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Nielsen IH, Tolver A, Piil K, Kjeldsen L, Grønbæk K, Jarden M. Family caregiver quality of life and symptom burden in patients with hematological cancer: A Danish nationwide cross-sectional study. Eur J Oncol Nurs 2024; 69:102538. [PMID: 38457934 DOI: 10.1016/j.ejon.2024.102538] [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: 06/26/2023] [Revised: 02/05/2024] [Accepted: 02/16/2024] [Indexed: 03/10/2024]
Abstract
OBJECTIVE To investigate the quality of life (QoL) and the impact of caregiving in family caregivers of hematological cancer patients and its association with patient symptom burden. METHODS A cross-sectional study including Danish patients (n = 375) and caregivers (n = 140). Caregivers completed scales for anxiety and depression using the Hospital Anxiety and Depression Scale, sleep quality using the Pittsburgh Sleep Quality Index, health related QoL using the 12-item Short-Form Health Survey, and caregiver roles using the Caregiver Roles and Responsibilities Scale. Patients reported symptoms using the MD Anderson Symptom Inventory. Analysis of covariance was used to examine associations between patient symptom burden and caregivers' QoL outcomes. RESULTS The results show that caregivers experience sleep difficulties, moderate anxiety, and reduced QoL. Patient symptom burden was significantly associated with caregiver anxiety (p = 0.009), and mental well-being (p = 0.002), while patient treatment status was a significant factor associated with caregiver anxiety (p = 0.016), depression (p = 0.009), emotional well-being (p = 0.002), and sleep (p = 0.01). CONCLUSION Caregivers of patients with hematological cancers undergoing active treatment face a high symptom burden, which significantly impacts their QoL, including sleep, psychological well-being, and emotional health. Patients reported a high symptom burden, and patient symptom burden was significantly associated with caregiver QoL. Adequate patient and caregiver support is needed to promote their well-being and mitigate adverse health effects in caregivers, and this should be acknowledged in the context of caring for patients with hematological cancer.
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Affiliation(s)
- Iben Husted Nielsen
- Department of Haematology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.
| | - Anders Tolver
- Department of Mathematical Sciences, Data Science Laboratory, University of Copenhagen, Universitetsparken 5, 2200, Copenhagen, Denmark
| | - Karin Piil
- Department of Oncology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark; Department of Public Health, Aarhus University, Bartholins Allé 2, 8000, Aarhus C, Denmark
| | - Lars Kjeldsen
- Department of Haematology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Kirsten Grønbæk
- Department of Haematology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark; Biotech Research & Innovation Centre (BRIC), University of Copenhagen, Ole Maaløes Vej 5, 2200, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
| | - Mary Jarden
- Department of Haematology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
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Peng F, Li H, Zhang J, Li X, Zhang H, Li Y. Effects of different psychological interventions on quality of life and remission rate in patients with acute leukemia receiving chemotherapy: A randomized controlled trial. Front Psychol 2023; 14:1045031. [PMID: 36874817 PMCID: PMC9978370 DOI: 10.3389/fpsyg.2023.1045031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 01/30/2023] [Indexed: 02/18/2023] Open
Abstract
Aims This study aimed to examine and compare different psychological intervention effects on the quality of life (QoL) and remission rates of patients with acute leukemia receiving chemotherapy. Methods A total of 180 participants were randomly divided into a cognitive intervention group, a progressive muscle relaxation (PMR) group, a cognitive intervention plus PMR group, and a usual care control group. QoL via the Chinese version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 and remission rate were assessed at baseline and immediate post-intervention. A Generalized Linear Mixed Model was used for statistical analysis. Cost-effectiveness analysis with the value of the Incremental Cost-effectiveness Ratio was conducted to realize the economic evaluation of psychological interventions. Results The total score of QoL and its most dimensions were significantly improved for participants in the intervention groups compared with the control group. The cognitive intervention plus PMR intervention was the most effective concerning QoL with cost-effectiveness. No significant improvements were indicated in participants' remission rates among the groups. Conclusion The cognitive intervention plus PMR intervention is the most effective in improving QoL with cost-effectiveness among patients with acute leukemia receiving chemotherapy. More rigorous randomized controlled trials with multiple follow-up points are suggested to clarify the psychological interventions on remission rates in this population.
