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Baunacke M, Groeben C, Borkowetz A, Hoffmann F, Chun FKH, Weissbach L, Thomas C, Huber J. Urologist communication is a primary factor leading to erectile dysfunction treatment postprostatectomy. J Sex Med 2024; 21:904-911. [PMID: 39214554 DOI: 10.1093/jsxmed/qdae105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 07/02/2024] [Accepted: 07/30/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Studies have shown insufficient utilization of care for patients with erectile dysfunction (ED) after radical prostatectomy (RP). AIM The aim of this study was to evaluate variables associated with barriers to seeking and receiving ED treatment. METHODS In this multicenter prospective cross-sectional study, the functional outcomes of 936 patients were assessed 10 to 15 years after RP. A total of 525 patients with ED or incontinence were asked about their treatment experiences or lack thereof. The data were analyzed using the chi-square test, t test, and multivariate logistic analyses. OUTCOMES Patients answered validated questionnaires regarding information sources, communication with their partner and urologist, and barriers to ED treatment. RESULTS Of the 525 patients, 80 were not available to survey. A total of 304 patients answered the survey (response: 68.0%). A total of 246 patients had ED and were included in this study. The mean age at surgery was 64.4 ± 6.1 years, and the mean age at the time of this survey was 77.1 ± 6.2 years. The mean follow-up duration was 12.7 ± 1.5 years. Forty-six percent (n = 114 of 246) of the patients had never received ED treatment. The most important conversation partners regarding the ED were the partner (69% [n = 169 of 246]) and the urologist (48% [n = 118 of 246]). Patients who never received ED treatment were less likely to have conversations with their urologist (34% vs 60%; P < .001), had less support (51% vs 68%; P = .01), and had less interest in sex from their partner (20% vs 40%; P = .001). Communication with other groups (general practitioners, other physicians, family, friends, and the Internet) had no influence on ED treatment utilization. The most relevant barrier to receiving ED treatment was the belief that treatment would not help (65%). No interest in sex from their partner (odds ratio, 3.9) and no conversation with their urologist about ED (odds ratio, 2.9) were found to be independent predictors of not receiving ED treatment. CLINICAL IMPLICATIONS Urologists should have enhanced awareness of how to approach patients directly about their ED and actively offer them treatment options. STRENGTHS AND LIMITATIONS These results should be further validated in a multicenter, prospective study. Response bias may have affected the results. Furthermore, the current cohort was relatively old. CONCLUSION This study revealed that no interest in sex from one's partner and insufficient communication with a urologist were relevant barriers to insufficient utilization of ED treatment after RP.
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Affiliation(s)
- Martin Baunacke
- Department of Urology, TU Dresden, Fetscherstrasse 74, 01307 Dresden, Germany
| | - Christer Groeben
- Department of Urology, Philipps-University Marburg, Baldingerstraße, 35043 Marburg, Germany
| | - Angelika Borkowetz
- Department of Urology, TU Dresden, Fetscherstrasse 74, 01307 Dresden, Germany
| | - Falk Hoffmann
- Department of Health Services Research, Carl Von Ossietzky University, Ammerlaender Heerstrasse 140, 26111 Oldenburg, Germany
| | - Felix K H Chun
- Department of Urology, Goethe-University Hospital, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany
| | - Lothar Weissbach
- Health Research for Men gGmbH, Gfm, Claire-Waldoff-Strasse 3, 10117 Berlin, Germany
| | - Christian Thomas
- Department of Urology, TU Dresden, Fetscherstrasse 74, 01307 Dresden, Germany
| | - Johannes Huber
- Department of Urology, Philipps-University Marburg, Baldingerstraße, 35043 Marburg, Germany
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2
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Zhi S, Gu W, Miao R, Zhang L, Jing X, Ramachandran HJ, Wang W. Associations between dyadic communication and dyadic coping of patients with cervical cancer and their spouses: a study utilizing the actor-partner interdependence model. Support Care Cancer 2024; 32:90. [PMID: 38190000 DOI: 10.1007/s00520-023-08304-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 12/31/2023] [Indexed: 01/09/2024]
Abstract
There is a growing focus on exploring dyadic interactions and outcomes between couples undergoing cervical cancer (CC). The purpose of this cross-sectional study was to figure out how dyadic communication influences both CC patients' and spouses' coping abilities. A sample of 286 CC dyads completed questionnaires assessing dyadic communication and dyadic coping. The actor-partner interdependence model was used to analyze the interaction effect between the dyads. Dyadic communication among cervical cancer (CC) patients has a predictive effect on their own negative dyadic coping (β = - 0.141, P = 0.034) and on their spouses' delegated dyadic coping (β = 0.133, P = 0.044). In contrast, dyadic communication among CC spouses is negatively associated with their own supportive dyadic coping (β = - 0.237, P < 0.001), delegated dyadic coping (β = - 0.156, P = 0.018), common dyadic coping (β = - 0.148, P = 0.026) and also with CC patients' supportive dyadic coping (β = - 0.153, P = 0.022). Dyadic communication between CC patients and their spouses affect their own and each other's dyadic coping. Exploring interventions focused on the CC couples' communication strategies to enhance their positive dyadic coping should be considered.
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Affiliation(s)
- Shihan Zhi
- School of Nursing, Health Science Center, Xi'an Jiaotong University, No.76 Yanta West Road, Xi'an, 710061, Shaanxi, China
| | - Wei Gu
- School of Nursing, Health Science Center, Xi'an Jiaotong University, No.76 Yanta West Road, Xi'an, 710061, Shaanxi, China.
| | - Runna Miao
- Shaanxi Provincial People's Hospital, No.256, Youyi West Road, Xi'an, 710068, Shaanxi, China
| | - Lihong Zhang
- School of Nursing, Health Science Center, Xi'an Jiaotong University, No.76 Yanta West Road, Xi'an, 710061, Shaanxi, China
| | - Xiaoyu Jing
- Northwest Women's and Children's Hospital, No.73 Houzaimen, Xi'an, 710003, Shaanxi, China
| | - Hadassah Joann Ramachandran
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Block MD11, Level 2, Clinical Research Centre, 10 Medical Drive, Singapore, 117597, Singapore.
| | - Wenru Wang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Block MD11, Level 2, Clinical Research Centre, 10 Medical Drive, Singapore, 117597, Singapore
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Kastrinos A, Bylund C, Bacharz K, Applebaum A, Fisher CL. Understanding the role of parents' information sharing and withholding on emerging and young adults' caregiving and coping during their parents' advanced cancer. J Psychosoc Oncol 2023; 42:412-426. [PMID: 37929571 PMCID: PMC11070447 DOI: 10.1080/07347332.2023.2276940] [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] [Indexed: 11/07/2023]
Abstract
Emerging and young adult caregivers (EYACs) who provide care to their parents are a hidden, unsupported population of caregivers. Research identifies information sharing or withholding as a key aspect of caregivers' ability to cope and adjust, which may be especially critical when a parent is diagnosed with advanced cancer. The goal of this study was to examine the impact of parent information sharing/withholding on EYACs' caregiving and coping experiences. We conducted in-depth, semi-structured interviews with 33 EYACs between the ages of 18-35 who cared for a parent that died of advanced cancer. Interview transcripts were thematically analyzed. Three factors played a role in how parents' information sharing/withholding affected EYACs' caregiving/coping: 1) topic, 2) timing, and 3) who is included. Findings highlight the adaptive functioning of parents' information sharing and negative outcomes associated with information withholding, illustrating how parents' disclosure decisions function to promote or inhibit EYACs' care involvement and coping.
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Affiliation(s)
- Amanda Kastrinos
- Memorial Sloan Kettering Cancer Center, Department of Psychiatry and Behavioral Sciences, New York, NY
| | - Carma Bylund
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, FL
| | - Kelsey Bacharz
- Department of Clinical & Health Psychology, University of Florida, Gainesville, FL
| | - Allison Applebaum
- Memorial Sloan Kettering Cancer Center, Department of Psychiatry and Behavioral Sciences, New York, NY
| | - Carla L. Fisher
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, FL
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4
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Rothausen CS, Clausen AM, Voltelen B, Dieperink KB. Protective Buffering: Nurses Facilitating Communication Between Adults With Cancer and Their Adult Family Caregivers Who Overprotect One Another-An Integrative Review. JOURNAL OF FAMILY NURSING 2023; 29:417-436. [PMID: 36866540 DOI: 10.1177/10748407231156454] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
The aim of this study was to explore how nurses can alleviate protective buffering between adult patients with cancer and their adult family caregivers (PROSPERO No. CRD42020207072). An integrative review was conducted. PubMed, CINAHL, Embase, and Cochrane Library were searched for primary research articles published between January 2010 and April 2022. Only research conducted in oncology, hematology, or multiple settings and investigating communication between adult patients with cancer and their adult family caregivers and/or the communication between patients, family caregivers, and nurses was included. The constant comparison method outlined the approach to the analysis and synthesis of the included studies. Titles and abstracts of 7,073 references were screened; 22 articles (19 qualitative and three quantitative studies) were included in the review. Three themes emerged during data analysis: (a) family coping, (b) an isolating journey, and (c) the nurse's role. A study limitation was that "protective buffering" is not a common term in the nursing literature. There is a need for further research on protective buffering in families with cancer, particularly on psychosocial interventions that focus on the whole family across various cancer types.
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Affiliation(s)
- Camilla S Rothausen
- University of Southern Denmark, Odense, Denmark
- Odense University Hospital, Denmark
| | - Anne M Clausen
- University of Southern Denmark, Odense, Denmark
- Odense University Hospital, Denmark
| | - Barbara Voltelen
- University of Southern Denmark, Odense, Denmark
- University College Lillebælt, Vejle, Denmark
| | - Karin B Dieperink
- University of Southern Denmark, Odense, Denmark
- Odense University Hospital, Denmark
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5
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Wright KB, Bylund CL, Vasquez TS, Mullis MD, Sae-Hau M, Weiss ES, Bagautdinova D, Fisher CL. Adult-Child Caregivers' Family Communication Experiences after an Older Parent's Blood Cancer Diagnosis: A Survey Exploring Their Openness, Avoidance, and Social Support. Cancers (Basel) 2023; 15:3177. [PMID: 37370787 DOI: 10.3390/cancers15123177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 06/06/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
Adult-child caregivers of an aging parent living with a blood cancer describe struggling to communicate with one another and within the family system. They may avoid critical care conversations, which may impede care and their ability to receive social support. We examined what approaches adult-child caregivers of a parent diagnosed with a blood cancer use to enhance their family communication, the topics they find most challenging to discuss, and the roles of openness and support. We used qualitative and quantitative approaches to analyze data from a larger online survey study. In partnership with the Leukemia & Lymphoma Society, we recruited 121 adult-child caregivers. Responses to one open-ended item were analyzed to capture strategies used to enhance communication with their parent and family. They reported utilizing digital communication modalities, prioritizing frequent communication, engaging in openness, establishing boundaries, kinkeeping, and enacting support. Within the quantitative data, we further explored two of these themes (openness and support) and their relationships to other variables using t-tests and regression analysis. Adult-child caregivers and diagnosed parents avoid talking about mortality and negative feelings. Openness in the family about cancer was linked to caregivers' perceptions of receiving social support. Findings demonstrate that cultivating openness between midlife adult children and diagnosed parents may enhance opportunities to receive support.
