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Ellis KR, Furgal A, Wayas F, Contreras A, Jones C, Perez S, Raji D, Smith M, Vincent C, Song L, Northouse L, Langford AT. Symptom burden and quality of life among patient and family caregiver dyads in advanced cancer. Qual Life Res 2024:10.1007/s11136-024-03743-8. [PMID: 39046614 DOI: 10.1007/s11136-024-03743-8] [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] [Accepted: 07/16/2024] [Indexed: 07/25/2024]
Abstract
PURPOSE Symptom management among patients diagnosed with advanced cancer is a high priority in clinical care that often involves the support of a family caregiver. However, limited studies have examined parallel patient and caregiver symptom burden and associations with their own and each other's quality of life (QOL). This study seeks to identify patient and caregiver symptom clusters and investigate associations between identified clusters and demographic, clinical, and psychosocial factors (cognitive appraisals and QOL). METHODS This study was a secondary analysis of self-reported baseline survey data collected from a randomized clinical trial of 484 adult advanced cancer patients and their caregivers. Latent class analysis and factor analysis were used to identify symptom clusters. Bivariate statistics tested associations between symptom clusters and demographic, clinical, and psychosocial variables. RESULTS The most prevalent symptom for patients was energy loss/fatigue and for caregivers, mental distress. Low, moderate, and high symptom burden subgroups were identified at the patient, caregiver, and dyad level. Age, gender, race, income, chronic conditions, cancer type, and treatment type were associated with symptom burden subgroups. Higher symptom burden was associated with more negative appraisals of the cancer and caregiving experience, and poorer QOL (physical, social, emotional, functional, and overall QOL). Dyads whose caregivers had more chronic conditions were more likely to be in the high symptom burden subgroup. CONCLUSION Patient and caregiver symptom burden influence their own and each other's QOL. These findings reinforce the need to approach symptom management from a dyadic perspective.
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Affiliation(s)
- Katrina R Ellis
- School of Social Work, University of Michigan, 1080 South University Avenue, Ann Arbor, MI, 48109, USA.
- School of Public Health, University of Michigan, Ann Arbor, MI, USA.
- Research Center for Group Dynamics, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA.
| | - Allison Furgal
- School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Feyisayo Wayas
- School of Social Work, University of Michigan, 1080 South University Avenue, Ann Arbor, MI, 48109, USA
- Research Centre for Health Through Physical Activity, Lifestyle and Sport (HPALS), Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Alexis Contreras
- School of Social Work, University of Michigan, 1080 South University Avenue, Ann Arbor, MI, 48109, USA
| | - Carly Jones
- Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Sierra Perez
- School of Social Work, University of Michigan, 1080 South University Avenue, Ann Arbor, MI, 48109, USA
| | - Dolapo Raji
- School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Madeline Smith
- School of Social Work, University of Michigan, 1080 South University Avenue, Ann Arbor, MI, 48109, USA
| | - Charlotte Vincent
- School of Social Work, University of Michigan, 1080 South University Avenue, Ann Arbor, MI, 48109, USA
| | - Lixin Song
- University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
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Bachman SL, Gomes E, Aryal S, Cella D, Clay I, Lyden K, Leach HJ. Do Measures of Real-World Physical Behavior Provide Insights Into the Well-Being and Physical Function of Cancer Survivors? Cross-Sectional Analysis. JMIR Cancer 2024; 10:e53180. [PMID: 39008350 DOI: 10.2196/53180] [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: 09/28/2023] [Revised: 02/26/2024] [Accepted: 04/24/2024] [Indexed: 07/16/2024] Open
Abstract
BACKGROUND As the number of cancer survivors increases, maintaining health-related quality of life in cancer survivorship is a priority. This necessitates accurate and reliable methods to assess how cancer survivors are feeling and functioning. Real-world digital measures derived from wearable sensors offer potential for monitoring well-being and physical function in cancer survivorship, but questions surrounding the clinical utility of these measures remain to be answered. OBJECTIVE In this secondary analysis, we used 2 existing data sets to examine how measures of real-world physical behavior, captured with a wearable accelerometer, were related to aerobic fitness and self-reported well-being and physical function in a sample of individuals who had completed cancer treatment. METHODS Overall, 86 disease-free cancer survivors aged 21-85 years completed self-report assessments of well-being and physical function, as well as a submaximal exercise test that was used to estimate their aerobic fitness, quantified as predicted submaximal oxygen uptake (VO2). A thigh-worn accelerometer was used to monitor participants' real-world physical behavior for 7 days. Accelerometry data were used to calculate average values of the following measures of physical behavior: sedentary time, step counts, time in light and moderate to vigorous physical activity, time and weighted median cadence in stepping bouts over 1 minute, and peak 30-second cadence. RESULTS Spearman correlation analyses indicated that 6 (86%) of the 7 accelerometry-derived measures of real-world physical behavior were not significantly correlated with Functional Assessment of Cancer Therapy-General total well-being or linked Patient-Reported Outcomes Measurement Information System-Physical Function scores (Ps≥.08). In contrast, all but one of the physical behavior measures were significantly correlated with submaximal VO2 (Ps≤.03). Comparing these associations using likelihood ratio tests, we found that step counts, time in stepping bouts over 1 minute, and time in moderate to vigorous activity were more strongly associated with submaximal VO2 than with self-reported well-being or physical function (Ps≤.03). In contrast, cadence in stepping bouts over 1 minute and peak 30-second cadence were not more associated with submaximal VO2 than with the self-reported measures (Ps≥.08). CONCLUSIONS In a sample of disease-free cancer survivors, we found that several measures of real-world physical behavior were more associated with aerobic fitness than with self-reported well-being and physical function. These results highlight the possibility that in individuals who have completed cancer treatment, measures of real-world physical behavior may provide additional information compared with self-reported and performance measures. To advance the appropriate use of digital measures in oncology clinical research, further research evaluating the clinical utility of real-world physical behavior over time in large, representative samples of cancer survivors is warranted. TRIAL REGISTRATION ClinicalTrials.gov NCT03781154; https://clinicaltrials.gov/ct2/show/NCT03781154.
