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Christodoulou L, Parpottas P, Petkari E. Psychological interventions to enhance positive outcomes in adult cancer caregivers: A systematic review. J Health Psychol 2024; 29:747-769. [PMID: 38439520 DOI: 10.1177/13591053241236254] [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] [Indexed: 03/06/2024] Open
Abstract
This systematic review aims to examine the characteristics of psychological interventions that aim to enhance positive outcomes, such as wellbeing, post-traumatic growth, or hope in cancer caregivers. Studies published until December 2023 were searched on PubMed, Scopus, PsycINFO, WOS, PsycARTICLES and were included when examining interventions targeting positive outcomes with adult cancer caregivers. Of the 1424 articles retrieved through the databases, 16 studies were eligible for inclusion in this review, targeting 908 caregivers (70.2% female; Mage = 53.5). A narrative synthesis was used to describe the interventions, which were based on a variety of approaches such as psychoeducation, mindfulness, or Existential Behavioral Therapy, and reported positive gains for the positive outcomes. The results show few randomized controlled trials published to date, highlight the contrast between the focus shift towards these outcomes and the need for systematic testing of the interventions, to be able to inform evidence-based service delivery.
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Sun Z, Yang X, Wang Y, Li R, Zhang Y, Li Q, Zhao J. A couple-based unmet supportive care needs intervention for colorectal cancer couples: A preliminary feasibility study. Eur J Oncol Nurs 2024; 70:102608. [PMID: 38795445 DOI: 10.1016/j.ejon.2024.102608] [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: 03/15/2024] [Revised: 05/05/2024] [Accepted: 05/08/2024] [Indexed: 05/28/2024]
Abstract
PURPOSE To support colorectal cancer couples cope with cancer, we developed a couple-based unmet supportive care needs intervention program guided by the Supportive Care Needs Framework and examined the feasibility, acceptability, and initial effects of the unmet supportive care needs program. METHODS The design of a pre-and post-intervention study was conducted among Chinese colorectal cancer couples. The intervention was delivered in five sessions through in-person and telephone interventions combined. To measure program feasibility through recruitment and retention rates, and to test program acceptability through quantitative and qualitative post-intervention program assessments. The complete data (N = 20 pairs) were used to calculate effect sizes to assess the initial intervention effect. RESULTS There was evidence of the feasibility of the intervention program in terms of recruitment (66.7%) and retention (83.3%) rates. Participants' satisfaction with the program also attested to its acceptability. The intervention (Cohen's = 0.15-0.56) had a small-moderate effect size in improving unmet supportive care needs and most cancer-adapted outcomes for colorectal cancer couples, validating the initial effect of the program. CONCLUSIONS The unmet supportive care needs program is feasible, acceptable, and preliminarily effective in supporting Chinese colorectal cancer couples to improve unmet supportive care needs and cancer adaptability, as provided by this study.
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Affiliation(s)
- Zheng Sun
- Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Xueli Yang
- Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Ye Wang
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Rongyu Li
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Yi Zhang
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Qiuping Li
- Affiliated Hospital of Jiangnan University, Wuxi, China; Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China.
| | - Jie Zhao
- Affiliated Hospital of Jiangnan University, Wuxi, China.
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Zhang Z, Liew K, Kuijer R, She WJ, Yada S, Wakamiya S, Aramaki E. Differing Content and Language Based on Poster-Patient Relationships on the Chinese Social Media Platform Weibo: Text Classification, Sentiment Analysis, and Topic Modeling of Posts on Breast Cancer. JMIR Cancer 2024; 10:e51332. [PMID: 38723250 PMCID: PMC11117131 DOI: 10.2196/51332] [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: 07/28/2023] [Revised: 10/19/2023] [Accepted: 04/04/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Breast cancer affects the lives of not only those diagnosed but also the people around them. Many of those affected share their experiences on social media. However, these narratives may differ according to who the poster is and what their relationship with the patient is; a patient posting about their experiences may post different content from someone whose friends or family has breast cancer. Weibo is 1 of the most popular social media platforms in China, and breast cancer-related posts are frequently found there. OBJECTIVE With the goal of understanding the different experiences of those affected by breast cancer in China, we aimed to explore how content and language used in relevant posts differ according to who the poster is and what their relationship with the patient is and whether there are differences in emotional expression and topic content if the patient is the poster themselves or a friend, family member, relative, or acquaintance. METHODS We used Weibo as a resource to examine how posts differ according to the different poster-patient relationships. We collected a total of 10,322 relevant Weibo posts. Using a 2-step analysis method, we fine-tuned 2 Chinese Robustly Optimized Bidirectional Encoder Representations from Transformers (BERT) Pretraining Approach models on this data set with annotated poster-patient relationships. These models were lined in sequence, first a binary classifier (no_patient or patient) and then a multiclass classifier (post_user, family_members, friends_relatives, acquaintances, heard_relation), to classify poster-patient relationships. Next, we used the Linguistic Inquiry and Word Count lexicon to conduct sentiment analysis from 5 emotion categories (positive and negative emotions, anger, sadness, and anxiety), followed by topic modeling (BERTopic). RESULTS Our binary model (F1-score=0.92) and multiclass model (F1-score=0.83) were largely able to classify poster-patient relationships accurately. Subsequent sentiment analysis showed significant differences in emotion categories across all poster-patient relationships. Notably, negative emotions and anger were higher for the "no_patient" class, but sadness and anxiety were higher for the "family_members" class. Focusing on the top 30 topics, we also noted that topics on fears and anger toward cancer were higher in the "no_patient" class, but topics on cancer treatment were higher in the "family_members" class. CONCLUSIONS Chinese users post different types of content, depending on the poster- poster-patient relationships. If the patient is family, posts are sadder and more anxious but also contain more content on treatments. However, if no patient is detected, posts show higher levels of anger. We think that these may stem from rants from posters, which may help with emotion regulation and gathering social support.
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Affiliation(s)
- Zhouqing Zhang
- Graduate School of Science and Technology, Nara Institute of Science and Technology, Ikoma, Japan
| | - Kongmeng Liew
- Graduate School of Science and Technology, Nara Institute of Science and Technology, Ikoma, Japan
- School of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
| | - Roeline Kuijer
- School of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
| | - Wan Jou She
- Graduate School of Science and Technology, Nara Institute of Science and Technology, Ikoma, Japan
- Department of Information Science, Kyoto Institute of Technology, Kyoto, Japan
| | - Shuntaro Yada
- Graduate School of Science and Technology, Nara Institute of Science and Technology, Ikoma, Japan
| | - Shoko Wakamiya
- Graduate School of Science and Technology, Nara Institute of Science and Technology, Ikoma, Japan
| | - Eiji Aramaki
- Graduate School of Science and Technology, Nara Institute of Science and Technology, Ikoma, Japan
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Andreasen TK, Boje IR, Tolstrup LK, Missel M, Larsen MK. Treatment and Rehabilitation for Esophageal Cancer-Striving to Meet Obstacles and Long-term Impacts: A Qualitative Descriptive Study. Cancer Nurs 2024:00002820-990000000-00242. [PMID: 38625759 DOI: 10.1097/ncc.0000000000001359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/18/2024]
Abstract
BACKGROUND Following esophagogastric cancer treatment, patients with esophageal cancer and their relatives struggle with adjusting to a new everyday life as they experience various challenges after treatment requiring rehabilitation. Health professionals must address long-term impacts on patients' health, everyday life, family functioning, and support needs. OBJECTIVE This qualitative descriptive study aimed to explore patients', relatives', and health professionals' experience with long-term impacts and rehabilitation after treatment for esophageal cancer. METHODS A qualitative approach based on a phenomenological-hermeneutical methodology was used. Two methods were selected in the study: focus group interviews with health professionals and individual interviews with patients and relatives. Inductive thematic analysis with inspiration from Braun and Clarke was used for data analysis. RESULTS Three main themes emerged from the data analysis: (1) forced into limitations in everyday life, (2) learning and navigating a new everyday life, and (3) rehabilitation accepting new normality. CONCLUSION Patients and relatives experience persistent long-term impacts after treatment for esophageal cancer, making rehabilitation strenuous and demanding. Relatives take considerable responsibility for the patients' rehabilitation but feel invisible and unsupported by health professionals. Health professionals acknowledge the severity of long-term impacts but fail to prepare patients and relatives for the impacts and do not see the relatives' need for support. IMPLICATIONS FOR PRACTICE The study emphasizes the need for a proactive approach in the healthcare system, addressing patients' and relatives' physical and psychological vulnerability. Cancer nurses need to prepare and involve patients and relatives in treatment, long-term impacts, and rehabilitation.