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Affiliation(s)
- Kevin B Wright
- Department of Communication, College of Humanities and Social Sciences, George Mason University, Fairfax, VA 22030, USA
| | - Carma L Bylund
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32611, USA
| | - Taylor S Vasquez
- Department of Advertising, College of Journalism and Communications, University of Florida, Gainesville, FL 32611, USA
| | - M Devyn Mullis
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32611, USA
| | - Maria Sae-Hau
- The Leukemia & Lymphoma Society, Rye Brook, NY 10573, USA
| | - Elisa S Weiss
- The Leukemia & Lymphoma Society, Rye Brook, NY 10573, USA
| | - Diliara Bagautdinova
- Department of Advertising, College of Journalism and Communications, University of Florida, Gainesville, FL 32611, USA
| | - Carla L Fisher
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32611, USA
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6
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Kastrinos A, Bacharz K, Mroz EL, Fisher CL, Applebaum AJ. A Mixed-Method Examination of Emerging and Young Adult Cancer Caregivers' Experiences during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5537. [PMID: 37107819 PMCID: PMC10138842 DOI: 10.3390/ijerph20085537] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/27/2023] [Accepted: 04/11/2023] [Indexed: 05/11/2023]
Abstract
Advanced cancer caregivers in emerging and young adulthood (EYACs; ages 18-35) are an understudied yet vulnerable caregiving population. The COVID-19 pandemic created new challenges for advanced cancer caregivers but also created unique contexts from which caregivers sometimes benefited. To understand how the pandemic may have positively and negatively impacted their caregiving and bereavement experiences, we examined EYACs' experiences of caring for and losing a parent with advanced cancer during the pandemic in comparison to those of EYACs with a parent who died outside the context of the pandemic. Eligible EYACs completed an online survey and semi-structured interview. Quantitative analyses compared responses for pre-pandemic EYACS (n = 14) and pandemic EYACs (n = 26). A thematic analysis of the interview transcripts of pandemic EYACS (n = 14) was conducted. Pandemic EYACs experienced non-significant but higher communal coping, benefit finding, negative emotional experiences, and caregiver strain than pre-pandemic EYACs. Thematic analysis revealed that the pandemic negatively affected EYACs' caregiving efficacy, personal well-being, interpersonal dynamics, and bereavement; shifts to remote work and schooling were reported as benefits. The findings can inform the design of resources to support EYACs whose parents died during the pandemic and who are navigating the healthcare system today.
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Affiliation(s)
- Amanda Kastrinos
- Memorial Sloan Kettering Cancer Center, Department of Psychiatry and Behavioral Sciences, New York, NY 10065, USA
| | - Kelsey Bacharz
- Department of Clinical & Health Psychology, University of Florida, Gainesville, FL 32601, USA
| | - Emily L. Mroz
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT 06520, USA
| | - Carla L. Fisher
- University of Florida Health Cancer Center, Gainesville, FL 32601, USA
| | - Allison J. Applebaum
- Memorial Sloan Kettering Cancer Center, Department of Psychiatry and Behavioral Sciences, New York, NY 10065, USA
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7
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Harju E, Rantanen A, Helminen M, Kaunonen M, Isotalo T, Åstedt-Kurki P. The marital relationship and health-related quality of life of prostate cancer patients and their spouses: A prospective, longitudinal study. Int J Nurs Pract 2022; 28:e13093. [PMID: 35971274 PMCID: PMC10078317 DOI: 10.1111/ijn.13093] [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: 12/03/2019] [Revised: 06/18/2022] [Accepted: 07/23/2022] [Indexed: 12/24/2022]
Abstract
AIMS This study aims to measure any changes in the marital relationship during the first year after a diagnosis of prostate cancer, identify the demographic characteristics that influenced such changes, and measure changes related to health-related quality of life (HRQoL). BACKGROUND Knowledge is limited on the impact of a diagnosis of prostate cancer on the marital relationship and HRQoL of patients and their spouses. DESIGN A 1-year longitudinal study. METHODS Data were collected from five Finnish hospitals between October 2013 and January 2017. Of the 350 recruited couples (N = 700), 179 patients and 166 spouses completed the Marital Questionnaire and the RAND 36-Item Health Survey 1 year after diagnosis. RESULTS No major changes were found in the marital relationship during the follow-up period. The spouses reported statistically significant changes in their marital relationships, but the patients did not. Furthermore, changes in the marital relationship were not associated with the patients' HRQoL. Among spouses, emotional well-being was associated with changes in the marital relationship. CONCLUSION The marital relationship was relevant in terms of the spouses' HRQoL during the first year after a diagnosis of prostate cancer. Nurses and other healthcare providers should assess counselling and support provided to spouses individually.
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Affiliation(s)
- Eeva Harju
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Department of Surgery, Pirkanmaa Hospital District, Tampere University Hospital, Tampere, Finland
| | - Anja Rantanen
- Faculty of Social Sciences, Nursing Science, Tampere University, Tampere, Finland
| | - Mika Helminen
- Faculty of Social Sciences, Health Sciences, Tampere University, Tampere, Finland.,Tays Research Services, Tampere University Hospital, Tampere, Finland
| | - Marja Kaunonen
- Faculty of Social Sciences, Nursing Science, Tampere University, Tampere, Finland.,Department of General Administration, Pirkanmaa Hospital District, Tampere University Hospital, Tampere, Finland
| | - Taina Isotalo
- Department of Surgery, Päijät-Häme Central Hospital, Lahti, Finland
| | - Päivi Åstedt-Kurki
- Faculty of Social Sciences, Nursing Science, Tampere University, Tampere, Finland.,Department of General Administration, Pirkanmaa Hospital District, Tampere University Hospital, Tampere, Finland
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8
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Nik Jaafar NR, Abd Hamid N, Hamdan NA, Rajandram RK, Mahadevan R, Mohamad Yunus MR, Zakaria H, Mohd Shariff N, Hami R, Isa S, Shari NI, Leong Bin Abdullah MFI. Posttraumatic Growth, Positive Psychology, Perceived Spousal Support, and Psychological Complications in Head and Neck Cancer: Evaluating Their Association in a Longitudinal Study. Front Psychol 2022; 13:920691. [PMID: 35814154 PMCID: PMC9266623 DOI: 10.3389/fpsyg.2022.920691] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 06/03/2022] [Indexed: 11/13/2022] Open
Abstract
Despite head and neck cancer (HNC) association with various negative impacts, collective evidence is accumulating regarding the positive impacts of positive psychology on cancer survivors. However, data on how positive psychology is related to the psychological complications of HNC across time are lacking. This longitudinal study examined the trends of positive psychology (e.g., posttraumatic growth [PTG], hope, and optimism), perceived spousal support, and psychological complications (e.g., depression, anxiety, and posttraumatic stress symptoms) and determined the association between them, psychological complications, and PTG across two timelines among a cohort of HNC patients. A total of 175 HNC respondents exhibited an increasing trend of positive psychology and perceived spousal support while reporting a decreasing trend of psychological complications between baseline and follow-up assessments. A greater degree of hope and perceived spousal support contributed to a higher degree of PTG across time. Conversely, a higher severity of anxiety symptoms was associated with a lower degree of PTG over time. Female gender had a moderating effect on the association between severity of anxiety symptoms and PTG, but did not moderate the association between hope, perceived spousal support and PTG. This study indicates the pivotal role of incorporating psychosocial interventions into the treatment regimen to enhance the degree of hope and perceived spousal support and reduce the severity of anxiety symptoms, which, in turn, will facilitate the development of PTG in HNC patients.
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Affiliation(s)
- Nik Ruzyanei Nik Jaafar
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Norhaliza Abd Hamid
- Department of Community Health, Advance Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Malaysia
| | - Nur Amirah Hamdan
- Department of Community Health, Advance Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Malaysia
| | - Rama Krsna Rajandram
- Department of Oral and Maxillofacial Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Raynuha Mahadevan
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Mohd Razif Mohamad Yunus
- Department of Otorhinolaryngology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Hazli Zakaria
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Noorsuzana Mohd Shariff
- Department of Community Health, Advance Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Malaysia
| | - Rohayu Hami
- Department of Community Health, Advance Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Malaysia
| | - Salbiah Isa
- Department of Community Health, Advance Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Malaysia
| | - Nurul Izzah Shari
- School of Human Resource Development and Psychology, Faculty of Social Sciences and Humanities, Universiti Teknologi Malaysia, Skudai, Malaysia
- *Correspondence: Nurul Izzah Shari
| | - Mohammad Farris Iman Leong Bin Abdullah
- Department of Community Health, Advance Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Malaysia
- Mohammad Farris Iman Leong Bin Abdullah
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9
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Hasson-Ohayon I, Goldzweig G, Braun M, Hagedoorn M. Beyond "being open about it": A systematic review on cancer related communication within couples. Clin Psychol Rev 2022; 96:102176. [PMID: 35700574 DOI: 10.1016/j.cpr.2022.102176] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 04/26/2022] [Accepted: 06/01/2022] [Indexed: 11/16/2022]
Abstract
Extensive literature addresses the correlates of communication behaviors within couples in the specific stressful context of oncology. This literature focused mainly on the concepts of disclosure, concealment, holding back and protective buffering to gain more insight into the potential benefits of open communication on the psychological and relational wellbeing of the patient, the spouse and the dyad. The current systematic review aims to present this literature, summarize research findings and suggest empirical, theoretical and clinical implications. Methods: The search method applied in this review was in line with the PRISMA guidelines. Key words related to couples' communication and oncology were used to identify relevant studies according to title and abstract fields from 1.1.2000 until 31.1.22. Results: Out of 3277 papers, a total of 55 articles were identified as relevant for this review. These quantitative studies used cross-sectional and longitudinal designs. Overall, integrating findings from different studies showed that while avoiding communication is negatively associated with psychological and relational wellbeing, the benefits of disclosure seems to be dependent on different factors including the partner's responsiveness, contextual factors and personal characteristics. The existing literature is limited in providing data regarding the nature of adequate or helpful partner responses, the best timing, and the specific topics that are recommended to be disclosed such as specific fears. Most importantly, it is limited in heterogeneity of constructs of communication that were studied, scales that were used and diverse mediators and moderators that were examined. Accordingly, an effort to reach consensus of definition and assessment of communicative behavior is recommended for future studies, and addressing responsiveness to communicative initiations seems to be important for clinical practice.
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Affiliation(s)
| | | | | | - Mariët Hagedoorn
- Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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10
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Wood AW, Martin JL, Bruns K. An Integrative Counseling Approach for African American Couples With Prostate Cancer. ADULTSPAN JOURNAL 2021. [DOI: 10.1002/adsp.12113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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11
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Thompson T, Ketcher D, Gray TF, Kent EE. The Dyadic Cancer Outcomes Framework: A general framework of the effects of cancer on patients and informal caregivers. Soc Sci Med 2021; 287:114357. [PMID: 34500320 DOI: 10.1016/j.socscimed.2021.114357] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 08/24/2021] [Accepted: 08/28/2021] [Indexed: 01/22/2023]
Abstract
It is widely acknowledged that cancer affects not only patients but also their friends and family members who provide informal, and typically unpaid, care. Given the dual impact that cancer often has on patients and their informal caregivers (i.e., family members, partners, or friends), an expanded dyadic framework that encompasses a range of health and psychosocial outcomes and includes primary caregivers with a range of relationships to the patients is critically needed. Moreover, an emphasis on the role of social and contextual factors may help the framework resonate with a broader range of patient-caregiver relationships and allow for the development of more effective dyadic interventions. This article describes the development of the Dyadic Cancer Outcomes Framework, which was created to guide future research and intervention development. Using an iterative process, we conducted a conceptual review of currently used dyadic and/or caregiving models and frameworks and developed our own novel dyadic framework. Our novel Dyadic Cancer Outcomes Framework highlights individual- and dyad-level predictors and outcomes, as well as incorporating the disease trajectory and the social context. This framework can be used in conjunction with statistical approaches including the Actor Partner Interdependence Model to evaluate outcomes for different kinds of partner-caregiver dyads. This flexible framework can be used to guide intervention development and evaluation for cancer patients and their primary caregivers, with the ultimate goal of improving health, psychosocial, and relationship outcomes for both patients and caregivers. Future research will provide valuable information about the framework's effectiveness for this purpose.
