A Systematic Review. West J Nurs Res 2024; 46:143-151. [PMID: 38124438 DOI: 10.1177/01939459231218956] [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: 12/23/2023]
Abstract
BACKGROUND Involving family caregivers in a team-based approach has become increasingly important. Simulation-based interventions in nursing have been effective. However, the effect of simulation on family caregiver education is not widely known and is limited. OBJECTIVE This study aimed to describe the current state of simulation-based interventions in family caregivers of patients with chronic diseases. METHODS This systematic review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The literature search was conducted in PubMed, CINAHL, PsycINFO, and Cochrane with a medical librarian's help. This review included quantitative, primary, peer-reviewed English-written research articles that reported outcomes for family caregivers. We focused on the data about purpose, design, setting, population, intervention characteristics, and outcomes. Before analyzing the selected studies, we evaluated the risk of bias using the revised Cochrane Risk-Of-Bias tool for randomized trials. RESULTS Our search yielded 9 articles that met the inclusion criteria. The majority of the 9 articles analyzed were designed in a quasi-experimental design. In addition, most studies focused on certain diseases and used low-fidelity simulators. The simulation content mainly focused on technical simulations to help care for patients. Some simulations had a positive influence on family caregivers' knowledge, attitudes, and skills. CONCLUSIONS We expect more simulation-based interventions for caregivers, especially those targeting diverse populations, using appropriate modalities and randomized control designs.
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Affiliation(s)
- Yujin Hur
- College of Nursing, Catholic University of Pusan, Busan, South Korea
| | - Ronald L Hickman
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
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31
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Feng Y, Su M, Liu Y, Peng J, Sun X. Health-related quality of life among cancer survivors: pre-existing chronic conditions are to be given priority. Support Care Cancer 2024; 32:124. [PMID: 38252273 DOI: 10.1007/s00520-024-08315-7] [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: 09/03/2023] [Accepted: 01/09/2024] [Indexed: 01/23/2024]
Abstract
PURPOSE This study aimed to describe the health-related quality of life (HRQoL) of cancer survivors in China by the five-level EuroQol-5-dimension (EQ-5D-5L) questionnaire and to explore the impact of the comorbidity of pre-existing chronic conditions on HRQoL in cancer survivors. METHODS Data on cancer survivors were obtained from two cross-sectional surveys conducted in Shandong Province, China. The data of the Chinese general population, the Chinese diabetes population, the Chinese hypertension population, and the Chinese urban population from the published studies were used as the controls. The χ2 test was conducted to compare the incidence of five-dimensional problems between the study and control populations. The non-parametric Mann-Whitney U test and Kruskal-Wallis test were performed to examine the differences in EQ-5D-5L utility scores. Besides, the Tobit regression model was used to examine the variables influencing the EQ-5D-5L utility score. RESULTS One thousand fifty-one adult cancer survivors were included. Cancer survivors had significantly lower EQ-5D-5L utility scores (Z = - 15.939, P < 0.001) and EQ-VAS scores (Z = - 11.156, P < 0.001) than the general adult population. The average EQ-5D-5L utility score of hypertensive cancer survivors was lower than that of the hypertensive population (Z = - 1.610, P = 0.107), but the difference was not statistically significant. CONCLUSION Compared to the general population, the HRQoL of cancer survivors was extremely poor in all dimensions of the EQ-5D-5L. Pre-existing chronic conditions had significant antecedent effects on the HRQoL of cancer survivors. Therefore, more attention should be paid to chronic diseases, and effective interventions should be adopted based on this.
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Affiliation(s)
- Yujia Feng
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Wenhuaxi Road 44#, Jinan, China
- National Health Commission Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Mingzhu Su
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Wenhuaxi Road 44#, Jinan, China
- National Health Commission Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Yanxiu Liu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Wenhuaxi Road 44#, Jinan, China
- National Health Commission Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Jiaqi Peng
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Wenhuaxi Road 44#, Jinan, China
- National Health Commission Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Xiaojie Sun
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Wenhuaxi Road 44#, Jinan, China.
- National Health Commission Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China.
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Kumar R, Fu J, Ortiz BL, Cao X, Shedden K, Choi SW. Dyadic and Individual Variation in 24-Hour Heart Rates of Cancer Patients and Their Caregivers. Bioengineering (Basel) 2024; 11:95. [PMID: 38247972 PMCID: PMC10813060 DOI: 10.3390/bioengineering11010095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/12/2024] [Accepted: 01/17/2024] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND Twenty-four-hour heart rate (HR) integrates multiple physiological and psychological systems related to health and well-being, and can be continuously monitored in high temporal resolution over several days with wearable HR monitors. Using HR data from two independent datasets of cancer patients and their caregivers, we aimed to identify dyadic and individual patterns of 24 h HR variation and assess their relationship to demographic, environmental, psychological, and clinical variables of interest. METHODS a novel regularized approach to high-dimensional canonical correlation analysis (CCA) was used to identify factors reflecting dyadic and individual variation in the 24 h (circadian) HR trajectories of 430 people in 215 dyads, then regression analysis was used to relate these patterns to explanatory variables. RESULTS Four distinct factors of dyadic covariation in circadian HR were found, contributing approximately 7% to overall circadian HR variation. These factors, along with non-dyadic factors reflecting individual variation exhibited diverse and statistically robust patterns of association with explanatory variables of interest. CONCLUSIONS Both dyadic and individual anomalies are present in the 24 h HR patterns of cancer patients and their caregivers. These patterns are largely synchronous, and their presence robustly associates with multiple explanatory variables. One notable finding is that higher mood scores in cancer patients correspond to an earlier HR nadir in the morning and higher HR during the afternoon.
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Affiliation(s)
- Rajnish Kumar
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI 48109, USA; (R.K.); (B.L.O.); (X.C.)
| | - Junhan Fu
- Department of Statistics, College of Literature, Science, and the Arts, University of Michigan, Ann Arbor, MI 48109, USA; (J.F.); (K.S.)
| | - Bengie L. Ortiz
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI 48109, USA; (R.K.); (B.L.O.); (X.C.)
| | - Xiao Cao
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI 48109, USA; (R.K.); (B.L.O.); (X.C.)
| | - Kerby Shedden
- Department of Statistics, College of Literature, Science, and the Arts, University of Michigan, Ann Arbor, MI 48109, USA; (J.F.); (K.S.)
| | - Sung Won Choi
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI 48109, USA; (R.K.); (B.L.O.); (X.C.)
