1
|
Sun H, Chen S, Chen X, Yang Q, Zhang H, Wacharasin C, Hengudomsub P. Predictors of changes in resilience among spousal caregivers of patients with advanced cancer within the first 6 months after initial treatment. J Clin Nurs 2024; 33:2619-2632. [PMID: 38108199 DOI: 10.1111/jocn.16972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 10/26/2023] [Accepted: 12/07/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND While previous research has established that resilience is affected by various factors, these studies have primarily focussed on individual variables associated with resilience, without providing insights into how to influence the rate of change in resilience. AIM To examine the trajectory of resilience and identify the factors associated with changes in resilience among spousal caregivers of patients with newly diagnosed advanced cancer receiving treatment during the first 6 months. DESIGN An observational longitudinal study. METHODS A total of 312 spousal caregivers of patients with newly diagnosed advanced cancer were recruited from January 2022 to December 2022 in Yancheng, China. Three data collection points were established, spanning from the first month to 6 months after initial cancer treatment. A latent growth model was employed to depict the resilience trajectory at various time points. A latent growth model with time-invariant covariates was adopted to determine the factors influencing resilience trajectory. The study adhered to the STROBE checklist for proper reporting. RESULTS Throughout the follow-up period, the participants experienced a significant increase in resilience. Gender, family income, the patient's health status, spirituality and belief in familism were significantly associated with the baseline resilience level. Moreover, family income, the patient's health status, spirituality, caregiver burden and belief in familism were significantly associated with the rate of resilience change over time. CONCLUSIONS Spousal caregivers demonstrated a linear increase in resilience during the first 6 months after initial treatment. Meanwhile, changes in resilience were influenced by multiple factors during the early phase of cancer treatment. Thus, more attention should be paid to early identification and implementation of targeted interventions. RELEVANCE TO CLINICAL PRACTICE Healthcare professionals should understand the change in resilience among spousal caregivers and conduct timely mental health interventions to enhance the resilience of families affected by cancer. PATIENT OR PUBLIC CONTRIBUTION The Guidance for Reporting Involvement of Patients and the Public-Short Form reporting checklists were used to improve patient and public involvement.
Collapse
Affiliation(s)
- Haiyan Sun
- School of Nursing, Jiangsu Vocational College of Medicine, Jiangsu, P. R. China
- Faculty of Nursing, Burapha University, Chon Buri, Thailand
| | - Shuqiao Chen
- Department of Nursing, Yancheng NO.1 People's Hospital, Jiangsu, P. R. China
| | - Xi Chen
- Department of Nursing, Yancheng NO.1 People's Hospital, Jiangsu, P. R. China
| | - Qin Yang
- School of Nursing, Jiangsu Vocational College of Medicine, Jiangsu, P. R. China
- Faculty of Nursing, Burapha University, Chon Buri, Thailand
| | - Hu Zhang
- Department of Basic Medicine, Jiangsu Vocational College of Medicine, Jiangsu, P. R. China
| | | | | |
Collapse
|
2
|
Ochoa CY, Cho J, Miller KA, Baezconde-Garbanati L, Chan RY, Farias AJ, Milam JE. Hispanic/Latinos and non-Hispanic whites' childhood cancer survivors and parents: a dyadic analysis of coping resources and mental health. J Cancer Surviv 2024; 18:996-1005. [PMID: 36853581 PMCID: PMC10460832 DOI: 10.1007/s11764-023-01339-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 01/18/2023] [Indexed: 03/01/2023]
Abstract
PURPOSE While limited, dyadic research demonstrates the interdependent relationship between the health and adjustment after treatment between cancer survivors and caregivers. We examined interrelationships between coping resources and mental health among childhood cancer survivors (CCS)-parent dyads. METHODS One hundred sixty CCS-parent dyads from the Project Forward pilot study completed validated questions assessing social support, religiosity, spirituality, depressive symptoms, and perceived stress. Bidirectional associations were identified with path analysis utilizing the actor-partner interdependence model (APIM). We used a multigroup approach to test for the moderating effects by Hispanic ethnicity on these relationships. RESULTS Mean age of CCS was 20 years old, 51% female, 30% diagnosed with leukemia, and mean of 7 years from diagnosis. The mean age of parents was 49 years old and 89% were mothers. For both CCS and parents, perceived social support was inversely associated with their depressive symptoms and perceived stress (e.g., actor effects). Parents' social support was not significantly associated with CCS's depressive symptoms and stress. However, higher perceived social support by the CCS was inversely associated with parents' depressive symptoms (β = - 0.202, p < 0.01) and perceived stress (β = - 0.164, p < 0.05) (e.g., partner effects). Additional actor effects were observed between spirituality, religiosity, and depressive systems when we explored the moderating effects of Hispanic ethnicity. CONCLUSION Partner effects of social support among CCS-parent dyads may influence psychological distress. IMPLICATION FOR CANCER SURVIVORS Our findings on parent-child associations between social support and psychosocial well-being imply that survivorship care can be enhanced when the social support needs of both survivors and their parents are addressed together.
Collapse
Affiliation(s)
- Carol Y Ochoa
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, N. Soto Street, 3rdFloor, Room 312-30, Los Angeles, CA, 90032, USA.
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, San Diego, CA, USA.
| | - Junhan Cho
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, N. Soto Street, 3rdFloor, Room 312-30, Los Angeles, CA, 90032, USA
| | - Kimberly A Miller
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, N. Soto Street, 3rdFloor, Room 312-30, Los Angeles, CA, 90032, USA
| | - Lourdes Baezconde-Garbanati
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, N. Soto Street, 3rdFloor, Room 312-30, Los Angeles, CA, 90032, USA
| | - Randall Y Chan
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Albert J Farias
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, N. Soto Street, 3rdFloor, Room 312-30, Los Angeles, CA, 90032, USA
| | - Joel E Milam
- Department of Epidemiology and Biostatistics, Department of Medicine, University of California, Irvine, Irvine, CA, USA
| |
Collapse
|
3
|
Lin D, Liang D, Huang M, Xu X, Bai Y, Meng D. The dyadic effects of family resilience and social support on quality of life among older adults with chronic illness and their primary caregivers in multigenerational families in China: A cross-sectional study. Heliyon 2024; 10:e27351. [PMID: 38463805 PMCID: PMC10923707 DOI: 10.1016/j.heliyon.2024.e27351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 02/18/2024] [Accepted: 02/28/2024] [Indexed: 03/12/2024] Open
Abstract
Older adults with chronic illness, as well as their primary caregivers in multigenerational families, may experience a complex interplay of factors that affect their quality of life (QOL). However, this interplay is not yet well-characterized for Chinese multigenerational families in particular. In this study, we analyzed how family resilience and social support affect the QOL of both older adults and caregivers in multigenerational Chinese families specifically. We enrolled 258 pairs of older adults with chronic illness and their primary caregivers in a multicenter cross-sectional study conducted in southern China in December 2021. Using the Actor-Partner Interdependence Model (APIM), we then examined the correlation between family resilience, social support, and QOL in dyadic analysis and found that QOL, family resilience, and social support for primary caregivers were better than those of older adults with chronic illness (t = 3.66-16.3, p<0.01). These factors were found to be positively correlated (r = 0.22-0.60, p<0.05), except for the family resilience of primary caregivers and the QOL of older adults with chronic illness (r = -0.14, p = 0.04). Additionally, actor effect results showed that when a dyadic member has high family resilience and objective social support, they tend to have a better QOL (β = 0.5-1.48, P < 0.01). However, partner effect results showed that when the primary caregiver has high family resilience, this is associated with a worse QOL for the older adult (β = -1.06, P < 0.01). Furthermore, we found that objective social support of dyads does not significantly influence their partner's QOL (β = 0.88/0.31, P>0.05) for any pair. This suggests that medical staff should pay attention to the impact of family resilience on the QOL of older adult and caregiver dyads and explore health management plans that focus on binary coping in multigenerational families.
Collapse
Affiliation(s)
- Dan Lin
- Nursing College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu province, 210023, China
| | - Dong Liang
- The School of Public Health, Fujian Medical University, Fuzhou, Fujian province, 350122, China
| | - Minqing Huang
- The School of Public Health, Fujian Medical University, Fuzhou, Fujian province, 350122, China
| | - Xinxin Xu
- The School of Public Health, Fujian Medical University, Fuzhou, Fujian province, 350122, China
| | - Yamei Bai
- Nursing College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu province, 210023, China
| | - Dijuan Meng
- Nursing College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu province, 210023, China
| |
Collapse
|
4
|
Milbury K, Whisenant M, Weathers S, Malliaha S, Snyder S, Jackson N, Li J, Li Y, Silva RF, Shih YT, Cohen L. Dyadic versus individual delivery of a yoga program for family caregivers of glioma patients undergoing radiotherapy: Results of a
3‐arm
randomized controlled trial. Cancer Med 2022; 12:7567-7579. [PMID: 36468605 PMCID: PMC10067051 DOI: 10.1002/cam4.5514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 11/09/2022] [Accepted: 11/24/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Despite their significant distress, supportive care interventions for caregivers of glioma patients are generally lacking. And, whether caregivers are more likely to benefit from interventions targeting patient-caregiver dyads or caregivers individually is unknown. This pilot randomized controlled trial compared the feasibility and preliminary efficacy of a dyadic yoga (DY) versus an individual caregiver yoga (CY) intervention as a supportive care strategy for family caregivers. METHODS Patient-caregiver dyads were randomized to a DY, CY or usual care (UC) arm. DY and CY interventions were delivered over 15 sessions. Caregivers completed assessments of their depressive symptoms, quality of life (QOL), and caregiving reactions at baseline, 6 weeks, and 12 weeks, and a subset completed qualitative interviews at 12 weeks. RESULTS With a consent rate of 63%, 67 dyads were randomized. Attendance in the DY was higher than in the CY group (session means, DY = 12.23, CY = 9.00; p = 0.06). Caregivers (79% female; 78% non-Hispanic White; mean age, 53 years) reported significantly more subjective benefit in the CY arm than in the DY arm (d = 2.1; p < .01), which was consistent with the qualitative assessment. There were medium effect sizes for improved mental QOL (d = 0.46) and financial burden (d = 0.53) in favor of the CY over the UC group. Caregivers in the CY group reported more caregiving esteem (d = 0.56) and less health decline (d = 0.60) than those in the DY group. CONCLUSION Individual rather than dyadic delivery may be a superior supportive care approach for this vulnerable caregiver population. A larger, adequately powered efficacy trial is warranted.
Collapse
Affiliation(s)
- Kathrin Milbury
- The University of Texas MD Anderson Cancer Center Houston Texas USA
| | - Meagan Whisenant
- The University of Texas MD Anderson Cancer Center Houston Texas USA
- The University of Texas Health Science Center at Houston, Cizik School of Nursing Houston Texas USA
| | | | - Smitha Malliaha
- The University of Texas MD Anderson Cancer Center Houston Texas USA
| | - Stella Snyder
- The University of Texas MD Anderson Cancer Center Houston Texas USA
| | - Natalie Jackson
- The University of Texas MD Anderson Cancer Center Houston Texas USA
- The University of Texas Health Science Center at Houston, Cizik School of Nursing Houston Texas USA
| | - Jing Li
- The University of Texas MD Anderson Cancer Center Houston Texas USA
| | - Yisheng Li
- The University of Texas MD Anderson Cancer Center Houston Texas USA
| | | | | | - Lorenzo Cohen
- The University of Texas MD Anderson Cancer Center Houston Texas USA
| |
Collapse
|
5
|
Thompson T, Davis M, Pérez M, Jonson-Reid M, Jeffe DB. "We're in this together": Perceived effects of breast cancer on African American survivors' marital relationships. JOURNAL OF THE SOCIETY FOR SOCIAL WORK AND RESEARCH 2022; 13:789-815. [PMID: 36687398 PMCID: PMC9850417 DOI: 10.1086/713478] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Objective We examined married African American breast cancer survivors' perceptions of how cancer affected their marriage, social support from their spouses, and spouses' physical and mental health. Method We conducted a thematic analysis of semi-structured interviews with 15 married African American breast cancer survivors who had participated in a larger randomized controlled trial. Interviews were professionally transcribed and then independently coded by two coders. Results Themes emerged related to the challenges of maintaining mutually supportive relationships. There was variability in the perceived effects of cancer on relationships, as well as uncertainty about cancer's effects on their husbands' emotional and physical health and the adequacy of emotional and tangible support from their husbands. Participants described husbands' key role in promoting wives' positive body image, as well as the challenges of negotiating sexual activity. Participants were receptive to help from medical professionals in dealing with relationship issues. Conclusions Findings show variability in couples' responses to cancer, with some patients and couples adapting well and others needing additional support. During treatment and at follow-up, oncology social workers can assess patients' and family members' social support needs, provide mental health services, and provide patient navigation to help patients and caregivers access health care and community resources.