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Affiliation(s)
- Tess Thompson
- Washington University in St. Louis, Brown School of Social Work, One Brookings Drive, Campus Box 1196, St. Louis, MO, 63130, USA.
| | - Dana Ketcher
- Moffitt Cancer Center, Department of Health Outcomes and Behavior, Tampa, FL, USA
| | - Tamryn F Gray
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Institute, Boston, MA, USA; Phyllis F. Cantor Center for Research in Nursing & Patient Care Services, Dana-Farber Cancer Institute, Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Erin E Kent
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, USA; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, USA
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12
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Tiete J, Delvaux N, Liénard A, Razavi D. Efficacy of a dyadic intervention to improve communication between patients with cancer and their caregivers: A randomized pilot trial. PATIENT EDUCATION AND COUNSELING 2021; 104:563-570. [PMID: 33129628 DOI: 10.1016/j.pec.2020.08.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 07/27/2020] [Accepted: 08/19/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Cancer-related communication is critical for patients' and caregivers' adaptation to illness. This randomized pilot study was conducted to test the feasibility, acceptability, and efficacy of a specific dyadic intervention to improve communication. METHODS A four weekly-session intervention was developed to reinforce cancer-related patient-caregiver communication. Patients receiving treatment for any diagnosed cancer, and their caregivers, were recruited from two oncology clinics in Belgium. Sixty-four patient-caregiver dyads were assigned randomly to intervention and waitlist groups. Cancer-related dyadic communication, dyadic coping and emotional distress were assessed at baseline and post-intervention. RESULTS The intervention attrition rate was 6 %. Linear mixed models were performed on 60 dyads. Significant two-way group × time interaction indicated improvement in participants' cancer-related dyadic communication frequency (β = -1.30; SE = 0.31; p = .004), self-efficacy (β = -10.03; SE = 3.90; p = .011) and dyadic coping (β = -5.93; SE = 2.73; p = .046) after the intervention. CONCLUSION These results indicate that the brief dyadic communication intervention is feasible and acceptable, and show preliminary evidence of efficacy. PRACTICE IMPLICATIONS Encouraging patients and caregivers to discuss personal cancer-related concerns may improve their ability to cope with the illness together.
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Affiliation(s)
- Julien Tiete
- Université Libre de Bruxelles, Faculté des Sciences Psychologiques et de l'Education, 50 Avenue Franklin Roosevelt, Brussels, Belgium; Hôpital Erasme, Service de Psychologie, 808 Route de Lennik, Brussels, Belgium.
| | - Nicole Delvaux
- Université Libre de Bruxelles, Faculté des Sciences Psychologiques et de l'Education, 50 Avenue Franklin Roosevelt, Brussels, Belgium; Hôpital Erasme, Service de Psychologie, 808 Route de Lennik, Brussels, Belgium
| | - Aurore Liénard
- Université Libre de Bruxelles, Faculté des Sciences Psychologiques et de l'Education, 50 Avenue Franklin Roosevelt, Brussels, Belgium; Institut Jules Bordet, Clinique de Psycho-oncologie, 121 Boulevard de Waterloo, Brussels, Belgium
| | - Darius Razavi
- Université Libre de Bruxelles, Faculté des Sciences Psychologiques et de l'Education, 50 Avenue Franklin Roosevelt, Brussels, Belgium; Institut Jules Bordet, Clinique de Psycho-oncologie, 121 Boulevard de Waterloo, Brussels, Belgium
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13
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Ketcher D, Thompson C, Otto AK, Reblin M, Cloyes KG, Clayton MF, Baucom BR, Ellington L. The Me in We dyadic communication intervention is feasible and acceptable among advanced cancer patients and their family caregivers. Palliat Med 2021; 35:389-396. [PMID: 33225821 PMCID: PMC8258799 DOI: 10.1177/0269216320972043] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Advanced cancer affects the emotional and physical well-being of both patients and family caregivers in profound ways and is experienced both dyadically and individually. Dyadic interventions address the concerns of both members of the dyad. A critical gap exists in advanced cancer research, which is a failure of goals research and dyadic research to fully account for the reciprocal and synergistic effects of patients' and caregivers' individual perspectives, and those they share. AIM We describe the feasibility and acceptability of the Me in We dyadic intervention, which is aimed at facilitating communication and goals-sharing among caregiver and patient dyads while integrating family context and individual/shared perspectives. DESIGN Pilot study of a participant-generated goals communication intervention, guided by multiple goals theory, with 13 patient-caregiver dyads over two sessions. SETTING/PARTICIPANTS Patients with advanced cancer and their self-identified family caregivers were recruited from an academic cancer center. Dyads did not have to live together, but both had to consent to participate and all participants had to speak and read English and be at least 18 years or age. RESULTS Of those approached, 54.8% dyads agreed to participate and completed both sessions. Participants generated and openly discussed their personal and shared goals and experienced positive emotions during the sessions. CONCLUSIONS This intervention showed feasibility and acceptability using participant-generated goals as personalized points of communication for advanced cancer dyads. This model shows promise as a communication intervention for dyads in discussing and working towards individual and shared goals when facing life-limiting or end-of-life cancer.
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Veenstra CM, Acosta J, Sharar R, Hawley ST, Morris AM. Partners' engagement in surveillance among survivors of colorectal cancer: A qualitative study. Cancer Med 2021; 10:1289-1296. [PMID: 33463029 PMCID: PMC7926003 DOI: 10.1002/cam4.3725] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 12/12/2020] [Accepted: 12/26/2020] [Indexed: 11/09/2022] Open
Abstract
Objectives Following treatment of Stage III colorectal cancer, guidelines recommend 3–5 years of surveillance for recurrence. However, over half of the 1.2 million U.S. survivors of colorectal cancer fail to receive guideline‐concordant surveillance. In light of growing recognition that members of couples are interdependent and influence each other's health behaviors, we sought to describe, in their own words, the perspectives of spouses/partners on their engagement in patients’ surveillance. Methods We conducted in‐person, semi‐structured interviews with 10 survivors of stage III colorectal cancer and their partners, together and separately. Interviews were transcribed verbatim, iteratively coded, and analyzed to identify emergent themes pertaining to partner engagement. Findings were validated through triangulation between study team members and triangulation between dyadic and individual interviews, and through an extensive search of transcripts for disconfirming evidence. Results We identified three overarching domains of partner engagement in surveillance. First, psychosocial engagement included promoting patient participation in surveillance, showing care and concern, and attending to partner self‐care. Second, information‐seeking and dyadic communication focused on gathering information, staying informed about test results, and communicating about surveillance. Third, instrumental engagement referred to any explicit, objective activities such as scheduling appointments, attending appointments, and managing responsibilities at home. Participants shared strategies, examples, and in some cases unmet needs. Conclusions This study generated new, clinically meaningful knowledge about the ways in which partners engage in patients’ surveillance. Opportunities to leverage partners as informal resources in surveillance include development of dyadic interventions to help partners engage most effectively.
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Affiliation(s)
- Christine M Veenstra
- Division of Hematology/Oncology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA.,Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Rebecca Sharar
- University of Washington School of Medicine, Seattle, Washington, USA
| | - Sarah T Hawley
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA.,Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Arden M Morris
- Department of Surgery, S-Spire Center, Stanford University, Stanford, California, USA
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15
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Loh KP, Soto-Perez-de-Celis E, Duberstein PR, Culakova E, Epstein RM, Xu H, Kadambi S, Flannery M, Magnuson A, McHugh C, Trevino KM, Tuch G, Ramsdale E, Yousefi-Nooraie R, Sedenquist M, Liu JJ, Melnyk N, Geer J, Mohile SG. Patient and caregiver agreement on prognosis estimates for older adults with advanced cancer. Cancer 2021; 127:149-159. [PMID: 33036063 PMCID: PMC7736110 DOI: 10.1002/cncr.33259] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 07/06/2020] [Accepted: 08/07/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Disagreements between patients and caregivers about treatment benefits, care decisions, and patients' health are associated with increased patient depression as well as increased caregiver anxiety, distress, depression, and burden. Understanding the factors associated with disagreement may inform interventions to improve the aforementioned outcomes. METHODS For this analysis, baseline data were obtained from a cluster-randomized geriatric assessment trial that recruited patients aged ≥70 years who had incurable cancer from community oncology practices (University of Rochester Cancer Center 13070; Supriya G. Mohile, principal investigator). Patient and caregiver dyads were asked to estimate the patient's prognosis. Response options were 0 to 6 months, 7 to 12 months, 1 to 2 years, 2 to 5 years, and >5 years. The dependent variable was categorized as exact agreement (reference), patient-reported longer estimate, or caregiver-reported longer estimate. The authors used generalized estimating equations with multinomial distribution to examine the factors associated with patient-caregiver prognostic estimates. Independent variables were selected using the purposeful selection method. RESULTS Among 354 dyads (89% of screened patients were enrolled), 26% and 22% of patients and caregivers, respectively, reported a longer estimate. Compared with dyads that were in agreement, patients were more likely to report a longer estimate when they screened positive for polypharmacy (β = 0.81; P = .001), and caregivers reported greater distress (β = 0.12; P = .03). Compared with dyads that were in agreement, caregivers were more likely to report a longer estimate when patients screened positive for polypharmacy (β = 0.82; P = .005) and had lower perceived self-efficacy in interacting with physicians (β = -0.10; P = .008). CONCLUSIONS Several patient and caregiver factors were associated with patient-caregiver disagreement about prognostic estimates. Future studies should examine the effects of prognostic disagreement on patient and caregiver outcomes.
