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Muralidharan S, Sikalgar FR, B D, Nikalje MR, Subramaniam T, Kumar M. Exploring the Unmet Needs of Cancer Caregivers in India: A Cross-Sectional Survey. Cureus 2024; 16:e62159. [PMID: 38868547 PMCID: PMC11167582 DOI: 10.7759/cureus.62159] [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: 05/24/2024] [Accepted: 06/11/2024] [Indexed: 06/14/2024] Open
Abstract
Introduction Caregivers of individuals with head, neck, and face cancer play a pivotal role in providing support, yet they face distinct challenges. This study aims to explore caregiving experiences and consequences among this population. Methods A multicentric cross-sectional study involving 200 caregivers using a convenience sampling method was conducted in Pune. Caregivers involved in patient care were included in head, neck, and face cancer. The Cancer Caregiving Consequences Inventory (CaTCoN) questionnaire was utilized to assess various dimensions of caregiving. Ethical clearance was obtained from institutional review boards. Results The demographic profile revealed that 89% of caregivers were spouses/partners, primarily females (77%), aged 25-40 (81.5%), and urban dwellers (68.5%). Caregivers were predominantly married or cohabiting (100%) and had children (95%). Most had a graduate-level education (97.5%) and were employed full-time (82.5%). The mean scores from the CaTCoN questionnaire highlighted substantial caregiving responsibilities, with significant associations found in multivariate regression analysis. Spouses/partners showed stronger correlations with increased workload, personal growth challenges, financial difficulties, and the need to maintain an everyday life. Conclusion This study comprehensively explains caregiving consequences among head, neck, and face cancer cases. The predominance of spouses/partners as caregivers emphasizes the need for targeted interventions to address their unique challenges. The study highlights the demanding nature of caregiving, with potential positive outcomes.
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Affiliation(s)
| | - Farha R Sikalgar
- Community Medicine, ZVM Unani Medical College and Hospital, Pune, IND
| | - Deepak B
- Clinical Naturopathy, National Registration Board, Ministry of Ayush, Pune, IND
| | - Monali R Nikalje
- Dentistry, Symbiosis Medical College for Women and Symbiosis University Hospital and Research Centre, Pune, IND
| | - Tulsi Subramaniam
- Dentistry, Symbiosis Medical College for Women and Symbiosis University Hospital and Research Centre, Pune, IND
| | - Manasvi Kumar
- Health Care, School for Skill Development and Allied Health Sciences, Bharati Vidyapeeth (Deemed to be) University, Pune, IND
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Vitale E, Halemani K, Shetty A, Chang YC, Hu WY, Massafra R, Moretti A. Sex Differences in Anxiety and Depression Conditions among Cancer Patients: A Systematic Review and Meta-Analysis. Cancers (Basel) 2024; 16:1969. [PMID: 38893089 PMCID: PMC11171373 DOI: 10.3390/cancers16111969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Revised: 05/15/2024] [Accepted: 05/16/2024] [Indexed: 06/21/2024] Open
Abstract
(1) Background: Evidence suggested inconsistent results in anxiety and depression scores among female and male cancer patients. The present systematic review and meta-analysis aimed to assess how anxiety and depression conditions among cancer patients vary according to sex. (2) Methods: This systematic review and meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA). The protocol was registered in PROSPERO with id no. CRD42024512553. The search strategy involved combining keywords using Boolean operators, including "Anxiety", "Cancer", and "Depression", across several databases: Embase, PubMed, Scopus, and Web of Science. The outcomes were evaluated using the Hospital Anxiety and Depression Scale (HADS). (3) Results: Data were collected from five studies, enrolling a total of 6317 cancer patients, of whom 2961 were females and 3356 males. For each study, HADS-A and HADS-D scores were considered, also differentiating HADS scores according to cancer typology, and then three different meta-analyses were performed. Generally, females reported significantly higher levels of depression scores than males and, conversely, males reported significantly greater levels of anxiety than females. (4) Conclusions: Previous studies suggested higher rates of depression and anxiety conditions in females than in males, but the present data highlighted controversial findings, since males reported significantly higher levels of anxiety than females. In this scenario, the theoretical approach justified females being more open than males to expressing anxiety or depression conditions. It would be necessary for healthcare professionals to improve effective measures purposed at assessing and mitigating depressive symptoms in cases of advanced cancer, thereby improving their mental health, given the high rates of depression in advanced cancer patients, due to the difficulty level of performing their daily living activities, which deteriorate further over time.
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Affiliation(s)
- Elsa Vitale
- Scientific Directorate, IRCCS Istituto Tumori “Giovanni Paolo II”, 70124 Bari, Italy
| | - Kurvatteppa Halemani
- College of Nursing, All India Institute of Medical Sciences (AIIMS), Raebareli 229405, India;
| | - Asha Shetty
- College of Nursing, All India Institute of Medical Sciences (AIIMS), Bhubaneswar 751019, India;
| | - Yun-Chen Chang
- School of Nursing and Graduate Institute of Nursing, China Medical University, Taichung 406040, Taiwan;
- Nursing Department, China Medical University Hospital, Taichung 404328, Taiwan
| | - Wen-Yu Hu
- School of Nursing, College of Medicine, National Taiwan University, Taipei 106319, Taiwan;
- Department of Nursing, National Taiwan University Hospital, Taipei 100225, Taiwan
| | - Raffaella Massafra
- Laboratorio di Bioinformatica e Biostatistica, IRCCS Istituto Tumori “Giovanni Paolo II”, 70124 Bari, Italy;
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Methi F, Nes RB, Skirbekk V, Hansen T. The double-edged sword of becoming a caregiver: dynamic impact on four dimensions of well-being in Norway. BMC Psychol 2024; 12:120. [PMID: 38439109 PMCID: PMC10913458 DOI: 10.1186/s40359-024-01623-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 02/25/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Becoming a caregiver can be a transformative journey with profound, multifaceted implications for well-being. However, existing research predominantly emphasizes the negative aspects of caregiving, paying less attention to the positive sides. This study aims to explore the impact of transitioning into a caregiving role on various well-being indicators, such as negative hedonic, positive hedonic, eudaimonic, and social well-being. METHODS We use Norwegian panel data (2019-2021) and employ a combination of nearest-neighbour matching and a difference-in-differences approach to analyse well-being trajectories among new caregivers (n = 304) and non-caregivers (n = 7822). We assess ten items capturing the dimensions of negative hedonic (anxiousness, sadness, and worriedness), positive hedonic (happiness and life satisfaction), eudaimonic (contributing to others' happiness, engagement, and meaning), and social (strong social relations and loneliness) well-being. RESULTS Our results show a general increase in negative hedonic well-being and a decline in positive hedonic well-being for new caregivers. These impacts are larger for caregivers providing daily care, compared to those providing weekly and monthly care, and for those providing care inside rather than outside their own household. We observe only minor differences regarding gender and age. Interestingly, we also notice neutral or beneficial changes for eudaimonic aspects of well-being; of note, caregivers generally experience an increased sense of contributing to others' happiness. CONCLUSION Our study reveals that adopting a caregiving role often leads to significant psychosocial challenges, especially in intensive caregiving situations. However, it also uncovers potential positive influences on eudaimonic aspects of well-being. Future research should explore underlying explanatory mechanisms, to inform strategies that enhance caregivers' well-being.
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Affiliation(s)
- Fredrik Methi
- Department of Health Services, Norwegian Institute of Public Health, Postboks 222, Skøyen, N-0213, Oslo, Norway.
| | - Ragnhild Bang Nes
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
- Promenta Research Center, University of Oslo, Oslo, Norway
- Department of Philosophy, Classics, and History of Arts and Ideas, University of Oslo, Oslo, Norway
| | - Vegard Skirbekk
- Center for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Thomas Hansen
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
- Promenta Research Center, University of Oslo, Oslo, Norway
- Oslo Metropolitan University, Oslo, Norway
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Tufvesson Stiller H, Schmitt-Egenolf M, Fohlin H, Uppugunduri S. Patient reported experiences of Swedish patients being investigated for cancer during the Covid-19 pandemic. Support Care Cancer 2023; 31:416. [PMID: 37354327 DOI: 10.1007/s00520-023-07897-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: 03/07/2023] [Accepted: 06/21/2023] [Indexed: 06/26/2023]
Abstract
BACKGROUND Patient reported experiences in individuals being investigated for cancer have been recorded in a nationwide survey in Sweden, providing an opportunity to assess the impact of the Covid-19-pandemic. MATERIAL AND METHODS Questionnaires from 45920 patients were analyzed to assess the experience of being investigated for cancer. Data from before the Covid-19-pandemic (2018-2019) was compared to data acquired during the pandemic (2020-2021), using chi-square and Wilcoxon rank sum tests. Both, patients who were cleared from suspicion of cancer and those who were diagnosed with cancer were included. RESULTS Fewer patients in total visited health services during the pandemic. However, patients that did seek help did so to a similar extent during as prior to the pandemic. Patient waiting time was perceived to be shorter during the pandemic and judged as neither too long nor too short by most patients. The emotional support to patients improved during the pandemic, whereas the support to next of kin declined. A majority of patients received the results from the investigation in a meeting with the physician. Although there was a preference for receiving results in a meeting with the physician, the pandemic has brought an increasing interest in receiving results by phone. CONCLUSION Swedish cancer healthcare has shown resilience during the Covid-19-pandemic, maintaining high patient satisfaction while working under conditions of extraordinary pressure. Patients became more open to alternatives to physical "in person" health care visits which could lead to more digital visits in the future. However, support to significant others demands special attention.
