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Toly VB, Zauszniewski JA, Wang M, Russell KN, Ross K, Musil CM. Efficacy of a Resourcefulness Intervention to Enhance the Physical and Mental Health of Parents Caring for Technology-dependent Children at Home: A Randomized Controlled Trial. J Pediatr Health Care 2024; 38:337-353. [PMID: 37897454 PMCID: PMC11045667 DOI: 10.1016/j.pedhc.2023.09.012] [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: 09/28/2023] [Accepted: 09/30/2023] [Indexed: 10/30/2023]
Abstract
INTRODUCTION Parent caregivers of children who require lifesaving medical technology (e.g., mechanical ventilation, feeding tubes) must constantly maintain vigilance. Poor physical and psychological health can negatively impact their ability to do so. METHOD A two-arm randomized controlled trial was conducted with 197 parent caregivers of technology-dependent children (aged < 18 years) to test the efficacy of Resourcefulness Training1, a cognitive-behavioral intervention that teaches social (help-seeking) and personal (self-help) resourcefulness skills, in improving key outcomes including mental health-related quality of life (HRQOL), depressive cognitions and symptoms, perceived and physiological chronic stress, burden, and physical HRQOL at five-time points. RESULTS Mixed-effects models using the intent-to-treat principle indicated statistically significant improvement with intervention participants at six and/or nine months postintervention for depressive cognitions, perceived stress, and physical HRQOL, controlling for covariates. DISCUSSION Study findings support the efficacy of Resourcefulness Training to significantly decrease perceived stress and improve psychological/physical outcomes with these vulnerable caregivers.
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Goldberg I, Sherwood P, Sereika SM, Donovan HS, Weimer J, Drappatz J, Boele F, Shi X, Loughan A. Predictors of Healthcare Utilization in Family Caregivers of Persons With a Primary Malignant Brain Tumor. J Neurosci Nurs 2023; 55:222-227. [PMID: 37782769 PMCID: PMC10754244 DOI: 10.1097/jnn.0000000000000732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
ABSTRACT BACKGROUND: Negative physical health results from the emotional stress of providing care to a family member with a primary malignant brain tumor; however, the downstream effects on caregivers' healthcare utilization (HCU) are unknown. This analysis examined associations between caregivers' emotional health and markers of HCU during the 6 months after patients' diagnoses. METHODS: Caregivers' self-report HCU data from a longitudinal study with 116 neuro-oncology caregivers were analyzed. Healthcare utilization was operationalized as number of prescription medications, reporting visits to primary care providers (PCPs), nature of PCP visit, number of comorbid conditions, and change in comorbid conditions. Potential predictors were caregivers' depressive symptoms (Center for Epidemiologic Studies-Depression Scale), hours providing care per day, mastery (Pearlin and Schooler), and burden (Caregiver Reaction Assessment). Logistic mixed effects modeling were used. RESULTS : Caregivers with higher levels of depressive symptoms ( P < .01), anxiety ( P = .02), burden related to schedule ( P = .02), and abandonment ( P < .01) were more likely to report worsening comorbid conditions. Those with higher mastery ( P = .02) were less likely to report worsening comorbid conditions. Caregivers who had a PCP visit and reported higher burden related to feelings of self-esteem ( P = .03) were more likely to report an illness-related visit. CONCLUSION : Findings suggest a relationship between neuro-oncology caregivers' emotional health and their HCU. Data highlight the importance of caregivers' PCPs identifying caregivers at risk for deteriorating health and increased HCU and intervene to ensure caregivers' self-care.
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Xiang D, Zhang ZX, Ge S, Wang WN, Lin BL, Chen SY, Guo EF, Zhang PB, Liu ZW, Li H, Mei YX. Physio-psycho-social interaction mechanism in dyadic health of young and middle-aged stroke survivors and their spousal caregivers: a longitudinal observational study protocol. BMJ Open 2023; 13:e065767. [PMID: 37041051 PMCID: PMC10106025 DOI: 10.1136/bmjopen-2022-065767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/13/2023] Open
Abstract
INTRODUCTION In recent years, stroke has become more common among young people. Stroke not only has a profound impact on patients' health but also incurs stress and health threats to their caregivers, especially spousal caregivers. Moreover, the health of stroke survivors and their caregivers is interdependent. To our knowledge, no study has explored dyadic health of young and middle-aged stroke survivors and their spousal caregivers from physiological, psychological and social perspectives. Therefore, this proposed study aims to explore the mechanism of how physiological, psychological and social factors affect dyadic health of young and middle-aged stroke survivors and their spousal caregivers. The findings of this study will provide implications for developing interventions to improve dyadic health of this growing population. METHODS AND ANALYSES We will collect data from 57 dyads of young and middle-aged stroke survivors and their spousal caregivers during hospitalisation and at 1, 3, 6, 9 and 12 months after discharge. Questionnaires will be used to collect participants' demographic information, stress, depression, anxiety, benefit finding, social support, mutuality and quality of life. The following physiological reactions will be collected at baseline, including interleukin 6, tumour necrosis factor-alpha and salivary cortisol. ETHICS AND DISSEMINATION The study was approved by the ethics review committee of life sciences of Zhengzhou University (No. ZZUIRB2020-53). Prior to being enrolled in the study, participants will be given full and detailed information about the possible risks involved, the informed consent process, confidentiality, the study procedure and secure data storage. Participants will be guaranteed that they can withdraw from the study at any time without providing a reason or leading to any consequences. Both oral and written informed consent will be obtained from all participants. The findings of this proposed study will be disseminated through peer-reviewed journals and academic conferences.
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Affiliation(s)
- Dandan Xiang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Zhen-Xiang Zhang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Song Ge
- Department of Natural Science, University of Houston Downtown, Houston, Texas, USA
| | - Wen Na Wang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Bei-Lei Lin
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Su-Yan Chen
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Er-Feng Guo
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Peng-Bo Zhang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Zhi-Wei Liu
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Hui Li
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Yong-Xia Mei
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
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Longacre ML, Miller MF, Fang CY. The psychometric properties of a caregiving-related strain scale in oncology. Qual Life Res 2023; 32:285-294. [PMID: 36053408 DOI: 10.1007/s11136-022-03235-7] [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] [Accepted: 08/08/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND Caregivers are rarely assessed for caregiving-related strain. This study explored the psychometric properties of the caregiving-related physical, emotional, and financial strain questions in the National Alliance for Caregiving's (NAC) survey and a new total score (NAC-3). METHODS Comparisons were made to existing caregiver quality of life, distress, and burden instruments through an online, cross-sectional survey of U.S. adult cancer caregivers. RESULTS Findings from 299 caregivers showed that the NAC-3 was moderately to strongly associated with each of the comparison instruments. Similar concepts were also shown to be more strongly correlated (except physical health construct) and dissimilar concepts items had weaker correlations. CONCLUSION Findings suggest that the total score and individual items are psychometrically sound for use as compared to established caregiving-related instruments. The total score and items provide a concise option, potentially beneficial for clinical use, and can be compared to nationally representative samples of caregivers through NAC's surveys.
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Affiliation(s)
- Margaret L Longacre
- Department of Public Health, College of Health Sciences, Arcadia University, 450 S. Easton Rd, Glenside, PA, USA.
| | - Melissa F Miller
- Department of Public Health, College of Health Sciences, Arcadia University, 450 S. Easton Rd, Glenside, PA, USA
| | - Carolyn Y Fang
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA, USA
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R. R, Shetty S, Bhandary R, Kulkarni V. Assessment of psychological stress among family care takers of cancer subjects in India- A cross-sectional study. Biomedicine (Taipei) 2022. [DOI: 10.51248/.v42i5.2157] [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
Introduction and Aim: A rapid increase in cancer rate is one of major concerns in India. It is a well-known fact that family caretakers play an essential part in aiding cancer subjects who are in critical stage. But the psychological strain and economic impact on caretakers are not widely known. The present cross-sectional study assesses the relationship between various factors and higher burden among family caretakers of cancer subjects.
Materials and Methods: One hundred and ninety family caretakers of cancer patients who met inclusion criteria were recruited for study. A proforma was collected regarding the age, gender, social and economic status according to Modified Kuppuswamy Scale 2019, the type of family or the caregiver and their relation to the patient.
Results: Monthly income had an inter quartile range of Rs.10,000-25,000 with the median being Rs.14,000. Higher number of males participated (58.4%) as compared to the females (41.6%). Moderate to severe stress (53.3%), and severe stress (6.7%) was maximum in class 5 of the socio-economic classification. Lower income was found to be related to higher burden scores.
Conclusion: Present study showed that the burden was more among class 5 of the Kuppuswamy Socioeconomic classification. The findings suggest that education levels, occupation and monthly income are the major contribution for the burden among the caregivers.
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Aljuaid M, Ilyas N, Altuwaijri E, Albedawi H, Alanazi O, Shahid D, Alonazi W. Quality of Life among Caregivers of Patients Diagnosed with Major Chronic Disease during COVID-19 in Saudi Arabia. Healthcare (Basel) 2022; 10:healthcare10030523. [PMID: 35327001 PMCID: PMC8953432 DOI: 10.3390/healthcare10030523] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 03/03/2022] [Accepted: 03/08/2022] [Indexed: 12/19/2022] Open
Abstract
Quality of life (QoL) is considered one of the measures of health outcomes. Limited research studies have assessed family caregivers’ QoL, especially among patients diagnosed with chronic disease. This study measures the QoL of caregivers who guardian patients diagnosed with cardiovascular disease, diabetes, cancer, and/or other diseases during the COVID-19 pandemic. Participants were primary caregivers who were supporting, in the last six months, individuals diagnosed with one of the previously mentioned chronic diseases. This included caregivers of patients admitted to a tertiary hospital from January 2021 to July of the same year (n = 1081); all participants completed the World Health Organization Quality of Life Assessment tool (WHOQOL-BREF) questionnaire. Caregivers of patients with cancer reported the highest mean level of QoL, followed by diabetes, cardiovascular diseases, then other different diseases (M = 3.80; M = 3.38; M = 3.37; and M = 2.51, respectively). A chi-square test of independence was performed to examine the relationship between the QoL of the four groups and their behaviors (i.e., caregivers’ psychological onuses and physical actions/reactions). The relation between these variables was significant, X2 (3, n = 1081) = 8.9, p = 0.001. The Kruskal–Wallis test indicated significant differences among the four groups (p ≤ 0.001). While the overall results of the QoL level of participants were low, a major recommendation of this study was to incorporate a QoL assessment to caregivers of chronically ill patients. Regular psychological and physical health check-ups of caregivers should be mandated in the healthcare system. Research studies should consider investigating and identifying the factors affecting health outcomes and positive developments which have a great impact on the wellbeing of both caregivers and patients on personal, organizational, and national levels.
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Affiliation(s)
- Mohammed Aljuaid
- Department of Health Administration, College of Business Administration, King Saud University, Riyadh 11587, Saudi Arabia; (M.A.); (E.A.)
| | - Namrah Ilyas
- Centre for Clinical Psychology, University of the Punjab, Lahore 66000, Pakistan;
| | - Eman Altuwaijri
- Department of Health Administration, College of Business Administration, King Saud University, Riyadh 11587, Saudi Arabia; (M.A.); (E.A.)
