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La IS, Johantgen M, Storr CL, Zhu S, Cagle JG, Ross A. Spirituality moderates the relationship between cancer caregiver burden and depression. Palliat Support Care 2024; 22:470-481. [PMID: 38131143 DOI: 10.1017/s1478951523001785] [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
OBJECTIVES Cancer has become a chronic disease that requires a considerable amount of informal caregiving, often quite burdensome to family caregivers. However, the influence of spirituality on the caregivers' burden and mental health outcomes has been understudied. This study was to examine how caregiver burden, spirituality, and depression change during cancer treatment and investigate the moderating role of spirituality in the relationship between caregiver burden and depression for a sample of caregivers of persons with cancer. METHODS This secondary analysis used a longitudinal design employing 3 waves of data collection (at baseline, 3 months, and 6 months). Family caregivers completed the Caregiver Reaction Assessment, Spiritual Perspective Scale, and the PROMIS® depression measure. Linear mixed model analyses were used, controlling for pertinent covariates. RESULTS Spirituality, total caregiver burden, and depression remained stable over 6 months. More than 30% of the caregivers had mild to severe depressive symptoms at 3 time points. There was evidence of overall burden influencing depression. Of note was a protective effect of caregivers' spirituality on the relationship between depression and caregiver burden over time (b = -1.35, p = .015). The lower the spirituality, the stronger the relationship between depression and burden, especially regarding subscales of schedule burden, financial burden, and lack of family support. SIGNIFICANCE OF RESULTS Spirituality was a significant resource for coping with caregiving challenges. This study suggests that comprehensive screening and spiritual care for cancer caregivers may improve their cancer caregiving experience and possibly influence the care recipients' health.
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Affiliation(s)
- In Seo La
- College of Nursing Science, Kyung Hee University, Seoul, South Korea
| | - Meg Johantgen
- University of Maryland School of Nursing, Baltimore, MD, USA
| | - Carla L Storr
- University of Maryland School of Nursing, Baltimore, MD, USA
| | - Shijun Zhu
- University of Maryland School of Nursing, Baltimore, MD, USA
| | - John G Cagle
- University of Maryland School of Social Work, Baltimore, MD, USA
| | - Alyson Ross
- Wisdom of the Whole Coaching Academy, Asheville, NC, USA
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El Hajj W, Buisson A, Olympie A, Ravel MH, Devos C, Trang-Poisson C, Macaigne G, Nahon S. Impact of Inflammatory Bowel Disease on Patients' Caregivers: Results From a French Survey. Inflamm Bowel Dis 2024; 30:538-546. [PMID: 37260357 DOI: 10.1093/ibd/izad093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Indexed: 06/02/2023]
Abstract
BACKGROUND The impact of inflammatory bowel disease (IBD) on caregivers has rarely been investigated. Our work aims to explore the burden of IBD on the different aspects of caregivers' lives. METHODS We conducted an online survey via the social network of the French IBD patient organization addressed to patients' caregivers who were asked to fill in a questionnaire covering the impact of the disease on different aspects of their lives. Impacts were measured by a visual analog scale (VAS). A VAS score ≥5 of 10 was considered significantly high. We then performed uni- and multivariate analyses of predictors of higher impact on parents and partners, separately. RESULTS A total of 853 caregivers participated, predominantly women (77%). The mean age was 48.5 years. Their relationship with the patient was mainly parents in 57.1% and partners in 30.6%. The type of IBD was Crohn's disease in 63% and ulcerative colitis in 35%. The psychological burden was the highest among parents and was mainly correlated with a lack of knowledge about IBD and professional compromise (P < .05). The impact on leisure was the highest among partners and was affected by psychological, sexual, and professional burdens (P < .05). About 50% of partners experienced an absent sexual relationship for weeks/months and decreased libido regardless of IBD type. Professional impact was greater in parents compared with partners, and 36% of caregivers needed work arrangements. CONCLUSIONS IBD has a high impact on different aspects of life of patients' caregivers. Therefore, interventions to reduce the disease burden in this population are needed.
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Affiliation(s)
- Weam El Hajj
- Gastroenterology Division, Groupe Hospitalier Intercommunal Le Raincy-Montfermeil, Montfermeil, France
| | - Anne Buisson
- Department of Clinical Research, Afa Crohn RCH, Paris, France
| | - Alain Olympie
- Department of Clinical Research, Afa Crohn RCH, Paris, France
| | | | - Corinne Devos
- Department of Clinical Research, Afa Crohn RCH, Paris, France
| | | | - Gilles Macaigne
- Gastroenterology Division, Groupe Hospitalier Intercommunal Le Raincy-Montfermeil, Montfermeil, France
| | - Stéphane Nahon
- Gastroenterology Division, Groupe Hospitalier Intercommunal Le Raincy-Montfermeil, Montfermeil, France
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Ngo D, Palmer GM, Gorrie A, Kenmuir T, Crawford M, Jaaniste T. Caregiver Burden Associated With Pediatric Chronic Pain: A Retrospective Study Using the Pediatric Electronic Persistent Pain Outcomes Collaboration Database. Clin J Pain 2024; 40:137-149. [PMID: 38149451 DOI: 10.1097/ajp.0000000000001189] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 12/14/2023] [Indexed: 12/28/2023]
Abstract
OBJECTIVES This retrospective, cross-sectional study investigated the nature and extent of burden experienced by caregivers of children and adolescents with chronic pain, and factors associated with increased caregiver burden. METHODS The Pediatric Electronic Persistent Pain Outcomes Collaboration database provided prospectively collected data from 1929 families attending 9 pediatric chronic pain services across Australia and New Zealand. Data included demographic information, responses to child pain and functioning measures, caregiver work impairment, and psychosocial functioning. RESULTS Caregivers of children with chronic pain reported work impairment associated with their child's pain (mean: 15% ± SD 25 absenteeism; 38% ± SD 29 productivity lost), significantly worse than published international population norms (large-scale community survey data), most other caregiver samples of adults and children with other chronic conditions, and adult samples with various pain conditions. Caregivers reported considerable burden in multiple psychosocial functioning domains, particularly leisure functioning, pain-related catastrophizing, and adverse parenting behaviors (with greater pain-related avoidance). Caregiver psychosocial burden was significantly associated with child psychosocial functioning (β = -0.308, P < 0.01), school absenteeism (β = 0.161, P < 0.01), physical disability (β = 0.096, P < 0.05), and pain duration (β = 0.084, P < 0.05), but not pain intensity. Caregiver work productivity loss was significantly associated with school absenteeism (β = 0.290, P < 0.01), child physical disability (β = 0.148, P < 0.01), child health care utilization (β = 0.118, P < 0.05), and worst pain intensity (β = 0.101, P < 0.05). DISCUSSION These results highlight the significant and varied impacts experienced by caregivers of children with chronic pain. This work is novel in reporting significant work impairment and confirms psychosocial burden in a larger sample than previous studies.
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Affiliation(s)
- Danny Ngo
- Department of Pain, Sydney Children's Hospital, Randwick
- School of Clinical Medicine, University of New South Wales, Kensington, NSW
| | - Greta M Palmer
- Children's Pain Management Service, Royal Children's Hospital, Melbourne
- Department of Pediatrics, University of Melbourne
- Murdoch Children's Research Institute, VIC, Australia
| | - Andrew Gorrie
- Department of Pain, Sydney Children's Hospital, Randwick
- School of Clinical Medicine, University of New South Wales, Kensington, NSW
| | - Tracey Kenmuir
- Department of Pain, Sydney Children's Hospital, Randwick
- School of Clinical Medicine, University of New South Wales, Kensington, NSW
| | | | - Tiina Jaaniste
- Department of Pain, Sydney Children's Hospital, Randwick
- School of Clinical Medicine, University of New South Wales, Kensington, NSW
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Cheung A, Kuti EL, Osenenko KM, Friesen M, Donato BMK. Impact of Caring for Individuals With Heart Failure in the United States: A Systematic Literature Review. J Cardiovasc Nurs 2024; 39:128-141. [PMID: 37249549 DOI: 10.1097/jcn.0000000000001005] [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: 05/31/2023]
Abstract
BACKGROUND Given the functional impairments and complex care routines associated with heart failure (HF), patients often rely on the support of informal caregivers. Although the importance of caregivers' roles is widely recognized, the intensity and time required for care duties may negatively impact caregiver health and well-being, potentially precipitating their own need for care. OBJECTIVE The aim of this study was to synthesize estimates of economic, clinical, burden, and health-related quality-of-life impact among caregivers of those with HF in the United States. METHODS A systematic review was conducted to identify studies reporting estimates of caregiver impact. Abstract and full-text review as well as data extraction were performed according to established guidelines. Patient and caregiver characteristics were summarized, as well as estimates of impact of caring for those with HF. RESULTS From 3680 abstracts, 44 studies reporting caregiver burden estimates were included. Mean caregiver age ranged from 41.4 to 71.4 years; caregivers were primarily female (range, 49%-100%) and the patient's spouse/partner (21%-100%). Time spent caregiving (6 studies) ranged from 2 to 52 h/wk, and depression was identified in up to 40% of caregivers (9 studies). Numerous instruments were used to measure burden, which consistently documented the high impact of caregiving. CONCLUSIONS This review demonstrates the multifaceted impact of caregiving for patients with HF. Despite limited data, notable findings included the considerable burden to caregivers, variability in time spent caregiving, and frequent experience of depression among caregivers, possibly leading to increased healthcare resource use. Future research is needed to better characterize the caregiving impact in HF, including evaluating the drivers of burden.
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Allison K, Power R, Ussher JM, Perz J. "Queer people are excellent caregivers, but we're stretched so very thin": Psychosocial wellbeing and impacts of caregiving among LGBTQI cancer carers. BMC Cancer 2024; 24:36. [PMID: 38182998 PMCID: PMC10768402 DOI: 10.1186/s12885-023-11732-2] [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: 06/06/2023] [Accepted: 12/08/2023] [Indexed: 01/07/2024] Open
Abstract
BACKGROUND LGBTQI (lesbian, gay, bisexual, transgender, queer and/or intersex) communities are increasingly recognized as a vulnerable and high-risk population in oncology. LGBTQI cancer carers, including carers who are LGBTQI and other carers of LGBTQI people, experience many of the same stressors as LGBTQI patients but their support needs are often overlooked in the cancer literature. METHOD This mixed-methods study examined distress and quality of life in LGBTQI cancer carers. Online surveys were completed by 129 carers and 31 carers took part in a one-to-one semi-structured interview. Analyses of variance (ANOVAs) tested for differences in psychosocial outcomes and carer experiences by gender, sexuality, age, carer relationship and carer/patient LGBTQI status. Reflexive thematic analysis of interviews and open-ended survey responses facilitated in-depth examination of subjective experiences. RESULTS 42.6% of participants reported high or very high distress. Distress was significantly positively correlated with discrimination in cancer care, health impact, financial impact and lack of family support; it was negatively correlated with comfort in LGBTQI sexuality and gender identity, social support and quality of life. Four themes were identified in thematic analysis of qualitative data: (1) Identity on the sidelines: LGBTQI sexuality and gender pushed aside during cancer caregiving; (2) Fear of being shut-out: rejection and exclusion of LGBTQI cancer carers; (3) Lack of support for LGBTQI caregivers; and (4) Closer and stronger relationships due to a culture of mutual caregiving. CONCLUSIONS LGBTQI cancer carers must contend with typical caregiving demands whilst also managing additional minority stressors, including discrimination, rejection from family, isolation from LGBTQI communities, and invisibility in healthcare and support services. Despite this, LGBTQI carers showed resilience in building their own mutually supportive networks to rally around the person with cancer, which were reported to ameliorate psychosocial vulnerabilities. Service providers need to recognize the needs of LGBTQI cancer carers through inclusive and reflective practices. This will facilitate trust and patient and carer sexuality and gender identity disclosure, with positive consequences for wellbeing and satisfaction with cancer care.
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Affiliation(s)
- Kimberley Allison
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
| | - Rosalie Power
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
| | - Jane M Ussher
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia.
| | - Janette Perz
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
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Flora DR, Evens AM, Liu N, Yu KS, Byrd R, Fanale MA, Holmes K, Flores C, Surinach A, Parsons SK. The impact of classic Hodgkin lymphoma on informal caregivers: results from the CONNECT cross-sectional survey. Support Care Cancer 2023; 31:664. [PMID: 37914825 PMCID: PMC10620297 DOI: 10.1007/s00520-023-08120-8] [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: 05/11/2023] [Accepted: 10/15/2023] [Indexed: 11/03/2023]
Abstract
PURPOSE As part of the CONNECT study, we evaluated the caregiver role in treatment decision-making when caring for patients with classic Hodgkin lymphoma (cHL) in the USA. METHODS The CONNECT caregiver survey was administered online December 2020-March 2021 to self-identified adult caregivers of cHL patients recruited from patient referrals and online panels. The caregiver's role in treatment decision-making, health-related quality of life (HRQoL, PROMIS-Global), and work impacts (WPAI:CG) were assessed. RESULTS We surveyed 209 caregivers (58% women; median age 47 years; 54% employed; 53% spouse/partner); 69% of patients cared for were diagnosed with cHL in the past 1-2 years, with 48% having stage III/IV cHL and 29% in remission. More spouse/partner than other caregivers were involved in caregiving at symptom onset (61% vs 27%), whereas more other than spouse/partner caregivers began after first treatment (34% vs 5%). Cure, caregivers' top treatment goal (49%), was rated higher by spouse/partner than other caregivers (56% vs 42%). More spouse/partner than other caregivers were involved in treatment option discussions with physicians (52% vs 28%), were involved in patients' treatment decisions (54% vs 23%), and were aligned with patients' treatment goals (93% vs 79%). While caregivers reported HRQoL similar to that of the general population, nearly 30% of employed caregivers reported work impairment. CONCLUSION Cure was caregivers' top treatment goal. Spouse/partner vs other caregivers were more involved, were involved earlier, and reported greater alignment with patient treatment goals and decision-making. Caregivers reported good HRQoL; however, caregiving impacted work productivity regardless of patient relationship.
