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Zhong M, Sun S, Long J, Yuan M, Wang M, Zhang Z. Tools to measure the burden on informal caregivers of cancer patients: A literature review. J Clin Nurs 2024; 33:2949-2970. [PMID: 38528583 DOI: 10.1111/jocn.17112] [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: 11/21/2023] [Revised: 01/23/2024] [Accepted: 03/01/2024] [Indexed: 03/27/2024]
Abstract
OBJECTIVES (1) To describe existing tools to assess the burden of informal caregivers of people with cancer, (2) to describe how these tools have been validated and (3) to describe the areas of interest of existing assessment tool entries. BACKGROUND The caregiver burden of informal caregivers of people with cancer greatly affects their lives. There is a wide variety of relevant assessment tools available, but there are no studies to help researchers to select tools. METHODS A search was conducted using the keywords 'cancer', 'caregiver', 'burden' and 'scale' in Medline (PubMed), CINAHL and EMBASE to include articles that developed or applied tools to assess the burden on informal caregivers of cancer patients. Once eligible tools were identified, we searched their 'primary reference' studies. If the original scale was assessed in a population other than informal caregivers of cancer patients, we again searched for psychometric measures in the population of caregivers of cancer patients. RESULTS This study retrieved 938 articles on developing or applying the informal caregiver burden instrument for cancer patients, including 42 scales. Internal consistency of the original scales ranged from 0.53 to 0.96. Nineteen scales initially developed to assess caregiver burden for patients with dementia, stroke and other disorders were later used for caregivers of cancer patients, eight of which have not yet been validated. Reclassifying all scale domains of concern revealed that scale assessments focused more on caregivers' physical health, emotional state and caregiving tasks. CONCLUSION This review identifies many scales for assessing informal caregiver burden in cancer patients and gives scales recommended. However, a portion still needs to be validated. The development of a new scale proposes to be based on a theoretical framework and to consider dimensions for assessing support resources. IMPACT What problem did the study address?: This paper collates assessment tools on the burden of informal carers of people with cancer. It also provides information on the applicable population, reliability and validity. What were the main findings?: 41 scales could be considered for use, eight of which have not been validated. The scales focus more on assessing caregivers' physical health, emotional state and caregiving tasks, and less on the dimension of support resources. Where and on whom will the research have an impact?: There are implications for informal carers of cancer patients in hospitals or in the community, as well as for relevant researchers. REPORTING METHOD Retrieved with reference to systematic evaluation. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Mingming Zhong
- School of Nursing, Lanzhou University, Lanzhou, Gansu, PR China
- Department of Critical Care Medicine, Lanzhou University First Hospital, Lanzhou, Gansu, PR China
| | - Shanshan Sun
- School of Nursing, Lanzhou University, Lanzhou, Gansu, PR China
- Department of Critical Care Medicine, Lanzhou University First Hospital, Lanzhou, Gansu, PR China
| | - Jianying Long
- School of Nursing, Lanzhou University, Lanzhou, Gansu, PR China
- Department of Critical Care Medicine, Lanzhou University First Hospital, Lanzhou, Gansu, PR China
| | - Mengyuan Yuan
- School of Nursing, Lanzhou University, Lanzhou, Gansu, PR China
- Department of Critical Care Medicine, Lanzhou University First Hospital, Lanzhou, Gansu, PR China
| | - Min Wang
- School of Nursing, Lanzhou University, Lanzhou, Gansu, PR China
- Department of Critical Care Medicine, Lanzhou University First Hospital, Lanzhou, Gansu, PR China
| | - Zhigang Zhang
- School of Nursing, Lanzhou University, Lanzhou, Gansu, PR China
- Department of Critical Care Medicine, Lanzhou University First Hospital, Lanzhou, Gansu, PR China