- Department of Administrative and Social Sciences, College of Business Applied Studies and Community Service, King Saud University, Riyadh 11587, Saudi Arabia
| | - Haddel Albedawi
- Department of Community Health, College of Applied Medical Sciences, King Saud University, Riyadh 11587, Saudi Arabia;
| | - Ohoud Alanazi
- Department of Public Administration, College of Business Administration, King Saud University, Riyadh 11587, Saudi Arabia;
| | - Duaa Shahid
- Hult International Business School, Cambridge, MA 02141, USA;
| | - Wadi Alonazi
- Department of Health Administration, College of Business Administration, King Saud University, Riyadh 11587, Saudi Arabia; (M.A.); (E.A.)
- Correspondence: ; Tel.: +966-114-693-999
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Toly VB, Zauszniewski JA, Yu J, Sattar A, Rusincovitch B, Musil CM. Resourcefulness Intervention Efficacy for Parent Caregivers of Technology-Dependent Children: A Randomized Trial. West J Nurs Res 2022; 44:296-306. [PMID: 34965784 PMCID: PMC9166934 DOI: 10.1177/01939459211062950] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Parent caregivers of children who require lifesaving technology (e.g., mechanical ventilation, feeding tubes) must maintain a high level of vigilance 24/7. A two-arm randomized controlled trial tested the efficacy of a resourcefulness intervention on parents' mental/physical health and family functioning at four time points over six months. Participants (n = 93) cared for their technology-dependent children <18 years at home. The intervention arm received teaching on social (help-seeking), personal (self-help) resourcefulness skills; access to the intervention video and skill application video-vignettes; four weeks of skills reinforcement using daily logs; four weekly phone contacts; and booster sessions at two- and four-month postenrollment. The attention control arm received phone contact at identical time points plus the current standard of care. Statistically significant improvement was noted; fewer depressive cognitions and improved physical health for the intervention participants than attention control participants over time after controlling for covariates. The findings support the resourcefulness intervention efficacy.
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Affiliation(s)
| | | | - Jiao Yu
- Institute for Social Research and Data Innovation, University of Minnesota
| | - Abdus Sattar
- Department of Population and Quantitative Health Science, School of Medicine, Case Western Reserve University
| | | | - Carol M. Musil
- Frances Payne Bolton School of Nursing, Case Western Reserve University
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Boele FW, Weimer JM, Marsland AL, Armstrong TS, Given CW, Drappatz J, Donovan HS, Sherwood PR. The effects of SmartCare © on neuro-oncology family caregivers' distress: a randomized controlled trial. Support Care Cancer 2022; 30:2059-2068. [PMID: 34655326 PMCID: PMC10411320 DOI: 10.1007/s00520-021-06555-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 08/30/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE Patients with primary malignant brain tumors have high symptom burden and commonly rely on family caregivers for practical and emotional support. This can lead to negative mental and physical consequences for caregivers. We investigated effectiveness of an 8-week nurse-led online needs-based support program (SmartCare©) with and without online self-guided cognitive behavioral therapy (CBT) for depression compared to enhanced care as usual (ECAU) on depressive symptoms, caregiving-specific distress, anxiety, mastery, and burden. METHODS Family caregivers scoring ≥ 6 on a depressive symptoms inventory were randomized to three groups: ECAU plus self-guided CBT and SmartCare©; ECAU plus SmartCare©; ECAU only. Primary outcomes (depressive symptoms; caregiving-specific distress) and secondary outcomes (anxiety, caregiver mastery, and caregiver burden) were assessed online. Intention to treat (ITT) and per protocol (PP) analyses of covariance corrected for baseline scores were performed for outcomes at 4 months. RESULTS In total, 120 family caregivers participated. Accrual and CBT engagement were lower than expected, therefore intervention groups were combined (n = 80) and compared to ECAU (n = 40). For depressive symptoms, no statistically significant group differences were found. Caregiving-specific distress decreased in the intervention group compared with ECAU (ITT: p = 0.01, partial ɳ2 = 0.08; PP: p = 0.02, partial ɳ2 = 0.08). A trend towards improvement in mastery for the intervention group compared with ECAU was identified (ITT: p = 0.08, partial ɳ2 = 0.04; PP: p = 0.07, partial ɳ2 = 0.05). CONCLUSIONS SmartCare©, with or without self-guided CBT, reduced caregiving-specific distress with a trend towards improving mastery. SmartCare© has the potential to improve the lives of families coping with a brain tumor diagnosis. TRIAL REGISTRATION NUMBER NCT02058745; 10 February 2014.
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Affiliation(s)
- Florien W Boele
- Leeds Institute of Medical Research At St James's, University of Leeds, Beckett Street, Leeds, LS9 7TF, UK
- Leeds Institute of Health Sciences, University of Leeds, Leeds, LS2 9NL, UK
| | - Jason M Weimer
- School of Nursing, University of Pittsburgh, 336 Victoria Bldg., 3500 Victoria St., Pittsburgh, PA, 15261, USA
| | - Anna L Marsland
- School of Psychology, University of Pittsburgh, 3490 O'Hara St., Pittsburgh, PA, 15261, USA
| | - Terri S Armstrong
- Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - Charles W Given
- College of Nursing C346 Life Sciences Bldg, Michigan State University, 1355 Bogue St East, Lansing, MI, 48824, USA
| | - Jan Drappatz
- Division of Hematology/Oncology, Hillman Cancer Center, University of Pittsburgh Medical Center, 5115 Centre Avenue, Pittsburgh, PA, 15232, USA
| | - Heidi S Donovan
- School of Nursing, University of Pittsburgh, 336 Victoria Bldg., 3500 Victoria St., Pittsburgh, PA, 15261, USA.
- School of Nursing, University of Pittsburgh, 415 Victoria Building, 3500 Victoria St, Pittsburgh, PA, 15261, USA.
| | - Paula R Sherwood
- School of Nursing, University of Pittsburgh, 336 Victoria Bldg., 3500 Victoria St., Pittsburgh, PA, 15261, USA.
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Ashare RL, Brewer B, Patterson F, Hubbard A, Longacre ML. Psychological and behavioral moderators of physical health among caregivers and non-caregivers. Geriatr Nurs 2021; 43:77-84. [PMID: 34844128 DOI: 10.1016/j.gerinurse.2021.11.004] [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: 07/30/2021] [Revised: 11/01/2021] [Accepted: 11/03/2021] [Indexed: 11/04/2022]
Abstract
The current study sought to evaluate whether psychological and/or behavioral health moderate the relationship between caregiving and physical health. MATERIALS AND METHODS Using data from the Behavioral Risk Factor Surveillance System (BRFSS) survey (2017-2018), separate composite scores were created for psychological and behavioral health. Self-reported physical health was the primary outcome. The sample was 1,387 non-caregivers and 266 caregivers. RESULTS The psychological, behavioral, and self-reported physical health did not significantly differ between caregivers and non-caregivers, but psychological and behavioral health were shown to differentially affect self-reported health outcomes among caregivers, compared to non-caregivers. Caregivers with worse psychological health had higher odds of experiencing poor physical health versus non-caregivers, while caregivers with better behavioral health had lower odds of having better general health versus non-caregivers. DISCUSSION These data extend our understanding on how to consider the impact of psychological and behavioral health as a caregiver and opportunities to develop targeted interventions.
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Affiliation(s)
- Rebecca L Ashare
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, United States; Department of Psychology, State University of New York at Buffalo, Buffalo, NY 14260, United States
| | - Benjamin Brewer
- College of Health Sciences, University of Delaware, The STAR Campus, Newark, DE 19713, United States
| | - Freda Patterson
- College of Health Sciences, University of Delaware, The STAR Campus, Newark, DE 19713, United States
| | - Adeline Hubbard
- Department of Public Health, College of Health Sciences, Arcadia University, Glenside, PA 19038, United States
| | - Margaret L Longacre
- Department of Public Health, College of Health Sciences, Arcadia University, Glenside, PA 19038, United States.
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Karampela M, Porat T, Mylonopoulou V, Isomursu M. Rehabilitation Needs of Head and Neck Cancer Patients and Stakeholders: Case Study. Front Oncol 2021; 11:670790. [PMID: 34631516 PMCID: PMC8499693 DOI: 10.3389/fonc.2021.670790] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 08/25/2021] [Indexed: 11/13/2022] Open
Abstract
Background The incidents of Head and Neck Cancer (HNC) are rising worldwide, suggesting that this type of cancer is becoming more common. The foreseen growth of incidents signifies that future rehabilitation services will have to meet the needs of a wider population. Objective The aim of this paper is to explore the needs of patients, caregivers and healthcare professionals during HNC rehabilitation. Methods This paper reports the empirical findings from a case study that was conducted in a cancer rehabilitation center in Copenhagen to elicit the needs of HNC cancer patients, informal caregivers and healthcare professionals. Results Four areas of needs during the rehabilitation process were identified: service delivery, emotional, social and physical needs. Service delivery needs and emotional needs have been identified as the most prevalent. Conclusions Stakeholders' needs during the rehabilitation process were found to be interrelated. All stakeholders faced service delivery challenges in the form of provision and distribution of information, including responsibilities allocation between municipalities, hospitals and rehabilitation services. Emotional and social needs have been reported by HNC patients and informal caregivers, underlining the importance of inclusion of all actors in the design of future healthcare interventions. Connected Health (CH) solutions could be valuable in provision and distribution of information.
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Affiliation(s)
- Maria Karampela
- Faculty of Information Technology and Electrical Engineering, University of Oulu, Oulu, Finland
| | - Talya Porat
- Faculty of Engineering, Dyson School of Design Engineering, Imperial College London, London, United Kingdom
| | - Vasiliki Mylonopoulou
- Department Of Applied Information Technology, Division of Human Computer Interaction, University of Gothenburg, Gothenburg, Sweden
| | - Minna Isomursu
- Faculty of Information Technology and Electrical Engineering, University of Oulu, Oulu, Finland
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Tanco K, Prado B, Qian Y, Park M, Liu D, Guzman-Gutierrez D, Bruera E. A Comparison of Caregiver Burden of Patients with Advanced Cancer in Different Palliative Cancer Care Settings. J Palliat Med 2021; 24:1766-1775. [PMID: 33926226 DOI: 10.1089/jpm.2021.0026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Background: Informal caregivers may experience a significant burden while caring for cancer patients. Little is known about how caregiver burden varies across different palliative cancer care settings and the factors influencing it. Objectives: We compared the severity of caregiver subjective stress burden (emotional impact) among caregivers of patients seen in the outpatient supportive care center (SCC) with those being cared for in the acute palliative care unit (PCU). Secondary aims were to compare other caregiver burden dimensions, quality of life, and any association of caregiver subjective stress burden to various patient and caregiver factors. Setting and Design: Eligible patients and their informal caregivers in the SCC or PCU at a comprehensive cancer center in the USA were approached and enrolled. The Montgomery-Borgatta Caregiver Burden Scale and the Short-form 36 were used to measure burden and quality of life. Multivariate general linear regression was employed to evaluate the effect of covariates on subjective stress burden. Results: Ninety-eight dyads in the SCC and 74 dyads in the PCU were enrolled. PCU caregivers reported worse subjective stress burden (p = 0.0029) and mental health (p = 0.0299). Multivariate analysis showed correlations between subjective stress burden and caregivers' objective burden (p = 0.0136), subjective demand burden (p ≤ 0.0001), mental health (p = 0.0074), duration of caregiving (p = 0.0680), education (p = 0.0192) and with patients' anxiety (p = 0.0003) and current/recent cancer treatment (p = 0.0579). Conclusion: PCU caregivers demonstrated worse emotional burden and mental health than those in the SCC. More research is needed to tailor interventions for various caregiver burden dimensions. NCI Clinical Trial Registration Number ID: NCI-2019-01197.