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Affiliation(s)
| | - Andrew M Evens
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | | | | | | | | | | | | | | | - Susan K Parsons
- Tufts Medical Center, 800 Washington Street, Boston, MA, 02111, USA.
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Van Houtven CH, Miller KEM, James HJ, Blunt R, Zhang W, Mariani AC, Rose S, Alolod GP, Wilson-Genderson M, Smith VA, Thomson MD, Siminoff LA. Economic costs of family caregiving for persons with advanced stage cancer: a longitudinal cohort study. J Cancer Surviv 2023:10.1007/s11764-023-01462-6. [PMID: 37823982 DOI: 10.1007/s11764-023-01462-6] [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: 07/03/2023] [Accepted: 09/05/2023] [Indexed: 10/13/2023]
Abstract
PURPOSE To form a multifaceted picture of family caregiver economic costs in advanced cancer. METHODS A multi-site cohort study collected prospective longitudinal data from caregivers of patients with advanced solid tumor cancers. Caregiver survey and out-of-pocket (OOP) receipt data were collected biweekly in-person for up to 24 weeks. Economic cost measures attributed to caregiving were as follows: amount of OOP costs, debt accrual, perceived economic situation, and working for pay. Descriptive analysis illustrates economic outcomes over time. Generalized linear mixed effects models asses the association of objective burden and economic outcomes, controlling for subjective burden and other factors. Objective burden is number of activities and instrumental activities of daily living (ADL/IADL) tasks, all caregiving tasks, and amount of time spent caregiving over 24 h. RESULTS One hundred ninety-eight caregivers, 41% identifying as Black, were followed for a mean period of 16 weeks. Median 2-week out-of-pocket costs were $111. One-third of caregivers incurred debt to care for the patient and 24% reported being in an adverse economic situation. Whereas 49.5% reported working at study visit 1, 28.6% of caregivers at the last study visit reported working. In adjusted analysis, a higher number of caregiving tasks overall and ADL/IADL tasks specifically were associated with lower out-of-pocket expenses, a lower likelihood of working, and a higher likelihood of incurring debt and reporting an adverse economic situation. CONCLUSIONS Most caregivers of cancer patients with advanced stage disease experienced direct and indirect economic costs. IMPLICATIONS FOR CANCER SURVIVORS Results support the need to find solutions to lessen economic costs for caregivers of persons with advanced cancer.
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Affiliation(s)
- Courtney Harold Van Houtven
- Department of Population Health Sciences, Duke University, 215 Morris Street, Durham, NC, 27701, USA.
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, 508 Fulton Street, Durham, NC, 27705, USA.
- Duke-Margolis Center for Health Policy, Washington, DC, USA.
| | - Katherine E M Miller
- Department of Medical Ethics and Health Policy, University of Pennsylvania, Philadelphia, USA
| | - Hailey J James
- RTI International, 3040 Cornwallis Road, Durham, NC, 27709, USA
| | - Ryan Blunt
- Department of Social and Behavioral Sciences, Temple University, 1700 N. Broad Street, Philadelphia, PA, 19121, USA
| | - Wenhan Zhang
- Department of Population Health Sciences, Duke University, 215 Morris Street, Durham, NC, 27701, USA
| | - Abigail Cadua Mariani
- Department of Health Behavior and Policy, Virginia Commonwealth University, 830 E. Main Street, Richmond, VA, 23219, USA
| | - Sydney Rose
- Department of Social and Behavioral Sciences, Temple University, 1700 N. Broad Street, Philadelphia, PA, 19121, USA
| | - Gerard P Alolod
- Department of Social and Behavioral Sciences, Temple University, 1700 N. Broad Street, Philadelphia, PA, 19121, USA
| | - Maureen Wilson-Genderson
- Department of Social and Behavioral Sciences, Temple University, 1700 N. Broad Street, Philadelphia, PA, 19121, USA
| | - Valerie A Smith
- Department of Population Health Sciences, Duke University, 215 Morris Street, Durham, NC, 27701, USA
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, 508 Fulton Street, Durham, NC, 27705, USA
- Division of General Internal Medicine, Department of Medicine, Duke University, Durham, NC, 27705, USA
| | - Maria D Thomson
- Department of Health Behavior and Policy, Virginia Commonwealth University, 830 E. Main Street, Richmond, VA, 23219, USA
| | - Laura A Siminoff
- Department of Social and Behavioral Sciences, Temple University, 1700 N. Broad Street, Philadelphia, PA, 19121, USA
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Keramat SA, Hashmi R, Aregbeshola BS, Comans T. Informal Caregiving Provision for Disabled or Elderly in the Families and Work Productivity: Evidence from 11 Waves of an Australian Population-Based Cohort. PHARMACOECONOMICS 2023; 41:1117-1136. [PMID: 37338746 PMCID: PMC10449655 DOI: 10.1007/s40273-023-01283-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/17/2023] [Indexed: 06/21/2023]
Abstract
BACKGROUND Informal carers are family members, friends or neighbours who care for persons in need. In 2018, around one in ten Australians offered some informal care, most of which was unpaid. It is essential to comprehend how informal caregivers' productivity at work is affected by their caregiving responsibilities. We examine the association between informal caregiving and productivity loss in Australia. METHODS We utilised 11 waves of data drawn from the Household, Income and Labour Dynamics in Australia (HILDA) survey. Longitudinal random-effects logistic regression and random-effects Poisson regression techniques were used to assess the between-person differences in the association between informal caregiving and productivity loss (absenteeism, presenteeism and working hour tension). RESULTS The results suggest informal caregiving is associated with a higher rate of absenteeism, presenteeism and working hour tension. We reveal that absence/leave rates at work are greater for those with lighter, moderate and intensive care responsibilities than those without caregiving responsibilities, given other covariates reference categories remain constant. Our findings also indicate that workers with intensive, moderate, and light caregiving responsibilities have considerably higher rates of working hour tension than their peers without caregiving commitments if other covariate reference categories are held constant. The result further shows that, on average, an individual with lighter, moderate and intensive caregiving roles had incurred AUD 276.13, AUD 246.81, and AUD 1927.16, respectively, in absenteeism costs annually compared with their counterparts without caregiving duties. CONCLUSION Our study reveals that working-age caregivers experience greater absenteeism, presenteeism and working hour tension. Adverse effects of informal caregiving are required to perform the cost effectiveness of an intervention given to caregivers to improve carer and patient health. Our findings will assist health technology assessment (HTA) practitioners in performing an economic evaluation of interventions given to caregivers by providing the indirect cost (productivity loss) of caregiving.
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Affiliation(s)
- Syed Afroz Keramat
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD Australia
| | - Rubayyat Hashmi
- School of Business, The University of Southern Queensland, Toowoomba, Australia
| | - Bolaji Samson Aregbeshola
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Newcastle, NSW Australia
| | - Tracy Comans
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD Australia
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Xander NSH, Fiets WE, Uyl-de Groot CA. Cost-effectiveness and budget impact of pembrolizumab+axitinib versus sunitinib in patients with advanced clear-cell renal cell carcinoma in the Netherlands. Front Oncol 2023; 13:1205700. [PMID: 37448519 PMCID: PMC10336227 DOI: 10.3389/fonc.2023.1205700] [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: 04/14/2023] [Accepted: 06/12/2023] [Indexed: 07/15/2023] Open
Abstract
Background The phase 3 clinical trial KEYNOTE-426 suggested a higher efficacy regarding overall survival (OS) and progression-free survival (PFS) of pembrolizumab+axitinib compared to sunitinib as a first-line treatment for patients with advanced renal cell carcinoma. In this analysis, the potential cost-effectiveness of this combination treatment versus sunitinib for patients with advanced clear-cell renal cell carcinoma (accRCC) was examined from the societal perspective in the Netherlands. Methods For this analysis, a partitioned survival model was constructed. Clinical data were obtained from the published KEYNOTE-426 trial reports; data on costs and (dis-)utilities were derived from published literature. Costs outside of the healthcare sector included treatment-related travel, informal care and productivity loss. Next to a probabilistic scenario analysis, various scenario analyses were performed that aimed at survival extrapolation, different utility values, treatment duration and drug pricing, as well as restricting the cohort to patients with an intermediate or poor prognosis. Further, a budget impact analysis over three years was conducted, in which a sensitivity analysis concerning ranges in costs and the number of patients was applied. Moreover, a scenario concerning increasing market penetration of pembrolizumab+axitinib up to a market share of 80% in the third year was analyzed. Results The incremental cost-effectiveness ratio (ICER) of pembrolizumab+axitinib was estimated at €368,396/quality-adjusted life year (QALY) gained, with an incremental QALY gain of 0.55 over sunitinib. The probability of cost-effectiveness at a willingness-to-pay threshold of €80,000/QALY was estimated at 0%, a 50% probability was estimated at €340,000/QALY. Cost-effectiveness was not achieved in any of the applied scenarios. The budget impact over three years amounted to €417.3 million upon instantaneous and full replacement of sunitinib, and to €214.9 million with increasing market penetration. Conclusion Pembrolizumab+axitinib was not estimated to be cost-effective compared to sunitinib as a first-line treatment for patients with accRCC in the Netherlands from a societal perspective. In none of the analyzed scenarios, cost-effectiveness was achieved. However, price reductions and shorter treatment durations might lead to a more favorable ICER.
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Affiliation(s)
- Nicolas S. H. Xander
- Department of Health Technology Assessment, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, Netherlands
- Erasmus Centre for Health Economics Rotterdam, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - W. Edward Fiets
- Department of Medical Oncology, Medical Center Leeuwarden, Leeuwarden, Netherlands
| | - Carin A. Uyl-de Groot
- Department of Health Technology Assessment, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, Netherlands
- Erasmus Centre for Health Economics Rotterdam, Erasmus University Rotterdam, Rotterdam, Netherlands
- Institute for Medical Technology Assessment, Rotterdam, Netherlands
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Keita Fakeye MB, Samuel LJ, Drabo EF, Bandeen-Roche K, Wolff JL. Caregiving-Related Work Productivity Loss Among Employed Family and Other Unpaid Caregivers of Older Adults. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2023; 26:712-720. [PMID: 35973924 PMCID: PMC9922792 DOI: 10.1016/j.jval.2022.06.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 06/01/2022] [Accepted: 06/16/2022] [Indexed: 05/03/2023]
Abstract
OBJECTIVES Although nearly half of all family and unpaid caregivers to older adults work, little is known about short-term work impacts of caregiving using measures encompassing both missed work time and reduced productivity while physically at work. We quantify the prevalence, costs, and correlates of caregiving-related work productivity loss. METHODS We used the 2015 National Study of Caregiving and National Health and Aging Trends Study to estimate caregiving-related work absences (absenteeism) and reduced productivity while at work (presenteeism). We calculated costs of lost productivity using hours lost, compensation, and a wage multiplier, accounting for the additional cost of replacing employee time. We examined correlates of caregiving-related absenteeism and presenteeism separately, using multivariable logistic regression models, adjusting for caregiver sociodemographic characteristics, occupation and hours worked, role overload, older adult health, use of respite care, support groups, flexible workplace schedules, help from family or friends, and caregiver training. RESULTS Nearly 1 in 4 (23.3%) of the estimated 8.8 million employed family caregivers reported either absenteeism or presenteeism over a 1-month period owing to caregiving. Among those affected, caregiving reduced work productivity by one-third on average-or an estimated $5600 per employee when annualized across all employed caregivers-primarily because of reduced performance while present at work. Productivity loss was higher among caregivers of older adults with significant care needs and varied according to sociodemographic characteristics and caregiver supports. CONCLUSIONS Findings emphasize the potential economic value of targeted policy intervention to support working caregivers.
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Affiliation(s)
- Maningbè B Keita Fakeye
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | | | - Emmanuel F Drabo
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Karen Bandeen-Roche
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jennifer L Wolff
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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11
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Beauchamp Legault MÈ, Chênevert D, Maisonneuve F, Mansour S. How do Informal Caregivers of Seniors' Tasks Lead to Presenteeism and Absenteeism Behaviors? A Canadian Quantitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5392. [PMID: 37048005 PMCID: PMC10094296 DOI: 10.3390/ijerph20075392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/23/2023] [Accepted: 03/31/2023] [Indexed: 06/19/2023]
Abstract
This study extends our knowledge on the role of informal caregivers of seniors and the impact of this role on presenteeism and absenteeism at work. Based on the conservation of resources theory, this article seeks to gain insights into the mechanisms and antecedents of presenteeism and absenteeism among employees who are also informal caregivers of seniors. Specifically, this article argues that family-work conflict and emotional exhaustion mediate the relationship between the informal caregiver's role, presenteeism, and absenteeism. Quantitative data (questionnaire) from this cross-sectional study were collected from 915 informal caregivers of seniors from 8 Canadian organizations. Structural equation modelling (SEM) was undertaken using IBM SPSS AMOS 28.0 to test all hypotheses. Informal caregivers of seniors who need to coordinate and organize healthcare are at a higher risk of experiencing family-work conflict. Family-work conflict experienced by informal caregivers subsequently leads to emotional exhaustion, presenteeism, and absenteeism. Because informal caregiving of seniors is likely to increase in coming years for many workers, organizations must be aware of the possible consequences of this role on work productivity. This study shows that not all tasks of informal caregivers of older adults lead to presenteeism and absenteeism through family-work conflict and emotional exhaustion. This study is innovative because, to our knowledge, no study of informal caregivers of older adults has examined the effect of different tasks in this role on presenteeism and absenteeism.
