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Durak A, Catikkas NM. Is caregiver sleep quality an important clinical issue? Sleep Biol Rhythms 2024; 22:403-410. [PMID: 38962792 PMCID: PMC11217237 DOI: 10.1007/s41105-024-00523-2] [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: 10/31/2023] [Accepted: 03/06/2024] [Indexed: 07/05/2024]
Abstract
Sleep quality is directly related to general health and quality of life. Caregivers' sleep disturbances affect not only their own health, but also the optimal care of their patients, with negative consequences such as neglect and medication errors. This study was conducted prospectively in the palliative care unit. The participants were divided into two groups: the caregivers and the control group. The caregiver groups were categorized into two subgroups: family and paid caregivers. The sleep quality of the caregivers was evaluated with the Pittsburgh Sleep Quality Index (PSQI). The demographics, body mass index, educational level, the presence of chronic diseases and medications, need for spiritual support, daytime sleepiness, duration of caregiving, nighttime awakening, and tea/coffee consumption were recorded. The study included 250 caregivers (female: 74.8%, mean age: 50.6 ± 12.1) and 103 control group members. Family caregivers significantly had an advanced age, lower educational level, more chronic diseases, and medications, need for spiritual support, and longer duration of caregiving compared to the paid caregivers (p = 0.018, < 0.001, 0.001, 0.005, < 0.001, and 0.003, respectively). The total PSQI scores of caregivers were significantly higher in the FDR, family group, females, those with need of spiritual support, and tea/coffee consumption close to bedtime (p = 0.002 < 0.004. 0.026. < 0.001, and 0.022, respectively). The fact that the sleep quality of family group caregivers is worse than that of paid caregivers may prevent healthy medical service delivery. The provision of care by paid professional caregivers will improve quality of care and quality of life.
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Affiliation(s)
- Ayfer Durak
- Division of Geriatrics, Department of Internal Medicine, Hamidiye Faculty of Medicine, Sancaktepe Prof. Dr. Ilhan Varank Training and Research Hospital, University of Health Sciences Istanbul, Sancaktepe, 34785 Istanbul, Turkey
| | - Nezahat Muge Catikkas
- Division of Geriatrics, Department of Internal Medicine, Hamidiye Faculty of Medicine, Sancaktepe Prof. Dr. Ilhan Varank Training and Research Hospital, University of Health Sciences Istanbul, Sancaktepe, 34785 Istanbul, Turkey
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2
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Langer SL, Joseph RP, Mistretta EG, Tao C, Porter LS, Campos AS, Khera N. Family-Focused Facilitated Fitness: Feasibility and Acceptability of a Couple-Based Physical Activity Intervention for Hematopoietic Cell Transplant Recipients and Their Caregiving Partners. Transplant Cell Ther 2024; 30:450.e1-450.e17. [PMID: 38244696 DOI: 10.1016/j.jtct.2024.01.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 01/12/2024] [Accepted: 01/14/2024] [Indexed: 01/22/2024]
Abstract
Reductions in physical activity (PA) are common among patients following hematopoietic cell transplantation, and a risk factor for poor physical functioning. PA among spouses/cohabiting partners, who frequently serve as the patient's primary caregiver, may also be reduced due to caregiving demands and limited bandwidth for self-care. In addition, the patient-caregiver relationship can be compromised, and communication patterns disrupted. All PA interventions in the hematopoietic cell transplantation setting have focused entirely on patients, ignoring an opportunity to synergistically engage and benefit the caregiver as well. We sought to test feasibility and acceptability of a couple-based intervention entitled Family-Focused Facilitated Fitness (FFFF), designed to improve PA as assessed by daily step counts among both patients undergoing hematopoietic cell transplantation and their caregivers. Guided by interdependence and communal coping perspectives, FFFF is an 8-week, remotely-delivered intervention that provides training in communication skills and joint problem-solving to help patients and caregivers support one another in PA. Participants are also given a Fitbit to track their steps and weekly individualized step prescription based on the 75th percentile ranked value of their last 7 recorded daily step counts. A priori benchmarks for feasibility and acceptability in this single-arm pilot were as follows: 50% of eligible couples would agree