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Affiliation(s)
- Kimberson Tanco
- Department of Palliative, Rehabilitation, and Integrative Medicine and The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Bernard Prado
- Oncology and Hematology Center, Hospital Israelita Albert Einstein, Sao Paulo, Brasil
| | - Yu Qian
- Tongji Medical College, Huazhong University of Science and Technology, Hubei Cancer Hospital, Wuhan, Hubei, China
| | - Minjeong Park
- US Food and Drug Administration, Bethesda, Maryland, USA
| | - Diane Liu
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Diana Guzman-Gutierrez
- Department of Palliative, Rehabilitation, and Integrative Medicine and The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Eduardo Bruera
- Department of Palliative, Rehabilitation, and Integrative Medicine and The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Reblin M, Ketcher D, McCormick R, Barrios-Monroy V, Sutton SK, Zebrack B, Wells KJ, Sahebjam S, Forsyth P, Byrne MM. A randomized wait-list controlled trial of a social support intervention for caregivers of patients with primary malignant brain tumor. BMC Health Serv Res 2021; 21:360. [PMID: 33865382 PMCID: PMC8052543 DOI: 10.1186/s12913-021-06372-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 04/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Informal family caregivers constitute an important and increasingly demanding role in the cancer healthcare system. This is especially true for caregivers of patients with primary malignant brain tumors based on the rapid progression of disease, including physical and cognitive debilitation. Informal social network resources such as friends and family can provide social support to caregivers, which lowers caregiver burden and improves overall quality of life. However, barriers to obtaining needed social support exist for caregivers. To address this need, our team developed and is assessing a multi-component caregiver support intervention that uses a blend of technology and personal contact to improve caregiver social support. METHODS We are currently conducting a prospective, longitudinal 2-group randomized controlled trial which compares caregivers who receive the intervention to a wait-list control group. Only caregivers directly receive the intervention, but the patient-caregiver dyads are enrolled so we can assess outcomes in both. The 8-week intervention consists of two components: (1) The electronic Social Network Assessment Program, a web-based tool to visualize existing social support resources and provide a tailored list of additional resources; and (2) Caregiver Navigation, including weekly phone sessions with a Caregiver Navigator to address caregiver social support needs. Outcomes are assessed by questionnaires completed by the caregiver (baseline, 4-week, 8-week) and the cancer patient (baseline, and 8-week). At 8 weeks, caregivers in the wait-list condition may opt into the intervention. Our primary outcome is caregiver well-being; we also explore patient well-being and caregiver and patient health care utilization. DISCUSSION This protocol describes a study testing a novel social support intervention that pairs a web-based social network visualization tool and resource list (eSNAP) with personalized caregiver navigation. This intervention is responsive to a family-centered model of care and calls for clinical and research priorities focused on informal caregiving research. TRIAL REGISTRATION clinicaltrials.gov , Registration number: NCT04268979 ; Date of registration: February 10, 2020, retrospectively registered.
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Affiliation(s)
- Maija Reblin
- Department of Health Outcomes & Behavior, Moffitt Cancer Center, 12902 Magnolia Dr, Tampa, FL, 33612, USA.
| | - Dana Ketcher
- Department of Health Outcomes & Behavior, Moffitt Cancer Center, 12902 Magnolia Dr, Tampa, FL, 33612, USA
| | - Rachael McCormick
- Department of Health Outcomes & Behavior, Moffitt Cancer Center, 12902 Magnolia Dr, Tampa, FL, 33612, USA
| | - Veronica Barrios-Monroy
- Department of Health Outcomes & Behavior, Moffitt Cancer Center, 12902 Magnolia Dr, Tampa, FL, 33612, USA
| | - Steven K Sutton
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL, USA
| | - Bradley Zebrack
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | - Kristen J Wells
- Department of Psychology, San Diego State University, San Diego, CA, USA
- SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Solmaz Sahebjam
- Department of Neuro-Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Peter Forsyth
- Department of Neuro-Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Margaret M Byrne
- Department of Health Outcomes & Behavior, Moffitt Cancer Center, 12902 Magnolia Dr, Tampa, FL, 33612, USA
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13
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La IS, Johantgen M, Storr CL, Zhu S, Cagle JG, Ross A. Caregiver burden and related factors during active cancer treatment: A latent growth curve analysis. Eur J Oncol Nurs 2021; 52:101962. [PMID: 33962232 DOI: 10.1016/j.ejon.2021.101962] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 03/06/2021] [Accepted: 04/11/2021] [Indexed: 02/05/2023]
Abstract
PURPOSE Caregiver burden is frequently studied cross-sectionally, but longitudinal studies on family caregiver burden during active cancer treatment are lacking. The goals of this study were to characterize trajectories of caregivers' burden during a 6-month active treatment period, and to examine which predictors are associated with their burden. METHOD This study was a secondary analysis of data from a prospective study. A sample of 112 family caregivers of patients receiving cancer treatment were assessed at three time points (the initiation of new treatment regimen, 3-, and 6-month follow-up). Caregivers completed measures: Caregiver Reaction Assessment and Mutuality Scale of the Family Care Inventory. Data were analyzed using latent growth curve modeling. RESULTS The two highest burdens were subdomains related to disrupted schedule and financial problems. Models showed a decline in schedule burden over time, yet total burden and other subscales (financial problems, health problems, and lack of family support and self-esteem) remained relatively stable. In multivariate analysis, mutuality, the relationship quality between patients and caregivers was inversely related to burden at baseline. Being a spouse, a sole caregiver and lower income were related to higher burden over time. CONCLUSIONS Our findings confirmed significant determinants of caregiver burden over the course of active treatment. It is important for health care providers to be attentive to vulnerable caregivers who are at higher risk of elevated burden over time. Considering the multidimensional nature of caregiver burden, early assessment and tailored support programs may be effective by focusing on patient-caregiver relationships, caregiving roles, and income.
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Affiliation(s)
- In Seo La
- College of Nursing Science, Kyung Hee University, Seoul, South Korea; University of Maryland School of Nursing, Baltimore, MD, USA.
| | - 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
- National Institutes of Health, Clinical Center, Bethesda, MD, USA
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14
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Zamanipoor Najafabadi AH, van der Meer PB, Boele FW, Taphoorn MJB, Klein M, Peerdeman SM, van Furth WR, Dirven L. The long-term caregiver burden in World Health Organization grade I and II meningioma: It is not just the patient. Neurooncol Adv 2021; 3:vdaa169. [PMID: 33543144 PMCID: PMC7850085 DOI: 10.1093/noajnl/vdaa169] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background Little is known about long-term caregiver burden in meningioma patients. We assessed meningioma caregiver burden, its association with informal caregiver's well-being and possible determinants. Methods In this multicenter cross-sectional study, informal caregivers completed the Caregiver Burden Scale (five domains and total score). Patients completed a disease-specific health-related quality of life (HRQoL) questionnaire focusing on symptoms (EORTC QLQ-BN20) and underwent neurocognitive assessment. Both groups completed a generic HRQoL questionnaire (SF-36) and the Hospital Anxiety, and Depression Scale. We assessed the association between caregiver burden and their HRQoL, anxiety and depression. Furthermore, we assessed determinants for the caregiver burden. Multivariable regression analysis was used to correct for confounders. Results One hundred and twenty-nine informal caregivers were included (median 10 years after patients' treatment). Caregivers reported burden in ≥1 domain (34%) or total burden score (15%). A one-point increase in total caregiver burden score was associated with a clinically relevant decrease in caregiver's HRQoL (SF-36) in 5/8 domains (score range: -10.4 to -14.7) and 2/2 component scores (-3.5 to -5.9), and with more anxiety (3.8) and depression (3.0). Patients' lower HRQoL, increased symptom burden, and increased anxiety and depression were determinants for higher caregiver burden, but not patients' or caregivers' sociodemographic characteristics, patients' neurocognitive functioning, or tumor- and treatment-related characteristics. Conclusions Ten years after initial treatment, up to 35% of informal caregivers reported a clinically relevant burden, which was linked with worse HRQoL, and more anxiety and depression in both patients and caregivers, emphasizing the strong interdependent relationship. Support for meningioma caregivers is therefore warranted.
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Affiliation(s)
- Amir H Zamanipoor Najafabadi
- Department of Neurosurgery, University Neurosurgical Center Holland, Leiden University Medical Center and Haaglanden Medical Center & Haga Teaching Hospitals, Leiden and The Hague, The Netherlands.,Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - Pim B van der Meer
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - Florien W Boele
- Leeds Institute of Medical Research at St James's, St James's University Hospital, Leeds, UK.,Leeds Institute of Health Sciences, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Martin J B Taphoorn
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands.,Department of Neurology, Haaglanden Medical Center, The Hague, The Netherlands
| | - Martin Klein
- Brain Tumor Center Amsterdam, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Saskia M Peerdeman
- Department of Neurosurgery, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Wouter R van Furth
- Department of Neurosurgery, University Neurosurgical Center Holland, Leiden University Medical Center and Haaglanden Medical Center & Haga Teaching Hospitals, Leiden and The Hague, The Netherlands
| | - Linda Dirven
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands.,Brain Tumor Center Amsterdam, Amsterdam University Medical Centers, Amsterdam, The Netherlands
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15
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Caregiver Burden Domains and Their Relationship with Anxiety and Depression in the First Six Months of Cancer Diagnosis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17114101. [PMID: 32526823 PMCID: PMC7312950 DOI: 10.3390/ijerph17114101] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 06/05/2020] [Accepted: 06/06/2020] [Indexed: 12/16/2022]
Abstract
Cancer caregiving is associated with burden and a poor psychological state. However, there is no previous information about the predictive utility of specific burden domains on anxiety and depression in the first six months after a partner's cancer diagnosis. In a longitudinal study, 67 caregivers completed the Zarit Burden Interview (ZBI) and Hospital Anxiety and Depression Scale (HADS) at T1 (45-60 days after diagnosis) and T2 (180-200 days after diagnosis). Most of the caregivers were female (65.7%, mean age = 51.63, SD = 13.25), while patients were mostly male (56.7%). The TRIPOD checklist was applied. ZBI scores were moderate and HADS anxiety reached significant values. There were no differences in ZBI and HADS between T1 and T2. The relationship between burden, anxiety, and depression were more consistent at T2, while emotional burden at T1 were related and predicted anxiety and depression at T2. Some burden domains were related and predicted anxiety in caregivers in the first six months after partner cancer diagnosis. This information could be useful to prevent the onset of these symptoms in the first six months after diagnosis.