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Affiliation(s)
- Marie-Ève Beauchamp Legault
- HEC Montréal, Human Resources Management Department, 3000 Côte-Sainte-Catherine, Montreal, QC H3T 2A7, Canada
| | - Denis Chênevert
- HEC Montréal, Human Resources Management Department, 3000 Côte-Sainte-Catherine, Montreal, QC H3T 2A7, Canada
| | - Francis Maisonneuve
- HEC Montréal, Human Resources Management Department, 3000 Côte-Sainte-Catherine, Montreal, QC H3T 2A7, Canada
| | - Sari Mansour
- School of Administration Sciences, TÉLUQ University, Montréal, QC H2S 3L5, Canada
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12
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"I Needed to Know, No Matter What I Do, I Won't Make It Worse"-Expectations and Experiences of Last Aid Course Participants in Germany-A Qualitative Pilot Study. Healthcare (Basel) 2023; 11:healthcare11040592. [PMID: 36833126 PMCID: PMC9956657 DOI: 10.3390/healthcare11040592] [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: 12/22/2022] [Revised: 02/06/2023] [Accepted: 02/14/2023] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND The need to care for a loved one in a palliative state can lead to severe physical as well as psychological stress. In this context, Last Aid courses have been developed to support caring for relatives and to stimulate the public discussion on death and dying. The purpose of our pilot study is to gain an understanding of the attitudes, values, and difficulties of relatives caring for a terminally ill person. METHODS A qualitative approach was used in form of five semi-structured guided pilot interviews with lay persons who recently attended a Last Aid course. The transcripts of the interviews were analyzed following Kuckartz's content analysis. RESULTS Overall, the interviewed participants have a positive attitude toward Last Aid courses. They perceive the courses as helpful as they provide knowledge, guidance, and recommendations of action for concrete palliative situations. Eight main topics emerged during analysis: expectations regarding the course, transfer of knowledge, reducing fear, the Last Aid course as a safe space, support from others, empowerment and strengthening of own skills, and the improvement needs of the course. CONCLUSIONS In addition to the expectations before participation and the knowledge transfer during the course, the resulting implications for its application are also of great interest. The pilot interviews show initial indications that the impact, as well as supportive and challenging factors regarding the ability to care for relatives to cope, should be explored in further research.
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13
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Ulrich GR, Callan S, Ranby KW. Beliefs and interests in physical activity programs of cancer survivors and their romantic partners. J Cancer Surviv 2023; 17:160-173. [PMID: 33595753 PMCID: PMC7886842 DOI: 10.1007/s11764-021-00996-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 01/18/2021] [Indexed: 12/14/2022]
Abstract
PURPOSE Physical activity is associated with improved health outcomes for cancer survivors and their romantic partners, yet it is unclear if joint exercise programs for survivor-partner dyads are acceptable. This study examined demographic, relationship, exercise, and cancer history correlates of survivors' and their romantic partners' couples-based exercise beliefs and their preferences for program designs. METHODS All participants (survivors n=209, partners n=155, couples n=143) completed an online survey. Correlations and linear regression analyses were used to examine correlates of participants' importance of and interest in couples-based exercise and their likelihood of joining a couples-based exercise program. Intraclass correlations estimated shared variance at the couple level. RESULTS Most participants believed that couples-based exercise was highly important (51.8%) and were interested in a couples-based exercise program (61.5%), but fewer survivors believed their partner would be interested or would likely join a couples-based program. Across all outcomes, partner support for exercise was most strongly associated with participants' couples-based exercise beliefs (r = 0.19-0.54, p<.05), and couples were significantly aligned in their beliefs (ρ=0.20-0.31, p<.01). Participants were interested in exercise programs involving exercising together (67.3%) as well as exercising separately while sharing activity data on an app or website (48.0%). CONCLUSIONS This novel understanding of couples-based exercise beliefs provides a strong foundation upon which future exercise programs may be designed for survivors and their romantic partners. IMPACT FOR CANCER SURVIVORS Survivors' adoption and maintenance of exercise may be enhanced by the inclusion of romantic partners in exercise programs, and partners' inclusion is appealing to couples.
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Affiliation(s)
- G R Ulrich
- Department of Psychology, University of Colorado Denver, Denver, CO, USA.
| | - S Callan
- Department of Psychology, University of Colorado Denver, Denver, CO, USA
| | - K W Ranby
- Department of Psychology, University of Colorado Denver, Denver, CO, USA
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14
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Briggs LG, Sentana-Lledo D, Lage DE, Trinh QD, Morgans AK. Optimal assessment of quality of life for patients with prostate cancer. Ther Adv Med Oncol 2022; 14:17588359221141306. [PMID: 36531831 PMCID: PMC9747880 DOI: 10.1177/17588359221141306] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 11/07/2022] [Indexed: 10/04/2023] Open
Abstract
The burden of cancer and oncologic treatment is reflected not only through morbidity and mortality, but also through impacts on patient quality of life (QoL). However, QoL has not been historically measured or addressed with the same rigorous methodology as traditional disease-related outcomes such as overall survival and progression, as these are driven by objective measurements and events. Prostate cancer (PCa) is one of the most prevalent non-cutaneous cancers in men around the world. Both the cancer and its treatment significantly impact patients' physical, emotional, sexual, social, and overall QoL. Ensuring assessment and integration of QoL in research and clinical care enables improvement in treatment outcomes that matter most to patients while also facilitating alignment of healthcare priorities with reimbursements. Great strides toward this end have been made over the last decade, but significant room for improvement remains. To ensure high quality, reliable data collection, QoL assessment tools must be psychometrically validated, standardized, widely implemented across trials, and regularly assessed to allow internal and external validity, longitudinal comparative effectiveness research, and quality control. Additional consideration should be taken for instruments used to measure the aspects of QoL specific to minority, caregiver, and elderly populations. Open clinical questions include how providers should weight changes in different QoL subscales and how clinically meaningful difference thresholds should be defined. Review of ongoing clinical trials encouragingly reveals an increased focus on measuring and improving QoL for men with PCa which will inform the way we utilize QoL assessments. However, additional efforts herein described are needed to fully optimize these processes. In summary, this review will explain the rationale for QoL assessments in PCa populations, discuss requirements for effective implementation, describe considerations for vulnerable and under-evaluated populations, and summarize ongoing clinical trials assessing patient QoL.
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Affiliation(s)
- Logan G Briggs
- Department of Urology, Mayo Clinic, Phoenix, AZ, USA
- Center for Surgery and Public Health, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Daniel Sentana-Lledo
- Department of Hematology-Oncology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Daniel E Lage
- Department of Hematology-Oncology, Massachusetts General Hospital, Boston, MA, USA
| | - Quoc-Dien Trinh
- Center for Surgery and Public Health, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Alicia K Morgans
- Faculty in Medicine, Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Ave, Dana 09-930, Boston, MA 02215, USA
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15
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Fong ZV, Teinor J, 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, Wolff JL, Wu AW. Assessment of Caregivers' Burden When Caring for Patients With Pancreatic and Periampullary Cancer. J Natl Cancer Inst 2022; 114:1468-1475. [PMID: 35984312 PMCID: PMC9664174 DOI: 10.1093/jnci/djac153] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/14/2022] [Accepted: 08/01/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Family and other unpaid caregivers play an active role in the recovery of individuals with pancreatic and periampullary cancer after pancreatectomy. However, little is known about caregivers' experiences and how to better support them. METHODS Caregivers accompanying patients to 1-month postpancreatectomy visits at 3 hospitals completed an electronic survey between November 2018 and February 2020. We examine measures of absenteeism and work productivity loss among the subset of caregivers who reported working for pay and comparatively assess caregiver experiences by employment status. All analyses were performed as 2-sided tests. RESULTS Of 265 caregivers approached for study participation, 240 (90.6%) enrolled. Caregivers were primarily female (70.8% female, 29.2% male) and spouses (58.3%) or adult children (25.8%) of patients, with a median age of 60 years. Of the 240 caregivers included in the study, 107 (44.6%) worked for pay. Nearly half (44.4%) of working caregivers reported being absent from work because of caregiving amounting to a 14% loss in work hours. While at work, 58.9% of working caregivers reported increased work difficulty as a result of caregiving. Taken together, an estimated 59.7% loss in work productivity was experienced because of caregiving in the month following pancreatectomy. After adjustment for sociodemographic factors, working (vs nonworking) caregivers reported increased financial (odds ratio [OR] = 2.32; P = .04) and emotional (OR = 1.93; P = .04) difficulties and daily activity restrictions (OR = 1.85; P = .048). CONCLUSIONS Working caregivers of patients with pancreatic and periampullary cancer experience negative impacts on work and productivity, and caregiving-related financial and emotional difficulties may be amplified. This study highlights the need for workplace policies to support unpaid cancer caregiving.
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Affiliation(s)
- Zhi Ven Fong
- Department of Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - Jonathan Teinor
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Theresa P Yeo
- Department of Surgery, Thomas Jefferson University, Philadelphia, PA, USA
| | - Dee Rinaldi
- Department of Surgery, Thomas Jefferson University, Philadelphia, PA, USA
| | - Jonathan B Greer
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Harish Lavu
- Department of Surgery, Thomas Jefferson University, Philadelphia, PA, USA
| | - Motaz Qadan
- Department of Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - Fabian M Johnston
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - David C Chang
- Department of Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - Charles J Yeo
- Department of Surgery, Thomas Jefferson University, Philadelphia, PA, USA
| | | | - Andrew L Warshaw
- Department of Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - Keith D Lillemoe
- Department of Surgery, Massachusetts General Hospital, Boston, MA, USA
| | | | - Matthew J Weiss
- Department of Surgery, Northwell Health University Hospital, Manhasset, NY, USA
| | - Jennifer L Wolff
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Albert W Wu
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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16
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Schuit AS, Rienks MM, Hooghiemstra N, Jansen F, Lissenberg-Witte BI, Cuijpers P, Leeuw IMVD, Holtmaat K. Reach and efficacy of the eHealth application Oncokompas, facilitating partners of incurably ill cancer patients to self-manage their caregiver needs: a randomized controlled trial. Support Care Cancer 2022; 30:10191-10201. [PMID: 36367563 PMCID: PMC9650170 DOI: 10.1007/s00520-022-07441-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 10/30/2022] [Indexed: 11/13/2022]
Abstract
Abstract
Purpose
Many partners of incurably ill cancer patients experience caregiver burden. The eHealth application “Oncokompas” supports these partners to manage their caregiver needs and to find optimal supportive care for themselves. The aim of this randomized controlled trial (RCT) was to investigate the reach of Oncokompas and its efficacy on caregiver burden, self-efficacy, and health-related quality of life (HRQOL).
Methods
The reach was estimated based on eligibility, participation rate, and an evaluation of the recruitment process. Efficacy on caregiver burden was measured using the Caregiver Strain Index + (CSI +). Secondary outcomes were self-efficacy (General Self-Efficacy Scale (GSE)) and HRQOL (EQ-5D VAS). Assessments were scheduled at baseline, 2 weeks after randomization and 3 months after baseline. Linear mixed models were used to compare longitudinal changes between the experimental and control group from baseline to the 3-month follow-up.
Results
The reach, in terms of eligibility and participation rate, was estimated at 83–91%. Partners were most likely reached via palliative care consultants, patient organizations, and palliative care networks. In the one-and-a-half-year recruitment period and via the 101 organizations involved, 58 partners were included. There were no significant effects of Oncokompas on caregiver burden, self-efficacy, or HRQOL.
Conclusion
The reach of Oncokompas among interested individuals was high, but the difficulties that were encountered to include partners suggest that the reach in real life may be lower. This study showed no effect of Oncokompas on caregiver burden, self-efficacy, or HRQOL in partners of incurably ill cancer patients.
Relevance
The results of this study may be used in the process of developing, efficacy testing, and implementing eHealth applications for caregivers of incurably ill cancer patients.
Trial registration
Netherlands Trial Register identifier: NTR7636/NL7411. Registered on November 23, 2018 (https://www.trialregister.nl/).
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17
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Johnston EA, Goodwin BC, Myers L, March S, Aitken JF, Chambers SK, Dunn J. Support-seeking by cancer caregivers living in rural Australia. Aust N Z J Public Health 2022; 46:850-857. [PMID: 36121279 DOI: 10.1111/1753-6405.13304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 06/01/2022] [Accepted: 07/01/2022] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE Rural cancer caregivers report poor wellbeing and high unmet needs for support. This study investigates sources of support sought by cancer caregivers living in rural Australia, and factors associated with support-seeking. METHODS Informal caregivers of people with cancer completed a questionnaire assessing sociodemographic characteristics, caregiver factors and support-seeking. Descriptive statistics, bivariate analyses and logistic regression were used to identify common sources of support and factors associated with support-seeking. Alluvial and radar plots were used to identify and describe support-seeking profiles. FINDINGS Of 244 rural caregivers, 64% reported seeking support for themselves, 72% for the cancer patient, and 22% did not seek any support. The most common sources of support were general practitioners and online. Higher caregiver burden, higher income, caring for someone with anxiety/depression or caring for someone who has difficulty completing their usual activities were associated with seeking support from a greater number of sources. The 'No support-seekers' profile had the highest proportions of caregivers who were male, caring for someone <12 months post-diagnosis and lower income earners. CONCLUSIONS Many rural caregivers seek support for themselves and the cancer patient, commonly from medical and online sources. IMPLICATIONS FOR PUBLIC HEALTH Further work may be needed to reduce caregiver burden and support caregivers who are male, caring for someone recently diagnosed, and those with lower incomes.