Collapse
Affiliation(s)
- Tess Thompson
- Brown School of Social Work, Washington University in St. Louis
| | - Maxine Davis
- School of Social Work, The University of Texas at Arlington
| | - Maria Pérez
- School of Medicine, Washington University in St. Louis
| | | | | |
Collapse
|
6
|
Religiosity, Emotions and Health: The Role of Trust/Mistrust in God in People Affected by Cancer. Healthcare (Basel) 2022; 10:healthcare10061138. [PMID: 35742189 PMCID: PMC9222636 DOI: 10.3390/healthcare10061138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/16/2022] [Accepted: 06/17/2022] [Indexed: 11/18/2022] Open
Abstract
Trust in God implies the conviction that God looks after a person’s own interests. The first evidence of a relationship between this construct and people’s psychological and emotional health dates back several centuries. However, the literature on this is limited, especially for people with physical health conditions, such as cancer. Therefore, the purpose of this study is to test the relationships between trust/mistrust in God, social support and emotions in people affected by cancer. The sample consisted of 177 women and men in Spain diagnosed with cancer. The instruments used were the Trust/Mistrust in God Scale, the Positive and Negative Affect Schedule and the Multidimensional Scale of Perceived Social Support. Correlation analysis and hierarchical regression analysis were performed to compare several explanatory models for the dependent variables: positive and negative emotions. The results show significant relationships between all variables. It was observed that, when trust/mistrust in God is included in the model, only mistrust in God predicts both types of emotions. In addition, both social support and some sociodemographic variables help to predict the dependent variables. This study shows that valuing the religiosity and spirituality of oncology patients in healthcare settings can have a significant positive impact on the health of these individuals. Moreover, it represents an important approach to the study of trust/mistrust in God in the context of a traditionally Catholic country.
Collapse
|
7
|
The presence of a secondary caregiver differentiates primary cancer caregiver well-being. Support Care Cancer 2022; 30:1597-1605. [PMID: 34546455 PMCID: PMC8732324 DOI: 10.1007/s00520-021-06544-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 09/04/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Informal caregivers play a fundamental role in the care of hematological cancer patients, but less is known about how secondary caregivers are involved. We assessed the presence or absence of a secondary caregiver, the types of caregiving activities performed by primary and secondary caregivers, and examined whether the presence of a secondary caregiver was associated with primary caregiver characteristics and well-being over time. METHODS A case series of hematological cancer patient-caregiver dyads (n = 171) were recruited from oncology clinics in Virginia and Pennsylvania and followed for 2 years. Multilevel models were developed to examine the associations between the presence of a secondary caregiver and the primary caregivers' well-being. RESULTS Most (64.9%) primary caregivers reported having secondary caregivers. Multilevel models showed primary caregivers without help had higher baseline mental and physical health, but experienced deteriorating physical health over time, compared to supported primary caregivers. Supported primary caregivers reported improvements in mental health over time that was associated with improvements in physical health. CONCLUSIONS Primary caregivers in good physical and mental health at the beginning of their caregiving journey but who have the least assistance from others may be at greatest risk for detrimental physical health effects long term. Attention to the arrangement of caregiving roles (i.e., who provides what care) over time is needed to ensure that caregivers remain healthy and well supported.
Collapse
|
8
|
King JJ, Segrin C, Badger TA, Thomson CA. Exploring the relationship between loneliness, spirituality, and health-related quality of life in Hispanic cancer caregivers. Support Care Cancer 2022; 30:4781-4788. [PMID: 35142912 PMCID: PMC9046141 DOI: 10.1007/s00520-022-06800-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 12/31/2021] [Indexed: 12/24/2022]
Abstract
Caregivers of cancer patients find it challenging to perform their roles and to meet the demands of caregiving. Spirituality has been investigated as a potential coping strategy employed by caregivers, yet spirituality and related practices vary among cultural groups. In this study, we investigated the relationship between spirituality and health-related quality of life (HRQOL) and evaluated mediation effects of loneliness on this relationship. The sample was 234 lower socioeconomic status (SES) Hispanic caregivers of breast cancer survivors using existing data from the Support for Latinas with Breast Cancer and Their Intimate and Family Partners study, funded by the American Cancer Society (Badger, PI). A cross-sectional analysis was conducted at baseline, using self-reported spirituality, loneliness, and HRQOL data collected from 2012 to 2017. The exposures and outcomes were assessed using the Spiritual Well-Being Scale, the Social Isolation-Short Form 8a PROMIS Item Bank v2.0 scale, and the Global Health Scale PROMIS v.1.0/1.1 scale. Descriptive and mediation analyses using the Preacher and Hayes' approach were conducted to estimate the direct effect of spirituality on HRQOL and the indirect effect of spirituality through mediation of loneliness in relation to HRQOL. A positive association between spirituality and HRQOL was found, whereas loneliness was inversely associated with HRQOL (b = - .18, SE = .03, p < .0001). Age did not function as a moderator of the spirituality-HRQOL association in any of the models tested, but in the model testing mediation, loneliness was shown to mediate the association between spirituality and HRQOL (b = - .17, p < .0001). These results suggest that spirituality may be beneficial to HRQOL in caregivers of Hispanic breast cancer survivors, due in part to reduced loneliness among more spiritual caregivers.
Collapse
Affiliation(s)
- Jennifer J King
- Department of Health Promotion Sciences, University of Arizona, Mel and Enid Zuckerman College of Public Health, 1295 N. Martin Ave., Drachman Hall, A260, PO Box: 245209, Tucson, AZ, 85719, USA.
| | - Chris Segrin
- College of Social and Behavioral Sciences, University of Arizona, Tucson, AZ, USA
| | - Terry A Badger
- College of Nursing, University of Arizona, Tucson, AZ, USA
| | - Cynthia A Thomson
- Department of Health Promotion Sciences and the University of Arizona Cancer Center, University of Arizona, Tucson, AZ, USA
| |
Collapse
|
9
|
Koljack CE, Miyasaki J, Prizer LP, Katz M, Galifianakis N, Sillau SH, Kluger BM. Predictors of Spiritual Well-Being in Family Caregivers for Individuals with Parkinson's Disease. J Palliat Med 2021; 25:606-613. [PMID: 34818097 DOI: 10.1089/jpm.2020.0797] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Parkinson's disease (PD) is a common neurodegenerative illness that causes disability through both motor and nonmotor symptoms. Family caregivers provide substantial care to persons living with PD, often at great personal cost. While spiritual well-being and spirituality have been suggested to promote resiliency in caregivers of persons living with cancer and dementia, this issue has not been explored in PD. Objective: The aim of this study was to identify predictors of spiritual well-being in PD patients' caregivers. Design: A cross-sectional analysis was performed. Our primary outcome measure, the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp), was measured in caregivers alongside measures of patient quality of life, symptom burden, global function, grief, and spiritual well-being and caregiver mood, burden, and perceptions of patient quality of life. Univariate correlation and multiple regression were used to determine associations between predictor variables and caregiver FACIT-Sp. Setting/Subjects: PD patient/caregiver dyads were recruited through three academic medical centers in the United States and Canada and regional community support groups. Results: We recruited 183 dyads. Patient faith, symptom burden, health-related quality of life, depression, motor function, and grief were significant predictors of caregiver spiritual well-being. Predictive caregiver factors included caregiver depression and anxiety. These factors remained significant in combined models, suggesting that both patient and caregiver factors make independent contributions to caregiver spiritual well-being. Conclusions: The present study suggests that both patient and caregiver factors are associated with spiritual well-being in PD. Further study is needed to understand the causal relationship of these factors and whether interventions to support caregiver spiritual well-being improve outcomes for caregivers or patients. Clinicaltrials.gov registration NCT02533921.
Collapse
Affiliation(s)
- Claire E Koljack
- Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Janis Miyasaki
- Division of Neurology, Department of Medicine, University of Alberta, Edmonton, Canada
| | | | - Maya Katz
- Department of Neurology, University of California San Francisco Medical Center, San Francisco, California, USA
| | - Nick Galifianakis
- Department of Neurology, University of California San Francisco Medical Center, San Francisco, California, USA
| | - Stefan H Sillau
- Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Benzi M Kluger
- Department of Neurology and Medicine, University of Rochester Medical Center, Rochester, New York, USA
| |
Collapse
|
10
|
Abstract
OBJECTIVES To provide an overview on the role of family caregivers (FCGs) in the care of older adults with cancer and review quality of life needs for FCGs. DATA SOURCES Journal articles, research reports, state of the science papers, position papers, and clinical guidelines from professional organizations were used. CONCLUSION The high prevalence of multiple comorbidities and the associated burden of geriatric events in older adults have a substantial impact on the quality of life of their FCGs. Practical and efficient models of comprehensive assessment, interventions, and caregiving preparedness support are needed to improve outcomes for both older adults with cancer and their FCGs. IMPLICATIONS FOR NURSING PRACTICE Oncology nurses practicing in clinical and research settings have a responsibility to prepare themselves with evidence-based knowledge and resources to include the needs of FCGs in the care provided to older adults with cancer.
Collapse
|
11
|
Huang LT, Tai CY, Longcoy J, McMillan SC. The Mutual Effects of Perceived Spiritual Needs on Quality of Life in Patients With Advanced Cancer and Family Caregivers. J Hosp Palliat Nurs 2021; 23:323-330. [PMID: 34185726 PMCID: PMC8243389 DOI: 10.1097/njh.0000000000000758] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Perceived spiritual needs may increase when patients with advanced cancer and their family caregivers are confronted with the challenges of physical and psychological distress. Given the intertwined relationships between patients and family caregivers, their interdependence should be considered to understand how perceived spiritual needs affect the quality of life of their own and of their partner. This study used the Actor-Partner Interdependence Model as the conceptual model to investigate the mutual effects of perceived spiritual needs on the quality of life in patients with advanced cancer and their family caregivers after being admitted to hospice. This cross-sectional study used the baseline data of a large clinical trial and identified that patients with cancer and their family caregivers perceived similar spiritual needs associated with the community and outlook needs and had fewer unmet spiritual needs. After controlling for partner effects, perceived outlook needs shown in patients significantly predicted their own functional well-being and social/spiritual well-being. Outlook and community needs perceived by family caregivers also significantly predicted their own mental health. Although partner effects were not shown as expected, the findings provide insight into the mutuality of spirituality and demonstrate the necessity of providing timely and ongoing spiritual assessment and care.
Collapse
Affiliation(s)
- Li-Ting Huang
- College of Nursing, University of Illinois at Chicago
| | - Chun-Yi Tai
- School of Nursing, National Taipei University of Nursing and Health Sciences
| | - Joshua Longcoy
- Center for Community Health Equity, Rush University Medical Center
| | | |
Collapse
|
12
|
The Interaction Between Hematological Cancer Patients and Family Caregivers and Their Life Changes: A Qualitative Dyadic Approach. Cancer Nurs 2021; 44:E201-E208. [PMID: 32195708 DOI: 10.1097/ncc.0000000000000800] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Diagnosis of hematological cancer affects patients and caregivers as a unit. Few studies have focused on the relationship between hematological cancer patients and their caregivers. OBJECTIVE To explore (a) the interaction between patients receiving treatment for hematological cancer in a hematology-oncology clinic and their family caregivers and (b) perceived changes in lives of patients receiving treatment for hematological cancer in a hematology-oncology clinic and their family caregivers. METHODS We used a qualitative descriptive design with a dyadic approach. The study sample included 11 patients with hematological cancer and 11 family caregivers selected through purposive sampling. In-depth interviews were conducted using a semistructured interview format. RESULTS As a result of a content analysis, 3 themes emerged: hidden emotions, companionship, and life changes. Both the patients and the family caregivers described coping by hiding their feelings, thoughts, and needs and reducing communication with each other. Dyad members described commitment to each other and an increase in confidence. In addition, the patients and the family caregivers experienced changes in their roles and perspectives during the diagnosis and treatment process. CONCLUSION Patients with hematological cancer and family caregivers need nurses' support. Nurses should be prepared to provide patient-caregiver-based interventions. IMPLICATION FOR PRACTICES It is important that nurses take action to strengthen the relationship between patients and their caregivers, particularly with a focus on carrying out interventions to improve communication between them. Nurses can also strengthen dyads' coping by drawing attention to positive developments in their perspectives and relationships.