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Sun H, Chen S, Chen X, Yang Q, Zhang H, Wacharasin C, Hengudomsub P. Predictors of changes in resilience among spousal caregivers of patients with advanced cancer within the first 6 months after initial treatment. J Clin Nurs 2024; 33:2619-2632. [PMID: 38108199 DOI: 10.1111/jocn.16972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 10/26/2023] [Accepted: 12/07/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND While previous research has established that resilience is affected by various factors, these studies have primarily focussed on individual variables associated with resilience, without providing insights into how to influence the rate of change in resilience. AIM To examine the trajectory of resilience and identify the factors associated with changes in resilience among spousal caregivers of patients with newly diagnosed advanced cancer receiving treatment during the first 6 months. DESIGN An observational longitudinal study. METHODS A total of 312 spousal caregivers of patients with newly diagnosed advanced cancer were recruited from January 2022 to December 2022 in Yancheng, China. Three data collection points were established, spanning from the first month to 6 months after initial cancer treatment. A latent growth model was employed to depict the resilience trajectory at various time points. A latent growth model with time-invariant covariates was adopted to determine the factors influencing resilience trajectory. The study adhered to the STROBE checklist for proper reporting. RESULTS Throughout the follow-up period, the participants experienced a significant increase in resilience. Gender, family income, the patient's health status, spirituality and belief in familism were significantly associated with the baseline resilience level. Moreover, family income, the patient's health status, spirituality, caregiver burden and belief in familism were significantly associated with the rate of resilience change over time. CONCLUSIONS Spousal caregivers demonstrated a linear increase in resilience during the first 6 months after initial treatment. Meanwhile, changes in resilience were influenced by multiple factors during the early phase of cancer treatment. Thus, more attention should be paid to early identification and implementation of targeted interventions. RELEVANCE TO CLINICAL PRACTICE Healthcare professionals should understand the change in resilience among spousal caregivers and conduct timely mental health interventions to enhance the resilience of families affected by cancer. PATIENT OR PUBLIC CONTRIBUTION The Guidance for Reporting Involvement of Patients and the Public-Short Form reporting checklists were used to improve patient and public involvement.
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Affiliation(s)
- Haiyan Sun
- School of Nursing, Jiangsu Vocational College of Medicine, Jiangsu, P. R. China
- Faculty of Nursing, Burapha University, Chon Buri, Thailand
| | - Shuqiao Chen
- Department of Nursing, Yancheng NO.1 People's Hospital, Jiangsu, P. R. China
| | - Xi Chen
- Department of Nursing, Yancheng NO.1 People's Hospital, Jiangsu, P. R. China
| | - Qin Yang
- School of Nursing, Jiangsu Vocational College of Medicine, Jiangsu, P. R. China
- Faculty of Nursing, Burapha University, Chon Buri, Thailand
| | - Hu Zhang
- Department of Basic Medicine, Jiangsu Vocational College of Medicine, Jiangsu, P. R. China
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Moscato EL, Albee MV, Anil A, Hocking MC. The interaction of family functioning and disease- and treatment-related factors on quality of life for children after cancer. J Psychosoc Oncol 2024:1-13. [PMID: 38831549 DOI: 10.1080/07347332.2024.2354298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024]
Abstract
PURPOSE Children with cancer experience low quality of life (QOL), yet heterogeneity underscores a need to understand how risk and resilience factors interact. This study evaluated if family functioning relates to QOL differentially depending on diagnosis and treatment intensity. METHODS Participants included children (ages 8-14) who completed treatment within six months for either brain tumor (BT; n = 42) or non-central nervous system solid tumor (ST; n = 29). Caregivers and children rated QOL and family functioning. Treatment intensity was categorized as low, moderate, or high. Cross-informant moderation models tested hypothesized interactions. RESULTS Child-reported family functioning significantly interacted with diagnosis and treatment intensity in models of caregiver-reported QOL. More maladaptive family functioning was associated with reduced QOL for children with BT and moderately-intense treatments. CONCLUSIONS Children with BT and moderate treatment intensities are sensitive to family functioning, highlighting an at-risk group to target for family-level intervention. Future work should evaluate these associations longitudinally.
