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Fu Y, Li S, Huang L, Liu D, Wang H, Zuo F, Zhou C, Liu Y, Lin M. The mediating effect of perceived social support between family resilience and meaning in life in breast cancer patients. Support Care Cancer 2024; 32:425. [PMID: 38864918 DOI: 10.1007/s00520-024-08605-0] [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: 12/29/2023] [Accepted: 05/24/2024] [Indexed: 06/13/2024]
Abstract
PURPOSE The beneficial effects of family resilience and meaning in life on patients are established, but limited is known for the effect of perceived social support. We aim to investigate the impact of family resilience on the meaning of life among Chinese patients with breast cancer (BC) and to further detect whether perceived social support mediated this association. METHODS From February to June 2022, we conducted this cross-sectional study with 276 women who were diagnosed with BC in a tertial hospital in Guangdong province, China. The Chinese version of Meaning in Life Scale (C-MiLS) was used to measure the meaning in life. The Chinese version of the family resilience assessment scale (C-FRAS) and the perceived social support scale (PSSS) were adopted to obtain the family resilience and perceived social support, respectively. The mediating effect of perceived spousal support was estimated using the bootstrapped confidence interval (CI) via IBM SPSS AMOS 22.0. RESULTS The mean scores were 60.79 ± 11.63 for meaning in life, 82.08 ± 11.48 for family resilience, and 62.72 ± 12.19 for perceived social support, respectively. Our results indicated the positive correlations of meaning in life with family resilience (β = 0.822, P < 0.05) and perceived social support (β = 0.886, P < 0.05). The perceived social support exerted the mediating effect in the relationship between family resilience and meaning in life (β = 0.368 [95%CI, 0.274, 0.450], P < 0.001), accounting for 54.6% of the variance in meaning in life. CONCLUSIONS Our findings highlight that family resilience and perceived social support should be enhanced for BC patients to improve their meaning in life. In particular, the association between family resilience and meaning in life was positively mediated by perceived social support. Thus, interventions for improving family resilience and perceived social support might be useful in easing psychological distress and improving meaning in life in individuals with BC.
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Affiliation(s)
- Youyuan Fu
- Department of Breast Oncology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, 510120, China
| | - Siyi Li
- Department of Urology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, 510120, China
| | - Limei Huang
- Department of Breast Oncology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, 510120, China
| | - Dan Liu
- Department of Breast Oncology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, 510120, China
| | - Huixin Wang
- Department of Breast Oncology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, 510120, China
| | - Fengjiao Zuo
- Department of Breast Oncology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, 510120, China
| | - Chunjiao Zhou
- Nursing Department, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), No.111, Dade Road, Yuexiu District, Guangzhou, 510120, China
| | - Yangchen Liu
- Nursing Department, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), No.111, Dade Road, Yuexiu District, Guangzhou, 510120, China
| | - Meizhen Lin
- Nursing Department, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), No.111, Dade Road, Yuexiu District, Guangzhou, 510120, China.
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Mollaei F, Sharif Nia H, Pouralizadeh M, Karkhah S, Javadi-Pashaki N, Ghorbani Vajargah P. Resilience and related factors in caregivers of adult cancer patients: a systematic review. Ann Med Surg (Lond) 2024; 86:3451-3459. [PMID: 38846864 PMCID: PMC11152843 DOI: 10.1097/ms9.0000000000001469] [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: 07/31/2023] [Accepted: 10/24/2023] [Indexed: 06/09/2024] Open
Abstract
Background This systematic review aimed to investigate resilience and its related factors in caregivers of adult patients with cancer. Materials and methods A systematic search of online electronic databases including Scopus, PubMed, Web of Science, Iranmedex, and Scientific Information Database (SID) was performed using keywords extracted from Medical Subject Headings such as "Psychological Resilience", "Caregiver", and "Cancer" from the earliest to 6 June 2023. The quality of the studies included in this review was evaluated using the appraisal tool for cross-sectional studies (AXIS tool). Results A total of 2735 caregivers of cancer patients participated in 15 studies. The majority of the studies found that caregivers of cancer patients had high levels of resilience. Factors related to the resilience of cancer patients' caregivers included caregivers' social support, caregivers' quality of life, patients' resilience, caregivers' family function, patients' performance, caregivers' age, caregivers' health status, caregivers' self-esteem, caregivers post-traumatic growth, caregivers religious, caregivers hope, caregivers positive affect, patients age, patients social support, patients resilience support, patients quality of life, caregivers' anxiety, caregivers' depression, caregivers' burden, caregivers level of education, caregivers financial problem, caregivers memory, caregivers negative affect, caregivers post-traumatic stress disorder, maternal distress, and patients post-traumatic stress disorder. Conclusion Therefore, healthcare administrators and policymakers can enhance the resilience of caregivers and the quality of care they provide by instituting ongoing training initiatives focused on evaluating mental well-being and implementing coping strategies for managing stress and depression.