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Affiliation(s)
| | - Emma Gomes
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, United States
| | | | - David Cella
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Ieuan Clay
- VivoSense, Inc, Newport Coast, CA, United States
| | - Kate Lyden
- VivoSense, Inc, Newport Coast, CA, United States
| | - Heather J Leach
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, United States
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Yan S, Fan W, Ma Y, Xie S, Li R, Lan Y, Xie L, Jing J. Pregnant Women's Dyadic Coping and Associated Factors: A Cross-Sectional Study Utilizing Latent Profile Analysis. Int J Womens Health 2024; 16:1009-1022. [PMID: 38835832 PMCID: PMC11149646 DOI: 10.2147/ijwh.s458763] [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: 01/09/2024] [Accepted: 05/11/2024] [Indexed: 06/06/2024] Open
Abstract
Background The problem of maternal mental health is a priority issue of global concern. Dyadic coping refers to the co-managing and making decisions between two parties in response to a joint stressful event. At present, china has limited focus on dyadic coping for pregnant women during pregnancy. This study aimed to investigate different categories and characteristics of dyadic coping in pregnant women throughout pregnancy and to analyze the factors that influence these categories. Methods This study was a cross-sectional, and 376 pregnant women who visited the obstetric clinic at a tertiary hospital in Sichuan province from June to September 2023 were interviewed face-to-face using convenience sampling. Data were collected using a sociodemographic questionnaire, dyadic coping scale, and family adaptability and cohesion evaluation scale. The data were imported into excel and exported to spss 27.0 to analyze the potential characteristics of pregnant women's dyadic coping during pregnancy and to explore the effects of this using univariate analysis and multifactorial logistic regression. Results A total of 376 valid questionnaires were collected. The results of the potential profile analysis showed that the dyadic coping of pregnant women during pregnancy could be categorized into three different groups: the "low coping group" (21.3%), the "general coping group" (67.5%), and the "high coping group" (11.2%). Multiple logistic regression analyses revealed that low monthly family income, early pregnancy, primipara, family adaptability and cohesion were the factors influencing the dyadic coping of pregnant women during pregnancy. Conclusion During pregnancy, pregnant women exhibit moderate levels of dyadic coping. Three different categories of dyadic coping patterns were exhibited: low coping group, general coping group, and high coping group, with significant heterogeneity. Therefore, there is a need to focus on the dyadic coping status of various categories of pregnant women and implement targeted couple and family-wide interventions.
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Affiliation(s)
- Shiqiong Yan
- College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, People's Republic of China
| | - Wenzhuo Fan
- Department of Nursing, Chengdu Women and Children's Central Hospital, Chengdu, Sichuan Province, People's Republic of China
| | - Yonghong Ma
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan Province, People's Republic of China
| | - Sijia Xie
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, People's Republic of China
| | - Rong Li
- Department of Nursing, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, People's Republic of China
| | - Yao Lan
- College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, People's Republic of China
| | - Linli Xie
- Department of Nursing, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, People's Republic of China
| | - Jie Jing
- Department of Nursing, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, People's Republic of China
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Chen M, Bolt G, Hooimeijer P. The impact of residential environment on older people's capabilities to live independently: a survey in Beijing. BMC Public Health 2024; 24:843. [PMID: 38500091 PMCID: PMC10949666 DOI: 10.1186/s12889-024-18262-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 03/03/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Studies have shown how environmental factors influence older people's health and functional limitations, which are crucial for achieving healthy aging. However, such a healthy aging model has been criticized for defining health as an absence of disease, because chronic conditions cannot be reversed through medical treatments. In response to such critiques, this study refers to Huber's positive health definition, arguing that health should not be defined as the absence of disease but as the ability to adapt and self-manage in the face of social, physical, and emotional challenges. There is a need to develop a community-based approach to healthy aging that considers how the residential environment enables older people to adapt and self-manage. Drawing on Sen's capability approach, this study proposes that such a community-based approach should provide a supportive environment to enable older people's capabilities to live independently. METHODS Using hierarchical multiple regression analysis of data from 650 older people (60 years and older) surveyed in Beijing, we unravel which features of the residential environment support older people' s capabilities to live independently and how these impacts differ depending on older people's frailty levels. RESULTS The results show that four environmental factors, namely perceived accessibility (B = 0.238, p < 0.001 for physical capability, B = 0.126, p < 0.001 for social capability, B = 0.195, p < 0.001 for psychological capability), pleasant surroundings (B = 0.079, p < 0.05 for physical capability, B = 0.065, p < 0.05 for social capability), meeting opportunities (B = 0.256, p < 0.001 for social capability, B = 0.188, p < 0,001 for psychological capability, and life convenience B = 0.089, p < 0.05 for physical capability, B = 0.153, p < 0.001 for psychological capability) positively affect older people's capabilities to live independently. These four environmental factors cause differences in older people's capabilities between different neighborhood types. Moderation analysis shows that meeting opportunities are more relevant for frail older people (B = 0.090, p < 0.001 for social capability, B = 0.086, p < 0.01 for psychological capability). CONCLUSIONS This study contributes to the literature by emphasizing the role of supportive residential environments in enabling older people to live independently. Furthermore, we identify four environmental factors that support older people's capabilities. Results can be used to develop effective community-based environmental support to enable older people to live independently.