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Affiliation(s)
- Kah Poh Loh
- Division of Hematology/Oncology, Department of Medicine, James P Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York, USA
| | - Enrique Soto-Perez-de-Celis
- Department of Geriatrics, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico
| | - Paul R. Duberstein
- Department of Health Behavior, Society, and Policy, Rutgers School of Public Health, Piscataway, New Jersey, USA
| | - Eva Culakova
- Division of Hematology/Oncology, Department of Medicine, James P Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York, USA
| | - Ronald M. Epstein
- Division of Hematology/Oncology, Department of Medicine, James P Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York, USA
- Department of Family Medicine, University of Rochester Medical Center, Rochester, New York, USA
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA
- Department of Medicine|Palliative Care, University of Rochester Medical Center, Rochester, New York, USA
| | - Huiwen Xu
- Division of Hematology/Oncology, Department of Medicine, James P Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York, USA
- Department of Surgery|Cancer Control, University of Rochester Medical Center, Rochester, New York, USA
| | - Sindhuja Kadambi
- Division of Hematology/Oncology, Department of Medicine, James P Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York, USA
| | - Marie Flannery
- School of Nursing, University of Rochester Medical Center, Rochester, New York, USA
| | - Allison Magnuson
- Division of Hematology/Oncology, Department of Medicine, James P Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York, USA
| | - Colin McHugh
- Division of Hematology/Oncology, Department of Medicine, James P Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York, USA
| | - Kelly M. Trevino
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Gina Tuch
- Department of Aged Care, Alfred Health, Melbourne, Australia
| | - Erika Ramsdale
- Division of Hematology/Oncology, Department of Medicine, James P Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York, USA
| | - Reza Yousefi-Nooraie
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, New York, USA
| | - Margaret Sedenquist
- SCOREboard Advisory Group, University of Rochester Medical Center, Rochester, New York, USA
| | - Jane Jijun Liu
- Heartland National Cancer Institute (NCI) Community Oncology Research Program (NCORP), USA
| | | | - Jodi Geer
- Metro Minnesota Community Oncology Research Program, USA
| | - Supriya G. Mohile
- Division of Hematology/Oncology, Department of Medicine, James P Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York, USA
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Siminoff LA, Wilson-Genderson M, Barta S, Thomson MD. Hematological cancer patient-caregiver dyadic communication: A longitudinal examination of cancer communication concordance. Psychooncology 2020; 29:1571-1578. [PMID: 32627258 PMCID: PMC8474783 DOI: 10.1002/pon.5458] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 05/27/2020] [Accepted: 06/23/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Informal caregivers play a fundamental role in care and decision making with hematological cancer patients. Concordant patient-caregiver communication is a critical antecedent to high quality decision making. Little is known about patterns of dyadic communication throughout the cancer treatment continuum. The objective of this study was to assess patterns of cancer communication concordance regarding treatment and care among hematological cancer patients undergoing active treatment and their informal caregivers and test whether patterns were associated with participant characteristics. 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. Latent Class Growth Models (LCGM) were used to analyze longitudinal data captured using Cancer Communication Assessment Tool for Patients and Families (CCAT-PF) and the association with participant characteristics. RESULTS White patient-caregiver dyads demonstrated decreased communication concordance and African American dyads demonstrated increased communication concordance over time. Lower communication concordance was found among dyads with lower levels of education and income, and cancers diagnosed at more advanced stages; these relationships were stable over time. Modeling identified the presence of three distinct communication groups (Stable Concordant (57.4%), Fluctuating Medium Concordant (37.8%), High Discordant (5.4%)) that differed by baseline level of communication concordance, patterns of concordance over time, race, income and the dyad relationship. CONCLUSIONS Patient-caregiver cancer communication concordance was not static overtime. Results suggest the presence of a new dyadic cancer communication typology that could help preemptively identify dyads at risk for communication difficulties that impede treatment decision making.
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Affiliation(s)
- Laura A Siminoff
- College of Public Health and Social and Behavioral Sciences, Temple University, Philadelphia, Pennsylvania, USA
| | - Maureen Wilson-Genderson
- College of Public Health and Social and Behavioral Sciences, Temple University, Philadelphia, Pennsylvania, USA
| | - Stefan Barta
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Maria D Thomson
- VCU School of Medicine Health Behavior and Policy, Virginia Commonwealth University, Richmond, Virginia, USA
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Zhang Y, Kwekkeboom KL. A Feasibility Study of an Uncertainty Management Intervention for Patient-Partner Dyads Experiencing Breast Cancer. Oncol Nurs Forum 2020; 47:595-608. [PMID: 32830807 DOI: 10.1188/20.onf.595-608] [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: 11/17/2022]
Abstract
OBJECTIVES To examine the feasibility, acceptability, and effects of a dyad-based uncertainty management intervention for breast cancer, including tailored information and coping skills training. SAMPLE & SETTING 16 patient-partner dyads experiencing breast cancer were enrolled from a midwestern comprehensive cancer center. METHODS & VARIABLES A single-group pre-/post-test design was used, and descriptive statistics and Cohen's d were calculated. Measures were completed before the intervention and during each treatment cycle. Feasibility, acceptability, fidelity, uptake, and outcome variables (uncertainty, dyadic coping, family functioning) were included. RESULTS 16 dyads were enrolled during a 13-month period; 15 dyads completed the training for the study, and 13 dyads completed all study activities. Overall, participants reported satisfaction with the intervention. Small to medium effect sizes were observed across the outcomes. IMPLICATIONS FOR NURSING This study highlights the need for nurses to help couples manage uncertainty related to new cancer treatment. Tailored interventions can allow nurses to use their time efficiently by focusing on individuals' actual needs.
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Communication Needs of Cancer Patients and/or Caregivers: A Critical Literature Review. JOURNAL OF ONCOLOGY 2020; 2020:7432849. [PMID: 32454826 PMCID: PMC7229568 DOI: 10.1155/2020/7432849] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 03/13/2020] [Accepted: 04/21/2020] [Indexed: 12/30/2022]
Abstract
Objective Effective communication for cancer patients and/or caregivers can meet information needs, reduce caregiver burden, improve physical and mental health, and promote intimacy. The aim of this review was to identify the communication needs of cancer patients and/or caregivers and to explore their specific communication needs to guide the development of future communication interventions. Methods Chinese and English databases were systematically searched from January 2010 to October 2019, including MEDLINE, CINAHL, PubMed, and the China Academic Journal Full-text Database. The key search terms used were “cancer” or “carcinoma” or “oncology” AND “patient” or “caregiver” or “carer” AND “communication” or “discussion” or “talk” AND “need” or “needs” or “desire.”. Results A total of 26 articles was identified and included in this review. The findings revealed the needs of cancer patients and/or caregivers in terms of communication target, content, style, timing, and preferences. Communication targets included health professionals, peers, caregivers, and patients. Communication content included illness-related, emotional support, daily life, sexuality, death, and a way to communicate with health professionals. Communication style needed to be expressed through such things as language and communication atmosphere. Communication timing mainly referred to before treatment and approaching death. Communication preferences were related to factors such as demographics and ethnic origin. Conclusions Cancer patients and/or caregivers have different communication needs in terms of target, content, style, and communication timing. A better understanding of the unique communication needs of patients and/or caregivers will offer health professionals detailed information on designing appropriate interventions to support cancer patients and caregivers.
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Ketcher D, Ellington L, Baucom BRW, Clayton MF, Reblin M. "In Eight Minutes We Talked More About Our Goals, Relationship, Than We Have in Years": A Pilot of Patient-Caregiver Discussions in a Neuro-Oncology Clinic. JOURNAL OF FAMILY NURSING 2020; 26:126-137. [PMID: 32475300 PMCID: PMC9119347 DOI: 10.1177/1074840720913963] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Primary brain cancer is a diagnosis that can have drastic health impacts on patient and caregiver alike. In high-stress situations, dyadic coping can improve psychosocial and health outcomes and communication about personal life goals maybe one way to facilitate this coping. In this study, we describe the feasibility and accessibility of a one-time, self-directed goal discussion pilot intervention for neuro-oncology patients and their primary caregivers. Ten dyads were taken to a private room to complete a pre-discussion questionnaire, a worksheet to elicit personal goals, complete an 8-min discussion of goals, a post-discussion questionnaire, and provided open-ended feedback about the process. Post-discussion, dyads reported that the intervention was not stressful. In open-ended feedback, dyads overwhelmingly reported that the intervention was a positive experience, providing a safe, calm environment to have difficult conversations. This intervention provides a positive framework for improving communication and discussion of goals between patient-caregiver dyads.
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Abstract
Family caregivers are centrally involved in cancer pain management, especially for patients with advanced disease. This issue is becoming ever more important as care shifts to the outpatient setting and home care and as the aging population creates more patients who have multiple illnesses and family caregivers who often live with serious illnesses. This narrative review evaluated current knowledge and literature regarding family caregivers' involvement in cancer pain management and identified areas for future research and clinical practice. There is a need for additional research in this area and for clinical models of support for family caregivers as they provide pain management for patients with cancer.
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Affiliation(s)
- Betty R Ferrell
- From the Division of Nursing Research and Education, City of Hope Comprehensive Cancer Center, Duarte, California
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21
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Ahluwalia S, Reddy NK, Johnson R, Emanuel L, Knight SJ. Dyadic Model of Adaptation to Life-Limiting Illness. J Palliat Med 2020; 23:1177-1183. [PMID: 32109183 DOI: 10.1089/jpm.2019.0444] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Context: We previously developed the reintegration model to describe the adjustment process for individuals at the end of life. However, caregivers and loved ones also require significant support and must work to reimagine their relationship with one another. Objectives: We sought to develop a dyadic version of the reintegration model that delineates key parts of the adjustment process that occur between the patient and another significant person rather than as two separate individuals. Methods: We refined an initial conceptual model of this dyadic process with findings from a narrative literature review on spousal dyadic mutuality. We assessed emergent themes regarding dyadic adjustment from the literature for their fit with our original reintegration model and through consensus discussion, applied the findings to a final proposed conceptual model of dyadic reintegration at the end of life. Results: Examples of dyadic adjustment in the literature relate to the comprehension, creative adaptation, and reintegration processes described in the original reintegration model. Evidence also supported three substantive additions in the new dyadic model: (1) shared understanding that the harmony of the dyad is interrupted; (2) consideration of the "we" (the dyad) and the "I" (the individual) in mutual reflection to create a shared narrative; and (3) emphasis on relationship as a factor impacting adjustment processes. Conclusions: Available evidence supports interdependent relationships between members of dyads for the three adaptation processes of comprehension, creative adaptation, and reintegration in the model. This dyadic reintegration model can be useful in clinical practice to support dyads facing life-limiting illness.
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Affiliation(s)
- Sangeeta Ahluwalia
- RAND Corporation, Santa Monica, California, USA.,UCLA Fielding School of Public Health, Los Angeles, California, USA
| | - Neha K Reddy
- Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Rebecca Johnson
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Linda Emanuel
- General Medicine Division, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Sara J Knight
- Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
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22
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Mendez-Luck CA, Miranda J, Mangione CM, Yoon J, VanGarde A. The Juntos Pilot Study: A Diabetes Management Intervention for Latino Caregiving Dyads. DIABETES EDUCATOR 2019; 45:507-519. [DOI: 10.1177/0145721719866619] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose The purpose of this study was to design a culturally sensitive dyad-level diabetes intervention to improve glycemic control for older Latino adults with type 2 diabetes. Methods This study used a pretest-posttest noncontrol group design. The intervention was developed from formative research with Mexican-origin caregiving dyads. The curriculum was adapted from 2 randomized trials of community interventions specifically designed for Latino older adults with type 2 diabetes. The curriculum consisted of communication skill-building exercises and dyad decision making on lifestyle changes to improve the older adult’s blood glucose levels. Thirty-two community-dwelling dyads completed a 6-week program of one-on-one sessions with a trained program facilitator. Main outcomes were feasibility and acceptability of the Juntos program. The authors assessed feasibility by examining participant burden and retention and acceptability by participant exit interviews. Although underpowered for outcomes, A1C, health status, and dyadic communication were also assessed to evaluate whether trends suggested the effectiveness of the intervention. Results Most participants viewed Juntos as an acceptable program and wanted the program expanded in terms of length and scope. All outcomes showed improvement from baseline through 6 months postintervention. Conclusions Results show that Juntos is acceptable to Mexican-origin caregiving dyads and is a promising approach for effectively controlling type 2 diabetes among older Latino adults who have a family caregiver.