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Abazari A, Chatterjee S, Moniruzzaman M. Understanding Cancer Caregiving and Predicting Burden: An Analytics and Machine Learning Approach. AMIA ... ANNUAL SYMPOSIUM PROCEEDINGS. AMIA SYMPOSIUM 2024; 2023:243-252. [PMID: 38222371 PMCID: PMC10785947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
Cancer caregivers are often informal family members who may not be prepared to adequately meet the needs of patients and often experience high stress along with significant physical, emotional, and financial burdens. Accurate prediction of caregiver's burden level is highly valuable for early intervention and support. In this study, we used several machine learning approaches to build prediction models from the National Alliance for Caregiving/AARP dataset. We performed data cleansing and imputation on the raw data to give us a working dataset of cancer caregivers. Then a series of feature selection methods were used to identify predictive risk factors for burden level. Using supervised machine learning classifiers, we achieved reasonably good prediction performance (Accuracy ∼ 0.94; AUC ∼ 0.97; F1∼ 0.93). We identify a small set of 15 features that are strong predictors of burden and can be used to build Clinical Decision Support Systems.
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Affiliation(s)
- Armin Abazari
- Innovation Empowerment and Design Application (IDEA) Lab Center for Information Systems & Technology Claremont Graduate University, Claremont, California, USA
| | - Samir Chatterjee
- Innovation Empowerment and Design Application (IDEA) Lab Center for Information Systems & Technology Claremont Graduate University, Claremont, California, USA
| | - Md Moniruzzaman
- Innovation Empowerment and Design Application (IDEA) Lab Center for Information Systems & Technology Claremont Graduate University, Claremont, California, USA
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McAndrew NS, Gray TF, Wallace L, Calkins K, Guttormson J, Harding ES, Applebaum AJ. Existential distress in family caregivers: scoping review of meaning-making interventions. BMJ Support Palliat Care 2024; 13:e676-e685. [PMID: 37604657 PMCID: PMC11040498 DOI: 10.1136/spcare-2023-004448] [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: 06/18/2023] [Accepted: 08/03/2023] [Indexed: 08/23/2023]
Abstract
OBJECTIVES Family and friend caregivers often feel overwhelmed by and ill-prepared for their responsibilities. Many feel helpless living with uncertainty about the outcome of the patient's illness, which leads to existential distress. Supportive care interventions that address existential distress by promoting meaning and purpose buffer the negative effects of caregiver burden and promote resilience and growth. The purpose of this scoping review is to describe the depth and breadth of available interventions targeting caregiver existential distress. METHODS We followed the Joanna Briggs Institute's scoping review methods and applied the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension checklist. SCOPUS, Ovid MEDLINE and PsycINFO databases were searched for interventions that targeted existential distress by promoting meaning-making, spiritual well-being, post-traumatic growth and/or benefit finding for caregivers of seriously ill adult patients. RESULTS We screened 1377 titles/abstracts and 42 full-text articles. Thirty-one articles (28 unique studies) met inclusion criteria. Most interventions were designed for caregivers supporting patients with cancer (n=14) or patients receiving palliative care (n=9). Promising interventions included Meaning-Centered Psychotherapy for Cancer Caregivers, Meaning-Based Intervention for Patients and their Partners, Legacy Intervention for Family Enactment, Family Participatory Dignity Therapy and Existential Behavioural Therapy. More than half of the studies (n=20, 64%) were in the feasibility/acceptability/pilot stage of intervention testing. CONCLUSION Large randomised controlled trials with more diverse samples of caregivers are needed. Future research should explore the impact of delivering meaning-making interventions to caregivers throughout the illness trajectory. Developing strategies for scaling up and conducting cost analyses will narrow the research and practice gap for meaning-making interventions.
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Affiliation(s)
- Natalie S McAndrew
- School of Nursing, College of Health Professions & Sciences, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
- Department of Patient Care Research, Froedtert & the Medical College of Wisconsin, Froedtert Hospital, Milwaukee, Wisconsin, USA
| | - Tamryn F Gray
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Lyndsey Wallace
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Kelly Calkins
- College of Nursing, Marquette University, Milwaukee, Wisconsin, USA
| | - Jill Guttormson
- College of Nursing, Marquette University, Milwaukee, Wisconsin, USA
| | - Eric S Harding
- Medical College of Wisconsin Libraries, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Allison J Applebaum
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of Psychiatry, Weill Cornell Medicine, New York, New York, USA
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Galvin A, Bertrand N, Boulahssass R, De Decker L, Dorval E, Clairaz B, Castaignède M, Mourey L, Baldini C, Bauvin E, Jacques B, Mallon I, Durand-Zaleski I, Guérin O, Krouri S, Soubeyran P. Rethinking care management for older adults with cancer: Proposals from the "PRIORITES AGE CANCER" French group. J Geriatr Oncol 2024; 15:101608. [PMID: 37684193 DOI: 10.1016/j.jgo.2023.101608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 07/27/2023] [Accepted: 08/17/2023] [Indexed: 09/10/2023]
Affiliation(s)
- Angéline Galvin
- Université de Bordeaux, Inserm, Bordeaux Population Health, équipe Epicene, UMR 1219, Bordeaux, France.
| | - Nicolas Bertrand
- Université de Lille, CHU Lille, ULR 2694 METRICS, Lille, France; UCOG Nord-Pas-De-Calais
| | - Rabia Boulahssass
- CHU de NICE, FHU ONCOAGE, Université of Nice-, Sophia Antipolis, France; UCOG PACA Est
| | - Laure De Decker
- Département de gériatrie, EA 1156-12, Pôle hospitalo-universitaire de gérontologie clinique, CHU Nantes, France; UCOG Pays-De-Loire
| | | | - Béatrice Clairaz
- Société Francophone des Sciences pharmaceutiques Officinales (SFSPO), Bièvres, France
| | | | - Loic Mourey
- Institut Universitaire du Cancer de Toulouse - Oncopole, Toulouse, France; UCOG Midi-Pyrénées
| | - Capucine Baldini
- DITEP - Département de développement des médicaments, Gustave Roussy, Villejuif, France
| | - Eric Bauvin
- Réseau Onco-Occitanie, CERPOP UMR 1295, Toulouse, France
| | - Béatrice Jacques
- Université de Bordeaux, CNRS, Centre Emile Durkheim, UMR 5116, Bordeaux, France
| | - Isabelle Mallon
- Université Lumière Lyon 2, Centre Max Weber UMR 5283, Lyon, France
| | | | - Olivier Guérin
- Université Côte d'Azur, Centre hospitalier universitaire de Nice, Service de médecine gériatrique et thérapeutique, CNRS UMR 7284/Inserm U108, Institut de recherche sur le cancer et le vieillissement Nice (IRCAN), Faculté de médecine, Nice, France
| | - Sadek Krouri
- Direction des Affaires Publiques et Gouvernementales, Sanofi France, Gentilly, France
| | - Pierre Soubeyran
- Université de Bordeaux, Institut Bergonié, Inserm UMR1312, SIRIC BRIO, Bordeaux, France; UCOG Aquitaine
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Galica J, Silva A, Robb K. Developing an educational resource for gynecological cancer survivors and their caregivers: A methods and experience paper. Can Oncol Nurs J 2024; 34:4-9. [PMID: 38352933 PMCID: PMC10861237 DOI: 10.5737/236880763414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024] Open
Abstract
Building upon the need for greater education, identified by gynecological cancer survivors and their caregivers, the objective of this paper is to describe our patient-clinician-researcher partnership to develop an evidence- and experiential-based educational resource. We engaged in five phases using multiple research methods: 1) assembling the essential expertise, 2) reviewing the literature, 3) drafting the resource, 4) testing the resource, and 5) disseminating the resource. Our diverse partnership provided expertise toward multiple research methods that produced results useful for each successive phase. This combination - a diverse partnership and multiple research methods - resulted in a useful resource to fulfill a gap identified by knowledge users. The combined features described in our paper fill a procedural gap for clinicians and researchers intending to develop educational resources that are empirically and experientially founded.