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Affiliation(s)
- Fang Peng
- Changsha Social Work College, Changsha, China
| | - Huiyuan Li
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Jingping Zhang
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Xiaoyun Li
- Second Xiangya Hospital of Central South University, Changsha, China
| | - Haimiao Zhang
- The School of Nursing and Rehabilitation, Xi'an Medical University, Xi'an, China
| | - Yifei Li
- Xiangya School of Nursing, Central South University, Changsha, China
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Coronel-Santos MA, Rodríguez-Macías JC. Integral definition and conceptual model of mental health: Proposal from a systematic review of different paradigms. FRONTIERS IN SOCIOLOGY 2022; 7:978804. [PMID: 36505761 PMCID: PMC9732731 DOI: 10.3389/fsoc.2022.978804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 10/31/2022] [Indexed: 06/17/2023]
Abstract
Global society presents a mental health scenario characterized by the prevalence of mental disorders and the limited existence of formal care services. Faced with such a context, it is necessary to review what is understood and done in favor of mental health. This implies, in the first instance, analyzing the concept of mental health from a comprehensive approach that takes into account different perspectives from the social and natural sciences, related factors, and care options. Therefore, the present work aimed to propose an integral definition and a conceptual model of mental health based on the Systematic Literature Review, with the PRISMA approach, of the theoretical frameworks of 52 articles related to mental health published up to February 2022. A qualitative approach was used, with a Grounded Theory design, which allowed comparing different paradigms and identifying gaps in conceptual notions to build an explanatory model of mental health. The results showed three dominant paradigms that circumscribe the concept of mental health. Mental health is understood as the absence of illness, positive mental health, and a state of equilibrium. In addition, the need to propose a definition that integrates these dominant paradigms was mainly identified, and that would allow a broader understanding of the state of equilibrium as the basic process through which the individual must pass in the search for personal recovery. From the comparative analysis of the categories designated according to the Grounded Theory approach, an explanatory model was proposed to define mental health as the internal process of self-care, centered on the self-awareness and self-regulation of the human being, in which the person seeks to balance their feelings, thoughts, and behaviors, intrapersonal and interpersonal ones, to approach an optimal state of wellbeing and absence of mental disorders according to universal values and symptoms, and biological, social, psychological, and environmental factors.
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Wei Y, Xiao H, Wu H, Yong B, Weng Z, Chen W. Psychometric properties of the Chinese version of quality of life in life-threatening illness-family carer version. Front Psychol 2022; 13:925062. [PMID: 35992475 PMCID: PMC9381691 DOI: 10.3389/fpsyg.2022.925062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 07/08/2022] [Indexed: 11/13/2022] Open
Abstract
Background The Quality of Life (QOL) in Life-threatening Illness-Family Carer Version (QOLLTI-F) has been proven to be a brief, reliable, and valid instrument for measuring the caregivers' QOL in western cultures. However, whether it is suitable to be used in Chinese culture is unclear. This study aimed to test the reliability and validity of the Chinese version of (QOLLTI-F-CV). Materials and methods A total of 202 family caregivers (FCs) of advanced cancer patients from Fujian Provincial hospice care center were investigated using the Chinese version of QOLLTI-F-CV from September 2019 to August 2020. The questionnaire was evaluated using an exploratory structural equation model. Its psychometric properties were examined in terms of factor structure, convergent validity, discriminant validity, internal consistency, and test-retest reliability. Results Differently from the seven-domain original QOLLTI-F, its Chinese version had only three domains including caregiver's self-feelings, caregiver's stress, and caregiver's outlooks. The total variance explanation rate for the domains was 55.4%. The Chinese version fitted well with the structure model (χ2 = 153.932, df = 75, P < 0.001); its comparative fit index (CFI) was 0.971; Tucker-Lewis index was 0.954; and the root mean square error of approximation (RMSEA) was 0.072. The success rate of its convergent and discriminant validity calibration test was 100%. Its Cronbach's alpha coefficient of the whole questionnaire and three domains was from 0.650 to 0.874, and test-retest reliability was 0.836. Conclusion The 3-domain QOLLTI-F-CV is a valid and reliable instrument for identifying QOL concerns of FCs of advanced cancer patients in China. The refactoring structure optimally matches Chinese culture and value system well.