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16
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Belcher SM, Donovan HS, Bovbjerg DH, Sherwood PR, Campbell GB, Sereika SM. Psychobehavioral risk factors for financial hardship and poor functional outcomes in survivors of multiple primary cancers. Psychooncology 2019; 29:507-516. [PMID: 31733024 DOI: 10.1002/pon.5293] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 11/13/2019] [Accepted: 11/14/2019] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Survivors of multiple primary cancers (MPC) are at increased risk for poor health outcomes compared with survivors of single cancers. Using an adapted psychobehavioral stress-response model, the study purpose was to identify pathways and individual risk factors associated with poor health outcomes in adults with MPC. METHODS Adult MPC survivors (N = 211) with first cancers (stages I-III) diagnosed within 1 to 10 years were recruited via tumor registry. Employing a cross-sectional design, established questionnaires were used to operationalize patient characteristics and theoretical constructs including perceived stress, psychological and behavioral responses, financial hardship, social role function, and physical health. Disease and treatment data were obtained via registry and medical records. Structural equation modeling (SEM) was performed to fit, test, and modify the hypothesized psychobehavioral model. RESULTS Following measurement model refinement, an SEM linking self-management behaviors, distress, financial hardship, and functional health demonstrated a good fit: χ2 (200, N = 206) = 332.06, P < .01; Tucker-Lewis index (TLI) = .95, comparative fit index (CFI) = .96, standardized root mean residual (SRMR) = .06, root-mean-square error of approximation (RMSEA) = .06. Less use of self-management behaviors predicted higher distress which, in turn, predicted higher financial hardship; higher distress and financial hardship predicted poorer functional health. Several sociodemographic and personal factors predicted self-management behaviors and distress. CONCLUSIONS The hypothesized stress-response model was partially supported. Data supported pathways among self-management behaviors, distress, financial hardship, and functional health. Self-management and distress may represent modifiable intervention targets for MPC survivors. High body mass index (BMI), less education, greater neuroticism, and lower social support were associated with less use of self-management behaviors and higher distress and should be further evaluated as potential markers of vulnerability.
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Affiliation(s)
- Sarah M Belcher
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Heidi S Donovan
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania.,School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.,Hillman Cancer Center, UPMC, Pittsburgh, Pennsylvania.,Magee Women's Hospital, UPMC, Pittsburgh, Pennsylvania
| | - Dana H Bovbjerg
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania.,School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.,Hillman Cancer Center, UPMC, Pittsburgh, Pennsylvania.,Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania.,Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Paula R Sherwood
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania.,School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.,Hillman Cancer Center, UPMC, Pittsburgh, Pennsylvania
| | - Grace B Campbell
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania.,Hillman Cancer Center, UPMC, Pittsburgh, Pennsylvania
| | - Susan M Sereika
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania.,Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania.,Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, Pennsylvania
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17
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Nadig NR, Sterba KR, Johnson EE, Goodwin AJ, Ford DW. Inter-ICU transfer of patients with ventilator dependent respiratory failure: Qualitative analysis of family and physician perspectives. PATIENT EDUCATION AND COUNSELING 2019; 102:1703-1710. [PMID: 30979579 DOI: 10.1016/j.pec.2019.04.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 04/01/2019] [Accepted: 04/04/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVES Ventilator dependent respiratory failure (VDRF) patients are seriously ill and often transferred between ICUs. Our objective was to obtain multi-stakeholder insights into the experiences of families during inter-ICU transfer. METHODS We conducted a qualitative study using semi-structured interviews with family members of VDRF patients as well as clinicians that have received or transferred VDRF patients to our hospital. Interviews were transcribed and template analysis was used to identify themes within/across stakeholder groups. RESULTS Patient, family, clinician and systems-level factors were identified as key themes during inter-ICU transfer. The main findings highlight that family members were rarely engaged in the decision to transfer as well as a lack of standardized communication between clinicians during care transitions. Family members were reassured with the care after transfer in spite of practical and financial challenges. Clinicians acknowledged the lack of a systematic approach for meeting the needs of families and suggested various resources. CONCLUSIONS This is one of the first qualitative studies to gather a multi-stakeholder perspective and identify problems faced by families during inter-ICU transfer of VDRF patients. PRACTICE IMPLICATIONS Our results provide a starting point for the development of family-centered support interventions which will need to be tested in future studies.
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Affiliation(s)
- Nandita R Nadig
- Division of Pulmonary and Critical Care Medicine, Medical University of South Carolina, 96 Jonathan Lucas Dr., Suite 816 CSB, Charleston, SC, 29425, USA.
| | - Katherine R Sterba
- Department of Public Health Sciences, Medical University of South Carolina, 135 Cannon Street, Suite 303 MSC 835, Charleston, SC, 29425, USA.
| | - Emily E Johnson
- College of Nursing, Medical University of South Carolina, 99 Jonathan Lucas Street, Charleston, SC, 29425, USA.
| | - Andrew J Goodwin
- Division of Pulmonary and Critical Care Medicine, Medical University of South Carolina, 96 Jonathan Lucas Dr., Suite 816 CSB, Charleston, SC, 29425, USA.
| | - Dee W Ford
- Division of Pulmonary and Critical Care Medicine, Medical University of South Carolina, 96 Jonathan Lucas Dr., Suite 816 CSB, Charleston, SC, 29425, USA.
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18
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Boele FW, Terhorst L, Prince J, Donovan HS, Weimer J, Sherwood PR, Lieberman FS, Drappatz J. Psychometric Evaluation of the Caregiver Needs Screen in Neuro-Oncology Family Caregivers. J Nurs Meas 2019; 27:162-176. [PMID: 31511403 DOI: 10.1891/1061-3749.27.2.162] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE The informal care demands of primary malignant brain tumor (PMBT) patients include unique issues associated with neurological and cognitive symptoms. Existing caregiver needs questionnaires do not include these disease-specific symptoms, which are particularly distressing. Therefore, we have developed the neuro-oncology Caregiver Needs Screen (CNS) and evaluated its psychometric properties. METHODS The 32-item instrument was developed based on PMBT caregiver interviews (N = 109) and expert review. The CNS was tested along measures of depression, anxiety, burden, and mastery in 122 PMBT caregivers. Principal components analysis was used to examine item properties and internal structure. Internal consistency reliability and construct validity were assessed. RESULTS Six subscales were identified with internal consistency ranging between alpha = .653 and .857. Convergent validity was verified by moderate/high correlations between measures of caregiver well-being and CNS scale scores. CONCLUSIONS Findings provide preliminary evidence of reliability and validity for the CNS. This instrument can be useful when assessing caregivers' needs for supportive care.
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Affiliation(s)
- Florien W Boele
- University of Leeds, Leeds Institute for Medical Research at St James's & Leeds Institute of Health Sciences, Leeds, United Kingdom
| | - Lauren Terhorst
- University of Pittsburgh, Department of Occupational Therapy
| | | | | | | | | | - Frank S Lieberman
- Division of Hematology/Oncology, Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh
| | - Jan Drappatz
- Division of Hematology/Oncology, Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh
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19
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Teixeira RJ, Remondes-Costa S, Graça Pereira M, Brandão T. The impact of informal cancer caregiving: A literature review on psychophysiological studies. Eur J Cancer Care (Engl) 2019; 28:e13042. [PMID: 30990936 DOI: 10.1111/ecc.13042] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 02/16/2019] [Accepted: 03/25/2019] [Indexed: 12/19/2022]
Abstract
Caregiving can be experienced as a stressful process, which can cause psychological and physical consequences. The combination of prolonged stress and the physical demands of caregiving may impair the physiological functioning of caregivers and increase the risk of health problems creating considerable stress in the life of caregivers regarding emotional, physical, social and financial areas. This literature review explored studies that used measures of the autonomic nervous system in caregivers of oncology patients such as electrodermal and cardiovascular (re)activity. The results revealed that caregivers had elevated stress levels and a serious autonomic imbalance that may, in the long term, trigger negative health consequences such as infectious diseases, cancer progression, cardiovascular disease and even premature death. The results showed the need to carry out preventive strategies in this population, in order to improve the autonomic profile of caregivers of cancer patients.
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Affiliation(s)
- Ricardo João Teixeira
- School of Psychology, University of Minho, Braga, Portugal.,Psychotherapy Department, Clínica da Ordem, Porto, Portugal.,Institute of Research and Advanced Training in Health Sciences and Technologies, CESPU, Gandra, Portugal
| | | | | | - Tânia Brandão
- Departamento de Psicologia, Centro de Investigação em Psicologia (CIP-UAL), Universidade Autónoma de Lisboa Luís de Camões, Lisboa, Portugal
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20
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Maternal Factors Associated With the Healthcare Utilization of Technology-Dependent Infants Following NICU Discharge. J Perinat Neonatal Nurs 2019; 33:268-275. [PMID: 31335857 DOI: 10.1097/jpn.0000000000000428] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This study examined the relationship of mothers' psychological well-being (depressive symptoms, posttraumatic stress symptoms) and resourcefulness with their technology-dependent infants' healthcare utilization (rehospitalization, emergency department [ED] visits) following discharge from the neonatal intensive care unit (NICU). This descriptive, correlational study was conducted at a large Midwest level 4 NICU in the United States. Mothers (n = 19) with a technology-dependent infant (eg, supplemental oxygen, feeding tubes) to be discharged home from the NICU within 2 to 3 weeks were interviewed face-to-face using standardized instruments. Infant rehospitalization and ED visit data were collected from the electronic medical record (EMR) for the first 3 months following the infant's discharge. Analyses included descriptive statistics and negative binomial regression. A majority of infants (72.2%) required at least 1 hospitalization; 33% required at least one ED visit. Mothers' age and resourcefulness were significant predictors of ED visits while only resourcefulness predicted rehospitalizations. Neither depressive symptoms nor posttraumatic stress symptoms significantly predicted healthcare utilization. Maternal resourcefulness was the only main variable that significantly predicted both ED visits and hospitalizations and one of the few modifiable factors that could assist mothers with successfully coping with the complexity of caring for a technology-dependent infant. Future research should focus on interventions to enhance mothers' resourcefulness prior to their technology-dependent infant's NICU discharge.