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Affiliation(s)
- Elizabeth A Johnston
- Viertel Cancer Research Centre, Cancer Council Queensland, Queensland.,School of Exercise and Nutrition Sciences, Queensland University of Technology, Queensland.,Population Health Program, QIMR Berghofer Medical Research Institute, Queensland
| | - Belinda C Goodwin
- Viertel Cancer Research Centre, Cancer Council Queensland, Queensland.,Centre for Health Research, University of Southern Queensland, Queensland
| | - Larry Myers
- Viertel Cancer Research Centre, Cancer Council Queensland, Queensland.,School of Psychology and Wellbeing, University of Southern Queensland, Queensland
| | - Sonja March
- Centre for Health Research, University of Southern Queensland, Queensland.,School of Psychology and Wellbeing, University of Southern Queensland, Queensland
| | - Joanne F Aitken
- Viertel Cancer Research Centre, Cancer Council Queensland, Queensland.,Centre for Health Research, University of Southern Queensland, Queensland.,School of Public Health and Social Work, Queensland University of Technology, Queensland.,School of Public Health, The University of Queensland, Queensland
| | - Suzanne K Chambers
- Faculty of Health Sciences, Australian Catholic University, Queensland.,St Vincent's Health Network Sydney, New South Wales.,Menzies Health Institute Queensland, Griffith University, Queensland
| | - Jeff Dunn
- Viertel Cancer Research Centre, Cancer Council Queensland, Queensland.,Centre for Health Research, University of Southern Queensland, Queensland.,Faculty of Health Sciences, Australian Catholic University, Queensland.,Menzies Health Institute Queensland, Griffith University, Queensland.,Exercise Medicine Research Institute, Edith Cowan University, Western Australia.,Prostate Cancer Foundation of Australia, New South Wales
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18
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Mellner C, Dahlen M, Simonsson O. Association between Lifetime Classic Psychedelic Use and Sick Leave in a Population-Based Sample. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11353. [PMID: 36141631 PMCID: PMC9517576 DOI: 10.3390/ijerph191811353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 09/05/2022] [Accepted: 09/06/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVES Absenteeism from work due to illness, and related costs, has increased steadily during the past decades. In recent years, there has been a reemergence of research on the therapeutic effects of classic psychedelics showing associations with both physical and mental health. However, the association between classic psychedelics and sick leave remains unknown. The aim of this study is to investigate the association between lifetime classic psychedelic use and sick leave in the past 30 days among adults in the United States (N = 407,717), using data from the National Survey on Drug Use and Health (2005-2019), weighted to be representative of the US adult population. METHODS The primary analysis was conducted using multiple linear regression, controlling for sociodemographic characteristics, risky behavior, and use of other substances. RESULTS There was a significant and negative association between lifetime classic psychedelic use and sick leave in the past 30 days (B = -0.09, p < 0.01) when adjusting for all control variables. CONCLUSION These findings suggest that classic psychedelics could potentially lead to reduced sick leave and associated costs in the general population, but more research is needed to investigate potential causal pathways of classic psychedelics on sick leave and evaluate possible mechanisms.
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Affiliation(s)
- Christin Mellner
- Department of Psychology, Stockholm University, 114 19 Stockholm, Sweden
| | - Micael Dahlen
- Stockholm School of Economics, 114 19 Stockholm, Sweden
| | - Otto Simonsson
- Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden
- Department of Sociology, University of Oxford, Oxford OX1 1JD, UK
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19
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Xiang E, Guzman P, Mims M, Badr H. Balancing Work and Cancer Care: Challenges Faced by Employed Informal Caregivers. Cancers (Basel) 2022; 14:cancers14174146. [PMID: 36077682 PMCID: PMC9454561 DOI: 10.3390/cancers14174146] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/19/2022] [Accepted: 08/25/2022] [Indexed: 11/25/2022] Open
Abstract
Simple Summary Caregiving for a family member or close friend with cancer can be particularly demanding for employed individuals who are juggling work responsibilities while providing care. With an eye toward stimulating research to develop programs and resources to support this vulnerable subgroup of caregivers, this narrative review first describes the financial, work, and mental health impacts of cancer on employed caregivers. Next, critical knowledge gaps are identified and directions for future research are described. The article concludes by formulating an agenda for practice that includes a multipronged effort on behalf of employers, healthcare, and community-based organizations to support and empower employed cancer caregivers. Abstract Individuals with cancer commonly rely on their informal caregivers (e.g., spouse/partner, family member, close friend) to help them manage the demands of the disease and its treatment. Caregiving, including helping with patient care, performing household chores, and providing emotional and practical support, can be particularly demanding for employed caregivers, who must juggle their work responsibilities while providing care. Although a burgeoning literature describes the toll that balancing these oft-competing demands can exact, few resources exist to support employed cancer caregivers. To address this gap, we conducted a narrative review of the impacts of cancer on employed caregivers. We found that employed caregivers experience significant financial impacts in terms of lost time and income. They also experience a variety of work-related (e.g., reduced productivity, absenteeism) and mental health (e.g., stress, burden) impacts. Going forward, prospective studies are needed to characterize changes in caregiver support needs and preferences at different time points along the cancer care continuum (e.g., at diagnosis, during treatment, end-of-life) so that appropriate workplace accommodations can be provided. More population-based studies are also needed to develop models for identifying caregivers who are at increased risk for poor employment or mental health outcomes so that more targeted support programs can be developed. Ultimately, a multipronged effort on behalf of employers, healthcare, and community-based organizations may be needed to support and empower this vulnerable subgroup.
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Affiliation(s)
- Ellen Xiang
- Department of Medicine, Section of Epidemiology and Population Science, Baylor College of Medicine, Houston, TX 77030, USA
| | - Patricia Guzman
- McGovern Medical School, Health Science Center, The University of Texas, Houston, TX 77225, USA
| | - Martha Mims
- Department of Medicine, Section of Hematology & Oncology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Hoda Badr
- Department of Medicine, Section of Epidemiology and Population Science, Baylor College of Medicine, Houston, TX 77030, USA
- Correspondence: ; Tel.: +1-713-798-1588
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20
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The Impact of Mobile Phone Reminders on Perceived Self-Care Levels of Informal Caregivers. INFORMATICS 2022. [DOI: 10.3390/informatics9030059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Informal caregivers play a fundamental role in caring for people that need assistance and provide an effective service in managing their loved ones’ health. Because of this, they have little time to attend to themselves and perform self-care practices. Some of these practices can improve mental health. By snowball sampling, we recruited 15 informal caregivers, 12 females and three males. Using the Wilcoxon signed-rank test, we analyzed the impact of the reminders on a self-care scale. We used the Mindful Self-Care Scale, comparing the same population without reminders and with reminders. Results indicated that total self-care scores with reminders increased statistically significantly, T = 13, Z = −2.481, p ≤ 0.013, with a large effect size (r = 0.64). This study shows a significant self-care increase in informal caregivers after using reminders. Future development of a reminders-based approach could focus on increasing self-care and the time caregivers take for themselves, empowering them to take a more active role in meeting their own needs.
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A Scoping Review of Food Insecurity and Related Factors among Cancer Survivors. Nutrients 2022; 14:nu14132723. [PMID: 35807902 PMCID: PMC9269347 DOI: 10.3390/nu14132723] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/24/2022] [Accepted: 06/27/2022] [Indexed: 02/05/2023] Open
Abstract
Despite growing awareness of the financial burden that a cancer diagnosis places on a household, there is limited understanding of the risk for food insecurity among this population. The current study reviewed literature focusing on the relationship between food insecurity, cancer, and related factors among cancer survivors and their caregivers. In total, 49 articles (across 45 studies) were reviewed and spanned topic areas: patient navigation/social worker role, caregiver role, psychosocial impacts, and food insecurity/financial toxicity. Patient navigation yielded positive impacts including perceptions of better quality of care and improved health related quality of life. Caregivers served multiple roles: managing medications, emotional support, and medical advocacy. Subsequently, caregivers experience financial burden with loss of employment and work productivity. Negative psychosocial impacts experienced by cancer survivors included: cognitive impairment, financial constraints, and lack of coping skills. Financial strain experienced by cancer survivors was reported to influence ratings of physical/mental health and symptom burden. These results highlight that fields of food insecurity, obesity, and cancer control have typically grappled with these issues in isolation and have not robustly studied these factors in conjunction. There is an urgent need for well-designed studies with appropriate methods to establish key determinants of food insecurity among cancer survivors with multidisciplinary collaborators.
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22
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Pop RS, Payne S, Tint D, Pop CP, Mosoiu D. Instruments to assess the burden of care for family caregivers of adult palliative care patients. Int J Palliat Nurs 2022; 28:80-99. [PMID: 35446673 DOI: 10.12968/ijpn.2022.28.2.80] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND A primary caregiver shares the illness experience of the patient and undertakes vital care work, alongside managing the patient's emotions, and is actively involved in care process without being paid. When faced with the palliative care patient's needs, caregivers are affected on multiple levels (physical, psychological and socio-economic), thereby experiencing a moderate or severe burden of care. AIM To identify assessment instruments for the burden of care for family caregivers that are suitable to be used in clinical practice. METHOD A narrative review was conducted using an electronic search in Pubmed, PsychINFO, CINAHL of articles published in English between 2009-2019, using the search terms: 'caregiver/family, caregiver/carer and burden and palliative care/hospice/end of life'. An assessment grid was developed to appraise the clinical use of identified instruments. RESULTS Of the 568 articles identified, 40 quantitative studies were selected using 31 instruments to measure the caregiver burden of cancer, noncancer and terminally ill patients. Most instruments 23 (74.11%) evaluate the psycho-emotional and, 22 (70.96%) the social domain, 12 instruments (38.7%) focused on the physical domain, three (9.67%) on the spiritual field and six instruments (19.35%) on economic aspects. For the multidimensional instruments, the assessment grid scored highest for the Burden Scale for Family Caregiver (BSFC). CONCLUSION The BSFC is the tool that seems to meet the most requirements, being potentially the most useful tool in clinical practice.
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Affiliation(s)
- Rodica Sorina Pop
- Assistant Professor, Department of Family Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Faculty of Medicine, Cluj-Napoca, Romania
| | - Sheila Payne
- Professor, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Diana Tint
- Professor, Transilvania University, Faculty of Medicine, Brasov, Romania
| | | | - Daniela Mosoiu
- Associate Professor, Transilvania University, Faculty of Medicine, Brasov, Romania
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23
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The prevalence of physical activity among informal carers: a systematic review of international literature. SPORT SCIENCES FOR HEALTH 2022. [DOI: 10.1007/s11332-021-00893-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Xiao H, Bertwistle D, Khela K, Middleton-Dalby C, Hall J. Patient and caregiver socioeconomic burden of first-line systemic therapy for advanced gastroesophageal adenocarcinoma. Future Oncol 2022; 18:1199-1210. [PMID: 34984914 DOI: 10.2217/fon-2021-1449] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Aim: This study assessed the work productivity and financial impact of advanced gastroesophageal adenocarcinomas, comprising gastric, esophageal and gastroesophageal junction cancers, on patients of working age and their caregivers. Patients & methods: A multicenter medical chart review and surveys of patients with advanced gastroesophageal adenocarcinoma and their caregivers was conducted in France, Germany, the UK, China, Japan and the USA. Results: Across differing regions, the study highlighted the impact of cancer on patients' ability to work, to function normally and on their wellbeing, as well as the economic burden placed on patients and their caregivers. Conclusion: Advanced gastroesophageal adenocarcinomas have a significant impact on patients' and caregivers' well-being and are associated with reduced work productivity, and income loss.
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Affiliation(s)
- Hong Xiao
- Bristol Myers Squibb, Princeton, NJ, USA
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Understanding the financial and psychological impact of employment disruption among caregivers of pediatric HSCT recipients: a mixed methods analysis. Support Care Cancer 2022; 30:4747-4757. [PMID: 35132462 PMCID: PMC8821838 DOI: 10.1007/s00520-022-06883-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 01/28/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE Pediatric hematopoietic stem cell transplantation (HSCT) confers a substantial financial burden onto patients' families. In addition to high direct medical costs, HSCTs typically require at least one caregiver to take time away from work or other responsibilities, often leading to reduced household income. Using mixed methods, we sought to understand the impact of pediatric HSCT on caregiver employment and financial need. METHODS We surveyed caregivers of living pediatric patients who underwent HSCT at one of two southeastern transplant centers between 2012 and 2018 (N = 95). We then interviewed a subset of caregivers (N = 18) to understand whether and how employment disruption contributed to financial distress. RESULTS Among caregivers surveyed, the majority of household wage earners changed their work schedules to attend medical appointments and missed workdays. This resulted in income loss for 87% of families, with 31% experiencing an income reduction of over 50%. Qualitative interviews pointed to four emergent themes: (1) employment disruption exacerbated existing financial challenges; (2) parental division of labor between caregiving and providing financially led to heightened psychological distress; (3) existing employment leave and protection resources were essential but not sufficient; and (4) the ability to work remotely and having a supportive employer facilitated employment maintenance throughout the HSCT process. CONCLUSION Expanded employment protections and access to accommodations are needed to limit the impact of HSCT on household income, health insurance, and financial hardship. Additionally, interventions are needed to ensure caregivers are equipped with the information necessary to navigate conversations with employers and prepare for the financial and psychological reality of employment disruption.
