1
|
Rothpletz-Puglia P, Smith J, Pavuk C, Leotta J, Pike K, Presley CJ, Krok-Schoen JL, Braun A, Cohen MK, Rogers GT, Chui KKH, Zhang FF, Spees CK. A theoretical explanation for how a nutrition counseling and medically tailored meal delivery program benefitted participants living with lung cancer. Support Care Cancer 2024; 32:428. [PMID: 38869623 DOI: 10.1007/s00520-024-08616-x] [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: 01/31/2024] [Accepted: 05/29/2024] [Indexed: 06/14/2024]
Abstract
PURPOSE The purpose of this study was to assess participants' perceptions and experiences while participating in a Food is Medicine medically tailored meal plus intensive nutrition counseling intervention to create a theoretical explanation about how the intervention worked. METHODS This interpretive qualitative study included the use of semi-structured interviews with active participants in a randomized controlled trial aimed at understanding how a medically tailored meal plus nutrition counseling intervention worked for vulnerable individuals with lung cancer treated at four cancer centers across the USA. During the 8-month long study, participants in the intervention arm were asked to be interviewed, which were recorded, transcribed verbatim, and analyzed using conventional content analysis with principles of grounded theory. RESULTS Twenty individuals participated. Data analysis resulted in a theoretical explanation of the intervention's mechanism of action. The explanatory process includes three linked and propositional categories leading to patient resilience: engaging in treatment, adjusting to diagnosis, and active coping. The medically tailored meals plus nutrition counseling engaged participants throughout treatment, which helped participants adjust to their diagnosis, leading to active coping through intentional self-care, behavior change, and improved quality of life. CONCLUSIONS These findings provide evidence that a Food is Medicine intervention may buffer some of the adversity related to the diagnosis of lung cancer and create a pathway for participants to experience post-traumatic growth, develop resilience, and change behaviors to actively cope with lung cancer. Medically tailored meals plus intensive nutrition counseling informed by motivational interviewing supported individuals' adjustment to their diagnosis and resulted in perceived positive behavior change.
Collapse
Affiliation(s)
- Pamela Rothpletz-Puglia
- Rutgers, The State University of New Jersey, School of Health Professions, New Brunswick, NJ, USA
| | - Jade Smith
- School of Health and Rehabilitation Sciences, Division of Medical Dietetics, The Ohio State University, College of Medicine, Columbus, OH, USA
| | - Chloe Pavuk
- School of Health and Rehabilitation Sciences, Division of Medical Dietetics, The Ohio State University, College of Medicine, Columbus, OH, USA
| | - Jana Leotta
- School of Health and Rehabilitation Sciences, Division of Medical Dietetics, The Ohio State University, College of Medicine, Columbus, OH, USA
| | - Kimberli Pike
- Rutgers, The State University of New Jersey, School of Health Professions, New Brunswick, NJ, USA
| | - Carolyn J Presley
- The James Comprehensive Cancer Center, Columbus, OH, USA
- Division of Medical Oncology, Department of Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Jessica L Krok-Schoen
- The James Comprehensive Cancer Center, Columbus, OH, USA
- School of Health and Rehabilitation Sciences, Division of Health Sciences, The Ohio State University, College of Medicine, Columbus, OH, USA
| | - Ashlea Braun
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences, Tulsa, OK, USA
| | - Mary Kathryn Cohen
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Gail T Rogers
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Kenneth Kwan Ho Chui
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Fang Fang Zhang
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Colleen K Spees
- School of Health and Rehabilitation Sciences, Division of Medical Dietetics, The Ohio State University, College of Medicine, Columbus, OH, USA.
- The James Comprehensive Cancer Center, Columbus, OH, USA.
| |
Collapse
|
2
|
Atsu FS, Botha NN, Segbedzi CE, Ogum MA, Apaak D, Tsedze IS, Akoto LA, Ansah EW. Care for the cerebrovascular accident survivors: experiences of family caregivers. BMC Palliat Care 2024; 23:138. [PMID: 38824599 PMCID: PMC11143680 DOI: 10.1186/s12904-024-01468-6] [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: 08/11/2023] [Accepted: 05/22/2024] [Indexed: 06/03/2024] Open
Abstract
BACKGROUND The role of family caregivers in the management of cerebrovascular accident survivors is invaluable. So far, there is a strong evidence affirming the effectiveness of family support for cerebrovascular accident survivors. Meanwhile, caring for cerebrovascular survivors can be labour and time intensive and pretty stressful for caregivers. The purpose of the study was to examine the lived experiences of family caregivers of cerebrovascular accident survivors in the Ho Municipality in the Volta Region of Ghana. This aims are to establish their caregivers' knowledge, preparedness, and impact of caregiving on the caregiver, and coping strategies caregivers adopted. METHODS Using a four-item (with 14 prompts) interview guide and descriptive phenomenological approach, we gathered and analysed data from 37 family caregivers in the Ho Municipality of Ghana. RESULTS We found that caregivers had limited knowledge about cerebrovascular disease-risk factors and were ill-prepared for their caregiving roles. Additionally, we found limited knowledge about coping strategies among the caregivers. We further report that some caregivers lost close relationships, and their jobs because of the caregiving, they also used fasting and prayer as coping strategies. CONCLUSIONS Caregivers suffered broken relationship, loss their jobs and incomes due to their caregiving roles. Moreover, some engaged in fasting and prayers, and alcohol use to cope with the stress associated with caring for the cerebrovascular accident survivors. We discussed the potential implications of our findings on the realisation of the Sustainable Development Goal 3.4. The aim of this goal is to reduce by 75% premature deaths due to cerebrovascular and other non-communicable diseases by 2030.
Collapse
Affiliation(s)
| | - Nkosi Nkosi Botha
- Department of Health, Physical Education and Recreation (HPER), University of Cape Coast, Cape Coast, Ghana.
- Air Force Medical Centre, Air Force Base, Takoradi, Ghana.
| | - Cynthia Esinam Segbedzi
- Department of Health, Physical Education and Recreation (HPER), University of Cape Coast, Cape Coast, Ghana
| | - Mary Aku Ogum
- Department of Health, Physical Education and Recreation (HPER), University of Cape Coast, Cape Coast, Ghana
| | - Daniel Apaak
- Department of Health, Physical Education and Recreation (HPER), University of Cape Coast, Cape Coast, Ghana
| | - Ivy Selorm Tsedze
- Department of Adult Health, School of Nursing and Midwifery, University of Cape Coast, Cape Coast, Ghana
| | | | - Edward Wilson Ansah
- Department of Health, Physical Education and Recreation (HPER), University of Cape Coast, Cape Coast, Ghana
| |
Collapse
|
3
|
Driessen HPA, Bakker EM, Rietjens JAC, Luu KLN, Lugtenberg M, Witkamp FE, Kranenburg LW. A qualitative study on redefining normality in relatives of patients with advanced cancer. Cancer Med 2024; 13:e7211. [PMID: 38785201 PMCID: PMC11117454 DOI: 10.1002/cam4.7211] [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: 12/21/2023] [Revised: 04/08/2024] [Accepted: 04/11/2024] [Indexed: 05/25/2024] Open
Abstract
OBJECTIVE To obtain insight into adaptation processes of redefining normality and its influencing factors in relatives of patients with advanced cancer. METHODS An exploratory qualitative study among relatives of patients with advanced cancer was conducted. Participants were purposively recruited. Ten in-depth individual (relative only) and 16 dyad (relative and patient together) interviews were conducted, transcribed verbatim, and analyzed by means of thematic analysis, drawing on elements of grounded theory, combining both inductive and deductive elements. RESULTS Two adaptation processes of (redefining) normality were identified: assimilation and accommodation. The latter was found to be the main way of adapting to new events. Assimilative coping strategies entailed "continuing to do the same activities as done before the disease," "difficulty accepting the situation," "avoiding to think about the disease," and "living in the short term." Accommodative strategies involved "arranging practical matters," "thinking about the future," "doing what is feasible," "engaging in new activities," "accepting the situation," "seeking distraction," "living in the short term," and "focusing on what truly matters in life." The interplay between the diagnosis and treatment of cancer, a deteriorating disease status, and the accompanying uncertainty about the future was of influence on the relatives' coping strategies. CONCLUSION When the new situation is too divergent to assimilate, accommodation may be necessary for relatives to cope with the growing complexity of the consequences of their loved one's illness. Accommodative coping then involves accepting the changing reality and actively making the necessary adjustments to build resilience and cope with the new circumstances.
Collapse
Affiliation(s)
- Helen P. A. Driessen
- Department of Psychiatry, Section of Medical Psychology and Psychotherapy, Erasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands
- Scientific Center for Care and Welfare (Tranzo), Tilburg School of Social and Behavioral SciencesTilburg UniversityTilburgThe Netherlands
| | - Evi M. Bakker
- Research Center Innovations in CareRotterdam University of Applied SciencesRotterdamThe Netherlands
| | - Judith A. C. Rietjens
- Research Center Innovations in CareRotterdam University of Applied SciencesRotterdamThe Netherlands
- Erasmus MC Cancer InstituteErasmus MC, University Medical Center RotterdamRotterdamthe Netherlands
| | - Khanh L. N. Luu
- Research Center Innovations in CareRotterdam University of Applied SciencesRotterdamThe Netherlands
| | - Marjolein Lugtenberg
- Department of Public Health, Erasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands
- Department of Design, Organization, and Strategy, Faculty of Industrial Design EngineeringDelft University of TechnologyDelftThe Netherlands
| | - Frederika E. Witkamp
- Research Center Innovations in CareRotterdam University of Applied SciencesRotterdamThe Netherlands
- Department of DermatologyErasmus MC, University Medical Center RotterdamRotterdamThe Netherlands
| | - Leonieke W. Kranenburg
- Department of Psychiatry, Section of Medical Psychology and Psychotherapy, Erasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands
| |
Collapse
|
4
|
Tragantzopoulou P, Giannouli V. Echoes of Support: A Qualitative Meta-Synthesis of Caregiver Narratives in Lung Cancer Care. Healthcare (Basel) 2024; 12:828. [PMID: 38667590 PMCID: PMC11049801 DOI: 10.3390/healthcare12080828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 04/10/2024] [Accepted: 04/12/2024] [Indexed: 04/28/2024] Open
Abstract
Lung cancer stands as one of the prevalent cancers, impacting both men and women globally. Family caregivers, deeply involved in the care of individuals affected by this disease, often endure heightened distress and struggle to navigate the manifold challenges associated with caregiving. Understanding the intricate experiences and challenges of caregivers in the realm of lung cancer care is critical, given its profound impact on their well-being and the quality of patient care. This study aimed to comprehensively examine and synthesize qualitative data concerning caregiver experiences within the context of lung cancer. Six databases were systematically searched for studies with qualitative findings relevant to caregivers and lung cancer. Seventeen studies were included, and findings were reviewed and synthesized. The main challenges identified were: 'Information accessibility', 'Dual roles and family dynamics', 'Coping with emotional challenges and uncertainty', and 'Need for support networks'. These findings underscore the profound challenges faced by caregivers, shedding light on the substantial impact of cancer on their well-being and functionality. Moreover, the study accentuates the pressing need for tailored support systems that can address the emotional toll and information needs of caregivers. This emphasis on supportive interventions is vital to enhance the quality of care and overall well-being for both patients and caregivers within the lung cancer care continuum.
Collapse
Affiliation(s)
| | - Vaitsa Giannouli
- School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| |
Collapse
|
5
|
Lu Y, Bai X, Pan C. Impact of exercise interventions on quality of life and depression in lung cancer patients: A systematic review and meta-analysis. Int J Psychiatry Med 2024; 59:199-217. [PMID: 37607565 DOI: 10.1177/00912174231190451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
INTRODUCTION Lung cancer is a leading cause of cancer-related mortality worldwide. Depression is also a common concern for lung cancer patients and is of concern because it negatively impacts overall well-being. This study summarizes the existing literature on the impact of exercise interventions on quality of life and depression in patients diagnosed with lung cancer. METHODS A systematic search of electronic databases was performed to identify relevant randomized controlled trials (RCTs) investigating the effects of exercise interventions on depression and quality of life in patients with lung cancer. Two evaluators collected information from the chosen studies utilizing a standardized data extraction form. The quality of the studies was evaluated using the Cochrane risk of bias tool. RESULTS Nine RCTs were included in the meta-analysis, with 798 participants. The pooled standardized mean difference (SMD) for the effect of exercise interventions on depression was -0.60, representing a statistically significant reduction in depression levels following exercise interventions (p < 0.001). The pooled SMD for the effect of exercise interventions on quality of life was 0.61, indicating a statistically significant association between quality of life and exercise interventions (p < 0.001). CONCLUSION There is evidence that exercise may benefit the mental health of individuals with lung cancer, including improvements in depression symptoms and quality of life, based on the intervention studies reviewed here. Given the heterogeneity in findings, however, additional randomized controlled trials are needed to augment the existing findings. Nevertheless, there appears to be sufficient evidence for now to encourage primary care physicians to recommend exercise for patients with lung cancer, while offering guidelines on how to gradually and safely increase physical activity depending on the patient's health status.