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21
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Abstract
Survivorship has become a significant topic within oncologic care. The tools and means by which the provision of survivorship care can be implemented and delivered are in development and are the focus of significant research oncology-wide. These tools and methods include innovations of survivorship care delivery, survivorship care plans, and improving communication among all stakeholders in an individual patient's care as the means to elevate health-related quality of life. The merits of these survivorship care provisions in the field of neuro-oncology and its patients' exigent need for more patient-centric care focused on living with their illness are discussed. Since 2014 there has been a mandate within the United States for adult cancer patients treated with curative intent to receive survivorship care plans, comprising a treatment summary and a follow-up plan, intended to facilitate patients' care after initial diagnosis and upfront treatment. Several cancer-specific survivorship care plans have been developed and endorsed by health care professional organizations and patient advocacy groups. A survivorship care plan specific for neuro-oncology has been collaboratively developed by a multidisciplinary and interprofessional committee; it is endorsed by the Society for Neuro-Oncology Guidelines Committee. It is available as open access for download from the Society for Neuro-Oncology website under "Resources": https://www.soc-neuro-onc.org/SNO/Resources/Survivorship_Care_Plan.aspx. Survivorship care offers an opportunity to begin directly addressing the range of issues patients navigate throughout their illness trajectory, an oncology initiative to which neuro-oncology patients both need and deserve equitable access.
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Affiliation(s)
- Heather Leeper
- Department of Neurology, NorthShore University Health System, Evanston, Illinois
| | - Kathrin Milbury
- Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
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22
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Teixeira RJ, Applebaum AJ, Bhatia S, Brandão T. The impact of coping strategies of cancer caregivers on psychophysiological outcomes: an integrative review. Psychol Res Behav Manag 2018; 11:207-215. [PMID: 29872357 PMCID: PMC5973462 DOI: 10.2147/prbm.s164946] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose A growing number of studies have explored the psychosocial burden experienced by cancer caregivers, but less attention has been given to the psychophysiological impact of caregiving and the impact of caregivers’ coping strategies on this association. This paper reviews existing research on the processes underlying distress experienced by cancer caregivers, with a specific focus on the role of coping strategies on psychophysiological correlates of burden. Methods A broad literature search was conducted in health-related databases namely MEDLINE, Science Citations Index Expanded, Scopus, and PsycINFO, using relevant search terms. All types of studies published in English were considered for inclusion. Results We found that cancer caregiving was related to increased blood pressure, dysregulation of autonomic nervous system, hypothalamic–pituitary–axis dysregulation, immune changes, and poor health-related behaviors. We also found that problem-focused coping was associated with decreased caregiver burden, decreased depression, and better adjustment, while emotion-focused coping was related to higher levels of posttraumatic growth and psychological distress. The way coping impacts psychophysiological correlates of burden, however, remains unexplored. Conclusion A better understanding of the psychophysiological elements of caregiver burden is needed. We propose a model that attends specifically to factors that may impact psychophysiological correlates of burden among cancer caregivers. Based on the proposed model, psychosocial interventions that specifically target caregivers’ coping and emotion regulation skills, family functioning, and self-care are endemic to the preservation of the health and well-being of this vulnerable population.
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Affiliation(s)
- Ricardo João Teixeira
- Department of Education and Psychology, University of Aveiro, Aveiro, Portugal.,Clínica daOrdem, Porto, Portugal.,CESPU, Institute of Research and Advanced Training in Health Sciences and Technologies, Gandra, Portugal.,MamaHelp, Breast Cancer Support Center, Porto, Portugal
| | | | - Sangeeta Bhatia
- Department of Psychology, Gargi College, University of Delhi, New Delhi, India
| | - Tânia Brandão
- Departamento de Psicologia, Centro de Investigação em Psicologia (CIP-UAL), Universidade Autónoma de Lisboa Luís de Camões, Lisboa, Portugal
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23
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Reblin M, Small B, Jim H, Weimer J, Sherwood P. Mediating burden and stress over time: Caregivers of patients with primary brain tumor. Psychooncology 2017; 27:607-612. [PMID: 28801927 PMCID: PMC10111220 DOI: 10.1002/pon.4527] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 06/20/2017] [Accepted: 08/04/2017] [Indexed: 11/06/2022]
Abstract
There is a growing literature on the effects of cancer caregiving on the well-being of informal family caregivers. However, there has been little longitudinal research on caregivers of patients with the complex, rapidly-changing disease of primary malignant brain tumor. OBJECTIVE Our objective was to model longitudinal relationships between caregiver burden, social support, and distress within caregivers of patients with primary brain tumor. METHODS Caregiver participants were recruited from a neuro-oncology clinic. Caregiver questionnaire data, including sociodemographics, social support, depression, anxiety, and caregiving burden, were collected at 4 time points (diagnosis, +4, +8, and +12 mo). Using the stress process model as a guide, we hypothesized that early burden would predict later depression and anxiety, and this would be mediated by social support. RESULTS Using data from 147 participants, we found support for the stress process model in caregivers of patients with primary brain tumor. Greater burden at diagnosis was associated with lower social support at 4 months, and lower social support was related to higher depression and anxiety at 8 months, as well as to changes in anxiety between 8 and 12 months. CONCLUSION We found evidence of the stress process model in caregivers of primary brain tumor patients unfolding over the course of a year after diagnosis. Our findings emphasize the potential importance of early programs for caregivers to ensure low initial levels of burden, which may have a positive effect on social support, depression, and anxiety.
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24
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Boele FW, van Uden-Kraan CF, Hilverda K, Weimer J, Donovan HS, Drappatz J, Lieberman FS, Verdonck-de Leeuw I, Sherwood PR. Neuro-oncology family caregivers' view on keeping track of care issues using eHealth systems: it's a question of time. J Neurooncol 2017; 134:157-167. [PMID: 28550505 PMCID: PMC5543187 DOI: 10.1007/s11060-017-2504-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 05/20/2017] [Indexed: 01/05/2023]
Abstract
Primary brain tumors (PBTs) are rare but have a great impact on both patient and family caregiver wellbeing. Supporting caregivers can help them to continue their caregiving activities to maintain the patients’ best possible level of quality of life. Efforts to improve PBT caregiver wellbeing should take into account country- or culture-specific differences in care issues and supportive care needs to serve larger caregiver groups. We aimed to explore PBT caregivers’ satisfaction with the current supportive care provision, as well as their thoughts on monitoring their care issues with both paper-based and digital instruments. Twelve PBT caregivers were interviewed in the United States. The semi-structured interviews were transcribed verbatim and analyzed by two coders independently. Data were combined with those collected in the Netherlands, following similar methodology (N = 15). We found that PBT caregivers utilize both formal and informal support services, but that those who experience more care issues would prefer more support, particularly in the early disease phase. Keeping track of care issues was thought to provide more insight into unmet needs and help them find professional help, but it requires investment of time and takes discipline. Caregivers preferred a brief and easy-to-use ‘blended care’ instrument that combines digital monitoring with personal feedback. The present study shows that the preferences of family caregivers in neuro-oncology toward keeping track of care issues are likely not heavily influenced by country- or culture-specific differences. The development of any instrument thus has the potential to benefit a large group of family caregivers.
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Affiliation(s)
- Florien W Boele
- School of Nursing, University of Pittsburgh, 336 Victoria Bldg, Pittsburgh, PA, 15261, USA. .,Leeds Institute for Cancer and Pathology, St James's Hospital, University of Leeds, Beckett Street, Leeds, LS9 7TF, UK. .,Leeds Institute of Health Sciences, University of Leeds, Worsley Building, Clarendon Way, Leeds, LS2 9NL, UK.
| | - Cornelia F van Uden-Kraan
- Department of Clinical, Neuro and Developmental Psychology, VU University, Van der Boechorststraat 1-3, 1081BT, Amsterdam, The Netherlands
| | - Karen Hilverda
- Department of Medical Psychology, VU University Medical Center, PO Box 7057, 1007MB, Amsterdam, The Netherlands
| | - Jason Weimer
- School of Nursing, University of Pittsburgh, 336 Victoria Bldg, Pittsburgh, PA, 15261, USA
| | - Heidi S Donovan
- School of Nursing, University of Pittsburgh, 336 Victoria Bldg, Pittsburgh, PA, 15261, USA
| | - Jan Drappatz
- Division of Neuro-Oncology, Hillman Cancer Center, University of Pittsburgh Medical Center, 5115 Centre Avenue, Pittsburgh, PA, 15232, USA
| | - Frank S Lieberman
- Division of Neuro-Oncology, Hillman Cancer Center, University of Pittsburgh Medical Center, 5115 Centre Avenue, Pittsburgh, PA, 15232, USA
| | - Irma Verdonck-de Leeuw
- Department of Clinical, Neuro and Developmental Psychology, VU University, Van der Boechorststraat 1-3, 1081BT, Amsterdam, The Netherlands
| | - Paula R Sherwood
- School of Nursing, University of Pittsburgh, 336 Victoria Bldg, Pittsburgh, PA, 15261, USA
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25
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Longacre ML, Valdmanis VG, Handorf EA, Fang CY. Work Impact and Emotional Stress Among Informal Caregivers for Older Adults. J Gerontol B Psychol Sci Soc Sci 2017; 72:522-531. [PMID: 27048567 DOI: 10.1093/geronb/gbw027] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Accepted: 02/19/2016] [Indexed: 11/13/2022] Open
Abstract
Objectives With the growing aging population and reliance on informal caregivers in the United States, many individuals will take on the role of caregiver as an adult. We examined whether informal caregivers experience work interference or a change in work status (i.e., retiring/quitting) due to caregiving. We also explored whether experiencing work interference or a change in work status was associated with greater emotional stress. Method This secondary analysis is drawn from the Fifth National Survey of Older Americans Act (OAA) program participants, which included 1,793 family caregivers. The present analysis is on caregivers of working age (18-64 years) providing care to another adult, which included 922 caregivers. Ordinal logit models were used to assess associations between experiencing work interference or a change in work status and emotional stress. Study weights were applied for all analyses. Results At the time of the survey, more than half (52.9%) of caregivers were employed full- or part-time. Among nonworking caregivers (i.e., not working or retired) at the time of the survey, 39.8% responded that they had quit or retired early due to caregiving demands. Among employed caregivers, 52.4% reported that informal caregiving had interfered with their employment. Importantly, those respondents who reported work interference or a change in work status were more likely to report higher levels of emotional stress associated with caregiving demands. Discussion These findings suggest the need to further explore work among informal caregivers and associations with emotional stress, as well as consider work-based policy approaches, organizational and/or societal, to support informal caregivers.