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Humanistic and socioeconomic burden of COPD patients and their caregivers in Malaysia. Sci Rep 2021; 11:22598. [PMID: 34799609 PMCID: PMC8604899 DOI: 10.1038/s41598-021-01551-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 10/28/2021] [Indexed: 11/25/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is associated with substantial humanistic and socioeconomic burden on patients and their caregivers. COPD is expected to be 7th leading cause of disease burden till 2030. The objective of the current study was to assess the humanistic and socioeconomic burden of COPD patients and their caregivers in Malaysia. The burden includes the cost of management of COPD, QOL of COPD patients and their caregivers, work productivity and activity impairment of COPD patients and their caregivers due to COPD. One hundred and fifty COPD patients and their caregivers from the chest clinic of Penang Hospital were included in the study from August 2018 to August 2019. Caregiving cost was estimated using the replacement cost approach, while humanistic and social burden was assessed with the help of health status questionnaires. Overall, 64.66% and 7.1% of COPD patients reported to depend on informal caregivers and professional caregivers respectively. COPD patients reported dyspnoea score as 2.31 (1.31), EQ-5D-5L utility index 0.57 (0.23), CCI 2.3 (1.4), SGRQ-C 49.23 (18.61), productivity loss 31.87% and activity impairment 17.42%. Caregivers reported dyspnoea score as 0.72 (0.14), EQ-5D-5L utility index 0.57 (0.23), productivity loss 7.19% and social activity limitation as 21.63% due to taking care of COPD patients. In addition to the huge direct cost of management, COPD is also associated with substantial burden on society in terms of compromised quality of life, reduced efficiency at the workplace, activity impairment and caregiver burden.
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Antczak E, Miszczyńska KM. Causes of Sickness Absenteeism in Europe-Analysis from an Intercountry and Gender Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182211823. [PMID: 34831580 PMCID: PMC8623318 DOI: 10.3390/ijerph182211823] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 11/07/2021] [Accepted: 11/10/2021] [Indexed: 12/17/2022]
Abstract
This study aims to extract and explain the territorially varied relation between socioeconomic factors and absence rate from work due to own illness or disability in European countries in the years 2006-2020. For this purpose, several causes were identified, depending on men and women. To explain the absenteeism and emphasize gender as well as intercountry differences, geographically weighted regression was applied. For men, there were five main variables that influenced sickness absence: body mass index, the average rating of satisfaction by job situation, employment in the manufacturing sector, social benefits by sickness/health care, and performing health-enhancing physical activity. For women, there were five main variables that increased the absence rate: the risk of poverty or social exclusion, long-standing illness or health problems, employment in the manufacturing sector, social protection benefits, and deaths due to pneumonia. Based on the conducted research, it was proven that the sickness absence observed in the analyzed countries was highly gender and spatially diverged. Understanding the multifactorial factors playing an important role in the occurrence of regional and gender-divergent sickness absence may be a good predictor of subsequent morbidity and mortality as well as be very useful to better prevent this outcome.
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Affiliation(s)
- Elżbieta Antczak
- Department of Spatial Econometrics, Faculty of Economics and Sociology, University of Lodz, 90-255 Lodz, Poland
- Correspondence: ; Tel.: +48-609-210-588
| | - Katarzyna M. Miszczyńska
- Department of Public Finance, Faculty of Economics and Sociology, University of Lodz, 90-255 Lodz, Poland;
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Majellano EC, Clark VL, Gibson PG, Foster JM, McDonald VM. The needs and well-being of severe asthma and COPD carers: A cross-sectional study. Respirology 2021; 27:134-143. [PMID: 34643011 DOI: 10.1111/resp.14167] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 08/12/2021] [Accepted: 09/20/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND OBJECTIVE Caring for people with severe asthma and chronic obstructive pulmonary disease (COPD) can impair the quality of life (QoL) of the carer. We aimed to describe the QoL and needs of severe asthma and COPD carers. METHODS Carers of severe asthma (n = 89) and COPD (n = 48) completed an online cross-sectional survey assessing QoL and carer support needs using the Short Form Health Survey 12v2 (SF-12), the Hospital Anxiety and Depression Scale (HADS) and Carers Support Needs Assessment Tool (CSNAT) questionnaires. RESULTS Carers of people with severe asthma and COPD were similar in age (mean ± SD 57.78 ± 14.09 vs. 56.93 ± 12.91) and gender (65% female vs. 66%); however, they differed in caring duration (proportion caring for >10 years: 65% vs. 33%, p < 0.002). QoL was impaired in both groups, but there were no significant differences between severe asthma and COPD carers in either of the SF-12 component scores. The HADS scores revealed no difference between groups. Compared to severe asthma carers, COPD carers had significantly greater needs for: 'having time for self' (33% vs. 13%, p = 0.006), 'equipment to help care for relative' (33% vs. 13%, p = 0.006), 'practical help in the home' (35% vs. 18%, p = 0.006) and 'getting a break from caring overnight' (21% vs. 6%, p = 0.023). CONCLUSION QoL is impaired in carers of people with severe asthma to a similar degree of COPD carers and other debilitating diseases like cancer. These novel data highlight the support needs of severe asthma carers and identifies areas where tailored support is needed to reduce their substantial carer burden.
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Affiliation(s)
- Eleanor C Majellano
- National Health and Medical Research Council, Centre for Research Excellence in Severe Asthma and The Priority Research Centre for Health Lungs, The University of Newcastle, Newcastle, New South Wales, Australia.,School of Nursing and Midwifery, The University of Newcastle, Newcastle, New South Wales, Australia
| | - Vanessa L Clark
- National Health and Medical Research Council, Centre for Research Excellence in Severe Asthma and The Priority Research Centre for Health Lungs, The University of Newcastle, Newcastle, New South Wales, Australia.,School of Nursing and Midwifery, The University of Newcastle, Newcastle, New South Wales, Australia
| | - Peter G Gibson
- National Health and Medical Research Council, Centre for Research Excellence in Severe Asthma and The Priority Research Centre for Health Lungs, The University of Newcastle, Newcastle, New South Wales, Australia.,Department of Respiratory and Sleep Medicine, John Hunter Hospital, Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Juliet M Foster
- Clinical Management Group, Woolcock Institute of Medical Research and The University of Sydney, Sydney, New South Wales, Australia
| | - Vanessa M McDonald
- National Health and Medical Research Council, Centre for Research Excellence in Severe Asthma and The Priority Research Centre for Health Lungs, The University of Newcastle, Newcastle, New South Wales, Australia.,School of Nursing and Midwifery, The University of Newcastle, Newcastle, New South Wales, Australia.,Department of Respiratory and Sleep Medicine, John Hunter Hospital, Hunter Medical Research Institute, Newcastle, New South Wales, Australia
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Longacre ML, Weber-Raley L, Kent EE. Cancer Caregiving While Employed: Caregiving Roles, Employment Adjustments, Employer Assistance, and Preferences for Support. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:920-932. [PMID: 31858439 DOI: 10.1007/s13187-019-01674-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Cancer patients commonly require assistance from a relative or friend, and many of these "family caregivers" are navigating employment while caring. The purpose of this analysis was to understand the experience of employment while providing care to someone with cancer, including these caregivers' roles and burden, adjustments made to employment, assistance provided by employers, and preferences for employment and financial support. To further highlight this group of cancer caregivers, we compare it with (1) cancer caregivers who were not employed while caring; (2) caregivers for patients with a primary condition other than cancer who were employed while caring; and (3) caregivers for patients with a primary condition other than cancer who were not employed while caring. This secondary analysis is drawn from the National Alliance for Caregiving's (NAC)/AARP Caregiving in the US dataset of unpaid adult (i.e., age 18 and older) caregivers. Half of the cancer caregivers were employed while providing care, and these employed caregivers were significantly more likely to be younger than those non-employed while caring. The employed cancer caregivers provided significantly fewer hours of care per week on average than those non-employed (23.4 vs. 42.5 h/week) but provided a nearly equivalent number of ADLs on average. Nearly half (48%) of the employed cancer caregivers reported coming in late to work, leaving early, or taking off work to accommodate caregiving, while 24% cut back on hours at work or went from full-time to part-time employment and 11% retired early or quit work entirely. The employed cancer caregivers (excluding self-employed) indicated having access to flexible working hours (57%) or paid sick leave (48%), and most (73%) reported that their supervisor was aware of their caregiving role, which was significantly higher than employed non-cancer caregivers (55%). These findings suggest that balancing work and cancer caregiving is especially prevalent among younger caregivers, and that work adjustments are needed but that the cancer caregiving role might be more commonly discussed or shared with supervisors. These findings suggest the need to develop workplace educational resources for employees caring for a cancer patient but also for supervisors to enhance their understanding of caregiver strain, workload, and work-based strategies to assist cancer caregivers.
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Affiliation(s)
- M L Longacre
- Department of Public Health, College of Health Sciences, Arcadia University, Brubaker Hall 214, 450 S. Easton Rd., Glenside, PA, 19038, USA.
| | | | - E E Kent
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
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Ross A, Jumin Lee L, Wehrlen L, Cox R, Yang L, Perez A, Bevans M, Ding A, Wallen G. Factors That Influence Health-Promoting Behaviors in Cancer Caregivers. Oncol Nurs Forum 2021; 47:692-702. [PMID: 33063787 DOI: 10.1188/20.onf.692-702] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To describe cancer caregivers' participation in health-promoting behaviors and to identify factors influencing participation. SAMPLE & SETTING 129 informal cancer caregivers at the National Institutes of Health Clinical Center. METHODS & VARIABLES Cross-sectional survey methodology using Health-Promoting Lifestyle Profile-II (HPLP-II), PROMIS® Global Physical Health, NIH Toolbox Stress and Self-Efficacy, Caregiver Reaction Assessment, and Family Care Inventory Mutuality subscale. RESULTS Caregivers reported the highest HPLP-II subscale scores for spirituality and interpersonal relationships and the lowest for physical activity. Caregivers who were older, with lower body mass indices, in better physical health, and with higher self-efficacy and mutuality participated in more health-promoting behaviors. Sixty percent of the caregivers reported that they exercised less since becoming a caregiver, and 47% reported that their diet was worse. IMPLICATIONS FOR NURSING Future research is needed to examine novel interventions to increase health-promoting activities in cancer caregivers, and these interventions might be strengthened by including components that focus on increasing self-efficacy and/or improving the strength of the relationship between the caregiver and care recipient.
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Affiliation(s)
- Alyson Ross
- National Institutes of Health Clinical Center
| | | | | | - Robert Cox
- National Institutes of Health Clinical Center
| | - Li Yang
- National Institutes of Health Clinical Center
| | - Avery Perez
- Philadelphia College of Osteopathic Medicine
| | | | - Alice Ding
- National Institutes of Health Clinical Center
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Stone CJL, Johnson AP, Robinson D, Katyukha A, Egan R, Linton S, Parker C, Robinson A, Digby GC. Health Resource and Cost Savings Achieved in a Multidisciplinary Lung Cancer Clinic. Curr Oncol 2021; 28:1681-1695. [PMID: 33947127 PMCID: PMC8161784 DOI: 10.3390/curroncol28030157] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 04/27/2021] [Indexed: 12/25/2022] Open
Abstract
Background: Lung cancer (LC) care is resource and cost intensive. We launched a Multidisciplinary LC Clinic (MDC), where patients with a new LC diagnosis received concurrent oncology consultation, resulting in improved time to LC assessment and treatment. Here, we evaluate the impact of MDC on health resource utilization, patient and caregiver costs, and secondary patient benefits. Methods: We retrospectively analyzed patients in a rapid assessment clinic with a new LC diagnosis pre-MDC (September 2016-February 2017) and post-MDC implementation (February 2017-December 2018). Data are reported as means; unpaired t-tests and ANOVA were used to assess for significance. We also conducted a cost analysis. Resource utilization, out-of-pocket costs, procedure-related costs, and indirect costs were evaluated from the societal perspective and presented in 2019 Canadian dollars (CAD); multi-way worst/best case and threshold sensitivity analyses were conducted. Results: We reviewed 428 patients (78 traditional model, 350 MDC). Patients in the MDC model required significantly fewer oncology visits from LC diagnosis to first LC treatment (1.62 vs. 2.68, p < 0.001), which was significant for patients with stage 1, 3, and 4 disease. Compared with the traditional model, there was no change in mean biopsies/patient (1.32 traditional vs. 1.17 MDC, p = 0.18) or staging investigations/patient (2.24 traditional vs. 2.02 MDC, p = 0.20). Post-MDC, there was an increase in invasive mediastinal staging for patients with stage 2/3 LC (15.0% vs. 60.0%, p < 0.001). Over 22 months, MDC resulted in savings of CAD 48,389 including CAD 24,167 CAD in direct patient out-of-pocket expenses. For the threshold analyses, MDC was estimated to cost CAD 25,708 per quality-adjusted life year (QALY), considered to be below current willingness to pay thresholds (at CAD 80,000 per QALY). MDC also facilitated oncology assessment for 29 non-LC patients. Conclusions: An MDC led to a reduction in patient visits and direct patient and caregiver costs.
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Affiliation(s)
| | - Ana P. Johnson
- Department of Public Health Science, Queen’s University, Kingston, ON K7L 3N6, Canada;
| | - Danielle Robinson
- School of Medicine, Queen’s University, Kingston, ON K7L 3N6, Canada; (D.R.); (A.K.)
| | - Andriy Katyukha
- School of Medicine, Queen’s University, Kingston, ON K7L 3N6, Canada; (D.R.); (A.K.)
| | - Rylan Egan
- School of Nursing, Queen’s University, Kingston, ON K7L 3N6, Canada;
| | - Sophia Linton
- Department of Medicine, Queen’s University, Kingston, ON K7L 5P9, Canada; (S.L.); (C.P.)
| | - Christopher Parker
- Department of Medicine, Queen’s University, Kingston, ON K7L 5P9, Canada; (S.L.); (C.P.)
| | - Andrew Robinson
- Department of Oncology, Queen’s University, Kingston, ON K7L 5P9, Canada;
| | - Geneviève C. Digby
- Department of Medicine, Queen’s University, Kingston, ON K7L 5P9, Canada; (S.L.); (C.P.)