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Affiliation(s)
- Emily L Moscato
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - May V Albee
- Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Ashley Anil
- Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Matthew C Hocking
- Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Zhang M, Wang X, Shao M, Du R, Zhou H, Zhu J, Zhang H, Ma B, Chen C, Wang T. Supportive care needs and associated factors among caregivers of patients with colorectal cancer: a cross-sectional study. Support Care Cancer 2024; 32:194. [PMID: 38411723 PMCID: PMC10899272 DOI: 10.1007/s00520-024-08390-w] [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: 08/15/2023] [Accepted: 02/16/2024] [Indexed: 02/28/2024]
Abstract
To assess the level of supportive care needs of caregivers of colorectal cancer patients and explore the related key influencing factors. Totaling 283 caregivers of patients with colorectal cancer were investigated in this study. Firstly, caregivers were invited to complete a set of questionnaires, including the general information questionnaire, the Supportive Care Needs Survey-Partners and the Caregivers of cancer patients, the Caregiver Preparedness Scale, the Benefit Finding Scale, and the Comprehensive Score for Financial Toxicity. Univariate and multivariate linear regression were performed to investigate the associated factors of supportive care needs. The caregivers of patients with colorectal cancer have a moderate level of needs, scored at 2.71 ± 0.42. Caregiver preparedness, benefit finding, and financial toxicity were significantly negatively associated with the supportive care needs of caregivers (r = - 0.555, P < 0.001; r = - 0.534, P < 0.001; and r = - 0.615, P < 0.001, respectively). Our multivariate regression analysis identified some factors that directly affected the supportive care needs of caregivers, including the duration of illness, tumor stage, the age and educational level of caregivers, caregiver preparedness, benefit finding, and financial toxicity (R2 = 0.574, F = 23.337, P < 0.001). Supportive care needs are common among caregivers of colorectal cancer patients. Higher caregiver preparedness, benefit finding, and financial toxicity tend to ease these needs. Healthcare workers should have an in-depth understanding of the needs of caregivers of colorectal cancer patients and actively provide targeted financial/informational/technical/emotional support to promote nursing skills and reduce caregivers' burdens.
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Affiliation(s)
- Menghan Zhang
- The College of Nursing and Health of Zhengzhou University, Zhengzhou, 450001, China
| | - Xin Wang
- The College of Nursing and Health of Zhengzhou University, Zhengzhou, 450001, China
| | - Mengwei Shao
- The College of Nursing and Health of Zhengzhou University, Zhengzhou, 450001, China
| | - Ruofei Du
- The College of Nursing and Health of Zhengzhou University, Zhengzhou, 450001, China
- Academy of Medical Sciences of Zhengzhou University, Zhengzhou, 450001, China
| | - Huiyue Zhou
- Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510000, China
| | - Jizhe Zhu
- The College of Nursing and Health of Zhengzhou University, Zhengzhou, 450001, China
| | - Haoning Zhang
- The College of Nursing and Health of Zhengzhou University, Zhengzhou, 450001, China
| | - Bin Ma
- School of Medical, Molecular and Forensic Sciences, Murdoch University, Perth, 6149, Australia
| | - Changying Chen
- Department of Quality Control, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.
| | - Tao Wang
- The College of Nursing and Health of Zhengzhou University, Zhengzhou, 450001, China.
- Telethon Kids Institute, Perth, WA, 6872, Australia.
- Medical School, University of Western Australia, Perth, WA, 6872, Australia.
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Shao M, Wang X, Zhang M, Ding Y, Ma B, Yang Y, Yu L, Chen C, Wang T. Caregiver burden, mutuality, and family resilience in colorectal cancer caring: A mediating model analysis. Eur J Oncol Nurs 2024; 68:102480. [PMID: 38101244 DOI: 10.1016/j.ejon.2023.102480] [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: 10/14/2023] [Revised: 11/15/2023] [Accepted: 11/18/2023] [Indexed: 12/17/2023]
Abstract
PURPOSE This study investigates the interaction between caregiver burden, mutuality, and family resilience in colorectal cancer management, and determines whether mutuality affects the effect of caregiver burden on family resilience. METHOD In this cross-sectional study, 295 family caregivers of colorectal cancer patients from two major public hospitals (Henan Province, China) were analyzed. Caregiver burden, mutuality, and family resilience were assessed through Chinese versions of the Zarit Burden Interview (ZBI-C), the mutuality Scale (MS-C), and the Family Resilience Questionnaire (FaREQ-C). The structural equation model and multiple mediating effect test were applied to explore the interaction between caregiver burden, mutuality, and family resilience. RESULTS Total and subscale scores of caregiver burden were negatively correlated with both mutuality (r = -0.54 to -0.32, P < 0.01) and family resilience (r = -0.60 to -0.26, P < 0.01). Family resilience and its four dimensions were positively correlated with mutuality (r = 0.17 to 0.51, P < 0.01). Mutuality served as a partial mediator between caregiver burden and family resilience. Caregiver burden had an indirect effect on family resilience through mutuality (β = -0.157, 95%CI: -0.316, -0.046, P = 0.009). CONCLUSIONS This study examined the interaction between caregiver burden, mutuality, and family resilience for colorectal cancer caring and confirmed the mediating role of mutuality in caregiver burden and family resilience. Therefore, we suggested that clinicians should develop strategies to improve the relationship between patients and caregivers so that both parties can actively manage stress and trauma experiences for improved colorectal cancer management.