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Affiliation(s)
- Mengyuan Chen
- Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Princetonlaan 8a, 3584CB, Utrecht, The Netherlands.
| | - Gideon Bolt
- Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Princetonlaan 8a, 3584CB, Utrecht, The Netherlands
| | - Pieter Hooimeijer
- Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Princetonlaan 8a, 3584CB, Utrecht, The Netherlands
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Yusufov M, Adeyemi O, Flannery M, Bouillon-Minois JB, Van Allen K, Cuthel AM, Goldfeld KS, Ouchi K, Grudzen CR. Psychometric Properties of the Functional Assessment of Cancer Therapy-General for Evaluating Quality of Life in Patients With Life-Limiting Illness in the Emergency Department. J Palliat Med 2024; 27:63-74. [PMID: 37672598 PMCID: PMC11074445 DOI: 10.1089/jpm.2022.0270] [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] [Accepted: 07/20/2023] [Indexed: 09/08/2023] Open
Abstract
Background: The Functional Assessment of Cancer Therapy-General (FACT-G) is a widely used quality-of-life measure. However, no studies have examined the FACT-G among patients with life-limiting illnesses who present to emergency departments (EDs). Objective: The goal of this study was to examine the psychometric properties of the FACT-G among patients with life-limiting illnesses who present to EDs in the United States. Methods: This cross-sectional study pooled data from 12 EDs between April 2018 and January 2020 (n = 453). Patients enrolled in the study were adults with one or more of the four life-limiting illnesses: advanced cancer, Congestive Heart Failure, Chronic Obstructive Pulmonary Disease, or End-Stage Renal Disease. We conducted item, exploratory, and confirmatory analyses (exploratory factor analysis [EFA] and confirmatory factor analysis [CFA]) to determine the psychometric properties of the FACT-G. Results: The FACT-G had good internal consistency (Cronbach's alpha α = 0.88). The simplest EFA model was a six-factor structure. The CFA supported the six-factor structure, evidenced by the adequate fit indices (comparative fit index = 0.93, Tucker-Lewis index = 0.92, root-mean-square error of approximation = 0.05; 90% confidence interval: 0.04 - 0.06). The six-factor structure comprised the physical, emotional, work and daily activities-related functional well-being, and the family and friends-related social well-being domains. Conclusions: The FACT-G is a reliable measure of health-related quality of life among patients with life-limiting illnesses who present to the ED. Clinical Trial Registration: NCT03325985.