Collapse
|
13
|
Cho D, Kim S, Durrani S, Liao Z, Milbury K. Associations Between Spirituality, Mindfulness, and Psychological Symptoms Among Advanced Lung Cancer Patients and Their Spousal Caregivers. J Pain Symptom Manage 2021; 61:898-908.e1. [PMID: 33039605 PMCID: PMC8026767 DOI: 10.1016/j.jpainsymman.2020.10.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 09/27/2020] [Accepted: 10/02/2020] [Indexed: 11/17/2022]
Abstract
CONTEXT Patients with metastatic lung cancer and their spousal caregivers are at high risk of psychological symptoms. Mindfulness may improve psychological symptoms via spiritual well-being (SW); yet, this mediation model has not been examined in a dyadic context. OBJECTIVES We examined the mediating role of two dimensions of SW (meaning/peace and faith) in the mindfulness-symptoms link in Stage IV lung cancer patients and their spousal caregivers. METHODS We examined the actor-partner interdependence model of mediation using multivariate multilevel modeling with 78 couples. Four actor-partner interdependence model of mediation analyses were conducted to examine one predictor (mindfulness) × two mediators (meaning/peace and faith) × two psychological symptoms (depressive symptoms and cancer distress). We also tested four alternative models in which mindfulness mediates the associations between SW and psychological symptoms. RESULTS The alternative model (SW → mindfulness → psychological symptoms) was preferred than the original model (mindfulness → SW → psychological symptoms). For patients, meaning/peace was directly associated with their own psychological symptoms, whereas faith was only indirectly associated with their own psychological symptoms via mindfulness. For spouses, meaning/peace was both directly and indirectly associated with their own psychological symptoms, whereas faith was only directly associated with their own depressive symptoms (but not cancer distress). Moreover, spouses' faith was indirectly associated with patients' psychological symptoms through patients' mindfulness. CONCLUSION SW is associated with patients' and spouses' psychological symptoms both directly and indirectly through mindfulness. Thus, interventions that target SW, particularly meaning and peace, along with mindfulness may be beneficial to the psychological management of patients facing a terminal disease and their spousal caregivers.
Collapse
Affiliation(s)
- Dalnim Cho
- University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
| | - Seokhun Kim
- University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Sania Durrani
- University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Zhongxing Liao
- University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Kathrin Milbury
- University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| |
Collapse
|
14
|
Nightingale G, Battisti NML, Loh KP, Puts M, Kenis C, Goldberg A, Haase KR, Krok-Schoen J, Liposits G, Sattar S, Stolz-Baskett P, Pergolotti M. Perspectives on functional status in older adults with cancer: An interprofessional report from the International Society of Geriatric Oncology (SIOG) nursing and allied health interest group and young SIOG. J Geriatr Oncol 2021; 12:658-665. [PMID: 33172805 PMCID: PMC8102651 DOI: 10.1016/j.jgo.2020.10.018] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 08/17/2020] [Accepted: 10/27/2020] [Indexed: 12/18/2022]
Abstract
Most adults with cancer are over 65 years of age, and this cohort is expected to grow exponentially. Older adults have an increased burden of comorbidities and risk of experiencing adverse events on anticancer treatments, including functional decline. Functional impairment is a predictor of increased risk of chemotherapy toxicity and shorter survival in this population. Healthcare professionals caring for older adults with cancer should be familiar with the concept of functional status and its implications because of the significant interplay between function, cancer, anticancer treatments, and patient-reported outcomes. In this narrative review, we provide an overview of functional status among older patients with cancer including predictors, screening, and assessment tools. We also discuss the impact of functional impairment on patient outcomes, and describe the role of individual members of an interprofessional team in addressing functional impairment in this population, including the use of a collaborative approach aiming to preserve function.
Collapse
Affiliation(s)
- Ginah Nightingale
- Department of Pharmacy Practice, Jefferson College of Pharmacy, Thomas Jefferson University, Philadelphia, PA, USA.
| | - Nicolò Matteo Luca Battisti
- Breast Unit, Department of Medicine, The Royal Marsden NHS Foundation Trust, Sutton, Surrey SM1 2JP, United Kingdom; Breast Cancer Research Division, The Institute of Cancer Research, London SM2 5NG, United Kingdom
| | - Kah Poh Loh
- James P Wilmot Cancer Institute, Division of Hematology/Oncology, Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Martine Puts
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON M5T 1P8, Canada
| | - Cindy Kenis
- Department of General Medical Oncology and Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Annette Goldberg
- Department of Nutrition, Dana Farber Cancer Institute, Boston, MA, USA
| | - Kristen R Haase
- School of Nursing, University of British Columbia, Wesbrook Mall, Vancouver, British Columbia, Canada
| | - Jessica Krok-Schoen
- School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Gábor Liposits
- Department of Oncology, Regional Hospital West Jutland, Herning, Denmark
| | - Schroder Sattar
- College of Nursing, University of Saskatchewan, Saskatoon, Canada
| | - Petra Stolz-Baskett
- Oncology Service, Nelson Hospital Nelson Marlborough Health, Nelson 7048, New Zealand
| | - Mackenzi Pergolotti
- ReVital Cancer Rehabilitation, Select Medical; Colorado State University, Fort Collins, CO, USA
| |
Collapse
|
15
|
Røen I, Brenne AT, Brunelli C, Stifoss-Hanssen H, Grande G, Solheim TS, Kaasa S, Knudsen AK. Spiritual quality of life in family carers of patients with advanced cancer-a cross-sectional study. Support Care Cancer 2021; 29:5329-5339. [PMID: 33661369 PMCID: PMC8295139 DOI: 10.1007/s00520-021-06080-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 02/17/2021] [Indexed: 12/25/2022]
Abstract
Purpose Caring affects carers’ psychological and physical health, mortality, and quality of life (QoL) negatively. Lower spiritual QoL is associated with anxiety and depression, but the spiritual dimension is rarely investigated in carers. The present study aimed to explore which patient- and carer-related characteristics were associated with spiritual QoL in carers of patients with advanced cancer. Methods Secondary analyses were conducted using data from a prospective study investigating integration between oncology and palliative care. Adult patients with advanced cancer and their carers were included, and baseline data considering demographics, clinical characteristics, symptoms, social support, and religious meaning-making were registered. Spiritual QoL was measured using the Functional Assessment of Chronic Illness Therapy - Spiritual well-being (FACIT-Sp-12) questionnaire. Associations to spiritual QoL were explored by bivariate and multivariate regression models. Results In total, 84 carers were included, median age was 62.5 years, 52 (62%) were female, and the average spiritual QoL score was 23.3. In bivariate analyses, higher education, social support, and lower patients’ symptom burden were significantly associated with higher spiritual QoL. The multivariate regression model (n=77) had an explained variance (R2) = 0.34 and showed a significant association for social support, higher education, having children < 18 years living at home, and patient’s age. Conclusion The study indicates that spiritual QoL in carers were low and were negatively affected by several factors related to both carers and patients. However, there could be other important factors not yet described. Health care professionals should be aware of the known associated factors, as carers who hold these may need extra support.
Collapse
Affiliation(s)
- Ingebrigt Røen
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
- St. Olavs Hospital, Trondheim University Hospital, 4. etg. Kunnskapssenteret vest, St. Olavs Hospital, 7006, Trondheim, Norway.
- Chaplaincy, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
| | - Anne-Tove Brenne
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- St. Olavs Hospital, Trondheim University Hospital, 4. etg. Kunnskapssenteret vest, St. Olavs Hospital, 7006, Trondheim, Norway
- Cancer Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Cinzia Brunelli
- Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - Hans Stifoss-Hanssen
- Center of diakonia and professional practice, VID Specialized University, Oslo, Norway
| | - Gunn Grande
- Division of Nursing, Midwifery and Social Work, The University of Manchester, Manchester, England
| | - Tora Skeidsvoll Solheim
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- St. Olavs Hospital, Trondheim University Hospital, 4. etg. Kunnskapssenteret vest, St. Olavs Hospital, 7006, Trondheim, Norway
| | - Stein Kaasa
- European Palliative Care Research Centre (PRC), Oslo University Hospital and University of Oslo, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Oncology, Oslo University Hospital, Oslo, Norway
- University of Oslo, Oslo, Norway
| | - Anne Kari Knudsen
- European Palliative Care Research Centre (PRC), Oslo University Hospital and University of Oslo, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Oncology, Oslo University Hospital, Oslo, Norway
| |
Collapse
|
16
|
Wang Y, Yan J, Chen J, Wang C, Lin Y, Wu Y, Hu R. Comparison of the anxiety, depression and their relationship to quality of life among adult acute leukemia patients and their family caregivers: a cross-sectional study in China. Qual Life Res 2021; 30:1891-1901. [PMID: 33595826 DOI: 10.1007/s11136-021-02785-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2021] [Indexed: 12/17/2022]
Abstract
PURPOSE To compare the anxiety, depression and explore their relationship to quality of life (QoL) among adult acute leukemia (AL) patients and family caregivers (FCs) in China. METHODS A multicenter cross-sectional study was conducted from April 2017 to January 2018. The sample comprised 207 dyads of adult AL patients and FCs. The participants were required to complete socio-demographic information and the Hospital Anxiety and Depression Scale (HADS). The Functional Assessment of Cancer Therapy-Leukemia (FACT-Leu, only for patients) and MOS 36-item Short-Form Health Survey (SF-36, only for FCs) were used to measure QoL. RESULTS The mean scores of anxiety and depression for AL patients were 7.89 ± 3.85 and 7.18 ± 4.23, respectively. For FCs, the mean scores of anxiety and depression were 9.96 ± 3.73 and 8.64 ± 3.74. In this study, adult AL Patients' sex, patients' depression score, whether patients achieving a CR or not, education, FCs' depression score, patients' social/family well-being and emotional well-being were significantly associated with patients' anxiety or depression (p < 0.05). For FCs, depression was significantly related to the physical component summary (β = 0.127, p = 0.008). There were significant differences in anxiety (t = - 5.92, p < 0.001) and depression (t = - 4.19, p < 0.001) between patients and FCs. CONCLUSIONS AL patients' FCs showed higher score of anxiety and depression than that of patients. The psychological health may have a potential relationship between AL patients and their FCs. Healthcare professionals can conduct family-center interventions to improve mental health and QoL of AL patients and FCs.
Collapse
Affiliation(s)
- Ying Wang
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Jie Yan
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - JingYi Chen
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - ChunFeng Wang
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - YingChun Lin
- Department of Hematology, The First Affiliated Hospital of Fujian University, NO.1 Xueyuan Road, Shangjie Town, Minhou County, Fuzhou City, 350122, Fujian Province, China
| | - Yong Wu
- Department of Hematology, Fujian Medical University Union Hospital, Fujian Institute of Hematology, 29 Xinquan Road, Fuzhou, 350001, China.
| | - Rong Hu
- The School of Nursing, Fujian Medical University, Fuzhou, China.
| |
Collapse
|
17
|
Stolz-Baskett P, Taylor C, Glaus A, Ream E. Supporting older adults with chemotherapy treatment: A mixed methods exploration of cancer caregivers' experiences and outcomes. Eur J Oncol Nurs 2020; 50:101877. [PMID: 33248360 DOI: 10.1016/j.ejon.2020.101877] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 08/16/2020] [Accepted: 11/12/2020] [Indexed: 01/22/2023]
Abstract
PURPOSE Due to delivery of chemotherapy being mostly in ambulatory care settings, support of people with cancer relies heavily on caregivers (e.g. relatives). Whilst cancer caregiver research has been flourishing, there has been little focus on the specific experiences of caregivers of older people (>70yrs) with cancer, and little considerations of cultural influences on their experiences. This study explored caregiver experiences and outcomes in the geriatric oncology context in Switzerland. METHODS Sequential mixed-methods design, comprising a) cross-sectional survey (n = 86/RR52%; age range 37-85) and b) interviews (n = 19) to explore experiences of caregivers of older people (mean age in yrs 74.6 (sd 4.3) with cancer, and factors related to caregivers' psychological morbidity and health related quality of life (HrQoL). RESULTS Caregivers reported a median of three moderate/high unmet needs (range 0-41) and 44% reported clinically significant psychological morbidity. Demographics (caregiver age, gender, and marital status), caregiving tasks (physical, psycho-emotional, social and/or treatment related care), unmet needs and caregiver burden collectively explained between 20 and 57% of variance in caregiver psychological morbidity and HRQoL. Two main themes emerged from interviews: "Being a caregiver and doing caregiving" and "Living through the situation." These indicated that caregiver roles are multiple and fluid, and identified responsibilities not previously reported outside of palliative care settings, such as thinking about and planning for death and dying. CONCLUSIONS Caregiving for an older person with cancer can have detrimental impacts on caregivers' wellbeing and quality of life. Consideration needs to be given to the particular needs of caregivers in geriatric oncology settings. Their support needs appear different to those of their counterparts caring for younger people with cancer, notably related to spiritual needs; this may in part relate to possible differences arising from caregivers themselves being older.