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Affiliation(s)
- Trine Kromann Andreasen
- Author Affiliations: Department of Cardiology, Odense University Hospital, Odense, Denmark (Ms Andreasen); Department of Health, Region of Southern Denmark, Vejle, Denmark (Ms Boje); Department of Oncology, Odense University Hospital, Odense, Denmark (Dr Tolstrup); Institute of Clinical Research, University of Southern Denmark, Odense, Denmark (Drs Tolstrup and Larsen); Department of Cardiothoracic Surgery, Copenhagen University Hospital, Copenhagen, Denmark (Dr Missel); Department of Surgery, Odense University Hospital, Odense, Denmark (Dr Larsen)
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Thomas S, Ryan NP, Byrne LK, Hendrieckx C, White V. Psychological Distress Among Parents of Children With Chronic Health Conditions and Its Association With Unmet Supportive Care Needs and Children's Quality of Life. J Pediatr Psychol 2024; 49:45-55. [PMID: 37840456 PMCID: PMC10799716 DOI: 10.1093/jpepsy/jsad074] [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: 04/19/2023] [Revised: 09/19/2023] [Accepted: 09/29/2023] [Indexed: 10/17/2023] Open
Abstract
OBJECTIVE To assess parent psychological distress in families of children with common chronic health conditions (CHC) and to explore relationships between parent psychological distress, unmet supportive care needs and children's quality of life (QoL). METHOD Cross-sectional study involving parents of children diagnosed with a common CHC between 0 and 12 years of age and who had received treatment within the last 5 years. Eligible parents completed an online survey, that included the Depression Anxiety Stress Scale (DASS-21) assessing distress in parents and a 34-item assessment of unmet supportive care needs across 6 domains. Parents completed ratings of their child's current functioning (QoL) using the 23-item PedsQL. Multivariable regression models examined the relative association between unmet needs, children's QoL and parents' depression, anxiety, and stress. RESULTS The sample consisted of 194 parents of children with congenital heart disease (n=97; 50%), diabetes (n=50; 26%), cancer (n=39; 20%), and asthma (n=8; 4%). A significant proportion of parents had moderate-severe symptoms of depression (26%), anxiety (38%), and stress (40%). Of the PedsQL scales, the poorest outcomes were found for emotional and school functioning. Multivariable analyses showed that both higher unmet needs and poorer child emotional functioning were associated with parent depression, anxiety, and stress symptoms. CONCLUSION Evidence linking parent distress symptoms to higher unmet needs and poorer child emotional functioning suggests these factors may be targets for interventions to alleviate parent distress. Longitudinal research using larger samples is required to replicate findings, and clarify the magnitude and direction of associations.
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Affiliation(s)
- Sangeetha Thomas
- Faculty of Health, School of Psychology, Deakin University, Australia
| | - Nicholas P Ryan
- Faculty of Health, School of Psychology, Deakin University, Australia
- Department of Paediatrics, University of Melbourne, Australia
| | - Linda K Byrne
- Faculty of Health, School of Psychology, Deakin University, Australia
- Faculty of Psychology, Counselling and Psychotherapy, The Cairnmillar Institute, Australia
| | - Christel Hendrieckx
- Faculty of Health, School of Psychology, Deakin University, Australia
- The Australian Centre for Behavioural Research in Diabetes, Australia
- Faculty of Health, Institute of Health Transformation, Deakin University, Australia
| | - Victoria White
- Faculty of Health, School of Psychology, Deakin University, Australia
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Australia
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Stragapede E, Petricone-Westwood D, Hales S, Galica J, Lebel S. Patient quality of life and caregiver experiences in ovarian cancer: How are they related? Qual Life Res 2023; 32:3521-3529. [PMID: 37535264 DOI: 10.1007/s11136-023-03481-3] [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] [Accepted: 07/06/2023] [Indexed: 08/04/2023]
Abstract
PURPOSE Patients with ovarian cancer and their spousal caregivers report similarities in health-related quality of life (HRQoL) and experiences throughout the cancer process. Previous research has reflected these shared experiences, demonstrating caregivers' capacity to accurately rate their patient-partner's HRQoL as a proxy. In response, this study examines associations between caregivers' perceptions of their patient-partner's HRQoL and their own caregiving responsibilities, consequences to well-being, and desired assistance from the healthcare system. This study will be beneficial when developing supports to assist caregivers throughout the cancer journey. METHODS Using a cross-sectional survey design, spousal caregivers (N = 82) of patients with ovarian cancer completed measures on perceived patient HRQoL and caregiver experiences. Correlation analyses determined medical and sociodemographic covariates. A multivariate multiple regression was conducted using four proxy HRQoL functioning subscales and three factors of reported experiences as caregivers in cancer. Post-hoc univariate regression analyses were run on significant factors to assess the associations that exist. RESULTS Caregiver-perceived patient physical functioning was significantly associated with more caregiving tasks after controlling for education, age, and stage of ovarian cancer, but no other HRQoL functioning scale (i.e., role, emotional, social) was associated with caregiver experiences. CONCLUSION The study provides a unique perspective into the caregiver experience by attending to interpersonal factors in relation to caregiver experiences. Results may be able to guide interventions aimed at supporting caregivers through the cancer process by offering more assistance with tasks as their partner's physical condition worsens.
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Affiliation(s)
- Elisa Stragapede
- School of Psychology, Vanier Hall, University of Ottawa, 136 Jean Jacques Lussier Private, Ottawa, ON, K1N 6N5, Canada.
| | | | - Sarah Hales
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Jacqueline Galica
- School of Nursing, Faculty of Health Sciences, Queen's University, Kingston, Canada
| | - Sophie Lebel
- School of Psychology, Vanier Hall, University of Ottawa, 136 Jean Jacques Lussier Private, Ottawa, ON, K1N 6N5, Canada
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Valero-Cantero I, Casals C, Espinar-Toledo M, Barón-López FJ, García-Agua Soler N, Vázquez-Sánchez MÁ. Effects of Music on the Quality of Life of Family Caregivers of Terminal Cancer Patients: A Randomised Controlled Trial. Healthcare (Basel) 2023; 11:1985. [PMID: 37510427 PMCID: PMC10379219 DOI: 10.3390/healthcare11141985] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 07/06/2023] [Accepted: 07/07/2023] [Indexed: 07/30/2023] Open
Abstract
The aim of this study was to investigate the effects of listening to self-chosen music on the quality of life of family caregivers of cancer patients receiving palliative home care. A total of 82 family caregivers were assigned either to the intervention group (n = 41) or to the control group (n = 41) in this double-blind, multicentre, randomised controlled clinical trial. The recruitment period was between July 2020 and September 2021. The intervention group received individualised pre-recorded music in daily 30 min sessions for 7 consecutive days. The control group was given a recorded repetition of the basic therapeutic training education also in 30 min sessions for 7 consecutive days. The primary endpoint assessed was the caregivers' quality of life (Quality of Life Family Version and European Quality of Life visual analogue scale) before and after the intervention. The secondary endpoint was their perceived satisfaction with the intervention (Client Satisfaction Questionnaire). The music intervention was successful, producing a tangible improvement in the caregivers' quality of life (p < 0.01) and satisfaction with the care provided (p = 0.002). The intervention was not only effective but produced no adverse effects. This study encourages the use of self-chosen music as a complementary intervention in nursing care for family caregivers of palliative cancer patients.
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Affiliation(s)
| | - Cristina Casals
- ExPhy Research Group, Department of Physical Education, Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Universidad de Cádiz, 11519 Puerto Real, Spain
| | - Milagrosa Espinar-Toledo
- Rincón de la Victoria Clinical Management Unit, Malaga-Guadalhorce Health District, 29730 Malaga, Spain
| | - Francisco Javier Barón-López
- Department of Preventive Medicine, Public Health and Science History, Institute of Biomedical Research in Málaga (IBIMA), University of Malaga, 29007 Malaga, Spain
| | | | - María Ángeles Vázquez-Sánchez
- Department of Nursing, Faculty of Health Sciences, PASOS Research Group, UMA REDIAS Network of Law and Artificial Intelligence Applied to Health and Biotechnology, University of Malaga, 29071 Malaga, Spain
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Mullis MD, Fisher CL, Kastrinos AL, Sae-Hau M, Weiss ES, Rajotte M, Bylund CL. Survivorship transitions in blood cancer: Identifying experiences and supportive care needs for caregivers. J Cancer Surviv 2023:10.1007/s11764-023-01422-0. [PMID: 37420150 PMCID: PMC11024982 DOI: 10.1007/s11764-023-01422-0] [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: 05/05/2023] [Accepted: 06/21/2023] [Indexed: 07/09/2023]
Abstract
PURPOSE Survivorship care often refers to continued healthcare after cancer treatment. Jacobsen and colleagues advocated to expand this to include patients on extended treatments and maintenance/prophylactic therapies, recognizing the care continuum as more complex. Transitions of care for individuals diagnosed with a blood cancer can be complicated. We sought to better understand blood cancer caregivers' experiences as their diagnosed family member encountered "survivorship transitions" across the continuum. METHODS We conducted semi-structured interviews with adults caring for a parent or a child with a blood cancer. Caregivers were segmented into survivorship groups based on two transitional contexts: (1) when patients transitioned to a new line of therapy (active treatment or maintenance therapy); (2) when patients ended treatment. We conducted a thematic analysis and triangulated findings to compare transitional experiences. RESULTS Caregivers in both groups reported experiencing a "new normal," which included personal, relational, and environmental adjustments. Caregivers in the treatment transitions group (n = 23) also described uncertainty challenges (e.g., losing their "safety net") and disrupted expectations (e.g., feeling "caught off guard" by challenges). Whereas caregivers in the end-of-treatment transitions group (n = 15) described relief coupled with worry (e.g., feeling hopeful yet worried). CONCLUSIONS Survivorship transitions for caregivers are riddled with challenges that include difficult readjustments, uncertainty/worry, and unmet expectations. While there seems to be a cohesive experience of "survivorship transitions," each transition group revealed nuanced distinctions. IMPLICATIONS FOR CANCER SURVIVORS Tailored supportive resources are needed for caregivers throughout survivorship transitions.