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Affiliation(s)
- Jacqueline Galica
- Queen's University School of Nursing; Kingston, ON; Queen's Cancer Research Institute, Division of Cancer Care and Epidemiology, Kingston, ON
| | - Amina Silva
- Brock University School of Nursing; St. Catharines, ON
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Galica J, Silva A, Robb K. Élaboration d’une ressource d’information à l’intention des survivantes d’un cancer gynécologique et de leurs proches aidants : exposé sur le vécu et les méthodes. Can Oncol Nurs J 2024; 34:10-15. [PMID: 38352925 PMCID: PMC10861229 DOI: 10.5737/2368807634110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024] Open
Abstract
Le présent article fait ressortir la nécessité de mieux informer les survivantes de cancer gynécologique (CG) et leurs proches aidants. Il vise à décrire le partenariat établi entre les patientes, les cliniciens et les chercheurs pour concevoir une ressource d’information fondée sur l’expérience et les données probantes. L’élaboration de cette ressource d’information a fait appel à plusieurs méthodes de recherche. Elle s’est déroulée en cinq étapes : 1) réunion de l’expertise nécessaire; 2) revue de la littérature; 3) ébauche de la ressource; 4) mise à l’essai; 5) diffusion de la ressource. La diversité des partenaires apportait l’expertise nécessaire à l’utilisation de multiples méthodes de recherche ayant produit des résultats utiles à chaque étape. Grâce à cette combinaison (partenariat diversifié et multiples méthodes de recherche), on a élaboré une ressource utile pour répondre à un manque observé par les utilisateurs des connaissances. La combinaison des caractéristiques décrites dans le présent article vient combler une lacune dans la procédure utilisée par les cliniciens et les chercheurs désireux d’élaborer des ressources d’information fondées à la fois sur l’expérience et la pratique.
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Affiliation(s)
- Jacqueline Galica
- École des sciences infirmières de l'Université Queen's, Kingston, ON; Institut de recherche sur le cancer de l'Université Queen's, Division d'oncologie et d'épidémiologie; Kingston, ON
| | - Amina Silva
- École des sciences infirmières de l'Université Brock, St. Catharines, ON
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Odom JN, Young HM, Sterba K, Sannes TS, Reinhard S, Nightingale C, Meier D, Gray TF, Ferrell B, Fernandez ME, Donovan H, Curry K, Currie ER, Bryant T, Bakitas MA, Applebaum AJ. Developing a national implementation strategy to accelerate uptake of evidence-based family caregiver support in U.S. cancer centers. Psychooncology 2024; 33:e6221. [PMID: 37743780 PMCID: PMC10896495 DOI: 10.1002/pon.6221] [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: 07/23/2023] [Revised: 08/24/2023] [Accepted: 09/14/2023] [Indexed: 09/26/2023]
Abstract
OBJECTIVE Characterize key factors and training needs of U.S. cancer centers in implementing family caregiver support services. METHODS Sequential explanatory mixed methods design consisting of: (1) a national survey of clinicians and administrators from Commission-on-Cancer-accredited cancer centers (N = 238) on factors and training needed for establishing new caregiver programs and (2) qualitative interviews with a subsample of survey respondents (N = 30) to elicit feedback on survey findings and the outline of an implementation strategy to facilitate implementation of evidence-based family caregiver support (the Caregiver Support Accelerator). Survey data was tabulated using descriptive statistics and transcribed interviews were analyzed using thematic analysis. RESULTS Top factors for developing new caregiver programs were that the program be: consistent with the cancer center's mission and strategic plan (87%), supported by clinic leadership (86.5%) and providers and staff (85.7%), and low cost or cost effective (84.9%). Top training needs were how to: train staff to implement programs (72.3%), obtain program materials (63.0%), and evaluate program outcomes (62.6%). Only 3.8% reported that no training was needed. Qualitative interviews yielded four main themes: (1) gaining leadership, clinician, and staff buy-in and support is essential; (2) cost and clinician burden are major factors to program implementation; (3) training should help with adapting and marketing programs to local context and culture; and (4) the Accelerator strategy is comprehensive and would benefit from key organizational partnerships and policy standards. CONCLUSION Findings will be used to inform and refine the Accelerator implementation strategy to facilitate the adoption and growth of evidence-based cancer caregiver support in U.S. cancer centers.
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Affiliation(s)
- J. Nicholas Odom
- School of Nursing, University of Alabama at Birmingham (UAB), Birmingham, Alabama, USA
- Division of Geriatrics, Gerontology, and Palliative Care, UAB Department of Medicine, Birmingham, Alabama, USA
- UAB Center for Palliative and Supportive Care, Birmingham, Alabama, USA
| | - Heather M. Young
- Betty Irene Moore School of Nursing, University of California, Davis, Davis, CA, USA
| | - Katherine Sterba
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | | | | | - Chandelyn Nightingale
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Diane Meier
- Mount Sinai Medical Center, New York, NY, USA
| | - Tamryn F. Gray
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | | | - Maria E. Fernandez
- Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston School of Public Health, Houston, TX, USA
| | - Heidi Donovan
- Schools of Nursing and Medicine, and the National Rehabilitation Research & Training Center on Family Support, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kayleigh Curry
- School of Nursing, University of Alabama at Birmingham (UAB), Birmingham, Alabama, USA
| | - Erin R. Currie
- School of Nursing, University of Alabama at Birmingham (UAB), Birmingham, Alabama, USA
| | | | - Marie A. Bakitas
- School of Nursing, University of Alabama at Birmingham (UAB), Birmingham, Alabama, USA
- Division of Geriatrics, Gerontology, and Palliative Care, UAB Department of Medicine, Birmingham, Alabama, USA
- UAB Center for Palliative and Supportive Care, Birmingham, Alabama, USA
| | - Allison J. Applebaum
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Bybee S, Hebdon M, Cloyes K, Hiatt S, Iacob E, Reblin M, Clayton M, Ellington L. Cancer caregivers at the end-of-life: How much me vs. how much we? PEC INNOVATION 2023; 3:100193. [PMID: 37554722 PMCID: PMC10404724 DOI: 10.1016/j.pecinn.2023.100193] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 07/18/2023] [Accepted: 07/24/2023] [Indexed: 08/10/2023]
Abstract
OBJECTIVE This study explored cancer caregivers' individual and communal coping through their use of personal and communal pronouns during naturally occurring conversations. METHODS Nurse-home hospice visits involving cancer patients and their partner caregivers were audio recorded and then transcribed. Pronoun use was analyzed using Linguistic Inquiry Word Count (LIWC) software and descriptive statistics compared patient and partner caregivers' pronoun use. Personal and communal pronoun use was examined within six identified topics of caregiver speech: patient medical care, daily life, emotion, criticism/disagreement, relationships with family/friends, and asserting needs. RESULTS Dyads (N = 76) had an average of 35.8 years in their relationship. Caregivers used proportionately more first-person singular (I-talk) than first-person plural (we-talk). However, they used significantly less I-talk than patients and less I-talk than LIWC measures in naturally occurring speech. Caregivers were most likely to discuss patient medical care (41.9%) and least likely to discuss their own needs (3.8%). CONCLUSION Partner caregivers may find it easier to express emotions related to communal stressors, rather than their individual ability to cope with end-of-life caregiving. INNOVATION Examining personal and communal pronoun use by partner caregivers during nurse-home hospice visits may provide a more objective measure of caregiver coping than standard self-report measures.