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Affiliation(s)
- Fereshteh Mollaei
- Department of Nursing, Shahid Beheshti School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Hamid Sharif Nia
- Psychosomatic Research Center, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Nursing, Amol School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
| | - Moluk Pouralizadeh
- Department of Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Samad Karkhah
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
- Burn and Regenerative Medicine Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Nazila Javadi-Pashaki
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
- Social Determinants of Health Research Center (SDHRC), Guilan University of Medical Sciences, Rasht, Iran
| | - Pooyan Ghorbani Vajargah
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
- Burn and Regenerative Medicine Research Center, Guilan University of Medical Sciences, Rasht, Iran
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Gao C, Li M, Guo L, Duan H, Zhang P, Ding Y. Developing a conceptual model for understanding caregiving experience and their impacts on quality of life for Chinese breast cancer family caregivers: A qualitative study. Nurs Open 2024; 11:e2139. [PMID: 38488440 PMCID: PMC10941575 DOI: 10.1002/nop2.2139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 02/16/2024] [Accepted: 02/23/2024] [Indexed: 03/18/2024] Open
Abstract
AIM The purpose of this study was to understand the caregiving experiences of breast cancer family caregivers and explore the profound impacts of those experiences on their quality of life. DESIGN A qualitative research method was used. METHODS We extended invitations to 23 family caregivers of outpatients and inpatients receiving breast surgery and oncology treatments in Taiyuan, China, to participate in semi-structured interviews. The interviews were audio-recorded and transcribed verbatim. Thematic analysis was employed to analyse the interview data. RESULTS Four themes and associated categories were identified: (1) changes in family dynamics, (2) the socio-medical context, (3) interactions between family and society, (4) self-efficacy and nine subthemes and their related categories, where virtually all participants expressed future uncertainty, emotional contagion, and personal challenges, and self-efficacy had a moderating influence on the first three themes. PATIENT OR PUBLIC CONTRIBUTION This study did not involve direct participation of patients or the public. However, their experiences and perspectives on caregiving were indirectly reflected through the insights provided by the family caregivers who participated in the interviews. Their valuable input contributed to a deeper understanding of the caregiving experience and its impact on the quality of life for Chinese breast cancer family caregivers.