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Affiliation(s)
- Yitao Wei
- School of Nursing, Fujian Medical University, Fuzhou, China
| | - Huimin Xiao
- School of Nursing, Fujian Medical University, Fuzhou, China
| | - Hong Wu
- Department of Hospice Care, Fujian Provincial Hospital, Fuzhou, China
| | - Binbin Yong
- School of Nursing, Fujian Medical University, Fuzhou, China
| | - Zhichao Weng
- Department of Hospice Care, Fujian Provincial Hospital, Fuzhou, China
| | - Weiling Chen
- School of Nursing, Fujian Medical University, Fuzhou, China
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Huan Y, Mujun X, Xin L, Ping Z, Limei F, Aming L, Xinquan L. Short Sleep Duration as a Risk Factor for Depression, Anxiety and Fatigue in Patients with Leukemia. Neuropsychiatr Dis Treat 2022; 18:1573-1582. [PMID: 35937713 PMCID: PMC9346604 DOI: 10.2147/ndt.s362229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 06/18/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE Our study aimed to investigate the level of depression, anxiety, and fatigue in patients with leukemias, and analyze the influence of sleep duration on the mental symptoms of patients with leukemias. METHODS A total of 127 patients were enrolled in our study and completed the questionnaire survey. Self-Assessment Depression Scale (SDS), Self-Assessment Anxiety Scale (SAS), and the Fatigue Scale-14 (FS-14) were adopted. The patient's lifestyle information, including exercise, alcohol abuse, and smoking, was obtained from the patient's self-report. RESULTS Depression score of patients with sleep duration >8 hours (long duration group) was 56.21±11.63, which was significantly lower than that of patients sleep duration between 6 and 8 hours (medium duration group) with 59.61±8.77 and patients sleep <6 hours (short duration group) with 64.82±6.42 (P = 0.007). Similarly, the anxiety score of long duration group, medium duration group and short duration group was 45.36±11.41, 48.26±6.96 and 53.53±5.87, respectively (P = 0.005). The fatigue score of short duration group is 8.47±2.45, which is higher than others (P = 0.046). To further identify the relationship, we evaluated physical fatigue and mental fatigue levels in patients with or without symptoms of depression. We found that patients with symptoms of depression have a higher score both in physical fatigue and mental fatigue (all p < 0.001). Similar trend was observed in patients with or without symptoms of anxiety (all p < 0.001). However, alzhough patients with leukemia in long duration group have the highest score of physical fatigue (p = 0.016), no significant difference in mental fatigue was found in different sleeping duration group (p = 0.587). Furthermore, multivariate analyses were conducted and revealed that sleep duration was the independent factor associated with depression (OR = 0.270, P = 0.003) and anxiety (OR = 0.473, P = 0.010). CONCLUSION For leukemia patients with short sleep duration, a prompt evaluation of their level of depression, anxiety, and fatigue and the initiation of timely interventions is essential.