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Affiliation(s)
| | - Jeanne Miranda
- UCLA Department of Psychiatry and Biobehavioral Sciences, Los Angeles, California
| | - Carol M. Mangione
- David Geffen School of Medicine at UCLA and the UCLA Fielding School of Public Health, Los Angeles, California
| | - Jangho Yoon
- Oregon State University, College of Public Health and Human Sciences, Corvallis, Oregon
| | - Aurora VanGarde
- Oregon State University, College of Public Health and Human Sciences, Corvallis, Oregon
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The role of concealment and relationship quality on patient hospitalizations, care strain and depressive symptoms in heart failure dyads. Eur J Cardiovasc Nurs 2019; 19:118-124. [DOI: 10.1177/1474515119863791] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Heart failure is one of the most common reasons for hospitalization among older adults and negatively influences person-reported outcomes of patients and their care partners. Moreover, the majority of heart failure research examines patients and care partners separately, ignoring the interdependent nature of the heart failure dyad. Aims: The aim of this study was to examine the interpersonal factors associated with depressive symptoms of heart failure patients and spouse care partners, patient hospitalizations over the last 12 months and care strain. Methods: A descriptive, cross-sectional design was used to examine 60 community-dwelling adults with heart failure and their spouse care partners. Multilevel modeling controlled for the interdependent nature of the dyadic data. Results: Patients had significantly worse depressive symptoms than their spouse care partners. More patient concealment (i.e. hiding concerns/worries) and worse relationship quality were significantly associated with greater depressive symptoms for patients, but not spouse care partners. Better relationship quality (reported by spouse care partners) was significantly associated with lower levels of care strain, whereas better relationship quality (reported by patients) was significantly associated with worse care strain. Patients who had one or more hospitalizations over the past 12 months were significantly more likely to report higher levels of concealment; relationship quality was not associated with patient hospitalizations. Conclusion: Findings highlight the interdependent nature of heart failure and the complexity of the interpersonal context. Greater focus on how the heart failure dyad navigates illness as a unit over time is needed to design and tailor innovative lines of clinical intervention to optimize dyadic and individual health.
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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: 16] [Impact Index Per Article: 3.2] [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.
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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)
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Manne SL, Kashy DA, Zaider T, Kissane D, Lee D, Kim IY, Heckman CJ, Penedo FJ, Murphy E, Virtue SM. Couple-focused interventions for men with localized prostate cancer and their spouses: A randomized clinical trial. Br J Health Psychol 2019; 24:396-418. [PMID: 30852854 DOI: 10.1111/bjhp.12359] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 02/11/2019] [Indexed: 01/21/2023]
Abstract
OBJECTIVES Few couple-focused interventions have improved psychological and relationship functioning among men diagnosed with localized prostate cancer and their spouses. This study compared the impact of intimacy-enhancing therapy (IET), a general health and wellness intervention (GHW), and usual care (UC) on the psychological and relationship functioning of localized prostate cancer patients and their partners. Relationship length, relationship satisfaction, and patient masculinity were evaluated as moderators. DESIGN This study was a randomized clinical trial with three study arms and four assessment time points. METHODS A total of 237 patients and partners were randomly assigned to receive IET, GHW, or UC. Participants completed measures of psychological functioning and relationship satisfaction at baseline, 5 weeks, 3 months, and 6 months post-baseline. Primary outcomes were psychological adjustment, depression, cancer-specific distress, cancer concerns, and relationship satisfaction. RESULTS Spouses in IET showed greater increases in relationship satisfaction than spouses in GHW and UC between the baseline and 5-week follow-up. Among patients in longer relationships, significant increases in psychological adjustment were found in both treatments compared to UC. Among spouses in longer relationships, psychological adjustment increased in both IET and UC but declined in GHW. CONCLUSIONS Intimacy-enhancing therapy did not show an impact on general or cancer-specific distress, but did show an early impact on relationship satisfaction among spouses. IET was superior to UC for patients in longer relationships. It will be important for researchers to understand which couple-focused interventions benefits both patients and spouses and to identify characteristics of patients, partners, and couples who may not benefit from psychological treatments. Statement of contribution What is already known on this subject? Men diagnosed with localized prostate cancer report lower health-related quality of life and both patients and spouses report elevated distress. Relationship communication plays a role in couples' psychological adaptation to prostate cancer. Couple-focused interventions have illustrated an impact on relationship communication. There are no studies comparing different couple-focused interventions. What does this study add? Intimacy-enhancing therapy was not superior to no treatment or a comparison treatment for the broad range of psychological and relationship outcomes. Intimacy-enhancing therapy was superior to no treatment for patients in longer-term relationship. The general health and wellness intervention was not beneficial for men in shorter relationships and for men who did not endorse traditional masculine norms.
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Affiliation(s)
- Sharon L Manne
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | | | - Talia Zaider
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, USA
| | - David Kissane
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, USA.,Department of Psychiatry, Monash Medical Center, Monash University, Clayton, Victoria, Australia
| | - David Lee
- Penn Urology, Penn Presbyterian Medical Center, Philadelphia, Pennsylvania, USA
| | - Isaac Y Kim
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - Carolyn J Heckman
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA.,Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA
| | - Frank J Penedo
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, Illinois, USA
| | - Evangelynn Murphy
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
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Lyons KS, Hiatt SO, Gelow JM, Auld J, Mudd JO, Chien CV, Lee CS. Depressive symptoms in couples living with heart failure: the role of congruent engagement in heart failure management. Aging Ment Health 2018; 22:1585-1591. [PMID: 28959891 DOI: 10.1080/13607863.2017.1381945] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES The life-threatening context of heart failure (HF), high variability of the illness and complexity of care place considerable demands on both the adult patient and his/her spouse. The current study examines the role of congruent engagement in HF management behaviors on the depressive symptoms of the couple living with HF. METHOD A cross-sectional design was used to examine 60 couples living with HF. Multilevel modeling was used to examine partner and within-dyad effects of engagement in HF behaviors on depressive symptoms. RESULTS Just over one quarter (27%) of couples had both members experiencing at least mild depressive symptoms. Controlling for stage of HF and one's own level of engagement, one's partner's level of engagement was significantly associated with one's level of depressive symptoms; higher levels of engagement by one's partner were associated with lower levels of depressive symptoms. Additionally, spouses had lower levels of depressive symptoms when they had similar levels of engagement to their partner with HF; spouses had higher levels of depressive symptoms when they had higher levels of engagement than their partner with HF. CONCLUSION Findings confirm the importance of screening both members of the couple for depression and fostering collaboration within the couple.
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Affiliation(s)
- Karen S Lyons
- a School of Nursing , Oregon Health and Science University , Portland , OR , USA
| | - Shirin O Hiatt
- a School of Nursing , Oregon Health and Science University , Portland , OR , USA
| | - Jill M Gelow
- b Knight Cardiovascular Institute , Oregon Health and Science University , Portland , OR , USA
| | - Jonathan Auld
- a School of Nursing , Oregon Health and Science University , Portland , OR , USA
| | - James O Mudd
- b Knight Cardiovascular Institute , Oregon Health and Science University , Portland , OR , USA
| | - Christopher V Chien
- b Knight Cardiovascular Institute , Oregon Health and Science University , Portland , OR , USA
| | - Christopher S Lee
- c School of Nursing/Knight Cardiovascular Institute , Oregon Health and Science University , Portland , OR , USA
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Katapodi MC, Ellis KR, Schmidt F, Nikolaidis C, Northouse LL. Predictors and interdependence of family support in a random sample of long-term young breast cancer survivors and their biological relatives. Cancer Med 2018; 7:4980-4992. [PMID: 30187678 PMCID: PMC6198202 DOI: 10.1002/cam4.1766] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 08/07/2018] [Accepted: 08/09/2018] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE Women diagnosed with breast cancer younger than 45 years (young breast cancer survivors-YBCS) and their biological relatives face significant stressors. Although family support is an important coping resource, little is known about YBCS' and relatives' support and whether it is interdependent. The study described family support in YBCS and their biological relatives; identified demographic, clinical, and psychosocial predictors of support; and determined the interdependence of support in YBCS-relatives family units. METHODS Data were collected from a random sample of YBCS and their first- or second-degree female relatives. Actor-partner interdependence models (APIM) explored predictors and interdependence of YBCS' and relatives' family support in dyads (YBCS and relative) and triads (YBCS and two relatives). RESULTS Among n = 310 YBCS and n = 431 first- or second-degree relatives, family support was higher in triads compared to dyads. APIMs identified actor effects in dyads, and actor and partner effects in triads. Across all family units, YBCS' higher self-efficacy was associated with higher YBCS support (actor effect) and relative support (partner effect); YBCS' prior diagnosis of depression was associated with lower YBCS and relative support (actor and partner effect); cost-related lack of access to care was associated with lower support among YBCS (actor effect) and relatives (actor and partner effect). CONCLUSIONS Family support was interdependent and was affected by self-efficacy, depression, and access to care. Interventions should include YBCS and relatives, enhance self-efficacy and access to care.
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Affiliation(s)
- Maria C. Katapodi
- Nursing ScienceFaculty of MedicineUniversity of BaselBaselSwitzerland
- School of NursingUniversity of MichiganAnn ArborMichigan
| | | | - Franziska Schmidt
- Institute of Higher Education and Research in Healthcare ‐ IUFRSUniversity Hospital Vaudois ‐ CHUVUniversity of Lausanne ‐ UNILLausanneSwitzerland
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Manne S, Kashy DA, Zaider T, Lee D, Kim IY, Heckman C, Penedo F, Kissane D, Virtue SM. Interpersonal processes and intimacy among men with localized prostate cancer and their partners. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2018; 32:664-675. [PMID: 29771551 PMCID: PMC6072581 DOI: 10.1037/fam0000404] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The present study focused on intimacy processes in the relationships of men diagnosed with localized prostate cancer and their partners. Using the actor-partner interdependence model (APIM), we examined the interpersonal process model of intimacy, which proposes associations between self- and perceived partner disclosure about cancer and perceived partner responsiveness as predictors of global relationship intimacy. The study's outcomes were patients' and spouses' ratings of global relationship intimacy. Both actor (my disclosure predicts my intimacy) and partner (my partner's disclosure predicts my intimacy) effects were examined, as well as possible moderating effects for cancer-related concerns. Two hundred and nine couples in which one or both partners reported elevated cancer-specific distress completed measures of self- and perceived partner disclosure and perceived partner responsiveness regarding discussions about prostate cancer, global relational intimacy, and cancer-related concerns. Results were consistent with the interpersonal process model of intimacy in that perceived responsiveness mediated the association between self- and perceived partner disclosure about cancer and global relational intimacy for both patients and spouses. Results also indicated moderation of the links between disclosure and relational intimacy by level of patient cancer-related concerns such that the links were stronger when concerns were higher. Finally, there was also evidence of moderated mediation such that indirect effects of disclosure on relational intimacy via perceived partner responsiveness were stronger when concerns were higher. Interventions for distressed couples coping with prostate cancer would benefit from focusing on facilitating disclosure and responsiveness, particularly among distressed couples who report cancer concerns. (PsycINFO Database Record
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Affiliation(s)
| | | | | | - David Lee
- Perelman School of Medicine, University of Pennsylvania
| | - Isaac Y Kim
- Department of Surgery, Rutgers Cancer Institute of New Jersey
| | - Carolyn Heckman
- Cancer Prevention and Control Program, Fox Chase Cancer Center
| | - Frank Penedo
- Department of Medical Social Sciences, Northwestern University School of Medicine
| | | | - Shannon Myers Virtue
- Department of Pediatric Dentistry and Community Oral Health Sciences, Temple University School of Dentistry
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Abstract
Mishel's uncertainty in illness theory provides a conceptual framework to explain how uncertainty is generated and how it affects psychological adjustment to the cancer experience. Since 1981, when it was created, researchers have used the theory to develop and test uncertainty management interventions in multiple populations of patients with cancer. This article reviews the theory's concepts and propositions, summarizes supporting evidence, and discusses extension of the theory, clinical implications, and future directions for research.