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Affiliation(s)
- Chaoyue Gao
- School of nursingShanxi Medical UniversityTaiyuanChina
| | - Min Li
- School of nursingShanxi Medical UniversityTaiyuanChina
| | - Linfang Guo
- School of nursingShanxi Medical UniversityTaiyuanChina
| | - Haoran Duan
- The Second Affiliated Hospital Zhejiang University School of MedicineHangzhouChina
| | - Peili Zhang
- First Hospital of Shanxi Medical universityTaiyuanChina
| | - Yongxia Ding
- School of nursingShanxi Medical UniversityTaiyuanChina
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Tao L, Ma X, Yang Y, Hu X, Fu L, Li J. Investigating fear of cancer recurrence among female breast cancer survivors and their spouses in southwest China: a cross-sectional study. BMJ Open 2024; 14:e077964. [PMID: 38331853 PMCID: PMC10860109 DOI: 10.1136/bmjopen-2023-077964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 01/25/2024] [Indexed: 02/10/2024] Open
Abstract
OBJECTIVES Examining fear of cancer recurrence (FCR) among breast cancer survivors and their spouses, and the protective effect of family resilience on FCR among couples affected by breast cancer. DESIGN Cross-sectional survey design. SETTING Ten general grade IIIa (>500 beds) hospitals in southwest China. PARTICIPANTS Overall, 392 early breast cancer survivors and their spousal caregivers (N=392) were recruited from cancer centres in hospitals. PRIMARY AND SECONDARY OUTCOME MEASURES Spouses' and survivors' FCR were the primary outcome measures. Family resilience and perceived stress were the secondary outcome measures. Using a convenience sampling method, we collected data on-site using paper questionnaires. The Chinese version of the Family Resilience Assessment Scale, Perceived Stress Scale, Fear of Progression Questionnaire Short Form and Fear of Progression Questionnaire-Short Form for spouses were used to evaluate the outcomes. RESULTS The model accounted for 66.3% and 53.6% of the variance in spouses' FCR and survivors' FCR, respectively. Family resilience directly negatively affected perceived stress and spouses' and survivors' FCR (β=-0.22; β=-0.13; β=-0.19). Perceived stress was a partial mediator of the association between family resilience and survivors' FCR (β=-0.070; 95% CI :-0.151 to -0.022). Spouses' FCR partially mediated the association between family resilience and survivors' FCR (β=-0.048; 95% CI= -0.092 to -0.015). Perceived stress and spouses' FCR played a significant chain-mediated role between family resilience and survivors' FCR (β=-0.061; 95% CI: -0.119 to -0.022). CONCLUSIONS Family-centred approaches to reducing survivors' perceived stress can improve the psychological well-being of couples affected by breast cancer and ultimately reduce FCR. Medical staff should consider the psychological feelings of survivors and their spousal caregivers when devising the intervention plan, which should address the families' potential and mobilise family and community resources for increasing family resilience.
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Affiliation(s)
- Lin Tao
- Cancer Day-Care Unit, Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University/ West China School of Nursing, Sichuan University, Chengdu, China
| | - Xiaolin Ma
- Cancer Day-Care Unit, Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University/ West China School of Nursing, Sichuan University, Chengdu, China
| | - Ying Yang
- Cancer Day-Care Unit, Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University/ West China School of Nursing, Sichuan University, Chengdu, China
| | - Xiaoxia Hu
- Division of Breast Surgery, Department of General Surgery, West China Hospital, Sichuan University, Breast Center,West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Lan Fu
- Division of Breast Surgery, Department of General Surgery, West China Hospital, Sichuan University, Breast Center,West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Junying Li
- Thoracic Oncology Ward, Cancer Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
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Zhang Y, Li J, Zhang Y, Chen C, Guan C, Zhou L, Zhang S, Chen X, Hu X. Mediating effect of social support between caregiver burden and quality of life among family caregivers of cancer patients in palliative care units. Eur J Oncol Nurs 2024; 68:102509. [PMID: 38310666 DOI: 10.1016/j.ejon.2024.102509] [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: 04/13/2023] [Revised: 11/29/2023] [Accepted: 01/09/2024] [Indexed: 02/06/2024]
Abstract
PURPOSE To identify factors influencing the quality of life of family caregivers with terminal cancer in Chinese palliative wards and to test whether social support mediates the relationship between caregiver burden and caregiver quality of life. METHODS A cross-sectional study design was used. Sociodemographic data were collected and the Quality of Life Scale, the Caregiver Burden Scale, and the Social Support Rating Scale were administered to Chinese family caregivers from December 2021 to December 2022. The factors influencing quality of life and caregiver burden were examined using the Mann‒Whitney U test and the Kruskal‒Wallis H test. The mediating role of social support was assessed using the bootstrap method. RESULTS Family caregivers' quality of life in Chinese terminal cancer palliative units was related to caregivers' daily care time, the caregiver-patient relationship, and patient age. Caregiver quality of life was negatively associated with caregiver burden and positively associated with social support. In addition, social support mediated the relationship between caregiver burden and caregiver quality of life. CONCLUSION Social support mediated the impact of caregiver burden on caregiver quality of life. Family, society, and palliative care institutions should be integrated to take actions to reduce family caregiver burden, increase social support, and transfer the positive aspects of specific cultural contexts to the culture of palliative care in general to collaboratively cope with various problems related to end-stage cancer.