Collapse
Affiliation(s)
- Petra Stolz-Baskett
- Zürich University of Applied Sciences (ZHAW), Institute of Nursing, Winterthur - CHPresent Address: Nelson Marlborough Health, Nelson Hospital PO Box Nelson, 7048, New Zealand.
| | - Cath Taylor
- School of Health Sciences, University of Surrey, Guilford, UK.
| | - Agnes Glaus
- Tumour & Breast Centre ZeTuP, St. Gallen, Switzerland
| | - Emma Ream
- School of Health Sciences, University of Surrey, Guilford, UK.
| |
Collapse
|
18
|
Milbury K, Li Y, Durrani S, Liao Z, Tsao AS, Carmack C, Cohen L, Bruera E. A Mindfulness-Based Intervention as a Supportive Care Strategy for Patients with Metastatic Non-Small Cell Lung Cancer and Their Spouses: Results of a Three-Arm Pilot Randomized Controlled Trial. Oncologist 2020; 25:e1794-e1802. [PMID: 32621630 DOI: 10.1634/theoncologist.2020-0125] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 06/12/2020] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Although mindfulness-based interventions have been widely examined in patients with nonmetastatic cancer, the feasibility and efficacy of these types of programs are largely unknown for those with advanced disease. We pilot-tested a couple-based meditation (CBM) relative to a supportive-expressive (SE) and a usual care (UC) arm targeting psychospiritual distress in patients with metastatic lung cancer and their spousal caregivers. PATIENTS AND METHODS Seventy-five patient-caregiver dyads completed baseline self-report measures and were then randomized to one of the three arms. Couples in the CBM and SE groups attended four 60-minute sessions that were delivered via videoconference. All dyads were reassessed 1 and 3 months later. RESULTS A priori feasibility benchmarks were met. Although attendance was high in both groups, dyads in the CBM group indicated greater benefit of the sessions than those in the SE group (patients, CBM mean = 2.63, SE mean = 2.20, p = .003; spouses, CBM mean = 2.71, SE mean = 2.00, p = .005). Compared with the UC group, patients in the CBM group reported significantly lower depressive symptoms (p = .05; d = 0.53) and marginally reduced cancer-related stress (p = .07; d = 0.68). Medium effect sizes in favor of the CBM compared with the SE group for depressive symptoms (d = 0.59) and cancer-related stress (d = 0.54) were found. Spouses in the CBM group reported significantly lower depressive symptoms (p < .01; d = 0.74) compared with those in the UC group. CONCLUSION It seems feasible and possibly efficacious to deliver dyadic interventions via videoconference to couples coping with metastatic lung cancer. Mindfulness-based interventions may be of value to managing psychological symptoms in the palliative care setting. Clinical trial identification number. NCT02596490 IMPLICATIONS FOR PRACTICE: The current randomized controlled trial has established that a mindfulness approach to the management of patients' and spouses' psychospiritual concerns is acceptable and subjectively deemed more beneficial than a supportive-expressive treatment for patients with metastatic non-small cell lung cancer (NSCLC). We also revealed that videoconference delivery, here FaceTime, is an acceptable approach even for geriatric patients with metastatic NSCLC and that patients and their spousal caregivers prefer a dyadic delivery of this type of supportive care strategy. Lastly, this trial has laid the foundation for the role of mindfulness-based interventions in the palliative care setting supporting patients with advanced NSCLC and their spousal caregivers.
Collapse
Affiliation(s)
- Kathrin Milbury
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Yisheng Li
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Sania Durrani
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Zhongxing Liao
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Anne S Tsao
- Department of Head and Neck/Thoracic Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Cindy Carmack
- Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Lorenzo Cohen
- Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Eduardo Bruera
- Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| |
Collapse
|
19
|
La IS, Johantgen M, Storr CL, Cagle JG, Zhu S, Ross A. Spirituality among family caregivers of cancer patients: The Spiritual Perspective Scale. Res Nurs Health 2020; 43:407-418. [PMID: 32515862 DOI: 10.1002/nur.22044] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 04/09/2020] [Accepted: 05/19/2020] [Indexed: 12/22/2022]
Abstract
Spirituality is a critical resource for family caregivers of patients with cancer. However, studies on spirituality are hampered because measures of spirituality lack consistency and have not been validated in cancer caregivers. This study examined the validity of the Spiritual Perspective Scale (SPS) among cancer caregivers and explored whether measurement bias may influence differences in spirituality across caregiver and patient characteristics. In this secondary analysis, 124 caregivers of cancer patients were used to evaluate the validity of the 10-item SPS. A multiple indicators multiple causes model was applied to explore differences in the association between a latent spirituality factor and characteristics of caregivers and patients. Overall reliability of the SPS was adequate (Cronbach's α = .95). The SPS scores were predictive of higher meaning and purpose (r = .32, p = .004) and lower depression (r = -.22, p = .046) at 3-month follow-up. Construct validity of the SPS with a single-factor structure was supported in cancer caregivers. Adjusting for a direct effect of race did not alter the pattern of results, and caregivers who were older, female, ethnic minorities, less-educated, affiliated with a religion, and who provided care to another individual in addition to the patient had greater levels of spirituality. This study provides evidence for psychometric validation of the SPS in cancer caregivers. Understanding differences in caregivers' spirituality by using the SPS with psychometrically acceptable properties and minimal measurement bias deserves more attention to optimize spirituality assessment and support in cancer caregiving.
Collapse
Affiliation(s)
- In Seo La
- University of Maryland School of Nursing, Baltimore, Maryland
| | - Meg Johantgen
- University of Maryland School of Nursing, Baltimore, Maryland
| | - Carla L Storr
- University of Maryland School of Nursing, Baltimore, Maryland
| | - John G Cagle
- University of Maryland School of Social Work, Baltimore, Maryland
| | - Shijun Zhu
- University of Maryland School of Nursing, Baltimore, Maryland
| | - Alyson Ross
- National Institutes of Health Clinical Center, Bethesda, Maryland
| |
Collapse
|
20
|
Ting A, Lucette A, Carver CS, Cannady RS, Kim Y. Preloss Spirituality Predicts Postloss Distress of Bereaved Cancer Caregivers. Ann Behav Med 2020; 53:150-157. [PMID: 30052710 DOI: 10.1093/abm/kay024] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background Although spirituality has been identified as a psychological resource relevant to coping with caregiving stress, little is known about the differential roles of spirituality's facets in bereaved caregivers' adjustment. Purpose This study examined this question with regard to bereavement-specific and general distress in cancer caregivers. Methods Cancer caregivers provided data at 2 years after their relative's diagnosis when all the patients were alive (Time 1, preloss) and 3 years later, after the patient had died (Time 2, postloss: N = 128). Demographics and three facets of spirituality (meaning, peace, and faith) were measured at Time 1. Psychological distress and time since the death were measured at Time 2. Results Younger age, less education, and being a spousal caregiver of the patient related to greater bereavement-specific and general distress (ts ≥ 2.02, ps < .05, partial η2 ≥ .15). Above and beyond these demographic factors, two preloss spirituality facets related to postloss distress. Specifically, a greater sense of inner peace at preloss was prospectively associated with less bereavement-specific distress (both intrusive thoughts and hyperarousal, ts ≥ 2.24, ps < .05, partial η2 ≥ .41). Greater reliance on faith at preloss was also prospectively associated with lower intrusive thoughts (t = 2.24, p < .05, partial η2 = .34). Conclusion Findings highlight the importance of preloss sense of peace as a predictor of psychological distress during bereavement. Programs and interventions might be designed to help caregivers find inner peace while caregiving, in an effort to augment their resiliency against psychological distress when facing the loss of the patient.
Collapse
Affiliation(s)
- Amanda Ting
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Aurelie Lucette
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Charles S Carver
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | | | - Youngmee Kim
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| |
Collapse
|
21
|
Teo I, Baid D, Ozdemir S, Malhotra C, Singh R, Harding R, Malhotra R, Yang MG, Neo SHS, Cheung YB, Neo PSH, Kanesvaran R, Kumarakulasinghe NB, Lee LH, Koh GCH, Finkelstein EA. Family caregivers of advanced cancer patients: self-perceived competency and meaning-making. BMJ Support Palliat Care 2019; 10:435-442. [PMID: 31806656 DOI: 10.1136/bmjspcare-2019-001979] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 10/03/2019] [Accepted: 11/10/2019] [Indexed: 11/04/2022]
Abstract
BACKGROUND Family caregivers of patients with advanced cancer have been reported to provide long hours of care and be at risk for poor psychological outcomes. Although research has focused on the nature of caregiving burden, little attention has been paid to identifying protective factors that improve caregiver psychological outcomes. AIM We examined the relationship between caregivers' time spent caregiving and the following psychological outcomes: anxiety, depression and caregiving esteem. Subsequently, we explored the main and moderating effects of caregiver-perceived self-competency and sense of meaning on caregiver psychological outcomes. DESIGN/PARTICIPANTS Cross-sectional analysis was conducted using the baseline data from an ongoing cohort study. Family caregivers of advanced cancer patients (n=287) were recruited from two tertiary hospitals in Singapore. RESULTS Time spent caregiving was not significantly associated with caregiver anxiety, depression or caregiving esteem. However, significant main effects of self-competency on anxiety and caregiving esteem; and sense of meaning on anxiety, depression and caregiving esteem were observed. Moderator analyses further indicated that self-competency attenuated the positive relationship between time spent caregiving and anxiety, while sense of meaning attenuated the negative relationship between time spent caregiving and caregiving esteem. CONCLUSION Greater perceived self-competency and sense of meaning are related to better caregiver psychological outcomes, and protect caregivers from worsening outcomes as caregiving hours increase. Our findings suggest that screening caregivers for distress is an important part of care, and that supportive interventions for caregivers should aim to enhance their perceived caregiving competencies and the ability to make meaning of their caregiving role.
Collapse
Affiliation(s)
- Irene Teo
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore .,Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore.,Program in Health Services & Systems Research, Duke-NUS Medical School, Singapore
| | - Drishti Baid
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
| | - Semra Ozdemir
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore.,Program in Health Services & Systems Research, Duke-NUS Medical School, Singapore
| | - Chetna Malhotra
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore.,Program in Health Services & Systems Research, Duke-NUS Medical School, Singapore
| | - Ratna Singh
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
| | - Richard Harding
- Department of Palliative Care and Policy, King's College London, London, UK
| | - Rahul Malhotra
- Program in Health Services & Systems Research, Duke-NUS Medical School, Singapore.,Centre for Aging Research and Education, Duke-NUS Medical School, Singapore
| | - Meijuan Grace Yang
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore.,Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore
| | - Shirlyn Hui-Shan Neo
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore
| | - Yin Bun Cheung
- Program in Health Services & Systems Research, Duke-NUS Medical School, Singapore.,Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore.,Center for Child Health Research, Tampere University, Tampere, Pirkanmaa, Finland
| | - Patricia Soek Hui Neo
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore
| | | | | | - Lai Heng Lee
- Department of Haematology, Singapore General Hospital, Singapore
| | - Gerald Choon Huat Koh
- Program in Health Services & Systems Research, Duke-NUS Medical School, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Eric A Finkelstein
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore.,Program in Health Services & Systems Research, Duke-NUS Medical School, Singapore
| | | |
Collapse
|
22
|
Impact of informal cancer caregiving across the cancer experience: A systematic literature review of quality of life. Palliat Support Care 2019; 18:220-240. [DOI: 10.1017/s1478951519000622] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractObjectiveInformal caregiving may likely increase as the number of cancer survivors grows. Caregiving responsibilities can impact caregivers’ quality of life (QOL). Understanding the current state of the science regarding caregiving QOL could help inform future research and intervention development.MethodsA systematic literature review in PubMed/Medline examined research on QOL among informal cancer caregivers and related psychosocial health outcomes. Original research articles in English, published between 2007 and 2017 about caregivers (aged >18 years) of adult cancer patients in the United States were included. Abstracted articles were categorized according to caregiving recipient's phase of survivorship (acute, middle to long-term, end of life/bereavement).ResultsOf 920 articles abstracted, 60 met inclusion criteria. Mean caregiver age ranged from 37 to 68 with the majority being female, non-Hispanic white, with at least a high school degree, and middle income. Almost half of the studies focused on caregivers who provided care for survivors from diagnosis through the end of active treatment. Studies examined physical health, spirituality, psychological distress, and social support. Differences in QOL were noted by caregiver age, sex, and employment status.Significance of ResultsAdditional research includes the examination of the needs of diverse cancer caregivers and determines how additional caregiver characteristics (e.g., physical functioning, financial burden, etc.) affect QOL. This includes studies examining caregiver QOL in the phases following the cessation of active treatment and assessments of health systems, support services, and insurance to determine barriers and facilitators needed to meet the immediate and long-term needs of cancer caregivers.