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Affiliation(s)
- Mengwei Shao
- The College of Nursing and Health of Zhengzhou University, Zhengzhou, 450001, China.
| | - Xin Wang
- The College of Nursing and Health of Zhengzhou University, Zhengzhou, 450001, China.
| | - Menghan Zhang
- The College of Nursing and Health of Zhengzhou University, Zhengzhou, 450001, China
| | - Yangqing Ding
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Bin Ma
- School of Medical, Molecular and Forensic Sciences, Murdoch University, 6149, Australia
| | - Yi Yang
- The College of Nursing and Health of Zhengzhou University, Zhengzhou, 450001, China
| | - Lulu Yu
- The College of Nursing and Health of Zhengzhou University, Zhengzhou, 450001, China
| | - Changying Chen
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.
| | - Tao Wang
- The College of Nursing and Health of Zhengzhou University, Zhengzhou, 450001, China; Telethon Kids Institute, Perth, WA, 6872, Australia; Medical School, University of Western Australia, Perth, WA, 6872, Australia; People' s Hospital of Hebi, Hebi, 458010, China.
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Tay DL, Reblin M, Iacob E, Cloyes KG, Hebdon MCT, Reynaga M, Mooney K, Ellington L. Cancer Hospice Caregivers' Self-care Behaviors: The Role of Caregiving Tasks, Burden, and Mental Health. J Hosp Palliat Nurs 2023; 25:286-295. [PMID: 37347956 PMCID: PMC10524198 DOI: 10.1097/njh.0000000000000962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
Cancer hospice family caregivers provide intensive support for patients at the end of life, sometimes at the expense of self-care. This secondary analysis examined the role of caregiving burden, activities of daily living, and mental health on self-care behaviors among cancer hospice family caregivers. Logistic regression models were adjusted for sociodemographic and caregiver characteristics, and model fit was evaluated with Hosmer-Lemeshow tests. Participants (N = 86) were mostly women (n = 62, 72.09%), White (n = 76, 88.37%), and spousal caregivers (n = 44, 51.16%). Almost half reported not getting enough rest (47.67%), time to exercise (47.67%), or time to slow down and rest when feeling ill (46.51%). Caregivers with better mental health reported being more likely to have enough time to exercise (adjusted odds ratio [OR adj ], 1.15, [1.05, 1.26]; P = .004), rest (OR adj , 1.11, [1.01, 1.22]; P = .031), and slow down when ill (OR adj , 1.16, [1.04, 1.30]; P = .010). Controlling for sociodemographic and caregiver characteristics, men caregivers had 88% lower odds of being able to rest when ill (OR adj , 0.12, [0.03, 0.52]; P = .005) compared with women. Number of care tasks, not caregiving burden, was associated with self-care behaviors. Findings provide a preliminary understanding of factors related to caregiver self-care and have implications for increased assessment of caregiver mental health and self-care needs to better support family-oriented hospice care.