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Affiliation(s)
- M Devyn Mullis
- College of Medicine, University of Florida, Gainesville, FL, USA.
| | - Carla L Fisher
- College of Medicine, University of Florida, Gainesville, FL, USA
| | | | | | | | | | - Carma L Bylund
- College of Medicine, University of Florida, Gainesville, FL, USA
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Chen X, Wang Z, Zhou J, Li Q. Intervention and coping strategies for self-perceived burden of patients with cancer: A systematic review. Asia Pac J Oncol Nurs 2023; 10:100231. [PMID: 37251112 PMCID: PMC10209491 DOI: 10.1016/j.apjon.2023.100231] [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: 02/16/2023] [Accepted: 04/07/2023] [Indexed: 05/31/2023] Open
Abstract
Objective Self-perceived burden (SPB) is a painful experience for patients with cancer and their caregivers. However, the intervention and coping strategies for SPB have not been systematically summarized. This work reviews the effects of interventions and coping strategies on SPB. Methods A systematic search, including trawling through six electronic databases, was performed to identify the articles published from January 2003 to February 2023, both in English and in Chinese. The key terms related to burden on others, intervention, and coping of patients with cancer were adopted. Manual search was also applied. Results Thirty articles were identified. Interventions were presented in three dimensions: physical, psychological, and financial/family. Coping strategies were presented in terms of coping attitudes and behaviors. Interventions such as functional exercise and psychological adjustment can improve SPB in the three dimensions mentioned above and thus alleviate SPB. Patients with different coping styles have different implications for prognosis. In addition, the impact of caregivers on patients and the coping they provided were worthy of attention. Conclusions This article reviewed interventions for SPB in patients with cancer and the coping strategies from patients and caregivers. The interventions targeting on SPB can alleviate SPB by improving patients' physical condition, psychological status, and financial/family situation. However, the coping attitudes and behaviors of both patients and caregivers were depending on the individual cognitions and perceptions; different coping strategies produced different outcomes. To achieve improvements in SPB, interventions should incorporate the coping strategies. Appropriate patient-caregiver dyad interventions should be constructed based on the commonalities in coping with SPB.
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Affiliation(s)
- Xuan Chen
- Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Zhiming Wang
- Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Junrui Zhou
- Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Qiuping Li
- Wuxi School of Medicine, Jiangnan University, Wuxi, China
- Affiliated Hospital of Jiangnan University, Wuxi, China
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Keleş MN, Salameh T, Seven M. Quality of Life of Caregivers of Women Receiving Cancer Treatment in Turkey. FLORENCE NIGHTINGALE JOURNAL OF NURSING 2023; 31:S31-S37. [PMID: 37162052 PMCID: PMC10911777 DOI: 10.5152/fnjn.2023.22235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 04/14/2023] [Indexed: 05/11/2023]
Abstract
AIM The study aims to explore the predictors of the quality of life of caregivers of women receiving cancer treatment in Turkey. METHOD This study was conducted in a Medical-Oncology inpatient clinic of a University Hospital in Istanbul, Turkey, between February and June 2020. Descriptive data were collected from 128 family caregivers using caregiver and patient identification forms and the quality of life scale- family version. Bivariate analyses and multiple regression were used to analyze the data. RESULTS The mean score of the quality of life was 4.41 (standard deviation=0.63). A backward multiple regression revealed that being female caregivers, increased time spent for care per day, and caring for women with metastatic cancer were factors associated with poor quality of life. CONCLUSION Although caregiving responsibilities bring challenges to every caregiver, those who are at high risk for impaired quality of life during caregiving need further support in their caregiving to maintain quality of life. Further research should focus on finding solutions to better support caregivers who are experiencing impairment in their quality of life.
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Affiliation(s)
- Maide Nur Keleş
- Department of Nursing, Halic University, Faculty of Health Sciences, Istanbul, Turkey
- Koc University Graduate School of Health Sciences, İstanbul, Turkey
| | | | - Memnun Seven
- Koç University, School of Nursing, İstanbul, Turkey
- Department of Nursing, University of Massachusetts Amherst College of Nursing, MA, USA
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Cormican O, Dowling M. The hidden psychosocial impact of caregiving with chronic haematological cancers: A qualitative study. Eur J Oncol Nurs 2023; 64:102319. [PMID: 37141662 DOI: 10.1016/j.ejon.2023.102319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 02/20/2023] [Accepted: 03/10/2023] [Indexed: 03/19/2023]
Abstract
PURPOSE People living with a chronic haematological malignancy (CHM) are living longer due to the continued emergence of novel treatments. Their care is mostly delivered in an outpatient setting, and little is known about their experience of this disease trajectory. The aim of this qualitative study was to explore carers' experiences, expressed needs and psychosocial vulnerability. METHOD In-depth interviews with a purposive sample of carers (n=11) explored their experiences of caring for someone with a CHM and the impact it had on their lives. Reflexive thematic analysis guided data analysis. RESULTS Two main themes were developed from the interview data: 1) restructured living, and 2) sustaining caring, with six subthemes: shrinking world, constant carer, healthcare professional support, needing information, particularly in the early days, peer support, and taking control. CONCLUSIONS Caregivers of patients with a CHM undergo a significant life change which is often invisible to others. Identifying carers at risk of psychosocial vulnerability and recognising the caregiver as a member of the care team are significant steps towards addressing the support needs of this population.
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Affiliation(s)
| | - Maura Dowling
- School of Nursing and Midwifery, University of Galway, Ireland
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Zhao XS, Gui L, Zhou LJ, Zhang B, Chen HY. Risk factors associated with the comprehensive needs of cancer caregivers in China. Support Care Cancer 2023; 31:170. [PMID: 36790489 DOI: 10.1007/s00520-023-07622-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 01/30/2023] [Indexed: 02/16/2023]
Abstract
BACKGROUND Cancer incidence and mortality rates have been rising in developing countries, especially in Asia. Cancer caregivers face unique challenges which put them at risk for burden, poor quality of life, and burnout. The purpose of this study was to investigate the comprehensive needs and associated factors of cancer caregivers, and explore the correlation with cancer patients. METHODS In Mainland China, 200 cancer patient-caregiver dyads were chosen and interviewed for a cross-sectional questionnaire survey by convenient sampling method. Cancer caregivers' comprehensive needs were assessed with Comprehensive Needs Assessment Tool in cancer for Caregivers(CNAT-C), including seven domains (health and psychological problems, family and social support, healthcare staffs, information, religious/spiritual support, hospital facilities and services, and practical support). The comprehensive needs assessment tool in cancer for patients (CNAT) was used to assess patients' comprehensive needs. The sociodemographic survey was completed by both cancer patients and caregivers. The mean differences in domain scores for different groups of characteristics were compared by one-way ANOVA or non-parametric analyses, and those factors that had significant differences were selected for the multivariate regression analysis to determine the final influencing factors. The correlation between cancer patients' and caregivers' needs was evaluated by Spearman's correlation analysis. RESULTS The cancer caregivers' need for healthcare staff (82.60±19.56) was the highest among the seven domains, followed by the need for information (72.17±14.61) and the need for hospital facilities and services (56.44±18.22). The lowest score was the need for religious/spiritual support (28.33±16.05). Caregivers who were younger, highly educated, with high household income, and less than 1 year since diagnosis had higher scores of CNAT-C. Also sociodemographic characteristics were associated with each domain of cancer caregivers' need. Correlations between patients' and caregivers' comprehensive needs were low to moderate (0.013~0.469). CONCLUSION Cancer caregivers experience high levels of comprehensive needs, which are closely related to their sociological characteristics. The tailored interventions and mobilization of social and health care support may thus provide multiple levels of benefit across cancer trajectories. The patient-caregiver dyad should be regarded as a unit for treatment in cancer care.
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Affiliation(s)
- Xin-Shuang Zhao
- College of Nursing, Naval Medical University, Shanghai, 200433, People's Republic of China
| | - Li Gui
- College of Nursing, Naval Medical University, Shanghai, 200433, People's Republic of China.
| | - Ling-Jun Zhou
- College of Nursing, Naval Medical University, Shanghai, 200433, People's Republic of China
| | - Bing Zhang
- College of Nursing, Naval Medical University, Shanghai, 200433, People's Republic of China
| | - Hai-Yan Chen
- College of Nursing, Henan University of Science and Technology, Luoyang, 471023, People's Republic of China
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Tremblay D, Touati N, Usher S, Gentil B, Courval MJ. The challenge of optimizing supports for people living with and beyond cancer: creating proximity between cancer and non-profit community-based providers. Support Care Cancer 2023; 31:108. [PMID: 36625923 PMCID: PMC9831956 DOI: 10.1007/s00520-022-07569-3] [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: 07/23/2022] [Accepted: 12/30/2022] [Indexed: 01/11/2023]
Abstract
PURPOSE Non-profit community-based organizations (CO) remain insufficiently integrated into cancer networks. Drawing on dimensions of proximity, this study explores how and why coordination between cancer teams and COs is established and solidified. METHODS A descriptive interpretive study is undertaken in Québec (Canada), where a cancer program has long promoted the integration of COs in the cancer trajectory. Semi-directed interviews with providers, managers and people living with and beyond cancer (total n = 46) explore the challenges of coordination between cancer and CO providers, along with facilitating or impeding factors. Three main themes related to coordination in cancer networks emerge, which are analyzed by operationalizing the multi-dimensional framework of proximity. RESULTS Findings reveal a lack of cognitive proximity, which calls for efforts to both identify patient needs and increase cancer team knowledge and appreciation of CO resources. Organizational proximity refers to systems and rules that facilitate interactions, and we find that referral mechanisms and communication channels are inadequate, with patients often playing a linking role despite barriers. Coordination improves when relational proximity is established between cancer and CO teams, and this can be enhanced by geographic proximity; in one region, COs have a physical presence within the cancer center. CONCLUSION Integrating COs into the cancer network can help meet the spectrum of needs faced by people living with and beyond cancer. This study offers managers and decision-makers insight into how coordination between cancer teams and COs can be supported. Proximity allows the distinct contributions of actors to be considered in context and contributes to understanding the "how" of integrated practice.