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Affiliation(s)
- Margaret L Longacre
- Department of Cancer Prevention and Control, Fox Chase Cancer Center, Philadelphia, Pennsylvania.,Cancer Support Community, Research and Training Institute, Philadelphia, Pennsylvania
| | - Vivian G Valdmanis
- Department of Economics, Grand Valley State University, Grand Rapids, Michigan
| | - Elizabeth A Handorf
- Department of Biostatistics, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Carolyn Y Fang
- Department of Cancer Prevention and Control, Fox Chase Cancer Center, Philadelphia, Pennsylvania
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Understanding family assessment in the Australian context; what are adult oncology nursing practices? Collegian 2017. [DOI: 10.1016/j.colegn.2016.01.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Boele FW, Grant R, Sherwood P. Challenges and support for family caregivers of glioma patients. ACTA ACUST UNITED AC 2017. [DOI: 10.12968/bjnn.2017.13.1.8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
| | - Robin Grant
- Consultant neurologist, Edinburgh Centre for Neuro-Oncology
| | - Paula Sherwood
- Professor, University of Pittsburgh (Acute and Tertiary Care, School of Nursing)
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Saria MG, Courchesne N, Evangelista L, Carter J, MacManus DA, Gorman MK, Nyamathi AM, Phillips LR, Piccioni D, Kesari S, Maliski S. Cognitive dysfunction in patients with brain metastases: influences on caregiver resilience and coping. Support Care Cancer 2016; 25:1247-1256. [PMID: 27921222 PMCID: PMC10187463 DOI: 10.1007/s00520-016-3517-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 11/28/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE Neurologic deficits that may be manifested as cognitive impairment contribute to the challenges faced by caregivers of patients with brain metastases. To better address their needs, we examined how caregivers respond to these challenges and explore the relationship between the patient's cognitive impairment and caregiver resilience and coping. METHODS We conducted a descriptive, cross-sectional study using self-reported data from 56 caregivers of patients with brain metastases. Study participants from a comprehensive cancer center were asked to complete a series of instruments that measured their perception of the patient's cognitive dysfunction (revised memory and behavior problems checklist, RMBC), their own personal resilience (Resilience Scale, RS), and their utilization of a broad range of coping responses (COPE inventory and Emotional-Approach Coping scale). RESULTS Caregivers reported that memory-related problems occurred more frequently in the patients they cared for compared to depression and disruptive behavior (mean scores 3.52 vs 2.34 vs. 1.32, respectively). Coping strategies most frequently used by caregivers were acceptance (3.28), planning (3.08), and positive reinterpretation and growth (2.95). Most caregivers scored moderate to high on the RS (77%). The coping strategy acceptance correlated significantly with the memory and disruptive behavior subscales of the RMBC. CONCLUSIONS Given the protective effect of problem-focused coping and the high rate of caregivers utilizing less effective coping strategies in instances of worsening cognitive dysfunction, healthcare professionals need to systematically assess the coping strategies of caregivers and deliver a more personalized approach to enhance effective coping among caregivers of patients with brain metastases.
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Affiliation(s)
- Marlon Garzo Saria
- School of Nursing, University of California, Los Angeles, Factor Bldg., 700 Tiverton Ave, Los Angeles, CA, 90095, USA. .,John Wayne Cancer Institute and Pacific Neuroscience Institute at Providence Saint John's Health Center, 2200 Santa Monica Boulevard, Santa Monica, CA, 90404, USA.
| | - Natasia Courchesne
- Moores Cancer Center, University of California San Diego, 3855 Health Sciences Drive, La Jolla, CA, 92093, USA
| | - Lorraine Evangelista
- Nursing Science, University of California, Irvine, 299E Berk Hall, Irvine, CA, 92697-3959, USA
| | - Joshua Carter
- Quintiles, 10 Waterview Boulevard, Parsippany, NJ, 07054, USA
| | - Daniel A MacManus
- Moores Cancer Center, University of California San Diego, 3855 Health Sciences Drive, La Jolla, CA, 92093, USA
| | - Mary Kay Gorman
- Moores Cancer Center, University of California San Diego, 3855 Health Sciences Drive, La Jolla, CA, 92093, USA
| | - Adeline M Nyamathi
- School of Nursing, University of California, Los Angeles, Factor Bldg., 700 Tiverton Ave, Los Angeles, CA, 90095, USA
| | - Linda R Phillips
- School of Nursing, University of California, Los Angeles, Factor Bldg., 700 Tiverton Ave, Los Angeles, CA, 90095, USA
| | - David Piccioni
- School of Medicine, University of California San Diego, 3855 Health Sciences Drive, La Jolla, CA, 92093, USA
| | - Santosh Kesari
- John Wayne Cancer Institute and Pacific Neuroscience Institute at Providence Saint John's Health Center, 2200 Santa Monica Boulevard, Santa Monica, CA, 90404, USA
| | - Sally Maliski
- School of Nursing, University of California, Los Angeles, Factor Bldg., 700 Tiverton Ave, Los Angeles, CA, 90095, USA.,School of Nursing, University of Kansas Medical Center, Mail Stop 2029, 3901 Rainbow Blvd., Kansas City, KS, 66160, USA
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Nightingale CL, Curbow BA, Wingard JR, Pereira DB, Carnaby GD. Burden, quality of life, and social support in caregivers of patients undergoing radiotherapy for head and neck cancer: A pilot study. Chronic Illn 2016; 12:236-45. [PMID: 27068111 PMCID: PMC5515480 DOI: 10.1177/1742395316644305] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Accepted: 01/30/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The purpose of this pilot study was to (1) obtain preliminary data on changes in burden and quality of life in head and neck cancer caregivers during and shortly following patient radiotherapy, (2) assess the relationship between perceived social support and burden as well as perceived social support and quality of life in caregivers during radiotherapy, and (3) identify preferences for sources of support among caregivers during radiotherapy. METHODS Caregivers completed burden and quality of life instruments at the start of patient radiotherapy (T1), 5 weeks into radiotherapy (T2), and 1 month post-radiotherapy (T3) and instruments for perceived social support and support preferences at T2 only. RESULTS Caregivers showed a trend toward increased burden and worsened quality of life for the majority of subscales at T2 or T3 than at T1. Caregivers reported significantly lower esteem and significantly greater disruption at T2 than at T1 and significantly worse health at T3 than at T2. Higher perceived social support was typically associated with lower burden and higher quality of life at T2. Spouses/partners were the most commonly preferred source of support. DISCUSSION These pilot findings suggest that caregivers experience psychosocial impairments during and shortly after patient radiotherapy, but more research using larger samples is warranted.
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Affiliation(s)
- Chandylen L Nightingale
- Division of Public Health Sciences, Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Barbara A Curbow
- School of Public Health, Department of Behavioral and Community Health, University of Maryland, College Park, MD, USA
| | - John R Wingard
- College of Medicine, Division of Hematology/Oncology, University of Florida, Gainesville, FL, USA
| | - Deidre B Pereira
- College of Public Health and Health Professions, Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Giselle D Carnaby
- College of Health and Public Affairs, Department of Communication Science and Disorders, University of Central Florida, Orlando, FL, USA
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Nightingale CL, Pereira DB, Curbow BA, Wingard JR, Carnaby GD. A Prospective Biopsychosocial Investigation Into Head and Neck Cancer Caregiving. Biol Res Nurs 2016; 19:87-96. [PMID: 27465999 DOI: 10.1177/1099800416660760] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Head and neck cancer (HNC) patients suffer from significant morbidity, which may introduce challenging care demands and subsequent stress-induced mind-body interactions for informal caregivers. This prospective study evaluated patient and caregiver predictors of diurnal cortisol rhythm among HNC caregivers during radiation treatment. METHOD Patient-caregiver dyads completed measures at radiation treatment start (T1; n = 32) and 5 weeks into treatment (T2; n = 29). Measures included the Functional Assessment of Cancer Therapy-Head and Neck, the Caregiver Quality of Life (QOL) Index-Cancer, the Caregiver Reaction Assessment, the Medical Outcomes Social Support Survey, and the Eating Assessment tool. Patients also received a clinical swallowing evaluation using the Functional Assessment of Oral Intake Scale. Caregiver cortisol concentrations were assessed from salivary samples at T1 and T2. RESULTS Caregiver cortisol slope became significantly flatter during radiation treatment. Greater caregiver schedule burden was associated with a flatter cortisol slope (β = .35, p = .05) in caregivers at T1. Lower patient functional QOL (β = -.41, p = .05) and lower overall caregiver QOL at T1 (β = -.39, p = .04) were each separately associated with a flatter cortisol slope in caregivers over treatment. CONCLUSIONS Results suggest the presence of a mind-body interaction in HNC caregivers. Dysregulation in diurnal cortisol rhythm in caregivers was significantly associated with increased caregiver schedule burden and lower patient and caregiver QOL. Targeted interventions developed for HNC caregivers may help to prevent negative health outcomes associated with dysregulated cortisol.
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Affiliation(s)
- Chandylen L Nightingale
- 1 Department of Social Science and Health Policy, Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Deidre B Pereira
- 2 Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Barbara A Curbow
- 3 Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD, USA
| | - John R Wingard
- 4 Division of Hematology/Oncology, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Giselle D Carnaby
- 5 Department of Communication Science & Disorders, College of Health and Public Affairs, University of Central Florida, Gainesville, FL, USA
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Alexander KE, Cooper BA, Paul SM, Yates P, Aouizerat BE, Miaskowski C. Phenotypic and molecular characteristics associated with various domains of quality of life in oncology patients and their family caregivers. Qual Life Res 2016; 25:2853-2868. [PMID: 27160108 DOI: 10.1007/s11136-016-1310-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2016] [Indexed: 12/12/2022]
Abstract
PURPOSE Not all oncology patients and their family caregivers (FCs) experience the same quality of life (QOL). The purposes of this study were to identify latent classes of oncology patients (n = 168) and their FCs (n = 85) with distinct physical, psychological, social, and spiritual well-being trajectories from prior to through 4 months after the completion of radiation therapy and to evaluate for demographic, clinical, and genetic characteristics that distinguished between these latent classes. METHODS Using growth mixture modeling, two latent classes were found for three (i.e., physical, psychological, and social well-being) of the four QOL domains evaluated. RESULTS Across these three domains, the largest percentage of participants reported relatively high well-being scores across the 6 months of the study. Across these three QOL domains, patients and FCs who were younger, female, belonged to an ethnic minority group, had children at home, had multiple comorbid conditions, or had a lower functional status, were more likely to be classified in the lower QOL class. The social well-being domain was the only domain that had a polymorphism in nuclear factor kappa beta 2 (NFKB2) associated with latent class membership. Carrying one or two doses of the rare allele for rs7897947 was associated with a 54 % decrease in the odds of belonging to the lower social well-being class [OR (95 % CI) = .46 (.21, .99), p = .049]. CONCLUSIONS These findings suggest that a number of phenotypic and molecular characteristics contribute to differences in QOL in oncology patients and their FCs.
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Affiliation(s)
- Kimberly E Alexander
- School of Nursing, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Brisbane, Australia
| | - Bruce A Cooper
- Department of Physiological Nursing, School of Nursing, University of California, 2 Koret Way - N631Y, San Francisco, CA, 94143-0610, USA
| | - Steven M Paul
- Department of Physiological Nursing, School of Nursing, University of California, 2 Koret Way - N631Y, San Francisco, CA, 94143-0610, USA
| | - Patsy Yates
- School of Nursing, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Brisbane, Australia
| | | | - Christine Miaskowski
- Department of Physiological Nursing, School of Nursing, University of California, 2 Koret Way - N631Y, San Francisco, CA, 94143-0610, USA.