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Affiliation(s)
- Sara Bybee
- University of Utah College of Nursing, 10 S 2000 E, Salt Lake City, UT 84112, United States of America
| | - Megan Hebdon
- UT Austin School of Nursing, 1710 Red River St, Austin, TX 78712, United States of America
| | - Kristin Cloyes
- Oregon Health & Science University, 3455 SW US Veterans Hospital Rd., Portland, OR 97239-2941, United States of America
| | - Shirin Hiatt
- University of Utah College of Nursing, 10 S 2000 E, Salt Lake City, UT 84112, United States of America
| | - Eli Iacob
- University of Utah College of Nursing, 10 S 2000 E, Salt Lake City, UT 84112, United States of America
| | - Maija Reblin
- University of Vermont College of Medicine, Given Medical Building, E-126, 89 Beaumont Ave, Burlington, VT 05405, United States of America
| | - Margaret Clayton
- University of Utah College of Nursing, 10 S 2000 E, Salt Lake City, UT 84112, United States of America
| | - Lee Ellington
- University of Utah College of Nursing, 10 S 2000 E, Salt Lake City, UT 84112, United States of America
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Ginsburg O, Vanderpuye V, Beddoe AM, Bhoo-Pathy N, Bray F, Caduff C, Florez N, Fadhil I, Hammad N, Heidari S, Kataria I, Kumar S, Liebermann E, Moodley J, Mutebi M, Mukherji D, Nugent R, So WKW, Soto-Perez-de-Celis E, Unger-Saldaña K, Allman G, Bhimani J, Bourlon MT, Eala MAB, Hovmand PS, Kong YC, Menon S, Taylor CD, Soerjomataram I. Women, power, and cancer: a Lancet Commission. Lancet 2023; 402:2113-2166. [PMID: 37774725 DOI: 10.1016/s0140-6736(23)01701-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 06/27/2023] [Accepted: 08/11/2023] [Indexed: 10/01/2023]
Affiliation(s)
- Ophira Ginsburg
- Centre for Global Health, US National Cancer Institute, Rockville, MD, USA.
| | | | | | | | - Freddie Bray
- International Agency for Research on Cancer, Lyon, France
| | - Carlo Caduff
- Department of Global Health and Social Medicine, King's College London, London, UK
| | - Narjust Florez
- Dana-Farber Cancer Institute, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | | | - Nazik Hammad
- Department of Medicine, Division of Hematology-Oncology, St. Michael's Hospital, University of Toronto, Canada; Department of Oncology, Queens University, Kingston, Canada
| | - Shirin Heidari
- GENDRO, Geneva, Switzerland; Gender Centre, Geneva Graduate Institute, Geneva, Switzerland
| | - Ishu Kataria
- Center for Global Noncommunicable Diseases, RTI International, New Delhi, India
| | - Somesh Kumar
- Jhpiego India, Johns Hopkins University Affiliate, Baltimore, MD, USA
| | - Erica Liebermann
- University of Rhode Island College of Nursing, Providence, RI, USA
| | - Jennifer Moodley
- Cancer Research Initiative, Faculty of Health Sciences, School of Public Health and Family Medicine, and SAMRC Gynaecology Cancer Research Centre, University of Cape Town, Cape Town, South Africa
| | - Miriam Mutebi
- Department of Surgery, Aga Khan University, Nairobi, Kenya
| | - Deborah Mukherji
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon; Clemenceau Medical Center Dubai, Dubai, United Arab Emirates
| | - Rachel Nugent
- Center for Global Noncommunicable Diseases, RTI International, Durham, NC, USA; Department of Global Health, University of Washington, Seattle, WA, USA
| | - Winnie K W So
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong Special Administrative Region, China
| | - Enrique Soto-Perez-de-Celis
- Department of Geriatrics, National Institute of Medical Science and Nutrition Salvador Zubiran, Mexico City, Mexico
| | | | - Gavin Allman
- Center for Global Noncommunicable Diseases, RTI International, Durham, NC, USA
| | - Jenna Bhimani
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - María T Bourlon
- Department of Hemato-Oncology, National Institute of Medical Science and Nutrition Salvador Zubiran, Mexico City, Mexico
| | - Michelle A B Eala
- College of Medicine, University of the Philippines, Manila, Philippines; Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA, USA
| | | | - Yek-Ching Kong
- Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Sonia Menon
- Cochrane Hepato-Biliary Group, Copenhagen Trial Unit, Centre for Clinical Intervention Research, The Capital Region, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
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Burke H, Dunne S. "You nearly feel a little bit like you've less right to grieve": a qualitative study on the impact of cancer on adult siblings. J Cancer Surviv 2023; 17:1628-1638. [PMID: 36401074 PMCID: PMC9676809 DOI: 10.1007/s11764-022-01295-9] [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: 09/14/2022] [Accepted: 11/07/2022] [Indexed: 11/19/2022]
Abstract
PURPOSE Family members of cancer patients experience a range of challenges and are impacted in various ways by cancer. To our knowledge, the impact of cancer on adult siblings has yet to be explored. Sibling relationships are one of the longest relationships individuals have across the lifespan. Thus, the current study sought to investigate the perspectives of siblings of those who previously had cancer. METHODS Ten participants were recruited using purposive sampling. A qualitative, cross-sectional design was implemented with both virtual and in-person semi-structured interviews. Interviews were audio-recorded, transcribed and analysed using thematic analysis. RESULTS The researchers identified five themes relating to both the impact of cancer on siblings and the supports they received: changes in family relationships, sibling's grief is forgotten, benefits of social support networks, supporting their sibling and caregiving and self-support. CONCLUSIONS Cancer organizations and support services should focus on signposting services for siblings in order to ensure they can access support. Further research is needed with siblings to gain greater insight into what supports siblings feel are available for them to access, whether there are any for them to access or how supports can be improved. IMPLICATIONS FOR CANCER SURVIVORS The provision of appropriate psychological support for siblings of cancer patients will ensure they can provide optimal support and care to their siblings. This will in turn benefit cancer patients along their cancer trajectory as adequate support from their caregivers will enhance their quality of life.