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Affiliation(s)
- Dominique Tremblay
- School of Nursing, Université de Sherbrooke, Longueuil Campus, 150 Place Charles-Le Moyne, Longueuil, Québec, J4K 0A8, Canada. .,Centre de Recherche Charles-Le Moyne, 150 Place Charles-Le Moyne, Longueuil, Québec, J4K 0A8, Canada.
| | - Nassera Touati
- École nationale d’administration Publique, 4750 Ave Henri-Julien, 5E Étage, Montréal, Québec H2T 3E5 Canada
| | - Susan Usher
- Centre de Recherche Charles-Le Moyne, 150 Place Charles-Le Moyne, Longueuil, Québec J4K 0A8 Canada ,École nationale d’administration Publique, 4750 Ave Henri-Julien, 5E Étage, Montréal, Québec H2T 3E5 Canada
| | - Barbara Gentil
- Centre de Recherche Charles-Le Moyne, 150 Place Charles-Le Moyne, Longueuil, Québec J4K 0A8 Canada
| | - Marie-Josée Courval
- Centre Intégré de Santé et de Services Sociaux (CISSS) de la Montérégie-Centre, 3120 Boul. Taschereau, Greenfield Park, Québec J4V 2H1 Canada
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14
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Hiatt J, Young A, Brown T, Banks M, Segon B, Bauer J. A qualitative comparison of the nutrition care experiences of carers supporting patients with head and neck cancer throughout surgery and radiation treatment and survivorship. Support Care Cancer 2022; 30:9359-9368. [PMID: 36109395 PMCID: PMC9633518 DOI: 10.1007/s00520-022-07348-0] [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: 01/18/2022] [Accepted: 08/24/2022] [Indexed: 01/05/2023]
Abstract
PURPOSE To understand and compare the nutrition care experiences of carers supporting patients throughout surgery and radiation treatment for head and neck cancer (HNC) to inform changes to service delivery in the inpatient and outpatient setting to ensure carers needs in their supportive role throughout the treatment and survivorship period are met. METHODS As part of a larger study, narrative interviews were completed with fourteen carers of patients diagnosed with HNC at 2 weeks, 3 months and 12 months post-treatment completion. Reflexive thematic analysis was used to interpret and understand differences in carer experiences of nutrition care between surgery and radiation treatment. RESULTS Two main themes across each treatment modality were identified: (1) access to information and support from healthcare professionals and (2) adjustment to the physical and psychological impact of treatment. CONCLUSION This study highlights the increasing need to ensure carers are included in the provision of nutrition information and support to patients throughout and beyond their treatment trajectory. Having structured support available to patients and carers throughout radiation treatment meant that carer needs were reduced. However, without the opportunity for structured support in the inpatient setting, many carers expressed high care needs in supporting patients in the post-surgical phase. IMPLICATIONS FOR CANCER SURVIVORS Providing carers with access to structured support for nutrition care in the inpatient and outpatient setting can reduce their supportive care needs throughout the treatment and survivorship period.
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Affiliation(s)
- Joanne Hiatt
- School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, Australia. .,Department of Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Level 2, Dr James Mayne Building, Butterfield Street, 4029, Herston, QLD, Australia.
| | - Adrienne Young
- School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, Australia.,Department of Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Level 2, Dr James Mayne Building, Butterfield Street, 4029, Herston, QLD, Australia
| | - Teresa Brown
- School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, Australia.,Department of Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Level 2, Dr James Mayne Building, Butterfield Street, 4029, Herston, QLD, Australia
| | - Merrilyn Banks
- School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, Australia.,Department of Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Level 2, Dr James Mayne Building, Butterfield Street, 4029, Herston, QLD, Australia
| | - Bronwyn Segon
- School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, Australia
| | - Judith Bauer
- School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, Australia.,Department of Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Level 2, Dr James Mayne Building, Butterfield Street, 4029, Herston, QLD, Australia
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15
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Paterson C, Toohey K, Bacon R, Kavanagh PS, Roberts C. What Are the Unmet Supportive Care Needs of People Affected by Cancer: An Umbrella Systematic Review. Semin Oncol Nurs 2022:151353. [DOI: 10.1016/j.soncn.2022.151353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 09/16/2022] [Accepted: 10/12/2022] [Indexed: 11/24/2022]
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16
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Investigating the self-perceived educational priorities among oncology nurses. Nurse Educ Pract 2022; 64:103426. [DOI: 10.1016/j.nepr.2022.103426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 06/21/2022] [Accepted: 08/02/2022] [Indexed: 11/21/2022]
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17
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Jadidi A, Ameri F. Social Support and Meaning of Life in Women with Breast Cancer. Ethiop J Health Sci 2022; 32:709-714. [PMID: 35950056 PMCID: PMC9341025 DOI: 10.4314/ejhs.v32i4.6] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 03/28/2022] [Indexed: 02/03/2023] Open
Abstract
Background Social support is known as an affection-oriented coping mechanism when a person is involved with cancer. Therefore, this study was conducted to investigate the relationship between family social support and the meaning of life in women with breast cancer. Methods In this cross-sectional study, 84 women with a mean age of 60 (SD = 5.7) years with breast cancer who were admitted to a teaching hospital participated. Data were collected using social support and meaning of life questionnaires. After collecting the completed questionnaires and entering the data into the computer, the analysis was performed using SPSS software and using t-test, ANOVA, and Pearson correlation test at a significant level of 0.01. Results The mean score of their social support was 39.35 ± 9.51, respectively and the meaning of life was 29.5 ± 7.49. ANOVA results indicated that the social support score and meaning of life had no significant relationship with any of the demographic variables. Also, the findings suggest that there is a statistically significant correlation between social support and the meaning of life (r = 0.773, P < 0.001). Conclusion It is proposed to increase the level of social support from the family to help improve the meaning of life in cancer patients.
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Affiliation(s)
- Ali Jadidi
- Ph.D in Nursing, School of Nursing, Arak University of Medical Sciences, Arak, Iran
| | - Farzad Ameri
- Bs in Nursing, School of Nursing, Arak University of Medical Sciences, Arak, Iran
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18
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Peters S, Van Hout E, Jansen L, van den Akker M. Psychosocial Well-Being of Older Spouses During End-of-Life Caregiving for Their Partners With Cancer: A Phenomenological Study. J Gerontol Nurs 2022; 48:33-39. [PMID: 35648580 DOI: 10.3928/00989134-20220506-02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Specific burdens of older spousal caregivers often remain invisible, and spousal caregivers rarely receive the support they need to perform their role. To provide suitable support for spousal caregivers, it is crucial to develop a comprehensive understanding of their well-being, particularly during end-of-life caregiving. The aim of the current study was to gain more insight into the psychosocial well-being of older spouses engaged in end-of-life caregiving for their partners with cancer. This qualitative study uses a phenomenological approach with in-depth interviews conducted with older (aged ≥65 years) spousal caregivers of individuals who died of cancer. Eleven spouses participated in the study. Strains on psychosocial well-being during end-of-life caregiving fell into four major themes: The Disease Itself, The Caregiving Process, The Partner Relationship, and Support From Others. Results suggest that older spousal caregivers are experiencing issues that might be more pronounced due to their older age, for example, physical and emotional exhaustion and loneliness. Providing care is time-consuming and often leads to a reduced social network, which enhances loneliness. Moreover, as relationships with ailing partners changed and communication deteriorated, participants reported feeling more like a caregiver rather than a partner. [Journal of Gerontological Nursing, 48(6), 33-39.].
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19
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Cheng Q, Ng MS, Choi KC, So WK. Unmet needs, anxiety, depression, and quality of life among caregivers of adolescents and young adults with cancer: A cross-sectional study. Asia Pac J Oncol Nurs 2022; 9:100108. [PMID: 36118621 PMCID: PMC9475260 DOI: 10.1016/j.apjon.2022.100108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 06/07/2022] [Indexed: 11/04/2022] Open
Abstract
Objective To assess unmet needs, anxiety, depression, and quality of life of caregivers of adolescents and young adults with cancer and examine their associations. Methods A total of 282 caregivers of adolescents and young adults with cancer were recruited by convenience sampling at a tertiary cancer hospital in Chinese Mainland. The participants’ unmet needs, anxiety, depression, and quality of life were assessed using self-reported questionnaires. Hierarchical regression analyses were conducted to examine associations between unmet needs and health outcomes. Results The five most prevalent high unmet needs were related to ‘worries about future’ and ‘information’, including dealing with not knowing what lies in the future (n = 161, 57.1%), dealing with worry about the cancer getting worse (n = 151, 53.5%), dealing with worry about the cancer coming back (n = 147, 52.1%), finding information about complementary or alternative therapies (n = 137, 48.6%), and finding information about the long-term side effects of treatments and medicines (n = 126, 44.7%). Around 40% of the caregivers reported moderate to severe anxiety and depression. After adjusting for sociodemographic and clinical characteristics, personal and emotional needs, healthcare access and continuity, and financial needs remained significantly associated with anxiety, depression, or quality of life. Conclusions Nurses need to be aware of the unmet needs of caregivers of adolescents and young adults with cancer. More effort is needed to identify services and interventions that address the unmet needs, particularly personal and emotional, healthcare access and continuity, and financial needs, to improve the caregivers’ health outcomes.