Collapse
Affiliation(s)
- Ying Lu
- Department Oncology, Wuhan Third Hospital, Tongren Hospital of WuHan University, Wuhan, China
| | - Xuelian Bai
- Department of Oncology, Baotou Central Hospital, Baotou Inner mongolia, Baotou, China
| | - Chengwen Pan
- Department of Cardiothoracic Surgery, the Second Hospital of Yinzhou District, Ningbo, China
| |
Collapse
|
6
|
Torres-Blasco N, Peña-Vargas C, Costas-Muñiz R, Rosario-Ramos L, Shen MJ, Castro E. Psychosocial symptoms associated with spiritual well-being in Latino patients and caregivers coping with advanced cancer. Support Care Cancer 2024; 32:195. [PMID: 38411749 DOI: 10.1007/s00520-024-08360-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 02/09/2024] [Indexed: 02/28/2024]
Abstract
PURPOSE The objective of this study was to investigate the relationship among hopelessness, anxiety, and depression, with spiritual well-being in patients and family caregivers. METHODS A cross-sectional survey was administered to patients (n = 57) and caregivers (n = 57) that incorporated assessments that measured spiritual well-being, depression, anxiety, hopelessness, quality of life, family relationship, burden, fatalism, religiosity, and distress. Logistic regression and cross-tabulation analyses were conducted to examine the relationship between hopelessness, anxiety, and depression, with spiritual well-being. Logistic regression was used to quantify the impact of spiritual well-being on anxiety, depression, and hopelessness. Additionally, cross-tabulations with chi-square tests were conducted to explore associations between severity of hopelessness and severity of anxiety and depression. RESULTS Logistic regression analyses showed negative associations between spiritual well-being and mental health outcomes, although not all findings were statistically significant. Among caregivers, a significant negative relationship was observed for depression (B = - 0.161, p = 0.022). Hopelessness also exhibited a negative association with spiritual well-being among caregivers (B = - 0.099, p = 0.054) and patients (B = - .152, p = 0.038). Cross-tabulations highlighted significant associations in the severity of hopelessness symptoms with anxiety and depression levels among caregivers (p < .001). CONCLUSION Results reveal a relationship among psychosocial symptoms among Latino patient-caregivers coping with cancer. By emphasizing spiritual well-being, hopelessness, and anxiety and involving family patients and caregivers in the treatment process as a unit of care. Also, it indicates the need to develop culturally tailored interventions that aim to provide valuable assistance to Latino patients and caregivers coping with cancer.
Collapse
Grants
- 5G12MD007579, 5R25MD007607, R21MD013674, and 5U54MS007579-35 National Institute of Minority Health and Health Disparities
- 5G12MD007579, 5R25MD007607, R21MD013674, and 5U54MS007579-35 National Institute of Minority Health and Health Disparities
- 5G12MD007579, 5R25MD007607, R21MD013674, and 5U54MS007579-35 National Institute of Minority Health and Health Disparities
- 5G12MD007579, 5R25MD007607, R21MD013674, and 5U54MS007579-35 National Institute of Minority Health and Health Disparities
- 5G12MD007579, 5R25MD007607, R21MD013674, and 5U54MS007579-35 National Institute of Minority Health and Health Disparities
- 5G12MD007579, 5R25MD007607, R21MD013674, and 5U54MS007579-35 National Institute of Minority Health and Health Disparities
- 2U54CA163071 and 2U54CA163068), R21CA180831-02 , , 5K08CA234397-01A1 National Cancer Institute National Cancer Institute
- 2U54CA163071 and 2U54CA163068), R21CA180831-02 , , 5K08CA234397-01A1 National Cancer Institute National Cancer Institute
- 2U54CA163071 and 2U54CA163068), R21CA180831-02 , , 5K08CA234397-01A1 National Cancer Institute National Cancer Institute
- 2U54CA163071 and 2U54CA163068), R21CA180831-02 , , 5K08CA234397-01A1 National Cancer Institute National Cancer Institute
- P30CA008748 Memorial Sloan Kettering Cancer Center
- P30CA008748 Memorial Sloan Kettering Cancer Center
- P30CA008748 Memorial Sloan Kettering Cancer Center
- P30CA008748 Memorial Sloan Kettering Cancer Center
- 133798-PF-19-120-01-CPPB American Cancer Society
- 133798-PF-19-120-01-CPPB American Cancer Society
- 133798-PF-19-120-01-CPPB American Cancer Society
- 133798-PF-19-120-01-CPPB American Cancer Society
- 133798-PF-19-120-01-CPPB American Cancer Society
- 5U54MS007579-35 by National Institute of Minority Health and Health Disparities
- 5U54MS007579-35 by National Institute of Minority Health and Health Disparities
- 5U54MS007579-35 by National Institute of Minority Health and Health Disparities
- 5U54MS007579-35 by National Institute of Minority Health and Health Disparities
- 5U54MS007579-35 by National Institute of Minority Health and Health Disparities
Collapse
Affiliation(s)
- Normarie Torres-Blasco
- School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce, Puerto Rico.
- Ponce's Research Institute, Ponce Health Sciences University, Ponce, Puerto Rico.
| | - Cristina Peña-Vargas
- Ponce's Research Institute, Ponce Health Sciences University, Ponce, Puerto Rico
| | - Rosario Costas-Muñiz
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Lianel Rosario-Ramos
- School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce, Puerto Rico
| | - Megan J Shen
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Eida Castro
- School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce, Puerto Rico
- Ponce's Research Institute, Ponce Health Sciences University, Ponce, Puerto Rico
| |
Collapse
|
7
|
Rothpletz-Puglia P, Smith J, Pavuk C, Leotta J, Pike K, Presley CJ, Krok-Schoen J, Braun A, Cohen MK, Rogers GT, Kwan HKC, Zhang FF, Spees C. How a Medically Tailored Meal Intervention with Intensive Nutrition Counseling Created Active Coping with Behavior Change for Vulnerable Patients with Lung Cancer. RESEARCH SQUARE 2024:rs.3.rs-3915333. [PMID: 38352464 PMCID: PMC10862975 DOI: 10.21203/rs.3.rs-3915333/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
Purpose The purpose of this study was to assess participants' perceptions and experiences while participating in a Food is Medicine medically tailored meal plus nutrition counseling intervention to create a theoretical explanation about how the intervention worked. Methods This interpretive qualitative study included the use of semi-structured interviews with active intervention participants. Purposeful sampling included vulnerable (uninsured, rural zip code residency, racial/ethnic minority, 65 years old, and/or low-income) individuals with lung cancer treated at four cancer centers across the United States. Interviews were recorded, transcribed verbatim, and analyzed using conventional content analysis with principles of grounded theory. Results Twenty individuals participated. Data analysis resulted in a theoretical explanation of the intervention's mechanism of action. The explanatory process includes 3 linked and propositional categories leading to patient resilience: engaging in treatment, adjusting to diagnosis, and active coping. The medically tailored meals plus intensive nutrition counseling engaged participants throughout treatment, which helped participants adjust to their diagnosis, leading to active coping through intentional self-care, behavior change, and improved quality of life. Conclusions These findings provide evidence that a food is medicine intervention may buffer some of the adversity related to the diagnosis of lung cancer and create a pathway for participants to experience post-traumatic growth, develop resilience, and change behaviors to actively cope with lung cancer. Medically tailored meals plus intensive nutrition counseling informed by motivational interviewing supported individuals' adjustment to their diagnosis and resulted in perceived positive behavior change.
Collapse
|
8
|
Montiel C, Bedrossian N, Myre A, Kramer A, Piché A, Mcdonough MH, Sabiston CM, Petrella A, Gauvin L, Doré I. "In My Mind, It Was Just Temporary": A Qualitative Study of the Impacts of Cancer on Men and Their Strategies to Cope. Am J Mens Health 2024; 18:15579883231215153. [PMID: 38179864 PMCID: PMC10771074 DOI: 10.1177/15579883231215153] [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: 09/12/2023] [Revised: 10/25/2023] [Accepted: 10/30/2023] [Indexed: 01/06/2024] Open
Abstract
Individuals who are diagnosed and treated for cancer use a variety of strategies to manage its impacts. However, there is currently a lack of research on men's experience with managing cancer impacts, which is necessary to better support them throughout the cancer care continuum. This study explored the experience of men diagnosed with cancer, focusing on the impacts of the illness and its treatment and men's strategies to cope. A qualitative descriptive design was used. Thirty-one men (Mage = 52.7 [26-82] years) diagnosed with various cancer types were recruited to take part in individual telephone interviews (n = 14) or online focus groups (n = 17) addressing the impacts of cancer and strategies they used to cope with these impacts. Directed content analysis was performed, using Fitch's (2008) supportive care framework to guide the analysis. Cancer impacts and strategies used to cope were classified into six categories: physical, psychological, interpersonal, informational, practical, and spiritual. Results indicate that the cancer experience is diverse and multifaceted rather than homogeneous. Medical and supportive care services could be more effectively personalized to meet the diversity of men's needs by adopting a comprehensive and holistic approach to supportive care. Working in partnership with patients, it appears promising to recognize and identify men's needs and match them to appropriate resources to provide truly supportive care.
Collapse
Affiliation(s)
| | - Nathalie Bedrossian
- Centre de recherche du Centre hospitalier de l’Université de Montréal, Montréal, Quebec, Canada
| | - André Myre
- Peer Researcher, Montréal, Quebec, Canada
| | | | - Alexia Piché
- Centre de recherche du Centre hospitalier de l’Université de Montréal, Montréal, Quebec, Canada
| | | | | | - Anika Petrella
- University College London Hospitals NHS Foundation Trust, London, UK
| | - Lise Gauvin
- Centre de recherche du Centre hospitalier de l’Université de Montréal, Montréal, Quebec, Canada
| | - Isabelle Doré
- Centre de recherche du Centre hospitalier de l’Université de Montréal, Montréal, Quebec, Canada
| |
Collapse
|
9
|
Burke H, Dunne S. "You nearly feel a little bit like you've less right to grieve": a qualitative study on the impact of cancer on adult siblings. J Cancer Surviv 2023; 17:1628-1638. [PMID: 36401074 PMCID: PMC9676809 DOI: 10.1007/s11764-022-01295-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 11/07/2022] [Indexed: 11/19/2022]
Abstract
PURPOSE Family members of cancer patients experience a range of challenges and are impacted in various ways by cancer. To our knowledge, the impact of cancer on adult siblings has yet to be explored. Sibling relationships are one of the longest relationships individuals have across the lifespan. Thus, the current study sought to investigate the perspectives of siblings of those who previously had cancer. METHODS Ten participants were recruited using purposive sampling. A qualitative, cross-sectional design was implemented with both virtual and in-person semi-structured interviews. Interviews were audio-recorded, transcribed and analysed using thematic analysis. RESULTS The researchers identified five themes relating to both the impact of cancer on siblings and the supports they received: changes in family relationships, sibling's grief is forgotten, benefits of social support networks, supporting their sibling and caregiving and self-support. CONCLUSIONS Cancer organizations and support services should focus on signposting services for siblings in order to ensure they can access support. Further research is needed with siblings to gain greater insight into what supports siblings feel are available for them to access, whether there are any for them to access or how supports can be improved. IMPLICATIONS FOR CANCER SURVIVORS The provision of appropriate psychological support for siblings of cancer patients will ensure they can provide optimal support and care to their siblings. This will in turn benefit cancer patients along their cancer trajectory as adequate support from their caregivers will enhance their quality of life.
Collapse
Affiliation(s)
- Hazel Burke
- School of Psychology, Dublin City University, Glasnevin, Dublin 9, Dublin, Ireland
| | - Simon Dunne
- School of Psychology, Dublin City University, Glasnevin, Dublin 9, Dublin, Ireland.
| |
Collapse
|
10
|
Rezaeipandari H, Morowatisharifabad MA, Shaghaghi A. Religious and Spiritual Coping Elements in Dealing with Chronic Diseases: A Qualitative Exploration of the Perspectives of Older Iranian Zoroastrians. JOURNAL OF RELIGION AND HEALTH 2023; 62:3017-3041. [PMID: 36991287 DOI: 10.1007/s10943-023-01797-5] [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: 03/07/2023] [Indexed: 06/19/2023]
Abstract
Religiosity is a desirable alternative coping strategy for many people when facing negative life events including age-related infirmities and stressors. Religious coping mechanisms (RCMs) have been investigated meagerly with regard to religious minorities around the world and, to the best of current knowledge, no study has been conducted on Iranian Zorostrians to explore their religious coping mechanisms in dealing with age-related chronic diseases. This qualitative research, therefore, was aimed to canvas perceptions about RCMs that are utilized by Iranian Zoroastrian older adults to deal with chronic diseases in the city of Yazd, Iran. Semi-structured interviews were conducted with purposefully selected fourteen Zoroastrian older patients and four Zoroastrian priests in 2019. The main extracted themes included performing certain religious behaviors and having sincere religion-based beliefs as employed mechanisms for better coping with their chronic diseases. Prevalent dilemmas/barriers with mitigating impact on the coping capacities in dealing with a persistent illness was another predominant identified theme. Identification of RCMs that religious and ethnic minorities are using to better confront diverse life events, such as chronic diseases, could pave the path to expand new approaches in planing sustainable disease management and proactive quality of life improvement initiatives.