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Collaço N, Rivas C, Matheson L, Nayoan J, Wagland R, Alexis O, Gavin A, Glaser A, Watson E. Prostate cancer and the impact on couples: a qualitative metasynthesis. Support Care Cancer 2018; 26:1703-1713. [PMID: 29511952 DOI: 10.1007/s00520-018-4134-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 02/25/2018] [Indexed: 12/19/2022]
Abstract
PURPOSE To review and interpret existing qualitative literature on the experiences of couples affected by prostate cancer (PCa). METHODS A metasynthesis was carried out which included a systematic search of seven databases between 2000 and 2016. A modified version of Noblit and Hare's meta-ethnographic approach was used to synthesise qualitative study findings and inform overarching interpretations. RESULTS Thirty-seven studies focusing on the experiences of men with PCa and their partner dyad were included producing seven interconnected constructs. The construct accepting change vs seeking continuity reflects the range of ways individuals within the dyad and couples adjust to the diagnosis. Cultivating connection vs disengaging illustrates how couples seek to manage the impact of PCa and its treatment on their relationship, which may lead to a threatened identity, including sexual insecurities. Shielding me, you and us reflects the ways in which couples strive to protect themselves as individuals and/or each other from the impact of PCa. Being a partner and its challenges highlights the responsibilities partners assume and the impact of their supporting role. Yet, partners sometimes report feeling unsupported and side-lined both by the man they are caring for and by healthcare professionals. Couples often recognise the value of facing PCa together. CONCLUSIONS PCa affects both members of the dyad as individuals, as well as the couple's relationship. How best to support couples and how to overcome difficulties in expressing their concerns to one another requires further consideration. Healthcare professionals should endeavour to employ a couple-focused approach where appropriate.
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Affiliation(s)
- Nicole Collaço
- Faculty of Health and Life Sciences, Oxford Brookes University, Jack Straws Lane, Oxford, OX3 0FL, UK.
| | - Carol Rivas
- Faculty of Health Sciences, University of Southampton, S017 1BJ, Southampton, UK
| | - Lauren Matheson
- Faculty of Health and Life Sciences, Oxford Brookes University, Jack Straws Lane, Oxford, OX3 0FL, UK
| | - Johana Nayoan
- Faculty of Health Sciences, University of Southampton, S017 1BJ, Southampton, UK
| | - Richard Wagland
- Faculty of Health Sciences, University of Southampton, S017 1BJ, Southampton, UK
| | - Obrey Alexis
- Faculty of Health and Life Sciences, Oxford Brookes University, Jack Straws Lane, Oxford, OX3 0FL, UK
| | - Anna Gavin
- School of Medicine, Dentistry and Biomedical Sciences, Centre for Public Health, Queen's University, Belfast, BT12 6BA, UK
| | - Adam Glaser
- Leeds Institute of Cancer and Pathology, Faculty of Medicine and Health, University of Leeds, Worsley Building, Leeds, LS2 9NL, UK
| | - Eila Watson
- Faculty of Health and Life Sciences, Oxford Brookes University, Jack Straws Lane, Oxford, OX3 0FL, UK
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Song L, Dunlap KL, Tan X, Chen RC, Nielsen ME, Rabenberg RL, Asafu-Adjei JK, Koontz BF, Birken SA, Northouse LL, Mayer DK. Enhancing Survivorship Care Planning for Patients With Localized Prostate Cancer Using a Couple-Focused mHealth Symptom Self-Management Program: Protocol for a Feasibility Study. JMIR Res Protoc 2018; 7:e51. [PMID: 29483070 PMCID: PMC5847815 DOI: 10.2196/resprot.9118] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 11/22/2017] [Accepted: 11/22/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND This project explores a new model of care that enhances survivorship care planning and promotes health for men with localized prostate cancer transitioning to posttreatment self-management. Survivorship care planning is important for patients with prostate cancer because of its high incidence rate in the United States, the frequent occurrence of treatment-related side effects, and reduced quality of life (QOL) for both men and their partners. A key component of comprehensive survivorship care planning is survivorship care plans (SCPs), documents that summarize cancer diagnosis, treatment, and plans for follow-up care. However, research concerning the effectiveness of SCPs on patient outcomes or health service use has thus far been inconclusive. SCPs that are tailored to individual patients' needs for information and care may improve effectiveness. OBJECTIVE This study aims to examine the feasibility of an enhanced survivorship care plan (ESCP) that integrates a symptom self-management mHealth program called Prostate Cancer Education and Resources for Couples (PERC) into the existing standardized SCP. The specific aims are to (1) examine the feasibility of delivering ESCPs and (2) to estimate the magnitude of benefit of ESCPs. METHODS We will use a two-group randomized controlled pretest-posttest design and collect data at baseline (T1) and 4 months later (T2) among 50 patients completing initial treatment for localized prostate cancer and their partners. First, we will assess the feasibility of ESCP by recruitment, enrollment, and retention rates; program satisfaction with the ESCP; and perceived ease of use of the ESCP. To achieve the secondary aim, we will compare the ESCP users with the standardized SCP users and assess their primary outcomes of QOL (overall, physical, emotional, and social QOL); secondary outcomes (reduction in negative appraisals and improvement in self-efficacy, social support, and health behaviors to manage symptoms); and number of visits to posttreatment care services between T1 and T2. We will assess the primary and secondary outcomes using measurements with sound psychometrical properties. We will use a qualitative and quantitative mixed methods approach to achieve the research aims. RESULTS This project is ongoing and will be completed by the end of 2018. CONCLUSIONS The results from this study will help design a definitive randomized trial to test the efficacy of the ESCPs, a potentially scalable program, to enhance supportive care for prostate cancer patients and their families.
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Affiliation(s)
- Lixin Song
- School of Nursing, University of North Carolina, Chapel Hill, NC, United States
- Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina, Chapel Hill, NC, United States
| | - Kaitlyn L Dunlap
- School of Nursing, University of North Carolina, Chapel Hill, NC, United States
| | - Xianming Tan
- Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina, Chapel Hill, NC, United States
| | - Ronald C Chen
- Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina, Chapel Hill, NC, United States
| | - Matthew E Nielsen
- Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina, Chapel Hill, NC, United States
| | | | | | | | - Sarah A Birken
- University of North Carolina, Chapel Hill, NC, United States
| | | | - Deborah K Mayer
- School of Nursing, University of North Carolina, Chapel Hill, NC, United States
- Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina, Chapel Hill, NC, United States
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Wertheim R, Goldzweig G, Mashiach-Eizenberg M, Pizem N, Shacham-Shmueli E, Hasson-Ohayon I. Correlates of concealment behavior among couples coping with cancer: Actor partner model. Psychooncology 2017; 27:583-589. [DOI: 10.1002/pon.4552] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 08/06/2017] [Accepted: 08/29/2017] [Indexed: 11/06/2022]
Affiliation(s)
- Reut Wertheim
- Department of Psychology; Bar-Ilan University; Ramat-Gan Israel
| | - Gil Goldzweig
- The School of Behavioral Sciences; The Academic College of Tel-Aviv-Yaffo; Tel-Aviv-Yaffo Israel
| | - Michal Mashiach-Eizenberg
- Department of Health Systems Management; Max Stern Academic College of Emek Yezreel; Emek Yezreel Israel
| | - Noam Pizem
- Chaim Sheba Medical Center at Tel Hashomer; Ramat-Gan Israel
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Abstract
This article contains a review of literature published from 2010 to 2016 on family caregiving in oncology. An analysis of 810 citations resulted in 50 randomized trials. These trials describe the need to prepare family caregivers for the complex role they play in cancer care. Several studies have demonstrated improved quality of life for family caregivers and improved emotional support from interventions. Several studies addressed communication and relational intimacy, which are key concerns. An additional focus of these trials was in the area of caregiving tasks and ways to diminish the burden of caregiving and preparedness for this role. Further research is needed in this area given the shift to outpatient care and as family caregivers become the primary providers of care. Future research should include expanding tested models of family caregiver support in clinical practice and in diverse populations. CA Cancer J Clin 2017. © 2017 American Cancer Society. CA Cancer J Clin 2017;67:318-325. © 2017 American Cancer Society.
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Affiliation(s)
- Betty Ferrell
- Director, Division of Nursing Research and Education, City of Hope National Medical Center, Duarte, CA
| | - Elaine Wittenberg
- Associate Professor, Division of Nursing Research and Education, City of Hope National Medical Center, Duarte, CA
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Pinks D, Davis C, Pinks C. Experiences of partners of prostate cancer survivors: A qualitative study. J Psychosoc Oncol 2017; 36:49-63. [PMID: 28506193 DOI: 10.1080/07347332.2017.1329769] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Prostate cancer, Australia's leading cancer, has treatment side effects that reduce the quality of life for both survivors and partners. Limited partner research exists. This study aimed to address this gap in the literature by gathering data directly from partners to obtain a deeper understanding of their experiences of prostate cancer survivorship that helps inform healthcare service providers. A qualitative approach was taken to explore participant views (N = 16) through three focus groups and two in-depth interviews. Five themes emerged relating to caregiver burden, knowledge deficit, isolation, changes of sexual relations, and unmet needs. Possible implications for practice may include the need for specific partner-related information and interventions to assist couples to cope with the emotional distress caused by treatment side effects.
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Affiliation(s)
- Darren Pinks
- a School of Social Sciences , University of the Sunshine Coast , Sippy Downs , Australia
| | - Cindy Davis
- b Faculty of Arts, Business, and Law , University of the Sunshine Coast , Sippy Downs , Australia
| | - Clair Pinks
- a School of Social Sciences , University of the Sunshine Coast , Sippy Downs , Australia
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Kim HS, Ahn HJ. Effects of stress, dyadic communication and adaptation on prostatectomy patients' quality of life. INTERNATIONAL JOURNAL OF UROLOGICAL NURSING 2017. [DOI: 10.1111/ijun.12115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Hae Sook Kim
- Department of Nursing; Cheong Ju University; Cheong Ju Korea
| | - Han Jong Ahn
- Department of Urology, Asan Medical Center; University of Ulsan College of Medicine; Seoul Korea
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Takanashi S, Sakka M, Sato I, Watanabe S, Tanaka S, Ooshio A, Saito N, Kamibeppu K. Factors influencing mother-child communication about fathers with neurobehavioural sequelae after brain injury. Brain Inj 2017; 31:312-318. [PMID: 28156141 DOI: 10.1080/02699052.2016.1225986] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The present study clarified factors related to mother-child communication openness when fathers suffer neurobehavioural sequelae after stroke or traumatic brain injury. RESEARCH DESIGN A cross-sectional study using self-report anonymous questionnaires was conducted. METHODS AND PROCEDURES Forty-one mothers with 6-22-year-old children participated. The questionnaire examined personal factors (mother's psychological distress), social/family factors (family support functioning), illness-related factors (father's time at home and neurobehavioural sequelae severity) and mother's perceived level of open communication. Multiple regression was used to analyse factors related to mother-child communication openness. RESULTS Mother-child open communication was explained by family support functioning (β = 0.449), father's time at home (β = -0.325) and mother's psychological distress (β = -0.303). Neurobehavioural sequelae severity was not associated with mother-child open communication. CONCLUSIONS Personal, social/family and illness-related factors were related to mother-child communication about paternal illness. Professionals should promote optimal family support functioning, connect families with external resources and assess families' interaction processes.