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Affiliation(s)
- Hazel Burke
- School of Psychology, Dublin City University, Glasnevin, Dublin 9, Dublin, Ireland
| | - Simon Dunne
- School of Psychology, Dublin City University, Glasnevin, Dublin 9, Dublin, Ireland.
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Chen D, Liu Q, Zhang L, Qian H. Effectiveness of Dyadic Psychoeducational Intervention on Cancer Patients and Their Caregivers: A Systematic Review and Meta-analysis. Cancer Nurs 2023:00002820-990000000-00197. [PMID: 38011076 DOI: 10.1097/ncc.0000000000001307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
BACKGROUND Dyadic psychoeducational intervention targets the dyads of cancer patients and caregivers as active participants in partnership, which can potentially address the needs and challenges faced by patients with cancer and their caregivers. However, there is insufficient evidence on the effectiveness of the intervention on psychological health and illness-related outcomes among the dyads. OBJECTIVE To systematically examine the dyadic psychoeducational intervention of cancer patients and their caregivers on psychological health and illness-related outcomes. METHODS Cochrane Library, EMBASE, CINAHL, PsycINFO, PubMed, Web of Science, and 4 Chinese databases were searched from inception to May 29, 2022. Two investigators independently extracted data and evaluated methodological quality. RevMan 5.4 was used for meta-analysis; heterogeneity was evaluated using Higgins' I2 (%). Standardized mean difference (SMD) with a 95% confidence interval (CI) was used to assess the effects. RESULTS Eight randomized controlled trials that involved 1234 dyads were collected. Meta-analysis showed that the intervention was effective in reducing the dyadic depression (patients' SMD, -0.41 [95% CI, -0.78 to -0.04; P = .03]; caregivers' SMD, -0.70 [95% CI, -1.31 to -0.09; P = .03]). It also improved caregivers' quality of life (SMD, -0.29 [95% CI, -0.56 to -0.03; P = .03]), whereas no significant effect was found on patients' quality of life. Dyadic results including anxiety, self-efficacy, disease communication, and appraisals of illness/caregiving were observed. CONCLUSION Dyadic psychoeducational intervention reduced the dyadic depression. It also improved caregivers' quality of life. IMPLICATIONS FOR PRACTICE Nurses can apply dyadic psychoeducational intervention in clinical practice. More studies are needed to draw higher-quality conclusions and investigate the effects on psychological health and illness-related outcomes in cancer patients and caregivers.
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Affiliation(s)
- Daoming Chen
- Author Affiliations: Department of Operating Room, The Affiliated Hospital of Xuzhou Medical University (Ms Chen), Xuzhou; and School of Nursing, Medical College, Soochow University (Ms Liu and Dr Zhang); and Department of Respiratory, The First Affiliated Hospital of Soochow University (Ms Qian), Suzhou, Jiangsu, People's Republic of China
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Brunt LJ, Rivalland A, Panek-Hudson Y, Krishnasamy M. An Integrative Review of the Support Needs of Informal Caregivers of Hematological Cancer Patients in the Period Immediately Following Discharge From Inpatient to Outpatient Care. Cancer Nurs 2023:00002820-990000000-00186. [PMID: 37962212 DOI: 10.1097/ncc.0000000000001292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
BACKGROUND Preparing informal caregivers for a patient's transition to outpatient care is an important component of safe, quality hematological cancer care. The development of many novel therapies and emerging treatments has created opportunities to address the needs of informal caregivers following the discharge of patients from inpatient settings. OBJECTIVE To review and synthesize the literature on the needs of informal caregivers of patients with a hematological malignancy postdischarge from inpatient care. INTERVENTIONS/METHODS Integrative review methodology was used to explore the body of evidence available. This included a quality appraisal of qualitative, quantitative, and mixed-methods research findings, subsequent data extraction, and inductive thematic synthesis. RESULTS One thousand eight articles were screened with 10 included in the review. Key insights into the needs of caregivers entering the outpatient setting were identified and grouped into key subheadings: Encountering complex emotions knowing what to know, little time for yourself, and collateral impact. CONCLUSION Findings convey the complex and multiple needs of informal caregivers of hematological cancer patients. With a growing population of people with hematological malignancies and innovations in outpatient cancer therapies, there is a pressing need to codesign interventions to support their caregivers. IMPLICATIONS FOR PRACTICE This review has identified a need for more robust research to coproduce interventions in collaboration with caregivers. In addition, interventions developed from further research should be tested in quality implementation science studies to determine their feasibility, sustainability, and impact on outcomes that matter to hematological cancer caregivers.
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Affiliation(s)
- Laura J Brunt
- Author Affiliations: Department of Clinical Haematology, The Royal Melbourne Hospital, City Campus (Mss Brunt, Rivalland, and Panek-Hudson); and Department of Clinical Haematology (Mss Brunt, Rivalland, and Panek-Hudson) and Academic Nursing Unit (Dr Krishnasamy), Peter MacCallum Cancer Centre, Parkville; and Sir Peter MacCallum Departments of Oncology and Nursing, The University of Melbourne (Dr Krishnasamy); and Victorian Comprehensive Cancer Centre Alliance (Dr Krishnasamy), Melbourne, Victoria, Australia
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Longacre ML, Chwistek M, Keleher C, Siemon M, Egleston BL, Collins M, Fang CY. Patient-Caregiver Portal System in Palliative Oncology: Assessment of Usability and Perceived Benefit. JMIR Hum Factors 2023; 10:e47624. [PMID: 37917129 PMCID: PMC10654898 DOI: 10.2196/47624] [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: 03/27/2023] [Revised: 07/06/2023] [Accepted: 08/27/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND The engagement of family caregivers in oncology is not universal or systematic. OBJECTIVE We implemented a process intervention (ie, patient-caregiver portal system) with an existing patient portal system to (1) allow a patient to specify their caregiver and communication preferences with that caregiver, (2) connect the caregiver to a unique caregiver-specific portal page to indicate their needs, and (3) provide an electronic notification of the dyad's responses to the care team to inform clinicians and connect the caregiver to resources as needed. METHODS We assessed usability and satisfaction with this patient-caregiver portal system among patients with cancer receiving palliative care, their caregivers, and clinicians. RESULTS Of 31 consented patient-caregiver dyads, 20 patients and 19 caregivers logged in. Further, 60% (n=12) of patients indicated a preference to communicate equally or together with their caregiver. Caregivers reported high emotional (n=9, 47.3%), financial (n=6, 31.6%), and physical (n=6, 31.6%) caregiving-related strain. The care team received all patient-caregiver responses electronically. Most patients (86.6%, 13/15 who completed the user experience interview) and caregivers (94%, 16/17 who completed the user experience interview) were satisfied with the system, while, of the 6 participating clinicians, 66.7% agreed "quite a bit" (n=1, 16.7%) or "very much" (n=3, 50%) that the system allowed them to provide better care. CONCLUSIONS Our findings demonstrate system usability, including a systematic way to identify caregiver needs and share with the care team in a way that is acceptable to patients and caregivers and perceived by clinicians to benefit clinical care. Integration of a patient-caregiver portal system may be an effective approach for systematically engaging caregivers. These findings highlight the need for additional research among caregivers of patients with less advanced cancer or with different illnesses.