Collapse
|
23
|
Milbury K, Li J, Weathers SP, Shih T, Malliaha S, Li Y, Cohen L. A research protocol for a pilot, randomized controlled trial designed to examine the feasibility of a dyadic versus individual yoga program for family caregivers of glioma patients undergoing radiotherapy. Pilot Feasibility Stud 2019; 5:95. [PMID: 31367462 PMCID: PMC6657047 DOI: 10.1186/s40814-019-0479-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 07/09/2019] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Although the diagnosis and treatment of a primary brain tumor present unique challenges to patients and their family caregivers, evidence-based supportive care interventions are generally lacking. The primary aim of this research protocol is to determine the feasibility of implementing a dyadic yoga (DY) versus a caregiver yoga (CY) intervention or a wait-list control (WLC) group using a randomized controlled trial design. METHODS Seventy-five glioma patients undergoing radiotherapy and their family caregivers are randomized to the DY, CY, or a WLC group. Patient-caregiver dyads in the DY group and caregivers in the CY group receive 15 sessions (45 min each) over the course of patients' standard radiotherapy (6 weeks). Patients and caregivers in all groups complete baseline assessments of symptoms, quality of life (QOL), and health utilization outcomes prior to randomization. Follow-up assessments are performed 6 weeks and then again 3 months later. The primary outcome is feasibility (i.e., ≥ 50% of eligible dyads consent, ≥ 70% of enrolled dyads complete all assessments, and ≥ 50% of all practice sessions are attended). We will also perform primarily descriptive analyses of the self-reported outcomes (e.g., fatigue, overall QOL) and explore potential intervention moderators (e.g., performance status) to inform a larger future trial. CONCLUSION This trial will provide important information regarding the feasibility of a dyadic versus a caregiver yoga intervention regarding symptom, QOL, and health utilization outcomes in glioma patients and their caregivers. TRIAL REGISTRATION ClinicalTrials.gov NCT02481349.
Collapse
Affiliation(s)
- Kathrin Milbury
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, 1155 Pressler St, Houston, TX 77030 USA
| | - Jing Li
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Shiao-Pei Weathers
- Department of Neuro-Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Tina Shih
- Department of Health Services, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Smitha Malliaha
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, 1155 Pressler St, Houston, TX 77030 USA
| | - Yisheng Li
- Department of Biostatics, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Lorenzo Cohen
- Department of Palliative, Rehabilitation & Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| |
Collapse
|
24
|
Lim JW, Shon EJ. The Dyadic Effects of Family Cohesion and Communication on Health-Related Quality of Life: The Moderating Role of Sex. Cancer Nurs 2019; 41:156-165. [PMID: 28114262 PMCID: PMC5519452 DOI: 10.1097/ncc.0000000000000468] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Spouses' ability to care for survivors can be particularly challenging because patients and spouses are interdependent and mutually influence one another. Family functioning such as family cohesion and communication may play a primary role in improving the health-related quality of life (HRQOL) of couples, given that cancer can influence family dynamics. OBJECTIVE The aims of this study were to investigate the mediating effect of family communication on the relationship between family cohesion and HRQOL and examine the moderating effect of sex on this relationship among cancer survivor-spouse dyads. METHODS A total of 91 cancer survivors with a diagnosis of breast, colorectal, or prostate cancer and their spouses were recruited from the University Hospital Registry in Cleveland, Ohio. The dyadic data were analyzed using structural equation modeling with the actor-partner interdependence mediation model. RESULTS Findings demonstrated that the spouses' own perceived family communication mediated the associations between their own family cohesion and physical HRQOL and between the survivors' family cohesion and physical HRQOL. The spouse actor effects between family communication and HRQOL significantly differed by sex. CONCLUSIONS Enhancing family cohesion and communication within the family can improve the spouses' HRQOL. Findings regarding sex differences serve as a rationale for gender-based approaches to improving HRQOL in survivorship care in the family context. IMPLICATIONS FOR PRACTICE Couple- and/or family-based interventions should be designed to enhance family cohesion and improve family communication skills for effective adjustments within couples and families. Supportive care within the family context can be promoted to address the diverse challenges of survivorship care.
Collapse
Affiliation(s)
- Jung-Won Lim
- Author Affiliations: College of Social Welfare, Kangnam University, Yongin, Gyeonggi, Korea (Dr Lim); and Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH (Ms Shon)
| | | |
Collapse
|
25
|
Durrani S, Contreras J, Mallaiah S, Cohen L, Milbury K. The Effects of Yoga in Helping Cancer Patients and Caregivers Manage the Stress of a Natural Disaster: A Brief Report on Hurricane Harvey. Integr Cancer Ther 2019; 18:1534735419866923. [PMID: 31364416 PMCID: PMC6669833 DOI: 10.1177/1534735419866923] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 02/27/2019] [Accepted: 07/01/2019] [Indexed: 12/29/2022] Open
Abstract
Background: This small qualitative study reports on the experiences of patients and family caregivers who participated in a dyadic yoga pilot trial while undergoing cancer treatment in the midst of Hurricane Harvey. Our primary purpose was to determine if participants implemented components of the program to cope with the stressors associated with Hurricane Harvey and if they perceived benefits from the yoga practices. Methods: We administered brief semistructured interviews to the dyads participating in a dyadic yoga pilot trial. Participants (n = 5 dyads) were asked to discuss their experience with Hurricane Harvey, including factors that helped them cope with the event while receiving treatment. Result: Patients had a mean age of 55.6 years, were mostly non-Hispanic White, male, and had advance stage head and neck cancer. Caregivers had a mean age of 58 years and were mainly non-Hispanic White and female. Analyses of the interviews revealed 2 overarching themes: (1) the storm's negative impact and (2) the use of yoga to cope with the hurricane-related stressors. Conclusions: Patient-caregiver dyads experienced psychological distress during the storm and/or its aftermath. Dyads used yoga techniques to cope with these psychological stressors. Yoga served as a means of social support as dyads either participated in these activities together or with other family members.
Collapse
Affiliation(s)
- Sania Durrani
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Smitha Mallaiah
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lorenzo Cohen
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Kathrin Milbury
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| |
Collapse
|
26
|
Kemp E, Prior K, Beatty L, Lambert SD, Brown C, Koczwara B. Relationships between supportive care needs and perceived burden in breast cancer survivor-caregiver dyads. Eur J Cancer Care (Engl) 2018; 27:e12875. [PMID: 30015995 DOI: 10.1111/ecc.12875] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 03/21/2018] [Accepted: 06/05/2018] [Indexed: 12/20/2022]
Abstract
While burden in cancer caregivers is high and associated with poor outcomes, little is known about significance of specific supportive care needs' domains in determining survivors' or caregivers' perceived caregiver burden. This cross-sectional study explored which domains of survivor- and caregiver-reported supportive care needs were most associated with survivor- and caregiver-reported caregiver burden, in breast cancer survivor-caregiver dyads. Cancer survivors (N = 55) and their caregivers (N = 44) completed measures of supportive care needs, anxiety, depression, functional well-being and perceived caregiver burden. Correlation and linear regression analyses were used to determine relative significance of survivor and caregiver supportive care needs in accounting for variance in survivor and caregiver perceptions of burden. Higher survivor-perceived caregiver burden and higher caregiver-perceived difficulty of caregiving were associated with higher levels of survivor and caregiver supportive care needs. Survivors' psychological needs uniquely contributed to survivors' self-perceived burden, and survivors' sexual needs and caregivers' work and social needs uniquely contributed to caregivers' perceived difficulty of caregiving. Caregiver's perceived time spent caregiving was associated with access to services needs but not other needs. Survivor and caregiver supportive care needs and burden appear interdependent. Longitudinal research with larger samples is warranted to examine these relationships.
Collapse
Affiliation(s)
- Emma Kemp
- Department of Medical Oncology, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.,Flinders Centre for Innovation in Cancer, Bedford Park, South Australia, Australia
| | - Kirsty Prior
- Department of Medical Oncology, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.,Flinders Centre for Innovation in Cancer, Bedford Park, South Australia, Australia
| | - Lisa Beatty
- Department of Medical Oncology, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.,Flinders Centre for Innovation in Cancer, Bedford Park, South Australia, Australia
| | - Sylvie D Lambert
- Ingram School of Nursing, McGill University, Montreal, Québec, Canada.,St. Mary's Research Centre, St. Mary's Hospital, Montreal, Québec, Canada
| | - Chris Brown
- University of Sydney, Sydney, New South Wales, Australia
| | - Bogda Koczwara
- Department of Medical Oncology, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.,Flinders Centre for Innovation in Cancer, Bedford Park, South Australia, Australia
| |
Collapse
|
27
|
|
28
|
Exploring the associations between spiritual well-being, burden, and quality of life in family caregivers of cancer patients. Palliat Support Care 2018; 17:294-299. [PMID: 29749317 DOI: 10.1017/s1478951518000160] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The spiritual dimension is important in the process of coping with stress and may be of special relevance for those caring for cancer patients in the various phases of caregivership, although current attention is most prevalent at the end of life. This study explores the associations among spiritual well-being (SWB), caregiver burden, and quality of life (QoL) in family caregivers of patients with cancer during the course of the disease. METHOD This is a cross-sectional study. All participants (n = 199) underwent the following self-report questionnaires: the SWB-Index, the Medical Outcomes Study Short Form, and the Caregiver Burden Inventory (CBI). SWB scores were dichotomized at a cutoff corresponding to the 75th percentile. Statistical analyses were made using the Student t or by chi-square test to compare high and low SWB groups.ResultThe high SWB group reported significantly better Medical Outcomes Study Short Form scores in bodily pain (p = 0.035), vitality (p < 0.001), social activities (p = 0.001), mental health (p < 0.001), and in standardized mental component subscales (p < 0.001) than the low SWB group. No significant differences were detected between the two SWB groups in physical activity, physical role, general health, emotional status, and standardized physical component scale. The high SWB group also had better CBI scores in the physical (p = 0.049) and developmental burden (p = 0.053) subscales. There were no significant differences in the other CBI scores (overall and sections).Significance of resultsThis study points out that high SWB caregivers have a more positive QoL and burden. Knowledge of these associations calls for more attention on the part of healthcare professionals toward spiritual resources among family cancer caregivers from the moment of diagnosis and across the entire cancer trajectory.
Collapse
|
29
|
Vitorino LM, Lopes-Júnior LC, de Oliveira GH, Tenaglia M, Brunheroto A, Cortez PJO, Lucchetti G. Spiritual and religious coping and depression among family caregivers of pediatric cancer patients in Latin America. Psychooncology 2018; 27:1900-1907. [PMID: 29663569 DOI: 10.1002/pon.4739] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 03/21/2018] [Accepted: 04/09/2018] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Several studies have shown that spiritual/religious beliefs are associated with mental health and quality of life. However, so far, no study assessed the relationship between spiritual/religious coping (SRC) and depressive symptoms in family caregivers (FCs) of pediatric cancer patients, particularly in Latin America. This study aimed to investigate whether Positive and Negative SRC strategies are associated with depressive symptoms in FCs of pediatric cancer patients in Brazil. METHODS We conducted a cross-sectional study comprising 77 FCs of pediatric cancer patients from one Brazilian Pediatric Oncology Institute. Spiritual/religious coping was assessed using the Brief SRC scale, and depressive symptoms were evaluated by the Beck Depression Inventory. Multiple regression models were performed to identify factors associated with SRC of FCs and their depressive symptoms. RESULTS In the unadjusted linear regression models, depressive symptoms were positively associated with Negative SRC (B = 0.401; P < .001; Adjusted R2 = 16.1%) but not with Positive SRC (B = 0.111; P = .334). After adjusting for socio-demographics, religious practice/faith, and health, Negative SRC remained associated with depressive symptoms (B = 3.56; P = .01; Adjusted R2 = 37.8%). In the logistic regression models, depressive symptoms were positively associated with Negative SRC (OR = 3.68; 95% CI, 1.46-9.25; P = .006), but not with Positive SRC (OR = 1.49; 95% CI, .69-3.22; P = .309). After adjustments, Negative SRC remained significant (OR = 4.01; 95% CI, 1.21-13.33; P = .023). CONCLUSIONS Negative SRC was associated with depressive symptoms in FCs of pediatric cancer patients. Health professionals must be aware of the use of Negative SRC strategies in oncology care.