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20
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Torres Blasco N, Costas Muñiz R, Zamore C, Porter L, Claros M, Bernal G, Shen MJ, Breitbart W, Castro EM. Cultural adaptation of meaning-centered psychotherapy for latino families: a protocol. BMJ Open 2022; 12:e045487. [PMID: 35379609 PMCID: PMC8981324 DOI: 10.1136/bmjopen-2020-045487] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Literature suggests couple-based interventions that target quality of life and communication can lead to positive outcomes for patients with cancer and their partners. Nevertheless, to date, an intervention to address the needs of Latino families coping with advanced cancer has not been developed. Meta-analytic evidence suggests that culturally adapted evidenced-based intervention targeting a specific cultural group is four times more effective. Our goal is to culturally adapt a novel psychosocial intervention protocol entitled 'Caregivers-Patients Support to Latinx coping advanced-cancer' (CASA). We hypothesised that combine two evidence-based interventions and adapting them, we will sustain a sense of meaning and improving communication as patients approach the end of life among the patient-caregiver dyad. METHODS AND ANALYSIS To culturally adapt CASA, we will follow an innovative hybrid research framework that combines elements of an efficacy model and best practices from the ecological validity model, adaptation process model and intervention mapping. As a first step, we adapt a novel psychosocial intervention protocol entitled protocol entitled 'Caregivers-Patients Support to Latinx coping advanced-cancer' (CASA). The initial CASA protocol integrates two empirically based interventions, meaning-centred psychotherapy and couple communication skills training. This is an exploratory and prepilot study, and it is not necessary for a size calculation. However, based on recommendations for exploratory studies of this nature, a priori size of 114 is selected. We will receive CASA protocol feedback (phase 1b: refine) by conducting 114 questionnaires and 15 semistructured interviews with patients with advanced cancer and their caregivers. The primary outcomes of this study will be identifying the foundational information needed to further the develop the CASA (phase IIa: proof-of-concept and phase IIb: pilot study). ETHICS AND DISSEMINATION The Institutional Review Board of Ponce Research Institute approved the study protocol #1907017527A002. Results will be disseminated through peer-reviewed publications.
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Affiliation(s)
| | - Rosario Costas Muñiz
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Carolina Zamore
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Laura Porter
- Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, USA
| | - Maria Claros
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Guillermo Bernal
- Professor of Psychology (Retired), Universidad de Puerto Rico, San Juan, Puerto Rico
| | | | - William Breitbart
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - E M Castro
- SBBS, Ponce Health Sciences University, Ponce, Puerto Rico
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21
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Agbayani CJ, Tucker JA, Nelson EL, Martinez F, Cortes H, Khoury D, Kain ZN, Lin C, Torno L, Fortier MA. Immunological and psychosocial functioning in parents of children with cancer. Support Care Cancer 2022; 30:3379-3388. [PMID: 34994860 PMCID: PMC9833860 DOI: 10.1007/s00520-021-06770-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 12/16/2021] [Indexed: 01/13/2023]
Abstract
PURPOSE Research has shown that parents of children with cancer exhibit an altered immune profile compared to parents of healthy children, reflective of increased susceptibility to illness. These parents are also at risk for poorer psychosocial outcomes and quality of life. The current study compares peripheral blood cell analyses and psychosocial self-reports from parents of children being treated for cancer (n = 21) to parents of healthy children (n = 30). METHODS A blood sample was drawn from parents to analyze immune profiles. Parents also completed the Perceived Stress Scale (PSS), Medical Outcomes Study Short Form-36 (MOS), and Patient-Reported Outcomes Measurement Information System Short Form v1.0 Emotional Distress-Anxiety 8a, and Emotional Distress-Depression 8a (PROMIS). Mann-Whitney U tests and independent samples t-tests were conducted to examine differences in outcomes between parent groups. RESULTS Parents of children with cancer exhibited higher monocyte percentages in their peripheral blood compared to peers with healthy children. Parents of children with cancer also reported poorer psychosocial outcomes: higher perceived stress, higher anxiety and depression symptoms, more role disability resulting from emotional problems, poorer general and mental health, and poorer social functioning. CONCLUSION These findings support research that has shown a direct effect of chronic stress on the immune system. Symptoms reported by parents of children with cancer indicate unmet psychosocial needs that could potentially affect long-term health. Given the central role of parents in their children's cancer care, it is compelling to address and work to improve parent immunological and psychosocial well-being.
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Affiliation(s)
- Crystle-Joie Agbayani
- UCI Center on Stress and Health, School of Medicine, University of California-Irvine, Irvine, CA, USA,Department of Psychological Science, University of California-Irvine, Irvine, CA, USA
| | - Jo A. Tucker
- Department of Medicine, Division of Hematology Oncology, University of California-Irvine, Irvine, CA, USA,Institute for Immunology, University of California-Irvine, Irvine, CA, USA
| | - Edward L. Nelson
- Department of Medicine, Division of Hematology Oncology, University of California-Irvine, Irvine, CA, USA,Institute for Immunology, University of California-Irvine, Irvine, CA, USA,NCI-Designated Chao Family Comprehensive Cancer Center, Irvine, CA, USA
| | - Freddy Martinez
- UCI Center on Stress and Health, School of Medicine, University of California-Irvine, Irvine, CA, USA
| | - Haydee Cortes
- UCI Center on Stress and Health, School of Medicine, University of California-Irvine, Irvine, CA, USA,Department of Anesthesiology & Perioperative Care, University of California-Irvine, Irvine, CA, USA
| | - Dina Khoury
- UCI Center on Stress and Health, School of Medicine, University of California-Irvine, Irvine, CA, USA,Department of Medicine, Division of Hematology Oncology, University of California-Irvine, Irvine, CA, USA
| | - Zeev N. Kain
- UCI Center on Stress and Health, School of Medicine, University of California-Irvine, Irvine, CA, USA,Department of Anesthesiology & Perioperative Care, University of California-Irvine, Irvine, CA, USA,Department of Pediatrics, CHOC, Orange, CA, USA,Child Study Center, School of Medicine, Yale University, New Haven, CT, USA
| | - Carol Lin
- Hyundai Cancer Institute, CHOC, Orange, CA, USA
| | | | - Michelle A Fortier
- UCI Center on Stress and Health, School of Medicine, University of California-Irvine, Irvine, CA, USA,Department of Psychological Science, University of California-Irvine, Irvine, CA, USA,NCI-Designated Chao Family Comprehensive Cancer Center, Irvine, CA, USA,Department of Anesthesiology & Perioperative Care, University of California-Irvine, Irvine, CA, USA,Department of Psychology, CHOC, Orange, CA, USA,Sue & Bill Gross School of Nursing, University of California-Irvine, Irvine, CA, USA
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22
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Abstract
Informal caregivers invest a significant amount of time and effort to provide cancer patients with physical, psychological, information, and social support. These challenging tasks can harm their own health and well-being, while a series of social-ecological factors may also influence the outcomes of cancer caregiving. Several instruments have been developed to help clinicians and researchers understand the multi-dimensional needs and concerns of caregivers. A growing body of evidence indicates that supportive interventions including psychoeducation, skills training, and therapeutic counseling can help improve the burden, information needs, coping strategies, physical functioning, psychological well-being, and quality of life of caregivers. However, there is difficulty in translating research evidence into practice. For instance, some supportive interventions tested in clinical trial settings are regarded as inconsistent with the actual needs of caregivers. Other significant considerations are the lack of well-trained interdisciplinary teams for supportive care provision and insufficient funding. Future research should include indicators that can attract decision-makers and funders, such as improving the efficient utilization of health care services and satisfaction of caregivers. It is also important for researchers to work closely with key stakeholders, to facilitate evidence dissemination and implementation, to benefit caregivers and the patient.
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23
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Addressing a critical need for caregiver support in neuro-oncology: development of a caregiver navigation intervention using eSNAP social resource visualization. Support Care Cancer 2022; 30:5361-5370. [PMID: 35290512 PMCID: PMC8922391 DOI: 10.1007/s00520-022-06977-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 03/10/2022] [Indexed: 12/24/2022]
Abstract
Informal caregivers are key to oncology care, but often have unmet needs, leading to poor psychological and physical health outcomes. Comprehensive, proactive caregiver support programs are needed. We describe the development of a support intervention for caregivers of persons with brain tumors. The intervention uses a caregiver navigator to help participants identify and capitalize on existing social support resources captured using a web-based tool (eSNAP) and connects participants to existing formal services. We describe the iterative development process of the manualized intervention with particular focus on the caregiver navigator sessions. The process included review of the literature and published patient navigation programs, expert and stakeholder review, and study team member review. Quantitative and qualitative data were captured from the first 15 participants randomized to receive the intervention, enrolled from February 2020 to December 2020. Four participants dropped from the study, 9 completed at least 7 modules, and 8 participants completed all 8. Quantitative and qualitative data were collected primarily from those who completed the intervention; data suggest caregivers were satisfied with the intervention and found it helpful. Our intervention is one of the first theory-based caregiver support interventions to include caregiver navigation in neuro-oncology. We use best-practice guidelines for design, including extensive stakeholder feedback. COVID-19 may have impacted recruitment and participation, but some preliminary data suggest that those able to engage with the intervention find it helpful. Data collection is ongoing in a larger trial. If effective, caregiver navigation could be a model for future interventions to ensure caregiver support.