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Affiliation(s)
| | - Marcin Chwistek
- Supportive Oncology and Palliative Care Program, Fox Chase Cancer Center, Philadelphia, PA, United States
| | - Cynthia Keleher
- Web Technologies Department, Fox Chase Cancer Center, Philadelphia, PA, United States
| | - Mark Siemon
- Web Technologies Department, Fox Chase Cancer Center, Philadelphia, PA, United States
| | - Brian L Egleston
- Biostatistics and Bioinformatics Facility, Fox Chase Cancer Center, Philadelphia, PA, United States
| | - Molly Collins
- Supportive Oncology and Palliative Care Program, Fox Chase Cancer Center, Philadelphia, PA, United States
| | - Carolyn Y Fang
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA, United States
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Wang Y, Wu Y, Hu R. Decision-making trade-offs: A classic grounded theory study of Chinese acute leukaemia patients and their family caregivers across the trajectory of illness. J Clin Nurs 2023; 32:7834-7845. [PMID: 37614047 DOI: 10.1111/jocn.16851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 07/12/2023] [Accepted: 08/02/2023] [Indexed: 08/25/2023]
Abstract
AIM AND OBJECTIVES To identify the main concern of patients with acute leukaemia and their family caregivers in the process of coping with the disease and to determine how patients and their family caregivers address these concerns on an ongoing basis. BACKGROUND Acute leukaemia is a progressive disease that may lead to physical problems and mental stress in patients. It also affects the psychological well-being and quality of life of family caregivers. Nevertheless, few studies explore the behavioural pattern across the trajectories of illness in Chinese patients with acute leukaemia and their family caregivers. DESIGN Grounded theory. METHODS Theoretical sampling was performed to collect 14 sets of secondary data from Bilibili platform, literature, articles from WeChat official account, press releases and documentary. A total of 29 participants were selected to participate in semistructured interviews from the haematology department of a tertiary care hospital in Fuzhou, Fujian Province from January 2021 to November 2021. Data collection and analysis were conducted in a synchronous iterative manner until theoretical saturation was reached. Data analysis included open coding, selective coding and constant comparison, et al. The CCOREQ checklist was utilised. RESULTS This study discovered the main concern (i.e. seeking survival) and main behavioural pattern of how patients with acute leukaemia and their family caregivers addressed this issue. Three decision-making strategies, 'responding' 'accommodating' and 'resisting' also emerged. CONCLUSIONS This study explored the behavioural pattern of patients with acute leukaemia and their family caregivers in the process of coping with disease. The study found that the main concern of patients with acute leukaemia and their family caregivers, and provided a theoretical basis for disease management and nursing interventions for them in the future. RELEVANCE TO CLINICAL PRACTICE The findings of this study contribute to nursing knowledge, practice in the field of patients' participation in decision-making. PATIENT OR PUBLIC CONTRIBUTION Due to the characteristics of grounded theory (no presupposition of research questions), the interviews in this study mainly focus on theory generation. Participants were not asked to assess the burden of the intervention and the time required to participate in the study, as interviews were conducted for theory generation. This study may assist patients and family caregivers in obtaining better understand and adapt to changes across the trajectory of illness, as well as to promote public destigmatisation of acute leukaemia and reforms in family-hospital-community diversified care.
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Affiliation(s)
- Ying Wang
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Yong Wu
- Department of Hematology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Rong Hu
- The School of Nursing, Fujian Medical University, Fuzhou, China
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van Niekerk K, Stancheva V, Smith C. Caregiver burden among caregivers of children with autism spectrum disorder. S Afr J Psychiatr 2023; 29:2079. [PMID: 37928940 PMCID: PMC10623632 DOI: 10.4102/sajpsychiatry.v29i0.2079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 09/13/2023] [Indexed: 11/07/2023] Open
Abstract
Background Autism spectrum disorder (ASD) is a neurodevelopmental disorder with deficits in social communication and interaction, restricted and repetitive patterns of behaviour, interests and activities. Autism spectrum disorder is associated with multiple comorbidities. As a result, caregivers of children with ASD experience increased levels of burden and poor quality of life. However, there is a paucity of information on the burden. Aim The study aimed to describe the sociodemographic profiles and determine the extent of the burden experienced by caregivers of children and adolescents with ASD. Setting The Child, Adolescent and Family Unit (CAFU) outpatient services at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH). Methods A quantitative, descriptive, cross-sectional study was done. Two self-administered questionnaires were used: a sociodemographic questionnaire and the 12-item Zarit Burden Interview questionnaire. Results The questionnaires were completed by 77 caregivers, of which the majority were female (n = 56 or 72.3%), mothers to children with ASD (n = 49 or 64.3%) and identified as Christian (p < 0.001). Most had completed secondary school or had a tertiary education (p = 0.003) and were employed (p < 0.001). Among the caregivers, 41.6% experienced mild to moderate burden, 33.8% experienced high burden and only 24.9% reported no to mild burden. Conclusion Caregivers of children and adolescents with a diagnosis of ASD are mostly mothers and experience mild to moderate levels of caregiver burden, suggesting the need for improved screening and psychosocial support programmes. Contribution This study highlights the burden experienced by primary caregivers of children with ASD and is one of the few comprehensive studies on this issue within the context of South Africa.