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Affiliation(s)
- Helena Tufvesson Stiller
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
- Regional Cancer Center Southeast, Linköping, Sweden.
| | | | - Helena Fohlin
- Regional Cancer Center Southeast, Linköping, Sweden
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Srinivas Uppugunduri
- Regional Cancer Center Southeast, Linköping, Sweden
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
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Brosseau DC, Peláez S, Ananng B, Körner A. Obstacles and facilitators of cancer-related dyadic efficacy experienced by couples coping with non-metastatic cancers. Front Psychol 2023; 14:949443. [PMID: 37359859 PMCID: PMC10285665 DOI: 10.3389/fpsyg.2023.949443] [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: 05/20/2022] [Accepted: 05/10/2023] [Indexed: 06/28/2023] Open
Abstract
Introduction Cancer-related dyadic efficacy is an individual's confidence to work together with a partner to conjointly manage the effects of cancer and its treatment. In other health contexts, higher levels of dyadic efficacy have been associated with fewer symptoms of psychological distress and higher ratings of relationship satisfaction. The aim of the current study was to explore patient and partner perspectives on what obstructs and facilitates cancer-related dyadic efficacy. Methods These aims were accomplished through a secondary analysis of data collected as a part of a collective qualitative case study. Participants (N = 17 participants) were patients undergoing treatment or recently completed treatment (within 6 months) for a non-metastatic cancer and their partners. To enable in-depth discussions among participants, data was collected through five focus groups. Participants described obstacles and facilitators of dyadic efficacy as dimensions of a common influence. Consistent with these descriptions, reflexive thematic analysis was used to identify influences on cancer-related dyadic efficacy and their subsequent obstructive and facilitative dimensions. Results Four main categories of influence with the potential to obstruct or facilitate cancer-related dyadic efficacy were identified along with their subthemes: appraisals of the couple relationship (quality and togetherness), communication (pattern and interest in information), coping (strategy and evaluation), and responses to change (in tasks and roles and sex life). Eight obstructive and seven facilitative dimensions of these subthemes were described.Discussion: This first analysis of obstacles and facilitators of couples' cancer-related dyadic efficacy capitalized on the experiential expertise of individuals with cancer and their partners. These thematic results are instructive for the design of dyadic efficacy-enhancing interventions for couples coping with cancer.
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Affiliation(s)
- Danielle C. Brosseau
- Department of Psychology, The King’s University, Edmonton, AB, Canada
- Department of Educational and Counselling Psychology, McGill University, Montreal, QC, Canada
| | - Sandra Peláez
- Department of Psychology, The King’s University, Edmonton, AB, Canada
- École de kinésiologie et des sciences de l'activité physique (EKSAP), Faculté de Médecine, Université de Montréal, Montreal, QC, Canada
| | - Bethsheba Ananng
- Department of Psychology, The King’s University, Edmonton, AB, Canada
| | - Annett Körner
- Department of Psychology, The King’s University, Edmonton, AB, Canada
- Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada
- Department of Oncology, McGill University, Montreal, QC, Canada
- Louise Granofsky Psychosocial Oncology Program, Segal Cancer Center, Montreal, QC, Canada
- Psychosocial Oncology Program, McGill University Health Centre, Montreal, QC, Canada
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Lehto US, Aromaa A, Tammela T. Psychological recovery and well-being of spouses of patients with prostate cancer 5 years after primary treatment in Finland: a follow-up survey. BMJ Open 2023; 13:e063435. [PMID: 37105703 PMCID: PMC10151865 DOI: 10.1136/bmjopen-2022-063435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/29/2023] Open
Abstract
OBJECTIVE AND SETTING To study longitudinally cancer-related experiences of spouses of patients with prostate cancer and the predictors of their psychological recovery and quality of life (QOL) by following the participants of our previous survey at primary cancer treatment in a university hospital. DESIGN A 5-year longitudinal cohort design. PARTICIPANTS AND PROCEDURE A follow-up questionnaire was mailed to the female spouses/partners who participated in our previous survey (n=104). We quantitatively explored the spouses' prostate cancer-related experiences since the previous survey and measured their current psychological symptom distress and well-being/QOL. Seventy-seven (74%) of the initial participants responded. OUTCOMES The main outcome measures were the spouses' psychological recovery (psychological symptoms at the initial survey vs currently) and well-being/QOL (depressive symptoms, domains of QOL) at 5 years. We analysed their predictors with regression analyses. RESULTS The treatment had been prostatectomy in 70% of the patients. Psychological distress had alleviated in 76% of spouses (p<0.001) and emotional changes decreased (p=0.02), but a deteriorating impact on the partnership (from 4% to 16%) and on sex life ('strong impact' from 23% to 37%) had increased. The outcomes were inversely associated with negative depression-related psychological symptoms and emotional changes either initially or at follow-up. However, some early experiences also predicted the outcomes when other factors were controlled for. Prostate cancer-related information received by the spouses from several sources (leaflets/handouts, TV/radio, internet) predicted better recovery and well-being/QOL, whereas the patients' prostate cancer and treatment-related symptoms (pain, irritability/anger, bowel dysfunction) predicted poorer recovery and well-being/QOL in spouses. CONCLUSIONS A major negative impact of prostate cancer was experienced by the spouses still 5 years after primary treatment. Early prostate cancer-related experiences predicted long-term psychological recovery and QOL. Responding to the early information needs of spouses and effective symptom management for the patients are likely to enhance the spouses' long-term recovery and well-being.
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Affiliation(s)
- Ulla-Sisko Lehto
- Population Health/ Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Arpo Aromaa
- Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Teuvo Tammela
- Department of Surgery, Tampere University Hospital, Tampere, Finland
- Faculty of Medicine and Medical Technology, University of Tampere, Tampere, Finland
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Factors associated with psychological distress in caregivers of patients with malignant gliomas. Support Care Cancer 2022; 30:5811-5820. [DOI: 10.1007/s00520-022-06989-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 03/11/2022] [Indexed: 10/18/2022]
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Pan YC, Lin YS. Systematic Review and Meta-Analysis of Prevalence of Depression Among Caregivers of Cancer Patients. Front Psychiatry 2022; 13:817936. [PMID: 35633789 PMCID: PMC9133351 DOI: 10.3389/fpsyt.2022.817936] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 03/03/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Caregivers of cancer patients commonly experience depressive symptoms due to the heavy burden of caregiving responsibility. OBJECTIVE This meta-analysis examined the prevalence of depression among caregivers of cancer patients. METHODS We included 85 studies covering 23,317 participants published between 2001 and 2021 (25 countries) that reported the prevalence of depression among caregivers of cancer patients. We examined the pooled prevalence of depression and hypothesized moderators, including year, age, sex, geographic regions, percentage of spousal caregivers, depression measures, and cancer stage. RESULTS All 85 effect sizes included 6,077 caregivers of patients with depression. The weighted average prevalence of depression was 25.14% (95% CI, 21.42-29.27%) among caregivers. The prevalence rates were moderated by geographic region, patients' cancer stage, and measures for depression. The prevalence rates also varied among the different measures assessing depression. The prevalence rate decreased with the mean age of the caregivers and the percentage of spousal caregivers. CONCLUSIONS This study revealed a high prevalence of depression among caregivers of cancer patients. The prevalence rates also varied with the study design, demographics of caregivers, and patients' medical information. These findings highlight that psychological support and intervention may be crucial for patients and their caregivers in clinical practice.
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Affiliation(s)
- Yuan-Chien Pan
- Department of Psychology, National Taiwan University, Taipei, Taiwan
| | - Yaw-Sheng Lin
- Department of Psychology, National Taiwan University, Taipei, Taiwan
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Liang Y, Li J, Pan W. Family satisfaction in the intensive care unit: The influence of disease severity, care relationship, patient anxiety and patient pain. Intensive Crit Care Nurs 2020; 63:102995. [PMID: 33349481 DOI: 10.1016/j.iccn.2020.102995] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 11/15/2020] [Accepted: 11/22/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND There is little empirical evidence that can be used to identify factors associated with family satisfaction in the context of the intensive care unit, especially from the perspectives of the patient and patient-family member interactions. OBJECTIVES To explore the influence of disease severity, care relationship, anxiety, and pain of patients on family satisfaction in the intensive care unit. STUDY DESIGN A cross-sectional descriptive and exploratory study was conducted in the Surgical unit in the Zhongshan Hospital Fudan University, Shanghai, China. METHODS A total of 227 patients and their family member dyads were included and surveyed. The dependent variable family satisfaction was measured by the Chinese version of the critical care family satisfaction survey. The independent variables included patient characteristics, care relationship, disease severity, patient anxiety, and patient pain. Disease severity was assessed by The Acute Physiology and Chronic Health Evaluation II. Patient anxiety was measured using the Self-Rating Anxiety Scale. Patient pain was measured with Numeric rating scale. RESULTS Patients with higher self-rating anxiety scores (OR 0.92, 95% CI 0.87-0.97) were less likely to have higher family satisfaction for their family member dyad. However, those with mild perceived pain (OR 5.21, 95% CI 1.97-13.80) were more likely to have higher family satisfaction for their family member dyad. Disease severity and care relationship showed no significant associations with family satisfaction. CONCLUSIONS Future interventions may include open communication with family members giving explanations regarding the physical and psychological condition of the patient, care delivered and interventions received.