- Department of Oncology, Queen’s University, Kingston, ON K7L 5P9, Canada;
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Ahmad Zubaidi ZS, Ariffin F, Oun CTC, Katiman D. Caregiver burden among informal caregivers in the largest specialized palliative care unit in Malaysia: a cross sectional study. BMC Palliat Care 2020; 19:186. [PMID: 33292214 PMCID: PMC7722979 DOI: 10.1186/s12904-020-00691-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 11/30/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Informal caregivers (IC) are often overshadowed by the attention required by the terminally ill. This study aims to reveal the estimated proportion of caregiver burden, psychological manifestations and factors associated with caregiver burden among IC in the largest specialized Palliative Care Unit (PCU) in Malaysia. METHODS This was a cross-sectional study involving IC attending a PCU. Caregiver burden and psychological manifestations were measured using previously translated and validated Zarit Burden Interview and DASS-21 questionnaires respectively. Two hundred forty-nine samples were selected for analysis. RESULT The mean ZBI score was 23.33 ± 13.7. About half of the population 118(47.4%) was found to experienced caregiver burden whereby majority have mild to moderate burden 90(36.1%). The most common psychological manifestation among IC is anxiety 74(29.7%) followed by depression 51(20.4%) and stress 46(18.5%). Multiple logistic regression demonstrated that women who are IC to patients with non-malignancy were less likely to experience caregiver burden. IC who were highly educated and spent more than 14 h per day caregiving were at least twice likely to experience caregiver burden. Finally, those with symptoms of depression and anxiety were three times more likely to suffer from caregiver burden. CONCLUSION Caregiver burden among IC to palliative patients is prevalent in this population. IC who are men, educated, caregiving for patients with malignancy, long hours of caregiving and have symptoms of depression and anxiety are at risk of developing caregiver burden. Targeted screening should be implemented and IC well-being should be given more emphasis in local policies.
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Affiliation(s)
- Zati Sabrina Ahmad Zubaidi
- Clinical lecturer and Family Medicine Specialist, Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA (UiTM) Selayang campus, Jalan Prima 7, 68100, Batu Caves, Selangor, Malaysia.
| | - Farnaza Ariffin
- Clinical lecturer and Family Medicine Specialist, Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA (UiTM) Selayang campus, Jalan Prima 7, 68100, Batu Caves, Selangor, Malaysia
| | - Cindy Teoh Cy Oun
- Palliative Medicine Physician, Palliative Care Unit, Selayang Hospital, 68100, Batu Caves, Selangor, Malaysia
| | - Diana Katiman
- Clinical lecturer and Palliative Medicine Physician, Department of Medicine, Faculty of Medicine, Universiti Teknologi MARA (UiTM) Sg Buloh campus, Jalan Hospital, 47000, Sungai Buloh, Selangor, Malaysia
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Employment changes among Chinese family caregivers of long-term cancer survivors. BMC Public Health 2020; 20:1787. [PMID: 33238976 PMCID: PMC7690119 DOI: 10.1186/s12889-020-09922-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 11/18/2020] [Indexed: 12/28/2022] Open
Abstract
Background Family caregivers (FCGs) play a key role in the plan of care provision for long-term cancer survivors, yet few studies have been conducted on the impact of long-term caregiving on FCGs and their employment patterns. This study aims to further our understanding of the effect that caregiving role has on FCGs by identifying what cancer-related characteristics influence reduction of employment hours among FCGs in the post-treatment phase in China. Methods A total of 1155 cancer survivors participated in this study. Patients reported changes in the employment patterns of their FCGs. Descriptive analysis looked at demographic and cancer-related characteristics of cancer survivors and types of FCGs’ employment changes in both primary- and post-treatment phases. Chi-square test was used to statistically test the association between survivors’ characteristics and changes in FCGs’ hours of labor force work in post-treatment phase. Separate multivariable logistic regression models were used to examine the relationship between cancer-related characteristics of participants and employment reduction patterns among FCGs in post-treatment phase while controlling for demographic factors. Results In the primary-treatment phase, 45.6% of all FCGs reduced their working hours and 17.4% stopped working altogether. In the post-treatment phase, 25.2% of FCGs worked fewer hours and 6.6% left the workforce completely. The results show that a higher probability of change in employment hours among FCGs is associated with the following patient characteristics: having comorbidities, receiving chemotherapy treatment, limited ability to perform physical tasks, limited ability to perform mental tasks, and diagnosis of stage II of cancer. Conclusions Care for cancer patients in both primary- and post- treatment phases may have substantial impacts on hours of formal employment of Chinese FCGs. Interventions helping FCGs balance caregiving duties with labor force work are warranted. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-020-09922-9.
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Detaille SI, de Lange A, Engels J, Pijnappels M, Hutting N, Osagie E, Reig-Botella A. Supporting Double Duty Caregiving and Good Employment Practices in Health Care Within an Aging Society. Front Psychol 2020; 11:535353. [PMID: 33262718 PMCID: PMC7687392 DOI: 10.3389/fpsyg.2020.535353] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Accepted: 10/02/2020] [Indexed: 11/25/2022] Open
Abstract
Background: Due to the aging society the number of informal caregivers is growing. Most informal caregivers are women working as nurses within a health organization (also labeled as double-duty caregiver) and they have a high risk of developing mental and physical exhaustion. Until now little research attention has been paid to the expectations and needs of double duty caregivers and the role of self-management in managing private-work balance. Objective: The overall aim of this study was to investigate the expectations and needs of double duty caregivers in Netherlands, and to examine the meaning of self-management in managing work-life balance. Method: Different research methods have been applied in this exploratory study. Firstly, a scoping review has been conducted on the topics self-management and sustainable employability of double-duty caregivers using the search engines: CINAHL, MEDLINE, PubMed, and Google Scholar. Furthermore, a qualitative study has been conducted through focus groups with double duty caregivers. Results: Twenty studies that met the inclusion criteria (i.e., nurses with double duty caregiving tasks) could be identified. We found that double duty caregivers have different motivations for being a double duty caregiver based on internal and external expectations. Double duty caregiving causes a lot of mental and physical pressure for the caregiver. To be able to combine both duty’s, double duty caregivers need flexibility and understanding from the workplace. Through two focus groups (N = 17) we found that social support from the workplace is not enough to be able to manage the situation. Self-management skills are important to be able to communicate effectively with the workplace and community care organizations about the kind of support needed. Also, health care organizations should offer the same support to double duty caregivers as any other informal caregiver. Discussion: Double-duty caregivers are at high risk of developing symptoms of overload and risk of reduced self-management quality and employability levels across time. Health care organizations and the double duty caregiver often wait too long to act instead of taking more preventive measures. Furthermore, community care organizations should dialog with double duty caregivers about their wishes concerning the division of caring tasks. This finding calls for special attention, with long-term solutions at both macro (health-care level), organizational (meso-level), and employee level (micro level).
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Affiliation(s)
- Sarah I Detaille
- Department of Human Resource Management, HAN University of Applied Sciences, Nijmegen, Netherlands.,Department of Psychology, Universidade da Coruna, A Coruña, Spain
| | - Annet de Lange
- Department of Human Resource Management, HAN University of Applied Sciences, Nijmegen, Netherlands.,Department of Psychology, Universidade da Coruna, A Coruña, Spain.,Faculty of Psychology, Open University Heerlen, Heerlen, Netherlands.,Norwegian School of Hotel Management, University of Stavanger, Stavanger, Norway.,Faculty of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Josephine Engels
- Department of Human Resource Management, HAN University of Applied Sciences, Nijmegen, Netherlands
| | - Mirthe Pijnappels
- Department of Human Resource Management, HAN University of Applied Sciences, Nijmegen, Netherlands
| | - Nathan Hutting
- Department of Human Resource Management, HAN University of Applied Sciences, Nijmegen, Netherlands
| | - Eghe Osagie
- Department of Human Resource Management, HAN University of Applied Sciences, Nijmegen, Netherlands
| | - Adela Reig-Botella
- Department of Human Resource Management, HAN University of Applied Sciences, Nijmegen, Netherlands.,Department of Psychology, Universidade da Coruna, A Coruña, Spain
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Guerriere D, Husain A, Marshall D, Zagorski B, Kennedy J, Coyte PC. Transitions in Labour Force Participation over the Palliative Care Trajectory. Healthc Policy 2020; 16:25-40. [PMID: 33337312 PMCID: PMC7710958 DOI: 10.12927/hcpol.2020.26355] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
BACKGROUND Home-based palliative programs rely on family caregivers, who often miss time from employment. This article identified changes in caregivers' labour force participation over the palliative trajectory. METHODS Family caregivers (n = 262) were interviewed biweekly to measure transitions across four employment categories. RESULTS More than half of the caregivers had one employment transition and 29% had three or more. The highest proportion of transitions occurred for caregivers who were employed part-time. INTERPRETATION Understanding these transitions is critical to the development of strategies tailored to caregivers to contain labour force losses and to support caregivers during a time of high caregiving demands.
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Affiliation(s)
- Denise Guerriere
- Adjunct Professor, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON
| | - Amna Husain
- Clinician Scientist, Temmy Latner Centre for Palliative Care, Lunenfeld Tanenbaum Research Institute, Sinai Health System, Toronto, ON
| | - Denise Marshall
- Medical Director, Niagara West Palliative Care Team and McNally House Hospice, Grimsby, ON; Professor, Department of Family Medicine, Division of Palliative Care, David Braley Health Sciences Centre, McMaster University, Hamilton, ON
| | - Brandon Zagorski
- Adjunct Professor, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON
| | - Julia Kennedy
- Consultant, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON
| | - Peter C Coyte
- Professor of Health Economics, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON
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Hofmann S, Himmler S, Ostwald D, Dünzinger U, Launonen A, Thuresson PO. The societal impact of obinutuzumab in the first-line treatment of patients with follicular lymphoma in Germany. J Comp Eff Res 2020; 9:1017-1026. [PMID: 33016109 DOI: 10.2217/cer-2020-0131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
In this study, we assessed the productivity gains associated with the use of obinutuzumab in combination with chemoimmunotherapy (G-chemo) in first-line treatment among follicular lymphoma patients. Health benefits, measured as an increase in progression-free survival, were translated into productivity gains in both paid and unpaid work using gross value added as productivity measure. From 2017 to 2030, 11,870 overall progression-free years can be gained by utilizing obinutuzumab. These progression-free years correspond to undiscounted productivity gains of about €187.9 million in paid work and about €535.9 million in unpaid work. Our study shows that the benefits of the use of obinutuzumab in the first-line treatment of follicular lymphoma extend beyond clinical advantages.
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Affiliation(s)
| | | | - Dennis Ostwald
- WifOR Institute, Darmstadt, 64283, Germany.,Steinbeis, School of International Business & Entrepreneurship (SIBE), Herrenberg, 71083, Germany
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Zand A, Kim BJ, van Deen WK, Stokes Z, Platt A, O'Hara S, Khong H, Hommes DW. The effects of inflammatory bowel disease on caregivers: significant burden and loss of productivity. BMC Health Serv Res 2020; 20:556. [PMID: 32552803 PMCID: PMC7302133 DOI: 10.1186/s12913-020-05425-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 06/12/2020] [Indexed: 01/01/2023] Open
Abstract
Background Caregiver burden is the emotional, physical, practical, and/or financial burden associated with taking care of a patient with a chronic condition. Limited literature on caregiver burden in Inflammatory Bowel Diseases (IBD) has accounted for some predictors, but its effect on work productivity (absenteeism and presenteeism) is unknown. Methods In a prospective study, patients and their respective caregivers were surveyed from November 2015 until July 2017. Data on demographics, work productivity, quality of life, disease activity, caregiver burden and productivity were collected. The burden on caregivers was assessed and associations between caregiver productivity and caregiver burden were analyzed. Additionally, predictors for caregiver burden were identified. Results One hundred two IBD patients and their respective caregiver were included. In total, 39% of IBD caregivers experienced burden. Caregivers with burden experienced significantly more absenteeism and presenteeism (65 and 85% respectively). Furthermore, 51% of caregivers felt that they should be doing more for their care recipient and felt they could do a better job at caregiving. Predictors of burden included race/ethnicity, history of fistulas, diagnosis of ulcerative colitis, higher caregiver education, and hours spent caregiving. Conclusion Caregivers with burden had significantly more productivity decrease compared to those without burden. Additionally, the majority of caregivers feel they should be providing more and better care for their recipients. The development of strategies to address caregiver’s distress and perceived burden when caring for IBD patients is warranted.