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Affiliation(s)
- Djin L. Tay
- University of Utah, College of Nursing, Salt Lake City, UT, USA
| | - Maija Reblin
- University of Vermont Cancer Center, Cancer Control and Population Health Sciences, Burlington, VT, USA
| | - Eli Iacob
- University of Utah, College of Nursing, Salt Lake City, UT, USA
| | - Kristin G. Cloyes
- School of Nursing, Oregon Health & Science University, Portland, OR, USA
| | | | - Miranda Reynaga
- University of Michigan, Department of Psychology, Ann Arbor, MI, USA
| | - Kathi Mooney
- University of Utah; Co-Leader Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Lee Ellington
- University of Utah, College of Nursing, Salt Lake City, UT, USA
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Kang J. Being devastated by critical illness journey in the family: A grounded theory approach of post-intensive care syndrome-family. Intensive Crit Care Nurs 2023; 78:103448. [PMID: 37167839 DOI: 10.1016/j.iccn.2023.103448] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 03/31/2023] [Accepted: 04/28/2023] [Indexed: 05/13/2023]
Abstract
OBJECTIVES This study aimed to explore the meaning and structure of postintensive care syndrome experienced by families of critically ill patients. METHODS This qualitative study applied the constructivist grounded theory approach and conducted one or two interviews with eight participants with postintensive care syndrome-family for a total of 12 interviews. The contents of the interviews were analysed through line-by-line coding, focused coding, and categorisation. Data collection and analysis were iterative, to enable continuous comparative analysis. FINDINGS The core category of postintensive care syndrome experienced by families was 'being devastated by the critical illness journey in the family' and comprised the interactions of four categories: 'overwhelming intensive care experience', 'taking responsibility for the recovery trajectory of critical illness', 'life devastated by the trauma of intensive care and family caregiving', and 'balancing and compromising'. CONCLUSION Based on this grounded theory approach, postintensive care syndrome experienced by families is a complex and ongoing phenomenon that arises from the recovery trajectory of a critical illness. It involves mental, physical, social and familial aspects, particularly the impact on the patient's family. IMPLICATIONS FOR CLINICAL PRACTICE The findings can guide critical care nurses to understand postintensive care syndrome experienced by families in providing patient or family-centred care. To improve the long-term outcomes and quality of life for families, it is necessary to assess their unique needs within the continuum of post-intensive care syndrome experienced by the family and to propose interventions to satisfy those needs.
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Affiliation(s)
- Jiyeon Kang
- College of Nursing, Dong-A University, Busan, South Korea.
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von Heymann A, Finsted E, Guldin MB, Andersen EAW, Dammeyer J, Sjøgren P, von der Maase H, Benthien KS, Kjellberg J, Johansen C, Bidstrup P. Effects of home-based specialized palliative care and dyadic psychological intervention on caregiver burden: results from a randomized controlled trial. Acta Oncol 2023; 62:803-807. [PMID: 37010505 DOI: 10.1080/0284186x.2023.2194491] [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: 10/13/2022] [Accepted: 03/18/2023] [Indexed: 04/04/2023]
Abstract
Background The Domus study, a randomized controlled trial (RCT), evaluated the effect of home-based specialized palliative care (SPC) reinforced with a psychological intervention for the patient-caregiver dyad on increasing advanced cancer patients' time spent at home, as opposed to hospitalized, and the number of home deaths. As palliative care extends to include support for patients' families and may thus assist caregivers and decrease demands on them, in this study we evaluated a secondary outcome, caregiver burden.Material and Methods Patients with incurable cancer and their caregivers were randomized (1:1) to care as usual or home-based SPC. Caregiver burden was assessed using the Zarit Burden Interview (ZBI) at baseline and 2, 4, 8 weeks and 6 months after randomization. Intervention effects were assessed in mixed effects models.Results A total of 258 caregivers were enrolled. Eleven per cent of informal caregivers experienced severe caregiver burden at baseline. Caregiver burden increased significantly over time in both groups (p = 0.0003), but no significant effect of the intervention was seen on overall caregiver burden (p = 0.5046) or burden subscales measuring role and personal strain.Conclusion In line with the majority of previous RCTs, the Domus intervention was not able to significantly reduce caregiver burden. Future interventions should consider targeting only caregivers reporting the greatest caregiver burden.