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Affiliation(s)
- Yun Zhang
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chendu, Sichuan, PR China
| | - Juejin Li
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chendu, Sichuan, PR China
| | - Yalin Zhang
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chendu, Sichuan, PR China
| | - Chongcheng Chen
- Department of Nephrology, West China Hospital, Sichuan University, Chendu, Sichuan, PR China
| | - Chang Guan
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chendu, Sichuan, PR China
| | - Lin Zhou
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chendu, Sichuan, PR China
| | - Shu Zhang
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chendu, Sichuan, PR China
| | - Xiaoli Chen
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chendu, Sichuan, PR China
| | - Xiaolin Hu
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chendu, Sichuan, PR China; Tianfu Jincheng Laboratory, City of Future Medicine, Chengdu, Sichuan, PR China.
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Bahrami M, Nasiri A. Behind the scenes of caregiving in patients with advanced cancer: A qualitative study on family caregivers. Asia Pac J Oncol Nurs 2024; 11:100330. [PMID: 38179137 PMCID: PMC10764250 DOI: 10.1016/j.apjon.2023.100330] [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: 09/20/2023] [Accepted: 10/23/2023] [Indexed: 01/06/2024] Open
Abstract
Objective Family caregivers may have concerns that they do not want to disclose to others. This study aims to delve into the concealed facets of care provided by family caregivers to patients with advanced cancer. Methods A qualitative approach was conducted in Iran from June 2022 to February 2023. Face-to-face, in-depth semi-structured interviews were carried out with 16 Iranian family caregivers of patients with advanced cancer, employing purposive sampling. The gathered data were analyzed using conventional content analysis, and Lincoln and Guba's criteria for rigor were applied to ensure the study's trustworthiness. Results The analysis of the data resulted in the identification of three main themes with nine subthemes. The key themes derived from the experiences of family caregivers encompassed (1) chaotic mentalities, (2) troubling interdependence, and (3) desperational emotions. Conclusions Caregivers of patients with advanced cancer commonly experience a highly fragile psychological state and are profoundly impacted by their concerns for the patient. Healthcare systems should prioritize ensuring that caregivers receive sufficient support and care.
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Affiliation(s)
- Mahnaz Bahrami
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran
| | - Ahmad Nasiri
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Birjand University of Medical Sciences, Birjand, Iran
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Mohammadian B, Mohammadi-Shahboulaghi F, Hosseini M, Arsalani N, Fallahi-Khoshknab M, Pirjani P. Factors influencing support provision to the family caregivers of elderly patients with cancer: A qualitative study. Eur J Oncol Nurs 2023; 67:102452. [PMID: 37883906 DOI: 10.1016/j.ejon.2023.102452] [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: 04/28/2023] [Revised: 10/11/2023] [Accepted: 10/15/2023] [Indexed: 10/28/2023]
Abstract
PURPOSE Family caregivers (FCs) play a significant role in providing care to elderly patients with cancer (PWC). Meanwhile, they face a wide range of challenges and are considered hidden patients who require special attention and support. Nonetheless, they do not receive adequate support. This study aimed at exploring the factors influencing support provision to the FCs of elderly PWC. METHOD This descriptive qualitative study was conducted in 2020-2022. Thirty-one FCs and family members of elderly PWC and healthcare providers were purposefully recruited from various healthcare centers in Tehran, Iran. Data were collected through semi-structured interviews and analyzed using Graneheim and Lundman's conventional content analysis approach. Trustworthiness was ensured through Lincoln and Guba's criteria. RESULTS Factors influencing support provision to the FCs of elderly PWC came into three main categories, namely the potential for supporting elderly PWC and FCs, complexity of family and social support, and support-related challenges of the healthcare system. CONCLUSIONS Identifying the factors influencing support provision to the FCs of elderly PWC can assist healthcare policymakers and authorities in developing more effective strategies to support these groups.
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Affiliation(s)
- Batol Mohammadian
- Nursing Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | - Farahnaz Mohammadi-Shahboulaghi
- Iranian Research Center on Aging, Nursing Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | - Mohammadali Hosseini
- Nursing Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | - Narges Arsalani
- Iranian Research Center on Aging, Nursing Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | | | - Pooneh Pirjani
- Iranian Cancer Control Center, Iran University of Medical Sciences, Tehran, Iran.