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Affiliation(s)
- Yan Liang
- School of Nursing, Fudan University, China
| | | | - Wenyan Pan
- Zhongshan Hospital, Fudan University, China.
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Caillot-Ranjeva S, Gourlain S, Amieva H, Helmer C, Bergua V. Study of mutual influence between trait anxiety and risk of depression among older couples facing cancer. J Geriatr Oncol 2020; 12:605-611. [PMID: 33004302 DOI: 10.1016/j.jgo.2020.09.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 03/27/2020] [Accepted: 09/16/2020] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The present study aims to examine the process of mutual influence in older couples with cancer diagnosis by studying their risk of depression. MATERIALS AND METHODS 282 couples with one spouse diagnosed with cancer were selected from the Three-City cohort study. Dyadic analyses were used to determine whether trait anxiety affects the risk of depression and whether a mutual influence process occurs prior and post cancer diagnosis. Cross-sectional analyses were performed at two time-points: before and after receiving the diagnosis. RESULTS A higher level of anxiety among cancer patients resulted in a decreased risk of depression among spousal caregivers. Moreover, a higher anxiety among spousal caregivers increased their own risk of depression, but it didn't influence depression risk among cancer patients. While there is an intra-individual relationship between a higher level of trait anxiety and a greater risk of depression prior to cancer diagnosis, there is no cross-influence between spouses. DISCUSSION The study findings indicate that a dyadic psychological adjustment process might help older adults to cope with cancer by limiting the risk of depression among spousal caregivers.
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Affiliation(s)
- Sybille Caillot-Ranjeva
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, 146 rue Léo Saignat, CS61292, F-33076 Bordeaux Cedex, France.
| | - Samuel Gourlain
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, 146 rue Léo Saignat, CS61292, F-33076 Bordeaux Cedex, France.
| | - Hélène Amieva
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, 146 rue Léo Saignat, CS61292, F-33076 Bordeaux Cedex, France.
| | - Catherine Helmer
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, 146 rue Léo Saignat, CS61292, F-33076 Bordeaux Cedex, France.
| | - Valérie Bergua
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, 146 rue Léo Saignat, CS61292, F-33076 Bordeaux Cedex, France.
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Schellekens MPJ, van der Lee ML. Loneliness and belonging: Exploring experiences with the COVID-19 pandemic in psycho-oncology. Psychooncology 2020; 29:1399-1401. [PMID: 32628307 PMCID: PMC7361721 DOI: 10.1002/pon.5459] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 06/17/2020] [Accepted: 06/18/2020] [Indexed: 11/13/2022]
Affiliation(s)
- Melanie P J Schellekens
- Scientific Research Department, Helen Dowling Institute, Centre for Psycho-Oncology, Bilthoven, The Netherlands
| | - Marije L van der Lee
- Scientific Research Department, Helen Dowling Institute, Centre for Psycho-Oncology, Bilthoven, The Netherlands.,Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
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Forst DA, Quain K, Landay SL, Anand M, Kaslow-Zieve E, Mesa MM, Jacobs JM, Dietrich J, Parsons MW, Horick N, Greer JA, Batchelor TT, Jackson VA, El-Jawahri A, Temel JS. Perceptions of prognosis and goal of treatment in patients with malignant gliomas and their caregivers. Neurooncol Pract 2020; 7:490-497. [PMID: 33014389 DOI: 10.1093/nop/npaa021] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Background Patients with malignant gliomas have a poor prognosis. However, little is known about patients' and caregivers' understanding of the prognosis and the primary treatment goal. Methods We conducted a prospective study in patients with newly diagnosed malignant gliomas (N = 72) and their caregivers (N = 55). At 12 weeks after diagnosis, we administered the Prognosis and Treatment Perceptions Questionnaire to assess understanding of prognosis and the Hospital Anxiety and Depression Scale to evaluate mood. We used multivariable regression analyses to explore associations between prognostic understanding and mood and McNemar tests to compare prognostic perceptions among patient-caregiver dyads (N = 48). Results A total of 87.1% (61/70) of patients and 79.6% (43/54) of caregivers reported that it was "very" or "extremely" important to know about the patient's prognosis. The majority of patients (72.7%, [48/66]) reported that their cancer was curable. Patients who reported that their illness was incurable had greater depressive symptoms (B = 3.01, 95% CI, 0.89-5.14, P = .01). There was no association between caregivers' prognostic understanding and mood. Among patient-caregiver dyads, patients were more likely than caregivers to report that their primary treatment goal was cure (43.8% [21/48] vs 25.0% [12/48], P = .04) and that the oncologist's primary goal was cure (29.2% [14/48] vs 8.3% [4/48], P = .02). Conclusions Patients with malignant gliomas frequently hold inaccurate perceptions of the prognosis and treatment goal. Although caregivers more often report an accurate assessment of these metrics, many still report an overly optimistic perception of prognosis. Interventions are needed to enhance prognostic communication and to help patients cope with the associated distress.
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Affiliation(s)
- Deborah A Forst
- Division of Neuro-Oncology, Department of Neurology, Massachusetts General Hospital Cancer Center, Boston, Massachusetts
| | - Kit Quain
- Department of Medicine, Division of Hematology & Oncology, Massachusetts General Hospital Cancer Center, Boston, Massachusetts
| | - Sophia L Landay
- Department of Medicine, Division of Hematology & Oncology, Massachusetts General Hospital Cancer Center, Boston, Massachusetts
| | - Maya Anand
- Department of Medicine, Division of Hematology & Oncology, Massachusetts General Hospital Cancer Center, Boston, Massachusetts
| | - Emilia Kaslow-Zieve
- Department of Medicine, Division of Hematology & Oncology, Massachusetts General Hospital Cancer Center, Boston, Massachusetts
| | - Michelle M Mesa
- Department of Medicine, Division of Hematology & Oncology, Massachusetts General Hospital Cancer Center, Boston, Massachusetts
| | - Jamie M Jacobs
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | - Jorg Dietrich
- Division of Neuro-Oncology, Department of Neurology, Massachusetts General Hospital Cancer Center, Boston, Massachusetts
| | - Michael W Parsons
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | - Nora Horick
- Massachusetts General Hospital Biostatistics Center, Boston, Massachusetts
| | - Joseph A Greer
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | - Tracy T Batchelor
- Department of Neurology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Vicki A Jackson
- Department of Medicine, Division of Hematology & Oncology, Massachusetts General Hospital Cancer Center, Boston, Massachusetts
| | - Areej El-Jawahri
- Department of Medicine, Division of Hematology & Oncology, Massachusetts General Hospital Cancer Center, Boston, Massachusetts
| | - Jennifer S Temel
- Department of Medicine, Division of Hematology & Oncology, Massachusetts General Hospital Cancer Center, Boston, Massachusetts
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Möllerberg ML, Årestedt K, Swahnberg K, Benzein E, Sandgren A. Family sense of coherence and its associations with hope, anxiety and symptoms of depression in persons with cancer in palliative phase and their family members: A cross-sectional study. Palliat Med 2019; 33:1310-1318. [PMID: 31368844 DOI: 10.1177/0269216319866653] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND There is evidence indicating that family sense of coherence predicts quality of family life and promotes family well-being. In families living with the palliative phase of cancer, low hope, anxiety and symptoms of depression are common in both persons with cancer and their family members. AIM To determine whether family sense of coherence was associated with hope, anxiety and symptoms of depression, respectively, in persons with cancer in the palliative phase and their family members. DESIGN An observational, cross-sectional, multicentre study was conducted. Nested linear regression analyses were performed in two blocks to determine whether family sense of coherence was associated with hope, anxiety and symptoms of depression. SETTING/PARTICIPANTS Persons with cancer (n = 179) and their family members (n = 165) were recruited from two oncology clinics and two palliative centres in three regions in Sweden. RESULTS The main findings showed that family sense of coherence was significantly and independently associated with hope, anxiety and symptoms of depression. Stronger family sense of coherence was associated with higher hope and lower anxiety and symptoms of depression levels in both persons with cancer and their family members. CONCLUSION Health care providers should strive to identify families with weak family sense of coherence, because of its associations with hope, anxiety and symptoms of depression, in order to offer them professional support and thereby achieve increased well-being during the palliative phase of cancer. Future studies should expand our knowledge of family sense of coherence and how to identify families at risk of lower levels of well-being.
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Affiliation(s)
| | - Kristofer Årestedt
- Faculty of Health and Life Sciences, Linnaeus University, Kalmar/Växjö, Sweden.,The Research Section, Kalmar County Council, Kalmar, Sweden
| | - Katarina Swahnberg
- Faculty of Health and Life Sciences, Linnaeus University, Kalmar/Växjö, Sweden
| | - Eva Benzein
- Faculty of Health and Life Sciences, Linnaeus University, Kalmar/Växjö, Sweden.,Center for Collaborative Palliative Care, Linnaeus University, Växjö, Sweden
| | - Anna Sandgren
- Faculty of Health and Life Sciences, Linnaeus University, Kalmar/Växjö, Sweden.,Center for Collaborative Palliative Care, Linnaeus University, Växjö, Sweden
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14
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Nouzari R, Najafi SS, Momennasab M. Post-Traumatic Growth among Family Caregivers of Cancer Patients and Its Association with Social Support and Hope. INTERNATIONAL JOURNAL OF COMMUNITY BASED NURSING AND MIDWIFERY 2019; 7:319-328. [PMID: 31641681 PMCID: PMC6779924 DOI: 10.30476/ijcbnm.2019.73959.0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background: Cancer not only is a traumatic experience for the patients, but also can affect the family caregivers. Post-traumatic growth (PTG) refers to positive psychological changes experienced by people as a result of a struggle in dealing with traumatic events in life. Both the patients and their caregivers may experience PTG. The present study aimed to assess the extent of PTG in caregivers of patients with gastrointestinal cancer and to examine the relationship between the PTG dimensions and both the social support (SS) and hope.