Collapse
Affiliation(s)
| | - Luís Carlos Lopes-Júnior
- Nursing Department, Center for Biological Sciences and Health of the Federal University of São Carlos-UFSCar, São Carlos, Brazil
| | | | - Mariane Tenaglia
- Pediatric Residency program at Hospital Infantil Cândido Fontoura (HICF), São Paulo, Brazil
| | | | | | - Giancarlo Lucchetti
- School of Medicine, Federal University of Juiz de Fora, Juiz de Fora, Brazil
| |
Collapse
|
30
|
Milbury K, Engle R, Tsao A, Liao Z, Owens A, Chaoul A, Bruera E, Cohen L. Pilot Testing of a Brief Couple-Based Mind-Body Intervention for Patients With Metastatic Non-Small Cell Lung Cancer and Their Partners. J Pain Symptom Manage 2018; 55:953-961. [PMID: 29208478 PMCID: PMC6620018 DOI: 10.1016/j.jpainsymman.2017.11.027] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 11/21/2017] [Accepted: 11/22/2017] [Indexed: 10/18/2022]
Abstract
CONTEXT Given the generally incurable nature of metastatic lung cancer, patients and their spouses/partners are at risk for psychological and spiritual distress. To address this concern, we developed a couple-based mind-body (CBMB) intervention. OBJECTIVES This formative research aimed at examining the intervention's acceptability and initial efficacy in patients with metastatic lung cancer undergoing treatment and their spouses. METHODS Intervention content evaluation sessions and an ensuing single-arm trial were conducted. To evaluate intervention content, participants performed intervention exercises and then participated in semistructured interviews and completed written evaluations. In the single-arm trial, four intervention sessions were delivered over two weeks, focusing on cultivating mindfulness, interpersonal connection, gratitude, and purpose. Newly recruited couples completed measures of depressive symptoms, cancer distress, spiritual well-being, and sleep disturbances before and after the intervention. RESULTS Content evaluations by seven dyads of patients and their partners revealed high acceptability ratings for the CBMB intervention (e.g., all participants would recommend the intervention). Consent and adherence rates (54% and 67%, respectively) were acceptable in the single-arm trial. All patients (n = 7 dyads; 67% male; mean age, 55 years) and partners (33% male; mean age, 59 years) rated the intervention as useful. Paired t-test analyses revealed large effect sizes for reduced sleep disturbances (d = 1.83) and medium effect sizes for cancer-specific distress (d = 0.61) for patients and large effect sizes for depressive symptoms (d = 0.90) for partners. CONCLUSION Based on these results, the CBMB intervention appears to be acceptable and subjectively useful. In addition, we observed preliminary evidence of quality of life gains in both patients and their partners.
Collapse
Affiliation(s)
- Kathrin Milbury
- Department of Palliative, Rehabilitative & Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
| | - Rosalinda Engle
- Department of Palliative, Rehabilitative & Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Anne Tsao
- Department of Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Zhongxing Liao
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - April Owens
- Department of Palliative, Rehabilitative & Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Alejandro Chaoul
- Department of Palliative, Rehabilitative & Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Eduardo Bruera
- Department of Palliative, Rehabilitative & Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Lorenzo Cohen
- Department of Palliative, Rehabilitative & Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| |
Collapse
|
31
|
A research protocol for a pilot randomized controlled trial designed to examine the feasibility of a couple-based mind-body intervention for patients with metastatic lung cancer and their partners. Pilot Feasibility Stud 2018; 4:37. [PMID: 29416870 PMCID: PMC5784695 DOI: 10.1186/s40814-018-0231-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 01/10/2018] [Indexed: 11/10/2022] Open
Abstract
Background Given the generally incurable nature of metastatic non-small cell lung cancer (mNSCLC), patients and their romantic partners are at risk for existential/spiritual distress. Although a handful of dyadic psychosocial interventions for lung cancer patients and their caregivers exist, none of them target spiritual well-being. Informed by the mindfulness-based intervention literature and our pilot work in couples affected by lung cancer, we developed a brief couple-based mind-body (CBMB) intervention. The primary aim of this research protocol is to determine the feasibility of implementing the CBMB intervention versus an active control (AC) or wait list control (WLC) group in patients with mNSCLC and their partners using a randomized controlled trial design. Methods Seventy-five patients with mNSCLC receiving treatment and their partners are randomized to the CBMB intervention, an AC or a WLC group. Those in the CBMB intervention and AC groups receive four intervention sessions of 60 min each over 4 weeks and complete weekly homework assignments. The first session is delivered in person, and the remaining sessions are delivered via videoconference. The dyads in the AC group discuss cancer-related and personal growth concerns with the interventionist but are not taught coping skills. Patients and partners in all groups complete baseline assessments of quality of life (QOL) prior to randomization. Follow-up assessments are performed 4 weeks and then again 3 months later. The primary outcome is feasibility (i.e., ≥ 30% of eligible couples consent, ≥ 70% of enrolled couples are retained, and ≥ 50% of all CBMB and AC sessions are attended). We will also perform primarily descriptive analyses of the self-reported outcomes (e.g., spiritual well-being and psychological distress) and explore potential intervention mediators (i.e., compassion, communication, mindfulness, and closeness) to inform a larger, future trial. Discussion This trial will provide important information regarding the feasibility of a behavioral intervention in a vulnerable yet understudied population using videoconferencing and descriptive data regarding spiritual well-being and other indices of QOL in both mNSCLC patients and their partners. Trial registration ClinicalTrials.gov NCT02596490
Collapse
|
32
|
Abstract
Diagnosis and treatment of malignant diseases affect in many ways the lives of patients, relatives and friends. Common reactions immediately after the diagnosis are shock and denial, frequently followed by depression, anxiety and/or anger. About a third of all cancer patients suffer from a co-morbid mental health condition, requiring professional support by the entire medical team, including psycho-oncologists. Often overlooked issues are financial and social problems due to inability to work or due to out-of-pocket costs for the medical treatment.
Collapse
Affiliation(s)
- Susanne Singer
- Division of Epidemiology and Health Services Research, Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre Mainz, Obere Zahlbacher Straße 69, 55131, Mainz, Germany.
| |
Collapse
|
33
|
Abstract
A person living with cancer will potentially have some degree of physical, cognitive, and/or psychological impairment, periods of unemployment, financial concerns, social isolation, and existential questions, any or all of which can impact the family and friends who surround them. In our current era of health care, patients with cancer receive invasive diagnostic studies and aggressive treatment as outpatients, and then convalesce at home. As such, cancer family caregivers are de facto partners with the healthcare team. The cancer family caregiver role is demanding and may lead to increased morbidity and mortality-in effect, the cancer family caregiver can become a second patient in need of care. This chapter discusses the consequences cancer family caregivers may accrue. The topics covered include caregiver mood disturbance and psychological impairment and some of the mutable factors that contribute to these states (i.e., sleep disturbance, decline in physical health, restriction of activities, and financial concerns), uncertainty, spiritual concerns, and caregiver witnessing. There is a discussion of the factors that influence the caregiving experience (caregiver characteristics, patient characteristics, and social supports). The chapter concludes with comments on intervention studies that have been conducted to ameliorate the burden of caregiving, and the state of caregiver research.
Collapse
Affiliation(s)
- Anna-Leila Williams
- Frank H. Netter MD School of Medicine, Quinnipiac University, Hamden, CT, USA.
| |
Collapse
|
34
|
Hassankhani H, Soheili A, Hosseinpour I, Eivazi Ziaei J, Nahamin M. A Comparative Study on the Meaning in Life of Patients with Cancer and Their Family Members. J Caring Sci 2017; 6:325-333. [PMID: 29302572 PMCID: PMC5747591 DOI: 10.15171/jcs.2017.031] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 07/17/2017] [Indexed: 11/30/2022] Open
Abstract
Introduction: The overwhelming effects of cancer could be catastrophic for the
patients and their family members, putting them at risk of experiencing uncertainty,
loss, and an interruption in life. Also, it can influence their sense of meaning, a
fundamental need equated with the purpose in life. Accordingly, this study aimed to
compare the meaning in life (MiL) of patients with cancer and their family members.
Methods: This descriptive comparative study was conducted on 400 patients with
cancer and their family members admitted to university hospitals in Tabriz and Ardebil
provinces, Iran. The participants were sampled conveniently and the Life Evaluation
Questionnaire (LEQ) were used for collecting data analyzed through descriptive and
inferential statistics in SPSS ver. 13 Software.
Results: The mean score for the MiL of the patients with cancer and their family
members was 119 (16.92) and 146.2 (17.07), respectively. There was a significant
difference between patients with cancer and their family members in terms of MiL.
Conclusion: The MiL of patients with cancer is lower than that of their family
members, which indicates the need for further attention to the psychological processes
and their modification in Iranian healthcare systems
Collapse
Affiliation(s)
- Hadi Hassankhani
- Department of Medical Surgical Nursing, Center of Qualitative Studies, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amin Soheili
- Department of Medical Surgical Nursing, Student Research Committee, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Issa Hosseinpour
- Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Jamal Eivazi Ziaei
- Hematology & Oncology Research Center, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mina Nahamin
- Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|
35
|
Caruso R, Nanni MG, Riba MB, Sabato S, Grassi L. The burden of psychosocial morbidity related to cancer: patient and family issues. Int Rev Psychiatry 2017; 29:389-402. [PMID: 28753076 DOI: 10.1080/09540261.2017.1288090] [Citation(s) in RCA: 116] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
With cancer incidence increasing over time, attention to the burden of related psychiatric and psychosocial consequences of the disease and treatment is a major topic for both cancer patients and their caregivers. Among cancer patients, psychiatric (e.g. adjustment, anxiety, depressive disorders) and neuropsychiatric disorders (e.g. cognitive disorders secondary to treatment, delirium) have been shown to affect an average of 30-35% patients, with differences according to stage and type of cancer. Also other psychosocial syndromes (e.g. demoralization, health anxiety, irritable mood) not taken into account in usual nosological systems should be considered for their impact on the patient's quality-of-life. Also, it has been repeatedly reported that psychological distress reverberates substantially throughout the nuclear family, and that a family approach is necessary in cancer care, with the caregiver-patient dyad as a unit to be the focus and direction of assessment and intervention. In this review the most significant psychosocial disorders causing burden for cancer patients and their caregivers are examined, and the main methods of assessment for more proper referral and treatment are summarized.
Collapse
Affiliation(s)
- Rosangela Caruso
- a Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences , University of Ferrara , Ferrara , Italy.,b University Hospital Psychiatric Unit , Program of Psycho-Oncology and Psychiatry in Palliative Care, Integrated Department of Mental Health and Addictive Behavior , S. Anna University Hospital and Health Authority , Ferrara , Italy
| | - Mara Giulia Nanni
- a Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences , University of Ferrara , Ferrara , Italy.,b University Hospital Psychiatric Unit , Program of Psycho-Oncology and Psychiatry in Palliative Care, Integrated Department of Mental Health and Addictive Behavior , S. Anna University Hospital and Health Authority , Ferrara , Italy
| | - Michelle B Riba
- c Department of Psychiatry , University of Michigan , Ann Arbor , MI , USA.,d University of Michigan Comprehensive Cancer Center , Ann Arbor , MI , USA.,e Psycho-oncology Program , University of Michigan Comprehensive Cancer Center , Ann Arbor , MI , USA
| | - Silvana Sabato
- a Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences , University of Ferrara , Ferrara , Italy
| | - Luigi Grassi
- a Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences , University of Ferrara , Ferrara , Italy.,b University Hospital Psychiatric Unit , Program of Psycho-Oncology and Psychiatry in Palliative Care, Integrated Department of Mental Health and Addictive Behavior , S. Anna University Hospital and Health Authority , Ferrara , Italy
| |
Collapse
|
36
|
Benefit Finding and Quality of Life in Caregivers of Childhood Cancer Survivors: The Moderating Roles of Demographic and Psychosocial Factors. Cancer Nurs 2017; 40:E28-E37. [PMID: 27472189 DOI: 10.1097/ncc.0000000000000419] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Benefit finding, or finding positive outcomes in the face of adversity, may play a role in predicting quality of life (QoL) among caregivers, but mixed results suggest that other factors may moderate this relationship. OBJECTIVE This study examined demographic and psychosocial moderators of the association between benefit finding and QoL among caregivers of childhood cancer survivors. METHODS Caregivers of childhood cancer survivors (n = 83) completed measures of benefit finding, QoL, coping, optimism, social support, caregiving demand, posttraumatic stress, and demographics. RESULTS The relationship between benefit finding and QoL was moderated by caregiver age, marital status, socioeconomic status, geographic location, acceptance and emotion-focused coping, optimism, caregiving demand, and posttraumatic stress. Benefit finding was more strongly related to QoL among caregivers with fewer demographic/psychosocial resources. CONCLUSIONS Results suggest that finding benefits in the cancer experience may have a greater positive impact for caregivers with relatively fewer demographic and psychosocial resources and may have less of an impact for caregivers with relatively greater resources. Findings further point to the complex nature of QoL among caregivers of childhood cancer survivors. IMPLICATIONS FOR PRACTICE Results may aid clinicians in identifying caregivers at particular risk for low QoL. They may be counseled to find benefits in their experience or provided with resources to strengthen other factors that impact QoL.