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Affiliation(s)
- Miryam Yusufov
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Oluwaseun Adeyemi
- Ronald O. Perelman Department of Emergency Medicine, Division of Supportive and Acute Care Services, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Mara Flannery
- Ronald O. Perelman Department of Emergency Medicine, Division of Supportive and Acute Care Services, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | | | - Kaitlyn Van Allen
- Ronald O. Perelman Department of Emergency Medicine, Division of Supportive and Acute Care Services, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Allison M. Cuthel
- Ronald O. Perelman Department of Emergency Medicine, Division of Supportive and Acute Care Services, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Keith S. Goldfeld
- Department of Population Health, Division of Supportive and Acute Care Services, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Kei Ouchi
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Serious Illness Care Program, Ariadne Labs, Boston, Massachusetts, USA
| | - Corita R. Grudzen
- Ronald O. Perelman Department of Emergency Medicine, Division of Supportive and Acute Care Services, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of Population Health, Division of Supportive and Acute Care Services, Memorial Sloan Kettering Cancer Center, New York, New York, USA
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Xu S, Tan X, Ma C, McElyea RS, Shieh K, Stover AM, Smith A, Stitzenberg K, Basch E, Song L. An eHealth symptom and complication management program for cancer patients with newly created ostomies and their caregivers (Alliance): a pilot feasibility randomized trial. BMC Cancer 2023; 23:532. [PMID: 37301841 PMCID: PMC10257159 DOI: 10.1186/s12885-023-10919-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 05/04/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Cancer patients with newly created ostomies face complications that reduce quality of life (QOL) and increase morbidity and mortality. This proof-of-concept study examined the feasibility, usability, acceptability, and initial efficacy of an eHealth program titled the "Patient Reported Outcomes-Informed Symptom Management System" (PRISMS) during post-ostomy creation care transition. METHODS We conducted a 2-arm pilot randomized controlled trial among 23 patients who received surgical treatment with curative intent for bladder and colorectal cancer and their caregivers. After assessing QOL, general symptoms, and caregiver burden at baseline, participants were randomly assigned to PRISMS (n = 16 dyads) or usual care (UC) (n = 7 dyads). After a 60-day intervention period, participants completed a follow-up survey and post-exit interview. We used descriptive statistics and t-tests to analyze the data. RESULTS We achieved an 86.21% recruitment rate and a 73.91% retention rate. Among the PRISMS participants who used the system and biometric devices (n = 14, 87.50%), 46.43% used the devices for ≥ 50 days during the study period. Participants reported PRISMS as useful and acceptable. Compared to their UC counterparts, PRISMS patient social well-being scores decreased over time and had an increased trend of physical and emotional well-being; PRISMS caregivers experienced a greater decrease in caregiver burden. CONCLUSIONS PRISMS recruitment and retention rates were comparable to existing family-based intervention studies. PRISMS is a useful and acceptable multilevel intervention with the potential to improve the health outcomes of cancer patients needing ostomy care and their caregivers during post-surgery care transition. A sufficiently powered RCT is needed to test its effects. TRIAL REGISTRATION ClinicalTrial.gov ID: NCT04492007. Registration date: 30/07/2020.
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Affiliation(s)
- Shenmeng Xu
- School of Nursing, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Xianming Tan
- UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
| | - Chunxuan Ma
- School of Nursing, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Rebecca S McElyea
- School of Nursing, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Karl Shieh
- School of Nursing, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Angela M Stover
- UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
- Gillings School of Global Public Health, UNC-CH, Chapel Hill, NC, USA
| | - Angela Smith
- UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
- School of Medicine, UNC-CH, Chapel Hill, NC, USA
| | - Karyn Stitzenberg
- UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
- School of Medicine, UNC-CH, Chapel Hill, NC, USA
| | - Ethan Basch
- UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
- School of Medicine, UNC-CH, Chapel Hill, NC, USA
| | - Lixin Song
- School of Nursing, University of North Carolina, Chapel Hill, North Carolina, USA.
- UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA.
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Guan T, Chapman MV, de Saxe Zerden L, Sharma A, Chen DG, Song L. Correlates of illness uncertainty in cancer survivors and family caregivers: a systematic review and meta-analysis. Support Care Cancer 2023; 31:242. [PMID: 36977804 DOI: 10.1007/s00520-023-07705-7] [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: 11/01/2022] [Accepted: 03/22/2023] [Indexed: 03/30/2023]
Abstract
PURPOSE Illness uncertainty is widely recognized as a psychosocial stressor for cancer survivors and their family caregivers. This systematic review and meta-analysis aimed to identify the sociodemographic, physical, and psychosocial correlates that are associated with illness uncertainty in adult cancer survivors and their family caregivers. METHODS Six scholarly databases were searched. Data synthesis was based on Mishel's Uncertainty in Illness Theory. Person's r was used as the effect size metric in the meta-analysis. Risk of bias was assessed using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. RESULTS Of 1116 articles, 21 articles met the inclusion criteria. Of 21 reviewed studies, 18 focused on cancer survivors, one focused on family caregivers, and 2 included survivors and family caregivers. Findings identified distinct correlates for illness uncertainty in cancer survivors, including sociodemographic factors (e.g., age, gender, race), stimuli frame (e.g., symptom, family history of cancer), structure providers (e.g., education), coping, and adaptation. Notable effect sizes were observed in the correlations between illness uncertainty and social support, quality of life, depression, and anxiety. Caregivers' illness uncertainty was associated with their race, general health, perception of influence, social support, quality of life, and survivors' prostate-specific antigen levels. Insufficient data precluded examining effect size of correlates of illness uncertainty among family caregivers. CONCLUSION This is the first systematic review and meta-analysis to summarize the literature on illness uncertainty among adult cancer survivors and family caregivers. Findings contribute to the growing literature on managing illness uncertainty among cancer survivors and family caregivers.
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Affiliation(s)
- Ting Guan
- Syracuse University, School of Social Work, 226 White Hall, Syracuse, Syracuse, NY, 13244, USA.