to participate, 70% of couples would attend all 8 sessions, 80% of participants would provide valid Fitbit wear data 4/7 days/ week, and among sessions reviewed for treatment fidelity, 85% of treatment protocol elements would be covered. Couples were recruited prior to transplant. Among 26 couples approached and deemed eligible, 17 enrolled (65% agreement) and completed baseline assessment. Three couples later withdrew after transplantation but prior to receiving the intervention, resulting in 14 couples commencing the intervention, on average 21 days post-transplant. Four couples subsequently discontinued due to medical complications (n = 3) or caregiver schedule (n = 1). Among the 10 couples who completed the intervention, the percentage of participants meeting our benchmark of valid Fitbit wear at least 4 days per week was 85% in week 1, 90% in weeks 2 to 7, and 80% in week 8. Treatment fidelity was 95% on average across 24 sessions reviewed (3 cases). Treatment satisfaction scores were uniformly high across multiple dimensions, with all means above 4 on the 1 to 5 scale. Daily step counts among those attending all 8 intervention sessions increased from 2249 ± 302 steps/day in week 1 to 4975 ± 1377 steps/day in week 8 among patients, and from 8676 ± 3760 steps/day in week 1 to 9838 ± 3723 steps/day in week 8 among caregivers. Qualitative feedback indicated perceived mental and physical health benefits of the program. Participants also offered suggestions for adaptations to accommodate medical setbacks and constraints. All a priori feasibility benchmarks were met or exceeded. Results offer promise for utility of the program to engage and leverage patient-caregiver dyads to increase PA following transplant. An investigation using a randomized controlled design will be necessary to adequately examine change over time relative to control and its possible impact on clinical and patient-reported outcomes.
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Affiliation(s)
- Shelby L Langer
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ.
| | - Rodney P Joseph
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ
| | - Erin G Mistretta
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA
| | - Chun Tao
- Mayo Clinic Arizona, Phoenix, AZ
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Amonoo HL, Johnson PC, Nelson AM, Clay MA, Daskalakis E, Newcomb RA, Deary EC, Mattera EF, Yang D, Cronin K, Boateng K, Lee SJ, LeBlanc TW, El-Jawahri A. Coping in caregivers of patients with hematologic malignancies undergoing hematopoietic stem cell transplantation. Blood Adv 2023; 7:1108-1116. [PMID: 36398978 PMCID: PMC10111355 DOI: 10.1182/bloodadvances.2022008281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 08/10/2022] [Accepted: 09/29/2022] [Indexed: 11/21/2022] Open
Abstract
Caregivers of patients with hematologic malignancies undergoing hematopoietic stem cell transplantation (HSCT) must cope with substantial caregiving burden, high rates of psychological distress, and diminished quality of life (QOL). However, data describing coping strategies before HSCT and the association between coping, QOL, and psychological outcomes in this population are lacking. We conducted a secondary analysis of data collected during a multisite randomized clinical trial of a supportive care intervention in HSCT recipients and their caregivers. Caregivers completed the Brief COPE, Hospital Anxiety and Depression Scale, and the Caregiver Oncology Quality of Life Questionnaire to measure coping strategies, psychological distress, and QOL, respectively. We grouped coping into 2 higher-order domains: approach-oriented (ie, emotional support and active coping) and avoidant (ie, self-blame and denial). We used the median split method to describe the distribution of coping and multivariate linear regression models to assess the relationship between coping and caregiver outcomes. We enrolled 170 caregivers, with a median (range) age of 53 (47-64) years. Most were White (87%), non-Hispanic (96%), and female (77%). Approach-oriented coping was associated with less anxiety (β = -0.210, P = .003), depression symptoms (β = -0.160, P = .009), and better QOL (β = 0.526, P = .002). In contrast, avoidant coping was associated with more anxiety (β = 0.687, P<.001), depression symptoms (β = 0.579, P < .001), and worse QOL (β = -1.631, P < .001). Our findings suggest that coping is related to distress and QOL among caregivers of HSCT recipients even before transplant. Hence, caregivers of patients with hematologic malignancies undergoing HSCT may benefit from resources that facilitate adaptive coping with the demands of caregiving.