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Yu J, Wang Y, Wang H, Li S, Zhou M, Xu J, Lin Z. Association between eHealth literacy, diabetic behavior rating, and burden among caregivers of children with type 1 diabetes: Cross-sectional survey study. J Pediatr Nurs 2023; 73:1-6. [PMID: 37597400 DOI: 10.1016/j.pedn.2023.08.012] [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] [Received: 06/04/2023] [Revised: 08/09/2023] [Accepted: 08/10/2023] [Indexed: 08/21/2023]
Abstract
OBJECTIVE The purpose of this study was to clarify the relationship between eHealth literacy, diabetic behavior rating, and caregiving burden among caregivers of children with type 1 diabetes mellitus (T1DM). METHODS A questionnaire-based cross-sectional study of 143 primary caregivers of T1DM was conducted. Electronic health literacy was quantified using the Chinese version of the eHealth Literacy Scale (eHEALS). Their diabetic management behavior rating and caregiving burden were measured by Diabetes Behavior Rating Scale-Parent Version (DBRS-P) and Zarit Burden Interview (ZBI), respectively. Pearson correlation analysis was used to estimate the relationship between the above variables. RESULTS Only 54 (37.76%) caregivers qualified by eHEALS scale, with a total score of 30.07 ± 4.54 out of 40. A positive correlation between DRBS-P scores and the scores of eHEALS (Pearson correlation coefficient r = 0.226, P = 0.007) and a negative correlation between ZBI and eHEALS scores (r = -0.166, P = 0.047) were observed. CONCLUSIONS The eHealth literacy level of caregivers of children with T1DM in China remains to be improved. Caregivers with higher eHealth literacy had better diabetic management behaviors and less caregiving burden. IMPLICATIONS TO PRACTICE This study suggests that hierarchical electronic health-based interventions should be designed according to the different levels of eHealth literacy of individuals, to enhance the ability of caregivers with different eHealth literacy levels to fully utilize eHealth resources to improve their daily disease management skills and reduce their burden when caring for T1DM children. In addition, improving eHealth literacy of caregivers for children with T1DM can be one of the important ways to enhance the effectiveness of electronic health-based programs designed for them.
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Affiliation(s)
- Jian Yu
- Department of Endocrinology, The First Affiliated Hospital with Nanjing Medical University (Jiangsu Province Hospital), Jiangsu, China
| | - Yubing Wang
- Department of Endocrinology, Children's Hospital of Nanjing Medical University, Jiangsu, China
| | - Hong Wang
- Department of Endocrinology, The First Affiliated Hospital with Nanjing Medical University (Jiangsu Province Hospital), Jiangsu, China
| | - Sha Li
- School of Nursing, Nanjing Medical University, Jiangsu, China
| | - Meijing Zhou
- Department of Endocrinology, The First Affiliated Hospital with Nanjing Medical University (Jiangsu Province Hospital), Jiangsu, China
| | - Jingjing Xu
- Department of Endocrinology, The First Affiliated Hospital with Nanjing Medical University (Jiangsu Province Hospital), Jiangsu, China
| | - Zheng Lin
- School of Nursing, Nanjing Medical University, Jiangsu, China; Department of Nursing, The First Affiliated Hospital with Nanjing Medical University (Jiangsu Province Hospital), Jiangsu, China.