Collapse
Affiliation(s)
- Hassan Rezaeipandari
- Department of Aging Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Elderly Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Ali Morowatisharifabad
- Department of Aging Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Elderly Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Abdolreza Shaghaghi
- Health Education and Promotion Department, Faculty of Health, Tabriz University of Medical Sciences, Golgasht Ave., Tabriz, 5166614711, Iran.
| |
Collapse
|
11
|
Kim JH, Yang HM. Moderating Effect of Self-Esteem on the Relationship between Depression and Family Conflict Coping Strategies in the Elderly with Chronic Diseases in Korea. Healthcare (Basel) 2023; 11:2569. [PMID: 37761766 PMCID: PMC10531067 DOI: 10.3390/healthcare11182569] [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: 08/21/2023] [Revised: 09/09/2023] [Accepted: 09/16/2023] [Indexed: 09/29/2023] Open
Abstract
(1) Background: The elderly with chronic diseases often experience high levels of depression, which can negatively affect their family conflict coping strategies. Additionally, as the level of depression increases, self-esteem tends to decrease. This study aims to investigate whether self-esteem plays a moderating role in the relationship between depression and family conflict coping strategies among the elderly with chronic diseases. (2) Method: The subjects were 2501 older adults with chronic diseases included in the 16th Korean Welfare Panel Study. The CES-D scale, Rosenberg Self-Esteem Scale, and the tool of Family Conflict Coping Strategies were used. (3) Results: Depression was negatively correlated with self-esteem and coping strategies for family conflict, while self-esteem was positively correlated with coping strategies for family conflict. In the multiple regression model, self-esteem had a moderating effect (F = 43.20, p < 0.001). This result indicated that as self-esteem increases, the negative influence of depression on family conflict coping strategies becomes weaker (β = -0.08, t = -3.04, p = 0.002). (4) Conclusions: When addressing family conflict coping strategies in the elderly with chronic diseases, it is crucial to focus on enhancing self-esteem. Additionally, it may be beneficial to classify the elderly into groups based on their level of self-esteem.
Collapse
Affiliation(s)
| | - Hwa-Mi Yang
- Department of Nursing, Daejin University, Pocheon-si 11159, Republic of Korea;
| |
Collapse
|
12
|
Öcalan S, Üzar-Özçetin YS. "I am in a Fight with My Brain": A Qualitative Study on Cancer-Related Ruminations of Individuals with Cancer. Semin Oncol Nurs 2023; 39:151450. [PMID: 37210226 DOI: 10.1016/j.soncn.2023.151450] [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: 12/19/2022] [Revised: 03/30/2023] [Accepted: 04/19/2023] [Indexed: 05/22/2023]
Abstract
OBJECTIVE This study aimed to determine the cancer-related ruminations from the subjective perspectives of individuals with cancer. DATA SOURCES The study adopted a qualitative design, and participants (N = 16) were individuals with cancer. The analysis and interpretation of data were carried out according to the phenomenological-hermeneutical method. CONCLUSION The following four themes emerged as a result of the analysis of qualitative data revealing the experiences of individuals with cancer: (1) attributed meanings to cancer-related ruminations, (2) perceived ruminations toward an uncertain future, (3) losing against intrusive ruminations, and (4) fighting with ruminations. The results underline the negative impact of ruminative thoughts on the disease process and social life of individuals with cancer. Individuals with cancer struggle with intense thoughts about the cause, treatment, and future of the disease from the moment they are diagnosed with cancer. In order to stop ruminative thoughts, individuals with cancer have tried solutions such as distracting activities and avoiding thoughts. IMPLICATIONS FOR NURSING PRACTICE Nurses have an important role in catching verbal and nonverbal cues for rumination, as they are constantly together with individuals with cancer and make observations. Therefore, nurses can raise awareness about their ruminative thoughts and teach coping skills to individuals with cancer.
Collapse
Affiliation(s)
- Sinem Öcalan
- MSc, PhD Candidate, RN, Research Assistant, Psychiatric Nursing Department, Faculty of Nursing, Hacettepe University, Ankara, Turkey.
| | - Yeter Sinem Üzar-Özçetin
- PhD, RN, Associate Professor, School of Nursing, Midwifery, and Health Systems, UCD Health Sciences Centre, University College Dublin, Dublin, Ireland
| |
Collapse
|
13
|
Öcalan S, Üzar-Özçetin YS. "Cancer Never Goes Out of Your Mind Even for a Single Second". Cancer-Related Ruminations From the Perspectives of Cancer Survivors. Semin Oncol Nurs 2023; 39:151427. [PMID: 37069011 DOI: 10.1016/j.soncn.2023.151427] [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: 12/08/2022] [Revised: 03/15/2023] [Accepted: 03/21/2023] [Indexed: 04/19/2023]
Abstract
OBJECTIVE This study aimed to explore a deeper understanding of how cancer survivors experience and manage ruminative thoughts. DATA SOURCES A descriptive qualitative design. The study was conducted with cancer survivors (n = 21). A semistructured interview guide was used for data collection, and content analysis method was implemented to gain a better understanding from the collected data. The study procedure and reporting adhere to the guideline for reporting qualitative research COnsolidated criteria for REporting Qualitative research (COREQ) checklist. CONCLUSION Three main themes were developed: "Struggling within cognitions", "Coping", and "Required needs". The results highlight that cancer survivors have intrusive ruminative thoughts about cancer and need support to cope with these thoughts. It was also found that over time, they experienced changes in their perspectives, gained meaning, and were able to use deliberate ruminations. IMPLICATIONS FOR NURSING PRACTICE Nurses have an effective role in providing care and determining the needs of individuals. Nurses can easily recognize intrusive ruminations, help cancer survivors raise awareness about the effects of ruminative thoughts on them, and support them in coping with intrusive ruminations using effective interventions.
Collapse
Affiliation(s)
- Sinem Öcalan
- Faculty of Nursing, Psychiatric Nursing Department, Hacettepe University, Ankara, Turkey 06100.
| | - Yeter Sinem Üzar-Özçetin
- University College Dublin, School of Nursing, Midwifery, and Health Systems, UCD Health Sciences Centre, Dublin, Ireland
| |
Collapse
|
14
|
Striving towards normality in an unpredictable situation. A qualitative interview study of how persons newly diagnosed with incurable oesophageal and gastric cancer manage everyday life. Eur J Oncol Nurs 2023; 63:102302. [PMID: 36893571 DOI: 10.1016/j.ejon.2023.102302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/13/2023] [Accepted: 02/19/2023] [Indexed: 02/22/2023]
Abstract
PURPOSE Getting an incurable oesophageal or gastric cancer diagnosis is a major stressful life event associated with severe physical, psychosocial and existential challenges. To provide timely and efficient support, based on patients' experiences, the aim of the study was to explore how patients newly diagnosed with incurable oesophageal and gastric cancer manage everyday life. METHOD Semi-structured interviews were conducted with 12 patients 1-3 months after being diagnosed with incurable oesophageal or gastric cancer. Four participants were interviewed twice, which resulted in 16 interviews. Data were analysed with qualitative content analysis. RESULTS An overall theme, "Striving towards normality in an unpredictable situation", with three related themes - "Trying to comprehend the disease", "Dealing with the consequences of illness" and "Re-evaluating what is important in everyday life" - and seven sub-themes were identified. The participants described an unexpected and unpredictable situation, in which they strived to maintain their normal life. Amidst struggling to manage problems related to eating, fatigue and an incurable diagnosis the participants talked about the importance of focusing on the positive and normal aspects of life. CONCLUSIONS The findings in this study point to the importance of supporting patients' confidence and skills, particularly with regard to managing eating, so that they can hold on to their normal life as much as possible. The findings further point to the possible benefit of integrating an early palliative care approach and could provide guidance for nurses and other professionals on how to support patients post diagnosis.
Collapse
|
15
|
Muacevic A, Adler JR, Desai SR, Chen PL, Seminario-Vidal L. Perspectives on and Quality of Life in Skin of Color Patients With Mycosis Fungoides/Sézary Syndrome: A Qualitative Analysis. Cureus 2023; 15:e34054. [PMID: 36824562 PMCID: PMC9941020 DOI: 10.7759/cureus.34054] [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: 11/24/2022] [Accepted: 01/22/2023] [Indexed: 01/23/2023] Open
Abstract
Background Prior quantitative studies have described the diminished health-related quality of life (HRQoL) faced by the overall mycosis fungoides (MF)/Sézary syndrome (SS) population; yet, little is known about how the disease affects HRQoL in skin of color (SOC) patients. This qualitative study sought to explore the lived experiences of SOC patients with MF/SS and gain deeper insights into the impact the disease has on various facets of HRQoL. Methodology Interviews with SOC patients with MF/SS ≥18 were recruited from a cutaneous lymphoma clinic. A thematic analysis was performed to identify overarching themes. Results Ten patients were invited to participate from July to September 2021. One patient with SS and seven patients with MF (four in the early stage and four in the advanced stage), with a median age of 60.5 years, agreed to participate. Emerging themes included diagnostic and therapeutic delays frequently due to initial misdiagnoses with other skin conditions. Physical and functional burdens significantly hindered participants' abilities to carry out daily responsibilities and maintain employment, and impacts on physical appearance (e.g., darkened skin) led to increased self-consciousness and lack of social acceptance. Participants regarded family and faith as main sources of support in addition to developing healthy coping strategies, such as self-acceptance and adaptability. All participants reported feeling satisfied with their access to healthcare information and the quality of care received. Conclusions Our findings provide greater insights into how HRQoL is impacted across SOC patients with MF/SS, which can help raise awareness among healthcare providers and assist with creating interdisciplinary healthcare approaches to better support the needs of this population.
Collapse
|
16
|
Hasan EM, Calma CL, Tudor A, Vernic C, Palade E, Tudorache E, Oancea C, Papava I. Gender Differences in Coping, Depression, and Anxiety in Patients with Non-Metastatic Lung Cancer. Cancer Manag Res 2022; 14:2041-2052. [PMID: 35757160 PMCID: PMC9231683 DOI: 10.2147/cmar.s368992] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 06/08/2022] [Indexed: 01/10/2023] Open
Abstract
Background Depression and anxiety are prevalent issues amongst individuals suffering from thoracic cancer. Gender differences in coping with thoracic cancer have a serious impact upon the management of emotional distress. The purpose of our study has been to assess sex variations in handling anxiety and depression, including the use of coping mechanisms and their relationship with respect to anxiety and depression. Methods This cross-sectional study registered 18 women and 22 men with non-metastatic lung cancer and operated upon. Pre-operatively and at one month post-operatively, the patients were assessed by means of scales (COPE, GAD-7 and PHQ-9). Results Post-operatively, the intensity of depression and anxiety was substantially greater in males than in females (p = 0.049, p = 0.042). Male individuals tended to use coping mechanisms of humour (p = 0.009) and restraint (p = 0.029) significantly more frequently than women. Moreover, in women, depression correlated significantly with denial and behavioural deactivation (rho = 0.465, p = 0.029, respectively, rho = 0.562, p = 0.006); whilst anxiety, similarly, correlated with positive interpretation, behavioural deactivation, and use of social-emotional support (rho = 0.484, p = 0.022, respectively, rho = 0.590, p = 0.004 and rho = 0.502, p = 0.017). Furthermore, in males, depression correlated significantly with mental deactivation, use of social-instrumental and social-emotional support (rho = 0.702, p = 0.001, respectively, rho = 0.505, p=0.033, and rho = 0.773 with p < 0.001), whilst anxiety correlated significantly with mental deactivation, denial, and use of social-emotional support (rho = 0.597, p = 0.009, respectively, rho = 0.553 with p = 0.017 and rho = 0.755, p < 0.001). Conclusion There were gender divergences in the use of coping mechanisms and the level of post-surgical anxiety and depression. We found significant positive relationships between some coping mechanisms and depression/anxiety. The patient’s gender governs the coping style, which in turn has bearing upon the post-operative evolution.