Methods: The present descriptive correlational study was conducted during May-August 2018 in Shiraz, Iran. The target population included 112 caregivers who visited hospitals affiliated to Shiraz University of Medical Sciences, Shiraz, Iran. Data collection instruments included a demographic information form, post-traumatic growth inventory, social support appraisals scale, and Miller hope scale. The data were analyzed using the SPSS software (version 23.0). P<0.05 was considered statistically significant.
Results: The mean score for PTG, hope, and SS was 75.41±16.49, 190.95±24.20, and 89.10±12.84, respectively. A significant positive correlation was found between PTG and both SS (P<0.001, r=0.59) and hope (P<0.001, r=0.70). The results of the multiple regression analysis showed a significant relationship between PTG, SS, and hope (P<0.001). Hope had a higher effect on PTG (ẞ=0.62) compared to SS (ẞ=0.27).
Conclusion: The results showed a good level of PTG among the caregivers and the experience of stressful situations positively affected their psychological condition. The positive change was associated with the perceived SS and hope.
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Affiliation(s)
- Razieh Nouzari
- Student Research Committee, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Saeed Najafi
- Community Based Psychiatric Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Marzieh Momennasab
- Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
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15
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Lee CS, Lyons KS. Patterns, relevance, and predictors of dyadic mental health over time in lung cancer. Psychooncology 2019; 28:1721-1727. [PMID: 31216606 DOI: 10.1002/pon.5153] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 05/28/2019] [Accepted: 06/11/2019] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To identify distinct patterns of dyadic mental health in a sample of lung cancer dyads over 12 months and associations with other health characteristics and individual, dyadic, and familial predictors. METHODS A sample of 113 patient-care partner dyads living with nonsmall cell lung cancer were examined five times over 12 months. An integrative multilevel and mixture modeling approach was used to generate dyadic mental health summaries and identify common dyadic patterns of mental health over time, respectively. RESULTS Three distinct patterns of dyadic mental health were observed: a congruent pattern (32.7%) characterized by almost identical mental health between members of the dyad, a disparate pattern (29.2%) characterized by better mental health of the patient compared with the care partner, and a parallel pattern (38.1%) characterized by care partner patterns of improvement and greater similarity in mental health over time. Membership of patterns was associated with physical health characteristics of both patient and care partner, levels of patient concealment regarding worries and concerns, and relationship quality reported by the care partner. Patterns did not differ by patient gender, care partner strain, or levels of social support. CONCLUSIONS Findings emphasize the importance of examining patterns of dyadic mental health to identify dyads most at risk so we may optimize the health of the dyad in tailored ways.
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Affiliation(s)
- Christopher S Lee
- William F. Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts
| | - Karen S Lyons
- William F. Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts
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16
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Wintermann GB, Petrowski K, Weidner K, Strauß B, Rosendahl J. Impact of post-traumatic stress symptoms on the health-related quality of life in a cohort study with chronically critically ill patients and their partners: age matters. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2019; 23:39. [PMID: 30736830 PMCID: PMC6368748 DOI: 10.1186/s13054-019-2321-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 01/11/2019] [Indexed: 12/25/2022]
Abstract
Background Survivors of an acute critical illness with continuing organ dysfunction and uncontrolled inflammatory responses are prone to become chronically critically ill. As mental sequelae, a post-traumatic stress disorder and an associated decrease in the health-related quality of life (QoL) may occur, not only in the patients but also in their partners. Currently, research on long-term mental distress in chronically critically ill patient-partner dyads, using appropriate dyadic analysis strategies (patients and partners being measured and linked on the same variables) and controlling for contextual factors, is lacking. Methods The present study investigates the interdependence of post-traumatic stress symptoms (PTSS) and the health-related QoL in n = 70 dyads of chronically critically ill patients and their partners, using the Actor-Partner-Interdependence Model (APIM) under consideration of contextual factors (age, gender, length of partnership). The Post-traumatic Stress Scale (PTSS-10) and Euro-Quality of Life (EQ-5D-3L) were applied in both the patients and their partners, within up to 6 months after the transfer from acute care ICU to post-acute ICU. Results Clinically relevant post-traumatic stress symptoms were reported by 17.1% of the patients and 18.6% of the partners. Both the chronically critically ill patients and their partners with more severe post-traumatic stress symptoms also showed a decreased health-related QoL. The latter was more pronounced in male partners compared to female partners or female patients. In younger partners (≤ 57 years), higher values of post-traumatic stress symptoms were associated with a decreased QoL in the patients. Conclusions Mental health screening and psychotherapeutic treatment options should be offered to both the chronically critically ill patients and their partners. Future research is required to address the special needs of younger patient-partner dyads, following protracted ICU treatment. Trial registration German Clinical Trials Register No. DRKS00003386. Registered 13 November 2011 Electronic supplementary material The online version of this article (10.1186/s13054-019-2321-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Gloria-Beatrice Wintermann
- Department of Psychotherapy and Psychosomatic Medicine, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, 01307, Dresden, Germany.
| | - Katja Petrowski
- Department of Psychotherapy and Psychosomatic Medicine, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, 01307, Dresden, Germany.,Institute of Medical Psychology and Medical Sociology, Clinic and Polyclinic for Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Kerstin Weidner
- Department of Psychotherapy and Psychosomatic Medicine, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, 01307, Dresden, Germany
| | - Bernhard Strauß
- Institute of Psychosocial Medicine and Psychotherapy, Jena University Hospital, Friedrich-Schiller University, Jena, Germany
| | - Jenny Rosendahl
- Institute of Psychosocial Medicine and Psychotherapy, Jena University Hospital, Friedrich-Schiller University, Jena, Germany.,Center for Sepsis Control and Care, Jena University Hospital, Friedrich-Schiller University, Jena, Germany
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17
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Gjerset GM, Tendille M, Skaali T, Kiserud CE, Dahl AA, Gudbergsson SB, Thorsen L. Gender differences in health status and benefits of a one-week educational programme for caregivers of cancer patients. Eur J Cancer Care (Engl) 2019; 28:e12992. [DOI: 10.1111/ecc.12992] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 11/16/2018] [Accepted: 12/16/2018] [Indexed: 01/22/2023]
Affiliation(s)
- Gunhild M. Gjerset
- National Advisory Unit on Late Effects after Cancer Treatment, Department of Oncology; Division of Cancer Medicine; Oslo University Hospital; Oslo Norway
- Montebello Center; The Norwegian Resource Center for Coping with Cancer; Mesnali Norway
| | - Mari Tendille
- Unit for Psychosocial Oncology, Coping and Rehabilitation, Department of Clinical Service; Division of Cancer Medicine; Oslo University Hospital; Oslo Norway
| | - Tone Skaali
- Unit for Psychosocial Oncology, Coping and Rehabilitation, Department of Clinical Service; Division of Cancer Medicine; Oslo University Hospital; Oslo Norway
| | - Cecilie E. Kiserud
- National Advisory Unit on Late Effects after Cancer Treatment, Department of Oncology; Division of Cancer Medicine; Oslo University Hospital; Oslo Norway
| | - Alv A. Dahl
- National Advisory Unit on Late Effects after Cancer Treatment, Department of Oncology; Division of Cancer Medicine; Oslo University Hospital; Oslo Norway
- University of Oslo; Oslo Norway
| | - Saevar B. Gudbergsson
- Montebello Center; The Norwegian Resource Center for Coping with Cancer; Mesnali Norway
| | - Lene Thorsen
- National Advisory Unit on Late Effects after Cancer Treatment, Department of Oncology; Division of Cancer Medicine; Oslo University Hospital; Oslo Norway
- Department of Clinical Service; Division of Cancer Medicine; Oslo University Hospital; Oslo Norway
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18
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Kim Y, Mitchell HR, Ting A. Application of psychological theories on the role of gender in caregiving to psycho-oncology research. Psychooncology 2018; 28:228-254. [PMID: 30488661 DOI: 10.1002/pon.4953] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 11/21/2018] [Accepted: 11/23/2018] [Indexed: 12/29/2022]
Abstract
BACKGROUND Cancer affects both men and women, yet systematic understanding of the role of gender in caregiving and dyadic caregiver-patient interactions is lacking. Thus, it may be useful to review how gender theories apply to cancer caregiving and to evaluate the adequacy of current cancer caregiving studies to the gender theories. METHODS Several databases, including MEDLINE (Ovid), PsychINFO, PubMed, and CINAHL, were used for searching articles published in English between 2000 and 2016. The search was restricted by age (≥18) and yielded 602 articles, which were subject to further screen and review based on selection criteria. Of 108 full texts reviewed to determine inclusion eligibility for this review, 55 met the criteria and included for review. RESULTS The reviewed studies supported the "gender role" and "doing gender" perspectives for caregiver selection. The role identity, role strain, and transactional stress theories were supported for predicting caregiving outcomes at the individual level. Furthermore, attachment, self-determination, and interdependence theories incorporated caregiver factors that predicted the patients' outcomes, and vice versa. CONCLUSION Despite limited gender theory-driven research in cancer caregiving and psycho-oncology in general, the utility of gender theories in (a) identifying subgroups of caregiver-patient dyads who are vulnerable to the adverse effects of cancer in the family and (b) developing evidence-based interventions is promising. Integrating broader issues of medical trajectory, lifespan, sociocultural, and biological factors in gender-oriented research and practice in psycho-oncology is encouraged.
