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Musters SCW, Kreca SM, van Dieren S, van der Wal-Huisman H, Romijn JA, Chaboyer W, Nieveen van Dijkum EJM, Eskes AM, Besselink MGH, Bakker CA, van Langen R, Heidsma C, Ouwens M, Hendriks MJ, van Leeuwen BL, de Jong M, Hoekstra R, Blaauw E, Smith R, Schreuder M. Surgical outcomes in surgical oncology patients who participated in a family involvement program. Surgery 2024; 176:826-834. [PMID: 38897885 DOI: 10.1016/j.surg.2024.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 04/29/2024] [Accepted: 05/06/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND There is a lack of evidence regarding the relationship between family involvement and outcomes in gastrointestinal oncology patients after surgery. To evaluate the effect of a family involvement program for patients undergoing oncologic gastrointestinal surgery on unplanned readmissions within 30 days after surgery. METHODS A multicenter patient-preference cohort study compared 2 groups: patients who participated in the family involvement program versus usual care. The program comprised involvement of family caregivers in care and training of health care professionals in family-centered care. Multivariable regression analyses were used to evaluate the effect of the FIP on the number of unplanned readmissions up to 30 days after surgery. Secondary outcomes included complications sensitive to fundamental care activities, emergency department visits, intensive care unit admissions, hospital length of stay, and the need for professional home care after discharge. RESULTS Of the 301 patients included, 152 chose the family involvement program, and 149 chose usual care. Postoperative readmissions occurred in 25 (16.4%) patients in the family involvement program group, and 15 (10.1%) in the usual care group (P = .11). A significant reduction of 16.2% was observed in the need for professional home care after discharge in the family involvement program group (P < .01). No significant differences were found between the 2 groups in the other secondary outcomes. CONCLUSION The family involvement program did not reduce the number of unplanned readmissions, but it led to a substantial reduction in-home care, which suggests an economic benefit from a societal perspective. Implementation of the family involvement program should, therefore, be considered in clinical practice.
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Affiliation(s)
- Selma C W Musters
- Amsterdam UMC Location University of Amsterdam, Department of Surgery, The Netherlands; Cancer Center Amsterdam, Treatment and Quality of Life, Amsterdam, The Netherlands
| | - Sani M Kreca
- Amsterdam UMC Location University of Amsterdam, Department of Surgery, The Netherlands; Cancer Center Amsterdam, Treatment and Quality of Life, Amsterdam, The Netherlands
| | - Susan van Dieren
- Amsterdam UMC Location University of Amsterdam, Department of Surgery, The Netherlands; Cancer Center Amsterdam, Treatment and Quality of Life, Amsterdam, The Netherlands
| | | | | | - Wendy Chaboyer
- Menzies Health Institute Queensland and School of Nursing and Midwifery, Griffith University, Gold Coast, QLD, Australia
| | - Els J M Nieveen van Dijkum
- Amsterdam UMC Location University of Amsterdam, Department of Surgery, The Netherlands; Cancer Center Amsterdam, Treatment and Quality of Life, Amsterdam, The Netherlands; Faculty of Health, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, The Netherlands
| | - Anne M Eskes
- Amsterdam UMC Location University of Amsterdam, Department of Surgery, The Netherlands; Cancer Center Amsterdam, Treatment and Quality of Life, Amsterdam, The Netherlands; Menzies Health Institute Queensland and School of Nursing and Midwifery, Griffith University, Gold Coast, QLD, Australia; Faculty of Health, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, The Netherlands.
| | - Marc G H Besselink
- Amsterdam UMC Location University of Amsterdam, Department of Surgery, The Netherlands
| | - Chris A Bakker
- Amsterdam UMC Location University of Amsterdam, Department of Surgery, The Netherlands
| | - Rosanna van Langen
- Amsterdam UMC Location University of Amsterdam, Department of Surgery, The Netherlands
| | - Charlotte Heidsma
- Amsterdam UMC Location University of Amsterdam, Department of Surgery, The Netherlands
| | - Marjan Ouwens
- Amsterdam UMC Location University of Amsterdam, Department of Surgery, The Netherlands
| | - Marie-José Hendriks
- Amsterdam UMC Location University of Amsterdam, Department of Surgery, The Netherlands
| | - Barbara L van Leeuwen
- Department of Surgery, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Maarten de Jong
- Department of Surgery, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Rommy Hoekstra
- Department of Surgery, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Eline Blaauw
- Department of Surgery, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Reggie Smith
- Amsterdam UMC Location University of Amsterdam, Department of Surgery, The Netherlands
| | - Marthe Schreuder
- Amsterdam UMC Location University of Amsterdam, Department of Surgery, The Netherlands
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Haslbeck J, Casanova F, Cascais D, Staudacher S. [Chat-based cancer counseling in Switzerland: A reflexive thematic analysis of chat protocols focused on cancer survivors' needs]. Pflege 2024; 37:187-195. [PMID: 38450628 DOI: 10.1024/1012-5302/a000986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
Chat-based cancer counseling in Switzerland: A reflexive thematic analysis of chat protocols focused on cancer survivors' needs Abstract: Background: The number of people diagnosed with cancer and continue to live as cancer survivors is growing. Together with their relatives, they have information and counseling needs during the illness trajectory. With Cancerline, the Swiss Cancer League offers a chat-based counseling service for cancer survivors. Research question/objective: For the first time, the qualitative study investigated which needs cancer survivors express in Cancerline to gain insights for the further development and quality assurance of chat-based cancer counseling. Methods: Based on the principles of Interpretive Description, 669 chat counseling transcripts were analyzed using Braun et al. (2018) reflexive thematic analysis in an iterative process in six analysis steps. Results: Cancer survivorship needs in Cancerline are multifaceted, and we have identified nine themes: need anonymous chat to communicate, get informed, weigh ethical dilemmas and make decisions, seek meaning and hope, find ways to manage burdensome emotions, resolve social conflict and not burden others, feel understood and give space to own needs, clarify role as significant other acting correctly and seeking security. Conclusions: Chat-based counseling may contribute to supporting cancer survivors with information needs about cancer in a flexible way that is close to everyday life. Professionals can sensitize survivors to chat-based counseling, which makes low-threshold counseling accessible.
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Affiliation(s)
| | | | - Diana Cascais
- Gynäkologisches Tumorzentrum, Universitätsspital Basel, Schweiz
| | - Sandra Staudacher
- Institut für Pflegewissenschaft, Universität Basel, Schweiz
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Niederlande
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Zhuang D, Wang Y, Chen Q, Wang T, Zhou P, Zhu F, Hu S. Validation of the Chinese version of the 'caring ability of family caregivers of patients with cancer scale (CAFCPCS)' in family caregivers of elderly patients with cancer: A study protocol. Nurs Open 2024; 11:e2227. [PMID: 39004915 PMCID: PMC11247114 DOI: 10.1002/nop2.2227] [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: 07/16/2024] Open
Abstract
AIM This study aims to translate the English version of the 'caring ability of family caregivers of patients with cancer scale (CAFCPCS)' into Chinese and validate its psychometric properties in the family caregivers of elderly patients with cancer. DESIGN A methodological study. METHODS Based on the Brislin translation model, the original scale will be translated and back-translated, the Delphi expert consultation method will be adopted for cross-cultural adaptation, and the pilot will be carried out in 20-30 family caregivers of elderly patients with cancer. Then, a dual-centre prospective study will be conducted by recruiting 371-542 family caregivers of elderly patients with cancer to validate the psychometric properties of the Chinese version of CAFCPCS. RESULTS The scale's content validity will be evaluated using the Delphi expert inquiry method, and the face validity will be evaluated using a pre-experiment. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) will be used to assess structural validity, while internal consistency reliability and split-half reliability will be used to assess reliability. PATIENT OR PUBLIC CONTRIBUTION Public involvement is of great significance for this study. Participants will be used in a pre-test to give feedback on whether the contents of the clinical pilot version of CAFCPCS after expert consultation can reflect real problems and whether the sentences can be well understood. Based on their opinions, the research group will further refine the scale.
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Affiliation(s)
- Dongmei Zhuang
- School of Nursing, Anhui Medical University, Hefei, Anhui, China
- Suzhou Hospital of Anhui Medical University, Suzhou, Anhui, China
| | - Yan Wang
- School of Nursing, Anhui Medical University, Hefei, Anhui, China
| | - Qin Chen
- Suzhou Hospital of Anhui Medical University, Suzhou, Anhui, China
| | - Ting Wang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Peng Zhou
- School of Nursing, Anhui Medical University, Hefei, Anhui, China
| | - Furong Zhu
- School of Nursing, Anhui Medical University, Hefei, Anhui, China
| | - Shaohua Hu
- Department of Nursing, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
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Cui P, Cheng C, An H, Chen X, Chen C, Hu H. A chain mediation model reveals the association between family sense of coherence and quality of life in caregivers of advanced cancer patients. Sci Rep 2024; 14:10701. [PMID: 38730003 PMCID: PMC11087510 DOI: 10.1038/s41598-024-61344-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 05/05/2024] [Indexed: 05/12/2024] Open
Abstract
Caregivers of advanced cancer patients face challenges impacting their quality of life (QoL). While evidence suggests that family sense of coherence (FSOC) can enhance individual psychological well-being and reduce distress symptoms, the precise mechanism through which FSOC improves caregivers' QoL remains unclear. This study aimed to explore the relationships among FSOC, psychological resilience, psychological distress, and QoL in primary caregivers of advanced cancer patients. A cross-sectional observational study was undertaken from June 2020 to March 2021 across five tertiary hospitals in China. Instruments included a general characteristic questionnaire, the Family Sense of Coherence Scale, the Patient Health Questionnaire-4, the 10-item Connor-Davidson Resilience Scale, and the 8-item SF-8 health survey. Pearson's correlation and chain mediation analyses were performed using IBM SPSS (version 21) and PROCESS macro (version 3.4). Out of 290 valid questionnaires, results demonstrated that FSOC directly and positively influences caregivers' QoL. Psychological distress partially mediated the FSOC-QoL association, with paths "FSOC-psychological distress-QoL" and "FSOC-psychological resilience-psychological distress-QoL" contributing 43.08% and 6.72% of the total effect, respectively. Furthermore, this study distinguished physical and mental aspects of QoL, confirming both conform to the chain mediation model. FSOC impacts caregivers' QoL directly and indirectly through the mediation of psychological distress and the chain mediation effect of "psychological resilience-psychological distress". These insights enhance our understanding of the complex interplay between FSOC and QoL, underscoring the potential benefits of bolstering FSOC to strengthen caregiver resilience, alleviate distress, and ultimately elevate their QoL.