Collapse
Affiliation(s)
| | - Crenguta Livia Calma
- Department of Functional Sciences, Center of Immuno-Physiology (CIFBIOTEH), "Victor Babeș" University of Medicine and Pharmacy, Timișoara, Romania
| | - Anca Tudor
- Department of Functional Sciences, "Victor Babeș" University of Medicine and Pharmacy, Timișoara, Romania
| | - Corina Vernic
- Department of Functional Sciences, "Victor Babeș" University of Medicine and Pharmacy, Timișoara, Romania
| | - Emanuel Palade
- Department of Cardiovascular and Thoracic Surgery, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Department of Thoracic Surgery, "Leon Daniello" Pneumophtysiology Hospital, Cluj-Napoca, Romania
| | - Emanuela Tudorache
- Department of Infectious Diseases, "Victor Babeș" University of Medicine and Pharmacy, Timișoara, Romania
| | - Cristian Oancea
- Department of Infectious Diseases, "Victor Babeș" University of Medicine and Pharmacy, Timișoara, Romania
| | - Ion Papava
- Department of Neuroscience, NEUROPSY - COG Center for Cognitive Research in Neuropsychiatric Pathology, "Victor Babes," University of Medicine and Pharmacy, Timișoara, Romania
| |
Collapse
|
17
|
Owoo B, Ninnoni JP, Ampofo EA, Seidu AA. Challenges encountered by family caregivers of prostate cancer patients in Cape Coast, Ghana: a descriptive phenomenological study. Palliat Care 2022; 21:108. [PMID: 35701817 PMCID: PMC9195311 DOI: 10.1186/s12904-022-00993-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 05/30/2022] [Indexed: 12/24/2022] Open
Abstract
Background In Ghana, prostate cancer is more prevalent than all other cancers, with a mortality rate of 75% partly due to late presentation to the health care facilities. Limited health services provision across the country and shortages of skilled nurses place a significant demand on family caregivers who are often ill-equipped for the caring role, resulting in many challenges. As they are expected to provide complex care at home with little resources, information, and support, the healthcare system rarely addresses the challenging needs of these family caregivers. This study explored the challenges encountered by family caregivers of people with prostate cancer. Methods We conducted interviews using a descriptive phenomenological approach. Twelve family caregivers of prostate cancer patients were selected through a purposive sampling technique at the Cape Coast Teaching Hospital. All interviews were recorded, transcribed, and analysed using Colaizzi’s (1978) data analysis approach. Results Three main themes were identified as critical challenges: education and training needs, resources and caregiver-nurse relationship issues. Under the three main themes emerged seven sub-themes that collectively hindered the family caregiver’s ability to meet the care demands. Sub-themes that emerged were; lack of preparedness towards the caring role, lack of knowledge about condition/ treatment, misconception about the condition, lack of accommodation facilities, financial constraints, poor communication, and poor staff attitude. Conclusion Caregiving is associated with significant challenges that hinder the family caregiver’s ability to care for the patient effectively, further diminishing the caregiver’s quality of life and patient care. Therefore, healthcare professionals, especially nurses, should consider these challenges family caregivers face and take measures to obviate them through education, preparation and support. Supplementary Information The online version contains supplementary material available at 10.1186/s12904-022-00993-6.
Collapse
Affiliation(s)
- Benedicta Owoo
- School of Nursing and Midwifery, University of Cape Coast, Cape Coast, Ghana.
| | - Jerry Paul Ninnoni
- School of Nursing and Midwifery, University of Cape Coast, Cape Coast, Ghana
| | | | - Abdul-Aziz Seidu
- Centre for Gender and Advocacy, Takoradi Technical University, Takoradi, Ghana.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, 4811, Australia
| |
Collapse
|
18
|
Family Caregivers' Experiences of Caring for Advanced Cancer Patients: A Qualitative Systematic Review and Meta-synthesis. Cancer Nurs 2022:00002820-990000000-00028. [PMID: 35482525 DOI: 10.1097/ncc.0000000000001104] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Advanced cancers qualify as severe stressors to family caregivers (FCGs), which can negatively impact caregivers' psychological and physical well-being because of their association with high symptom burden, distress, and poor prognosis. OBJECTIVE This review aims to synthesize FCGs' experiences of caring for advanced cancer patients using a qualitative systematic review method. METHODS A comprehensive search was conducted in 7 databases from inception until July 2020. Two reviewers independently screened and assessed each study using Joanna Briggs Institute instruments and subsequently undertook the meta-aggregation approach to synthesize findings. RESULTS A total of 26 studies were included, refined to 37 findings, and integrated into 9 categories and 5 synthesized findings. When a loved one with advanced cancer faced deterioration near the end of their life, FCGs showed a tremendous sense of responsibility for care and concerted great efforts to alleviate their loved one's suffering while lacking effective professional support. Cultural beliefs had a great impact on FCGs' responsibility and role recognition. Ultimately, the caregiving helped FCGs achieve personal transcendence inherent in their unique experience. CONCLUSIONS Caring for advanced cancer patients is a unique, culture-specific experience marked by struggle. Effective professional support, including early palliative care, should be considered to improve the FCGs' experience of caring for advanced cancer patients. Cultural beliefs should be considered to understand and develop appropriate strategies to support FCGs. IMPLICATIONS FOR PRACTICE Healthcare providers need to ensure that individualized, multifaceted interventions considering FCGs' needs are delivered at the optimal time with the appropriate approach.
Collapse
|
19
|
Opsomer S, Lauwerier E, De Lepeleire J, Pype P. Resilience in advanced cancer caregiving. A systematic review and meta-synthesis. Palliat Med 2022; 36:44-58. [PMID: 34986698 PMCID: PMC8796166 DOI: 10.1177/02692163211057749] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Close relatives provide much of the care to people with cancer. As resilience can shield family caregivers from mental health problems, there has been a burgeoning interest in resilience-promoting interventions. However, the evidence necessary for the development of these interventions is scant and unsynthesized. AIM To create an overall picture of evidence on resilience in cancer caregiving by a theory-driven meta-synthesis. DESIGN In this systematically constructed review a thematic synthesis approach has been applied. The original findings were coded and structured deductively according to the theoretical framework. Consequently, the codes were organized inductively into themes and subthemes. DATA SOURCES Through September 2019, five electronic databases were searched for qualitative studies on resilience in cancer caregiving. The search was extended by a supplementary hand search. Seventeen studies met the eligibility criteria. RESULTS The elements of resilience, as described in the pre-defined theoretical framework of Bonanno, are reflected in the lived experiences of family caregivers. The resilience process starts with the diagnosis of advanced cancer and may result in mental wellbeing, benefit finding, and personal growth. The process is influenced by context elements such as individual history, sociocultural background, caregiver characteristics, and the behavior of the supportive network. A repertoire of coping strategies that caregivers use throughout the caregiving process moderates the resilience process. CONCLUSION This review and theoretical synthesis reveal key elements of resilience in the process of cancer caregiving, including influencing factors and outcomes. Implications and avenues for further research are discussed.
Collapse
Affiliation(s)
- Sophie Opsomer
- Academic Centre for General Practice, Catholic University of Leuven, Leuven, Belgium.,Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Emelien Lauwerier
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.,Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Jan De Lepeleire
- Academic Centre for General Practice, Catholic University of Leuven, Leuven, Belgium
| | - Peter Pype
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.,End-of-Life Care Research Group, Ghent University, Ghent, Belgium
| |
Collapse
|
20
|
Hasan EM, Calma CL, Tudor A, Oancea C, Tudorache V, Petrache IA, Tudorache E, Papava I. Coping, Anxiety, and Pain Intensity in Patients Requiring Thoracic Surgery. J Pers Med 2021; 11:1221. [PMID: 34834573 PMCID: PMC8620564 DOI: 10.3390/jpm11111221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 11/09/2021] [Accepted: 11/16/2021] [Indexed: 12/04/2022] Open
Abstract
Stress, anxiety, and post-surgical chest pain are common problems among patients with thoracic surgical pathology. The way in which psychological distress is managed-the coping style-can influence the postsurgical evolution and quality of life of patients. In our study, we monitored the influence of coping style on patients' anxiety and the intensity of post-operative chest pain. We conducted a cross-sectional study on 90 subjects with thoracic surgical pathology. One month after their surgeries, patients completed the following scales and questionnaires, translated, adapted, and validated for the Romanian population: COPE scale inventory, Generalized Anxiety Disorder-7 Questionnaire, McGill Pain Questionnaire, and Numeric Pain Rating Scale. Anxiety (evaluated using the Generalized Anxiety Disorder-7 Questionnaire) and postoperative thoracic pain intensity (evaluated by means of the Numeric Pain Rating Scale, Number of Words Chosen, and McGill Pain Questionnaire) were significantly higher in patients exhibiting social-focused coping than in patients presenting emotion-focused or problem-focused coping as their main coping style (Kruskal-Wallis, p = 0.028, p = 0.022, p = 0.042, p = 0.007). In our study, there were no differences observed in pain intensity relative to level of anxiety. Coping style is an important concept in the management of anxiety and pain experienced by patients undergoing chest surgery. Therefore, a multidisciplinary approach should be considered in clinical practice.
Collapse
Affiliation(s)
- Elisei Moise Hasan
- Clinic of Thoracic Surgery, Emergency Clinical Municipal Hospital Timișoara, Gheorghe Dima Street No. 5, 300079 Timișoara, Romania; (E.M.H.); (I.A.P.)
- University of Medicine and Pharmacy Timișoara, Eftimie Murgu Square No. 2, 300041 Timișoara, Romania
| | - Crenguta Livia Calma
- Discipline of Physiology, Department of Functional Sciences, Center of Immuno-Physiology (CIFBIOTEH), “Victor Babeș” University of Medicine and Pharmacy Timișoara, Eftimie Murgu Square No. 2, 300041 Timișoara, Romania
| | - Anca Tudor
- Discipline of Biostatistics and Medical Informatics, Department of Functional Sciences, “Victor Babeș” University of Medicine and Pharmacy Timișoara, Eftimie Murgu Square No. 2, 300041 Timișoara, Romania;
| | - Cristian Oancea
- Discipline of Pneumology, Department of Infectious Diseases, “Victor Babeș” University of Medicine and Pharmacy Timișoara, Eftimie Murgu Square No. 2, 300041 Timișoara, Romania; (C.O.); (V.T.); (E.T.)
| | - Voicu Tudorache
- Discipline of Pneumology, Department of Infectious Diseases, “Victor Babeș” University of Medicine and Pharmacy Timișoara, Eftimie Murgu Square No. 2, 300041 Timișoara, Romania; (C.O.); (V.T.); (E.T.)
| | - Ioan Adrian Petrache
- Clinic of Thoracic Surgery, Emergency Clinical Municipal Hospital Timișoara, Gheorghe Dima Street No. 5, 300079 Timișoara, Romania; (E.M.H.); (I.A.P.)
- First Discipline of Surgical Semiology, First Department of Surgery, “Victor Babeș” University of Medicine and Pharmacy Timișoara, Eftimie Murgu Square No. 2, 300041 Timișoara, Romania
| | - Emanuela Tudorache
- Discipline of Pneumology, Department of Infectious Diseases, “Victor Babeș” University of Medicine and Pharmacy Timișoara, Eftimie Murgu Square No. 2, 300041 Timișoara, Romania; (C.O.); (V.T.); (E.T.)
| | - Ion Papava
- Discipline of Psychiatry, Department of Neuroscence, NEUROPSY-COG Center for Cognitive Research in Neuropsychiatric Pathology, “Victor Babeș” University of Medicine and Pharmacy Timișoara, Eftimie Murgu Square No. 2, 300041 Timișoara, Romania;
| |
Collapse
|
21
|
Levenets O, Stepurko T, Polese A, Pavlova M, Groot W. Coping with cancer in post-communist Europe: a systematic literature review. Health Policy Plan 2021; 36:1690-1704. [PMID: 34595512 DOI: 10.1093/heapol/czab121] [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: 10/05/2020] [Revised: 09/20/2021] [Accepted: 09/24/2021] [Indexed: 11/13/2022] Open
Abstract
In the post-communist countries, limited access to treatment, lack of financial protection mechanisms, lack of information and low quality of health care frequently imposes an enormous burden on family's well-being when cancer is diagnosed. While many studies have explored barriers to cancer treatment, little attention is paid to the question how patients and their caregivers cope with cancer. In this paper, we systematically review the evidence on patients' coping strategies with cancer in post-communist countries. We performed a literature search in PubMed, JSTOR, Web of Science and EBSCO (CINAHL) to identify papers that describe patients' coping strategies because of organizational and financial barriers to cancer treatment. Papers published between January 1991 and January 2020 were included if they described individual experiences of patients at any stage of cancer treatment. We applied the Preferred Reporting Items for Systematic Literature Review as a guide for our review. In total, 28 publications from post-communist countries were included in this review. They presented evidence on coping strategies and barriers faced by patients when coping with poor access to cancer treatment, lack of finances, lack of information and low quality of health care services. Most sought coping strategies included using personal finances to pay for medical services, medicines and supplies, charitable contributions to the hospital and informal payments; visiting a private medical doctor; using personal connections and looking for additional information. We conclude that coping strategies are similar across post-communist countries and can be seen as an indicator of the shortcomings in cancer treatment. This evidence can be used to study and/or improve access to cancer treatment and improve health care policies. Research on the prevalence and quantification of coping strategies is needed to provide evidence-informed policies for countries that face gaps in cancer treatment.