| | - Mimi V Chapman
- University of North Carolina at Chapel Hill, School of Social Work, Chapel Hill, NC, USA
| | - Lisa de Saxe Zerden
- University of North Carolina at Chapel Hill, School of Social Work, Chapel Hill, NC, USA
| | - Anjalee Sharma
- School of Medicine Johns Hopkins University, Baltimore, MD, USA
| | - Ding-Geng Chen
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
- Department of Statistics, University of Pretoria, Pretoria, South Africa
| | - Lixin Song
- UT Health San Antonio, School of Nursing, San Antonio, TX, USA
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Renner S, Loussikian P, Foulquié P, Marrel A, Barbier V, Mebarki A, Schück S, Bharmal M. Patient and Caregiver Perceptions of Advanced Bladder Cancer Systemic Treatments: Infodemiology Study Based on Social Media Data. JMIR Cancer 2023; 9:e45011. [PMID: 36972135 PMCID: PMC10131927 DOI: 10.2196/45011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 03/01/2023] [Accepted: 03/02/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND In 2022, it was estimated that more than 80,000 new cases of bladder cancer (BC) were diagnosed in the United States, 12% of which were locally advanced or metastatic BC (advanced BC). These forms of cancer are aggressive and have a poor prognosis, with a 5-year survival rate of 7.7% for metastatic BC. Despite recent therapeutic advances for advanced BC, little is known about patient and caregiver perceptions of different systemic treatments. To further explore this topic, social media can be used to collect the perceptions of patients and caregivers when they discuss their experiences on forums and online communities. OBJECTIVE The aim of this study was to assess patient and caregiver perceptions of chemotherapy and immunotherapy for treating advanced BC from social media-posted data. METHODS Public posts on social media in the United States between January 2015 and April 2021 from patients with advanced BC and their caregivers were collected. The posts included in this analysis were geolocalized to the United States; collected from publicly available domains and sites, including social media sites such as Twitter and forums such as patient association forums; and were written in English. Posts mentioning any line of chemotherapy or immunotherapy were qualitatively analyzed by two researchers to classify perceptions of treatments (positive, negative, mixed, or without perception). RESULTS A total of 80 posts by 69 patients and 142 posts by 127 caregivers mentioning chemotherapy, and 42 posts by 31 patients and 35 posts by 32 caregivers mentioning immunotherapy were included for analysis. These posts were retrieved from 39 public social media sites. Among patients with advanced BC and their caregivers, treatment perceptions of chemotherapy were more negative (36%) than positive (7%). Most of the patients' posts (71%) mentioned chemotherapy factually without expressing a perception of the treatment. The caregivers' perceptions of treatment were negative in 44%, mixed in 8%, and positive in 7% of posts. In combined patient and caregiver posts, immunotherapy was perceived positively in 47% of posts and negatively in 22% of posts. Caregivers also posted more negative perceptions (37%) of immunotherapy than patients (9%). Negative perceptions of both chemotherapy and immunotherapy were mainly due to side effects and perceived lack of effectiveness. CONCLUSIONS Despite chemotherapy being standard first-line therapy for advanced BC, negative perceptions were identified on social media, particularly among caregivers. Addressing these negative perceptions of treatment may improve treatment adoption. Strengthening support for patients receiving chemotherapy and their caregivers to help them manage side effects and understand the role of chemotherapy in the treatment of advanced BC would potentially enable a more positive experience.
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Song L, Keyserling TC, Chen RC, Ma C, Xu S, Shieh K, Fuller GP, Nielsen ME, Northouse LL, Tan X, Rini C. Role, race, and place: Prostate cancer disparities in Patients' and Partners' health outcomes and psychosocial factors. Cancer Med 2023; 12:9857-9867. [PMID: 36748581 PMCID: PMC10166971 DOI: 10.1002/cam4.5646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 12/18/2022] [Accepted: 01/13/2023] [Indexed: 02/08/2023] Open
Abstract
PURPOSE This study aimed to examine the effects of participant role (patient vs. partner), race (white vs. non-white), and place (less vs. more neighborhood deprivation) on health outcomes (quality of life [QOL] and symptoms) and stress-coping-related psychosocial factors (appraisals of illness and coping resources). METHODS This descriptive study included 273 patients and their partners (dyads) who transitioned from PCa treatment to self-management. We used established, psychometrically sound measures to assess health outcomes and psychosocial factors and conducted multilevel modeling analyses. RESULTS Compared to partners, patients reported worse physical QOL; less frequent anxiety; less pain and fatigue; less bothersome hormonal problems; more bothersome urinary and sexual problems; greater self-efficacy; and more instrumental support. Compared to their white counterparts, non-white dyads reported better overall, emotional, and functional QOL; less depression; more positive appraisals, and greater self-efficacy. Compared to dyads in low ADI neighborhoods, dyads in high ADI (more deprived) neighborhoods reported worse social QOL; more bothersome urinary, sexual, and hormonal symptoms; and less interpersonal support. White patients reported the highest emotional support among all groups, while white partners reported the lowest emotional support. CONCLUSION Our findings underscore the need to consider social determinants of health at multiple levels when investigating PCa disparities. Considering neighborhood-level socioeconomic factors, in addition to race and role, improves our understanding of the PCa disparities in QOL, symptoms, and psychosocial factors among patients and partners. Targeted multilevel supportive care interventions should tailor to the needs of racially diverse PCa patients and partners residing in deprived neighborhoods are needed.