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Affiliation(s)
- Hermioni L. Amonoo
- Department of Psychiatry, Brigham and Women’s Hospital, Boston, MA
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA
- Harvard Medical School, Boston, MA
| | - P. Connor Johnson
- Harvard Medical School, Boston, MA
- Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA
| | - Ashley M. Nelson
- Harvard Medical School, Boston, MA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA
| | - Madison A. Clay
- Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA
| | | | - Richard A. Newcomb
- Harvard Medical School, Boston, MA
- Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA
| | - Emma C. Deary
- Department of Psychiatry, Brigham and Women’s Hospital, Boston, MA
| | - Elizabeth F. Mattera
- Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA
| | - Daniel Yang
- Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA
| | - Katherine Cronin
- Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA
| | - Kofi Boateng
- Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA
| | - Stephanie J. Lee
- Clinical Research Division, Fred Hutchinson Cancer Research Center, and Division of Medical Oncology, University of Washington, Seattle, WA
| | - Thomas W. LeBlanc
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University School of Medicine, Durham, NC
| | - Areej El-Jawahri
- Harvard Medical School, Boston, MA
- Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA
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Lee LJ, Son H, Wallen GR, Flynn S, Cox R, Yang L, Ross A. Symptom Clusters in Family Caregivers of Hematopoietic Stem Cell Transplantation Recipients: Loneliness as a Risk Factor. Transplant Cell Ther 2023; 29:50.e1-50.e8. [PMID: 36202335 PMCID: PMC9825650 DOI: 10.1016/j.jtct.2022.09.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 09/20/2022] [Accepted: 09/25/2022] [Indexed: 11/06/2022]
Abstract
A symptom cluster is a group of 2 or more symptoms that occur together and are related to each other. Family caregivers of allogeneic hematopoietic stem cell transplantation (HSCT) recipients experience multiple concurrent symptoms, but the majority of symptom research in this population has focused on assessing and managing individual symptoms. The purpose of this analysis was to determine (1) whether clusters of 5 highly prevalent symptoms (fatigue, sleep disturbance, depression, anxiety, and cognitive impairment) in allogeneic HSCT caregivers could be identified and (2) which caregiver and patient characteristics influence membership in the identified symptom cluster groups. Baseline cross-sectional data were collected from allogeneic HSCT caregivers participating in a randomized controlled trial at the National Institutes of Health Clinical Center. Measures included the Caregiver Reaction Assessment (CRA), Health-Promoting Lifestyle Profile II (HPLP-II), Fatigue Symptom Inventory (MFSI), Pittsburgh Sleep Quality Index (PSQI), and Patient-Reported Outcomes Measurement Information System (PROMIS). Cluster analysis was used to identify symptom clusters, and univariate analyses and multiple logistic regression were performed to identify factors that contribute to symptom clusters. The average age of caregivers (n = 44) was 45.20 ± 15.05 years; primarily white (52.3%) and female (88.6%) and often the spouse/partner of the patient (50.0%). Two symptom cluster groups were identified: low symptom burden (n = 24; 54.5%) and high symptom burden (n = 20; 45.5%). Caregivers with higher levels of loneliness (odds ratio, 1.12; 95% confidence interval, 1.04 to 1.22; P = .004) were more likely to be in the high symptom burden group. This study provides evidence that 5 symptoms commonly found in family caregivers-fatigue, sleep disturbance, depression, anxiety, and cognitive impairment-tend to occur in clusters. Therefore, clinicians should be aware that caregivers with 1 or more of these symptoms may be at higher risk for developing the others, and caregivers reporting high levels of loneliness may be at particular risk. Future research is needed to identify novel interventions that target multiple, co-occurring symptoms. Such interventions also might include components that decrease loneliness. © 2022 American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc.
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Affiliation(s)
- Lena J Lee
- National Institutes of Health Clinical Center, Bethesda, Maryland.