Collapse
Affiliation(s)
- Olena Levenets
- Department of Health Services Research, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - Tetiana Stepurko
- School of Public Health, National University Kyiv Mohyla Academy, 2 Skovorody Street, 04655 Kyiv, Ukraine
| | - Abel Polese
- Tallinn School of Business and Governance, Tallinn University of Technology, Akadeemia Tee 3, 12611 Tallinn, Estonia
| | - Milena Pavlova
- Department of Health Services Research; CAPHRI, Maastricht University Medical Center, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - Wim Groot
- Top Institute Evidence-Based Education Research (TIER), Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| |
Collapse
|
22
|
Serçekuş P. Becoming a family caregiver of a patient living with cancer. Int J Palliat Nurs 2021; 26:206-212. [PMID: 32584696 DOI: 10.12968/ijpn.2020.26.5.206] [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: 11/11/2022]
Abstract
BACKGROUND There is insufficient information on how the burden of caregiving is affected when the family caregiver is a health professional. Studies are needed to investigate this issue. AIMS The purpose of this study was to reveal difficulties experienced by a nurse family caregiver offering care to a family member diagnosed with end-stage cancer and how she coped with these difficulties. METHODS This was an autoethnographic study. FINDINGS Findings were grouped under three headings: being both a researcher and a subject; effects of caregiving; and coping. CONCLUSIONS Offering care to a cancer patient has many physiological and psychological effects. If a family caregiver is a health professional, his/her caregiving burden can be even higher. Cultural values affect both life and coping ways of caregivers. It should be kept in mind that family caregivers need support from health professionals whatever their occupations are. Support to caregivers plays an important role in their coping.
Collapse
Affiliation(s)
- Pınar Serçekuş
- Associate Professor, Faculty of Health Sciences, Pamukkale University, Denizli, Turkey
| |
Collapse
|
23
|
Cochrane A, Reid O, Woods S, Gallagher P, Dunne S. Variables associated with distress amongst informal caregivers of people with lung cancer: A systematic review of the literature. Psychooncology 2021; 30:1246-1261. [PMID: 33945184 DOI: 10.1002/pon.5694] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 03/30/2021] [Accepted: 04/01/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Informal caregivers of people with lung cancer often experience a substantial care burden and associated negative consequences due to the often-contracted course of the disease. The objective of this review was to systematically examine the evidence on the factors associated with lung cancer caregiver distress. METHODS Five databases (MEDLINE, CINAHL, EMBASE, PsychINFO and Web of Science) were searched for studies investigating factors associated with distress amongst caregivers of people with lung cancer. Empirical studies published up to July 2020 were included if they measured distress using a valid and reliable measure and examined its association with at least one other factor, with a sample of 50 or more caregivers. RESULTS Thirty publications describing 27 studies (16 cross-sectional; 6 prospective; 8 intervention) involving 3744 caregivers (primarily spouse or adult child) were included. A narrative synthesis of the findings is presented due to heterogeneity in study design, variables measured and analyses conducted. Patient variables associated with greater distress included: stage of cancer and quality of spousal relationship. Caregiver variables associated with higher distress included: social support, coping strategies and self-efficacy. CONCLUSIONS Several variables were associated with distress amongst lung cancer caregivers. Understanding these variables could inform the development of interventions that will enable caregivers to care effectively while maintaining their own well-being. Screening for distress among caregivers may identify those caregivers who would benefit from early intervention.
Collapse
Affiliation(s)
- Andy Cochrane
- School of Psychology, Dublin City University, Dublin 9, Ireland
| | - Olivia Reid
- School of Psychology, Dublin City University, Dublin 9, Ireland
| | - Siobhan Woods
- School of Psychology, Dublin City University, Dublin 9, Ireland
| | | | - Simon Dunne
- School of Psychology, Dublin City University, Dublin 9, Ireland
| |
Collapse
|
24
|
Zhang H, Ma W, Wang G, Wang S, Jiang X. Effects of psychosocial factors on posttraumatic growth among lung cancer patients: A structural equation model analysis. Eur J Cancer Care (Engl) 2021; 30:e13450. [PMID: 33817877 DOI: 10.1111/ecc.13450] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 07/29/2020] [Accepted: 11/27/2020] [Indexed: 02/05/2023]
Abstract
OBJECTIVE The purpose of this study was to investigate how locus of control, coping strategies, emotion regulation strategies and social support affect posttraumatic growth. METHODS A cross-sectional study design was adopted. A convenience sample of 540 patients with lung cancer was recruited from November 2016 to July 2017 at two tertiary grade A hospitals in China. The participants completed a series of questionnaires. Structural equation modelling was used to explore the effects of psychosocial factors on posttraumatic growth. RESULTS Social support had a direct positive effect on posttraumatic growth (β = 0.318, SE = 0.071, BC 95% CI = 0.252/0.390), and it also had indirect effects on posttraumatic growth (β = 0.112, SE = 0.023, BC 95%CI = 0.088/0.135) through mediating psychological factors. Coping strategies and the cognitive reappraisal emotion regulation strategy were the main mediating variables, explaining approximately 73.1% of the indirect effect between social support and posttraumatic growth. CONCLUSIONS Our study suggests that Chinese lung cancer survivors can show relatively high posttraumatic growth. There are many mediating paths between social support and posttraumatic growth. These results may help healthcare professionals to identify the psychosocial factors that may benefit lung cancer patients and develop interventions to promote posttraumatic growth.
Collapse
Affiliation(s)
- Huaguo Zhang
- West China Hospital/West China School of Nursing, Sichuan University, Chengdu, China.,Department of Nursing, Chinese PLA General Hospital, Beijing, China
| | - Weiguang Ma
- School of Nursing, Peking Union Medical College, Beijing, China
| | - Guorong Wang
- Sichuan Cancer Center, Sichuan Cancer Hospital & Institute, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Song Wang
- West China Hospital/West China School of Nursing, Sichuan University, Chengdu, China
| | - Xiaolian Jiang
- West China Hospital/West China School of Nursing, Sichuan University, Chengdu, China
| |
Collapse
|
25
|
Samuels N, Oberbaum M, Ben-Arye E. Expectations of Patients and Their Informal Caregivers from an Integrative Oncology Consultation. Integr Cancer Ther 2021; 20:1534735421990080. [PMID: 33588610 PMCID: PMC7894684 DOI: 10.1177/1534735421990080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Integrative physicians (IPs) working in supportive and palliative care are often consulted about the use of herbal medicine for disease-related outcomes. We examined 150 electronic files of oncology patients referred to an IP consultation for demographic and cancer-related data; use of herbal medicine for disease-related outcomes; and narratives of patients and informal caregivers describing their expectations from the IP consultation. Over half (51.3%) of patients reported using herbal medicine for disease-related outcomes, more so among those adopting dietary changes for this goal (P < .005). Most (53.3%) were accompanied by an informal caregiver, especially those using herbal medicine (66.2%, P = .002) or adopting dietary changes (69.8%, P < .001). The majority of patients (84.4%) expected the IP to provide guidance on the use of herbal medicine for disease-related outcomes (e.g., "curing," "shrinking," "eradicating" and "cleansing"). Most caregivers (88.8%) expressed a similar expectation, with some having additional questions not mentioned by the patient. IPs need to identify and understand expectations of oncology patients and their informal caregivers, helping them make informed decisions on the effective and safe use of herbal medicine. The IP may need to "reframe" expectations regarding the ability of herbal medicine to treat cancer and immunity, to more realistic quality of life-focused goals.
Collapse
Affiliation(s)
- Noah Samuels
- Shaare Zedek Medical Center, Jerusalem, Israel.,Tel Aviv University, Tel Aviv, Israel
| | | | - Eran Ben-Arye
- Clalit Health Services, Haifa, Israel.,Technion-Israel Institute of Technology, Haifa, Israel
| |
Collapse
|
26
|
Darlington A, Randall D, Leppard L, Koh M. Palliative and end of life care for a child: Understanding parents' coping strategies. Acta Paediatr 2021; 110:673-681. [PMID: 32564398 DOI: 10.1111/apa.15429] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 06/03/2020] [Accepted: 06/16/2020] [Indexed: 12/21/2022]
Abstract
AIM Understanding of coping strategies that parents use before the death of their child is crucial and will enable us to best provide support. The current study aimed to explore parents' coping strategies, and map these onto an existing theoretical framework. METHODS Bereaved parents and parents of a child with a life-limiting/threatening condition were interviewed to investigate coping strategies, recruited through Intensive Care Units (2 Neonatal, 2 Paediatric, 1 Paediatric Cardiac) and a children's hospice. Analysis focused on coping strategies and mapping these onto the framework. RESULTS 24 parents of 20 children were interviewed and identified. Parents use a variety of coping strategies (n = 25) such as humour, staying positive, advocating and staying strong for others, expressing emotions and preparing, while also living life to the full, supported by others. The themes were successfully mapped onto the theoretical framework, which focuses on the constructs of approach and avoidance, as well as coping for self and others. CONCLUSION The findings have provided a detailed account of the breadth and depth of coping strategies parents use, including those classed as avoidance. The strategies were successfully mapped onto the theoretical framework. Future research should investigate changes over times, and associations to negative long-term outcomes.
Collapse
Affiliation(s)
| | - Duncan Randall
- School of Health Sciences University of Southampton Southampton UK
| | - Lisa Leppard
- Neonatal Intensive Care Unit University Hospital Southampton Southampton UK
| | - Michelle Koh
- University Hospital SouthamptonNaomi House Hospice Southampton UK
| |
Collapse
|
27
|
Acceptability and Usefulness of a Dyadic, Tailored, Web-Based, Psychosocial and Physical Activity Self-Management Program (TEMPO): A Qualitative Study. J Clin Med 2020; 9:jcm9103284. [PMID: 33066225 PMCID: PMC7650635 DOI: 10.3390/jcm9103284] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/08/2020] [Accepted: 10/10/2020] [Indexed: 12/11/2022] Open
Abstract
Caregivers of men with prostate cancer report high burden, and there is a need to develop cost-effective programs to support them in their roles. This study reports on the acceptability of a dyadic, Tailored, wEb-based, psychosocial and physical activity (PA) self-Management PrOgram called TEMPO. TEMPO was accessed by a convenience sample of 19 men with prostate cancer and their caregivers (n = 18), as well as six health care professionals (HCPs). User feedback was gathered via semi-structured qualitative interviews. Data were analyzed using thematic analysis. Most dyads were satisfied with TEMPO, particularly with the dyadic feature of TEMPO, the focus on goal setting to integrate self-management, and the extensive health library. The patients and caregivers motivated each other as they worked through TEMPO. Most goals to achieve during TEMPO pertained to increasing PA, followed by learning physical symptom management. One unanticipated benefit of TEMPO for the dyads was improved communication. HCPs agreed that TEMPO was a novel approach to online cancer self-management and they echoed the benefits reported by dyads. Key suggestions for improving TEMPO were to reduce repetition, tailor content, add more exercise ideas, and have more printing options. This study provides a strong foundation on which to plan a larger trial.
Collapse
|
28
|
Dönmez ÇF, Johnston B. Living in the moment for people approaching the end of life: A concept analysis. Int J Nurs Stud 2020; 108:103584. [PMID: 32450405 DOI: 10.1016/j.ijnurstu.2020.103584] [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] [Received: 11/29/2019] [Revised: 02/26/2020] [Accepted: 03/21/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND 'Living in the moment' is an essential part of dignity-conserving practice in end-of-life care settings. Although living in the moment is important for care at the end of life, from the perspective of both the person and their family, there is no clear conceptual understanding of what it represents. OBJECTIVE To explore the concept of 'living in the moment' in the context of dignity-conserving care at the end of life. DESIGN A concept analysis. DATA SOURCES The databases of Medline, CinAHL, PubMed, Web of Science, PsycINFO, SocINDEX and Cochrane were searched for studies published between 1941 and 2019, and searches of dictionaries and grey literature, as well as hand-searching were conducted, to yield qualitative, mixed methods and systematic reviews published in English, related to the term 'living in the moment'. METHOD The methods of Walker and Avant were used to identify antecedents, attributes and consequences of the concept of 'living in the moment'. RESULTS The literature review generated a total of 37 papers for this concept analysis. The attributes identified were (1) simple pleasure, (2) prioritising relationships, (3) living each day to the fullest, (4) maintaining normality, and (5) not worrying about the future. The antecedents were (1) awareness of dying, (2) living with life-threatening illness, (3) positive individual growth, and (4) living with an uncertain future. The consequences were (1) a good quality of life, (2) preserving dignity, and (3) coping with the uncertainty of life. CONCLUSIONS A universal definition and conceptual model of the main concept, including theoretical relationships between its antecedents, attributes and consequences, was developed. The definition and proposed conceptual model can allow instruments to be developed that measure the effects, existence or attributes of the concept, and identify a theoretical model, and can also lead to new perspectives and strategies for implementation by nurses to improve dignified person-centred care at the end of life.