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Affiliation(s)
- Panpan Cui
- Department of Nursing, Henan Provincial Key Medicine Laboratory of Nursing, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, No. 7 Weiwu Road, Zhengzhou, China
- School of Nursing, Zhengzhou University, Zhengzhou, China
| | - Chunyan Cheng
- Hematology Department, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Huiying An
- Gastroenterology, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Xinyi Chen
- Medical Oncology, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Changying Chen
- The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe Dong Road, Zhengzhou, China.
- Institute for Hospital Management of Henan Province, Zhengzhou, China.
| | - Hengyu Hu
- Department of Nursing, Henan Provincial Key Medicine Laboratory of Nursing, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, No. 7 Weiwu Road, Zhengzhou, China.
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Cui P, Yang M, Hu H, Cheng C, Chen X, Shi J, Li S, Chen C, Zhang H. The impact of caregiver burden on quality of life in family caregivers of patients with advanced cancer: a moderated mediation analysis of the role of psychological distress and family resilience. BMC Public Health 2024; 24:817. [PMID: 38491454 PMCID: PMC10941369 DOI: 10.1186/s12889-024-18321-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 03/10/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND The caregiver burden frequently experienced by family members tending to advanced cancer patients significantly impacts their psychological well-being and quality of life (QoL). Although family resilience might function as a mitigating factor in this relationship, its specific role remains to be elucidated. This study aims to probe the mediating effect of psychological distress on the relationship between caregiver burden and QoL, as well as the moderating effect of family resilience. METHODS A cross-sectional study was conducted between June 2020 and March 2021 in five tertiary hospitals in China. Data were collected on caregiver burden, family resilience, psychological distress (including anxiety and depression), and QoL. Moderated mediation analysis was performed. RESULTS Data analysis included 290 caregivers. It confirmed the mediating role of psychological distress in the caregiver burden-QoL relationship (P < 0.001). Both overall family resilience and the specific dimension of family communication and problem-solving (FCPS) demonstrated significant moderating effects on the "psychological distress/anxiety-QoL" paths (P < 0.05). The utilization of social and economic resources (USER) significantly moderated the association between depression and QoL (P < 0.05). CONCLUSIONS The study corroborates psychological distress's mediation between caregiver burden and QoL and family resilience's moderation between psychological distress and QoL. It underscores the need for minimizing psychological distress and bolstering family resilience among caregivers of advanced cancer patients. Accordingly, interventions should be tailored, inclusive of psychological assistance and promotion of family resilience, particularly focusing on FCPS and USER, to augment the caregivers' well-being and QoL.
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Affiliation(s)
- Panpan Cui
- Department of Nursing, Henan Provincial Key Medicine Laboratory of Nursing, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, No. 7 Weiwu Road, Zhengzhou, China
- School of Nursing, Zhengzhou University, Zhengzhou, China
| | - Ming Yang
- Nursing Department, Xinyang Central Hospital, Xinyang, China
| | - Hengyu Hu
- Department of Nursing, Henan Provincial Key Medicine Laboratory of Nursing, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, No. 7 Weiwu Road, Zhengzhou, China
| | - Chunyan Cheng
- Hemangiomatology Department, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Xinyi Chen
- Medical Oncology, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Jiaoxia Shi
- Medical Oncology, People's Hospital of Jiaozuo City, Jiaozuo, China
| | - Shifeng Li
- Medical Oncology, Xinyang Central Hospital, Xinyang, China
| | - Changying Chen
- The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe Dong Road, Zhengzhou, China.
- Institute for Hospital Management of Henan Province, Zhengzhou, China.
| | - Hongmei Zhang
- Department of Nursing, Henan Provincial Key Medicine Laboratory of Nursing, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, No. 7 Weiwu Road, Zhengzhou, China.
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Erbay Dalli Ö, Bulut H. Level of caregiving burden and affecting factors in family caregivers of patients with lung cancer: A cross-sectional study. Support Care Cancer 2023; 32:60. [PMID: 38145998 DOI: 10.1007/s00520-023-08259-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 12/15/2023] [Indexed: 12/27/2023]
Abstract
PURPOSE To determine the caregiving burden level and affecting factors of family members caring for patients with lung cancer (LC). METHODS This study used a cross-sectional design and a convenience sampling method. The study was conducted between April 2023 and August 2023 with the LC patients (n = 448) and their caregivers (n = 448) who met the inclusion criteria and were followed up in seven clinics of a specialized hospital for pulmonary diseases in Turkey. Data were collected by using (1) a demographic questionnaire (for patient and caregiver), (2) the Zarit Burden Interview (ZBI), (3) the Beck Depression Inventory (BDI), and (4) the Caregiver Quality of Life Index-Cancer (CQoLC). RESULTS The study included 448 caregivers, with a mean age of 45.09 ± 13.48 years, and 71.4% were female. The mean ZBI score of 31.45 ± 16.71 indicated mild to moderate burden. Pearson correlation analysis showed that caregivers' depression levels increased and quality of life decreased significantly as the care burden increased. Multiple regression analysis indicated a significant relationship between the caregiver burden and the patient's age (p < 0.05), caregiver's chronic disease (p < 0.05), type of treatment given to the patient (p < 0.05), patient's metastasis status (p < 0.05) and caregiver's quality of life (p < 0.01). CONCLUSION The fact that most of the risk factors identified in this study are non-modifiable highlights the necessity of identifying caregiver burden early by nurses and initiating the appropriate support processes.
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Affiliation(s)
- Öznur Erbay Dalli
- Bursa Uludag University Faculty of Health Sciences, Department of Internal Medicine Nursing, Nilüfer, BURSA, Turkey, 16059.
| | - Hülya Bulut
- Health Sciences University Izmir Dr Suat Seren Chest Diseases and Surgery Training and Research Hospital, Konak, İZMİR, Turkey, 35170
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Odom JN, Applebaum A, Bakitas MA, Bryant T, Currie E, Curry K, Donovan H, Fernandez ME, Ferrell B, Azuero A, Gray TF, Hendricks BA, Meier D, Nightingale C, Reinhard S, Sannes TS, Sterba K, Young HM. Availability of Family Caregiver Programs in US Cancer Centers. JAMA Netw Open 2023; 6:e2337250. [PMID: 37819661 PMCID: PMC10568368 DOI: 10.1001/jamanetworkopen.2023.37250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 08/29/2023] [Indexed: 10/13/2023] Open
Abstract
Importance Family caregivers provide the majority of health care to the 18 million patients with cancer in the US. Yet despite providing complex medical and nursing care, a large proportion of caregivers report no formal support or training. In recognition of this gap, many interventions to support cancer caregivers have been developed and tested over the past 2 decades. However, there are few system-level data on whether US cancer centers have adopted and implemented these interventions. Objective To describe and characterize the availability of family caregiver support programs in US cancer centers. Design, Setting, and Participants This cross-sectional national survey study was conducted between September 1, 2021, and April 30, 2023. Participants comprised clinical and administrative staff of Commission on Cancer-accredited US cancer centers. Data analysis was performed in May and June 2023. Main Outcomes and Measures Survey questions about the availability of 11 types of family caregiver programs (eg, peer mentoring, education classes, and psychosocial programs) were developed after literature review, assessment of similar program evaluation surveys, and discussions among a 13-member national expert advisory committee. Family caregiver programs were defined as structured, planned, and coordinated groups of activities and procedures aimed at specifically supporting family caregivers as part of usual care. Survey responses were tabulated using standard descriptive statistics, including means, proportions, and frequencies. Results Of the surveys sent to potential respondents at 971 adult cancer centers, 238 were completed (response rate, 24.5%). After nonresponse weight adjustment, most cancer centers (75.4%) had at least 1 family caregiver program; 24.6% had none. The most common program type was information and referral services (53.6%). Cancer centers with no programs were more likely to have smaller annual outpatient volumes (χ2 = 11.10; P = .011). Few centers had caregiver programs on training in medical and/or nursing tasks (21.7%), caregiver self-care (20.2%), caregiver-specific distress screening (19.3%), peer mentoring (18.9%), and children caregiving for parents (8.3%). Very few programs were developed from published evidence in a journal (8.1%). The top reason why cancer centers selected their programs was community members requesting the program (26.3%); only 12.3% of centers selected their programs based on scientific evidence. Most programs were funded by the cancer center or hospital (58.6%) or by philanthropy (42.4%). Conclusions and Relevance In this survey study, most cancer centers had family caregiver programs; however, a quarter had none. Furthermore, the scope of programming was limited and rarely evidence based, with few centers offering caregiving education and training. These findings suggest that implementation strategies are critically needed to foster uptake of evidence-based caregiver interventions.