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Affiliation(s)
- Karli van Niekerk
- Department of Psychiatry, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Venera Stancheva
- Department of Psychiatry, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Cornelia Smith
- Department of Psychiatry, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
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Suresh M, Risbud R, Patel MI, Lorenz KA, Schapira L, Gallagher-Thompson D, Trivedi R. Clinic-based Assessment and Support for Family Caregivers of Patients With Cancer: Results of a Feasibility Study. CANCER CARE RESEARCH ONLINE 2023; 3:e047. [PMID: 38328267 PMCID: PMC10846853 DOI: 10.1097/cr9.0000000000000047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
Background Cancer caregiving is burdensome with unique needs, highlighting the importance of assessing caregivers' distress. Caregivers often accompany patients to healthcare visits, presenting an opportunity to complete distress screening at patients' point-of-care. Objective To evaluate the feasibility of caregiver distress screening at patients' point-of-care and implementing a caregiver psychoeducational session. Methods We approached caregivers in outpatient cancer clinic waiting rooms. Participants completed depression, burden, anxiety, quality of life, and stress measures. A psychoeducational session with a psychologist was offered to those meeting clinical cutoffs for depression and/or burden. Fifty caregivers completed 1+ measure; however, due to incomplete consent documentation, findings from 23 caregivers are reported. Results 22% of caregivers screened positive for depression, 30% burden, and 70% anxiety. More than half rated stress as moderate or higher. Mental wellbeing was slightly below that of the general population. More than 75% screened positive on 1+ distress measure. Of the 9 caregivers who met cutoffs for depression and/or burden, two (22%) accepted the psychoeducational session. Conclusion Caregivers were moderately receptive to distress screening during patients' visits, but were less receptive to engaging in the psychoeducational session due to time constraints and privacy concerns. Implications for Practice Assessing caregivers' distress can facilitate referrals for supportive services. Offering caregivers psychoeducational intervention outside of patient care may not be acceptable. Future research may evaluate the integration of routine caregiver screening within patient care to promote engagement with mental health services. Foundational This research offers a unique method of assessing cancer caregivers' distress.
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Affiliation(s)
- Madhuvanthi Suresh
- Department of Neurological Sciences, Rush University Medical Center, Chicago, USA (Dr Suresh); Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, CA, USA (Drs Suresh, Lorenz and Trivedi, Ms Risbud); Division of Oncology, Stanford University School of Medicine, Stanford, CA USA (Dr Patel); Medical Services, VA Palo Alto Health Care System, Palo Alto, CA USA (Drs Patel and Lorenz); Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, USA (Dr Shapira); Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, USA (Dr Gallagher-Thompson); Division of Public Mental Health and Population Sciences, Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA (Dr Trivedi)
| | - Rashmi Risbud
- Department of Neurological Sciences, Rush University Medical Center, Chicago, USA (Dr Suresh); Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, CA, USA (Drs Suresh, Lorenz and Trivedi, Ms Risbud); Division of Oncology, Stanford University School of Medicine, Stanford, CA USA (Dr Patel); Medical Services, VA Palo Alto Health Care System, Palo Alto, CA USA (Drs Patel and Lorenz); Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, USA (Dr Shapira); Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, USA (Dr Gallagher-Thompson); Division of Public Mental Health and Population Sciences, Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA (Dr Trivedi)
| | - Manali I Patel
- Department of Neurological Sciences, Rush University Medical Center, Chicago, USA (Dr Suresh); Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, CA, USA (Drs Suresh, Lorenz and Trivedi, Ms Risbud); Division of Oncology, Stanford University School of Medicine, Stanford, CA USA (Dr Patel); Medical Services, VA Palo Alto Health Care System, Palo Alto, CA USA (Drs Patel and Lorenz); Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, USA (Dr Shapira); Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, USA (Dr Gallagher-Thompson); Division of Public Mental Health and Population Sciences, Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA (Dr Trivedi)
| | - Karl A Lorenz
- Department of Neurological Sciences, Rush University Medical Center, Chicago, USA (Dr Suresh); Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, CA, USA (Drs Suresh, Lorenz and Trivedi, Ms Risbud); Division of Oncology, Stanford University School of Medicine, Stanford, CA USA (Dr Patel); Medical Services, VA Palo Alto Health Care System, Palo Alto, CA USA (Drs Patel and Lorenz); Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, USA (Dr Shapira); Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, USA (Dr Gallagher-Thompson); Division of Public Mental Health and Population Sciences, Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA (Dr Trivedi)
| | - Lidia Schapira
- Department of Neurological Sciences, Rush University Medical Center, Chicago, USA (Dr Suresh); Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, CA, USA (Drs Suresh, Lorenz and Trivedi, Ms Risbud); Division of Oncology, Stanford University School of Medicine, Stanford, CA USA (Dr Patel); Medical Services, VA Palo Alto Health Care System, Palo Alto, CA USA (Drs Patel and Lorenz); Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, USA (Dr Shapira); Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, USA (Dr Gallagher-Thompson); Division of Public Mental Health and Population Sciences, Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA (Dr Trivedi)
| | - Dolores Gallagher-Thompson
- Department of Neurological Sciences, Rush University Medical Center, Chicago, USA (Dr Suresh); Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, CA, USA (Drs Suresh, Lorenz and Trivedi, Ms Risbud); Division of Oncology, Stanford University School of Medicine, Stanford, CA USA (Dr Patel); Medical Services, VA Palo Alto Health Care System, Palo Alto, CA USA (Drs Patel and Lorenz); Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, USA (Dr Shapira); Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, USA (Dr Gallagher-Thompson); Division of Public Mental Health and Population Sciences, Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA (Dr Trivedi)
| | - Ranak Trivedi
- Department of Neurological Sciences, Rush University Medical Center, Chicago, USA (Dr Suresh); Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, CA, USA (Drs Suresh, Lorenz and Trivedi, Ms Risbud); Division of Oncology, Stanford University School of Medicine, Stanford, CA USA (Dr Patel); Medical Services, VA Palo Alto Health Care System, Palo Alto, CA USA (Drs Patel and Lorenz); Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, USA (Dr Shapira); Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, USA (Dr Gallagher-Thompson); Division of Public Mental Health and Population Sciences, Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA (Dr Trivedi)
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Buchanan A, Sarfo A, Rangel ML, Nangia J, Badr H. A mixed-methods study to inform development of a caregiver-specific problem list for cancer distress screening. Psychooncology 2023; 32:1578-1585. [PMID: 37698499 DOI: 10.1002/pon.6209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 08/11/2023] [Accepted: 08/23/2023] [Indexed: 09/13/2023]
Abstract
OBJECTIVE Oncology guidelines for distress management recommend use of the single-item distress thermometer (DT) and accompanying Problem List (PL) to identify patients with high distress levels and their potential sources of distress. However, oncology practices have yet to establish standardized protocols to screen and triage caregivers with high distress levels. With an eye toward integrating caregiver-centered support services into cancer care, this mixed-methods study sought to assess caregiver distress and challenges that may contribute to their distress. METHODS Nineteen caregivers of metastatic breast cancer patients (60% female, 47% ethnic/racial minority) completed an interview and a survey comprised of the DT, the original 39-item PL, and five additional caregiver-specific PL items. RESULTS Caregivers reported moderate distress levels and more than half exceeded the National Comprehensive Cancer Network (NCCN) cut-off, denoting significant distress. There was no association between caregiver distress and the number of items endorsed on the original PL. Qualitative analysis identified nine problem domains as areas of caregiver unmet need needs (i.e., practical challenges, caregiving responsibilities, social/relationship issues, caregiver and patient emotional well-being, caregiver and patient physical well-being, spiritual well-being, and communication). Two of the problem domains (caregiving responsibilities and communication) were not captured in any way by the original PL. CONCLUSION With further research and development, the identified domains could serve as the basis for a caregiver-specific PL to facilitate triage and referral when incorporated as part of routine distress screening.