Collapse
Affiliation(s)
- Çiğdem Fulya Dönmez
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, Scotland, UK; School of Heath Sciences, Department of Nursing, Istanbul Arel University, Istanbul, Turkey.
| | - Bridget Johnston
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, Scotland, UK; Florence Nightingale Foundation Clinical Professor of Nursing, School of Medicine, Dentistry & Nursing, and NHS Greater Glasgow and Clyde, College of Medical, Veterinary & Life Sciences, University of Glasgow, 57-61 Oakfield Avenue, Glasgow G12 8LL, Scotland, UK.
| |
Collapse
|
29
|
Greer JA, Applebaum AJ, Jacobsen JC, Temel JS, Jackson VA. Understanding and Addressing the Role of Coping in Palliative Care for Patients With Advanced Cancer. J Clin Oncol 2020; 38:915-925. [PMID: 32023161 DOI: 10.1200/jco.19.00013] [Citation(s) in RCA: 91] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Advanced cancer, with its considerable physical symptoms and psychosocial burdens, represents an existential threat and major stressor to patients and their caregivers. In response to such stress, patients and their caregivers use a variety of strategies to manage the disease and related symptoms, such as problem-focused, emotion-focused, meaning-focused, and spiritual/religious coping. The use of such coping strategies is associated with multiple outcomes, including quality of life, symptoms of depression and anxiety, illness understanding, and end-of-life care. Accumulating data demonstrate that early palliative care, integrated with oncology care, not only improves these key outcomes but also enhances coping in patients with advanced cancer. In addition, trials of home-based palliative care interventions have shown promise for improving the ways that patients and family caregivers cope together and manage problems as a dyad. In this article, we describe the nature and correlates of coping in this population, highlight the role of palliative care to promote effective coping strategies in patients and caregivers, and review evidence supporting the beneficial effects of palliative care on patient coping as well as the mechanisms by which improved coping is associated with better outcomes. We conclude with a discussion of the limitations of the state of science, future directions, and best practices on the basis of available evidence.
Collapse
Affiliation(s)
- Joseph A Greer
- Massachusetts General Hospital, Boston, MA.,Harvard Medical School, Boston, MA
| | | | - Juliet C Jacobsen
- Massachusetts General Hospital, Boston, MA.,Harvard Medical School, Boston, MA
| | - Jennifer S Temel
- Massachusetts General Hospital, Boston, MA.,Harvard Medical School, Boston, MA
| | - Vicki A Jackson
- Massachusetts General Hospital, Boston, MA.,Harvard Medical School, Boston, MA
| |
Collapse
|
30
|
Borrayo EA, Scott KL, Drennen A, Bendriss TM, Kilbourn KM, Valverde P. Treatment challenges and support needs of underserved Hispanic patients diagnosed with lung cancer and head-and-neck cancer. J Psychosoc Oncol 2020; 38:449-462. [PMID: 31920170 DOI: 10.1080/07347332.2019.1705453] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Purpose: We explored the treatment challenges and support needs that Hispanic underserved lung cancer and head-and-neck cancer patients face while undergoing cancer treatment.Design: Qualitative design - ethnography.Sample: Using a sample of 29 participants, we conducted semi-structured interviews with nine lung cancer and head-and-neck cancer survivors and seven health care providers and focus group interviews with six caregivers and seven patient navigators.Method: Relevant themes were extracted with Ethnographic content analysis.Findings: Participants reported treatment challenges and support needs in four areas: medical, financial, socio-cultural, and mental health. Health care providers and navigators primarily identified medical and financial challenges that impact treatment adherence, while patients and caregivers expressed the need for support for mental health problems (i.e., depression, anxiety).Implications for psychosocial providers: Understanding the experiences of underserved Hispanic cancer survivors can aid in creating psychosocial interventions that successfully target treatment-related challenges and provide them with the support they need.
Collapse
Affiliation(s)
- Evelinn A Borrayo
- Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Katie L Scott
- Department of Neurology, Spectrum Health Medical Group, Grand Rapids, MI, USA
| | - Ava Drennen
- Health Psychology Associates, P.C., Greeley, CO, USA
| | - Tiare M Bendriss
- Psychiatry, Fremont Medical Center, Kaiser Permanente, Fremont, CA, USA
| | - Kristin M Kilbourn
- Department of Psychology, University of Colorado Denver, Denver, CO, USA
| | - Patricia Valverde
- Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| |
Collapse
|
31
|
Mowla F, Khanjari S, Haghani S. Effect of the combination of Benson's relaxation technique and brief psychoeducational intervention on religious coping, sense of coherence, and quality of life of family caregivers. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2020; 9:117. [PMID: 32642473 PMCID: PMC7325782 DOI: 10.4103/jehp.jehp_653_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 01/06/2020] [Indexed: 05/11/2023]
Abstract
INTRODUCTION Chronic diseases leave a huge impact on the life of children and their family caregivers (FCGs). Therefore, the present study was conducted to determine the effect of the combination of Benson's relaxation technique (BRT) and brief psycho-educational intervention (BPI) on religious coping (RCOPE), sense of coherence (SOC), and quality of life (QoL) of FCGs in children with chronic disease. MATERIALS AND METHODS The study population, consisted of 100 FCGs whose children were afflicted by chronic diseases, and participated in the current quasi-experimental pretest posttest design. The children were recruited from two state pediatric hospitals in Tehran, Iran. The RCOPE, SOC, and QoL of FCGs were assessed twice, through pretest (T1) and posttest (T2), four weeks after the intervention, by means of RCOPE, SOC and SF-36 questionnaires. The FCGs participated in four training sessions lasting up to 70 min over one week, followed by four more weeks of training. The Chi-square, Fisher's exact tests, independent t-test, and paired t-test were performed. RESULTS Positive RCOPE had a significant rise at T2 (P = 0.020) compared with negative RCOPE that did not show significant changes in T2. SOC scores for the intervention group remarkably rose at T2 (P = 0.022); but, for the control group, the drop was marginal. The QoL scores of both physical and mental components were statistically significant in the intervention group at T2 (P < 0.05). CONCLUSION Findings of the present study suggest that BRT and BPI can help significantly improve the RCOPE, SOC, and QoL of families with children suffering from chronic diseases. Measures that could enhance the RCOPE, SOC, and QoL include low-cost interventions, good safety, and decent outcome.
Collapse
Affiliation(s)
- Forough Mowla
- Vice-Chancellor's Office in Treatment Affairs, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sedigheh Khanjari
- Nursing Care Research Center, Department of Pediatric Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
- Address for correspondence: Dr. Sedigheh Khanjari, Nursing Care Research Center, Department of Pediatric Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Rashid Yasami Street, Valiasr Ave., Tehran, Iran. E-mail:
| | - Shima Haghani
- Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
32
|
Jankowska-Polańska B, Polański J, Chabowski M, Rosińczuk J, Mazur G. Influence of Coping Strategy on Perception of Anxiety and Depression in Patients with Non-small Cell Lung Cancer. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1251:57-70. [DOI: 10.1007/5584_2019_448] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
|
33
|
Litzelman K, Reblin M, McDowell HE, DuBenske LL. Trajectories of social resource use among informal lung cancer caregivers. Cancer 2019; 126:425-431. [PMID: 31626343 DOI: 10.1002/cncr.32545] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 08/20/2019] [Accepted: 08/31/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Social support is a key component in maintaining cancer caregiver well-being, and many resources exist to facilitate caregivers' use of social support (eg, cancer support groups). This study sought to determine how informal cancer caregivers use social resources over the course of caregiving. METHODS The data are from the Comprehensive Health Enhancement Support System study of informal caregivers (n = 202) of patients with recently diagnosed lung cancer. Caregivers self-reported their sociodemographic and caregiving characteristics and social resource use over 6 months. Generalized additive models were used to assess social resource use over time, and generalized estimating equation logistic regression models were used to assess the correlates of social resource use. RESULTS Nearly two-thirds of caregivers reported any social resource use. The most prevalent social resources were faith-based groups (38%) and social clubs (30%). Only 1 in 4 caregivers participated in a formal resource such as counseling (11%) or a cancer support group (6%). Social resource use was lowest immediately after the diagnosis and increased over time. Formal resource use exhibited a nonlinear association with time such that formal resource use peaked approximately 9 to 10 months after the cancer diagnosis. Caregivers were more likely to report social resource use if the patient also reported social engagement. CONCLUSIONS This study has found that many cancer caregivers do not use social resources, although social resource use increases over time after the cancer diagnosis. Because of the association between social engagement and well-being, this information may inform future research and interventions to improve outcomes for cancer caregivers and their families.
Collapse
Affiliation(s)
- Kristin Litzelman
- Department of Human Development and Family Studies, University of Wisconsin-Madison, Madison, Wisconsin.,Department of Psychiatry, University of Wisconsin Carbone Cancer Center, Madison, Wisconsin
| | | | | | - Lori L DuBenske
- Department of Human Development and Family Studies, University of Wisconsin-Madison, Madison, Wisconsin.,Department of Psychiatry, University of Wisconsin Carbone Cancer Center, Madison, Wisconsin
| |
Collapse
|
34
|
Abstract
The purposes of this study were to describe the coping processes and support needs of patients with incurable cancer. The study was conducted as a qualitative study. The research data were gathered by conducting thematic interviews with outpatients with incurable cancer (n = 16) and analyzed by means of inductive content analysis. The results of the study indicate that the lives of patients were temporarily interrupted by the incurable illness. A sympathetic family was perceived as strength, and after the initial shock, the patients began to rebuild their lives. They had conflicting thoughts about cancer treatment. The patients felt that they were courageous, but fragile, in the face of their illness. They prepared for the approaching death by discussing the issue with their family members and friends and planning their own palliative care. The patients expected to be approached holistically. The results of this study are applicable in circumstances in which health care professionals are preparing to approach an incurable cancer patient as an individual, instead of simply as a medical case. The results can also be utilized to develop evidence-based, family-oriented palliative nursing for cancer patients and to better identify the expectations and needs of the patients while receiving treatment.
Collapse
|
35
|
The experience of caring for an advanced lung cancer spouse: Vulnerable journey of caregiving. ENFERMERIA CLINICA 2019. [DOI: 10.1016/j.enfcli.2019.04.135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
36
|
Lightfoot N, MacEwan L, Tufford L, Holness DL, Mayer C, Kramer DM. Who cares? The impact on caregivers of suspected mining-related lung cancer. ACTA ACUST UNITED AC 2019; 26:e494-e502. [PMID: 31548817 DOI: 10.3747/co.26.4635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Background In the present study, we investigated the emotional, physical, financial, occupational, practical, and quality-of-life impacts on caregivers of patients with mining-related lung cancer. Methods This concurrent, embedded, mixed-methods study used individual in-depth qualitative interviews and the 36-item Short Form Health Survey (version 2: RAND Corporation, Santa Monica, CA, U.S.A.) quality-of-life measure with 8 caregivers of patients with suspected mining-related lung cancer who had worked in Sudbury or Elliot Lake (or both), and sometimes elsewhere. Individuals who assist workers in filing compensation claims were also interviewed in Sudbury and Elliot Lake. Interviews (n = 11) were transcribed and analyzed thematically. Results Caregiver themes focused on the long time to, and the shock of, diagnosis and dealing with lung cancer; not much of a life for caregivers; strong views about potential cancer causes; concerns about financial impacts; compensation experiences and long time to compensation; and suggestions for additional support. Quality-of-life scores were below the norm for most measures. Individuals who assist workers in preparing claims were passionate about challenges in the compensation journey; the requirement for more and better family support; the need to focus on compensation compared with cost control; the need for better exposure monitoring, controls, resources, and research; and job challenges, barriers, and satisfaction. Conclusions Caregivers expressed a need for more education about the compensation process and for greater support. Worker representatives required persistence, additional workplace monitoring and controls, additional research, and a focus on compensation compared with cost control. They also emphasized the need for more family support.