| | - Hyojin Son
- National Institutes of Health Clinical Center, Bethesda, Maryland
| | - Gwenyth R Wallen
- National Institutes of Health Clinical Center, Bethesda, Maryland
| | - Sharon Flynn
- National Heart, Lung, and Blood Institute, Bethesda, Maryland
| | - Robert Cox
- National Institutes of Health Clinical Center, Bethesda, Maryland
| | - Li Yang
- National Institutes of Health Clinical Center, Bethesda, Maryland
| | - Alyson Ross
- National Institutes of Health Clinical Center, Bethesda, Maryland
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Sfeir M, Zeitoun A, Hallit S, Obeid S. Presence of a psychiatric patient at home and work fatigue in family caregivers: The moderating effect of spirituality. Perspect Psychiatr Care 2022; 58:2664-2675. [PMID: 35578158 DOI: 10.1111/ppc.13107] [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] [Received: 01/14/2022] [Revised: 04/25/2022] [Accepted: 04/29/2022] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES To assess the association between the mental health of caregivers having a psychiatric patient at home and work fatigue, and if this association is moderated by spirituality. METHODS This case-control study enrolled 600 caregivers (July-September 2019). RESULTS Stress, anxiety, insomnia and the presence of a psychiatric patient at home were associated with higher levels of physical, mental, and emotional work fatigue. In the case of caregivers who have a psychiatric patient at home, those with low spirituality had more mental and emotional work fatigue. PRACTICAL IMPLICATIONS Healthcare professionals should enlighten caregivers more on the risks and the consequences of their job, assist them with information on what to expect, and teach them how to normalize feelings that they may face.
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Affiliation(s)
- Michel Sfeir
- Department of Psychology, University of Fribourg, Fribourg, Switzerland
| | - Abeer Zeitoun
- Department of Quality Assurance of Pharmaceutical Products, National Pharmacovigilance Program, Lebanese Ministry of Public Health, Beirut, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon.,Department of Psychology, College of Humanities, Effat University, Jeddah, Saudi Arabia.,Department of Research, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
| | - Sahar Obeid
- Department of Social and Education Sciences, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon
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Fye M, Yoder W, Manser K, Du Bois SN. Self-Care for Caregivers of Individuals Living With Multiple Sclerosis: Testing Mediation Models of Caregiver Stress, Health, and Self-Care. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2021. [DOI: 10.1177/1084822320973219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Individuals with Multiple Sclerosis (MS) often receive home health care, yet little research investigates the health of informal caregivers of individuals with MS. We tested a mediation model in which associations between caregiver stress and caregiver self-care were explained by each of four a priori caregiver health factors—caregiver negative affect, pain, tiredness, and functional limitations. Participants ( n = 60 informal caregivers) were recruited online or in-person from March—July 2018, and completed an online survey assessing demographics and their caregiving experience. After controlling for demographics, only caregiver tiredness mediated the association between caregiver stress and caregiver self-care. Therefore, caregiver tiredness may be an important construct for assessment, intervention, and future research, among caregivers of individuals with MS, and among anyone providing home health care. These findings have research, clinical, and policy implications.
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Affiliation(s)
- MacKenzie Fye
- Captain James A. Lovell Federal Healthcare Center, North Chicago, IL, USA
| | - Wren Yoder
- Illinois Institute of Technology, Chicago, IL, USA
| | - Kelly Manser
- Illinois Institute of Technology, Chicago, IL, USA
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7
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Baumgarten A, Hilgert JB, Rech RS, Cunha-Cruz J, de Goulart BNG. Caries experience in caregiver-intellectual deficient pair: Influence of caregiver's psychological morbidity. SPECIAL CARE IN DENTISTRY 2021; 41:707-715. [PMID: 34057228 DOI: 10.1111/scd.12617] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 04/24/2021] [Accepted: 05/18/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Evaluate how determinants of psychological morbidity were associated with dental caries experience in the caregiver-intellectual deficient pair. METHODS A cross-sectional study with 299 pair, who had their oral health status assessed using the DMFT index (decayed, missing and filled teeth). Symptoms of anxiety, depression, stress, quality of sleep, and socioeconomic variables were measured in caregivers. Adjusted prevalence ratios were estimated using Poisson regression with the caregiver and children's caries index as outcome. RESULTS The average prevalence of DMFT/dmft was 7.48 (SD ± 3.9) for students with ID and DMFT was 14.7 (SD ± 8.1) for their caregivers. For the caregiver's oral health, the following psychic comorbidities were associated with worse oral health condition: anxiety (PR = 1.48; 95%CI 1.07-2.06), depression (PR = 1.39; 95%CI 1.05-1.85), high level of stress (PR = 1.58; 95%CI 1.17-2.13) and sleep disorders (PR = 1.59; 95%CI 1.18-2.14). For people with ID, the caregiver's psychic comorbidities also showed association with a worse oral health condition, including anxiety (PR = 1.31; 95%CI 1.03-1.74), depression (PR = 1.28; 95%CI 1.01-1.67) and high level of stress (PR = 1.63; 95%CI 1.14-2.32), as well as mother's high level of DMFT (PR = 1.96; 95%CI 1.28-3.03). CONCLUSION Symptoms of depression, anxiety and stress were associated with higher levels of dental caries experience for caregivers and for people with intellectual disabilities.