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Affiliation(s)
- Lixin Song
- School of Nursing, University of Texas Health Science Center at San Antonio (UTHSCSA), San Antonio, Texas, USA.,Mays Cancer Center, UTHSCSA, San Antonio, Texas, USA
| | - Thomas C Keyserling
- School of Medicine, University of North Carolina-Chapel Hill (UNC-CH), Chapel Hill, North Carolina, USA
| | - Ronald C Chen
- University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Chunxuan Ma
- School of Nursing, University of Texas Health Science Center at San Antonio (UTHSCSA), San Antonio, Texas, USA
| | - Shenmeng Xu
- Jean and Alexander Heard Libraries, Digital Scholarship and Communications, Vanderbilt University, Tennessee, Nashville, USA
| | - Karl Shieh
- School of Nursing, UNC-CH, Chapel Hill, North Carolina, USA
| | - Gail P Fuller
- School of Nursing, UNC-CH, Chapel Hill, North Carolina, USA
| | - Matthew E Nielsen
- School of Medicine, University of North Carolina-Chapel Hill (UNC-CH), Chapel Hill, North Carolina, USA.,Lineberger Comprehensive Cancer Center, UNC-CH, Chapel Hill, North Carolina, USA
| | | | - Xianming Tan
- Lineberger Comprehensive Cancer Center, UNC-CH, Chapel Hill, North Carolina, USA.,Gillings School of Global Public Health, UNC-CH, Chapel Hill, North Carolina, USA
| | - Christine Rini
- Cancer Survivorship Institute and Department of Medical Social Sciences, Northwestern University, Evanston, Illinois, USA
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10
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Walsh EA, Pedreira PB, Moreno PI, Popok PJ, Fox RS, Yanez B, Antoni MH, Penedo FJ. Pain, cancer-related distress, and physical and functional well-being among men with advanced prostate cancer. Support Care Cancer 2022; 31:28. [PMID: 36515785 PMCID: PMC9757851 DOI: 10.1007/s00520-022-07453-0] [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: 09/08/2022] [Accepted: 11/11/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE Men with advanced prostate cancer (APC) experience high levels of pain, which contribute to poor psychosocial and functional outcomes. Cancer-related distress explains the relationship between pain severity and interference, yet specificity of distress characteristics (e.g., hyperarousal, intrusive, or avoidant symptoms) in explaining associations between pain experiences and well-being has not been explored within APC. This study examined men with APC entering a clinical trial and tested associations of baseline pain, cancer-related distress, and physical and functional well-being. METHODS One hundred ninety men with APC enrolled in a randomized-controlled trial and were assessed prior to randomization. The McGill Pain Questionnaire assessed pain severity, and the Functional Assessment of Cancer Therapy-General captures physical and functional well-being. The Impact of Events Scale-Revised measured cancer-specific distress symptoms, including hyperarousal, avoidance, and intrusion symptoms. Controlling for age, cancer stage at diagnosis, income, education, and race/ethnicity, mediation models (SPSS PROCESS, model 4) tested whether cancer-specific distress accounted for the associations between pain severity and physical and functional well-being. RESULTS Men were on average 68 years of age, White non-Hispanic, with stage IV cancer. Pain severity was related to poorer physical (p < .001) and functional well-being (p < .001). Associations between pain severity and physical and functional well-being were partially mediated by greater intrusive and hyperarousal symptoms but not avoidant symptoms. CONCLUSION For men with APC, intrusive and hyperarousal symptoms may partially explain the relationship between pain severity and decrements in physical and functional well-being. APC pain management should attend to such distress symptoms, which may contribute to interference if left unaddressed. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03149185.
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Affiliation(s)
- Emily A Walsh
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | | | - Patricia I Moreno
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA
| | - Paula J Popok
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Rina S Fox
- College of Nursing, University of Arizona, Tucson, AZ, USA
| | - Betina Yanez
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Michael H Antoni
- Department of Psychology, University of Miami, Coral Gables, FL, USA
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA
| | - Frank J Penedo
- Department of Psychology, University of Miami, Coral Gables, FL, USA.
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA.
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11
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He G, Liu L, Liu X, Guo H, Chen L, Li R. Comparison of clinical efficacy and safety of transvaginal natural endoscopic surgery and transumbilical single port laparoscopy surgery for endometrial cancer. Am J Transl Res 2022; 14:2647-2654. [PMID: 35559407 PMCID: PMC9091124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 03/09/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To explore the difference in clinical efficacy and safety of transvaginal and transumbilical single port laparoscopy for endometrial cancer. METHODS We retrospectively included 100 endometrial cancer patients who were admitted to the Fuzhou Second Hospital for surgical treatment from September 2020 to September 2021 and divided them into two groups according to different surgical treatment options. Patients in Group A (48 cases) were treated with transvaginal natural endoscopic surgery (TNES), and those in Group B (52 cases) were with transumbilical single port laparoscopic surgery (TSPLS). The operation time, intraoperative blood loss, time to postoperative exhaust, length of hospital stay, pelvic lymph node dissection, and incision infection rate of two groups were compared. The white blood cell count (WBC), hemoglobin (Hb), hematocrit (Hct) of the two groups of patients before and after the surgery were compared between the two groups, as well as th VAS score of 24 hours after the operation, rate of complications during hospitalization, satisfaction with surgery and quality of life 3 months after surgery. RESULTS Compared with Group B, the operation time and intraoperative blood loss of Group A patients were markedly increased. The time to postoperative exhaust, length of hospital stay, incision infection rate, VAS score at postoperative 24 h, and complication rate of Group A were significantly lower than that of Group B. In addition, Group A had higher performance on the number of pelvic lymph node dissections, surgical satisfaction and quality of life 3 months after surgery. CONCLUSION Transvaginal natural cavity endoscopy had better surgical results with faster postoperative recovery and higher safety compared with TSPLS, making it valuable in clinical application and worthy of further popularization.