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Affiliation(s)
- Shiho Takanashi
- a Department of Family Nursing, Division of Health Sciences and Nursing, Graduate School of Medicine , The University of Tokyo , Bunkyo-Ku , Tokyo , Japan
| | - Mariko Sakka
- a Department of Family Nursing, Division of Health Sciences and Nursing, Graduate School of Medicine , The University of Tokyo , Bunkyo-Ku , Tokyo , Japan
| | - Iori Sato
- a Department of Family Nursing, Division of Health Sciences and Nursing, Graduate School of Medicine , The University of Tokyo , Bunkyo-Ku , Tokyo , Japan
| | - Shu Watanabe
- b Department of Rehabilitation Medicine , the Jikei University School of Medicine , Minato-Ku , Tokyo , Japan
| | - Shota Tanaka
- c Department of Neurosurgery , Faculty of Medicine, The University of Tokyo , Bunkyo-Ku , Tokyo , Japan
| | - Ayumi Ooshio
- d Kitahara International Hospital , Hachioji City , Japan
| | - Nobuhito Saito
- c Department of Neurosurgery , Faculty of Medicine, The University of Tokyo , Bunkyo-Ku , Tokyo , Japan
| | - Kiyoko Kamibeppu
- a Department of Family Nursing, Division of Health Sciences and Nursing, Graduate School of Medicine , The University of Tokyo , Bunkyo-Ku , Tokyo , Japan
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Abstract
BACKGROUND With the research focus on family caregiving shifting from the individual to the dyadic level, there is a need to explore cancer dyads' concerns and needs and to understand their experiences of coping together with cancer. OBJECTIVE To objectives of this study were to gain a better understanding of the experience of couples living with cancer and to explore cancer couples' concerns and needs related to the caring role and experience of spousal caregivers. METHODS The focus group study design with a purposeful sampling strategy was adopted. We conducted 4 focus group interviews with 11 cancer patients and 17 spousal caregivers in a hospital. RESULTS Four themes and 15 subthemes emerged after a conventional content analysis. The 4 themes include communication dynamics, living with changes, negative and positive impacts, and network of support. Based on the findings, we drew a preliminary conceptualization of the couples' experience of coping and living with cancer as a whole. CONCLUSIONS This study provided insights to healthcare professionals regarding daily struggles of couples living with cancer and the development of intervention programs to support these couples. IMPLICATIONS FOR PRACTICE Healthcare professionals need to (1) be sensitive to the couples' needs and concerns, (2) offer sufficient and useful information to couples who are coping with cancer, (3) encourage and help spousal caregivers to take care of themselves while coping with the changes in their spouses, and (4) instill realistic hopes in couples and help them to sustain a positive attitude with a focus on the future, not just on the present.
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Lyons KS, Miller LM, McCarthy MJ. The Roles of Dyadic Appraisal and Coping in Couples With Lung Cancer. JOURNAL OF FAMILY NURSING 2016; 22:493-514. [PMID: 27803239 PMCID: PMC5405735 DOI: 10.1177/1074840716675976] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Given the high symptom burden and low survivability of lung cancer, patients and their spouses have been found to experience poor mental health. The current study examined the roles of dyadic appraisal and dyadic coping on the mental health of 78 couples living with non-small cell lung cancer. Multilevel modeling revealed that spouses, on average, reported significantly worse mental health than patients. Dyadic appraisal and dyadic coping played important roles in predicting mental health, controlling for known developmental and contextual covariates. Dyadic appraisal of the patient's pain and fatigue was significantly associated with spouse mental health, albeit in opposite directions. Dyadic coping significantly predicted patient mental health. The study underlines the need to incorporate routine screening of both patient and spouse mental health, and highlights the complex role of appraisal within the couple in a life-threatening context. Viewing the couple as a unit, rather than separate individuals, raises important awareness about the role of disparate illness appraisals and coping strategies within the dyad on the health of both members. Nurses are particularly well situated to engage in a collaborative family-focused approach to the couple with cancer that promotes communication and health.
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Park EO, Yates BC, Meza J, Kosloski K, Pullen C. Spousal Caregivers of Coronary Artery Bypass Surgery Patients: Differences between Caregivers with Low vs. High Caregiving Demands. Rehabil Nurs 2016; 41:260-9. [PMID: 26543015 PMCID: PMC4860178 DOI: 10.1002/rnj.252] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2015] [Indexed: 12/22/2022]
Abstract
PURPOSE Compared to non-caregivers, caregivers have higher rates of depressive symptoms, caregiver strain, less mutuality, and health care visits. However, few investigators have examined family caregivers after coronary artery bypass (CAB) surgery. The purpose of this study was to examine differences in caregiving difficulties, mutuality (i.e., open communication; avoiding sad thoughts), and depressive symptoms based on low vs. high caregiving demands among spousal caregivers. DESIGN A descriptive, comparative design was used to examine 33 spousal caregivers of CAB surgery patients (16 in low and 17 in high caregiving demand groups). METHODS Measures included: Caregiving Burden Scale, Mutuality and Interpersonal Sensitivity Scale, and Patient Health Questionnaire-9. Groups were compared using Mann-Whitney U statistics. FINDINGS It was found that caregivers with high caregiving demands reported more caregiving difficulties and more open communication about the surgery compared to caregivers with low demands. CONCLUSION Caregivers with greater caregiving demands may need additional support to assist them with the caregiving situation. CLINICAL RELEVANCE Priority should be given to family caregivers, who take care of patients in cardiac rehabilitation, with higher caregiving demand.
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Affiliation(s)
- Esther O. Park
- Nursing Department, Daegu University, 33 Seongdangro 50gil Namgu, Daegu 705-714, Republic of Korea
| | - Bernice C. Yates
- College of Nursing, University of Nebraska Medical Center, 42 and Emile, Omaha, NE, 68198,
| | - Jane Meza
- College of Public Health, University of Nebraska Medical Center, 984355 Medical Center, Omaha, NE, 68198-4355,
| | - Karl Kosloski
- Department of Gerontology, University of Nebraska Omaha, 6001 Dodge St. Omaha, NE, 68182,
| | - Carol Pullen
- College of Nursing, University of Nebraska Medical Center, 42 and Emile, Omaha, NE, 68198,
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Appraisals, perceived dyadic communication, and quality of life over time among couples coping with prostate cancer. Support Care Cancer 2016; 24:3757-65. [PMID: 27039207 DOI: 10.1007/s00520-016-3188-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 03/21/2016] [Indexed: 10/22/2022]
Abstract
PURPOSE Little research has examined how prostate cancer patients' and their spouses' appraisals of illness and quality of life (QOL) interact with one another. This study examined the interdependent relationships between their appraisals of illness and QOL and if their perceived dyadic communication mediated these relationships. METHODS We used the Actor-Partner Interdependence Mediation Model (APIMeM) approach to conduct a secondary analysis of longitudinal data from 124 prostate cancer patient-spouse dyads. We examined actor effects (each person's influence on his/her own outcomes) and partner effects (each person's influence on his/her partner's outcomes). Appraisals of illness, perceived dyadic communication, and QOL were measured using Appraisal of Illness Scale, Lewis Mutuality and Interpersonal Sensitivity Scale, and Functional Assessment of Chronic Illness Therapy General Scale, respectively. Analyses controlled for effects of prostate cancer symptoms and demographic factors. RESULTS Among actor effects, spouses with more negative appraisals at baseline perceived worse dyadic communication 4 months later (p < .05) and worse QOL 8 months later (p < .001). Patients and spouses who perceived more dyadic communication at 4 months had better QOL at 8 months (p < .01). Among partner effects, there was only weak evidence for an association between patient perceived dyadic communication at 4 months and better spouse QOL at 8 months of follow-up (p = .05). No mediation effects were found. CONCLUSIONS Patients' and spouses' appraisals of the illness and their dyadic communication were associated with their long-term QOL. Interventions that reduce negative appraisals of illness and promote dyadic communication may improve QOL for both patients with prostate cancer and their spouses.
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Men's use of networks to manage communication tensions related to a potential diagnosis of prostate cancer. Eur J Oncol Nurs 2016; 20:106-12. [DOI: 10.1016/j.ejon.2015.06.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Revised: 06/06/2015] [Accepted: 06/18/2015] [Indexed: 11/20/2022]
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Huber J, Streuli JC, Lozankovski N, Stredele RJF, Moll P, Hohenfellner M, Huber CG, Ihrig A, Peters T. The complex interplay of physician, patient, and spouse in preoperative counseling for radical prostatectomy: a comparative mixed-method analysis of 30 videotaped consultations. Psychooncology 2015; 25:949-56. [DOI: 10.1002/pon.4041] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 09/26/2015] [Accepted: 11/05/2015] [Indexed: 11/10/2022]
Affiliation(s)
- Johannes Huber
- Department of Urology; University of Heidelberg; Heidelberg Germany
| | - Jürg C. Streuli
- Department of Biomedical Ethics; University of Zürich; Zürich Switzerland
| | | | | | - Peter Moll
- Department of Urology; University of Heidelberg; Heidelberg Germany
| | | | | | - Andreas Ihrig
- Division of Psychooncology, Department for Psychosomatic and General Clinical Medicine; University of Heidelberg; Heidelberg Germany
| | - Tim Peters
- Center for Medical Education; Ruhr-University Bochum; Bochum Germany
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Re-affirmation of a Preliminary Live with Love Conceptual Framework for cancer couple dyads: A couple-based complex intervention study. Eur J Oncol Nurs 2015; 20:215-22. [PMID: 26447085 DOI: 10.1016/j.ejon.2015.09.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Revised: 08/08/2015] [Accepted: 09/22/2015] [Indexed: 11/24/2022]
Abstract
PURPOSE The relational dynamics of couples may be under great strain due to the diagnosis and treatment of cancer. A complex "Caring for Couples Coping with Cancer" (4Cs) intervention program, guided by a Preliminary Live with Love Conceptual Framework (P-LLCF) for Cancer Couple Dyads, was developed to support couples going through such hardship. The purpose of this paper is to present a re-analysis of the results of the 4Cs intervention program to determine whether the findings provide evidence to support the constructs in the P-LLCF. METHODS The 4Cs intervention was provided to support cancer patients and their spousal caregivers. The pre- and post-intervention findings of the 4Cs intervention program were re-analyzed using descriptive-correlational analysis and structural equation modeling (SEM) to test whether the findings provide evidence to support the constructs in the P-LLCF. RESULTS A total of 92 out of the 117 dyads at baseline (T0) were successfully followed-up at 6 weeks (T1). The re-analysis of the findings from the 4Cs program (T1 outcomes) showed inter-relationships among the components included in the P-LLCF: dyadic mediators, dyadic coping, dyadic appraisal, and dyadic outcomes. The SEM of all six models resulted in convergence and showed goodness of fit to the data and variables, which is supportive of the constructs in the P-LLCF. CONCLUSIONS The present analysis of the T1 outcome measures of the 4Cs program provides evidence to support the constructs in the P-LLCF. Multiple mutual effects existed between couples in the process of living and coping with cancer as dyads.