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Affiliation(s)
- J. Nicholas Odom
- School of Nursing, The University of Alabama at Birmingham, Birmingham
- Division of Geriatrics, Gerontology, and Palliative Care, Department of Medicine, The University of Alabama at Birmingham, Birmingham
- Center for Palliative and Supportive Care, The University of Alabama at Birmingham, Birmingham
| | - Allison Applebaum
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Marie A. Bakitas
- School of Nursing, The University of Alabama at Birmingham, Birmingham
- Division of Geriatrics, Gerontology, and Palliative Care, Department of Medicine, The University of Alabama at Birmingham, Birmingham
- Center for Palliative and Supportive Care, The University of Alabama at Birmingham, Birmingham
| | | | - Erin Currie
- School of Nursing, The University of Alabama at Birmingham, Birmingham
| | - Kayleigh Curry
- School of Nursing, The University of Alabama at Birmingham, Birmingham
| | - Heidi Donovan
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania
- School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
- National Rehabilitation Research and Training Center on Family Support, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Maria E. Fernandez
- Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston School of Public Health, Houston
| | | | - Andres Azuero
- School of Nursing, The University of Alabama at Birmingham, Birmingham
| | - Tamryn F. Gray
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | | | - Diane Meier
- Mount Sinai Medical Center, New York, New York
| | - Chandylen Nightingale
- Department of Social Sciences and Health Policy, School of Medicine, Wake Forest University, Winston-Salem, North Carolina
| | | | | | - Katherine Sterba
- Department of Public Health Sciences, Medical University of South Carolina, Charleston
| | - Heather M. Young
- Betty Irene Moore School of Nursing, University of California, Davis
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Rassouli M, Beiranvand S, Karami M, Dorcheh AE, Ashrafizadeh H. Caring ability and its related factors in the family caregivers of patients with cancer. Int J Palliat Nurs 2023; 29:422-432. [PMID: 37757807 DOI: 10.12968/ijpn.2023.29.9.422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Abstract
BACKGROUND Caregivers of cancer patients experience a variety of challenges caused by the prolonged burden of care. Many of these caregivers do not have the necessary knowledge, skills and caring ability to fulfil their caring role. Therefore, healthcare providers should support them in learning to provide high-quality care. Evaluating caregivers' ability will be the first step of this supportive programme. AIM The aim of this study was to determine the caring ability of the caregivers of cancer patients and its related factors. METHODS This descriptive correlational study was performed with 271 caregivers of cancer patients who were selected through convenience sampling conducted from July to December 2021 in selected hospitals in Tehran, the capital city of Iran. The data were collected using the caring ability of family caregivers of patients with cancer scale (CAFCPCS), which was developed by Nemati et al (2020). In addition, the stability reliability coefficient was calculated to be ICC=0.93. Data analysis was performed through Statistical Package for the Social Sciences (version 26), using descriptive and inferential statistics and correlation coefficient tests at a significance level of 0.05. RESULTS The mean score for the caring ability of the family caregivers of cancer patients in this study was 91.86±7.59. The mean total score of caring ability scale had a statistically significant correlation with the type of cancer and the duration of patient care (P-value=0.05). CONCLUSION The results of the study demonstrated that the family caregivers of cancer patients do not have the necessary knowledge and awareness to perform their caring role effectively. Therefore, it is recommended to empower caregivers and use strategies to improve their trust, especially in caregivers who oversee patient care for a significant period of time.
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Affiliation(s)
- Maryam Rassouli
- Cancer Research Center, Shahid Beheshti University of Medical Sciences
| | - Samira Beiranvand
- Nursing Care Research Center in Chronic Diseases, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Iran
| | - Maryam Karami
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Iran
| | - Azam Eshaghian Dorcheh
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Iran
| | - Hadis Ashrafizadeh
- Assistant professor of nursing, Student Research Committee, Faculty of Nursing, Dezful University of Medical Sciences, Iran
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Ghezeljeh TN, Seyedfatemi N, Bolhari J, Kamyari N, Rezaei M. Effects of family-based dignity intervention and expressive writing on anticipatory grief in family caregivers of patients with cancer: a randomized controlled trial. BMC Psychiatry 2023; 23:220. [PMID: 37005577 PMCID: PMC10068160 DOI: 10.1186/s12888-023-04715-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 03/23/2023] [Indexed: 04/04/2023] Open
Abstract
Family caregivers of dying cancer patients may suffer from grief experiences and bereavement complications. Previous studies have proposed some psycho-emotional interventions for the management of these complications. However, little attention has been given to family-based dignity intervention and expressive writing. This study was conducted to examine the effects of family-based dignity intervention and expressive writing, combined and alone, on anticipatory grief in family caregivers of dying cancer patients. This was a randomized controlled trial, in which 200 family caregivers of dying cancer patients were randomly assigned to four intervention groups: family-based dignity intervention (n = 50), expressive writing intervention (n = 50), combined family-based single dignity intervention and expressive writing (n = 50), and control group (n = 50). In three times (baseline, 1 week, and 2 weeks after the interventions), anticipatory grief was assessed by a 13-item anticipatory grief scale (AGS). Finally, we found a significant reducing effect of family-based dignity intervention on AGS (-8.12 ± 1.53 vs. -1.57 ± 1.52, P = 0.01) and its subscales including behavioral (-5.92 ± 0.97 vs. -2.17 ± 0.96, P = 0.04) and emotional (-2.38 ± 0.78 vs. 0.68 ± 0.77, P = 0.03) subscales compared to the control group. However, no significant effect was seen for expressive writing intervention and combined interventions of expressive writing and family-based dignity intervention. In conclusion, family-based dignity intervention may be a safe intervention for relieving anticipatory grief among family caregivers of dying cancer patients. Additional clinical trials are needed to confirm our findings. Registration number: IRCT20210111050010N1. Trial registration date:2021-02-06.
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Affiliation(s)
- Tahereh Najafi Ghezeljeh
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Naima Seyedfatemi
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Jafar Bolhari
- Spiritual Health Research Center, School of Behavioral Sciences and Mental Health, University of Medical Sciences, Tehran, Iran
| | - Naser Kamyari
- Department of Public Health, School of Health, Abadan University of Medical Sciences, Abadan, Iran
| | - Masoud Rezaei
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.
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O'Gara G, Wiseman T, Doyle AM, Pattison N. Chronic illness and critical care-A qualitative exploration of family experience and need. Nurs Crit Care 2022. [PMID: 35833675 DOI: 10.1111/nicc.12817] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 06/09/2022] [Accepted: 06/14/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND People with chronic illnesses such as cancer and cardiovascular disease are living longer and often require the support of critical care services. Current health care provision means patients may be discharged home once clinically stable despite still having high care demands including social, emotional, or physical needs. Families are often required to assume caregiving roles. Research into family burden using quantitative methods has increased awareness, however, little qualitative work exists and the development of support interventions for families is required. AIMS To explore the experience and needs of family members of people with an existing chronic illness who are admitted to the Critical Care Unit (CCU), and to identify the desired components of a family support intervention in the form of a resource toolkit. STUDY DESIGN A qualitative exploration of family experience and need, and content development for a resource toolkit using focus group methodology. Two focus groups and one face-to-face interview were conducted involving nine adult (≥18 years) family members of adult patients with chronic illness admitted to critical care in the preceding 9 months across two specialist hospitals in the UK. These were digitally recorded, transcribed, and thematically analysed. FINDINGS Four themes were identified: importance of communication, need for support, trauma of chronic illness, and having to provide "Do-it-Yourself" care. The immense responsibility of families to provide care throughout the illness trajectory is highlighted. Understandable information is essential for a family support toolkit. CONCLUSION Family members often view a critical care episode broadly from diagnosis through to recovery/rehabilitation. Basic communication training skills within critical care should be ensured, alongside coordination of simple solutions. The potential traumatic impact on families should be highlighted early within the pathway, and positive aspects used to harness essential family support. A simple and coordinated approach to a toolkit is preferred. RELEVANCE TO CLINICAL PRACTICE This study highlights that a critical care experience may impact broadly beyond CCU, and the importance of informing patients and families of this potential experience, prior to or on admission, to aid preparation. Further highlighted is the need for contemporaneous and accurate information from clinicians involved in care. Families report a better experience when there is good collaboration across critical care services and admitting clinical teams. Early involvement of families in overall discharge planning is essential to allow patients and families to adjust and plan for recovery.