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Affiliation(s)
- Youngmee Kim
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | | | - Amanda Ting
- Department of Psychology, University of Miami, Coral Gables, FL, USA
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19
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Lee S, Oh ST, Lee H, Lee JS, Pak H, Choi WJ, Jeon HH. Associated risk factors for psychological distress in patients with gastric epithelial neoplasm undergoing endoscopic submucosal dissection. Medicine (Baltimore) 2018; 97:e13912. [PMID: 30593210 PMCID: PMC6314696 DOI: 10.1097/md.0000000000013912] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
This study aimed to evaluate the psychological distress and associated risk factors for distress among patients with gastric epithelial neoplasm undergoing endoscopic submucosal dissection (ESD).A total of 91 patients treated with ESD for gastric epithelial neoplasm between May 2015 and June 2016 were prospectively enrolled. Sociodemographic factors, psychological distress, anxiety, depression, stress, and associated risk factors for psychological distress were evaluated the day before ESD.Twenty-six (28.6%) patients were identified as patients with psychological distress. The psychological distress group had a higher female ratio and more depression and anxiety symptoms than the non-distress group. Distress was also related to stress level. A multivariate analysis showed that unmarried status (odds ratio [OR], 4.94; 95% confidence interval [CI], 1.13-21.56, P = .034), anxiety (OR, 1.24; 95% CI, 1.12-1.39, P <.001), and stress (OR, 1.06; 95% CI, 1.01-1.12, P = .011) were associated with psychological distress.An unmarried status and a high level of anxiety and stress were associated with more psychological distress in patients undergoing gastric ESD. It could be helpful to screen and proactively monitor patients with such conditions before performing gastric ESD.
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Affiliation(s)
- San Lee
- Department of Psychiatry
- Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Seung-Taek Oh
- Department of Psychiatry
- Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Hyeok Lee
- Department of Psychiatry
- Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
| | | | - Haeyong Pak
- Institute of Health Insurance and Clinical Research, National Health Insurance Service Ilsan Hospital
| | - Won-Jung Choi
- Department of Psychiatry
- Yonsei Hana Psychiatry Clinic and Institute of Mental Health, Goyang
- Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
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20
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Isaksson J, Lilliehorn S, Salander P. Next of kin's motives for psychosocial consultation-Oncology social workers' perceptions of 54 next of kin cases. Psychooncology 2018; 28:154-159. [PMID: 30346070 DOI: 10.1002/pon.4925] [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: 06/21/2018] [Revised: 10/15/2018] [Accepted: 10/17/2018] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Although oncology social workers (OSWs) have emerged as a core profession in the provision of psychosocial services, there is a lack of empirical studies that describe their daily clinical work with next of kin (NOK). The overall aim of this study was to explore NOK's motives for consulting an OSW. This can provide us with insights into what types of skills OSWs need to have in order to fulfil their duties. METHODS From a nationwide survey, we used data from 54 NOK cases that Swedish OSWs met face to face. RESULTS About half of the motives concerned help in dealing with personal grief connected to the patients' cancer and distressing symptoms, while the other half concerned needs for help in dealing with the position of being the NOK, relationship conflicts, and assistance with socio-economic issues. CONCLUSIONS The motives show that NOK does not just ask for help to come to terms with distress related to the patient's situation. Based on the diversity of motives, we suggest that OSWs (at least in Sweden) need a broad education in counselling psychology. Furthermore, health care personnel need to be attentive to the NOK's own voice and not reduce it to the voice of the patient and the patient's needs in referrals.
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Affiliation(s)
- Joakim Isaksson
- Department of Social Work, Stockholm University, Stockholm, Sweden
| | - Sara Lilliehorn
- Department of Social Work, Umeå University, Umeå, Sweden.,Department of Radiation Sciences-Oncology, Umeå University, Umeå, Sweden
| | - Pär Salander
- Department of Social Work, Umeå University, Umeå, Sweden
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21
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The degree of social difficulties experienced by cancer patients and their spouses. BMC Palliat Care 2018; 17:83. [PMID: 29884235 PMCID: PMC5994032 DOI: 10.1186/s12904-018-0338-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Accepted: 05/28/2018] [Indexed: 12/02/2022] Open
Abstract
Background Although recent studies have increasingly reported physical and psychological problems associated with cancer and its treatment, social problems of cancer patients and their families have not been sufficiently elucidated. The present study aimed to identify cancer-associated social problems from the perspectives of both patients and their spouses and to compare and analyze differences in their problems. Methods This was a cross-sectional internet-based study. Subjects were 259 patients who developed cancer within the previous five years and 259 patients’ spouses; the data were derived from two surveys in 2010 (patients) and 2016 (spouses) whose participants were not part of the same dyad but matched by propensity scores, estimated for age, sex, and the presence or absence of recurrence. We investigated the social difficulties of cancer patients and patients’ spouses. Regarding social difficulties experienced by cancer patients and spouses, the 60 patient survey items were categorized into 14 labels by the Jiro Kawakita (KJ) method, which is a qualitative synthesis method developed by Kawakita to classify categorical data. Results Although patients had higher scores on most subcategories, young spouses aged 39 or younger and female spouses had difficulty scores as high as the corresponding patients on many subcategories. Conclusion Health care providers should show sufficient concern for both patients and their spouses, particularly young and female spouses.
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22
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Duprez C, Vanlemmens L, Untas A, Antoine P, Lesur A, Loustalot C, Guillemet C, Leclercq M, Segura C, Carlier D, Lefeuvre-Plesse C, Simon H, Frenel JS, Christophe V. Emotional distress and subjective impact of the disease in young women with breast cancer and their spouses. Future Oncol 2017; 13:2667-2680. [PMID: 29191056 DOI: 10.2217/fon-2017-0264] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AIM Evaluate the influence of emotional distress of young women with breast cancer and their spouses on their daily subjective experience of the disease, through application of the Actor-Partner Interdependence Model. PATIENTS & METHODS A total of 112 women under 45 years of age were diagnosed with nonmetastatic breast cancer and their spouses answered self-reported measures of anxiety, depression and subjective experience of the disease and its treatment. RESULTS The patient's emotional distress influenced more the subjective experience of her spouse than the spouse's emotional distress influenced the patient. The spouse's difficulties depended as much on his own distress level as on the patient's distress level. CONCLUSION These data confirm the importance of implementing couple-focused interventions.
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Affiliation(s)
- Christelle Duprez
- Univ. Lille, CNRS, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, F-59000 Lille, France.,SIRIC ONCOLille - Maison Régionale de la Recherche Clinique - 6, rue du Professeur Laguesse, 59037 Lille cedex, France
| | - Laurence Vanlemmens
- Centre Oscar Lambret - Département de Sénologie, BP 307, F-59020 Lille cedex, France
| | - Aurélie Untas
- Laboratoire de Psychopathologie et Processus de Santé EA 4057, Institut de Psychologie, Université Paris Descartes, Sorbonne Paris Cité, Boulogne-Billancourt, France
| | - Pascal Antoine
- Univ. Lille, CNRS, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, F-59000 Lille, France
| | - Anne Lesur
- Centre Alexis Vautrin, 6 avenue de Bourgogne 59000 Vandœuvre-lès-Nancy, France
| | - Catherine Loustalot
- Centre Georges François Leclerc, 1 rue du Pr Marion BP 1544 21034 Dijon cedex, France
| | | | - Monelle Leclercq
- Collèges des gynécologues, 39 Boulevard Clémenceau 59700 Marcq-en-Barœul, France
| | - Carine Segura
- Centre François Baclesse, Avenue du Général Harris 14076 Caen Cedex 5, France
| | - Damien Carlier
- Centre Léonard de Vinci, route de Cambrai 59187 Dechy, France
| | - Claudia Lefeuvre-Plesse
- Centre Eugene Marquis, avenue de la Bataille Flandres-Dunkerque CS 44229 35042 Rennes Cedex, France
| | - Hélène Simon
- CHRU Brest Morvan Institut de cancérologie et hématologie, 5 avenue Foch 29200 Brest, France
| | - Jean Sébastien Frenel
- Institut de Cancérologie de l'Ouest, Centre René Gauducheau, ld Jacques Monod 44800 Saint-Herblain, France
| | - Véronique Christophe
- Univ. Lille, CNRS, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, F-59000 Lille, France.,SIRIC ONCOLille - Maison Régionale de la Recherche Clinique - 6, rue du Professeur Laguesse, 59037 Lille cedex, France
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23
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Porter LS, Dionne-Odom JN. Supporting cancer family caregivers: How can frontline oncology clinicians help? Cancer 2017; 123:3212-3215. [PMID: 28464219 PMCID: PMC5568917 DOI: 10.1002/cncr.30759] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 04/03/2017] [Accepted: 04/10/2017] [Indexed: 11/07/2022]
Abstract
There is growing recognition of the demands placed on unpaid family members of patients with cancer, the need to support family caregivers, and the barriers that exist to meeting their needs. This commentary offers several messages that oncology providers can deliver to family caregivers to support them and empower them to seek the services they need.