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Affiliation(s)
- Aria Zand
- UCLA Center for Inflammatory Bowel Diseases, Vatche and Tamar Manoukian Division of Digestive Disease, David Geffen School of Medicine, University of California at Los Angeles, 10945 Le Conte Ave #2338, Los Angeles, CA, 90095, USA. .,Department of Digestive Diseases, Leiden University Medical Center, Leiden, the Netherlands.
| | - Brian J Kim
- UCLA Center for Inflammatory Bowel Diseases, Vatche and Tamar Manoukian Division of Digestive Disease, David Geffen School of Medicine, University of California at Los Angeles, 10945 Le Conte Ave #2338, Los Angeles, CA, 90095, USA
| | - Welmoed K van Deen
- UCLA Center for Inflammatory Bowel Diseases, Vatche and Tamar Manoukian Division of Digestive Disease, David Geffen School of Medicine, University of California at Los Angeles, 10945 Le Conte Ave #2338, Los Angeles, CA, 90095, USA.,Cedars-Sinai Center for Outcomes Research and Education, Division of Health Services Research, Cedars-Sinai Medical Center, California, Los Angeles, USA
| | - Zachary Stokes
- UCLA Center for Inflammatory Bowel Diseases, Vatche and Tamar Manoukian Division of Digestive Disease, David Geffen School of Medicine, University of California at Los Angeles, 10945 Le Conte Ave #2338, Los Angeles, CA, 90095, USA
| | - Anya Platt
- UCLA Center for Inflammatory Bowel Diseases, Vatche and Tamar Manoukian Division of Digestive Disease, David Geffen School of Medicine, University of California at Los Angeles, 10945 Le Conte Ave #2338, Los Angeles, CA, 90095, USA
| | - Shelby O'Hara
- UCLA Center for Inflammatory Bowel Diseases, Vatche and Tamar Manoukian Division of Digestive Disease, David Geffen School of Medicine, University of California at Los Angeles, 10945 Le Conte Ave #2338, Los Angeles, CA, 90095, USA
| | - Harrison Khong
- UCLA Center for Inflammatory Bowel Diseases, Vatche and Tamar Manoukian Division of Digestive Disease, David Geffen School of Medicine, University of California at Los Angeles, 10945 Le Conte Ave #2338, Los Angeles, CA, 90095, USA
| | - Daniel W Hommes
- UCLA Center for Inflammatory Bowel Diseases, Vatche and Tamar Manoukian Division of Digestive Disease, David Geffen School of Medicine, University of California at Los Angeles, 10945 Le Conte Ave #2338, Los Angeles, CA, 90095, USA.,Department of Digestive Diseases, Leiden University Medical Center, Leiden, the Netherlands
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Rehman AU, Hassali MAA, Harun SN, Abbas S, Muneswarao J, Ali IABH, Hussain R. Validation and clinical interpretation of the St George's respiratory questionnaire for COPD (SGRQ-C) after adaptation to Malaysian language and culture, in patients with COPD. Health Qual Life Outcomes 2020; 18:138. [PMID: 32404113 PMCID: PMC7218514 DOI: 10.1186/s12955-020-01393-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 05/05/2020] [Indexed: 01/29/2023] Open
Abstract
Background Cultural differences affect the administration and results of health status questionnaires. “Cross cultural adaptation” ensures retention of psychometric properties such as validity and reliability at an item and/or scale level. Objective To develop a Malaysian version of St George’s respiratory COPD specific questionnaire (SGRQ-CM), to evaluate the full spectrum of psychometric properties (reliability, validity and responsiveness), to test the factor structure and to assess minimum clinically important difference for the SGRQ-CM, to be used in population of Malaysia. Methodology SGRQ-C was translated to Bahasa Malaysia using a standard protocol. 240 COPD patients were included in the study. All patients were followed-up for six months. Construct validity, internal consistency, item convergent validity, test-retest ability, responsiveness, factor analysis and MCID of the Malaysian version of SGRQ-C to be used in population of Malaysia were evaluated. Results The Cronbach alpha coefficient and intraclass correlation coefficients (ICC) for SGRQ-CM were reported as 0.87, and 0.88 respectively. Correlation of SGRQ-CM with CAT, EQ-5D-5 L, mMRC dyspnea scales and FEV1%predicted were reported as 0.86, − 0.82, 0.72 and − 0.42 respectively. Correlation coefficient between the subscales and other clinical and health status measures ranged from r = − 0.35 to r = − 0.87. The MCID was reported as 5.07 (− 2.54–12.67). Conclusion The Malaysian version of SGRQ-C has a good psychometric property comparable to those of the original version and has a strong evidence of validity, reliability and responsiveness towards disease severity in Malaysian COPD patients. It can be recommended as a reliable quality of life measure for future research.
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Affiliation(s)
- Anees Ur Rehman
- Department of Clinical Pharmacy, School of Pharmaceutical Sciences, University Sains Malaysia, Minden, 11800, Penang, Malaysia. .,Faculty of Pharmacy, Bahauddin Zakariya University, Multan, Pakistan.
| | - Mohamed Azmi Ahmad Hassali
- Department of Clinical Pharmacy, School of Pharmaceutical Sciences, University Sains Malaysia, Minden, 11800, Penang, Malaysia
| | - Sabariah Noor Harun
- Department of Clinical Pharmacy, School of Pharmaceutical Sciences, University Sains Malaysia, Minden, 11800, Penang, Malaysia
| | - Sameen Abbas
- Department of Pharmacy, Quaid e Azam University, Islamabad, Pakistan
| | - Jaya Muneswarao
- Department of Clinical Pharmacy, School of Pharmaceutical Sciences, University Sains Malaysia, Minden, 11800, Penang, Malaysia
| | | | - Rabia Hussain
- Department of Clinical Pharmacy, School of Pharmaceutical Sciences, University Sains Malaysia, Minden, 11800, Penang, Malaysia
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Opioid Use Disorder and Employee Work Presenteeism, Absences, and Health Care Costs. J Occup Environ Med 2020; 62:344-349. [PMID: 32049873 DOI: 10.1097/jom.0000000000001830] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To measure the prevalence of opioid use disorder (OUD) and employee health care and productivity costs with and without OUD and to assess whether utilization of pharmacotherapy for OUD reduces those costs. METHODS We conducted a cross-sectional analysis of 2016 to 2017 commercial enrollment, health care, and pharmacy claims and health risk assessment data using the IBM MarketScan Databases (Ann Arbor, MI). We estimated regression models to assess the association between OUD and annual employee health care and productivity costs. RESULTS Health care and productivity costs for employees with OUD who did and did not receive pharmacotherapy were approximately $6294 and $21,570 more than for other employees, respectively. CONCLUSIONS Employers can make a business case for expanding access to pharmacotherapy treatment for OUD based on our finding that receipt of pharmacotherapy significantly reduces overall health care costs.
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Schuit AS, Holtmaat K, Hooghiemstra N, Jansen F, Lissenberg-Witte BI, Coupé VMH, Verdonck-de Leeuw IM. Efficacy and cost-utility of the eHealth self-management application 'Oncokompas', helping partners of patients with incurable cancer to identify their unmet supportive care needs and to take actions to meet their needs: a study protocol of a randomized controlled trial. Trials 2020; 21:124. [PMID: 32005280 PMCID: PMC6995084 DOI: 10.1186/s13063-019-4037-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Accepted: 12/29/2019] [Indexed: 01/04/2023] Open
Abstract
Background Incurable cancer does not only affect patients, it also affects the lives of their partners. Many partners take on caregiving responsibilities. The burden of these caregiving tasks are often associated with physical, psychological, and social difficulties and many partners have unmet supportive care needs. Oncokompas is an eHealth self-management application to support partners in finding and obtaining optimal supportive care, tailored to their quality of life and personal preferences. A randomized controlled trial will be carried out to determine the efficacy and cost-utility of Oncokompas. Methods A total of 136 adult partners of patients with incurable cancer will be included. Partners will be randomly assigned to the intervention group, which directly gets access to Oncokompas, or the waiting-list control group, which gets access to Oncokompas after three months. The primary outcome measure is caregiver burden. Secondary outcome measures comprise self-efficacy, health-related quality of life, and costs. Measures will be assessed at baseline, two weeks after randomization, and three months after the baseline measurement. Discussion This study will result in evidence on the efficacy and cost-utility of Oncokompas among partners of patients with incurable cancer, which might lead to implementation of Oncokompas as a health service for partners of patients with incurable cancer. Trial registration Netherlands Trial Register, NTR 7636. Registered on 23 November 2018.
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Affiliation(s)
- Anouk S Schuit
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioural and Movement Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.,Cancer Center Amsterdam (CCA), Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Karen Holtmaat
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioural and Movement Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.,Cancer Center Amsterdam (CCA), Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Nienke Hooghiemstra
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioural and Movement Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.,Cancer Center Amsterdam (CCA), Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Femke Jansen
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioural and Movement Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.,Cancer Center Amsterdam (CCA), Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.,Otolaryngology - Head and Neck Surgery, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Birgit I Lissenberg-Witte
- Department of Epidemiology and Biostatistics, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Veerle M H Coupé
- Department of Epidemiology and Biostatistics, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Irma M Verdonck-de Leeuw
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioural and Movement Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands. .,Cancer Center Amsterdam (CCA), Amsterdam Public Health Research Institute, Amsterdam, The Netherlands. .,Otolaryngology - Head and Neck Surgery, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
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Ohno S, Chen Y, Sakamaki H, Matsumaru N, Tsukamoto K. Humanistic and economic burden among caregivers of patients with cancer in Japan. J Med Econ 2020; 23:17-27. [PMID: 31578893 DOI: 10.1080/13696998.2019.1675672] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Aims: As the number of cancer patients increases in Japan, and people are living longer with cancer, the need for caregivers of cancer patients is expected to increase substantially. This study intended to reveal the humanistic and economic burden among caregivers of cancer patients, and to compare it with the burden among caregivers of patients with other conditions (other caregivers) and non-caregivers.Materials and methods: This cross-sectional analysis used data from the Japan National Health and Wellness Survey 2017. Outcome measures included the Short Form 12-item Health Survey for health-related quality of life (HRQoL), EuroQol 5-dimension scale (EQ-5D) for health states utilities, Work Productivity and Activity Impairment questionnaire for the impact of health on productivity and activity, and indirect costs. Multivariate analysis was used to compare across groups, with adjustment for potential confounding effects.Results: A total of 251 caregivers of cancer patients, 1,543 other caregivers, and 27,300 non-caregivers were identified. Caregivers of cancer patients (average 48.0 years old) tended to be younger than non-caregivers (51.5) and other caregivers (54.4) and had the highest education level (57.8% completed university education). Fewer non-caregivers had stress-related comorbidities than caregivers. Non-caregivers had significantly higher EQ-5D index scores than caregivers (average 0.81 vs. 0.73 vs. 0.74). Caregivers of cancer patients had significantly lower mental component summary scores than non-caregivers (40.18 vs. 46.70), and the difference indicated a clinically meaningful decrease in HRQoL. Caregivers of cancer patients had significantly higher presenteeism (37.31% vs. 20.43%), total work productivity impairment (38.85% vs. 21.98%), and activity impairment (40.94% vs. 25.78%) than non-caregivers. Additionally, caregivers of cancer patients had significantly higher total indirect costs (36.34% vs. 20.03% of average annual income).Conclusions: These results have implications for future healthcare planning, suggesting the importance of healthcare systems in Japan to consider the substantial burden borne by caregivers of cancer patients.
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Affiliation(s)
- Shinya Ohno
- Global Regulatory Science, Gifu Pharmaceutical University, Gifu, Japan
- Chugai Pharmaceutical Co., Ltd, Tokyo, Japan
| | | | - Hiroyuki Sakamaki
- Graduate School of Health Innovation, Kanagawa University of Human Services, Kawasaki, Japan
| | - Naoki Matsumaru
- Global Regulatory Science, Gifu Pharmaceutical University, Gifu, Japan
| | - Katsura Tsukamoto
- Global Regulatory Science, Gifu Pharmaceutical University, Gifu, Japan
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Martsolf GR, Kandrack R, Rodakowski J, Friedman EM, Beach S, Folb B, James AE. Work Performance Among Informal Caregivers: A Review of the Literature. J Aging Health 2019; 32:1017-1028. [DOI: 10.1177/0898264319895374] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives: To examine the association between informal caregiving and caregiver work performance. Method: A systematized review of the literature. Results: We found that caregiving has an adverse impact on work performance: caregivers experience substantial work disruptions and negative work performance outcomes, and these findings were consistent across measures. Our synthesis suggests that caregivers miss a significant amount of work and have reductions in productivity due to their caregiving responsibilities. However, significant methodological limitations with the reviewed studies make systematic interpretations and causal determinations challenging. Discussion: Examining the effect of caregiving on work performance is critical to better understand the full impact of caregiving, especially as demand for caregivers increases as the population ages. This comprehensive review suggests that caregiving has a significant negative impact on work performance, although methodological challenges remain in this area of science. These findings should inform both public policy development and workplace benefits design.
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Affiliation(s)
- Grant R. Martsolf
- RAND Corporation, Pittsburgh, PA, USA
- University of Pittsburgh, PA, USA
| | - Ryan Kandrack
- RAND Corporation, Pittsburgh, PA, USA
- The University of North Carolina at Chapel Hill, USA
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Impact of informal cancer caregiving across the cancer experience: A systematic literature review of quality of life. Palliat Support Care 2019; 18:220-240. [DOI: 10.1017/s1478951519000622] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractObjectiveInformal caregiving may likely increase as the number of cancer survivors grows. Caregiving responsibilities can impact caregivers’ quality of life (QOL). Understanding the current state of the science regarding caregiving QOL could help inform future research and intervention development.MethodsA systematic literature review in PubMed/Medline examined research on QOL among informal cancer caregivers and related psychosocial health outcomes. Original research articles in English, published between 2007 and 2017 about caregivers (aged >18 years) of adult cancer patients in the United States were included. Abstracted articles were categorized according to caregiving recipient's phase of survivorship (acute, middle to long-term, end of life/bereavement).ResultsOf 920 articles abstracted, 60 met inclusion criteria. Mean caregiver age ranged from 37 to 68 with the majority being female, non-Hispanic white, with at least a high school degree, and middle income. Almost half of the studies focused on caregivers who provided care for survivors from diagnosis through the end of active treatment. Studies examined physical health, spirituality, psychological distress, and social support. Differences in QOL were noted by caregiver age, sex, and employment status.Significance of ResultsAdditional research includes the examination of the needs of diverse cancer caregivers and determines how additional caregiver characteristics (e.g., physical functioning, financial burden, etc.) affect QOL. This includes studies examining caregiver QOL in the phases following the cessation of active treatment and assessments of health systems, support services, and insurance to determine barriers and facilitators needed to meet the immediate and long-term needs of cancer caregivers.