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Affiliation(s)
- Annika von Heymann
- Psychological Aspects of Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
- Cancer Survivorship and Treatment Late Effects, Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Emma Finsted
- Psychological Aspects of Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Mai-Britt Guldin
- Research Unit for General Practice, Public Health, Aarhus University, Aarhus, Denmark
| | | | - Jesper Dammeyer
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Per Sjøgren
- Palliative Research Group, Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Hans von der Maase
- Cancer Survivorship and Treatment Late Effects, Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Kirstine S Benthien
- Palliative Care Unit, Copenhagen University Hospital, Hvidovre, Denmark
- Center for Clinical Research and Prevention, Frederiksberg Hospital, Copenhagen, Denmark
| | - Jakob Kjellberg
- VIVE, The Danish Center for Social Science Research, Copenhagen, Denmark
| | - Christoffer Johansen
- Psychological Aspects of Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
- Cancer Survivorship and Treatment Late Effects, Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Pernille Bidstrup
- Psychological Aspects of Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
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Toledano-Toledano F, Jiménez S, Moral de la Rubia J, Merino-Soto C, Rivera-Rivera L. Positive Mental Health Scale (PMHS) in Parents of Children with Cancer: A Psychometric Evaluation Using Item Response Theory. Cancers (Basel) 2023; 15:2744. [PMID: 37345081 DOI: 10.3390/cancers15102744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 05/03/2023] [Accepted: 05/11/2023] [Indexed: 06/23/2023] Open
Abstract
Mental health is currently a public health issue worldwide. However, evidence is lacking regarding the validity of the instruments used to measure and assess positive mental health in specific populations. The objective of this study was to evaluate the psychometric properties of the PMHS using IRT. A cross-sectional retrospective study with non-probabilistic convenience sampling was conducted with 623 parents of children undergoing cancer treatment at the National Institute of Health in Mexico City. The participants responded to a battery of tests, including a sociodemographic questionnaire, the PMHS, Measurement Scale of Resilience, Beck Depression Inventory, Inventory of Quality of Life, Beck Anxiety Inventory, an interview regarding caregiver burden, and the World Health Organization Well-Being Index. PMHS responses were analyzed using Samejima's graded response model. The PMHS findings indicated that the IRT-based graded response model validated the single latent trait model. The scale scores were independent of depression, anxiety, well-being, caregiver burden, quality of life, and resilience. The PMHS scores were associated with low subjective well-being. The PMHS findings reveal that from an IRT-based perspective, this scale is unidimensional and is a valid, reliable, and culturally relevant instrument for assessing positive mental health in parents of children with chronic diseases.
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Affiliation(s)
- Filiberto Toledano-Toledano
- Unidad de Investigación en Medicina Basada en Evidencias, Hospital Infantil de México Federico Gómez, National Institute of Health, Dr. Márquez 162, Doctores, Cuauhtémoc, Mexico City 06720, Mexico
- Unidad de Investigación Multidisciplinaria en Salud, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Calzada México-Xochimilco 289, Arenal de Guadalupe, Tlalpan, Mexico City 14389, Mexico
- Dirección de Investigación y Diseminación del Conocimiento, Instituto Nacional de Ciencias e Innovación para la Formación de Comunidad Científica, INDEHUS, Periférico Sur 4860, Arenal de Guadalupe, Tlalpan, Mexico City 14389, Mexico
| | - Said Jiménez
- Unidad de Investigación en Medicina Basada en Evidencias, Hospital Infantil de México Federico Gómez, National Institute of Health, Dr. Márquez 162, Doctores, Cuauhtémoc, Mexico City 06720, Mexico
| | - José Moral de la Rubia
- Facultad de Psicología, Universidad Autónoma de Nuevo León, Dr. Carlos Canseco, 110, Esq. Dr. Aguirre Pequeño, Col. Mitras Centro, Monterrey 64460, Mexico
| | - Cesar Merino-Soto
- Instituto de Investigación de Psicología, Universidad de San Martín de Porres, 34, Lima 15011, Peru
| | - Leonor Rivera-Rivera
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Av. Universidad No. 655 Col. Santa María Ahuacatitlán, Cuernavaca 62100, Mexico
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Rock M, Kieserman JM, Sun V, Grant M, Ercolano E, McCorkle R, Holcomb MJ, Weinstein RS, Hornbrook MC, Krouse RS. Clinical and Demographic Differences Among Cancer Survivors With Ostomies With and Without Informal Caregivers. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2023; 38:455-461. [PMID: 35118608 DOI: 10.1007/s13187-022-02139-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/11/2022] [Indexed: 05/20/2023]