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Affiliation(s)
- Laura S Porter
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina
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24
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Rand S, Forder J, Malley J. A study of dyadic interdependence of control, social participation and occupation of adults who use long-term care services and their carers. Qual Life Res 2017; 26:3307-3321. [PMID: 28786019 PMCID: PMC5681980 DOI: 10.1007/s11136-017-1669-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2017] [Indexed: 10/25/2022]
Abstract
PURPOSE Unpaid care is an important source of support of people with long-term conditions. Interdependence of carers' and care recipients' quality of life would be expected due to the relational nature of caregiving. This study aims to explore interdependence of quality of life in carer/care-recipient dyads, especially in relation to mutual interdependence due to social feedback in the caregiving relationship and also the partner effects of one partner's experience of long-term care support on the other's outcomes. METHODS Using data collected in an interview survey of 264 adults with care support needs and their unpaid carers in England, we employed regression analysis to explore whether there is mutual interdependence of care-related quality of life within carer/care-recipient dyads for three quality of life attributes: Control over daily life, Social participation and Occupation. The influence of factors, including satisfaction with long-term care, were also considered on individuals' and dyad partners' care-related quality of life. RESULTS We found mutual interdependence of quality of life at the dyad-level for Control over daily life, but not Occupation or Social participation. A partner effect of care recipients' satisfaction with long-term care on carers' Control over daily life was also observed. Higher care recipient satisfaction with care services was associated with higher Control over daily life. By contrast, for Social participation and Occupation, there were only significant effects of care recipients' satisfaction with long-term care and their own quality of life. CONCLUSIONS These findings highlight the importance of considering the wider impact beyond the individual of long-term care on quality of life in the evaluation of long-term care policy and practice.
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Affiliation(s)
- Stacey Rand
- Personal Social Services Research Unit (PSSRU), University of Kent, Cornwallis Building, Canterbury, CT2 7NF, UK.
| | - Julien Forder
- Personal Social Services Research Unit (PSSRU), University of Kent, Cornwallis Building, Canterbury, CT2 7NF, UK
| | - Juliette Malley
- Personal Social Services Research Unit (PSSRU), London School of Economics and Political Science, Cowdray House, Houghton Street, London, WC2A 2AE, UK
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25
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Shaffer KM, Kim Y, Carver CS, Cannady RS. Depressive symptoms predict cancer caregivers' physical health decline. Cancer 2017; 123:4277-4285. [PMID: 28661573 DOI: 10.1002/cncr.30835] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 04/25/2017] [Accepted: 05/19/2017] [Indexed: 01/07/2023]
Abstract
BACKGROUND Cancer caregiving has been associated with worsening health among caregivers themselves, yet demographic and psychosocial predictors of their long-term health decline are less known. This study examines changes in caregivers' physical health 2 to 8 years after their family members' cancer diagnosis and prospective predictors of that change. METHODS Caregivers (n = 664; mean age, 53.2 years) participated in a nationwide study at 2 (T1), 5 (T2), and 8 (T3) years after their family members' cancer diagnosis. Physical health (12-item Medical Outcomes Study Short Form Health Survey Physical Component Scale) was assessed T1 through T3 as outcome. Predictors were self-reported at T1, including caregiver demographics (age, sex, education, income, relationship to patient, and employment status), patient cancer severity (from medical records), and caregiver psychosocial factors (caregiving stress, caregiving esteem, social support, and depressive symptoms). Latent growth modeling tested predictors of caregivers' initial physical health and their physical health change across time. RESULTS At T1, caregivers reported slightly better physical health than the US population (M = 51.22, P = .002), which declined over the following 6 years (Mslope = -0.27, P < .001). All demographic factors, patient cancer severity, and T1 caregiving stress were related to caregivers' initial physical health (P ≤ .03). Higher depressive symptoms were unrelated to caregivers' initial physical health, but were the only significant predictor of caregivers' more rapid physical health decline (B = -0.02, P = .004). CONCLUSION Findings highlight the unique contribution of caregivers' depressive symptoms to their physical health decline. Assessing and addressing depressive symptoms among caregivers early in the cancer survivorship trajectory may help to prevent premature health decline among this important yet vulnerable population. Cancer 2017;123:4277-4285. © 2017 American Cancer Society.
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Affiliation(s)
- Kelly M Shaffer
- Department of Psychology, University of Miami, Miami, Florida.,Memorial Sloan Kettering Cancer Center, Department of Psychiatry & Behavioral Sciences, New York, New York
| | - Youngmee Kim
- Department of Psychology, University of Miami, Miami, Florida
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Abstract
ABSTRACTObjective:Both trait and contextual self-concealment, as well as shame- and guilt-proneness, have previously been found to be associated with psychological distress. However, findings regarding the associations between these variables among patients with cancer and among the spouses of patients with cancer are limited. The aim of the current study was therefore to investigate the relationship between shame-proneness and psychological distress (anxiety and depression) by examining the mediating role of both trait and contextual self-concealment among patients with cancer and among the spouses of patients with cancer. METHOD The current study was part of a large-scale cross-sectional study on self-concealment among patients with cancer and spouses of patients with cancer. It was based on two independent subsamples: patients with cancer and spouses of patients with cancer, who were not dyads. A total of 80 patients with cancer and 80 spouses of (other) patients with cancer completed questionnaires assessing shame- and guilt-proneness, trait and contextual self-concealment, anxiety, and depression. RESULTS Results indicate that spouses reported both greater shame-proneness and anxiety than did patients (main effect of role). Female participants reported greater shame-proneness, higher levels of contextual self-concealment, and greater depression and anxiety than did male participants (main effect of gender). No group differences (role/gender) were found for guilt-proneness and trait self-concealment. Trait and contextual self-concealment partially mediated the relationship between shame-proneness and distress, pointing out the need to further examine additional mediators. SIGNIFICANCE OF RESULTS Findings suggest that contextual self-concealment and shame-proneness are important variables to consider when assessing distress in the setting of psycho-oncology. Study results may have significant clinical implications regarding the need to identify patients and spouses who are more prone to shame and self-concealment behavior in order to better tailor interventions for them.
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Brief supportive-expressive group therapy for partners of men with early stage prostate cancer: lessons learned from a negative randomized controlled trial. Support Care Cancer 2017; 25:1035-1041. [DOI: 10.1007/s00520-016-3551-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 12/20/2016] [Indexed: 10/20/2022]
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Nakaya N, Sone T, Nakaya K, Tomata Y, Hozawa A, Tsuji I. Psychological Distress among Individuals Whose Partners Have Cancer. TOHOKU J EXP MED 2017; 243:27-33. [DOI: 10.1620/tjem.243.27] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Naoki Nakaya
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University
| | - Toshimasa Sone
- Department of Rehabilitation, Faculty of Health Science, Tohoku Fukushi University
| | - Kumi Nakaya
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University
| | - Yasutake Tomata
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University Graduate School of Medicine
| | - Atsushi Hozawa
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University
| | - Ichiro Tsuji
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University Graduate School of Medicine
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Psychological distress of cancer patients with children under 18 years and their partners-a longitudinal study of family relationships using dyadic data analysis. Support Care Cancer 2016; 25:255-264. [PMID: 27624466 DOI: 10.1007/s00520-016-3411-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 09/05/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE With increasing age at pregnancy, the likelihood of cancer affecting a family with children under 18 is rising and the issue of parents with cancer is gaining importance. Here, we examined the level of anxiety and depression, social support, and partnership satisfaction of cancer patients with children under 18 years and their partners as well as the dyadic patient-partner relationship concerning psychological distress and predictor variables. METHODS We used a longitudinal survey, recruiting patients with children under legal age and their partners (t1 = post therapy, t2 = 6 months after t1, t3 = 12 months after t1). Patients and partners completed the Hospital Anxiety and Depression Scale (HADS), the Oslo 3-item Social Support Scale (OSS-3), and the Abbreviated Dyadic Adjustment Scale (ADAS). We surveyed 161 cancer patients and 115 partners by mail (t1). Anxiety and depression were compared to German normative data. Dyadic relationships of three variables (social support, partnership satisfaction, and employment) and the psychological distress of 81 patient-partner dyads were analyzed with a structural equation model to estimate the actor-partner interdependence model. RESULTS After cancer therapy, 28.3 % of the patients and 46.2 % of their partners had moderate to high levels of anxiety and 17.9 % and 23.1 % had moderate to high levels of depression, respectively. Partners' levels of anxiety (p = 0.002) and depression (p = 0.018) had decreased significantly over the 1-year period post therapy. We found no changes in patients' anxiety (p = 0.444) and depression (p = 0.636) over time. Anxiety and depression did not differ on pair level (p = 0.120-0.928). The level of anxiety in patients and partners was significantly higher than that in the general population (p < 0.001-0.006). The analyses of the dyadic relationships showed a positive effect of social support on psychological distress of the patient (beta = -0.206, p < 0.2). Social support (beta = -0.448, p < 0.001), employment (beta = -0.509, p < 0.01), and satisfaction with partnership (beta = -0.448, p < 0.001) showed a positive impact on psychological well-being of the partner. CONCLUSIONS A cancer experience within a family is a large burden for both patients and partners, highlighting the high incidence of anxiety. The results indicate that couples coping with cancer tend to react as an emotional system rather than as individuals. Patients' reintegration in employment is as important as encouraging partners in their working activities. The findings underline the importance of continuing social support for patients and their partners.