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Bani Younis MK, Al-Rawashdeh A, Alnjadat RM. The effect of palliative care intervention program on the quality of life among Jordanian caregivers of cancer patients. Home Health Care Serv Q 2019; 38:286-296. [PMID: 31518207 DOI: 10.1080/01621424.2019.1661325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The purpose of this study was to evaluate the effect of palliative care intervention on the quality of life among Jordanian caregivers of cancer patients. Repeated measures design was used in this study. Data were collected from 137 Jordanian caregivers of cancer patients utilizing a self-administered questionnaire. An intervention program called SHARE was implemented to the experimental groups and its effectiveness in improving the overall quality of life for caregivers of cancer patients was evaluated using repeated measure ANOVA test. The results showed a statistically significant effect on the quality of life domains. For workshop experimental group (F = 26.822, p < .001) and for home visit experimental group (F = 10.236, p = .003).
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Affiliation(s)
- Mohammad K Bani Younis
- Princess Aisha Bint Al-Hussein College of Nursing & Health Sciences, Al-Hussein Bin Talal University , Maan , Jordan
| | - Ahmad Al-Rawashdeh
- Princess Aisha Bint Al-Hussein College of Nursing & Health Sciences, Al-Hussein Bin Talal University , Maan , Jordan
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de Moor JS, Alfano CM, Kent EE, Norton WE, Coughlan D, Roberts MC, Grimes M, Bradley CJ. Recommendations for Research and Practice to Improve Work Outcomes Among Cancer Survivors. J Natl Cancer Inst 2019; 110:1041-1047. [PMID: 30252079 DOI: 10.1093/jnci/djy154] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 07/11/2018] [Indexed: 11/13/2022] Open
Abstract
Major knowledge gaps limit the development and implementation of interventions to improve employment outcomes among people with cancer. To identify research priorities to improve employment outcomes after cancer, the National Cancer Institute sponsored the meeting "Evidence-Based Approaches for Optimizing Employment Outcomes among Cancer Survivors." This article describes research recommendations stemming from the meeting. At the patient level, longitudinal studies are needed to better understand how patient sociodemographic and clinical characteristics and their experiences at work shape employment outcomes. Interventions that mitigate the impact of cancer and its treatment on employment are critical. At the provider-level, future research is needed to characterize the extent to which physicians and other healthcare providers talk to their patients about employment concerns and how that information is used to inform care. Additionally, there is a need to test models of care delivery that support routine screening of employment concerns, the capture of employment outcomes in electronic health records, and the effective use of this information to improve care. At the employer level, evidence-based training programs are needed to prepare supervisors, managers, human resources staff, and occupational health professionals to address health issues in the workplace; and future interventions are needed to improve patient -employer communication and facilitate workplace accommodations. Importantly, research is needed that reflects the perspectives and priorities of patients and their families, providers and healthcare systems, and employers. Transdisciplinary partnerships and stakeholder engagement are essential to ensure that employment-focused interventions and policies are developed, implemented, and sustained in real-world healthcare delivery and workplace settings.
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Affiliation(s)
- Janet S de Moor
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD
| | | | - Erin E Kent
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD
| | - Wynne E Norton
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD
| | - Diarmuid Coughlan
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD
| | - Megan C Roberts
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD
| | - Melvin Grimes
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD
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Hastert TA, Ruterbusch JJ, Nair M, Noor MI, Beebe-Dimmer JL, Schwartz K, Baird TE, Harper FWK, Thompson H, Schwartz AG. Employment Outcomes, Financial Burden, Anxiety, and Depression Among Caregivers of African American Cancer Survivors. JCO Oncol Pract 2019; 16:e221-e233. [PMID: 31496392 DOI: 10.1200/jop.19.00410] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
PURPOSE Caregivers of cancer survivors may need to take time off work or make other employment changes to handle caregiving demands. Work impacts of caregiving, financial burden, and psychosocial outcomes of caregivers are not well understood. METHODS Results include information from surveys completed by 202 employed caregivers of participants in the Detroit Research on Cancer Survivors cohort, a population-based cohort of African American survivors of breast, colorectal, lung, or prostate cancer. Relationships between work outcomes, financial burden, and anxiety and depression were assessed using logistic regression models controlling for demographic and cancer-related factors. RESULTS Most (73.8%) caregivers made some employment change. Sixty percent changed their schedule, hours, duties, or employment status; 15.3% took at least 1 month off to provide care, and 38% reported difficulty balancing work and caregiving. Employment changes were strongly associated with difficulty balancing work and caregiving (odds ratio [OR], 5.83; 95% CI, 2.38 to 14.0) and financial burden (OR, 2.12; 95% CI, 1.05 to 4.27). Difficulty balancing work and caregiving was associated with symptoms of anxiety (OR, 1.86; 95% CI, 1.01 to 3.43) and depression (OR, 2.40; 95% CI, 1.16 to 4.96). High (v low) financial burden was associated with symptoms of anxiety (OR, 2.85; 95% CI, 1.01 to 8.06). CONCLUSION Difficulty balancing work and caregiving is common among caregivers of African American cancer survivors and is associated with symptoms of depression and anxiety. Supports for caregivers facing employment challenges may improve their psychosocial well-being.
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Affiliation(s)
- Theresa A Hastert
- Wayne State University School of Medicine, Detroit, MI.,Karmanos Cancer Institute, Detroit, MI
| | - Julie J Ruterbusch
- Wayne State University School of Medicine, Detroit, MI.,Karmanos Cancer Institute, Detroit, MI
| | - Mrudula Nair
- Wayne State University School of Medicine, Detroit, MI.,Karmanos Cancer Institute, Detroit, MI
| | | | - Jennifer L Beebe-Dimmer
- Wayne State University School of Medicine, Detroit, MI.,Karmanos Cancer Institute, Detroit, MI
| | - Kendra Schwartz
- Wayne State University School of Medicine, Detroit, MI.,Karmanos Cancer Institute, Detroit, MI
| | - Tara E Baird
- Wayne State University School of Medicine, Detroit, MI.,Karmanos Cancer Institute, Detroit, MI
| | - Felicity W K Harper
- Wayne State University School of Medicine, Detroit, MI.,Karmanos Cancer Institute, Detroit, MI
| | - Hayley Thompson
- Wayne State University School of Medicine, Detroit, MI.,Karmanos Cancer Institute, Detroit, MI
| | - Ann G Schwartz
- Wayne State University School of Medicine, Detroit, MI.,Karmanos Cancer Institute, Detroit, MI
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Govina O, Vlachou E, Kalemikerakis I, Papageorgiou D, Kavga A, Konstantinidis T. Factors Associated with Anxiety and Depression among Family Caregivers of Patients Undergoing Palliative Radiotherapy. Asia Pac J Oncol Nurs 2019; 6:283-291. [PMID: 31259225 PMCID: PMC6518986 DOI: 10.4103/apjon.apjon_74_18] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objective: The family caregivers of patients receiving palliative care experience high levels of anxiety and depression. The aim of the present study was to investigate the factors associated with family caregivers’ anxiety and depression when caring for patients with advanced cancer in Greece. Methods: The sample consisted of 100 patients undergoing palliative radiotherapy and their respective caregivers. Patients completed the Hospital Anxiety and Depression Scale (HADS) and the MD Anderson Symptom Inventory. Their respective caregivers completed the Oberst Caregiving Burden Scale, the Bakas Caregiving Outcomes Scale, and the HADS. Correlational and multiple regression analyses were conducted to identify potential predictors of anxiety and depression. Results: The majority of patients were male (63.0%), whereas the majority of their caregivers were female (76.0%). The mean ages of patients and caregivers were 63.9 ± 10.8 and 53.3 ± 12.6 years, respectively. Caregiving anxiety and depression were associated with patients’ variables, such as gender (P < 0.0005), primary cancer (P = 0.008), and past surgery (P = 0.002), and caregiver's variables, such as gender (P = 0.001), co-residence (P = 0.05), previous care experience (P = 0.04), and means of transport (P = 0.038). In multiple regression analyses, caregiving anxiety and depression were significantly predicted by caregivers’ and patients’ characteristics, in a model that accounted for 48% of the anxiety variance (P < 0.0005) and 39% of the depression variance (P < 0.0005). Conclusion: The caregivers who experienced more anxiety and depression shared the following traits: they were women, cared for men with lung cancer, cared for patients not undergoing surgery, lived together, were younger, went to the hospital by private means of transport, had previous care experience, and perceived an increased degree of general burden. Further investigation of the factors that may affect caregivers’ psychological state is required to better identify parameters that may predict it.
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Affiliation(s)
- Ourania Govina
- Department of Nursing, University of West Attica, Athens, Greece
| | - Eugenia Vlachou
- Department of Nursing, University of West Attica, Athens, Greece
| | | | | | - Anna Kavga
- Department of Nursing, University of West Attica, Athens, Greece
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Silva AF, Robazzi MLDCC, Dalri RDCDMB, Silveira-Monteiro CA, Mendes AMOC. Presenteeism in multiprofessional team workers in the Adult Intensive Care Unit. Rev Bras Enferm 2019; 72:96-104. [PMID: 30942350 DOI: 10.1590/0034-7167-2017-0779] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 03/09/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To analyze the occurrence of presenteeism in multiprofessional team workers of an Adult Intensive Care Unit, relating it to sociodemographic and labor characteristics. METHOD It is an analytical cross-sectional qualitative study, which used a questionnaire for sociodemographic data collection, and Stanford Presenteeism Scale(SPS-6) to assess presenteeism. RESULTS There was predominance of women (75.9%), nursing workers (66.7%), mean age of 39.81 years, and 6 to 10 years (31.6%) of experience in the labor market. Regarding presenteeism, 48.7% presented work impairment and 31.8% presentedperformance and completion of tasks altered by this phenomenon. CONCLUSION Expressive numbers of general presenteeism were identified, with results indicating impairment in completing work. When connecting presenteeism to sociodemographic and labor characteristics, the variables sex, dependent children and absence from work presented values with statistical significance among the studied workers.
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Affiliation(s)
- Andressa Fernanda Silva
- Universidade de São Paulo, Ribeirão Preto College of Nursing. Ribeirão Preto, São Paulo, Brazil
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Łyszczarz B. Indirect costs and incidence of caregivers' short-term absenteeism in Poland, 2006-2016. BMC Public Health 2019; 19:598. [PMID: 31101035 PMCID: PMC6525462 DOI: 10.1186/s12889-019-6952-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 05/08/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND There is a growing interest in the costs of informal care; however, the results of previous studies mostly rely on self-reported data, which is subject to numerous biases. The aim of this study is to contribute to the topic by estimating the indirect costs of short-term absenteeism associated with informal caregiving in Poland with the use of social insurance data on care absence incidence. METHODS The human capital method was used to estimate the indirect costs of caregiving from a societal perspective. The incidence of caregiving was identified based on the Social Insurance Institution's data on absence days attributable to care provided to children and other family members. Gross domestic product (GDP) per worker was used as a proxy of labour productivity. Deterministic one-way sensitivity analysis was performed. RESULTS The indirect costs of short-term caregivers' absenteeism in Poland was €306.2 million (0.116% of GDP) in 2006 and increased to €824.0 million in 2016 (0.180% of GDP). The number of care absence days grew from 5.9 million (0.45 days per worker) in 2006 to 10.6 million (0.70 days per worker) in 2016. Approximately 85% of the total costs were attributable to child care. The results of the sensitivity analysis show that the indirect costs varied from the base scenario by - 30.8 to + 15.8%. CONCLUSION Informal short-term caregiving leads to substantial productivity losses in the Polish economy, and the dynamic upward trend of care absence incidence suggests that the costs of caregiving are expected to rise in the future.
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Affiliation(s)
- Błażej Łyszczarz
- Department of Public Health, Faculty of Health Sciences, Nicolaus Copernicus University in Toruń, ul. Sandomierska 16, 85-830, Bydgoszcz, Poland.
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Shaffer KM, Nightingale CL. Comparison of Healthcare Utilization Between Informal Caregivers and Non-Caregivers: An Analysis of the Health Information National Trends Survey. J Aging Health 2019; 32:453-461. [PMID: 30793639 DOI: 10.1177/0898264319830262] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: The demands of providing unpaid care for someone with a disabling health condition (i.e., informal caregiving) can limit attention to one's own health needs. Using a nationally representative survey, this study examines whether caregivers report different healthcare utilization relative to non-caregivers. Method: Participants in the Health Information National Trends Survey 5, Cycle 1 reported whether they provided unpaid care and healthcare utilization outcomes. Logistic regressions and chi-square tests with jackknife variance estimation were used. Results: Caregivers (N = 391) did not differ from non-caregivers (N = 2,894) in time since routine checkup or number of healthcare appointments in the past year (p values > .25). Among caregivers, number of healthcare appointments differed according to caregivers' relationship to the care recipient (p = .04). Discussion: Findings suggest that informal caregivers access routine healthcare at a frequency similar to non-caregivers. Further research should determine whether this utilization is optimal, or whether increased utilization during caregiving might help attenuate caregivers' longer term morbidity.
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Affiliation(s)
- Kelly M Shaffer
- University of Virginia School of Medicine, Charlottesville, USA.,Memorial Sloan Kettering Cancer Center, New York, NY, USA
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