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Affiliation(s)
- Geraldine O'Gara
- Applied Health Research, Royal Marsden NHS Foundation Trust, London, UK
| | - Theresa Wiseman
- Applied Health Research, Royal Marsden NHS Foundation Trust, London, UK
| | - Anne-Marie Doyle
- Department of Psychological Medicine, Royal Brompton Hospital, London, UK
| | - Natalie Pattison
- School of Health and Social Work, University of Hertfordshire/East and North Herts NHS Trust, Hertfordshire, UK
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Yoon J, Son H. Need differences by treatment phases between patients with colorectal cancer and their caregivers: A text mining analysis. Asia Pac J Oncol Nurs 2022; 9:100061. [PMID: 35619655 PMCID: PMC9126798 DOI: 10.1016/j.apjon.2022.03.013] [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: 02/21/2022] [Accepted: 03/31/2022] [Indexed: 11/02/2022] Open
Abstract
Objective Methods Results Conclusions
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Abstract
OBJECTIVES To provide an overview on the role of family caregivers (FCGs) in the care of older adults with cancer and review quality of life needs for FCGs. DATA SOURCES Journal articles, research reports, state of the science papers, position papers, and clinical guidelines from professional organizations were used. CONCLUSION The high prevalence of multiple comorbidities and the associated burden of geriatric events in older adults have a substantial impact on the quality of life of their FCGs. Practical and efficient models of comprehensive assessment, interventions, and caregiving preparedness support are needed to improve outcomes for both older adults with cancer and their FCGs. IMPLICATIONS FOR NURSING PRACTICE Oncology nurses practicing in clinical and research settings have a responsibility to prepare themselves with evidence-based knowledge and resources to include the needs of FCGs in the care provided to older adults with cancer.
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Coughlin SS, Datta B. Predictors of unhealthy physical and mental days among informal cancer caregivers: results from the 2019 Behavioral Risk Factor Surveillance System survey. Support Care Cancer 2021; 30:2163-2171. [PMID: 34693491 DOI: 10.1007/s00520-021-06635-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 10/16/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Patients with cancer and cancer survivors commonly rely upon family members and friends to act as caregivers to help manage cancer treatment and the late effects of that treatment. Informal caregivers provide a variety of supportive functions for cancer patients, including emotional, informational, and functional support, and practical assistance with skilled care activities. OBJECTIVE We examined predictors of unhealthy physical and mental days among informal cancer caregivers. Unhealthy days are an estimate of the overall number of days during the previous 30 days when the respondent felt that either his or her physical or mental health was not good. METHODS Data were used from the 2019 Behavioral Risk Factor Surveillance System (BRFSS), a cross-sectional, population-based study. The participants were adults aged ≥ 18 years who provided regular care or assistance to a friend or family member who had cancer in the past 30 days. RESULTS On average, caregivers who had a household income of less than $25,000 per year reported more (p < 0.05) unhealthy physical and mental days (during the last 30 days). Average reported number of mental unhealthy days was the highest for those who provided care for 2 or more years and 40 or more hours per week. Caregivers of Hispanic ethnicity had a greater risk of reporting unhealthy physical and mental days among those who provided care for 2 or more years. Among those who were providing care for 40 + h a week, caregivers from less wealthy households (income less than $50,000) were at greater risk of experiencing a larger number of unhealthy mental days. CONCLUSIONS Informal cancer caregiving can be a stressful experience with potentially negative consequences for both psychological and physical health. Of particular concern are caregivers who are low-income or have limited financial resources.
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Affiliation(s)
- Steven S Coughlin
- Department of Population Health Sciences, Augusta University, 1120 15thStreet, AE-1042, Augusta, GA, 30912, USA. .,Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA.
| | - Biplab Datta
- Department of Population Health Sciences, Augusta University, 1120 15thStreet, AE-1042, Augusta, GA, 30912, USA.,Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA
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Association between inflammatory cytokines and caregiving distress in family caregivers of cancer patients. Support Care Cancer 2021; 30:1715-1722. [PMID: 34570281 DOI: 10.1007/s00520-021-06578-y] [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: 02/19/2021] [Accepted: 09/13/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Caregivers of cancer patients experience distress that can manifest as caregiving burden, burnout, depression, and fatigue. Caregiving distress affects physical health in various ways such as causing the dysregulation of inflammatory functions. We examined the relationships between psychological distress experienced by and inflammatory cytokine levels of family caregivers of cancer patients. METHODS A descriptive, cross-sectional study involving 93 family caregivers of cancer patients was conducted. Self-report questionnaires were used to measure the distress variables, which included the caregiving burden, burnout, depression, and fatigue, and peripheral blood samples were collected to measure the IL-6, IL-10, and TNF-α levels. Multiple linear regression analyses were conducted to evaluate the impact of caregivers' distress on their inflammatory cytokine levels. RESULTS Inflammatory cytokine levels were negatively correlated with caregiving distress. High fatigue levels (B = - 0.047, p = 0.026) and additional days of care provided per week (B = - 0.048, p = 0.009) was associated with low IL-6 levels. High depression levels (B = - 0.250, p = 0.007), high fatigue levels (B = - 0.054, p = 0.027), and more days of care provided per week (B = - 0.048, p = 0.033) were associated with low TNF-α levels. The age of the caregiver (B = - 0.011, p = 0.020) and days of care provided per week (B = - 0.138, p = 0.031) were associated factors for IL-10 levels. CONCLUSION The inflammatory responses were associated with the distress in family caregiving for cancer patients. Thus, interventions are needed to support caregivers and manage their caregiving distress.
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Sakuma H, Hasuo H, Fukunaga M. Effect of handholding on heart rate variability in both patients with cancer and their family caregivers: a randomized crossover study. Biopsychosoc Med 2021; 15:14. [PMID: 34556144 PMCID: PMC8461863 DOI: 10.1186/s13030-021-00217-y] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 09/07/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Many family caregivers of patients with cancer feel guilty about self-care. A meaningful relationship with patients reduces such negative feelings and functions as self-care for family caregivers. Moreover, handholding improves autonomic functions in non-cancer patients. However, the effects of handholding on both patients with cancer and family caregivers remain unknown. METHODS We evaluated the effects of handholding on heart rate variability (HRV) in patients with cancer and their family caregivers. This randomized crossover study divided patients with cancer and their family caregivers into two trial groups: Handholding trial (the family caregiver holds the patient's hand for five minutes) and Beside trial (the family caregiver stays beside the patient without holding their hand). The study included 37 pairs of patients with cancer who received treatment in the cancer department of a university hospital in Japan and their family caregivers (n = 74). The primary end-point was the change in HRV before and during the intervention. RESULTS The median performance status of the patients was 3. An interaction was observed between trials in the standard deviation of the normal-to-normal interval (SDNN) of HRV for family caregivers (F = 7.669; p = 0.006), and a significant difference in time course was observed between the trials (before p = 0.351; during p = 0.003). No interaction was observed between trials in the SDNN for patients (F = 0.331; p = 0.566). Only a main effect in time course (F = 6.254; p = 0.014) was observed. SDNN increased significantly during the intervention in both trials (Handholding trial: p = 0.002, Beside trial: p = 0.049). CONCLUSIONS Handholding improves autonomic functions of family caregivers and may function as self-care for family caregivers. TRIAL REGISTRATION UMIN000020557 . Registered on January 15, 2016.
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Affiliation(s)
- Hiroko Sakuma
- Department of Psychosomatic Medicine, Kansai Medical University, Shinmachi 2-5-1, Osaka, 573-1090, Hirakata, Japan
| | - Hideaki Hasuo
- Department of Psychosomatic Medicine, Kansai Medical University, Shinmachi 2-5-1, Osaka, 573-1090, Hirakata, Japan.
| | - Mikihiko Fukunaga
- Department of Psychosomatic Medicine, Kansai Medical University, Shinmachi 2-5-1, Osaka, 573-1090, Hirakata, Japan
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Shahvand T, Sarafraz MR. Investigating the Mediatory Role of Hope and Shame in the Relationship between Caregiver Burden and Quality of Life of Patients with Cancer. South Asian J Cancer 2021; 9:174-179. [PMID: 34395330 PMCID: PMC8357453 DOI: 10.1055/s-0041-1723109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objective
Patients suffering from cancer need to receive care from their family; however, their family caregivers do this without preparation or training, so their involvement in patients’ care results in a caregiving burden that may affect patient’s hope and quality of life (QOL).
Methods
This study examines the effect of caregiving burden on the QOL of cancer patients (
n
= 100) with the mediatory role of hope and shame. To achieve this, Persian versions of Zarit Burden Interview, the World Health Organization QOL, Herth Hope Index, and Guilt and Shame Proneness Scale were used. Meanwhile, path regression analysis was implemented to analyze the relationship between caregiving burden and QOL.
Results
The results implied a relation among caregiver burden, hope, and QOL of patients diagnosed with cancer. It was found that there is a direct and negative relationship between caregiver burden and hope. In addition, there was an indirect and positive relationship between caregiver burden and QOL. Hope and QOL also had a high correlation. Besides, it was shown that there was a negative relationship between the shame experienced by patients and their hope and QOL.
Conclusion
caregiver burden was proved to be influential and negatively affected the factor for the QOL. Besides, patients’ hope decreases while caregiving burden increases; this will in turn affect patients’ recovery and their physical, mental, and cognitive functions. This study provides a foundation for future research in this critical area for oncology.