Abstract
Informal caregivers have an essential role for cancer survivors (CS). There may be important clinical and demographic differences between CS with ostomies based on caregiver status. Our aim was to identify items that may lead to future recommendations and interventions for CS with ostomies. This is a secondary analysis of 216 CS with ostomies that were enrolled in a clinical trial. Baseline data collected included demographics, clinical characteristics, and surveys (patient activation, self-efficacy, City of Hope Quality of Life - Ostomy). These factors were compared based on caregiver status using chi-squared analysis and t-tests. Logistic regression was used to examine the factors that affect the likelihood of having a caregiver. Most participants had an identified caregiver (57%; 124/216). There was no difference in age based on caregiver status (mean 64.4 and 62.0 for those with and without a caregiver, respectively). Of those with a caregiver, 66.9% were males, 79.0% were partnered, and 87.1% were white. Those with caregivers had a higher prevalence of diabetes (p < 0.001), heart disease (p = 0.002), and mobility issues (p = 0.002). Survivors with caregivers had both higher incomes (p = 0.012) and levels of education (p = 0.049). The only difference in survey measures was those with a caregiver were more successful at getting help when needed (p = .045). Differences in gender and comorbidities of CS with caregivers demand further investigation. Interventions such as encouraging CS without caregivers to utilize available sources of social support, including other survivors with ostomies, may improve their care and quality of life.
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Affiliation(s)
- Matthew Rock
- Perelman School of Medicine, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Jake M Kieserman
- Perelman School of Medicine, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Virginia Sun
- Division of Nursing Research and Education, Department of Population Sciences, City of Hope, Duarte, CA, USA
| | - Marcia Grant
- Division of Nursing Research and Education, Department of Population Sciences, City of Hope, Duarte, CA, USA
| | | | - Ruth McCorkle
- School of Nursing, Yale University, New Haven, CT, USA
| | - Michael J Holcomb
- Arizona Telemedicine Program, The University of Arizona Health Sciences, Tucson, AZ, USA
| | - Ronald S Weinstein
- Arizona Telemedicine Program, The University of Arizona Health Sciences, Tucson, AZ, USA
| | | | - Robert S Krouse
- Perelman School of Medicine Department of Surgery, University of Pennsylvania and and Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA.
- Department of Surgery, University of Pennsylvania, 3400 Spruce St., 4 Silverstein, Philadelphia, PA, 19104, USA.
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Secinti E, Fischer IC, Brennan EA, Christon L, Balliet W. The efficacy of psychosocial interventions for cancer caregiver burden: A systematic review and meta-analysis of randomized controlled trials. Clin Psychol Rev 2023; 99:102237. [PMID: 36516641 DOI: 10.1016/j.cpr.2022.102237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 10/13/2022] [Accepted: 11/24/2022] [Indexed: 12/05/2022]
Abstract
Caregivers of adults with cancer often provide prolonged demanding assistance (e.g., physical, emotional) to their loved ones, resulting in caregiver burden. This meta-analytic review examined the efficacy of psychosocial interventions in reducing caregiver burden in caregivers of adults with cancer. Randomized controlled trials (RCTs) were identified from six electronic databases and clinical trial registries. Random-effects meta-analyses were conducted for subgroups of interventions and control conditions. Overall, 90 records describing 50 RCTs showed that psychosocial interventions reduced caregiver burden compared to passive controls (e.g. wait-list) at post-intervention (g = 0.26, 95%CI [0.12, 0.40]), but not at the first follow-up (g = 0.10, 95%CI [-0.05, 0.24]). Subgroup analyses showed that compared to passive controls, therapeutic counseling and skills training interventions significantly reduced caregiver burden at post-intervention, whereas psycho-education/support interventions did not significantly reduce burden. Very few RCTs examined intervention efficacy compared to active controls (e.g., psycho-education/support). The evidence grade ranged from very low to moderate due to inconsistency and imprecision of the results. Therapeutic counseling and skills training interventions appear efficacious in improving caregiver burden at post-intervention, although these improvements attenuate over time. Rigorous trials examining intervention effects on long-term outcomes are needed to better understand the effective mechanisms to sustain reduction in caregiver burden.