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Young J, Snowden A. A systematic review on the factors associated with positive experiences in carers of someone with cancer. Eur J Cancer Care (Engl) 2016; 26. [DOI: 10.1111/ecc.12544] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2016] [Indexed: 01/28/2023]
Affiliation(s)
- J. Young
- Edinburgh Napier University; Edinburgh UK
| | - A. Snowden
- Edinburgh Napier University; Edinburgh UK
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Wintermann GB, Weidner K, Strauß B, Rosendahl J, Petrowski K. Predictors of posttraumatic stress and quality of life in family members of chronically critically ill patients after intensive care. Ann Intensive Care 2016; 6:69. [PMID: 27439709 PMCID: PMC4954797 DOI: 10.1186/s13613-016-0174-0] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 07/07/2016] [Indexed: 12/22/2022] Open
Abstract
Background Prolonged mechanical ventilation for acute medical conditions increases the risk of chronic critical illness (CCI). Close family members are confronted with the life-threatening condition of the CCI patients and are prone to develop posttraumatic stress disorder affecting their health-related quality of life (HRQL). Main aim of the present study was to investigate patient- and family-related risk factors for posttraumatic stress and decreased HRQL in family members of CCI patients. Methods In a cross-sectional design nested within a prospective longitudinal cohort study, posttraumatic stress symptoms and quality of life were assessed in family members of CCI patients (n = 83, aged between 18 and 72 years) up to 6 months after transfer from ICU at acute care hospital to post-acute rehabilitation. Patients admitted a large rehabilitation hospital for ventilator weaning. The Posttraumatic Stress Scale-10 and the Euro-Quality of life-5D-3L were applied in both patients and their family members via telephone interview. Results A significant proportion of CCI patients and their family members (14.5 and 15.7 %, respectively) showed clinically relevant scores of posttraumatic stress. Both CCI patients and family members reported poorer HRQL than a normative sample. Factors independently associated with posttraumatic stress in family members were the time following ICU discharge (β = .256, 95 % confidence interval .053–.470) and the patients’ diagnosis of PTSD (β = .264, 95 % confidence interval .045–.453). Perceived satisfaction with the relationship turned out to be a protective factor for posttraumatic stress in family members of CCI patients (β = −.231, 95 % confidence interval −.423 to −.015). Regarding HRQL in family members, patients’ acute posttraumatic stress at ICU (β = −.290, 95 % confidence interval −.360 to −.088) and their own posttraumatic stress 3 to 6 months post-transfer (β = −.622, 95 % confidence interval −.640 to −.358) turned out to be significant predictors. Conclusions Posttraumatic stress and HRQL should be routinely assessed in family members of CCI patients at regular intervals starting early at ICU. Preventive family-centered interventions are needed to improve posttraumatic stress and HRQL in both patients and their family members. Electronic supplementary material The online version of this article (doi:10.1186/s13613-016-0174-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Gloria-Beatrice Wintermann
- Department of Psychotherapy and Psychosomatic Medicine, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.,Center for Sepsis Control and Care, Jena University Hospital, Friedrich-Schiller University, Jena, Germany.,Institute of Psychosocial Medicine and Psychotherapy, Jena University Hospital, Friedrich-Schiller University, Stoystr. 3, 07743, Jena, Germany
| | - Kerstin Weidner
- Department of Psychotherapy and Psychosomatic Medicine, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Bernhard Strauß
- Institute of Psychosocial Medicine and Psychotherapy, Jena University Hospital, Friedrich-Schiller University, Stoystr. 3, 07743, Jena, Germany
| | - Jenny Rosendahl
- Institute of Psychosocial Medicine and Psychotherapy, Jena University Hospital, Friedrich-Schiller University, Stoystr. 3, 07743, Jena, Germany.
| | - Katja Petrowski
- Department of Workplace Health Promotion, German Sport University Cologne, Cologne, Germany.
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Burns W, Péloquin K, Sultan S, Moghrabi A, Marcoux S, Krajinovic M, Sinnett D, Laverdière C, Robaey P. A 2-year dyadic longitudinal study of mothers' and fathers' marital adjustment when caring for a child with cancer. Psychooncology 2016; 26:1660-1666. [PMID: 27278682 DOI: 10.1002/pon.4189] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 05/02/2016] [Accepted: 06/06/2016] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Studies examining interrelationships within parental couples confronted with pediatric cancer are scarce. This study explored dyadic longitudinal associations between both partners' family functioning and mood at diagnosis, and marital adjustment 2 years later. METHOD Parents of children (n = 47 couples) with acute lymphoblastic leukemia (ALL) completed the Family Well-Being Assessment and Profile of Mood States-Bipolar Form at diagnosis, and the Locke-Wallace Marital Adjustment Test 2 years post diagnosis. Multilevel linear models using the actor-partner interdependence model (APIM) and controlling for baseline marital adjustment were conducted to evaluate within subject and dyadic longitudinal effects. RESULTS For mothers, better marital adjustment 2 years post diagnosis was associated with perception of greater family support and less role conflict and role overload at diagnosis. For fathers, better marital adjustment 2 years post-diagnosis was associated with perception of less role conflict, greater role ambiguity, and being more tired at diagnosis, as well as their partner's perception of less role conflict at diagnosis. CONCLUSIONS These findings highlight the importance of considering both partners' perspectives in understanding marital adjustment across treatment phases in parents of children with ALL. Early interventions for couples should be tailored to meet each partner's needs in order to foster resilience within the couple.
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Affiliation(s)
- W Burns
- Department of Psychology, Université de Montréal, Montréal, Québec, Canada.,Sainte-Justine University Health Center, Montréal, Québec, Canada
| | - K Péloquin
- Department of Psychology, Université de Montréal, Montréal, Québec, Canada
| | - S Sultan
- Department of Psychology, Université de Montréal, Montréal, Québec, Canada.,Department of Pediatrics, Université de Montreal, Montréal, Québec, Canada.,Sainte-Justine University Health Center, Montréal, Québec, Canada
| | - A Moghrabi
- Sainte-Justine University Health Center, Montréal, Québec, Canada
| | - S Marcoux
- Department of Pediatrics, Université de Montreal, Montréal, Québec, Canada.,Sainte-Justine University Health Center, Montréal, Québec, Canada
| | - M Krajinovic
- Department of Pediatrics, Université de Montreal, Montréal, Québec, Canada.,Sainte-Justine University Health Center, Montréal, Québec, Canada
| | - D Sinnett
- Department of Pediatrics, Université de Montreal, Montréal, Québec, Canada.,Sainte-Justine University Health Center, Montréal, Québec, Canada
| | - C Laverdière
- Department of Pediatrics, Université de Montreal, Montréal, Québec, Canada.,Sainte-Justine University Health Center, Montréal, Québec, Canada
| | - P Robaey
- Sainte-Justine University Health Center, Montréal, Québec, Canada.,Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.,University of Ottawa, Ottawa, Ontario, Canada
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Ernst J, Hinz A, Niederwieser D, Döhner H, Hönig K, Vogelhuber M, Mehnert A, Weissflog G. Dyadic coping of patients with hematologic malignancies and their partners and its relation to quality of life – a longitudinal study. Leuk Lymphoma 2016; 58:655-665. [DOI: 10.1080/10428194.2016.1194983] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Jochen Ernst
- Medical Psychology & Medical Sociology, Psychosocial Oncology, University Medical Center Leipzig, Leipzig, Germany
| | - Andreas Hinz
- Medical Psychology & Medical Sociology, Psychosocial Oncology, University Medical Center Leipzig, Leipzig, Germany
| | - Dietger Niederwieser
- Division of Hematology and Oncology, University Hospital of Leipzig, Leipzig, Germany
| | - Hartmut Döhner
- Department of Internal Medicine III, University Hospital of Ulm, Ulm, Germany
- Comprehensive Cancer Center Ulm (CCCU), Ulm, Germany
| | - Klaus Hönig
- Comprehensive Cancer Center Ulm (CCCU), Ulm, Germany
- Department of Psychosomatic Medicine and Psychotherapy, University of Ulm, Ulm, Germany
| | - Martin Vogelhuber
- Department of Internal Medicine III, University of Regensburg, Regensburg, Germany
| | - Anja Mehnert
- Medical Psychology & Medical Sociology, Psychosocial Oncology, University Medical Center Leipzig, Leipzig, Germany
| | - Gregor Weissflog
- Medical Psychology & Medical Sociology, Psychosocial Oncology, University Medical Center Leipzig, Leipzig, Germany
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Shaffer KM, Kim Y, Carver CS. Physical and mental health trajectories of cancer patients and caregivers across the year post-diagnosis: a dyadic investigation. Psychol Health 2016; 31:655-74. [PMID: 26680247 DOI: 10.1080/08870446.2015.1131826] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Evidence suggests interdependence between cancer patients' and their caregivers' physical and mental health. However, the extent to which caregivers' health relates to their patients' recovery, or patients' health affects their caregivers' outcomes, is largely unknown. This dyadic investigation reports the relations between cancer patients' and their caregivers' physical and mental health trajectories during the year following diagnosis. DESIGN Ninety-two colorectal cancer patient-caregiver dyads completed questionnaires at 2, 6 and 12 months post-diagnosis. OUTCOME MEASURES Self-reported physical and mental health using the Medical Outcomes Study Short Form Health Survey-12. RESULTS Patients reported improved physical health over the year following their diagnosis, whereas caregivers reported declining physical health. Patients with lower mental health at diagnosis had stagnated physical health recovery. Caregivers' physical health declined most noticeably among those reporting low mental health at diagnosis and whose patients reported low physical health at diagnosis. CONCLUSION Findings suggest targeting health interventions to cancer patients and caregivers reporting poor mental health at diagnosis may mitigate their long-term physical morbidity. Limited evidence of dyadic interdependence between patients' and caregivers' physical and mental health trajectories suggests future studies are warranted to identify psychosocial and medical characteristics moderating the relations between patients' and caregivers' health.