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Affiliation(s)
- Guna He
- Department of Gynecology, Fuzhou Second Hospital, Fuzhou Second Hospital of Xiamen University, School of Medicine, Xiamen UniversityChina
- The Third Clinical Medical College, Fujian Medical UniversityFuzhou 350007, Fujian, China
| | - Lingyu Liu
- Department of Gynecology, Fuzhou Second Hospital, Fuzhou Second Hospital of Xiamen University, School of Medicine, Xiamen UniversityChina
- The Third Clinical Medical College, Fujian Medical UniversityFuzhou 350007, Fujian, China
| | - Xiaomei Liu
- Department of Gynecology, Fuzhou Second Hospital, Fuzhou Second Hospital of Xiamen University, School of Medicine, Xiamen UniversityChina
- The Third Clinical Medical College, Fujian Medical UniversityFuzhou 350007, Fujian, China
| | - Hui Guo
- Department of Gynecology, Fuzhou Second Hospital, Fuzhou Second Hospital of Xiamen University, School of Medicine, Xiamen UniversityChina
- The Third Clinical Medical College, Fujian Medical UniversityFuzhou 350007, Fujian, China
| | - Lingling Chen
- Department of Gynecology, Fuzhou Second Hospital, Fuzhou Second Hospital of Xiamen University, School of Medicine, Xiamen UniversityChina
- The Third Clinical Medical College, Fujian Medical UniversityFuzhou 350007, Fujian, China
| | - Rongzi Li
- Department of Gynecology, Fuzhou Second Hospital, Fuzhou Second Hospital of Xiamen University, School of Medicine, Xiamen UniversityChina
- The Third Clinical Medical College, Fujian Medical UniversityFuzhou 350007, Fujian, China
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12
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Song L, Nielsen ME, Chen RC, Rini C, Keyserling TC, Idiagbonya E, Fuller GP, Northouse L, Palmer MH, Tan X. Testing the efficacy of a couple-focused, tailored eHealth intervention for symptom self-management among men with prostate cancer and their partners: the study protocol. Trials 2022; 23:12. [PMID: 34983621 PMCID: PMC8725423 DOI: 10.1186/s13063-021-05948-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 12/17/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Men with localized prostate cancer often experience urinary, sexual, bowel, and hormonal symptoms; general distress; pain; fatigue; and sleep disturbance. For men in an intimate relationship, these symptoms disrupt couples' relationships and intimacy. The symptoms also reduce quality of life for both men and their partners, who are often their primary caregivers. Management of the negative effects of cancer and its treatment is a significantly under-addressed supportive care need for these men and their intimate partners. To address these unmet supportive care needs, our interdisciplinary team developed and pilot tested the usability and feasibility of an evidence-based, couple-focused, tailored eHealth intervention, "Prostate Cancer Education & Resources for Couples" (PERC). Based on the adapted stress and coping theoretical framework and developed with stakeholder involvement, PERC aims to improve quality of life for both men and their partners by enhancing their positive appraisals, self-efficacy, social support, and healthy behaviors for symptom management. METHODS We will test the efficacy of PERC using a population-based, geographically and demographically diverse cohort in a randomized controlled trial. Primary aim: Assess if patients and partners receiving PERC will report greater improvement in their cancer-related quality of life scores than those in the control group (usual care plus the National Cancer Institute prostate cancer website) at 4, 8, and 12 months post-baseline. Secondary aim: Test if patients and partners in PERC will report significantly more positive appraisals and higher levels of coping resources at follow-ups than those in the control group. Exploratory aim: Determine if patient race and ethnicity, education, type of treatment, or couples' relationship quality moderate the effects of PERC on patient and partner QOL at follow-ups. DISCUSSION This study will provide a novel model for self-managing chronic illness symptoms that impact couples' relationships, intimacy, and quality of life. It addresses the National Institute of Nursing Research's goal to develop and test new strategies for symptom self-management to help patients and caregivers better manage their illness and improve quality of life. It also responds to calls for programs from the Institute of Medicine and American Cancer Society to address treatment-related effects and improve survivors' QOL. TRIAL REGISTRATION CT.gov NCT03489057.
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Affiliation(s)
- Lixin Song
- School of Nursing, University of North Carolina (UNC), Chapel Hill, NC, USA.