Collapse
|
37
|
Rand S, Forder J, Malley J. A study of dyadic interdependence of control, social participation and occupation of adults who use long-term care services and their carers. Qual Life Res 2017; 26:3307-3321. [PMID: 28786019 PMCID: PMC5681980 DOI: 10.1007/s11136-017-1669-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2017] [Indexed: 10/25/2022]
Abstract
PURPOSE Unpaid care is an important source of support of people with long-term conditions. Interdependence of carers' and care recipients' quality of life would be expected due to the relational nature of caregiving. This study aims to explore interdependence of quality of life in carer/care-recipient dyads, especially in relation to mutual interdependence due to social feedback in the caregiving relationship and also the partner effects of one partner's experience of long-term care support on the other's outcomes. METHODS Using data collected in an interview survey of 264 adults with care support needs and their unpaid carers in England, we employed regression analysis to explore whether there is mutual interdependence of care-related quality of life within carer/care-recipient dyads for three quality of life attributes: Control over daily life, Social participation and Occupation. The influence of factors, including satisfaction with long-term care, were also considered on individuals' and dyad partners' care-related quality of life. RESULTS We found mutual interdependence of quality of life at the dyad-level for Control over daily life, but not Occupation or Social participation. A partner effect of care recipients' satisfaction with long-term care on carers' Control over daily life was also observed. Higher care recipient satisfaction with care services was associated with higher Control over daily life. By contrast, for Social participation and Occupation, there were only significant effects of care recipients' satisfaction with long-term care and their own quality of life. CONCLUSIONS These findings highlight the importance of considering the wider impact beyond the individual of long-term care on quality of life in the evaluation of long-term care policy and practice.
Collapse
Affiliation(s)
- Stacey Rand
- Personal Social Services Research Unit (PSSRU), University of Kent, Cornwallis Building, Canterbury, CT2 7NF, UK.
| | - Julien Forder
- Personal Social Services Research Unit (PSSRU), University of Kent, Cornwallis Building, Canterbury, CT2 7NF, UK
| | - Juliette Malley
- Personal Social Services Research Unit (PSSRU), London School of Economics and Political Science, Cowdray House, Houghton Street, London, WC2A 2AE, UK
| |
Collapse
|
38
|
Mosher CE, Secinti E, Johns SA, O'Neil BH, Helft PR, Shahda S, Jalal SI, Champion VL. Examining the effect of peer helping in a coping skills intervention: a randomized controlled trial for advanced gastrointestinal cancer patients and their family caregivers. Qual Life Res 2017; 27:515-528. [PMID: 28601957 DOI: 10.1007/s11136-017-1620-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE At the end of life, spiritual well-being is a central aspect of quality of life for many patients and their family caregivers. A prevalent spiritual value in advanced cancer patients is the need to actively give. To address this need, the current randomized trial examined whether adding a peer helping component to a coping skills intervention leads to improved meaning in life and peace for advanced gastrointestinal cancer patients and their caregivers. Feasibility and acceptability outcomes were also assessed. METHODS Advanced gastrointestinal cancer patients and caregivers (n = 50 dyads) were randomly assigned to a 5-session, telephone-based coping skills intervention or a peer helping + coping skills intervention. One or both dyad members had moderate-severe distress. Peer helping involved contributing to handouts on coping skills for other families coping with cancer. Patients and caregivers completed measures of meaning in life/peace, fatigue, psychological symptoms, coping self-efficacy, and emotional support. Patient pain and caregiver burden were also assessed. RESULTS Small effects in favor of the coping skills group were found regarding meaning in life/peace at 1 and 5 weeks post-intervention. Other outcomes did not vary as a function of group assignment, with both groups showing small decreases in patient and caregiver fatigue and caregiver distress and burden. High recruitment and retention rates supported feasibility, and high participant satisfaction ratings supported acceptability. CONCLUSIONS Although a telephone-based intervention is feasible and acceptable for this population, peer helping in the context of a coping skills intervention does not enhance spiritual well-being relative to coping skills alone.
Collapse
Affiliation(s)
- Catherine E Mosher
- Department of Psychology, Indiana University-Purdue University Indianapolis, 402 North Blackford Street, LD 124, Indianapolis, IN, 46202, USA.
| | - Ekin Secinti
- Department of Psychology, Indiana University-Purdue University Indianapolis, 402 North Blackford Street, LD 124, Indianapolis, IN, 46202, USA
| | - Shelley A Johns
- Center for Health Services Research, Regenstrief Institute, Indiana University School of Medicine, 1101 W. 10th Street, RF-226, Indianapolis, IN, 46202, USA
| | - Bert H O'Neil
- Department of Medicine, Indiana University School of Medicine, Indiana Cancer Pavilion, 535 Barnhill Drive, Room 473, Indianapolis, IN, 46202, USA
| | - Paul R Helft
- Department of Medicine, Indiana University School of Medicine, Indiana Cancer Pavilion, 535 Barnhill Drive, Room 473, Indianapolis, IN, 46202, USA
| | - Safi Shahda
- Department of Medicine, Indiana University School of Medicine, Indiana Cancer Pavilion, 535 Barnhill Drive, Room 473, Indianapolis, IN, 46202, USA
| | - Shadia I Jalal
- Department of Medicine, Indiana University School of Medicine, Indiana Cancer Pavilion, 535 Barnhill Drive, Room 473, Indianapolis, IN, 46202, USA
| | - Victoria L Champion
- Indiana University School of Nursing, 1111 Middle Drive, NU 340G, Indianapolis, IN, 46202, USA
| |
Collapse
|
39
|
|
40
|
Lee M, Kim K, Lim C, Kim JS. Posttraumatic growth in breast cancer survivors and their husbands based on the actor-partner interdependence model. Psychooncology 2017; 26:1586-1592. [PMID: 27943475 DOI: 10.1002/pon.4343] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 10/19/2016] [Accepted: 12/05/2016] [Indexed: 11/07/2022]
Abstract
OBJECTIVE This study aimed to verify actor and partner effects, by examining the effects of self-esteem, relationship quality, and subjective distress on posttraumatic growth in breast cancer survivors and their spouses, and involved a structural analysis of descriptive cause-and-effect relationships to verify the suitability of the actor-partner interdependence model. METHODS A structured questionnaire was used to collect data from breast cancer survivors and their spouses at outpatient centers, wards, and patient meetings in 4 general hospitals in Seoul between April 13 and September 20, 2015. Data for 336 individuals (168 couples) were analyzed. The suitability of the hypothetical model was assessed via SPSS Win 21.0 and AMOS 21.0. Actor and partner effects on posttraumatic growth in breast cancer survivors and their spouses were examined. RESULTS Self-esteem, relationship quality, and subjective distress exerted significant actor effects, and subjective distress exerted a significant partner effect on posttraumatic growth in breast cancer survivors. Relationship quality and support exerted significant actor effects, and self-esteem, relationship quality, and subjective distress exerted significant partner effects on posttraumatic growth in spouses. CONCLUSIONS Posttraumatic growth in breast cancer survivors was influenced by not only relationship quality and spouses' self- esteem but also subjective distress; therefore, solidarity between breast cancer survivors and their spouses was important and should be maintained to provide healthy relationship support and enhance posttraumatic growth. Further, health care providers should include spouses in health-related education and involve them in interventions and family support programs for couples.
Collapse
Affiliation(s)
- MyoSuk Lee
- Department of Nursing, Kyung-Bok University, Gyeonggi-do, Republic of Korea
| | - Kyunghee Kim
- Department of Nursing, Chung-Ang University, Seoul, Republic of Korea
| | - Changwon Lim
- Department of Applied Statistics, Chung-Ang University, Seoul, Republic of Korea
| | - Ji-Su Kim
- Department of Nursing, Chung-Ang University, Seoul, Republic of Korea
| |
Collapse
|
41
|
Abbasnezhad M, Rahmani A, Ghahramanian A, Roshangar F, Eivazi J, Azadi A, Berahmany G. Cancer Care Burden among Primary Family Caregivers of Iranian Hematologic Cancer Patients. Asian Pac J Cancer Prev 2016. [PMID: 26225701 DOI: 10.7314/apjcp.2015.16.13.5499] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Providing care for hematologic cancer patients may lead to many negative complications in different aspects of life in their family caregivers. Based on a wide review of relevant literature, there are limited data about the burden of giving care for hematologic cancer patients on their primary family caregivers in Iran or other Middle Eastern countries. Therefore, the aim of this study was to investigate the cancer care burden on primary family caregivers of hematologic cancer patients, in terms of physical, psychological, social, spiritual, and financial aspects. MATERIALS AND METHODS In this descriptive study, 151 primary family caregivers of hematologic cancer patients referred to two cancer care centers in East Azerbaijan Province in northwest of Iran participated. The Financial Distress/Financial Well-being Scale, Hospital Anxiety and Depression Scale, Vaux Social Support Questionnaire, Spiritual Well-being Scale, and SF-36 were used for data collection. Data analysis was performed with SPSS software. RESULTS The findings of this study indicated that the primary family caregivers experience a high level of financial distress and a significant percentage of them suffered from anxiety and depression. In addition, the physical quality of life in these caregivers was moderate. On the other hand, spiritual health and social support of participants was at an acceptable level. CONCLUSIONS Iranian primary family caregivers of hematologic cancer patients experience many problems in physical, psychological, and financial aspects of their life. Therefore, developing care plans for reducing these problems appears necessary.
Collapse
Affiliation(s)
- Masoomeh Abbasnezhad
- Medical and Surgical Department, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran E-mail :
| | | | | | | | | | | | | |
Collapse
|
42
|
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.
Collapse
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.
| |
Collapse
|
43
|
Kim Y, Carver CS, Cannady RS. Caregiving Motivation Predicts Long-Term Spirituality and Quality of Life of the Caregivers. Ann Behav Med 2016; 49:500-9. [PMID: 25637107 DOI: 10.1007/s12160-014-9674-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Studies have shown that caregivers report impaired quality of life (QOL). This study investigated how caregiving motives predict long-term spirituality and QOL among cancer caregivers and the role of gender in these associations. METHOD Caregiving motives of family members (n = 369) were measured 2 years after their relative's cancer diagnosis (T1), and both spirituality and QOL (mental and physical health) were measured at 5 years postdiagnosis (T2). RESULTS Structural equation modeling was used to test spirituality dimensions as potential mediators of links from caregiving motives to QOL. Among male caregivers, autonomous caregiving motives at T1 related to better mental health at T2, apparently because these motives led caregivers to find greater peace and meaning in life at T2. CONCLUSIONS Findings suggest that caregivers may benefit from interventions that facilitate their ability to be autonomously motivated and find contentment in their caregiving experience, which may improve spiritual adjustment and QOL years later.
Collapse
Affiliation(s)
- Youngmee Kim
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd Coral Gables, Miami, FL, USA,
| | | | | |
Collapse
|
44
|
Avvenuti G, Baiardini I, Giardini A. Optimism's Explicative Role for Chronic Diseases. Front Psychol 2016; 7:295. [PMID: 26973582 PMCID: PMC4773598 DOI: 10.3389/fpsyg.2016.00295] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 02/16/2016] [Indexed: 11/13/2022] Open
Abstract
The increasing interest about dispositional optimism's role in health status and its positive modulating effect on health outcomes has led to a remarkable scientific production in the last decade. To date lot is known for which diseases optimism is relevant, instead much less is known about how optimism interacts with other factors, both biological and psychological, in determining health status. The aim of this mini review is to explore the literature derived from clinical and experimental research assessing the associations between dispositional optimism and health status. Dispositional optimism can be considered as facet of personality that is cognitive in nature which holds the global expectation that the future will be plenty of good events. Optimists view desired goals as obtainable, so they often confront adversities in active manners resulting in perseverance and increased goal attainment. Only studies that explicitly included optimism and health outcomes, as measurable variables, and that reported a clear association between them have been reviewed. Cancer, cardiovascular disease, respiratory failure, and aging with multimorbidity were considered. Among the possible explicative hypotheses, two seem to best describe results: optimism may have a direct effect on the neuroendocrine system and on immune responses, and it may have an indirect effect on health outcomes by promoting protective health behaviors, adaptive coping strategies and enhancing positive mood. The research on optimism and health status has already shed light on important mechanisms regarding chronic diseases' management, however, further studies are needed to deepen the knowledge.