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Kent EE, Rowland JH, Northouse L, Litzelman K, Chou WYS, Shelburne N, Timura C, O'Mara A, Huss K. Caring for caregivers and patients: Research and clinical priorities for informal cancer caregiving. Cancer 2016; 122:1987-95. [PMID: 26991807 DOI: 10.1002/cncr.29939] [Citation(s) in RCA: 348] [Impact Index Per Article: 43.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Revised: 01/27/2016] [Accepted: 01/28/2016] [Indexed: 11/07/2022]
Abstract
Informal/family caregivers are a fundamental source of care for cancer patients in the United States, yet the population of caregivers and their tasks, psychosocial needs, and health outcomes are not well understood. Changes in the nature of cancer care and its delivery, along with the growing population of survivors and their caregivers, warrant increased attention to the roles and demands of caregiving. This article reviews current evidence presented at a 2-day meeting examining the state of the science of informal cancer caregiving that was convened by the National Cancer Institute and the National Institute of Nursing Research. The meeting sought to define who is an informal cancer caregiver, summarize the state of the science in informal cancer caregiving, and describe both the kinds of interventions developed to address caregiving challenges and the various outcomes used to evaluate their impact. This article offers recommendations for moving science forward in 4 areas: 1) improving the estimation of the prevalence and burden of informal cancer caregiving; 2) advancing the development of interventions designed to improve outcomes for cancer patients, caregivers, and patient-caregiver dyads; 3) generating and testing strategies for integrating caregivers into formal health care settings; and 4) promoting the use of technology to support informal cancer caregivers. Cancer 2016;122:1987-95. © 2016 American Cancer Society.
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Affiliation(s)
- Erin E Kent
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
| | - Julia H Rowland
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
| | | | - Kristin Litzelman
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
| | - Wen-Ying Sylvia Chou
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
| | - Nonniekaye Shelburne
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
| | - Catherine Timura
- Division of Science Policy and Public Liaison, National Institute of Nursing Research, Bethesda, Maryland
| | - Ann O'Mara
- Division of Cancer Prevention, National Cancer Institute, Bethesda, Maryland
| | - Karen Huss
- Division of Extramural Science Programs, Office of Extramural Programs, National Institute of Nursing Research, Bethesda, Maryland
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Depressive symptoms and anxiety in intensive care unit (ICU) survivors after ICU discharge. Heart Lung 2016; 45:140-6. [PMID: 26791248 PMCID: PMC4878700 DOI: 10.1016/j.hrtlng.2015.12.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 11/10/2015] [Accepted: 12/08/2015] [Indexed: 02/06/2023]
Abstract
BACKGROUND The association between intensive care unit (ICU) survivors' psychological sequelae, individual care needs, and discharge disposition has not been evaluated. OBJECTIVE To describe depressive symptoms and anxiety in ICU survivors and explore these symptoms based on individual care needs and discharge disposition for 4 months post-ICU discharge. METHODS We analyzed data from 39 ICU survivors who self-reported measures of depressive symptoms (Center for Epidemiologic Studies-Depression 10 items [CESD-10]) and anxiety (Shortened Profile of Mood States-Anxiety subscale [POMS-A]). RESULTS A majority of patients reported CESD-10 scores above the cut off (≥ 8) indicating risk for clinical depression. POMS-A scores were highest within 2 weeks post-ICU discharge and decreased subsequently. Data trends suggest worse depressive symptoms and anxiety when patients had moderate to high care needs and/or were unable to return home. CONCLUSION ICU survivors who need caregiver assistance and extended institutional care reported trends of worse depressive symptoms and anxiety.
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Jolly M, Thakkar A, Mikolaitis RA, Block JA. Caregiving, dyadic quality of life and dyadic relationships in lupus. Lupus 2015; 24:918-926. [DOI: 10.1177/0961203314567749] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Abstract
Aims Systemic lupus erythematosus (SLE) mostly affects young women, adversely affecting their quality of life (QOL). Caregivers may experience caregiver burden (CGB), and it may lower the quality of their relationship. Herein we studied caregiving and CGB and their effects on QOL and relationships in SLE. Methods We recruited 10 dyads from the Lupus Clinic. Data collected included demographics, CGB (CGB Scale, screen for CGB), QOL (SF-36) and the quality of the dyadic relationship (Dyadic Adjustment Scale (DAS)). We calculated correlation coefficients for associations between (i) CGB and (ii) dyadic QOL or DAS. Results The mean (± SD) age of SLE patients was 35.2 (± 9) years and of caregivers was 37.3 (± 9.64) years. The mean (± SD, min–max) total CGB score was 9.1 (± 5.8, 0–19). The caregiver's QOL correlated strongly with some of the domains of the patient's QOL. The SLE-related CGB was associated with the caregiver's own QOL and their SLE partner's QOL. The dyadic DAS was linked to the patient's QOL. Conclusions Because (i) CGB in SLE is associated with the caregiver's own QOL and with their SLE partner's QOL, and because (ii) the dyadic DAS score is linked primarily to the patient's QOL, then to optimize patient health outcomes and to decrease CGB, focus should be not only on the patient but should include the dyadic unit. Significant findings: To optimize patient outcomes of SLE patients, focus should be on the dyadic unit. CGB in SLE is associated with the caregiver's own QOL and with the SLE partner's QOL, making it crucial to study this relationship in more detail.
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Affiliation(s)
- M Jolly
- Rush University Medical Center, Chicago, IL, USA
| | - A Thakkar
- Rush University Medical Center, Chicago, IL, USA
| | | | - J A Block
- Rush University Medical Center, Chicago, IL, USA
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Patient and caregiver needs in oncology. An Italian survey. TUMORI JOURNAL 2015; 101:621-5. [PMID: 26108244 DOI: 10.5301/tj.5000362] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2015] [Indexed: 11/20/2022]
Abstract
AIMS AND BACKGROUND Cancer is a disease that has far-reaching consequences for patients and their families. The present study targets unmet caregiver needs so that better support can be provided and planned for. METHODS The first phase of the study was to conduct a survey designed to explore basic needs (medical and nursing information, psychological support, social welfare). The survey also investigated the caregiver's personal details (age, sex, degree of kinship). The survey was distributed to caregivers coming to the day hospitals of the 4 oncology departments involved in the study. RESULTS A total of 137 relatives of cancer patients completed the survey. Among the explored needs, the most recurrent was the availability of a doctor who provides full information on the treatment choices. A further important request was for consistency between the information provided by doctors and that provided by other health-care workers, with specific reference to a patient-centered approach that can be easily and fully understood, available therapeutic options especially at home, and prognosis. CONCLUSIONS The study showed that the need for exhaustive and simple information provided by a referral physician is still an unmet need in the Internet age.
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Boele FW, Rooney AG, Grant R, Klein M. Psychiatric symptoms in glioma patients: from diagnosis to management. Neuropsychiatr Dis Treat 2015; 11:1413-20. [PMID: 26089669 PMCID: PMC4467748 DOI: 10.2147/ndt.s65874] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Patients with primary intrinsic brain tumors can experience neurological, cognitive, and psychiatric symptoms that greatly affect daily life. In this review, we focus on changes in personality and behavior, mood issues, hallucinations, and psychosis, because these are either difficult to recognize, to treat, or are understudied in scientific literature. Neurobehavioral symptoms are common, often multiple, and causation can be multifactorial. Although different symptoms sometimes require a different treatment approach, we advise a comprehensive treatment approach, including pharmacological treatment and/or psychotherapy where appropriate. Further research is needed to obtain a better estimate of the prevalence of psychiatric symptoms in glioma patients, and the extent to which these affect everyday functioning and family life.
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Affiliation(s)
- Florien W Boele
- Department of Medical Psychology, VU University Medical Center, Amsterdam, the Netherlands
| | - Alasdair G Rooney
- Department of Clinical Neurosciences, Western General Hospital, Edinburgh, UK
| | - Robin Grant
- Department of Clinical Neurosciences, Western General Hospital, Edinburgh, UK
| | - Martin Klein
- Department of Medical Psychology, VU University Medical Center, Amsterdam, the Netherlands
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[Informing the family: emotions and attitudes of oncogenetic counselees for familial breast/ovarian and/or colon cancer risk]. Bull Cancer 2015; 102:162-73. [PMID: 25636360 DOI: 10.1016/j.bulcan.2014.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Accepted: 09/03/2014] [Indexed: 11/21/2022]
Abstract
BACKGROUND Transmission of oncogenetic information (TOI) by probands to their families is of major importance to organize medical prevention in his family. Little is known about the difficulties that the proband faces when he tries to endorse his "duty to warn". METHODS To characterize the barriers to TOI, a survey was performed, previously to the bioethic law of 2011, on a representative sample of 337 counselees seen in the last 10 years at the Centre Jean-Perrin Oncogenetics Department. A questionnaire comprising 97 items was prepared by experts and validated by a group of patients and health professionals. Nineteen Lickert-scale questions specially concerned TOI. RESULTS Analysis found two dimensions, one of emotions and one concerning communication attitudes. Both dimensions were negatively correlated (r=-0.34, P<10(-7)): high emotional levels limited communication attitudes. The probands' history of cancer was the main factor impacting TOI. TOI was more difficult for cancer patients than for healthy counselees (P=0.025). Delay since consultation and type of cancer risk had no bearing on TOI. CONCLUSION Cancer and its treatments seem to deeply affect patient's relatives and limit his capacity to involve his family into the oncogenetic inquiry. Measures are suggested to help ex-patients improve TOI.
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Yakar HK, Pinar R. Reliability and validity of Turkish version of the caregiver quality of life index cancer scale. Asian Pac J Cancer Prev 2014; 14:4415-9. [PMID: 23992013 DOI: 10.7314/apjcp.2013.14.7.4415] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Measuring effects of cancer on family caregivers is important to develop methods which can improve their quality of life (QOL) . Nevertheless, up to now, only a few tools have been developed to be used in this group. Among those, the Caregiver Quality of Life Index-Cancer Scale (CQOLC) has met minimum psychometric criteria in different populations in spite of conflicting results. The present study was conducted to evaluate reliability and validity of CQOLC among Turkish cancer family caregivers. MATERIALS AND METHODS The CQOLC was administered to 120 caregivers, along with Beck Depression Inventory (BDI), Medical Outcomes Study MOS 36- Item Short Form Health Survey (SF-36), State-Trait Anxiety Inventory (STAI), and Multidimensional Scale of Perceived Social Support (MSPSS). Internal consistency and test-retest stability were used to investigate reliability. Construct validity was examined by using known group method, convergent, and divergent validity. For the known group method, we hypothesized that CQOLC scores would differ between depressed and non-depressed subjects. We investigated convergent validity by correlating scores for CQOLC with scores for other similar measures including SF-36 and STAI. The MSPSS was completed at the same time as CQOLC to provide divergent validity. RESULTS The values for internal consistency and test-retest correlation were 0.88 and 0.96, respectively. The CQOLC discriminated those who were depressed from those who were not. Convergent validity supported strong correlations between CQOLC scores and two main component scores (PCS, MCS) in SF-36 although there was a weak correlation between CQOLC and STAI scores. Regarding divergent validity, the correlation between CQOLC and MSPSS was in the low range, as expected. CONCLUSIONS The Turkish CQOLC is a reliable and valid tool and it can be utilized to determine QOL of family caregivers.