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Marshall CA, Curran MA, Trejo J, Gonzalez AA, Armin J, Hamann HA, Badger TA, Garcia FAR. The Evolution of Un Abrazo Para La Familia: Implications for Survivors of Cancer. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:1075-1080. [PMID: 32239477 DOI: 10.1007/s13187-020-01737-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Un Abrazo Para La Familia™ (Abrazo) is a 3-h modular preventive intervention designed for low-income caregivers who are co-survivors of cancer. Here we (1) consider the benefit to survivors of cancer, that is, the care recipients who participate in Abrazo; (2) summarize the literature specific to research outreach to low-income, underserved populations when they are faced with cancer; and (3) describe current steps being taken in Southern Arizona to reach these populations via Abrazo. Specific to considering the benefit to care recipients, we analyzed care recipient data derived from three existing cohorts of Abrazo participants. Analyses of the combined cohorts of these data demonstrate that Abrazo is effective with care recipients given statistically significant higher cancer knowledge and self-efficacy scores, pre- vs. post-intervention. We can now report benefit to care recipients who participate in Abrazo. This allows us, with confidence, to expand research recruitment efforts to include care recipients as part of the Abrazo intervention in our efforts to serve low-income, underserved populations when faced with cancer.
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Affiliation(s)
- Catherine A Marshall
- Department of Disability and Psychoeducational Studies, The University of Arizona, Tucson, AZ, USA.
| | - Melissa A Curran
- Department of Family Studies and Human Development, Tucson, AZ, USA
| | - Juanita Trejo
- Un Abrazo Para La Familia, The University of Arizona, Tucson, AZ, USA
- Department of Psychology, The University of Arizona, Tucson, AZ, USA
| | - Alma A Gonzalez
- Department of Disability and Psychoeducational Studies, The University of Arizona, Tucson, AZ, USA
- Un Abrazo Para La Familia, The University of Arizona, Tucson, AZ, USA
| | - Julie Armin
- Department of Family and Community Medicine, The University of Arizona, Tucson, AZ, USA
| | - Heidi A Hamann
- Department of Psychology, The University of Arizona, Tucson, AZ, USA
| | - Terry A Badger
- Community and Systems Health Science Division, College of Nursing, The University of Arizona, Tucson, AZ, USA
- Department of Psychiatry, The University of Arizona, Tucson, AZ, USA
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25
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Norinder M, Årestedt K, Lind S, Axelsson L, Grande G, Ewing G, Holm M, Öhlén J, Benkel I, Alvariza A. Higher levels of unmet support needs in spouses are associated with poorer quality of life - a descriptive cross-sectional study in the context of palliative home care. BMC Palliat Care 2021; 20:132. [PMID: 34454454 PMCID: PMC8403446 DOI: 10.1186/s12904-021-00829-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 08/07/2021] [Indexed: 12/02/2022] Open
Abstract
Background Family caregivers often report having unmet support needs when caring for someone with life-threatening illness. They are at risk for psychological distress, adverse physical symptoms and negatively affected quality of life. This study aims to explore associations between family caregivers’ support needs and quality of life when caring for a spouse receiving specialized palliative home care. Methods A descriptive cross-sectional design was used: 114 family caregivers completed the Carer Support Needs Assessment Tool (CSNAT) and the Quality of Life in Life-Threatening Illness – Family caregiver version (QOLLTI-F) and 43 of them also answered one open-ended question on thoughts about their situation. Descriptive statistics, multiple linear regression analyses, and qualitative content analysis, were used for analyses. Results Higher levels of unmet support needs were significantly associated with poorer quality of life. All CSNAT support domains were significantly associated with one or more quality of life domains in QOLLTI-F, with the exception of the QoL domain related to distress about the patient condition. However, family caregivers described in the open-ended question that their life was disrupted by the patient’s life-threatening illness and its consequences. Family caregivers reported most the need of more support concerning knowing what to expect in the future, which they also described as worries and concerns about what the illness would mean for them and the patient further on. Lowest QoL was reported in relation to the patient’s condition, and the family caregiver’s own physical and emotional health. Conclusion With a deeper understanding of the complexities of supporting family caregivers in palliative care, healthcare professionals might help to increase family caregivers’ QoL by revealing their problems and concerns. Thus, tailored support is needed.
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Affiliation(s)
- Maria Norinder
- Department of Health Care Sciences, Palliative Research Centre, Ersta Sköndal Bräcke University College, Box 11189, 100 61, Stockholm, Sweden.,Capio Palliative Care, Dalen Hospital, 121 87, Stockholm, Sweden
| | - Kristofer Årestedt
- Faculty of Health and Life Sciences, Linnaeus University, 39182, Kalmar, Sweden. .,The Research Section, Region Kalmar County, Kalmar, Sweden.
| | - Susanne Lind
- Department of Health Care Sciences, Palliative Research Centre, Ersta Sköndal Bräcke University College, Box 11189, 100 61, Stockholm, Sweden
| | - Lena Axelsson
- Department of Nursing Science, Sophiahemmet University, Stockholm, Sweden
| | - Gunn Grande
- Division of Nursing, Midwifery & Social Care, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Gail Ewing
- Centre for Family Research, University of Cambridge, Cambridge, UK
| | - Maja Holm
- Department of Health Care Sciences, Palliative Research Centre, Ersta Sköndal Bräcke University College, Box 11189, 100 61, Stockholm, Sweden.,Department of Nursing Science, Sophiahemmet University, Stockholm, Sweden
| | - Joakim Öhlén
- Institute of Health and Care Sciences and the Centre for Person-Centred Care, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,The Palliative Care Unit, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Inger Benkel
- The Palliative Care Unit, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Geriatric Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anette Alvariza
- Department of Health Care Sciences, Palliative Research Centre, Ersta Sköndal Bräcke University College, Box 11189, 100 61, Stockholm, Sweden.,Capio Palliative Care, Dalen Hospital, 121 87, Stockholm, Sweden
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Stiller A, Goodwin BC, Crawford-Williams F, March S, Ireland M, Aitken JF, Dunn J, Chambers SK. The Supportive Care Needs of Regional and Remote Cancer Caregivers. ACTA ACUST UNITED AC 2021; 28:3041-3057. [PMID: 34436032 PMCID: PMC8395470 DOI: 10.3390/curroncol28040266] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 07/28/2021] [Accepted: 08/03/2021] [Indexed: 11/23/2022]
Abstract
Objective: As cancer survival rates continue to increase, so will the demand for care from family and friends, particularly in more isolated settings. This study aims to examine the needs of cancer caregivers in regional and remote Australia. Methods: A total of 239 informal (i.e., non-professional) cancer caregivers (e.g., family/friends) from regional and remote Queensland, Australia, completed the Comprehensive Needs Assessment Tool for Cancer Caregivers (CNAT-C). The frequencies of individuals reporting specific needs were calculated. Logistic regression analyses assessed the association between unmet needs and demographic characteristics and cancer type. Results: The most frequently endorsed needs were lodging near hospital (77%), information about the disease (74%), and tests and treatment (74%). The most frequent unmet needs were treatment near home (37%), help with economic burden (32%), and concerns about the person being cared for (32%). Younger and female caregivers were significantly more likely to report unmet needs overall (OR = 2.12; OR = 0.58), and unmet healthcare staff needs (OR = 0.35; OR = 1.99, respectively). Unmet family and social support needs were also significantly more likely among younger caregivers (OR = 0.35). Caregivers of breast cancer patients (OR = 0.43) and older caregivers (OR = 0.53) were significantly less likely to report unmet health and psychology needs. Proportions of participants reporting needs were largely similar across demographic groups and cancer type with some exceptions. Conclusions: Caregiver health, practical issues associated with travel, and emotional strain are all areas where regional and remote caregivers require more support. Caregivers’ age and gender, time since diagnosis and patient cancer type should be considered when determining the most appropriate supportive care.
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Affiliation(s)
- Anna Stiller
- Viertel Cancer Research Centre, Cancer Council Queensland, Fortitude Valley, Brisbane, QLD 4006, Australia; (B.C.G.); (F.C.-W.); (J.F.A.); (J.D.)
- Centre for Health Research, University of Southern Queensland, Springfield, QLD 4300, Australia; (S.M.); (M.I.)
- Correspondence:
| | - Belinda C. Goodwin
- Viertel Cancer Research Centre, Cancer Council Queensland, Fortitude Valley, Brisbane, QLD 4006, Australia; (B.C.G.); (F.C.-W.); (J.F.A.); (J.D.)
- Centre for Health Research, University of Southern Queensland, Springfield, QLD 4300, Australia; (S.M.); (M.I.)
| | - Fiona Crawford-Williams
- Viertel Cancer Research Centre, Cancer Council Queensland, Fortitude Valley, Brisbane, QLD 4006, Australia; (B.C.G.); (F.C.-W.); (J.F.A.); (J.D.)
- Centre for Health Research, University of Southern Queensland, Springfield, QLD 4300, Australia; (S.M.); (M.I.)
- Cancer Palliative Care Outcomes Centre, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia
| | - Sonja March
- Centre for Health Research, University of Southern Queensland, Springfield, QLD 4300, Australia; (S.M.); (M.I.)
- School of Psychology and Counselling, University of Southern Queensland, Ipswich, QLD 4305, Australia
| | - Michael Ireland
- Centre for Health Research, University of Southern Queensland, Springfield, QLD 4300, Australia; (S.M.); (M.I.)
- School of Psychology and Counselling, University of Southern Queensland, Ipswich, QLD 4305, Australia
| | - Joanne F. Aitken
- Viertel Cancer Research Centre, Cancer Council Queensland, Fortitude Valley, Brisbane, QLD 4006, Australia; (B.C.G.); (F.C.-W.); (J.F.A.); (J.D.)
- Centre for Health Research, University of Southern Queensland, Springfield, QLD 4300, Australia; (S.M.); (M.I.)