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Affiliation(s)
- Alexandre Baumgarten
- Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Juliana Balbinot Hilgert
- Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.,Postgraduate Program in Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Rafaela Soares Rech
- Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Joana Cunha-Cruz
- School of Dentistry and School of Public Health, University of Washington, Seattle, Washington
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Ravyts SG, Sannes TS, Dzierzewski JM, Zhou ES, Brewer BW, Natvig C, Laudenslager ML. Check your sleep before you start: A secondary analysis of a stress management intervention for caregivers of stem cell transplant patients. Psychooncology 2021; 30:936-945. [PMID: 33749066 DOI: 10.1002/pon.5680] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 02/26/2021] [Accepted: 03/08/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Caregiving for hematopoietic stem cell transplant (HSCT) patients is associated with significant physical and psychological sequelae. While psychosocial interventions may reduce caregiver burden, knowledge regarding which caregivers may benefit the most from such interventions is limited. The purpose of this secondary analysis was to examine whether HSCT caregivers' peritransplant sleep moderated the effect of a psychosocial intervention on depression and anxiety posttransplant. METHODS Participants included 135 caregivers (mean age = 54.23) who participated in randomized controlled trial and were assigned to receive either 8 weeks of Psychoeducation, Paced Respiration, and Relaxation (PEPRR) or treatment as usual (TAU). Sleep, depression, and anxiety were assessed using the Pittsburg Sleep Quality Index, the Center for Epidemiologic Studies Depression Scale, and the State-Trait Anxiety Inventory, respectively. Caregiver symptoms were assessed at baseline (e.g., peritransplant period) and 6-month posttransplant. RESULTS Baseline sleep quality (∆R2 = 0.04, p = 0.002), sleep efficiency (∆R2 = 0.03, p = 0.02), and sleep onset latency (∆R2 = 0.07, p < 0.001) independently moderated the effect of group assignment on depression outcomes at the 6-month follow-up. Specifically, caregivers with poor sleep at baseline who received PEPRR reported significantly lower depression scores at follow-up compared to caregivers with poor sleep who received TAU. By contrast, only sleep quality (∆R2 = 0.02, p = 0.01) and sleep onset latency (∆R2 = 0.02, p = 0.005) moderated the effect of the group assignment on anxiety. CONCLUSIONS Psychosocial interventions for HSCT caregivers may buffer against psychological morbidity, particularly among caregivers with poor sleep quality.
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Affiliation(s)
- Scott G Ravyts
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Timothy S Sannes
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Department of Psychosocial Oncology and Palliative Care, Harvard Medical School, Boston, Massachusetts, USA
| | - Joseph M Dzierzewski
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Eric S Zhou
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Department of Psychosocial Oncology and Palliative Care, Harvard Medical School, Boston, Massachusetts, USA
| | - Benjamin W Brewer
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Crystal Natvig
- University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
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Fatigue and Vigilance-Related Factors in Family Caregivers of Patients With Advanced Cancer: A Cross-sectional Study. Cancer Nurs 2021; 45:E621-E627. [PMID: 33813529 DOI: 10.1097/ncc.0000000000000944] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Family caregivers (FCs) commonly experience fatigue during caregiving. The factors of fatigue in the FCs of patients with advanced cancer have not yet been investigated in Taiwan. OBJECTIVE This study investigated potential predictors of fatigue in the FCs of patients with advanced cancer. METHODS A descriptive, cross-sectional study was conducted on 184 FCs. Data were collected using the Checklist Individual Strength and the palm-based psychomotor vigilance test. A linear regression model was the main statistical method for identifying the factors predictive of fatigue in FCs. RESULTS Subjective and objective measurements revealed that 95% of the FCs had fatigue and poor vigilance. Those who spent more time each day on caregiving tasks, had no religious beliefs, had a full- or part-time job, and had a greater caregiver burden experienced greater fatigue. CONCLUSIONS Fatigue and poor vigilance were common in the Taiwanese FCs of patients with advanced cancer. Family caregivers with risk factors for fatigue must be identified and given access to resources for assistance. IMPLICATION FOR PRACTICE Healthcare providers must proactively assess FCs for fatigue and vigilance status and provide interventions appropriate for individual needs.