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Chen X, Qiao C, Arber A, Shen Y, Rui Y, Zhang R, Pei Z, Tang Y, Sha Z, Bao J, Zhang J, Li J, Wang D, Wang X. Enhancing resilient coping strategies for quality of life in Chinese adult children caregiving for parents with advanced cancer: a cross-sectional study. Support Care Cancer 2023; 31:591. [PMID: 37749433 PMCID: PMC10520155 DOI: 10.1007/s00520-023-08057-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 09/19/2023] [Indexed: 09/27/2023]
Abstract
PURPOSE This study investigated the mediating role of individual resilience in the relationship between caregiver burden and quality of life (QoL) among Chinese adult children providing care to their parents with advanced cancer, with the aim to inform effective coping strategies and positive caregiving outcomes. METHODS In a cross-sectional design, 614 caregivers from multiple centers, whose parents were undergoing chemotherapy and/or radiotherapy, completed questionnaires encompassing demographics, caregiver burden, symptoms of anxiety and depression, resilience, and QoL. RESULTS Findings revealed a moderate level of caregiver burden among participants, significantly influenced by factors including education level, family income, single-child status, and participation in social media patient support groups. Caregivers who were only children or involved in patient support groups reported higher burden. Importantly, path analysis showed a significant impact of caregiver burden, anxiety, and depression on QoL, with these relationships being mediated by individual resilience. CONCLUSIONS Chinese adult child caregivers face a considerable burden, negatively influencing their QoL. Individual resilience, a modifiable factor, was identified as a critical mediator in this relationship, mitigating the negative implications of caregiver burden, anxiety, and depression. These findings underscore the need for caregiver interventions that consider not only demographics but also the socio-psychological dynamics of caregiving to enhance caregiver QoL.
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Affiliation(s)
- Xian Chen
- Gynaecology Department, Women's Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), Nanjing, People's Republic of China
| | - Chengping Qiao
- Gynaecology Department, Women's Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), Nanjing, People's Republic of China
| | - Anne Arber
- School of Health Sciences, Faculty of Health and Medical Sciences, The University of Surrey, Guildford, UK
| | - Yan Shen
- Interventional Radiology Department, The First Affiliated Hospital With Nanjing Medical University, Nanjing, People's Republic of China
| | - Yehao Rui
- Oncology Department, Zhongda Hospital Southeast University, Nanjing, People's Republic of China
| | - Rui Zhang
- Oncology Department, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, People's Republic of China
| | - Zhongling Pei
- Interventional Radiology Department, The First Affiliated Hospital With Nanjing Medical University, Nanjing, People's Republic of China
| | - Yuanyuan Tang
- Radiotherapy Department, The First Affiliated Hospital With Nanjing Medical University, Nanjing, People's Republic of China
| | - Ziyu Sha
- Oncology Department, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, People's Republic of China
| | - Jianying Bao
- Interventional Radiology Department, The First Affiliated Hospital With Nanjing Medical University, Nanjing, People's Republic of China
| | - Jia Zhang
- Oncology Department, The First Affiliated Hospital With Nanjing Medical University, Nanjing, People's Republic of China
| | - Jinhua Li
- Geriatric Oncology Department, The First Affiliated Hospital With Nanjing Medical University, Nanjing, People's Republic of China
| | - Dan Wang
- Oncology Department, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, People's Republic of China.
| | - Xuemei Wang
- Interventional Radiology Department, The First Affiliated Hospital With Nanjing Medical University, Nanjing, People's Republic of China.
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Liu Q, Zhang L, Xiang X, Mao X, Lin Y, Li J, Cui W. The influence of social alienation on maintenance hemodialysis patients' coping styles: chain mediating effects of family resilience and caregiver burden. Front Psychiatry 2023; 14:1105334. [PMID: 37457762 PMCID: PMC10342202 DOI: 10.3389/fpsyt.2023.1105334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 06/12/2023] [Indexed: 07/18/2023] Open
Abstract
Objective Research on the possible impact of social alienation, family resilience, and caregiver burden on the coping styles of Chinese patients on maintenance hemodialysis (MHD) is scarce. We explore the influence of social alienation, family resilience, and caregiver burden on the coping styles of MHD patients, both directly and indirectly. Methods We invited 173 MHD patients and their primary caregivers for a cross-sectional study; the study using convenience sampling method at the hemodialysis center of the First People's Hospital of Foshan. The Chinese version of the generalized social of alienation scale, the Chinese version of the simplified coping style questionnaire, and a sociodemographic questionnaire were completed by the MHD patients, while their primary caregivers had filled out the Chinese family resilience assessment scale, the Chinese version of the Zarit caregiver burden interview, and provided socio-demographic information. SPSS macro program PROCESS v3.3 Model 6 were used for analyses of chain-mediated effects. Results In the mediating effects model, the direct influence of social alienation upon coping styles was significant (95% CI -0.050, -0.014), and social alienation indirectly impacted coping style by family resilience in a significant way (95% CI -0.012, -0.001) or caregiver burden (95% CI -0.013, -0.001). In addition, social alienation significantly impacted coping style by both family resilience and caregiver burden (95% CI -0.008, -0.001). Conclusion Social alienation can exert both a direct and indirect influence on coping styles through the mediating factors of family resilience and caregiver burden. Clinicians can take interventions to strengthen family resilience and reduce caregiver burden, which may be useful in improving socially isolated behaviors and coping skills in MHD patients.