- School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia
- School of Public Health, The University of Queensland, Springfield, QLD 4300, Australia
| | - Jeff Dunn
- Viertel Cancer Research Centre, Cancer Council Queensland, Fortitude Valley, Brisbane, QLD 4006, Australia; (B.C.G.); (F.C.-W.); (J.F.A.); (J.D.)
- Centre for Health Research, University of Southern Queensland, Springfield, QLD 4300, Australia; (S.M.); (M.I.)
- Menzies Health Institute Queensland, Griffith University, Mt Gravatt, QLD 4222, Australia
- Prostate Cancer Foundation of Australia, St Leonards, Sydney, NSW 2065, Australia
- Faculty of Health, University of Technology Sydney, Ultimo, Sydney, NSW 2007, Australia;
| | - Suzanne K. Chambers
- Faculty of Health, University of Technology Sydney, Ultimo, Sydney, NSW 2007, Australia;
- Faculty of Health Sciences, Australian Catholic University, Banyo, Brisbane, QLD 4014, Australia
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Perth, WA 6027, Australia
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Lee JW, Lee J, Lee MH, Lee SK, Kim WS, Jung SY, Kim Z, Lee J, Youn HJ. Unmet needs and quality of life of caregivers of Korean breast cancer survivors: a cross-sectional study. Ann Surg Treat Res 2021; 101:69-78. [PMID: 34386455 PMCID: PMC8331555 DOI: 10.4174/astr.2021.101.2.69] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 04/22/2021] [Accepted: 04/27/2021] [Indexed: 12/24/2022] Open
Abstract
Purpose As the survival rates of cancer patients have been increasing due to early diagnosis and technological advances in treatment, their caregiver burden has also emerged as an important issue. In view of this situation, this study aims to investigate the unmet needs and quality of life of caregivers of Korean breast cancer survivors. Methods A multicenter cross-sectional interview survey was performed among 160 caregivers of Korean breast cancer survivors. Caregivers who gave written informed consent to participate completed the Comprehensive Needs Assessment Tool for Cancer Caregivers and EuroQol-5 Dimensions. Results The mean age of the caregivers was 46.4 years, 44.4% (71 of 160) were spouses of patients, and 52.5% (84 of 160) were personally taking care of cancer survivors. Unmet needs were highest in the ‘healthcare staff’ domain and the item with the highest level of unmet needs was ‘needed information about the current status of the patient's illness and its future courses.’ Poorer quality of life was closely related to higher levels of unmet needs. In multiple regression analysis, older age, employment, the presence of religion, and higher levels of stress and despair in daily life were associated with higher levels of unmet needs. Conclusion The most prevalent unmet need in Korean breast cancer caregivers was found in the ‘healthcare staff’ domain, and their quality of life was closely related to unmet needs. Therefore, healthcare staff is required to make efforts to accurately identify breast cancer caregivers vulnerable in terms of unmet needs and address their unmet needs.
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Affiliation(s)
- Jong Won Lee
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jihyoun Lee
- Department of Surgery, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Min Hyuk Lee
- Department of Surgery, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Se Kyung Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Wan Sung Kim
- Department of Surgery, Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea
| | - So-Youn Jung
- Breast Cancer Center, National Cancer Center, Goyang, Korea
| | - Zisun Kim
- Department of Surgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Juhyung Lee
- Department of Preventive Medicine, Jeonbuk National University Medical School, Jeonju, Korea
| | - Hyun Jo Youn
- Department of Surgery, Research Institute of Clinical Medicine, Jeonbuk National University Hospital, Jeonbuk National University and Biomedical Research Institute, Jeonju, Korea
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Unmet Needs and Quality of Life of Cancer Patients and Their Families: Actor-Partner Interdependence Modeling. Healthcare (Basel) 2021; 9:healthcare9070874. [PMID: 34356252 PMCID: PMC8305838 DOI: 10.3390/healthcare9070874] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 07/03/2021] [Accepted: 07/06/2021] [Indexed: 02/04/2023] Open
Abstract
Unmet needs and quality of life (QOL) are important nursing issues for both patients and their families. However, studies into their direct association, considering the dyadic relationship between them, have not been done. We investigated the associations using the actor–partner interdependence modeling for dyadic data. Data were collected from 115 patient–family dyads at a tertiary teaching hospital. The study variables were assessed using the questionnaires and clinical data. To analyze patient–family dyad data, the actor–partner interdependence modeling and structural equation modeling were used. The cancer patients and their families experienced diverse and high levels of unmet needs that affected their quality of life, both physically and mentally. The cancer patients’ unmet needs decreased their physical and mental quality of life, while those of their families had a negative impact on their own physical and mental quality of life. However, the cancer patients’ unmet needs did not have partner effects on their families’ quality of life, and vice versa. Therefore, unmet needs played important roles in their QOL taking into dyadic relationships in the model. The results suggest that nursing intervention programs to meet the needs of both patients and their families are required to improve their quality of life.
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Kent EE, Park EM, Wood WA, Bryant AL, Mollica MA. Survivorship Care of Older Adults With Cancer: Priority Areas for Clinical Practice, Training, Research, and Policy. J Clin Oncol 2021; 39:2175-2184. [PMID: 34043450 PMCID: PMC8260922 DOI: 10.1200/jco.21.00226] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 03/09/2021] [Accepted: 03/23/2021] [Indexed: 12/25/2022] Open
Affiliation(s)
- Erin E. Kent
- University of North Carolina at Chapel Hill, Chapel Hill, NC
- Lineberger Comprehensive Cancer Center, Chapel Hill, NC
| | - Eliza M. Park
- University of North Carolina at Chapel Hill, Chapel Hill, NC
- Lineberger Comprehensive Cancer Center, Chapel Hill, NC
| | - William A. Wood
- University of North Carolina at Chapel Hill, Chapel Hill, NC
- Lineberger Comprehensive Cancer Center, Chapel Hill, NC
| | - Ashley Leak Bryant
- University of North Carolina at Chapel Hill, Chapel Hill, NC
- Lineberger Comprehensive Cancer Center, Chapel Hill, NC
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Thana K, Sikorskii A, Lehto R, Given C, Wyatt G. Burden and psychological symptoms among caregivers of patients with solid tumor cancers. Eur J Oncol Nurs 2021; 52:101979. [PMID: 34058683 DOI: 10.1016/j.ejon.2021.101979] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/08/2021] [Accepted: 05/17/2021] [Indexed: 12/30/2022]
Abstract
PURPOSE To evaluate factors associated with burden reported by caregivers of people undergoing treatment for solid tumor cancers. METHODS A secondary analysis of baseline data collected in a cancer symptom management trial was conducted guided by the Organizing Framework for Caregiver Interventions. A total of 349 caregivers completed the Caregiver Reaction Assessment Tool evaluating caregiver burden; Bayliss Comorbidity Tool; and PROMIS-29 version1.0-Anxiety and Depression Short Forms. Multivariable linear models were used to examine the associations of Caregiver Reaction Assessment Tool subscales (caregiver self-esteem, family support, financial, schedule, and health burden) with caregiver sociodemographic characteristics, comorbidities, anxiety, and depression. RESULTS The majority of caregivers were female and spouses/partners who resided with the patient. Being female, Asian, a spouse of the patient, employed, and having a higher level of anxiety and depressive symptoms were significantly associated with lower caregiver self-esteem, and higher perceived schedule and health burden. Caregiver anxiety and depressive symptoms were also significantly associated with lack of family support and higher financial burden. CONCLUSIONS Clinicians should consider factors that contribute to higher perceived burden for caregivers when they are engaged in home-based supportive care for patients undergoing cancer treatment.
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Affiliation(s)
- Kanjana Thana
- Faculty of Nursing, Chiang Mai University, 100/406 Inthawarorod Rd., Maung, Chiangmai, 50200 , Thailand.
| | - Alla Sikorskii
- Department of Psychiatry, Michigan State University, 909 Fee Road Room 321-A, East Lansing, MI, 48824, USA.
| | - Rebecca Lehto
- College of Nursing, Michigan State University, 1355 Bogue Street #C344, East Lansing, MI, 48824, USA.
| | - Charles Given
- College of Nursing, Michigan State University, 1355 Bogue Street #C344, East Lansing, MI, 48824, USA.
| | - Gwen Wyatt
- College of Nursing, Michigan State University, 1355 Bogue Street #C344, East Lansing, MI, 48824, USA.
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Samuelsson M, Wennick A, Jakobsson J, Bengtsson M. Models of support to family members during the trajectory of cancer: A scoping review. J Clin Nurs 2021; 30:3072-3098. [PMID: 33973285 DOI: 10.1111/jocn.15832] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/31/2021] [Accepted: 04/19/2021] [Indexed: 12/15/2022]
Abstract
AIMS AND OBJECTIVES To map the existing literature on support models provided to family members during the cancer trajectory. BACKGROUND Cancer diagnosis, treatment and survivorship have a profound influence on the surrounding family members. This scoping review is part of the development of a support model for family members of persons diagnosed with colorectal cancer. DESIGN The method was guided by the Arksey and O'Malley framework, described in the Joanna Briggs Institute guidelines, and the reporting is compliant with PRISMA-ScR Checklist. Searches were conducted in PubMed, CINAHL and PsycINFO from November 2019-February 2020 with no limitation in publication year or study design. Complementing searches were conducted in reference lists and for grey literature, followed by an additional search in September 2020. Inclusion criteria were primary research about support provided by health care, to family members, during cancer, of an adult person, in Swedish or English, of moderate or high methodological quality. Quality was assessed using the Joanna Briggs Institute critical appraisal tools. Data were extracted using a charting form. RESULT A total of 32 studies were included in the review describing 39 support models. CONCLUSION The mapping of the existing literature resulted in the identification of three themes of support models: psychoeducation, caregiver training and psychological support. In addition, that future research should target a specific diagnosis and trajectory phase as well as include family members and intervention providers in model development. RELEVANCE FOR CLINICAL PRACTICE Knowledge from the literature on both the needs of the family members and existing support models should be incorporated with the prerequisites of clinical practice. Clinical practice should also be complemented with structured assessments of family members' needs conducted regularly.