Collapse
Affiliation(s)
- Giulia Avvenuti
- Psychology Unit, Scientific Institute of Montescano, Salvatore Maugeri Foundation, Istituto di Ricovero e Cura a Carattere Scientifico Montescano, Italy
| | - Ilaria Baiardini
- Allergy and Respiratory Diseases Clinic, Department of Internal Medicine, University of Genoa - IRCCS AOU San Martino-IST Genova, Italy
| | - Anna Giardini
- Psychology Unit, Scientific Institute of Montescano, Salvatore Maugeri Foundation, Istituto di Ricovero e Cura a Carattere Scientifico Montescano, Italy
| |
Collapse
|
45
|
Shaffer KM, Kim Y, Llabre MM, Carver CS. Dyadic associations between cancer-related stress and fruit and vegetable consumption among colorectal cancer patients and their family caregivers. J Behav Med 2016; 39:75-84. [PMID: 26245160 PMCID: PMC4724258 DOI: 10.1007/s10865-015-9665-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 07/30/2015] [Indexed: 10/23/2022]
Abstract
This study examined how stress from cancer affects fruit and vegetable consumption (FVC) in cancer patients and their family caregivers during the year following diagnosis. Colorectal cancer patients and their caregivers (92 dyads) completed questionnaires at two (T1), six (T2), and 12 months post-diagnosis (T3). Individuals reported perceived cancer-related stress (CRS) at T1 and days of adequate FVC at T1 through T3. Both patients and caregivers reported inadequate FVC during the first year post-diagnosis. Latent growth modeling with actor-partner interdependence modeling revealed that, at T1, one's own greater CRS was associated with one's partner having fewer concurrent days of adequate FVC (ps = .01). Patients' greater CRS predicted their own more pronounced rebound pattern in FVC (p = .01); both patients' and caregivers' CRS marginally predicted their partners' change in FVC (p = .09). Findings suggest that perceived stress from cancer hinders FVC around the diagnosis, but motivates positive dietary changes by the end of the first year.
Collapse
Affiliation(s)
- Kelly M Shaffer
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Coral Gables, FL, 33146, USA.
- Department of Psychiatry, Massachusetts General Hospital, Behavioral Medicine, Boston, MA, USA.
| | - Youngmee Kim
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Coral Gables, FL, 33146, USA
- Center for Advanced Study in the Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Maria M Llabre
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Coral Gables, FL, 33146, USA
| | - Charles S Carver
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Coral Gables, FL, 33146, USA
- Center for Advanced Study in the Behavioral Sciences, Stanford University, Stanford, CA, USA
| |
Collapse
|
46
|
Garland SN, Stainken C, Ahluwalia K, Vapiwala N, Mao JJ. Cancer-related search for meaning increases willingness to participate in mindfulness-based stress reduction. Integr Cancer Ther 2016; 14:231-9. [PMID: 25870034 DOI: 10.1177/1534735415580682] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE A cancer diagnosis can prompt an examination and reevaluation of life's meaning, purpose, and priorities. There is evidence that mindfulness-based stress reduction (MBSR) may help facilitate the meaning-making process. This study examined the influence of meaning in life on willingness to participate (WTP) in MBSR and identified factors associated with the search for and/or presence of meaning. METHODS A cross-sectional survey study of 300 patients undergoing radiation therapy was conducted. WTP in MBSR was dichotomized into yes/no by asking, "Would you participate in an MBSR program if it was offered at the cancer center?" The search for, and the presence of, meaning were assessed using the Meaning in Life Questionnaire. RESULTS Eighty patients (27%) indicated WTP in MBSR. In a multivariate logistic regression model, search for meaning was the only significant predictor of WTP in MBSR (adjusted odds ratio [AOR] =1.04, P ≤ .001, 95% CI = 1.01-1.08). Identifying as non-white (adjusted β = 4.62; 95% CI = 2.22-7.02; P < .001), and reporting subclinical (adjusted β = 3.59; 95% CI = 0.84-6.34; P = .01) or clinical levels (adjusted β = 5.52; 95% CI = 2.41-8.63; P = .001) of anxiety were the strongest predictors of search for meaning. CONCLUSION Our study indicates that patients searching for meaning are receptive to MBSR. Nonwhite patients and those experiencing high levels of anxiety are most likely to endorse a search for meaning. Future research is needed to understand how best to support patients who are searching for meaning and remove barriers to evidence-based programs like MBSR.
Collapse
Affiliation(s)
| | | | | | | | - Jun J Mao
- University of Pennsylvania, Philadelphia, PA, USA
| |
Collapse
|
47
|
Hou WK, Lau KM, Ng SM, Lee TMC, Cheung HYS, Shum TCY, Cheng ACK. Psychological detachment and savoring in adaptation to cancer caregiving. Psychooncology 2015; 25:839-47. [PMID: 26514926 DOI: 10.1002/pon.4019] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 08/11/2015] [Accepted: 09/29/2015] [Indexed: 11/08/2022]
Abstract
BACKGROUND Recovery experience including psychological detachment from caregiving and savoring positive moments in life could be complementary coping processes for cancer caregivers. This study aims to examine the nature of their associations with caregiving burden and anxiety and depressive symptoms among Chinese cancer caregivers in Hong Kong. METHODS A total of 155 Chinese caregivers of recently diagnosed cancer patients (mean time since diagnosis = 42.57 days, SD = 39.25) were recruited from two major government-funded hospitals and administered a questionnaire assessing psychological detachment, savoring, caregiving burden, anxiety and depressive symptoms, and demographics. RESULTS Controlling for demographic and medical covariates, structural equation modeling revealed significant associations of detachment, savoring, and their interaction term with caregiving burden and anxiety and depressive symptoms. Detachment and savoring were inversely associated with caregiving burden only when the other was at lower/medium levels. Detachment was inversely associated with anxiety and depressive symptoms at lower/medium levels of savoring, but savoring was inversely associated with anxiety and depressive symptoms across all levels of detachment. CONCLUSIONS Detachment and savoring could overshadow the positive impact of the other on caregiving burden if either one is at higher levels, while they could demonstrate concurrent positive impact on burden when both are at lower/medium levels. Savoring could have a prioritized role in ameliorating caregivers' anxiety and depressive symptoms, supplemented by detachment. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.
Collapse
Affiliation(s)
- Wai Kai Hou
- Department of Psychological Studies, The Hong Kong Institute of Education, Hong Kong.,Laboratory of Psychobiology of Emotion and Stress (LoPES), The Hong Kong Institute of Education, Hong Kong.,Centre for Psychosocial Health, The Hong Kong Institute of Education, Hong Kong
| | - Kam Man Lau
- Department of Psychological Studies, The Hong Kong Institute of Education, Hong Kong.,Laboratory of Psychobiology of Emotion and Stress (LoPES), The Hong Kong Institute of Education, Hong Kong
| | - Sin Man Ng
- Department of Psychological Studies, The Hong Kong Institute of Education, Hong Kong.,Laboratory of Psychobiology of Emotion and Stress (LoPES), The Hong Kong Institute of Education, Hong Kong
| | - Tatia Mei Chun Lee
- Department of Psychology, The University of Hong Kong, Hong Kong.,Laboratory of Neuropsychology, The University of Hong Kong, Hong Kong
| | | | | | | |
Collapse
|
48
|
Sun V, Kim JY, Irish TL, Borneman T, Sidhu RK, Klein L, Ferrell B. Palliative care and spiritual well-being in lung cancer patients and family caregivers. Psychooncology 2015; 25:1448-1455. [PMID: 26374624 DOI: 10.1002/pon.3987] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Revised: 06/29/2015] [Accepted: 08/21/2015] [Indexed: 12/12/2022]
Abstract
BACKGROUND Spiritual well-being is an important dimension of quality of life (QOL) and is a core component of quality oncology and palliative care. In this analysis, we aimed to describe spiritual well-being outcomes in a National Cancer Institute (NCI)-supported Program Project that tested the effectiveness of an interdisciplinary palliative care intervention in lung cancer patients and their family caregivers (FCGs). METHODS Patients undergoing treatments for NSCLC and their FCGs were enrolled in a prospective, quasi-experimental study. Patients and FCGs in the intervention group were presented at interdisciplinary care meetings and received four educational sessions that included one session focused on spiritual well-being. Spiritual well-being for patients was measured using the FACIT-Sp-12, and FCG spiritual well-being was measured using the COH-QOL-FCG spiritual well-being subscale. Multivariate analysis of covariance was undertaken for subscale and item scores at 12 weeks, controlling for baseline, by religious affiliations (yes or no) and group assignment. RESULTS Religiously affiliated patients reported better scores in the Faith subscale and items on finding strength and comfort in faith and spiritual beliefs compared to non-affiliated patients. Non-affiliated patients had better scores for feeling a sense of harmony within oneself. By group, patients who received the intervention had significantly better scores for the Meaning/Peace subscale. CONCLUSIONS Our findings support the multidimensionality of spiritual well-being that includes constructs such as meaning and faith for lung cancer patients and FCGs with or without religious affiliations. Palliative care interventions should include content that targets the spiritual needs of both patients and FCGs. Copyright © 2015 John Wiley & Sons, Ltd.
Collapse
Affiliation(s)
- Virginia Sun
- Division of Nursing Research and Education, Department of Population Sciences, City of Hope, Duarte, CA, USA
| | - Jae Y Kim
- Division of Thoracic Surgery, Department of Surgery, City of Hope, Duarte, CA, USA
| | - Terry L Irish
- Spiritual Care Services, Department of Supportive Care Medicine, City of Hope, Duarte, CA, USA
| | - Tami Borneman
- Division of Nursing Research and Education, Department of Population Sciences, City of Hope, Duarte, CA, USA
| | - Rupinder K Sidhu
- Division of Clinical Social Work, Department of Supportive Care Medicine, City of Hope, Duarte, CA, USA
| | - Linda Klein
- Billers Patient and Family Resource Center, Department of Supportive Care Medicine, City of Hope, Duarte, CA, USA
| | - Betty Ferrell
- Division of Nursing Research and Education, Department of Population Sciences, City of Hope, Duarte, CA, USA
| |
Collapse
|
49
|
Knobf M, Cooley M, Duffy S, Doorenbos A, Eaton L, Given B, Mayer D, McCorkle R, Miaskowski C, Mitchell S, Sherwood P, Bender C, Cataldo J, Hershey D, Katapodi M, Menon U, Schumacher K, Sun V, Ah D, LoBiondo-Wood G, Mallory G. The 2014–2018 Oncology Nursing Society Research Agenda. Oncol Nurs Forum 2015; 42:450-65. [DOI: 10.1188/15.onf.450-465] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
50
|
Westby RP, Berg CJ, Leach C. Gender, race, BMI, and social support in relation to the health-related quality of life of cancer survivors: a report from the American Cancer Society's Study of Cancer Survivors II (SCS-II). Qual Life Res 2015; 25:409-421. [PMID: 26289021 DOI: 10.1007/s11136-015-1084-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2015] [Indexed: 12/13/2022]
Abstract
PURPOSE We examined the main and interactive effects of race, BMI, and social support on physical and mental health-related quality of life (HRQoL) among male and female cancer survivors using the stress and coping theory to inform findings. METHODS HRQoL issues among 1768 cancer survivors were examined using the American Cancer Society's cross-sectional Study of Cancer Survivors II. Two-step multiple linear regressions were conducted to assess the physical and mental HRQoL of male and female cancer survivors, respectively. RESULTS The average age of participants was 67.36 (SD = 11.51); the majority were female (53.3 %; n = 941) and non-Hispanic White (85.9 %; n = 1517). The average BMI measurement for participants was 28.33 (SD = 5.90), with 41.3 % (n = 729) overweight and 30.3 % (n = 535) obese. Higher BMI was significantly associated with lower physical HRQoL across gender, while social support had significant main effects on physical and mental HRQoL across gender. Race moderated the relationship between social support and physical HRQoL among female cancer survivors and between BMI and mental HRQoL for both genders. CONCLUSIONS The results of this study contribute a unique gender- and racial-specific perspective to cancer survivorship research. While the buffering hypothesis of the stress and coping theory was not supported, the main effects of BMI and social support on HRQoL were different across gender and race.
Collapse
Affiliation(s)
- Ruth P Westby
- Department of Behavioral Science and Health Education, Emory University Rollins School of Public Health, Atlanta, GA, USA. .,ICF International, 3 Corporate Square, Suite 370, Atlanta, GA, 30329, USA.
| | - Carla J Berg
- Department of Behavioral Science and Health Education, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Corinne Leach
- Behavioral Research Center (BRC), American Cancer Society, Atlanta, GA, USA
| |
Collapse
|