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Affiliation(s)
- Ashley Buchanan
- Department of Psychology & Neuroscience, Baylor University, Waco, Texas, USA
| | - Astrid Sarfo
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Maria Lizette Rangel
- Margaret M. and Albert B. Alkek Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Julie Nangia
- Lester & Sue Smith Breast Center, Baylor College of Medicine, Houston, Texas, USA
- Dan L Duncan Comprehensive Cancer Center, Houston, Texas, USA
| | - Hoda Badr
- Margaret M. and Albert B. Alkek Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
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Richardson CL, Black D, Lindsey L, Nazar H. Community pharmacies as a place for informal carer support in mental health and wellbeing. Int J Clin Pharm 2023; 45:1302-1306. [PMID: 37269442 PMCID: PMC10239217 DOI: 10.1007/s11096-023-01606-9] [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: 02/09/2023] [Accepted: 05/12/2023] [Indexed: 06/05/2023]
Abstract
There are 5.3 million informal carers in the United Kingdom who take on caring responsibilities for family and friends. Informal carers can be forgotten patients within health and care services, yet because of carer burden, they are at risk of deterioration in health and wellbeing. There are higher levels of anxiety, depression, burnout and low self-esteem amongst carers but, to our knowledge work to date has mainly focused on supporting carers to provide better care for their family member, and less on carers' health and wellbeing. There is increasing interest in social prescribing as a method of linking patients with community-based services to improve health and wellbeing. Initiatives have included social prescribing via community pharmacies which are already recognized to be accessible for support and signposting. The coming together of community pharmacy services and social prescribing could represent a framework to better support carers in their mental health and wellbeing.
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Affiliation(s)
- Charlotte Lucy Richardson
- Faculty of Medical Sciences, School of Pharmacy, Newcastle University, King George VI Building, Newcastle Upon Tyne, NE2 7RU, UK.
| | - David Black
- Faculty of Medical Sciences, School of Pharmacy, Newcastle University, King George VI Building, Newcastle Upon Tyne, NE2 7RU, UK
| | - Laura Lindsey
- Faculty of Medical Sciences, School of Pharmacy, Newcastle University, King George VI Building, Newcastle Upon Tyne, NE2 7RU, UK
| | - Hamde Nazar
- Faculty of Medical Sciences, School of Pharmacy, Newcastle University, King George VI Building, Newcastle Upon Tyne, NE2 7RU, UK
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Almeida V, Pires D, Silva M, Teixeira M, Teixeira RJ, Louro A, Dinis MAP, Ferreira M, Teixeira A. Dermatological Side Effects of Cancer Treatment: Psychosocial Implications-A Systematic Review of the Literature. Healthcare (Basel) 2023; 11:2621. [PMID: 37830658 PMCID: PMC10572319 DOI: 10.3390/healthcare11192621] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 09/13/2023] [Accepted: 09/21/2023] [Indexed: 10/14/2023] Open
Abstract
Cancer is a leading cause of mortality and morbidity all over the world and the second major cause of death in Portugal. Dermatological side effects resulting from cancer treatment have a psychosocial impact on patients' lives, such as quality of life (QoL), body image, cognitive fusion and social inhibition. This systematic review aimed to explore and synthesize the psychosocial impact of dermatological side effects of cancer treatment, answering the following research objectives: (i) Do the dermatological side effects of the cancer treatment present any psychosocial impact for the patients? (ii) How does the psychosocial impact of the dermatological toxicities of the cancer treatment manifest in patients' lives? Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed and guided a systematic search through the PubMed, Cochrane Library and PyscNet databases. The considered studies correlate dermatological side effects of cancer treatments and their psychological/psychosocial outcomes. The studies found were all published in peer-reviewed journals. The results obtained established that cancer treatment causes the most varied skin changes, consequently reducing self-esteem and QoL; disturbing body image; and contributing to cases of stress, depression and anxiety. There is still limited literature that profoundly investigates the experience of living with these skin toxicities. The development of research lines to improve knowledge in this field will allow for significant improvements in healthcare for patients undergoing cancer treatment who need to focus more on the psychosocial implications of skin toxicities. The novelty of this review lies in adding knowledge summarizing the psychosocial implications of dermatological side effects of cancer treatment to support healthcare providers in the development of integrative therapeutic strategies for these patients in their clinical practice.
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Affiliation(s)
- Vera Almeida
- UNIPRO—Oral Pathology and Rehabilition Research Unit, University Institute of Health Sciences (IUCS), CESPU, CRL, 4585-116 Gandra, Portugal;
- UCIBIO—Applied Molecular Biosciences Unit, MedTech-Laboratory of Pharmaceutical Technology, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal;
| | - Daniela Pires
- University Institute of Health Sciences (IUCS), CESPU, CRL, 4585-116 Gandra, Portugal; (D.P.); (M.S.); (M.F.)
| | - Marta Silva
- University Institute of Health Sciences (IUCS), CESPU, CRL, 4585-116 Gandra, Portugal; (D.P.); (M.S.); (M.F.)
| | - Maribel Teixeira
- 1H-TOXRUN—One Health Toxicology Research Unit, University Institute of Health Sciences (IUCS), CESPU, CRL, 4585-116 Gandra, Portugal
| | - Ricardo João Teixeira
- REACH—Mental Health Clinic, 4000-138 Porto, Portugal;
- CINEICC, Faculty of Psychology and Educational Sciences, University of Coimbra, 3004-531 Coimbra, Portugal
| | - André Louro
- REACH—Mental Health Clinic, 4000-138 Porto, Portugal;
- RECI—Research Unit in Education and Community Intervention, Instituto Piaget—ISEIT/Viseu, 1950-157 Viseu, Portugal
| | - Maria Alzira Pimenta Dinis
- UFP Energy, Environment and Health Research Unit (FP-ENAS), University Fernando Pessoa (UFP), Praça 9 de Abril 349, 4249-004 Porto, Portugal;
- Fernando Pessoa Research, Innovation and Development Institute (FP-I3ID), University Fernando Pessoa (UFP), Praça 9 de Abril 349, 4249-004 Porto, Portugal
| | - Maria Ferreira
- University Institute of Health Sciences (IUCS), CESPU, CRL, 4585-116 Gandra, Portugal; (D.P.); (M.S.); (M.F.)
| | - Ana Teixeira
- UCIBIO—Applied Molecular Biosciences Unit, MedTech-Laboratory of Pharmaceutical Technology, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal;
- 1H-TOXRUN—One Health Toxicology Research Unit, University Institute of Health Sciences (IUCS), CESPU, CRL, 4585-116 Gandra, Portugal
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