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Longacre ML, Wong YN, Fang CY. Caregiver psychological health and hospitalization characteristics of older adult care recipients: an integrative review of U.S. studies. Res Gerontol Nurs 2014; 7:139-47. [PMID: 24496113 DOI: 10.3928/19404921-20140127-01] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Accepted: 12/05/2013] [Indexed: 11/20/2022]
Abstract
This integrative review involved studies conducted in the United States that assessed hospitalizations of older adults receiving family care and the psychological health of their family caregivers. The primary objectives were to (a) summarize findings between caregiver psychological health and older care recipient hospitalizations, and (b) describe how caregiver psychological health has been measured with regard to older care recipient hospitalizations. Online databases were searched for articles assessing caregiver psychological health (e.g., burden, strain, depressive or anxious symptoms) and older care recipient hospitalizations in the United States. According to the findings, few studies in the United States have assessed hospitalization characteristics of older care recipients and the psychological health of their family caregivers. All analyses incorporated a measure of depression; however, the measurement of other psychological health constructs (e.g., anxious symptoms, perceived burden) was limited or absent. Findings note the potential importance of focusing on readmission rates in light of caregiver psychological health. Findings also note the benefit of caregiver emotional and instrumental support toward reducing hospitalizations among older adults receiving family care.
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Stamataki Z, Ellis JE, Costello J, Fielding J, Burns M, Molassiotis A. Chronicles of informal caregiving in cancer: using 'The Cancer Family Caregiving Experience' model as an explanatory framework. Support Care Cancer 2014; 22:435-44. [PMID: 24091719 DOI: 10.1007/s00520-013-1994-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Accepted: 09/17/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND Cancer caregiving has emerged as a dominant focus of research in recent years. A striking feature of this vast amount of literature is that it is static, examining certain points of the cancer trajectory, mostly the diagnosis and palliative care. Only The Cancer Caregiving Experience Model conceptualised the caregiving experience and explored the conceptual implications of cancer family caregiving research. AIM The data from this paper aim to empirically support the Cancer Caregiving Experience model, by exploring the cancer caregiving experience longitudinally. METHODS Semi-structured interviews with 53 caregivers were carried out at patient's diagnosis (T1), 3 months (T2), 6 months (T3) and 12 months (T4) post diagnosis. RESULTS Analysis of 139 interviews generated four themes that reflected a complex and dynamic process. The themes that mapped those of the model were "Primary stressors", "Secondary stressors", "Appraisal", "Cognitive-Behavioural responses" and "Health and Well Being". CONCLUSIONS The study adds empirical support to The Cancer Caregiving Experience Model and confirms that different primary and secondary stressors influence how the caregivers perceive the caregiving demands, the coping mechanisms they employ and their health and well being during the cancer trajectory. Access to support services should be offered to all the caregivers from as early as the diagnosis period and take into account their specific needs.
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Affiliation(s)
- Z Stamataki
- Christie NHS Foundation Trust, Manchester, UK,
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Newberry AG, Choi CWJ, Donovan HS, Schulz R, Bender C, Given B, Sherwood P. Exploring spirituality in family caregivers of patients with primary malignant brain tumors across the disease trajectory. Oncol Nurs Forum 2013; 40:E119-25. [PMID: 23615145 DOI: 10.1188/13.onf.e119-e125] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To determine whether the perceived level of spirituality in family caregivers of patients with primary malignant brain tumors (PMBTs) changes across the disease trajectory. DESIGN Ongoing descriptive, longitudinal study. SETTING Southwestern Pennsylvania. SAMPLE 50 family caregivers of patients with PMBT. METHODS Caregivers and care recipients were recruited at time of diagnosis. Participants were interviewed at two subsequent time points, four and eight months following diagnosis. MAIN RESEARCH VARIABLES Care recipients' symptoms, neuropsychologic status, and physical function, as well as caregiver social support. FINDINGS Results showed no significant difference in spirituality scores reported at baseline and eight months (p = 0.8), suggesting that spirituality may be a stable trait across the disease trajectory. CONCLUSIONS Spirituality remains relatively stable along the course of the disease trajectory. Reports of caregiver depressive symptoms and anxiety were lower when paired with higher reports of spirituality. IMPLICATIONS FOR NURSING Clinicians can better identify caregivers at risk for negative outcomes by identifying those who report lower levels of spirituality. Future interventions should focus on the development and implementation of interventions that provide protective buffers such as increased social support. KNOWLEDGE TRANSLATION Spirituality is a relatively stable trait. High levels of spirituality can serve as a protective buffer from negative mental health outcomes. Caregivers with low levels of spirituality may be at risk for greater levels of burden, anxiety, and stress.
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Longacre ML, Ross EA, Fang CY. Caregiving Choice and Emotional Stress Among Cancer Caregivers. West J Nurs Res 2013; 36:806-24. [PMID: 24221954 DOI: 10.1177/0193945913510211] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Caring for a relative or friend with cancer may be highly demanding and emotionally burdensome. Theory suggests that personal characteristics of a caregiver may contribute directly to a caregiver's emotional health. An underexplored variable is a caregiver's perception of choice in providing care to a relative or friend. Thus, this study sought to characterize perceived choice in providing care among family cancer caregivers and examine its association with emotional stress. This study is a secondary analysis of cross-sectional telephone interviews of 1,247 family caregivers, which included 104 cancer caregivers. The findings indicated that a high majority of cancer caregivers expressed elevated emotional stress. Most caregivers perceived themselves to have had a choice in providing care; however, a perceived lack of choice in providing care was significantly associated with greater emotional stress. Assessing clinical and policy-related strategies for alleviating concerns related to choice may be of value in the cancer context.
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Affiliation(s)
| | - Eric A Ross
- Fox Chase Cancer Center, Philadelphia, PA, USA
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Fujinami R, Otis-Green S, Klein L, Sidhu R, Ferrell B. Quality of life of family caregivers and challenges faced in caring for patients with lung cancer. Clin J Oncol Nurs 2013. [PMID: 23178364 DOI: 10.1188/12.cjon.e210-e220] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Family caregivers (FCGs) of patients with lung cancer face multiple challenges that affect their quality of life and well-being. Whether challenged physically, emotionally, socially, or spiritually, distress in one area may compound challenges in other areas. To maintain function and health of FCGs as they provide valuable care for the health and well-being of the patient, attention must be given to the needs of FCGs for support and education. The purpose of this article is to describe the multifaceted challenges that FCGs of patients with lung cancer experience using case studies selected from a National Cancer Institute-funded program project. The cases are discussed in terms of how the FCG's quality of life is impacted by the caregiver role, as well as how stressors in one or more domains of quality of life compound difficulties in coping with the demands of the role. The importance of the oncology nurse's assessment of FCGs' needs for support, education, and self-care through the lung cancer illness trajectory is discussed while presenting accessible community resources to meet those needs.
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Affiliation(s)
- Rebecca Fujinami
- Department of Population Sciences, City of Hope National Medical Center in Duarte, CA, USA.
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Fasse L, Sultan S, Flahault C, MacKinnon CJ, Dolbeault S, Brédart A. How do researchers conceive of spousal grief after cancer? A systematic review of models used by researchers to study spousal grief in the cancer context. Psychooncology 2013; 23:131-42. [DOI: 10.1002/pon.3412] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Revised: 08/28/2013] [Accepted: 08/28/2013] [Indexed: 11/06/2022]
Affiliation(s)
- Léonor Fasse
- Institut Curie; Paris F-75006 France
- Université Paris Descartes; LPPS EA 4057, IUPDP; Paris France
| | - Serge Sultan
- Université Paris Descartes; LPPS EA 4057, IUPDP; Paris France
| | - Cécile Flahault
- Institut Curie; Paris F-75006 France
- Université Paris Descartes; LPPS EA 4057, IUPDP; Paris France
| | - Christopher J. MacKinnon
- Department of Educational and Counseling Psychology; McGill University; Montréal Québec Canada
- Palliative Care Research; SMBD Jewish General Hospital; Montréal Québec Canada
- Psychosocial Oncology Program; Montreal General Hospital; Montréal Québec Canada
| | - Sylvie Dolbeault
- Institut Curie; Paris F-75006 France
- Inserm, U 669; Paris France
- Université Paris-Sud and Université Paris Descartes; UMR-S0669; Paris France
| | - Anne Brédart
- Institut Curie; Paris F-75006 France
- Université Paris Descartes; LPPS EA 4057, IUPDP; Paris France
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Skalla KA, Smith EML, Li Z, Gates C. Multidimensional Needs of Caregivers for Patients With Cancer. Clin J Oncol Nurs 2013; 17:500-6. [DOI: 10.1188/13.cjon.17-05ap] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Teixeira R, Pereira M. Psychological morbidity and autonomic reactivity to emotional stimulus in parental cancer: a study with adult children caregivers. Eur J Cancer Care (Engl) 2013; 23:129-39. [DOI: 10.1111/ecc.12102] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2013] [Indexed: 11/27/2022]
Affiliation(s)
- R.J. Teixeira
- University of Minho; School of Psychology; Braga Portugal
| | - M.G. Pereira
- University of Minho; School of Psychology; Braga Portugal
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Factors associated with depressive symptoms in cancer family caregivers of patients receiving chemotherapy. Support Care Cancer 2013; 21:2387-94. [DOI: 10.1007/s00520-013-1802-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Accepted: 03/25/2013] [Indexed: 10/27/2022]
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Jiang Y, Terhorst L, Donovan HS, Weimer JM, Choi CWJ, Schulz R, Given B, Sherwood PR. Locke-Wallace Short Marital-Adjustment Test: Psychometric Evaluation in Caregivers for Persons With Primary Malignant Brain Tumor. J Nurs Meas 2013; 21:502-15. [DOI: 10.1891/1061-3749.21.3.502] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background and Purpose: Caregivers’ well-being has been found to be associated with marital adjustment. This study’s purpose was to evaluate the psychometric properties of the Locke-Wallace Short Marital-Adjustment Test (LWSMAT) in a sample of caregivers of persons with primary malignant brain tumor (PMBT). Methods: Secondary analysis of data collected from 114 caregivers. The LWSMAT was tested for factor structure, internal consistency reliability, and construct validity. Results: 5 extracted factors explained 60.55% of the total variance. Four interpretable factors (Contentment & Communication, Leisure & Sociality, Intimacy, and Shared Philosophy) had Cronbach’s alpha between 0.63 and 0.74. Convergent validity (r = −.35 and r = −.43, respectively, both p < .0001) and discriminant validity (r = .07, p = .49; and r = −.04, p = .67) were confirmed by comparing four factors with subdimensions of the Caregiver Reaction Assessment (CRA). Conclusion: The LWSMAT is a multidimensional, reliable, and valid measure of marital adjustment in caregivers of persons with a PMBT.
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Fasse L, Flahault C, Brédart A, Dolbeault S, Sultan S. Deuil et vulnérabilité psychique chez les personnes âgées. PSYCHO-ONCOLOGIE 2012. [DOI: 10.1007/s11839-012-0395-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
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