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Affiliation(s)
- Touraj Shahvand
- Department of Clinical Psychology, Shiraz University, Shiraz, Iran
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Unsar S, Erol O, Ozdemir O. Caregiving burden, depression, and anxiety in family caregivers of patients with cancer. Eur J Oncol Nurs 2021; 50:101882. [PMID: 33421929 DOI: 10.1016/j.ejon.2020.101882] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 11/13/2020] [Accepted: 11/20/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE The purpose of this cross-sectional study was to determine the caregiving burden, depression and anxiety of family caregivers of Turkish patients with cancer and the affecting factors. METHODS This cross-sectional study was conducted between January-May 2018 with one hundred and fifty-eight caregivers and one hundred and fifty-eight patients with cancer who were treated at a university hospital in Edirne, Turkey. Data were collected with a questionnaire form, Zarit Burden Interview (ZBI) Scale and the Hospital Anxiety Depression Scale (HADS). RESULTS This study found that 51.3% of the patients with cancer were male, 70.3% of the caregivers were female and more than half of them (57.0%) were the spouses of the patients. The mean ZBI score of the caregivers was 24.62 ± 14.19. There was a positive relationship between the ZBI scores and HADS scores of family caregivers (p < 0.05). As the caregiving burden of caregivers increased, their anxiety and depression levels were increased too. It was found that as the caregiving duration of family caregivers increased, the caregiving burden increased, and caregivers' anxiety depression scores got worse (p < 0.05). In the multivariate analysis, the duration of caregiving per day/hours, ECOG score and the age of the caregiver independently affected the caregiving burden (p < 0.05). As the functional status of the patient with cancer got worse, caregiving burden increased. Caregiving burden was found to be higher in those who were younger, female and giving care for longer times per day (p < 0.05). CONCLUSION This study found that as the caregiving burden and caregivers' daily patient care duration increased, the level of anxiety and depression increased too. Caregivers of patients with cancer should take appropriate psychological intervention to decrease their distress. In addition, we thought that healthcare professionals must consider the factors affecting the caregiving burden which affect the patient care directly.
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Affiliation(s)
- Serap Unsar
- Trakya University, Faculty of Health Sciences, Department of Internal Medicine Nursing, Balkan Campus, Edirne, Turkey.
| | - Ozgul Erol
- Trakya University, Faculty of Health Sciences, Department of Internal Medicine Nursing, Balkan Campus, Edirne, Turkey.
| | - Ozlem Ozdemir
- Kırklareli University, School of Health, Health Management Department, Kırklareli, Turkey.
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Colas M, Santarpia A, Cannone P, Bonnet C. Les effets narratifs de l’art pictural auprès du proche aidant en psycho-oncologie. PSYCHO-ONCOLOGIE 2020. [DOI: 10.3166/pson-2020-0136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Objectif : Cette étude qualitative vise à décrire les effets narratifs d’un protocole d’accompagnement psychooncologique s’appuyant sur les productions picturales d’une proche aidante (Mme Rose, 70 ans) accompagnant son mari atteint d’un cancer incurable.
Matériel et méthode : Il s’agit d’un protocole autour de la figuration picturale de la proche aidante composé de quatre étapes (temps) : l’entretien préliminaire (T1), une première rencontre autour de la création picturale (T2), une seconde rencontre d’approfondissement autour de la création picturale (T3), l’entretien final (T4). Nous avons utilisé le logiciel T-LAB 9.1.3 pour le calcul des associations de mots (cooccurrences) et réalisé une interprétation du récit selon l’approche humaniste/existentielle.
Résultats : Ce dispositif de recherche a permis de montrer les effets narratifs avant et après le travail artistique sur les problématiques psychiques inhérentes au vécu du proche aidant et notamment sur l’angoisse de mort. La dimension romantique du récit semble pouvoir supporter la narration tragique de Mme Rose.
Conclusion : Le « travail psychique avec la production picturale » peut permettre au proche aidant de mettre en figure l’amour et la mort à travers une narration personnelle empruntant à l’univers narratif du romantisme ses enjeux existentiels.
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Assessment of the psychosocial and economic impact according to sex in non-small cell lung cancer patients: an exploratory longitudinal study. BMC Psychol 2020; 8:123. [PMID: 33228796 PMCID: PMC7685640 DOI: 10.1186/s40359-020-00489-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 11/11/2020] [Indexed: 12/24/2022] Open
Abstract
Background Little is known about the impact of sex on lung cancer patients from the psychological, economic and social perspectives. This study was designed to explore the psychosocial and economic impact according to sex of metastatic non-small cell lung cancer (mNSCLC) in patients and caregivers. Methods Exploratory study of two cohorts of patients starting first-line treatment for mNSCLC. The following questionnaires were administered at baseline, 4 months later and following the first and second disease progression: APGAR, relationship impact scale, DUKE-UNC scale, economic impact in patients and caregiver, and Zarit scale. It was planned to include 1250 patients to get an 80% possibility of detecting as significant (p < 0.05) effect sizes less than 0.19 between men and women. Univariate comparisons were made between the tests applied to men and women. Overall survival was estimated with Kaplan–Meier method. Cox analyses were done to estimate hazard ratios (HRs) with 95% CI. Results 333 patients were included. Most families reported to continue being functional despite the lung cancer diagnosis. Regardless of sex, they did not perceive changes in their partner relationship. Most patients felt their social support was normal. Roughly 25% of people reported a worsening in their economic situation, without remarkable differences by sex. Statistically significant differences were found between both groups regarding the caregiver’s relationship to the patient (more parents were the caregiver in females than in males, p < 0.0001) and the caregiver’s employment situation (more employed caregivers in females) (p < 0.0001). Most caregivers of both sexes considered that taking care of their relative did not pose a significant burden.
Conclusions This study provides a preliminary insight into sex-related characteristics in the management of advanced NSCLC and its impact on the emotional, social and economic burden of patients and their caregivers, and recall the high priority of researching in cancer from a sex perspective. Nevertheless, due to the low recruitment rate and the relevant loss of patients during the follow-up, it was difficult to find differences by sex.
Trial registration ClinicalTrials.gov identifier: NCT02336061. Ethics committee Comité Ético de Investigación Clínica del Hospital Clínic de Barcelona, Spain. Reference number: HCB/2014/0705.
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Psychometric Evaluation of the Caring Ability of Family Caregivers of Patients With Cancer Scale-Mothers' Version for the Mothers of Children With Cancer. Cancer Nurs 2020; 45:E179-E186. [PMID: 33136613 DOI: 10.1097/ncc.0000000000000902] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The experience of caring for cancer patients has adverse outcomes for family caregivers. The ability to care for a sick child is affected by the mother's health; to empower mothers, it will be necessary to examine their caring ability. OBJECTIVE The aim of this study was to carry out a psychometric evaluation of the Caring Ability of Family Caregivers of Patients With Cancer Scale-Mothers' Version (CAFCPCS-Mothers' Version). METHODS The present study is a psychometric evaluation of the CAFCPCS-Mothers' Version. The sample consisted of 196 mothers of children in treatment for cancer selected through convenience sampling. The face, content and construct validity, internal consistency, and stability of the scale were measured. Data were analyzed using the software SPSS 19 and LISREL 8.8. RESULTS After removing 2 items during confirmatory factor analysis, the values of root-mean-square error of approximation, comparative fit index, and nonnormed fit index were reported to be 0.066, 0.92, and 0.91, respectively. The Cronbach's α was calculated to be 0.71 and the stability correlation coefficient was 0.75. The final tested scale included 29 items in 5 dimensions: effective role play, fatigue and surrender, trust, uncertainty, and caring ignorance for mothers of children with cancer. CONCLUSION The CAFCPCS-Mothers' Version has satisfactory content, face, and construct validity and adequate reliability in terms of internal consistency and stability in a sample of mothers of children receiving treatment for cancer. IMPLICATION FOR PRACTICE The CAFCPCS-Mothers' Version can be used to assess the caring ability of Iranian mothers of children with cancer and to determine maternal care needs.
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Yihedego E, Aga F, Gela D, Boka A. Quality of Life and Associated Factors Among Family Caregivers of Adult Cancer Patients in Addis Ababa, Ethiopia. Cancer Manag Res 2020; 12:10047-10054. [PMID: 33116861 PMCID: PMC7569250 DOI: 10.2147/cmar.s266416] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 10/02/2020] [Indexed: 01/04/2023] Open
Abstract
Background Cancer has a major impact on the lives of family caregivers, including their health and quality of life (QOL). However, little is known about the QOL of family caregivers of adult cancer patients in Ethiopia. This study aimed to assess the QOL and associated factors among primary family caregivers of adult cancer patients in Addis Ababa, Ethiopia. Methods In this cross-sectional study, 291 family caregivers completed the survey in the Amharic language. The Caregiver Quality of Life Index-Cancer (CQOLC) was used to measure QOL of family caregivers. Descriptive and linear regression analyses were conducted using SPSS version 23. Results The mean age of the family caregivers was 37.04±11.47 years and 51.5% were male. The mean score of QOL was 82.23 (±16.21). Not being employed in private sector (β = -0.128; CI=-7.82, -0.45; p= 0.028), having family monthly income less than 16 USD (β = 0.132; CI=0.87, 10.88; p= 0.021) and not having family monthly income greater than 64 USD (β = -0.128; CI= -10.43, -0.66; p= 0.026), being spouse (β = 0.179; CI: 1.34, 11.99; p= 0.019) and not residing in urban areas (β = -0.139; CI: -10.53, -0.96; p= 0.019) were negatively associated with the QOL of the family caregiver and explained 8.7% of the variation (R2 =0.087; p=0.000). Conclusion Our findings identified factors such as occupation, income, relationship with the patient, and place of residence that negatively associated with the QOL of family caregivers. Targeted interventions such as social and economic support and bringing the care to the patient's residence place are needed to improve the QOL of family caregivers of adult cancer patients.