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Affiliation(s)
- Yu Huan
- Department of Hematology, Chenzhou First People's Hospital, Chenzhou City, Hunan Province, People's Republic of China
| | - Xiong Mujun
- Department of Hematology, Chenzhou First People's Hospital, Chenzhou City, Hunan Province, People's Republic of China
| | - Liao Xin
- Department of Hematology, Chenzhou First People's Hospital, Chenzhou City, Hunan Province, People's Republic of China
| | - Zhu Ping
- Department of Hematology, Chenzhou First People's Hospital, Chenzhou City, Hunan Province, People's Republic of China
| | - Fu Limei
- Department of Hematology, Chenzhou First People's Hospital, Chenzhou City, Hunan Province, People's Republic of China
| | - Lei Aming
- Department of Hematology, Chenzhou First People's Hospital, Chenzhou City, Hunan Province, People's Republic of China
| | - Liang Xinquan
- Department of Hematology, Chenzhou First People's Hospital, Chenzhou City, Hunan Province, People's Republic of China
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Barriers to seeking psychosocial support among adult patients with hematologic neoplasms: a qualitative study. Support Care Cancer 2021; 30:2613-2620. [PMID: 34812953 DOI: 10.1007/s00520-021-06699-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 11/13/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE This study aims to explore the barriers that adult patients with hematologic neoplasms experience when seeking psychosocial support. METHODS A descriptive qualitative approach was used to investigate the experiences of patients with hematologic neoplasms. Face-to-face, semi-structured, in-depth individual interviews were conducted between June and October 2020 with 17 patients diagnosed with hematologic neoplasms. The interviews were audio-recorded and transcribed verbatim. A thematic analysis was performed to identify the essential themes. RESULTS Seventeen patients aged 28-67 years completed the interviews. Two themes and six subthemes were identified that describe barriers to seeking psychosocial support. Internal barriers included limited communication, negative emotions, social avoidance, and focusing on treatment rather than psychosocial needs; external barriers included traditional cultural influences and lack of professional support. CONCLUSIONS Significant others were the key source for psychosocial support for patients with hematologic neoplasms. Tackling diverse barriers to accessing psychosocial support remains a challenge for these patients. Healthcare providers should continually assess and provide effective support.
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Effects of a WeChat-based multimodal psychoeducational intervention on psychological well-being and quality of life in acute leukaemia patients in China: a randomised controlled trial. J Cancer Surviv 2021; 16:1461-1477. [PMID: 34705196 DOI: 10.1007/s11764-021-01124-5] [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: 07/27/2021] [Accepted: 10/15/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE The treatment and side effects of chemotherapy for acute leukaemia (AL) may cause both physical and psychological symptoms in patients. This study evaluated the effects of a WeChat-based multimodal psychoeducational intervention (ICARE programme) on fatigue, distress, anxiety, depression, and quality of life (QoL) among adult AL patients. METHODS In total, 72 participants were randomly assigned either to an intervention or control group (n = 36), respectively, from two large tertiary hospitals in Fuzhou, China (from April to December 2019). Data were collected at baseline, post-intervention, and after a 4-week follow-up using the Brief Fatigue Inventory, Distress Thermometer, Hospital Anxiety and Depression Scale, and Functional Assessment of Cancer Therapy-leukaemia. Descriptive statistics was used to summarise the sociodemographic and clinical characteristics of the participants and a linear mixed model was used to analyse the score changes. RESULTS Between the two groups, there were statistically significant improvements in fatigue, distress, anxiety, depression, physical well-being, social/family well-being, emotional well-being, functional well-being (all p < 0.001), and leukaemia-specific subscale (p = 0.001). The difference over time was significant for leukaemia-specific subscale and fatigue, both (p < 0.001), anxiety (p = 0.001), and social/family well-being (p = 0.005). The interaction effects were significant for fatigue, distress, anxiety, physical well-being, social/family well-being, and emotional well-being, all (p < 0.001), depression (p = 0.019), leukaemia-specific subscale (p = 0.008), and total QoL score (p = 0.004). CONCLUSION WeChat-based multimodal psychoeducational intervention demonstrated a significant effect in reducing fatigue, distress, anxiety, depression, and QoL in AL patients. This ICARE programme contributed to continuing care to support AL patients. IMPLICATIONS FOR CANCER SURVIVORS The ICARE programme can improve the mental health and QoL of AL patients. The application of WeChat-based psychoeducational interventions have significant potential to benefit cancer patients due to their reach and can be an added value to routine care.
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