- Lineberger Comprehensive Cancer Center, UNC, Chapel Hill, NC, USA.
| | - Matthew E Nielsen
- Lineberger Comprehensive Cancer Center, UNC, Chapel Hill, NC, USA
- School of Medicine, UNC, Chapel Hill, NC, USA
| | | | - Christine Rini
- Northwestern University, Cancer Survivorship Institute and Department of Medical Social Sciences, Chicago, USA
| | | | - Eno Idiagbonya
- School of Nursing, University of North Carolina (UNC), Chapel Hill, NC, USA
| | - Gail P Fuller
- School of Nursing, University of North Carolina (UNC), Chapel Hill, NC, USA
| | | | - Mary H Palmer
- School of Nursing, University of North Carolina (UNC), Chapel Hill, NC, USA
| | - Xianming Tan
- Lineberger Comprehensive Cancer Center, UNC, Chapel Hill, NC, USA
- Gillings School of Global Public Health, UNC, Chapel Hill, NC, USA
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13
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Tang N, Jia Y, Zhao Q, Liu H, Li J, Zhang H, Han L, Huangfu C. Influencing Factors of Dyadic Coping Among Infertile Women: A Path Analysis. Front Psychiatry 2022; 13:830039. [PMID: 35418892 PMCID: PMC8995970 DOI: 10.3389/fpsyt.2022.830039] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 02/28/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The infertility prevalence of married couples in China is increasing gradually. The dyadic coping level and its influencing factors of infertile women in China are poorly reported. The relationship between dyadic coping and the family cohesion and adaptability in infertile women was investigated. METHODS A total of 482 infertile women in the reproductive clinics of three affiliated hospitals of the Lanzhou University were selected by the convenience sampling method. The self-made general information questionnaire, family adaptability and cohesion evaluation scale, and dyadic coping questionnaire were used in this study. RESULTS The average age of infertile women was 31.73 ± 4.57 years, the duration of infertility was 28.66 ± 27.99 months, the total score of dyadic coping was 132.66 ± 25.49, the total score of family cohesion and adaptability was 101.48 ± 20.96. A significant positive correlation between dyadic coping and family cohesion and adaptability was observed (r = 0.74, p < 0.01). The multiple linear regression analysis showed that religious belief, number of miscarriages, relationship between family members, family intimacy, and adaptability were the influencing factors of dyadic coping level in the family of infertile women (R 2 = 0.566, p < 0.01). CONCLUSIONS The dyadic coping level of infertile women is in the medium level, which is significantly positively correlated with family intimacy and adaptability. In clinical nursing, nurses try to improve the family relationship of patients to increase the level of dyadic coping of infertile women.
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Affiliation(s)
- Nan Tang
- Center for Evidence-Based Nursing, School of Nursing, Lanzhou University, Lanzhou, China
| | - Yingying Jia
- Center for Evidence-Based Nursing, School of Nursing, Lanzhou University, Lanzhou, China
| | - Qing Zhao
- Center for Evidence-Based Nursing, School of Nursing, Lanzhou University, Lanzhou, China
| | - Huihui Liu
- Center for Evidence-Based Nursing, School of Nursing, Lanzhou University, Lanzhou, China
| | - Junzheng Li
- Center for Disease Control and Prevention, Western Theater Command, Lanzhou, China
| | - Hongchen Zhang
- Center for Evidence-Based Nursing, School of Nursing, Lanzhou University, Lanzhou, China
| | - Lin Han
- Center for Evidence-Based Nursing, School of Nursing, Lanzhou University, Lanzhou, China
| | - Chaoji Huangfu
- Center for Disease Control and Prevention, Western Theater Command, Lanzhou, China
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14
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Fear, worry and sadness: an exploratory study of psychological wellbeing in men caring for their partner with ovarian cancer. Support Care Cancer 2021; 30:825-833. [PMID: 34389907 DOI: 10.1007/s00520-021-06488-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 08/05/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Ovarian cancer is the leading cause of death from female cancers in Australia with the majority of women presenting with advanced disease. The burden of caregiving is largely borne by male carers; however, little research has examined the challenges male ovarian cancer caregivers (MOCC) experience. This study aimed to explore the psychosocial wellbeing and cancer-related challenges experienced by MOCC. METHODS A cross-sectional small-scale exploratory online survey study recruited 36 MOCC. The study questionnaire was comprised of the Generalised Anxiety Disorder Scale (GAD-7), Patient Health Questionnaire Depression Module (PHQ-9), Functional Assessment of Cancer Therapy Scale (FACT-G) Family Member, Fear of Cancer Recurrence Scale, Insomnia Severity Index (ISI), Functional Assessment of Chronic Illness Therapy Fatigue Scale (FACTIT-F) and Cancer-Related Challenges Scale (CRCS). RESULTS The most common challenges ever experienced were worry about the future (91%), fear of metastasis (90%) and feeling worried or uncertain (88%). The most common current challenges were fear of cancer recurrence (75%), fear of metastasis (68%) and changes in sexual relationships (64%). Depression and anxiety were significantly correlated with all psychosocial variables highlighting the relationships between elements of wellbeing for MOCC. Clinical levels of fear of cancer recurrence were reported by 89% of MOCC. CONCLUSIONS The challenges faced by MOCC are psychosocial in nature. There is a high correlation between anxiety and depression, and this coupled with the fear of disease recurrence indicates a greater need for screening of these issues, appropriate referral and development of support resources for this high-risk group of cancer carers.
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