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Affiliation(s)
- Eyerusalem Yihedego
- Oncology Nurse, Black Lion Specialized Hospital, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Fekadu Aga
- School of Nursing & Midwifery, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Debela Gela
- School of Nursing & Midwifery, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Abdisa Boka
- School of Nursing & Midwifery, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
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Nemati S, Rassouli M, Ilkhani M, Baghestani AR, Nemati M. Development and validation of 'caring ability of family caregivers of patients with cancer scale (CAFCPCS)'. Scand J Caring Sci 2020; 34:899-908. [PMID: 31922626 DOI: 10.1111/scs.12797] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 11/13/2019] [Indexed: 11/30/2022]
Abstract
AIM Family caregivers have limited abilities that make them vulnerable to the care needs of patients. Therefore, it seems necessary to evaluate their caring ability. The aim of this study was to design an instrument for assessing the caring ability of family caregivers of cancer patients. METHODS This was a sequential exploratory mixed-method study, carried out in two qualitative and quantitative phases. The concept of caring ability and its dimensions were explained using conventional content analysis in the qualitative phase. The research participants included 41 family caregivers of cancer patients and professional caregivers who were selected using purposeful sampling method until reaching data saturation. The scale items were designed using the results of the qualitative phase of the study, as well as the review of relevant literature. In the quantitative phase, the scale was validated using content and face validity, construct validity, as well as internal consistency and stability. RESULTS The primary item pool was prepared in 108 items. Content validity was determined using CVR with a cut-off point (0.62), CVI with a cut-off point (0.8) and kappa coefficient (κ) (>0.75). The validity of 72 items was confirmed. Then, the overlapping items were merged and eventually the 45-item scale entered the face validity stage and five items with an impact factor < 1.5 were omitted. Results of KMO = 0.904 and Bartlett = 6184.012 (p < 0.001) justified the need for factor analysis. Scree plot indicates five factors with eigenvalues above 1 and 67.7% of the total variance, including 'Effective role play, Fatigue and Surrender, Trust, Uncertainty, and Caring ignorance'. Reliability of the 31-item instrument indicated a Cronbach's alpha coefficient of 0.93 and ICC of 0.94. CONCLUSIONS Caring abilities scale (CAI) of family caregivers of patients with cancer is a valid and reliable instrument that can assess caregivers' caring ability.
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Affiliation(s)
- Shahnaz Nemati
- Nursing & Midwifery School, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Maryam Rassouli
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Director General, Health Promotion & Nursing Services, MOH, Tehran, Iran
| | - Mahnaz Ilkhani
- School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ahmad Reza Baghestani
- Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Nemati
- Department of Obstetrics and Gynecology, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
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Psychological and spiritual wellbeing of family caregivers of children with cancer at a teaching hospital in Ghana. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2020. [DOI: 10.1016/j.ijans.2020.100231] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Grover S, Rina K, Malhotra P, Khadwal A. Caregiver Burden in the Patients of Acute Myeloblastic Leukemia. Indian J Hematol Blood Transfus 2019; 35:437-445. [PMID: 31388254 DOI: 10.1007/s12288-018-1048-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Accepted: 11/14/2018] [Indexed: 10/27/2022] Open
Abstract
To study the caregiver burden and its correlates among the caregivers of adolescent and adult subjects with acute myeloblastic leukemia (AML). 30 caregivers of patients with AML were evaluated on family burden interview schedule (FBI), Caregiver Strain Index, multi-dimensional aspect of perceived social support scale, Cognitive-Behavioural Avoidance Scale, ways of coping checklist and General Health Questionnaire. Caregivers of patients with AML reported high caregiver burden (FBI objective burden score: 27.8; subjective burden score: 1.43). Among the various domains of FBI, the mean scores were highest for the domain of disruption of family activities and this was closely followed by disruption of family leisure. Patients with lower family income reported higher subjective and objective burden and were more overwhelmed. Patients belonging to lower socioeconomic status reported more financial burden. Caregiver burden was higher among caregivers who reported lower perceived social support, who more often used avoidance and escape as coping and less often used acceptability-responsibility and positive appraisal coping. Higher caregiver burden is associated with higher psychological morbidity. Caregivers of subjects with AML experience high level of caregiver burden and it is associated with lower social support and more often use maladaptive coping strategies.
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Affiliation(s)
- Sandeep Grover
- 1Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012 India
| | - Kumari Rina
- 1Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012 India
| | - Pankaj Malhotra
- 2Department of Hematology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012 India
| | - Alka Khadwal
- 2Department of Hematology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012 India
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Govina O, Vlachou E, Kalemikerakis I, Papageorgiou D, Kavga A, Konstantinidis T. Factors Associated with Anxiety and Depression among Family Caregivers of Patients Undergoing Palliative Radiotherapy. Asia Pac J Oncol Nurs 2019; 6:283-291. [PMID: 31259225 PMCID: PMC6518986 DOI: 10.4103/apjon.apjon_74_18] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objective: The family caregivers of patients receiving palliative care experience high levels of anxiety and depression. The aim of the present study was to investigate the factors associated with family caregivers’ anxiety and depression when caring for patients with advanced cancer in Greece. Methods: The sample consisted of 100 patients undergoing palliative radiotherapy and their respective caregivers. Patients completed the Hospital Anxiety and Depression Scale (HADS) and the MD Anderson Symptom Inventory. Their respective caregivers completed the Oberst Caregiving Burden Scale, the Bakas Caregiving Outcomes Scale, and the HADS. Correlational and multiple regression analyses were conducted to identify potential predictors of anxiety and depression. Results: The majority of patients were male (63.0%), whereas the majority of their caregivers were female (76.0%). The mean ages of patients and caregivers were 63.9 ± 10.8 and 53.3 ± 12.6 years, respectively. Caregiving anxiety and depression were associated with patients’ variables, such as gender (P < 0.0005), primary cancer (P = 0.008), and past surgery (P = 0.002), and caregiver's variables, such as gender (P = 0.001), co-residence (P = 0.05), previous care experience (P = 0.04), and means of transport (P = 0.038). In multiple regression analyses, caregiving anxiety and depression were significantly predicted by caregivers’ and patients’ characteristics, in a model that accounted for 48% of the anxiety variance (P < 0.0005) and 39% of the depression variance (P < 0.0005). Conclusion: The caregivers who experienced more anxiety and depression shared the following traits: they were women, cared for men with lung cancer, cared for patients not undergoing surgery, lived together, were younger, went to the hospital by private means of transport, had previous care experience, and perceived an increased degree of general burden. Further investigation of the factors that may affect caregivers’ psychological state is required to better identify parameters that may predict it.
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Affiliation(s)
- Ourania Govina
- Department of Nursing, University of West Attica, Athens, Greece
| | - Eugenia Vlachou
- Department of Nursing, University of West Attica, Athens, Greece
| | | | | | - Anna Kavga
- Department of Nursing, University of West Attica, Athens, Greece
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Kilic ST, Oz F. Family Caregivers' Involvement in Caring with Cancer and their Quality of Life. Asian Pac J Cancer Prev 2019; 20:1735-1741. [PMID: 31244294 PMCID: PMC7021632 DOI: 10.31557/apjcp.2019.20.6.1735] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Indexed: 01/28/2023] Open
Abstract
Background: Cancer is a chronic disease and a major health problem. It affects both patients and their family
caregivers multidimensionally. The family caregivers may be affected by not only the disease process but also hospital
policies, economic difficulties, accessibility and communication of health care service and can be in need of help.
This process may affect their quality of life. However, there have not been enough studies on quality of life of family
caregivers of patients with cancer in Turkish culture. Therefore, this study aimed to evaluate the quality of life of
family caregivers of patients with cancer in Turkey. Objectives: The purpose of study was to evaluate the quality of
life of family caregivers with cancer patients in Turkey. Methods: Participants consist of the family caregivers who
volunteered to take part in this descriptive study from 11 hospitals (n =378) which has a daily chemotherapy units
and located within the boundaries of Ankara, Turkey. ‘Sociodemographic Characteristic Form’ and ‘Quality of Life
Scale-Family Version were used as data collection tool. The Kruskal-Wallis and Mann-Whitney U, tests were used
for data analysis. Resultes:It is found that there are statistically significant difference among the factors of gender,
employment status, income level, and whether caregivers reside with their patients. Family caregivers’ quality of life is
negatively affected during the caregiving process (p < 0.05). Conclusion: The results indicate that family caregivers’
quality of life are negatively affected to care process. The results of this research are important as they highlight the
need to also consider family caregivers’ quality of life when caring for patients, and study highlight possible areas in
which support can be provided for family caregivers of cancer patients in Turkey.
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Affiliation(s)
- Sevcan Toptas Kilic
- Hacettepe University Faculty of Nursing, Psychiatric Nursing Department, Ankara, Turkey.
| | - Fatma Oz
- Near East University, Faculty of Nursing, Mersin, Turkey
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Han Y, Zhou Y, Wang J, Hall A, Zhao Q, Qin H, Fan Y, Song Y, Cui S. Chinese version of the Cancer Support Person's Unmet Needs Survey-Sort Form: A psychometric study. Eur J Cancer Care (Engl) 2018; 28:e12963. [PMID: 30474275 DOI: 10.1111/ecc.12963] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 07/30/2018] [Accepted: 10/21/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Psychometrically rigorous and comprehensive needs assessment measures for Chinese general cancer caregivers are relatively scarce. We described the development and psychometric evaluation of the Chinese version of the Cancer Support Person's Unmet Needs Survey-Short Form (SPUNS-SFC). METHODS A forward-backward translation method was utilised to develop the SPUNS-SFC. The construct validity, internal consistency, convergent validity and discriminant validity of the SPUNS-SFC were evaluated. RESULTS A total of 1,026 Chinese cancer caregivers completed the SPUNS-SFC. Items 10, 11, 13, 24 and 26 were removed as more than 80% of respondents reported having no unmet needs on these items. Exploratory factor analysis revealed a five-factor structure, which accounted for 78.47% of the total variance, and consisted of the following domains: information, healthcare access and continuity, personal and emotional needs, worries about the future, and financial needs. Internal consistency of the measure was high, with Cronbach's alpha coefficients ranging from 0.87 to 0.95 for the five domains. The measure illustrated adequate evidence of convergent validity, demonstrated by significant correlations with multiple measures of psychological well-being. Known-groups validity was established, as 87.5% of the hypotheses were supported. CONCLUSION This study indicates the SPUNS-SFC is a reliable and valid measure of the unmet needs of Chinese cancer caregivers.