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10
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Langer SL, Yi JC, Chi NC, Lindhorst T. Psychological Impacts and Ways of Coping Reported by Spousal Caregivers of Hematopoietic Cell Transplant Recipients: A Qualitative Analysis. Biol Blood Marrow Transplant 2020; 26:764-771. [DOI: 10.1016/j.bbmt.2019.11.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 11/08/2019] [Accepted: 11/18/2019] [Indexed: 12/20/2022]
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11
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Qin X, Chen J, Suo R, Feng L, Zhang Y, Jun Y. The dissimilarity between myocardial infarction patients' and spouses' illness perception and its relation to patients' lifestyle. J Clin Nurs 2020; 29:887-898. [PMID: 31793096 DOI: 10.1111/jocn.15132] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 09/16/2019] [Accepted: 11/19/2019] [Indexed: 11/26/2022]
Abstract
AIM AND OBJECTIVES To examine the dissimilarity between Chinese myocardial infarction (MI) patients' and spouses' illness perceptions (IPs), and to explore the relationship between patients' IP, differences in couples' IP and patients' lifestyle after discharge. BACKGROUND An individual's IP is affected and moderated by several factors, including the social context. One of the most influential members of the social network of patients is the spouse. DESIGN Cross-sectional design. METHODS From April 2016-April 2017, 111 MI patients and their spouses were recruited. Before discharge from hospital, revised Illness Perception Questionnaire was administered to MI patients and their spouses separately. Two months after discharge, patients' lifestyle was assessed using Health Promoting Lifestyle Profile II. The manuscript was organised according to STROBE guidelines. RESULTS Spouses were more likely to believe that the illness would last for a long time, and patients perceived MI as being more controllable than their spouses did. The patient-spouse dissimilarity in the perception of consequences was negatively correlated with both nutrition and stress control behaviours. Patients in couples with more dissimilar perception of environmental factors as a cause were more likely to choose a healthy diet, while patients in couples with more dissimilar perceived treatment control were more able to control stress. CONCLUSION There are both similarities and dissimilarities between MI patients' and spouses' IP, and these dissimilarities contributed the majority of the explained variance in patients' lifestyle after discharge. RELEVANCE TO CLINICAL PRACTICE We should consider both couples when examining how a patient copes with a chronic illness.
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Affiliation(s)
- Xiangjun Qin
- The Second Hospital Affiliated to Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Jing Chen
- School of Nursing, Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - Rongfei Suo
- School of Nursing, Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - Liqin Feng
- The Third Hospital Affiliated to Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Yuening Zhang
- Zhixin Middle School, Guangzhou, Guangdong Province, China
| | - Yan Jun
- School of Nursing, Sun Yat-Sen University, Guangzhou, Guangdong Province, China
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12
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Sun J, Chen M, Cai W, Wang Z, Wu S, Sun X, Liu H. Chronotype: implications for sleep quality in medical students. Chronobiol Int 2019; 36:1115-1123. [PMID: 31140322 DOI: 10.1080/07420528.2019.1619181] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Medical students who suffer from poor sleep quality may be afflicted by distress. While the change of chronotype may improve sleep quality, few studies have focused on this association. The objective of this study is to analyze the effects of chronotype on sleep quality in medical students while controlling for confounding covariate factors. A cross-sectional survey on sleep quality was conducted among 5497 medical students. Sleep quality, chronotype, and lifestyle were measured according to the Pittsburgh Sleep Quality Index, Morningness-eveningness Questionnaire and Health-promoting Lifestyle Profile. Hierarchical logistic regression was conducted to analyze the influence of various factors, especially chronotype effect on sleep quality. Our results showed that the total score of sleep quality in evening-types was 5.43 ± 2.66, which was significantly higher than that in morning-types (3.88 ± 2.20, P < .001). Morning-type students (OR = 0.40, 95%CI = 0.29-0.55) and intermediate-type students (OR = 0.53, 95%CI = 0.41-0.69) had a lower risk of poor sleep quality compared to evening-types. The strongest predictor of sleep quality was chronotype while controlling for covariates (grade, gender, father's educational level, mother's educational level, internet addiction, mood state, midnight snack frequency, and health-promoting lifestyle profile). Based on the results, we believe that sleep quality among evening-type students may be improved by shifting to keep early hours.