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Affiliation(s)
- Ekin Secinti
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA.
| | - Ian C Fischer
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | - Emily A Brennan
- MUSC Libraries, Medical University of South Carolina, Charleston, SC, USA
| | - Lillian Christon
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Wendy Balliet
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
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12
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The effect of caregiver educational program on caregiver reactions and lifestyle behaviors for caregivers of colorectal cancer patients: a quasi-experimental study. Support Care Cancer 2022; 30:4389-4397. [DOI: 10.1007/s00520-022-06862-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 01/24/2022] [Indexed: 12/22/2022]
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13
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Yuen SC, Amaefule AQ, Kim HH, Owoo BV, Gorman EF, Mattingly TJ. A Systematic Review of Cost-Effectiveness Analyses for Hepatocellular Carcinoma Treatment. PHARMACOECONOMICS - OPEN 2022; 6:9-19. [PMID: 34427897 PMCID: PMC8807829 DOI: 10.1007/s41669-021-00298-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/08/2021] [Indexed: 05/05/2023]
Abstract
BACKGROUND Hepatocellular carcinoma (HCC) is associated with significant financial burden for patients and payers. The objective of this study was to review economic models to identify, evaluate, and compare cost-effectiveness estimates for HCC treatments. METHODS A systematic search of the PubMed, Embase, and Cochrane Library databases to identify economic evaluations was performed and studies that modeled treatments for HCC reporting costs and cost effectiveness were included. Risk of bias was assessed qualitatively, considering costing approach, reported study perspective, and funding received. Intervention costs were adjusted to 2021 US dollars for comparison. For studies reporting quality-adjusted life-years (QALYs), we conducted analyses stratified by comparison type to assess cost effectiveness at the time of the analysis. RESULTS A total of 27 studies were included. Non-curative versus non-curative therapy comparisons were used in 20 (74.1%) studies, curative versus curative comparisons were used in 5 (18.5%) studies, and curative versus non-curative comparisons were used in 2 (7.4%) studies. Therapy effectiveness was estimated using a QALY measure in 20 (74.1%) studies, while 7 (25.9%) studies only assessed life-years gained (LYG). A health sector perspective was used in 26 (96.3%) of the evaluations, with only 1 study including costs beyond this perspective. Median intervention cost was $53,954 (range $4550-$4,760,835), with a median incremental cost of $6546 (range - $72,441 to $1,279,764). In cost-utility analyses, 11 (55%) studies found the intervention cost effective using a $100,000/QALY threshold at the time of the study, with an incremental cost-effectiveness ratio (ICER) ranging from - $1,176,091 to $1,152,440 when inflated to 2021 US dollars. CONCLUSION The majority of HCC treatments were found to be cost effective, but with significant variation and with few studies considering indirect costs. Standards for value assessment for HCC treatments may help improve consistency and comparability.
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Affiliation(s)
- Sydney C Yuen
- University of Maryland School of Pharmacy, 220 Arch Street, 12th Floor, Baltimore, MD, 21201, USA
| | - Adaeze Q Amaefule
- University of Maryland School of Pharmacy, 220 Arch Street, 12th Floor, Baltimore, MD, 21201, USA
| | - Hannah H Kim
- University of Maryland School of Pharmacy, 220 Arch Street, 12th Floor, Baltimore, MD, 21201, USA
| | - Breanna-Verissa Owoo
- University of Maryland School of Pharmacy, 220 Arch Street, 12th Floor, Baltimore, MD, 21201, USA
| | - Emily F Gorman
- Health Sciences and Human Services Library, University of Maryland, Baltimore, MD, USA
| | - T Joseph Mattingly
- University of Maryland School of Pharmacy, 220 Arch Street, 12th Floor, Baltimore, MD, 21201, USA.
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