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Affiliation(s)
- Yuan Han
- School of Nursing, Guangzhou Medical University, Guangzhou, China.,Cancer Center of Guangzhou Medical University, Guangzhou, China
| | - Ying Zhou
- School of Nursing, Guangzhou Medical University, Guangzhou, China
| | - Jing Wang
- School of Nursing, The University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Alix Hall
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Qian Zhao
- School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Huiying Qin
- Sun Yat-sen University Cancer Center, Sun Yat-sen University, Guangzhou, China
| | - Yuying Fan
- Sun Yat-sen University Cancer Center, Sun Yat-sen University, Guangzhou, China
| | - Yalan Song
- Cancer Center of Guangzhou Medical University, Guangzhou, China
| | - Shuzhong Cui
- Cancer Center of Guangzhou Medical University, Guangzhou, China
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Judkins J, Laska I, Paice J, Kumthekar P. Quality of Life of Family Caregivers of Patients With Cancer in Korçe, Albania. J Palliat Care 2018; 34:118-125. [PMID: 30465470 DOI: 10.1177/0825859718812432] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE: The primary objective of this study was to quantify cancer family caregiver (FCG) quality of life (QOL) in a Southern Albanian population and to determine whether differences exist between 4 domains of QOL (physical, psychological, social, and spiritual). This study also sought to compare QOL in our cohort to QOL in historical studies that used the same survey instrument, and to examine correlations between demographic characteristics and QOL to identify any high-risk groups. METHODS: A sample of 40 FCGs was recruited at the Mary Potter Palliative Care Clinic in Korçe, Albania. Each participant completed the City of Hope Quality of Life (Family Version), a validated 37-question instrument that measures caregiver well-being in 4 domains: physical, psychological, social, and spiritual well-being. RESULTS: There were no significant differences between the composite scores of the 4 QOL domains in our study. However, there were differences when comparing self-reported QOL between domains ("Rate your overall physical/psychological/social/spiritual well-being"). The QOL measured in our study was significantly lower than in 3 studies from the United States that used the same questionnaire. There were no significant correlations between demographic groups and QOL. CONCLUSIONS: This study examines the impact that the paucity of palliative services has on the QOL of Albanian cancer FCGs. Although there were no domains of QOL or demographic groups identified in our study that were faring significantly worse than others, the poor overall QOL provides further evidence to support the continued development of palliative services for both patients and family members in Albania.
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Affiliation(s)
- Jonathon Judkins
- 1 Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Irena Laska
- 2 Mary Potter Palliative Care Clinic, Korçe, Albania
| | - Judith Paice
- 1 Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Priya Kumthekar
- 1 Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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Kumari R, Kohli A, Malhotra P, Grover S, Khadwal A. Burden of caregiving and its impact in the patients of acute lymphoblastic leukemia. Ind Psychiatry J 2018; 27:249-258. [PMID: 31359980 PMCID: PMC6592200 DOI: 10.4103/ipj.ipj_75_18] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
AIM This study aims to study the caregiver burden and its correlates among the caregivers of adolescent and adult patients of acute lymphoblastic leukemia (ALL). MATERIALS AND METHODS Sixty caregivers of patients with ALL were assessed on Family Burden Interview Schedule (FBI), Caregiver Strain Index, multidimensional aspect of perceived social support scale, Cognitive-Behavioral Avoidance Scale, ways of coping checklist, and General Health Questionnaire. RESULTS Caregivers of patients with ALL reported high caregiver burden (FBI objective burden score - 21.77; subjective burden score - 1.83). Among the domains of FBI, the highest burden was seen in the form of financial burden closely followed by disruption of family leisure. Caregivers of male patients and those belonging to higher socioeconomic status reported higher level of objective burden. Caregiver burden was higher among caregivers who reported lower perceived social support, who more often used avoidance and escape as coping and less often used planful problem solving. Higher caregiver burden is associated with higher psychological morbidity. CONCLUSION Caregivers of patients with ALL experience high level of caregiver burden and it is associated with lower social support and more often use maladaptive coping strategies.
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Affiliation(s)
- Rina Kumari
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Adarsh Kohli
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Pankaj Malhotra
- Department of Hematology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sandeep Grover
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Alka Khadwal
- Department of Hematology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Mishra SI, Rishel Brakey H, Kano M, Nedjat-Haiem FR, Sussman AL. Health related quality of life during cancer treatment: Perspectives of young adult (23-39 years) cancer survivors and primary informal caregivers. Eur J Oncol Nurs 2017; 32:48-54. [PMID: 29353632 DOI: 10.1016/j.ejon.2017.11.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 11/20/2017] [Accepted: 11/26/2017] [Indexed: 12/24/2022]
Abstract
PURPOSE There is a paucity of information regarding health related quality of life (HRQoL) of young adults (YAs) with cancer and caregivers. Therefore, we characterize YA and caregiver perspectives on the impact of cancer and its treatment on HRQoL. METHODS We conducted descriptive qualitative in-depth, semi-structured interviews with YAs receiving cancer care at an academic health center in Albuquerque, New Mexico (USA) and primary informal caregivers. The interviews, conducted from September through December 2015, focused on perspectives on the impact of the disease and its treatment in terms of physical and emotional effects, coping, and strategies to enhance HRQoL. We used an iterative thematic analysis approach to identify emergent themes and create a coding structure. RESULTS We reached thematic saturation after interviewing 8 YAs and 8 caregivers. YAs and caregivers discussed cancer triggered challenges such as anxiety, depression, isolation, fear, and financial hardships. YAs and caregivers coped by maintaining positive perspectives, relying on friends and family, and prayer. Caregivers discussed how expectations for and experiences of a "good day" changed depending on their loved ones' stage of cancer treatment. YAs navigated challenges by focusing on activities and thoughts that provided meaning to their lives. YAs and caregivers suggested strategies to enhance HRQoL through patient/provider communication, support services, and decision making tools as potential mechanisms for grounding patient-centered interventions to improve cancer care. CONCLUSIONS Implications include the development and evaluation of informational and behavioral interventions tailored and targeted to address the pragmatic needs of YAs undergoing cancer treatment and informal caregivers.
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Affiliation(s)
- Shiraz I Mishra
- Department of Pediatrics, University of New Mexico Health Sciences Center, 1 University of New Mexico, MSC 10 5590, Albuquerque, NM 87131, USA; Department of Family and Community Medicine, University of New Mexico Health Sciences Center, 1 University of New Mexico, MSC 09 5040, Albuquerque, NM 87131, USA; University of New Mexico Comprehensive Cancer Center, University of New Mexico Health Sciences Center, 1201 Camino de Salud, Albuquerque, NM 87131, USA.
| | - Heidi Rishel Brakey
- University of New Mexico Clinical and Translational Science Center, University of New Mexico Health Sciences Center, 1 University of New Mexico, Albuquerque, NM 87131, USA
| | - Miria Kano
- Department of Family and Community Medicine, University of New Mexico Health Sciences Center, 1 University of New Mexico, MSC 09 5040, Albuquerque, NM 87131, USA; University of New Mexico Comprehensive Cancer Center, University of New Mexico Health Sciences Center, 1201 Camino de Salud, Albuquerque, NM 87131, USA
| | - Frances R Nedjat-Haiem
- New Mexico State University, School of Social Work, 1335 International Mall, Las Cruces, NM 88003, USA
| | - Andrew L Sussman
- Department of Family and Community Medicine, University of New Mexico Health Sciences Center, 1 University of New Mexico, MSC 09 5040, Albuquerque, NM 87131, USA; University of New Mexico Comprehensive Cancer Center, University of New Mexico Health Sciences Center, 1201 Camino de Salud, Albuquerque, NM 87131, USA
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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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Gregório H, Santos P, Pires I, Prada J, Queiroga FL. Comparison of veterinary health services expectations and perceptions between oncologic pet owners, non-oncologic pet owners and veterinary staff using the SERVQUAL methodology. Vet World 2016; 9:1275-1281. [PMID: 27956781 PMCID: PMC5146310 DOI: 10.14202/vetworld.2016.1275-1281] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 10/04/2016] [Indexed: 11/16/2022] Open
Abstract
AIM Client satisfaction gained great importance in health care as a measurement of service quality. One of the most popular methods to evaluate client satisfaction is the SERVQUAL inquiry which measures service quality by evaluating client expectations and services towards a service in five dimensions: Tangibles, Empathy, Assurance, Reliability and Responsiveness. MATERIALS AND METHODS In order to evaluate if owners of pets with cancer constitute a distinctive group from the general pet owner population and if these differences were perceived by the hospital staff we applied a SERVQUAL questionnaire to 51 owners of pet with cancer, 68 owners from the general pet population and 14 staff members. RESULTS Owners of oncologic pets had different expectations of an ideal service granting importance to Assurance questions (6.75 vs 6.5, p= 0.045) while showing unmet needs in Reliability and Empathy dimensions. Veterinarians failed to understand these specificities and over evaluated characteristics of Tangible dimension (6.75 vs 6.25, p=0.027). CONCLUSION Owners of pet with cancer seem to constitute a specific subpopulation with special needs and veterinary staff should invest resources towards Assurance instead of privileging tangible aspects of veterinary services. By aligning professionals expectations with those of pet owners veterinarians can achieve better client satisfaction, improved compliance and stronger doctor-owner relationships.