Collapse
Affiliation(s)
- N Lightfoot
- School of Rural and Northern Health, Laurentian University, Sudbury, ON
| | - L MacEwan
- School of Social Work, Laurentian University, Sudbury, ON
| | - L Tufford
- School of Social Work, Laurentian University, Sudbury, ON
| | - D L Holness
- Dalla Lana School of Public Health and Department of Medicine, University of Toronto, and Division of Occupational Medicine and Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON
| | - C Mayer
- Supportive Care Oncology Research Unit, Health Sciences North, Sudbury, ON
| | - D M Kramer
- School of Occupational and Public Health, Ryerson University, Toronto, ON
| |
Collapse
|
37
|
Gall TL, Bilodeau C. The role of positive and negative religious/spiritual coping in women’s adjustment to breast cancer: A longitudinal study. J Psychosoc Oncol 2019; 38:103-117. [DOI: 10.1080/07347332.2019.1641581] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
38
|
Hendriksen E, Rivera A, Williams E, Lee E, Sporn N, Cases MG, Palesh O. Manifestations of anxiety and coping strategies in patients with metastatic lung cancer and their family caregivers: a qualitative study. Psychol Health 2019; 34:886-899. [PMID: 31155947 DOI: 10.1080/08870446.2019.1579909] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: Advanced non-small cell lung cancer (NSCLC) is common, deadly, and associated with impairing anxiety for patients and caregivers who often co-experience similar symptoms that can vary together over time. We aimed to discover themes as to how NSCLC patients and caregivers express and cope with anxiety. Design: Semi-structured interviews of patient-caregiver dyads (N = 21), coded using NVivo Software. Main Outcome Measures: Open-ended questions on anxiety mutuality, giving or receiving care, communication, and the most difficult aspects of having or caring for someone with Stage IV NSCLC. Results: Analyses revealed that patients and caregivers were linked psychologically, co-experiencing symptoms of distress or coping, rising and falling together. Shared patient and caregiver themes emerged of cognitive, behavioural and physiological manifestations of anxiety and coping mechanisms. Conclusions: Patient and caregiver expressions of anxiety and coping methods mapped onto the cognitive-behavioural model, implying potential use of cognitive behavioural therapy (CBT) to address these issues. This expands understanding of symptoms and coping strategies in NSCLC, explores patient-caregiver interaction, and confirms the need for future clinical intervention. Future research should focus on development and dissemination of CBT-based dyadic interventions addressing anxiety in NSCLC patients and caregivers.
Collapse
Affiliation(s)
- Ellen Hendriksen
- a Department of Psychiatry and Behavioral Sciences , Stanford University School of Medicine , Stanford , California , USA
| | - Alexandra Rivera
- b PGSP-Stanford Psy.D. Consortium , Palo Alto , California , USA
| | - Emma Williams
- b PGSP-Stanford Psy.D. Consortium , Palo Alto , California , USA
| | - Eric Lee
- b PGSP-Stanford Psy.D. Consortium , Palo Alto , California , USA
| | - Nora Sporn
- c Department of Psychology , University of Kansas , Lawrence , Kansas , USA
| | - Mallory G Cases
- a Department of Psychiatry and Behavioral Sciences , Stanford University School of Medicine , Stanford , California , USA
| | - Oxana Palesh
- a Department of Psychiatry and Behavioral Sciences , Stanford University School of Medicine , Stanford , California , USA
| |
Collapse
|
39
|
He Y, Jian H, Yan M, Zhu J, Li G, Lou VWQ, Chen J. Coping, mood and health-related quality of life: a cross-sectional study in Chinese patients with advanced lung cancer. BMJ Open 2019; 9:e023672. [PMID: 31061015 PMCID: PMC6501988 DOI: 10.1136/bmjopen-2018-023672] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES The ways patients cope with advanced cancer can influence their health-related quality of life (HRQoL). This study aims to examine the mediating role of positive and negative mood in the relationship between coping and HRQoL in patients with advanced lung cancer. METHODS A consecutive sample of 261 patients (mean age: 59.99±9.53) diagnosed with stage III or IV lung cancer was recruited from the inpatient unit in a hospital that specialises in chest-related disease in Shanghai, China. Participants completed measurements including Medical Coping Modes Questionnaire, Positive and Negative Affect Schedule, and 5-level EuroQol 5-dimension instrument. RESULTS Although the total effects of confrontation on HRQoL were not significant, competing indirect effects via mood were identified: (1) positive indirect effects through positive mood were found for confrontation on mobility, usual activities, pain/discomfort and overall utility index (indirect effect=0.01, 95% CI 0.003 to 0.03); (2) negative indirect effects through negative mood were found for confrontation on mobility, pain/discomfort, anxiety/depression and overall utility index (indirect effect=-0.01, 95% CI -0.03 to -0.001). Resigned acceptance was negatively associated with HRQoL, and indirect effects via mood were identified: (1) negative indirect effects through positive mood were found for resigned acceptance on mobility, self-care, usual activities, pain/discomfort and overall utility index (indirect effect=-0.01, 95% CI -0.03 to -0.003); (2) negative indirect effects through negative mood were found for resigned acceptance on domains of HRQoL and overall utility index (indirect effect=-0.04, 95% CI -0.06 to -0.02). CONCLUSIONS Confronting advanced lung cancer can fuel ambivalent emotional experiences. Nevertheless, accepting the illness in a resigned way can be maladaptive for health outcomes. The findings suggest interventions that facilitate adaptive coping, reduce negative mood and enhance positive mood, as this could help to improve or maintain HRQoL in patients with advanced lung cancer.
Collapse
Affiliation(s)
- Yaping He
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
- Center for Health Technology Assessment, Shanghai Jiao Tong University China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Hong Jian
- Department of Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Meiqiong Yan
- Department of Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Jingfen Zhu
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
- Center for Health Technology Assessment, Shanghai Jiao Tong University China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Guohong Li
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
- Center for Health Technology Assessment, Shanghai Jiao Tong University China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Vivian W Q Lou
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
- Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong
| | - Jieling Chen
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
- Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong
| |
Collapse
|
40
|
Hou WK, Liang L, Lau KM, Hall M. Savouring and psychological well‐being in family dyads coping with cancer: An actor–partner interdependence model. Eur J Cancer Care (Engl) 2019; 28:e13047. [DOI: 10.1111/ecc.13047] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 02/01/2019] [Accepted: 03/25/2019] [Indexed: 01/07/2023]
Affiliation(s)
- Wai Kai Hou
- Laboratory of Psychology and Ecology of Stress (LoPES) The Education University of Hong Kong Hong Kong City Hong Kong
- Department of Psychology The Education University of Hong Kong Hong Kong Hong Kong
- Centre for Psychosocial Health The Education University of Hong Kong Hong Kong Hong Kong
| | - Li Liang
- Laboratory of Psychology and Ecology of Stress (LoPES) The Education University of Hong Kong Hong Kong City Hong Kong
- Department of Psychology The Education University of Hong Kong Hong Kong Hong Kong
- Centre for Psychosocial Health The Education University of Hong Kong Hong Kong Hong Kong
| | - Kam Man Lau
- Laboratory of Psychology and Ecology of Stress (LoPES) The Education University of Hong Kong Hong Kong City Hong Kong
| | - Mila Hall
- Teachers College Columbia University New York New York
| |
Collapse
|
41
|
The Dyadic Communicative Resilience Scale (DCRS): scale development, reliability, and validity. Support Care Cancer 2019; 27:4555-4564. [PMID: 30923889 DOI: 10.1007/s00520-019-04763-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 03/19/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE There has yet to be a quantitative measurement of communicative resilience processes as outlined in the Communicative Theory of Resilience (CTR). This study aims to determine the structure, reliability, and validity of the Dyadic Communicative Resilience Scale (DCRS) in cancer patients and partners. METHOD The DCRS was administered to 584 participants, including 312 cancer patients and 272 partners of cancer patients along with the common coping subscale of the dyadic coping inventory, the cancer-related communication problems with couples scale, and the resilience promoting scale. RESULTS Exploratory and confirmatory factor analyses revealed nine dimensions of dyadic communicative resilience within the five resilience processes outlined in the CTR. Structure reliability was shown with Cronbach's alphas between .77 and .88 and good to excellent model fit for the nine factors. Convergent and discriminant validities were demonstrated by significant Pearson correlations with relevant, established coping/resilience measures. CONCLUSIONS The DCRS has a clear nine factor structure and demonstrates good reliability. The measure has good convergent and discriminate validity indicating its utility in future research examining resilience in cancer populations.
Collapse
|
42
|
Huang X, Yan A, Liu Q, Wu L. Effects of magnanimous therapy on coping, adjustment, and living function in advanced lung cancer. ACTA ACUST UNITED AC 2019; 26:e48-e56. [PMID: 30853809 DOI: 10.3747/co.26.4126] [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] [Indexed: 01/11/2023]
Abstract
Objectives We examined the effects of magnanimous therapy on psychological coping, adjustment, living function, and survival rate in patients with advanced lung cancer. Methods Patients with advanced lung cancer (n = 145) matched by demographics and medical variables were randomly assigned to an individual computer magnanimous therapy group (ic-mt), a group computer magnanimous therapy group (gc-mt), or a control group (ctrl). Over 2 weeks, the ic-mt and gc-mt groups received eight 40-minute sessions of ic-mt or gc-mt respectively, plus usual care; the ctrl group received only usual care. The Cancer Coping Modes Questionnaire (ccmq), the Psychological Adjustment Scale for Cancer Patients (pascp), and the Functional Living Index-Cancer (flic) were assessed at baseline and 2 weeks later. The relationships of changes in those indicators were analyzed, and survival rates were compared. Results The psychological coping style, adjustment, and living function of the ic-mt and gc-mt groups improved significantly after the intervention (p < 0.01). After 2 weeks, significant (p < 0.01) differences between the treatment groups and the ctrl group in coping style, adjustment, and living function suggested successful therapy. The changes in living function were correlated with changes in psychological coping and adjustment. No difference in efficacy between ic-mt and gc-mt was observed. The survival rate was 31.84% in the ic-mt group and 9.375% in the ctrl group at 2 years after the intervention. Conclusions In patients with advanced lung cancer, ic-mt and gc-mt were associated with positive short-term effects on psychological coping style, adjustment, and living function, although the magnitude of the effect did not differ significantly between the intervention approaches. The effects on living function are partly mediated by improvements in psychological coping and adjustment.
Collapse
Affiliation(s)
- X Huang
- Department of Psychiatry and Medical Psychology, The First Affiliated Hospital, College of Clinical Medicine, Guangdong Pharmaceutical University, Guangzhou, P.R.C
| | - A Yan
- Zhongshan People's Hospital, Zhongshan City, Dongguan, P.R.C
| | - Q Liu
- Sun Yat-sen University Tung Wah Hospital, Dongguan, P.R.C
| | - L Wu
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Hui'ai Hospital), Guangzhou, P.R.C
| |
Collapse
|
43
|
Lippiett KA, Richardson A, Myall M, Cummings A, May CR. Patients and informal caregivers' experiences of burden of treatment in lung cancer and chronic obstructive pulmonary disease (COPD): a systematic review and synthesis of qualitative research. BMJ Open 2019; 9:e020515. [PMID: 30813114 PMCID: PMC6377510 DOI: 10.1136/bmjopen-2017-020515] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To identify, characterise and explain common and specific features of the experience of treatment burden in relation to patients living with lung cancer or chronic obstructive pulmonary disease (COPD) and their informal caregivers. DESIGN Systematic review and interpretative synthesis of primary qualitative studies. Papers were analysed using constant comparison and directed qualitative content analysis. DATA SOURCES CINAHL, EMBASE, MEDLINE, PsychINFO, Scopus and Web of Science searched from January 2006 to December 2015. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Primary qualitative studies in English where participants were patients with lung cancer or COPD and/or their informal caregivers, aged >18 years that contain descriptions of experiences of interacting with health or social care in Europe, North America and Australia. RESULTS We identified 127 articles with 1769 patients and 491 informal caregivers. Patients, informal caregivers and healthcare professionals (HCPs) acknowledged lung cancer's existential threat. Managing treatment workload was a priority in this condition, characterised by a short illness trajectory. Treatment workload was generally well supported by an immediacy of access to healthcare systems and a clear treatment pathway. Conversely, patients, informal caregivers and HCPs typically did not recognise or understand COPD. Treatment workload was balanced with the demands of everyday life throughout a characteristically long illness trajectory. Consequently, treatment workload was complicated by difficulties of access to, and navigation of, healthcare systems, and a fragmented treatment pathway. In both conditions, patients' capacity to manage workload was enhanced by the support of family and friends, peers and HCPs and diminished by illness/smoking-related stigma and social isolation. CONCLUSION This interpretative synthesis has affirmed significant differences in treatment workload between lung cancer and COPD. It has demonstrated the importance of the capacity patients have to manage their workload in both conditions. This suggests a workload which exceeds capacity may be a primary driver of treatment burden. PROSPERO REGISTRATION NUMBER CRD42016048191.