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Manne SL, Kissane D, Zaider T, Kashy D, Lee D, Heckman C, Virtue SM. Holding back, intimacy, and psychological and relationship outcomes among couples coping with prostate cancer. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2015; 29:708-19. [PMID: 26192132 PMCID: PMC5225663 DOI: 10.1037/fam0000096] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The present study evaluated intimacy as a mechanism for the effects of holding back sharing concerns about cancer on couples' psychological distress, well-being, and marital satisfaction using the actor-partner interdependence model (APIM), and evaluated 2 possible moderators of these associations: the number of patient and spouse cancer concerns. We had 139 men treated for localized prostate cancer in the past year and their spouses complete surveys about holding back sharing cancer concerns, intimacy, distress, and relationship satisfaction, as well as patient and spouse cancer concerns. APIM-indicated that the association between holding back sharing concerns, and patient and spouse distress, well-being, and relationship satisfaction could be partially accounted for by their influence on patient and spouse perceptions of relationship intimacy. The number of cancer concerns did not moderate the mediational model. Holding back has strong associations with both partners' well-being and distress. Holding back sharing concerns was particularly detrimental for couples' intimacy and relationship satisfaction.
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Affiliation(s)
- Sharon L Manne
- Section of Population Science, Rutgers Cancer Institute of New Jersey
| | - David Kissane
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center
| | - Talia Zaider
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center
| | | | - David Lee
- Department of Surgery, University of Pennsylvania School of Medicine
| | - Carolyn Heckman
- Cancer Prevention and Control Program, Fox Chase Cancer Center
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Hamilton LD, Van Dam D, Wassersug RJ. The perspective of prostate cancer patients and patients' partners on the psychological burden of androgen deprivation and the dyadic adjustment of prostate cancer couples. Psychooncology 2015; 25:823-31. [PMID: 26411285 DOI: 10.1002/pon.3930] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 06/04/2015] [Accepted: 07/15/2015] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Prostate cancer and its treatments, particularly androgen deprivation therapy (ADT), affect both patients and partners. This study assessed how prostate cancer treatment type, patient mood, and sexual function related to dyadic adjustment from patient and partner perspectives. METHODS Men with prostate cancer (n = 206) and partners of men with prostate cancer (n = 66) completed an online survey assessing the patients' mood (profile of mood states short form), their dyadic adjustment (dyadic adjustment scale), and sexual function (expanded prostate cancer index composite). RESULTS Analyses of covariance found that men on ADT reported better dyadic adjustment compared with men not on ADT. Erectile dysfunction was high for all patients, but a multivariate analysis of variance found that those on ADT experienced greater bother at loss of sexual function than patients not on ADT, suggesting that loss of libido when on ADT does not mitigate the psychological distress associated with loss of erections. In a multiple linear regression, patients' mood predicted their dyadic adjustment, such that worse mood was related to worse dyadic adjustment. However, more bother with patients' overall sexual function predicted lower relationship scores for the patients, while the patients' lack of sexual desire predicted lower dyadic adjustment for partners. CONCLUSIONS Both patients and partners are impacted by the prostate cancer treatment effects on patients' psychological and sexual function. Our data help clarify the way that prostate cancer treatments can affect relationships and that loss of libido on ADT does not attenuate distress about erectile dysfunction. Understanding these changes may help patients and partners maintain a co-supportive relationship. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
| | - Dexter Van Dam
- Psychology Department, Mount Allison University, Sackville, NB, Canada
| | - Richard J Wassersug
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada.,Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, VIC, Australia
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Ross KM, Ranby KW, Wooldridge JS, Robertson C, Lipkus IM. Effects of physical and mental health on relationship satisfaction: a dyadic, longitudinal examination of couples facing prostate cancer. Psychooncology 2015; 25:898-904. [DOI: 10.1002/pon.3931] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 06/05/2015] [Accepted: 07/15/2015] [Indexed: 11/09/2022]
Affiliation(s)
- Kaile M. Ross
- Department of Psychology; University of Colorado Denver; USA
| | - Krista W. Ranby
- Department of Psychology; University of Colorado Denver; USA
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Couper J, Collins A, Bloch S, Street A, Duchesne G, Jones T, Olver J, Love A. Cognitive existential couple therapy (CECT) in men and partners facing localised prostate cancer: a randomised controlled trial. BJU Int 2015; 115 Suppl 5:35-45. [DOI: 10.1111/bju.12991] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Jeremy Couper
- Psycho-oncology Research Unit; Peter MacCallum Cancer Centre; Melbourne Australia
- Department of Psychiatry; St Vincent's Hospital; Melbourne Australia
| | - Anna Collins
- Psycho-oncology Research Unit; Peter MacCallum Cancer Centre; Melbourne Australia
- Centre for Palliative Care; St Vincent's Hospital; Melbourne Australia
| | - Sidney Bloch
- Department of Psychiatry; St Vincent's Hospital; Melbourne Australia
| | - Annette Street
- Department of Public Health, Faculty of Health Sciences; LaTrobe University; Melbourne Australia
| | - Gillian Duchesne
- Department of Radiation Oncology; Peter MacCallum Cancer Centre; Melbourne Australia
| | - Tessa Jones
- Department of Clinical Psychology and Psychiatry; Peter MacCallum Cancer Centre; Melbourne Australia
| | - James Olver
- Department of Psychiatry, Austin Health; University of Melbourne; Melbourne Australia
| | - Anthony Love
- Centre for Cultural Diversity and Wellbeing, College of Arts; Victoria University; Melbourne Australia
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Song L, Rini C, Deal AM, Nielsen ME, Chang H, Kinneer P, Teal R, Johnson DC, Dunn MW, Mark B, Palmer MH. Improving couples' quality of life through a Web-based prostate cancer education intervention. Oncol Nurs Forum 2015; 42:183-92. [PMID: 25806885 PMCID: PMC5123564 DOI: 10.1188/15.onf.183-192] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To evaluate the feasibility and acceptability of a newly developed web-based, couple-oriented intervention called Prostate Cancer Education and Resources for Couples (PERC). DESIGN Quantitative, qualitative, mixed-methods approach. SETTING Oncology outpatient clinics at the University of North Carolina (UNC) Lineberger Comprehensive Cancer Center at UNC–Chapel Hill. SAMPLE 26 patients with localized prostate cancer (PCa) and their partners. METHODS Pre- and postpilot quantitative assessments and a postpilot qualitative interview were conducted. MAIN RESEARCH VARIABLES General and PCa-specific symptoms, quality of life, psychosocial factors, PERC’s ease of use, and web activities. FINDINGS Improvement was shown in some PCa-specific and general symptoms (small effect sizes for patients and small-to-medium effect sizes for partners), overall quality of life, and physical and social domains of quality of life for patients (small effect sizes). Web activity data indicated high PERC use. Qualitative and quantitative analyses indicated that participants found PERC easy to use and understand,as well as engaging, of high quality, and relevant. Overall, participants were satisfied with PERC and reported that PERC improved their knowledge about symptom management and communication as a couple. CONCLUSIONS PERC was a feasible, acceptable method of reducing the side effects of PCa treatment–related symptoms and improving quality of life. IMPLICATIONS FOR NURSING PERC has the potential to reduce the negative impacts of symptoms and enhance quality of life for patients with localized PCa and their partners, particularly for those who live in rural areas and have limited access to post-treatment supportive care.
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Affiliation(s)
- Lixin Song
- the School of Nursing University of North Carolina (UNC)–Chapel Hill and at the UNC Lineberger Comprehensive Cancer Center
| | - Christine Rini
- the Department of Health Behavior in the Gillings School of Global Public Health at the University of North Carolina (UNC)–Chapel Hill and at the UNC Lineberger Comprehensive Cancer Center
| | - Allison M. Deal
- Biostatistician at the UNC Lineberger Comprehensive Cancer Center
| | - Matthew E. Nielsen
- the Division of Urologic Oncology at the UNC Lineberger Comprehensive Cancer Center, as well as an assistant professor in the Department of Urology in the School of Medicine and an adjunct assistant professor in the Departments of Epidemiology and Health Policy and Management at the Gillings School of Global Public Health, all at UNC–Chapel Hill
| | - Hao Chang
- UNC–Chapel Hill and an undergraduate student in the Department of Mathematics at Dartmouth College in Hanover, NH
| | | | - Randall Teal
- Nutrition Communication for Health Applications and Interventions Core at the UNC Lineberger Comprehensive Cancer Center
| | | | - Mary W. Dunn
- both in the Department of Urology, UNC–Chapel Hill
| | - Barbara Mark
- Distinguished Professor in Aging, both in the School of Nursing, all at UNC–Chapel Hill
| | - Mary H. Palmer
- the Helen W. and Thomas L. Umphlet Distinguished Professor in Aging, both in the School of Nursing, all at UNC–Chapel Hill
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A preliminary study to develop an intervention to facilitate communication between couples in advanced cancer. Palliat Support Care 2015; 13:1381-90. [DOI: 10.1017/s1478951514001333] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjective:Psychosocial interventions directed to couples where one has advanced cancer can reduce distress, enhance communication, and provide an opportunity for relational growth. The present study aimed to develop an intervention to facilitate communication about living with advanced cancer using the Patient Dignity Inventory (PDI) as the focus of a clinical interview with couples toward the end of life.Method:Couples were recruited from oncology and palliative care services at a Sydney hospital. After the PDI was developed and manualized as an intervention for couples, the PDI–Couple Interview (PDI–CI) was delivered by a clinical psychologist and comprised the following: (1) the patient completed the PDI; (2) the patient's identified partner completed the PDI about how they thought the patient was feeling; and (3) the clinician reviewed the results with the couple, summarizing areas of concurrence and discordance and facilitating discussion.Results:Some 34 couples were referred, of which 12 consented, 9 of whom completed the clinical interview. Reported benefits included enabling couples to express their concerns together, identifying differences in understanding, and giving “permission to speak” with each other. The focus of the interview around the PDI provided a structure that was particularly acceptable for men. Most couples confirmed that they were “on the same page,” and where differences were identified, it provided a forum for discussion and a mutual understanding of the challenges in managing advanced cancer within a supportive context.Significance of Results:Participant couples' experiences of the PDI–CI provide valuable insight into the benefits of this intervention. This preliminary study indicates that the intervention is a relatively simple means of enhancing closer communication and connection between couples where one has advanced cancer and may be an important adjunct in helping prepare couples for the challenges inherent toward the end of life. Further investigation of feasibility with a larger sample is recommended.
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Daly MB. A Family-Centered Model for Sharing Genetic Risk. THE JOURNAL OF LAW, MEDICINE & ETHICS : A JOURNAL OF THE AMERICAN SOCIETY OF LAW, MEDICINE & ETHICS 2015; 43:545-551. [PMID: 26479564 PMCID: PMC4617664 DOI: 10.1111/jlme.12297] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The successes of the Human Genome Project have ushered in a new era of genomic science. To effectively translate these discoveries, it will be critical to improve the communication of genetic risk within families. This will require a systematic approach that accounts for the nature of family relationships and sociocultural beliefs. This paper proposes the application of the Family Systems Illness Model, used in the setting of cancer care, to the evolving field of genomics.
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Affiliation(s)
- Mary B. Daly
- Chair, Department of Clinical Genetics, Timothy R. Talbot Jr. Chair for Cancer Research, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA 19111, 609-397-9112 (home), 908-304-2236 (cell), 215-728-2791 (work), 215-214-3999 (fax)
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