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Affiliation(s)
- Hugo Gregório
- Veterinary Hospital Centre, Rua Manuel Pinto de Azevedo 118, 4100-320 Porto, Portugal
| | - Patricia Santos
- Department of Veterinary Sciences, University of Trás-os-Montes and Alto Douro, 5001-801 Vila Real, Portugal
| | - Isabel Pires
- Animal and Veterinary Research Centre (CECAV), University of Trás-os-Montes and Alto Douro, 5001-801 Vila Real, Portugal
| | - Justina Prada
- Animal and Veterinary Research Centre (CECAV), University of Trás-os-Montes and Alto Douro, 5001-801 Vila Real, Portugal
| | - Felisbina Luísa Queiroga
- Center for Research and Technology of Agro-Environment and Biological Sciences (CITAB), University of Trás-os-Montes and Alto Douro, 5001-801 Vila Real, Portugal
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Soylu C, Ozaslan E, Karaca H, Ozkan M. Psychological distress and loneliness in caregiver of advanced oncological inpatients. J Health Psychol 2016; 21:1896-906. [DOI: 10.1177/1359105314567770] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
The objective of this study is to compare and examine the relationships between levels of loneliness, anxiety, depression, and other variables on primary caregivers and cancer inpatients. The study involved 100 Turkish primary caregivers of inpatients with advanced or terminal stages of cancer. Loneliness and anxiety scores were significantly higher for the primary caregivers of inpatients with terminal stage of cancer than primary caregivers of inpatients with advanced stage of cancer. Excluding the cancer stage, loneliness and anxiety were primarily associated with the socio-demographic factors of primary caregivers rather than the characteristics of patients.
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Comparison of Oncology Patients’ and Their Family Caregivers’ Attitudes and Concerns Toward Pain and Pain Management. Cancer Nurs 2016; 39:328-34. [DOI: 10.1097/ncc.0000000000000319] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Wheelwright S, Darlington AS, Hopkinson JB, Fitzsimmons D, Johnson C. A systematic review and thematic synthesis of quality of life in the informal carers of cancer patients with cachexia. Palliat Med 2016; 30:149-60. [PMID: 26024885 DOI: 10.1177/0269216315588743] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Informal carers of cancer patients with cachexia face additional challenges to those encountered by informal carers in general because of the central role food and eating play in everyday life. Patient weight loss and anorexia, core features of cancer cachexia, are frequent causes of distress in caregivers. Identification of quality of life issues can inform the development of interventions for both caregivers and patients and facilitate communication with healthcare professionals. AIM To identify quality of life issues that are relevant to carers of cancer patients with cachexia. DESIGN A systematic review and thematic synthesis of the qualitative literature were conducted. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. DATA SOURCES PubMed, ISI Web of Knowledge, EMBASE, MEDLINE, CINAHL, PsycINFO and PsycARTICLES were searched for publications dated from January 1980 to February 2015 using search terms relating to cancer, cachexia, quality of life and carers. Papers written in the English language, featuring direct quotes from the carers of adult patients with any cancer diagnosis and cachexia or problems with weight loss or anorexia, were included. RESULTS Five themes were extracted from the 16 identified studies. These highlighted the impact on everyday life, the attempts of some carers to take charge, the need for healthcare professional's input, conflict with the patient and negative emotions. CONCLUSION The complexity of caring for a cancer patient with cachexia translates into a range of problems and experiences for informal carers. By addressing the impact of caring for a patient with cancer cachexia on carers, both caregiver and patient quality of life may improve.
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Affiliation(s)
- Sally Wheelwright
- Cancer Sciences, University of Southampton, Southampton, UK University Surgical Unit (MP 816), Southampton General Hospital, Southampton, UK
| | | | - Jane B Hopkinson
- Cardiff School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | | | - Colin Johnson
- Cancer Sciences, University of Southampton, Southampton, UK
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Schrank B, Ebert-Vogel A, Amering M, Masel EK, Neubauer M, Watzke H, Zehetmayer S, Schur S. Gender differences in caregiver burden and its determinants in family members of terminally ill cancer patients. Psychooncology 2015; 25:808-14. [PMID: 26477788 DOI: 10.1002/pon.4005] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 09/20/2015] [Accepted: 09/21/2015] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Female family caregivers consistently report higher levels of stress and burden compared to male caregivers. Explanations for the apparently higher psychological vulnerability of female caregivers are largely missing to date. This study assesses the correlates and determinants of caregiver burden in family caregivers of advanced cancer patients with a specific focus on gender differences. METHODS Three hundred and eight self-identified main informal caregivers of advanced cancer patients were cross-sectionally assessed using structured questionnaires for caregiver burden and hypothesised determinants of burden, including sociodemographic characteristics, caring arrangements, support needs, hope and coping style. Gender differences and predictors of burden were assessed using t-tests, chi-squared tests and univariate linear regression. Significant univariate predictors were entered in an analysis of covariance separately for men and women. RESULTS Burden was significantly higher in women. Hope was the most significant protective factor against burden in both genders, together with perceived fulfilment of support needs. Only in women emotion-oriented coping and being in employment while caring were significantly predictive of higher burden in the multivariate analysis. The model explained 36% of the variance in burden in men and 29% in women. CONCLUSION Psychological support interventions for family caregivers should take gender-specific risk factors into account. Interventions focusing on keeping up hope while caring for a terminally ill family member may be a valuable addition to palliative services to improve support for family carers. Women may benefit from interventions that address adaptive coping and strategies to deal with the dual demands of employment and caring. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- Beate Schrank
- Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Alexandra Ebert-Vogel
- Division of Palliative Care, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria
| | - Michaela Amering
- Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Eva K Masel
- Division of Palliative Care, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria
| | - Marie Neubauer
- Division of Palliative Care, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria
| | - Herbert Watzke
- Division of Palliative Care, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria
| | - Sonja Zehetmayer
- Section for Medical Statistics, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Sophie Schur
- Division of Palliative Care, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria
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Rha SY, Park Y, Song SK, Lee CE, Lee J. Caregiving burden and the quality of life of family caregivers of cancer patients: the relationship and correlates. Eur J Oncol Nurs 2015; 19:376-82. [DOI: 10.1016/j.ejon.2015.01.004] [Citation(s) in RCA: 99] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 01/06/2015] [Accepted: 01/15/2015] [Indexed: 01/20/2023]
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Effendy C, Vernooij-Dassen M, Setiyarini S, Kristanti MS, Tejawinata S, Vissers K, Engels Y. Family caregivers' involvement in caring for a hospitalized patient with cancer and their quality of life in a country with strong family bonds. Psychooncology 2014; 24:585-91. [DOI: 10.1002/pon.3701] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 09/10/2014] [Accepted: 09/11/2014] [Indexed: 12/11/2022]
Affiliation(s)
- Christantie Effendy
- School of Nursing, Medical Faculty; Universitas Gadjah Mada; Yogyakarta Indonesia
- Scientific Institute for Quality of Healthcare; Radboudumc; Nijmegen the Netherlands
| | - Myrra Vernooij-Dassen
- Scientific Institute for Quality of Healthcare; Radboudumc; Nijmegen the Netherlands
- Kalorama Foundation; Beek-Ubbergen the Netherlands
| | - Sri Setiyarini
- School of Nursing, Medical Faculty; Universitas Gadjah Mada; Yogyakarta Indonesia
| | | | - Sunaryadi Tejawinata
- Center of Development for Palliative and Pain Relief; Dr. Soetomo Hospital; Surabaya Indonesia
| | - Kris Vissers
- Department of Anesthesiology, Pain and Palliative Medicine; Radboudumc; Nijmegen the Netherlands
| | - Yvonne Engels
- Department of Anesthesiology, Pain and Palliative Medicine; Radboudumc; Nijmegen the Netherlands
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Assessing cancer caregivers' needs for an early targeted psychosocial support project: The experience of the oncology department of the Poliambulanza Foundation. Palliat Support Care 2014; 13:865-73. [DOI: 10.1017/s1478951514000753] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjective:Caregivers play a key role in the management of patients with cancer. However, some studies have suggested that caregivers have even more unmet needs than the patients.Method:To better identify the needs and changes in the lifestyles of the caregivers in our practice and to plan a targeted support project to decrease caregiver burden, we administered the Caregiver's QoL Index–Cancer (CQoLC) to 200 consecutive caregivers. This questionnaire assesses psychological well-being, the relationship with healthcare professionals, administration of finances, lifestyle disruption, and positive adaptation.Results:Our data showed that being a caregiver to a patient with metastatic disease negatively affected females mostly with regard to mental and emotional burden, while men complained more about their sexual life (42.3 vs. 33.6%), although this result was not significant. Some 93.5% of caregivers reported that they were pleased with their role, while 83.4% were concerned about financial difficulties.Significance of results:We strongly believe that early supportive care directed not only at patients but also to caregivers may improve the quality of life (QoL) in this population. We are currently developing a targeted support project to decrease caregiver burden.
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Kurtin S, Lilleby K, Spong J. Caregivers of Multiple Myeloma Survivors. Clin J Oncol Nurs 2013; 17 Suppl:25-32. [DOI: 10.1188/13.cjon.s2.25-32] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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