Collapse
Affiliation(s)
- Kate Alice Lippiett
- Faculty of Health Sciences, University of Southampton, Southampton, UK
- NIHR CLAHRC Wessex, University of Southampton, Southampton, UK
| | - Alison Richardson
- Faculty of Health Sciences, University of Southampton, Southampton, UK
- NIHR CLAHRC Wessex, University of Southampton, Southampton, UK
| | - Michelle Myall
- Faculty of Health Sciences, University of Southampton, Southampton, UK
- NIHR CLAHRC Wessex, University of Southampton, Southampton, UK
| | - Amanda Cummings
- Faculty of Health Sciences, University of Southampton, Southampton, UK
- NIHR CLAHRC Wessex, University of Southampton, Southampton, UK
| | - Carl R May
- London School of Hygiene and Tropical Medicine, London, UK
| |
Collapse
|
44
|
Abdel-Malek R, Farag DE, Shohdy KS, Cox S. Availability of Informal Caregivers for Palliative Care Patients with Cancer: Is there a Difference between Higher- and Lower-Income Settings. Indian J Palliat Care 2019; 25:379-382. [PMID: 31413452 PMCID: PMC6659530 DOI: 10.4103/ijpc.ijpc_199_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objective: Family caregivers are the default caring personnel for terminal cancer patients. The characteristics, demographics, distribution, psychological burden, and socioeconomic standards differ between high- and low-income countries. We aimed to assess those factors and their direct reflection on both the patient and the caregiver. Patients and Methods: This is a comparative cross-sectional study for terminal cancer patients in the palliative care unit between the United Kingdom (UK) as a high-income community and Egypt as a low-income community. We assessed the different characteristics, demographics, living place, the degree of relevance, and the availability of caregivers. Results: We have recruited 216 patients from the UK and 117 patients from Egypt. Informal caregivers were available in 74.5% and 92.3% for these patients with a mean age of 71.5 (standard deviation [SD] 16) years and 50.9 (SD 15.18) years, respectively. There has been a statistically significant difference between the two countries’ caregivers in being married, family, and living in the same household (P < 0.0001). Conclusion: Low-income countries are more common to have an informal caregiver who is a family member of different degree of relevance. Caregivers in low-income settings tend to be younger, of the female gender, married, and living in the same household than in high-income ones.
Collapse
Affiliation(s)
- Raafat Abdel-Malek
- Department of Clinical Oncology, Kasr Alainy School of Medicine, Cairo University, Cairo, Egypt
| | - Dina E Farag
- Department of Clinical Oncology, Kasr Alainy School of Medicine, Cairo University, Cairo, Egypt
| | - Kyrillus S Shohdy
- Department of Clinical Oncology, Kasr Alainy School of Medicine, Cairo University, Cairo, Egypt
| | - Sarah Cox
- Palliative Care Team, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| |
Collapse
|
45
|
Alqahtani MM, Holmes T, AL-Rammah TY, Alqahtani KM, Al Tamimi N, Alhrbi FH, Hussein Khayat A, Hassan Fadhel F. Are we meeting cancer patient needs? Complementary and alternative medicine use among Saudi cancer patients: A qualitative study of patients and healthcare professionals’ views. Eur J Integr Med 2018. [DOI: 10.1016/j.eujim.2018.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
46
|
Chabowski M, Jankowska-Polańska B, Lomper K, Janczak D. The effect of coping strategy on quality of life in patients with NSCLC. Cancer Manag Res 2018; 10:4085-4093. [PMID: 30323664 PMCID: PMC6173489 DOI: 10.2147/cmar.s175210] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background A cancer diagnosis is a source of emotional distress. The aim of the study was to evaluate coping strategies in patients with non-small-cell lung carcinoma and to assess how coping strategies along with other factors affect their quality of life. Patients and methods A total of 185 patients with non-small-cell lung carcinoma were enrolled in this observational, cross-sectional study. Demographic and clinical data were collected. Strategies for coping with cancer were assessed using a shortened version of the Mental Adjustment to Cancer (MiniMAC) scale. Health-related quality of life was assessed using the Short Form-8 Health Survey. Results Respondents (mean age: 62.84±9.6 years) most often emerged as using a fighting strategy, whereas a sense of helplessness was the strategy used least often. Overall, 65% of the respondents were revealed to have a medium level of constructive style of coping, whereas 62% had a medium level of destructive style. The coping style of nearly 50% of the respondents was predominantly constructive. Patients whose coping style was predominantly constructive had a significantly higher level of quality of life than patients whose coping style was predominantly destructive or whose results showed a balance between the two coping styles. Lung cancer patients had higher scores on the mental functioning scale (mental component summary = 50.20±39.26) than on the physical functioning scale (physical component summary = 40.07±28.58). Conclusion The majority of lung cancer patients use effective strategies for coping with the disease, which correlates with a better quality of life; a compromised quality of life is associated with a destructive coping style. Physicians should endeavor to promote positive, constructive, problem-oriented strategies of coping, especially in patients with a compromised quality of life, where the disease is advanced and when there are comorbidities.
Collapse
Affiliation(s)
- Mariusz Chabowski
- Division of Surgical Procedures, Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland, .,Department of Surgery, 4th Military Teaching Hospital, Wroclaw, Poland,
| | - Beata Jankowska-Polańska
- Division of Nursing in Internal Diseases, Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland
| | - Katarzyna Lomper
- Division of Nursing in Internal Diseases, Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland
| | - Dariusz Janczak
- Division of Surgical Procedures, Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland, .,Department of Surgery, 4th Military Teaching Hospital, Wroclaw, Poland,
| |
Collapse
|
47
|
How family caregivers of cancer patients manage symptoms at home: A systematic review. Int J Nurs Stud 2018; 85:68-79. [PMID: 29857223 DOI: 10.1016/j.ijnurstu.2018.05.004] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 05/05/2018] [Accepted: 05/08/2018] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Cancer affects not only the patient, but also the whole family, especially when a member of the family assumes the role of the family caregiver. This puts an additional emotional, social and financial strain on the family caregivers. Family caregivers of cancer patients are actively involved in the care provided at the home setting through various ways including practical tasks, symptom management and care coordination. The focus of preceding studies on family caregivers and symptom management was either on pain or the patients' and family caregivers' experience of symptom management and coping. The aim of this review was to provide evidence on how family caregivers manage symptoms and side effects at home, in adult cancer patients throughout the disease trajectory. METHODS A systematic literature review was performed in PubMed, CINAHL, Web of Science and the Cochrane Central Register of Controlled Trials with a combination of keywords and MeSH terms for family caregivers, cancer, symptoms, side effects and management. Based on predetermined inclusion and exclusion criteria, a total of 1270 articles were screened and 20 studies were included in the analysis. A descriptive analysis was performed due to the heterogeneity of the findings. RESULTS The results showed that only a limited number of studies (3/20) explored how and what family caregivers do in symptom management as a primary outcome. Family caregivers provided psychosocial support, such as supporting and motivating the patient and maintaining social engagement. Caregivers provided physical support such as with the administration of medicine and tube feeding. As an integral part of managing the symptoms, family caregivers actively monitored and assessed symptoms to timely recognize any treatment related side effects, assess the response to therapeutic interventions and recognize possible deterioration in physical status. Furthermore, family caregivers were often the decision maker - being alert, watching and waiting and decided when to act and when not to act. CONCLUSIONS Family caregivers are doing work similar to healthcare professionals, when managing symptoms and side effects at home in patients with cancer. Advanced tasks such as assessing, monitoring and deciding when and how to act are included in the daily routine of family caregivers.
Collapse
|
48
|
Rommer PS, König N, Sühnel A, Zettl UK. Coping behavior in multiple sclerosis-complementary and alternative medicine: A cross-sectional study. CNS Neurosci Ther 2018; 24:784-789. [PMID: 29635832 PMCID: PMC6120478 DOI: 10.1111/cns.12857] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 01/12/2018] [Accepted: 03/13/2018] [Indexed: 12/13/2022] Open
Abstract
Main Problem Treatment options for multiple sclerosis (MS) have enlarged tremendously over the last years. Nonetheless, lots of patients look for alternative treatment options. The use of complementary and alternative medicine (CAM) is widespread in MS, however, its scientific investigation is limited so far. The aim of the study is to analyse clinical and demographical differences of MS patients in dependency of their CAM utilization as coping strategy. Methods A total of 254 patients with a clinically definite MS were examined in a semistructured interview. Additional standardized questionnaires were used to measure different aspects of coping with illness. All patients underwent neurological examination. Results About 206 of all enrolled patients are CAM users (81.1%). They have a longer disease duration (8.3 years vs 7.3 years, P = 0.028) and show higher disability (median EDSS 4.0 vs 2.0, P < 0.001) than nonusers. CAM users differed significantly from nonusers in their coping behavior (P = 0.035). Users are brooding more heavily over the disease, looking for more information about MS, and are looking for a sense of their disease in religion more often than nonusers. CAM users are at a higher risk of depression. Almost two‐thirds of CAM users (57.6%) reported positive effects on the well‐being of their state of health. Conclusion Coping behavior differs significantly between CAM users and nonusers. CAM utilization is associated with higher disability and depression. More than 80% of our cohort has used alternative or complementary methods. CAM utilization may mirror unmet needs in the treatment of MS.
Collapse
Affiliation(s)
- Paulus S Rommer
- Department of Neurology, Neuroimmunological Section, University of Rostock, Rostock, Germany.,Department of Neurology, Medical University of Vienna, Vienna, Austria
| | | | - Annett Sühnel
- Department of Neurology, Neuroimmunological Section, University of Rostock, Rostock, Germany
| | - Uwe K Zettl
- Department of Neurology, Neuroimmunological Section, University of Rostock, Rostock, Germany
| |
Collapse
|
49
|
"All of a sudden, a lot less still makes it worthwhile to be alive:" Palliative care patients' views on life. Palliat Support Care 2018. [PMID: 29514725 DOI: 10.1017/s1478951518000081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE We aimed to elucidate the views on life as narrated by patients in palliative care (PC) to find out what patients deem to be essential in their life, whether something has changed concerning their view of life in light of the disease, and whether interviewees would like to give others something to take with them. METHOD Data were collected from narrative audio and video interviews with 18 inpatients in a specialized PC unit. Interviews were recorded and transcribed verbatim and analyzed using qualitative content analysis applying MAXQDA software. CDs and DVDs with recorded interviews were provided to patients. RESULT Eighteen interviews were analyzed: 11 audio and 7 video recordings. The age range was 41-80 years. Patients reported on changes in their views on life. Despite it being a complex and painful process, patients still gave examples of benefits experienced during their illness trajectory. Patients identified resources and coping strategies such as meaningful contacts with close others and mindfulness. Shifts have occurred in terms of taking more time for themselves, enjoying the moment, being more calm, and spending more time with family and friends. What patients wanted to pass on to others was to pay attention to the needs of both the self and the others, shape your life individually, confront yourself early with issues of death and dying, and care for your fellow human beings. Patients and relatives valued the opportunity to keep their interview as a CD/DVD. SIGNIFICANCE OF RESULTS Results support the idea that many people facing terminal illness continue to focus on living and remain within their biographies and the contexts of their lives, even if their functional status declines. Patients and relatives appreciated that interviews were provided as kind of a legacy. Yet, more robust research is needed to decide whether such interviews yield any therapeutic effect.
Collapse
|
50
|
Hutchinson A, Barclay-Klingle N, Galvin K, Johnson MJ. Living with breathlessness: a systematic literature review and qualitative synthesis. Eur Respir J 2018; 51:51/2/1701477. [PMID: 29467199 DOI: 10.1183/13993003.01477-2017] [Citation(s) in RCA: 85] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 12/09/2017] [Indexed: 02/03/2023]
Abstract
What is the experience of people living with breathlessness due to medical conditions, those caring for them and those treating them, with regard to quality of life and the nature of clinical interactions?Electronic databases (Ovid MEDLINE, Embase, CINAHL Plus and PsycINFO) were searched (January 1987 to October 2017; English language), for qualitative studies exploring the experience of chronic breathlessness (patients, carers and clinicians). Two independent reviewers screened titles, abstracts and papers retrieved against inclusion criteria. Disagreements were resolved with a third reviewer. Primary qualitative data were extracted and synthesised using thematic synthesis.Inclusion and synthesis of 101 out of 2303 international papers produced four descriptive themes: 1) widespread effects of breathlessness; 2) coping; 3) help-seeking behaviour; and 4) clinicians' responsiveness to the symptom of breathlessness. The themes were combined to form the concept of "breathing space", to show how engaged coping and appropriate help-seeking (patient) and attention to symptom (clinician) helps maximise the patient's quality of living with breathlessness.Breathlessness has widespread impact on both patient and carer and affects breathing space. The degree of breathing space is influenced by interaction between the patient's coping style, their help-seeking behaviour and their clinician's responsiveness to breathlessness itself, in addition to managing the underlying disease.
Collapse
|