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Affiliation(s)
- Jinbin Sun
- a School of Public Health , China Medical University , Shenyang , PR China
| | - Ming Chen
- b Department of Sports , China Medical University , Shenyang , PR China
| | - Weijie Cai
- a School of Public Health , China Medical University , Shenyang , PR China
| | - Zhong Wang
- b Department of Sports , China Medical University , Shenyang , PR China
| | - Shaoning Wu
- a School of Public Health , China Medical University , Shenyang , PR China
| | - Xiao Sun
- b Department of Sports , China Medical University , Shenyang , PR China
| | - Hongbo Liu
- a School of Public Health , China Medical University , Shenyang , PR China
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Characteristics of centenarians' lifestyles and their contribution to life satisfaction: A case study conducted on Hainan Island. Arch Gerontol Geriatr 2019; 83:20-27. [PMID: 30933742 DOI: 10.1016/j.archger.2019.03.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 03/14/2019] [Accepted: 03/25/2019] [Indexed: 01/07/2023]
Abstract
BACKGROUND Centenarians represent an intriguing model for healthy aging. They appear to have adapted well to their lives and are likely to be influenced by previous lifestyle habits, and their life satisfaction is influenced by mental and psychological health. OBJECTIVE The aim of this study is to explore centenarians' lifestyles by sex and their potential contribution to life satisfaction. METHOD In order to examine the common characteristics of centenarians in Hainan and the potential differences between men and women, a cross-sectional survey was conducted with 223 cognitively-intact Chinese centenarians. We also explored the association between life satisfaction and other physical factors using binary logistic regression and principal component analysis. RESULTS The results provided supplementary evidence indicating that women tended to live longer than men. However, the difference in life satisfaction observed between the sexes was not obvious (p = 0.659). The proportion of physical factors between each sex showed a similar trend in distribution. Most centenarians' lifestyles were similar, in that they followed a light diet and did not smoke or drink alcohol. Centenarians in better physical condition and with higher self-assessment, as well as those with "alcohol and tobacco habits," were more satisfied with their life. Of the factors examined in the binary logistic regression, sleep satisfaction was the only factor significantly positively correlated with life satisfaction (p < .01). CONCLUSION The research findings elucidated physiological and psychological health in centenarians and provided a model of healthy aging strategies for reference purposes.
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Byun E, Lerdal A, Gay CL, Lee KA. How Adult Caregiving Impacts Sleep: a Systematic Review. CURRENT SLEEP MEDICINE REPORTS 2016; 2:191-205. [PMID: 31080704 DOI: 10.1007/s40675-016-0058-8] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Sleep disturbance can contribute to negative health outcomes. However, sleep complaints have been under-recognized and undertreated in caregivers of ill family members. This systematic review describes the impact of family caregiving on sleep and summarizes factors associated with sleep disturbance in caregivers. A literature search using PubMed, MEDLINE, PsycINFO, and CINAHL databases yielded 22 relevant research articles on family caregivers of ill adults. Analyses revealed that up to 76% of caregivers reported poor sleep quality, and the proportion is considerably higher for female caregivers compared to male caregivers. Sleep measures indicated short sleep duration and frequent night awakenings. Characteristics of the care recipient, such as health status, and the caregiver's own health status and symptoms, such as depression, fatigue, and anxiety, were associated with sleep disturbance in caregivers. These factors may help clinicians identify caregivers at highest risk for developing sleep disturbance and guide the family toward additional support.
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Affiliation(s)
- Eeeseung Byun
- Department of Biobehavioral Nursing and Health Informatics, University of Washington, Seattle, WA
| | - Anners Lerdal
- Lovisenberg Diakonale Hospital, Oslo, Norway.,Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Norway
| | - Caryl L Gay
- Department of Family Health Care Nursing, University of California at San Francisco, San Francisco, CA
| | - Kathryn A Lee
- Department of Family Health Care Nursing, University of California at San Francisco, San Francisco, CA
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