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Affiliation(s)
- Kelly M Shaffer
- a Department of Psychology , University of Miami , Coral Gables , FL , USA.,b Department of Psychiatry , Massachusetts General Hospital , Boston , MA , USA
| | - Youngmee Kim
- a Department of Psychology , University of Miami , Coral Gables , FL , USA.,c Center for Advanced Study in the Behavioral Sciences , Stanford University , Stanford , CA , USA
| | - Charles S Carver
- a Department of Psychology , University of Miami , Coral Gables , FL , USA.,c Center for Advanced Study in the Behavioral Sciences , Stanford University , Stanford , CA , USA
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Gröpper S, van der Meer E, Landes T, Bucher H, Stickel A, Goerling U. Assessing cancer-related distress in cancer patients and caregivers receiving outpatient psycho-oncological counseling. Support Care Cancer 2015; 24:2351-2357. [DOI: 10.1007/s00520-015-3042-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 11/23/2015] [Indexed: 11/24/2022]
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Graham L, Dempster M, McCorry NK, Donnelly M, Johnston BT. Change in psychological distress in longer‐term oesophageal cancer carers: are clusters of illness perception change a useful determinant? Psychooncology 2015; 25:663-9. [DOI: 10.1002/pon.3993] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 08/24/2015] [Accepted: 08/25/2015] [Indexed: 11/09/2022]
Affiliation(s)
- Lisa Graham
- School of PsychologyQueen's University Belfast Belfast UK
| | | | | | - Michael Donnelly
- Centre of Excellence for Public HealthQueen's University Belfast Belfast UK
| | - Brian T. Johnston
- Department of GastroenterologyRoyal Victoria Hospital Belfast Belfast UK
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Rouleau CR, Garland SN, Carlson LE. The impact of mindfulness-based interventions on symptom burden, positive psychological outcomes, and biomarkers in cancer patients. Cancer Manag Res 2015; 7:121-31. [PMID: 26064068 PMCID: PMC4457221 DOI: 10.2147/cmar.s64165] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Research on the use of mindfulness-based stress reduction and related mindfulness-based interventions (MBIs) in cancer care has proliferated over the past decade. MBIs have aimed to facilitate physical and emotional adjustment to life with cancer through the cultivation and practice of mindfulness (ie, purposeful, nonjudgmental, moment-to-moment awareness). This descriptive review highlights three categories of outcomes that have been evaluated in MBI research with cancer patients - namely, symptom reduction, positive psychological growth, and biological outcomes. We also examine the clinical relevance of each targeted outcome, while describing recently published original studies to highlight novel applications of MBIs tailored to individuals with cancer. Accumulating evidence suggests that participation in a MBI contributes to reductions in psychological distress, sleep disturbance, and fatigue, and promotes personal growth in areas such as quality of life and spirituality. MBIs may also influence markers of immune function, hypothalamic-pituitary-adrenal axis regulation, and autonomic nervous system activity, though it remains unclear whether these biological changes translate to clinically important health benefits. We conclude by discussing methodological limitations of the extant literature, and implications of matching MBIs to the needs and preferences of cancer patients. Overall, the growing popularity of MBIs in cancer care must be balanced against scientific evidence for their impact on specific clinical outcomes.
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Affiliation(s)
- Codie R Rouleau
- Department of Psychology, Faculty of Arts, University of Calgary, Calgary, AB, Canada
| | - Sheila N Garland
- Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Linda E Carlson
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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Kim Y, Shaffer KM, Carver CS, Cannady RS. Quality of life of family caregivers 8 years after a relative's cancer diagnosis: follow-up of the National Quality of Life Survey for Caregivers. Psychooncology 2015; 25:266-74. [PMID: 25976620 DOI: 10.1002/pon.3843] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2014] [Revised: 03/12/2015] [Accepted: 04/13/2015] [Indexed: 11/08/2022]
Abstract
BACKGROUND The long-term impact of cancer caregiving on the family caregivers' quality of life (QOL) is currently not known. This study aimed (a) to characterize family caregivers of cancer survivors at 8 years post-diagnosis in terms of multidimensional aspects of QOL and (b) to identify demographic and early caregiving experience characteristics that may play significant roles in predicting the caregivers' longer-term QOL. METHODS A total of 1087 caregivers participated in the 8-year follow-up National Quality of Life Survey for Caregivers. Demographics and early caregiving experiences were measured 2 years post-diagnosis of their relative's cancer. Multidimensional aspects of QOL were assessed, including mental and physical health, psychological adjustment, and spirituality at both 2-year and 8-year post-diagnosis. RESULTS Approximately 90% of family caregivers ceased the caregiver role by 8 years. One-fourth of them were due to bereavement. Caregivers' demographic and early caregiving characteristics were significantly associated with QOL. In addition, being bereaved by the 8-year mark predicted poorer mental health and greater psychological distress independent of contributions of demographic and early caregiving characteristics. CONCLUSIONS Findings provided the first evidence that 8 years after the initial cancer diagnosis in the family, family members who became bereaved suffer from poorer mental health and greater psychological distress. Findings have theoretical implications for better understanding bereavement to cancer and practical implications for developing integrative programs to improve QOL among family members in the various phases of caregivership.
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Affiliation(s)
- Youngmee Kim
- Department of Psychology, University of Miami, Coral Gables, FL, USA.,Center for Advanced Study in the Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Kelly M Shaffer
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Charles S Carver
- Department of Psychology, University of Miami, Coral Gables, FL, USA.,Center for Advanced Study in the Behavioral Sciences, Stanford University, Stanford, CA, USA
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Cormio C, Romito F, Viscanti G, Turaccio M, Lorusso V, Mattioli V. Psychological well-being and posttraumatic growth in caregivers of cancer patients. Front Psychol 2014; 5:1342. [PMID: 25477853 PMCID: PMC4238371 DOI: 10.3389/fpsyg.2014.01342] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2014] [Accepted: 11/04/2014] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Although research has shown that many cancer patients report positive life changes following cancer diagnosis, there are few data in the literature related to PTG in caregivers of cancer patients. However, the few studies available have shown that this kind of positive changes can also be experienced by family members. The aims of this study were to explore PTG in caregivers of cancer patients and to investigate correlations between the Posttraumatic growth, psychological status and QoL of caregivers and those of patients, taking into account also clinical and socio-demographic aspects. METHODS We enrolled 60 patient/caregiver pairs in the Department of Medical Oncology of the National Research Center "Giovanni Paolo II" in Bari. Both patients and caregivers were assessed using the following scales: Posttraumatic growth Inventory (PTGI); Hospital anxiety and depression scale; Short Form (36) Health Survey (SF-36); ECOG Performance Status. Clinical and socio-demographic data were collected. RESULTS Caregivers showed significantly higher scores than patients in the dimension of "personal strength." Furthermore, we found a significantly close association between anxiety and depression of caregivers with those of patients. Younger caregivers were better than older ones in terms of physical activity, vitality, mental health, and social activities. Although the degree of relationship with the patient has no significant effect on the dependent variables of the study, it was found that caregivers with a degree of kinship more distant to the patient have less physical pain than the closest relatives. CONCLUSION RESULTS of the present study show that caregivers of cancer patients may experience post-traumatic growth as the result of their caregiver role. It would be interesting to investigate in future research which factor may mediate the presence of post-traumatic growth.
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Affiliation(s)
- Claudia Cormio
- Experimental Unit of Psycho-oncology, National Cancer Research Centre "Giovanni Paolo II," Bari, Italy
| | - Francesca Romito
- Experimental Unit of Psycho-oncology, National Cancer Research Centre "Giovanni Paolo II," Bari, Italy
| | - Giovanna Viscanti
- Experimental Unit of Psycho-oncology, National Cancer Research Centre "Giovanni Paolo II," Bari, Italy
| | - Marina Turaccio
- O.U. Medical Oncology, Sen. Antonio Perrino Hospital Brindisi, Italy
| | - Vito Lorusso
- O.U. of Medical Oncology, National Cancer Research Centre "Giovanni Paolo II," Bari, Italy
| | - Vittorio Mattioli
- O.U. of Anestesiology, National Cancer Research Centre "Giovanni Paolo II," Bari, Italy
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Haun MW, Estel S, Rücker G, Friederich HC, Thomas M, Hartmann M. Early palliative care for improving quality of life and survival time in adults with advanced cancer. Cochrane Database Syst Rev 2014. [DOI: 10.1002/14651858.cd011129] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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