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Affiliation(s)
- Qiaoling Liu
- School of Nursing, College of Medicine, Shantou University, Shantou, China
| | - Li Zhang
- Department of Office, First People’s Hospital of Foshan, Foshan, China
| | - Xia Xiang
- Department of Nursing, First People’s Hospital of Foshan, Foshan, China
| | - Xiaoying Mao
- Department of Office, First People’s Hospital of Foshan, Foshan, China
| | - Ying Lin
- School of Nursing, College of Medicine, Shantou University, Shantou, China
| | - Jingfeng Li
- Hemodialysis Center, First People‘s Hospital of Foshan, Foshan, China
| | - Wen Cui
- College of Nursing, Zunyi Medical University, Zhuhai, China
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Adler Jaffe S, Jacobson K, Farnbach Pearson AW, Baca LA, Dimauro N, Kano M. "Did I get into the twilight zone somehow?": sexual and gender minority cancer caregiver experiences during COVID. Cancer Causes Control 2023; 34:563-568. [PMID: 37145262 PMCID: PMC10161178 DOI: 10.1007/s10552-023-01708-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 04/20/2023] [Indexed: 05/06/2023]
Abstract
INTRODUCTION The COVID-19 pandemic created new challenges for cancer patients and caregivers. Little is known about the confluence of the pandemic and people with multiple marginalized identities, such as those in the Sexual and Gender Minority (SGM) community. METHODS We conducted a mixed-methods pilot study using semi-structured interviews to elicit experiences of cancer among a diverse population of SGM patients and caregivers and a matched set of cisgender heterosexual (cishet) individuals. Here, we present qualitative findings focused on caregiver experiences as ascertained from the broader study. RESULTS We discovered differences between SGM and cishet caregiving experiences, with SGM caregivers reporting less comfort in the cancer center environment; dissatisfaction with patient-provider communication; feeling excluded from their loved ones' care; and increased social isolation resulting from the caregiver experience. SGM and cishet caregivers described the detrimental impact of the pandemic. CONCLUSION Our data suggest SGM caregivers experience additional burdens to cancer caregiving when compared to cishet peers. Although SGM and cishet caregivers reported challenges stemming from the COVID-19 pandemic, challenges appeared greater and more acute for SGM caregivers. Pandemic-related findings point to overall gaps in SGM cancer caregiver supports that may be remedied by additional research and targeted intervention development.
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Affiliation(s)
- Shoshana Adler Jaffe
- University of New Mexico Comprehensive Cancer Center, 2325 Camino de Salud, Albuquerque, NM, 87131, USA.
| | - Kendal Jacobson
- University of New Mexico Comprehensive Cancer Center, 2325 Camino de Salud, Albuquerque, NM, 87131, USA
| | - Amy W Farnbach Pearson
- University of New Mexico Comprehensive Cancer Center, 2325 Camino de Salud, Albuquerque, NM, 87131, USA
| | - Lila A Baca
- University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Nina Dimauro
- University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Miria Kano
- University of New Mexico Comprehensive Cancer Center, 2325 Camino de Salud, Albuquerque, NM, 87131, USA
- University of New Mexico School of Medicine, Albuquerque, NM, USA
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Zhang Y, Ding Y, Liu C, Li J, Wang Q, Li Y, Hu X. Relationships Among Perceived Social Support, Family Resilience, and Caregiver Burden in Lung Cancer Families: A Mediating Model. Semin Oncol Nurs 2022:151356. [DOI: 10.1016/j.soncn.2022.151356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 10/12/2022] [Indexed: 11/13/2022]
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