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Affiliation(s)
- Maria Samuelsson
- Faculty of Health and Society, Department of Care Science, Malmö University, Malmö, Sweden.,Department of Pediatrics, Skåne University Hospital, Malmö, Sweden
| | - Anne Wennick
- Faculty of Health and Society, Department of Care Science, Malmö University, Malmö, Sweden
| | - Jenny Jakobsson
- Faculty of Health and Society, Department of Care Science, Malmö University, Malmö, Sweden
| | - Mariette Bengtsson
- Faculty of Health and Society, Department of Care Science, Malmö University, Malmö, Sweden
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Borsky AE, Zuvekas SH, Kent EE, de Moor JS, Ngo-Metzger Q, Soni A. Understanding the characteristics of US cancer survivors with informal caregivers. Cancer 2021; 127:2752-2761. [PMID: 33945632 DOI: 10.1002/cncr.33535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 02/16/2021] [Accepted: 02/23/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND Although informal caregivers such as family and friends provide people with cancer needed physical care and emotional support, little is known about which individuals have access to such caregivers. The purpose of this article is to provide a nationally representative description of the sociodemographic characteristics of cancer survivors who have or had an informal caregiver in the United States. METHODS Cross-sectional data were taken from the Experiences With Cancer Survivorship Supplement of the Medical Expenditure Panel Survey in 2011, 2016, and 2017. People were cancer survivors from diagnosis until the end of life. The study population consisted of adult survivors of cancer other than nonmelanoma skin cancer who were treated for cancer less than 3 years before the survey and were living in the community (n = 720). The main outcome measure was whether or not the cancer survivor reported having an informal caregiver. RESULTS In the United States, 55.2% of cancer survivors reported having an informal caregiver during or after their cancer treatment. The relationship of the caregiver to the survivor varied by sex: males were more likely to have a spouse as their caregiver, and females were more likely to have a child as their caregiver. In multivariate analyses, cancer survivors who were female, were married, were of a race/ethnicity other than White, or were in poor health were more likely to have an informal caregiver. CONCLUSIONS Future research can examine whether those without informal caregivers might need more formal support as they undergo cancer treatment and transition into cancer survivorship.
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Affiliation(s)
- Amanda E Borsky
- Agency for Healthcare Research and Quality, Rockville, Maryland
| | | | - Erin E Kent
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | | | - Quyen Ngo-Metzger
- Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California
| | - Anita Soni
- Agency for Healthcare Research and Quality, Rockville, Maryland
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Marshall CA. Reflections: a Daughter's Experience of Parental Cancer and the Beginnings of Un Abrazo Para La Familia™. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:431-434. [PMID: 32500454 PMCID: PMC7272137 DOI: 10.1007/s13187-020-01782-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
The author describes her impetus and journey in developing Un Abrazo Para La Familia™ [Embracing the Family] (Abrazo), 3 hours of cancer information presented in an educational and modular format and designed for low-income informal caregivers who are co-survivors of cancer. A rehabilitation-informed preventive intervention, Abrazo reflects the importance of family, culture, and socioeconomic background in its approach.
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Affiliation(s)
- Catherine A Marshall
- Department of Disability and Psychoeducational Studies, The University of Arizona, Tucson, AZ, 85721, USA.
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Thana K, Lehto R, Sikorskii A, Wyatt G. Informal caregiver burden for solid tumour cancer patients: a review and future directions. Psychol Health 2021; 36:1514-1535. [PMID: 33393827 DOI: 10.1080/08870446.2020.1867136] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Recent shifts in healthcare delivery and treatment for solid tumour cancer patients have modified the responsibilities of informal caregivers. The objective of this study was to: review informal caregiver burden factors and determine areas where future research is needed. METHODS The Arksey and O'Malley's framework and a modified Preferred Reporting Items for Systematic Reviews and Meta-Analyses were used in conducting this review. Research literature was systematically searched using five-electronic databases, including PubMed, PsycINFO, Cochrane, CINAHL, and SCOPUS, and reference lists from included studies to identify publications since 2010. Inclusion criterion was caregivers providing home-based care to a cancer patient. RESULTS The search yielded 43 eligible papers of 2119 reviewed, including articles from over 17 countries. Caregiver physical and psychological health, financial strain, and social isolation, as well as limited family and social support continued to be important factors contributing to high levels of caregiver burden. Less recognised factors affecting higher burden included caregivers' self-esteem, male gender, and the dynamic nature of cancer treatment. CONCLUSIONS This review updates the state of the science on informal caregiver burden when caring for patients with solid tumour cancers and informs future interventions on how to reduce this burden.
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Affiliation(s)
- Kanjana Thana
- Faculty of Nursing, Chiangmai University, Chiangmai, Thailand
| | - Rebecca Lehto
- College of Nursing, Michigan State University, East Lansing, MI, USA
| | - Alla Sikorskii
- Department of Psychiatry, Michigan State University, East Lansing, MI, USA
| | - Gwen Wyatt
- College of Nursing, Michigan State University, East Lansing, MI, USA
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Yang WFZ, Chan YH, Griva K, Kuparasundram S, Mahendran R. Lifestyle and Symptom Management Needs: A Network Analysis of Family Caregiver Needs of Cancer Patients. Front Psychiatry 2021; 12:739776. [PMID: 34616323 PMCID: PMC8488172 DOI: 10.3389/fpsyt.2021.739776] [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: 07/11/2021] [Accepted: 08/24/2021] [Indexed: 11/13/2022] Open
Abstract
Previous research on the needs of family cancer caregivers (FCCs) have not elucidated associations between specific caregiving needs. Network analysis, a statistical approach that allows the estimation of complex relationship patterns, helps facilitate the understanding of associations between needs and provides the opportunity to identify and direct interventions at relevant and specific targets. No studies to date, have applied network analysis to FCC populations. The aim of the study is to explore the network structure of FCC needs in a cohort of caregivers in Singapore. FCCs (N = 363) were recruited and completed a self-report questionnaire on socio-demographic data, medical data on their loved ones, and the Needs Assessment of Family Caregivers-Cancer scale. The network was estimated using state-of-the-art regularized partial correlation model. The most central needs were having to deal with lifestyle changes and managing care-recipients cancer-related symptoms. The strongest associations were between (1) having enough insurance coverage and understanding/navigating insurance coverage, (2) managing cancer-related pain and managing cancer-related symptoms, (3) being satisfied with relationships and having intimate relationships, and (4) taking care of bills and paying off medical expenses. Lifestyle changes, living with cancer, and symptom management are central to FCCs in Singapore. These areas deserve special attention in the development of caregiver support systems. Our findings highlight the need to improve access to social and medical support to help FCCs in their transition into the caregiving role and handle cancer-related problems.
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Affiliation(s)
- Winson Fu Zun Yang
- Department of Psychological Science, Texas Tech University, Lubbock, TX, United States.,Department of Psychological Medicine, National University Hospital, Singapore, Singapore
| | - Yiong Huak Chan
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Konstadina Griva
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | | | - Rathi Mahendran
- Department of Psychological Medicine, National University Hospital, Singapore, Singapore.,Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Shin JY, Chaar D, Kedroske J, Vue R, Chappell G, Mazzoli A, Hassett AL, Hanauer DA, Park SY, Debra B, Choi SW. Harnessing mobile health technology to support long-term chronic illness management: exploring family caregiver support needs in the outpatient setting. JAMIA Open 2020; 3:593-601. [PMID: 33758797 PMCID: PMC7969961 DOI: 10.1093/jamiaopen/ooaa053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 08/18/2020] [Accepted: 09/24/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Family caregiving is an important public health issue, particularly with the aging population. In recent years, mobile health (mHealth) technology has emerged as a potential low-cost, scalable platform to address caregiver support needs, and thereby alleviate the burden on caregivers. This study sought to examine the support needs of family caregivers in their lived experiences of outpatient care to inform the development of a future mHealth intervention. MATERAILS AND METHODS We conducted 20 semi-structured interviews in 2 outpatient hematopoietic cell transplant (HCT) clinics at a large academic medical center in the Midwestern United States. A thematic analysis was performed to define emerging themes. RESULTS Qualitative data analysis identified 5 primary themes that HCT caregivers faced: (I) lifestyle restrictions due to the patient's immunocompromised state; (II) Unmet needs due to limitations in the current resources, including unfamiliar medical tasks without necessary trainings; and (III) caregivers' adaptive strategies, including reformation of social relationships with family and friends. Based on these findings, we suggest 3 design considerations to guide the development of a future mHealth intervention. CONCLUSIONS The findings herein captured the family caregiver's lived experiences during outpatient care. There was broad agreement that caregiving was challenging and stressful. Thus, effective and scalable interventions to support caregivers are needed. This study provided data to guide the content and design of a future mHealth intervention in the outpatient setting.
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Affiliation(s)
- Ji Youn Shin
- Department of Media and Information, College of Communication Arts and Sciences, Michigan State University, East Lansing, Michigan, USA
| | - Dima Chaar
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
- School of Information, University of Michigan, Ann Arbor, Michigan, USA
| | - Jacob Kedroske
- Department of Pediatrics, Blood and Marrow Transplantation Program, University of Michigan, Ann Arbor, Michigan, USA
| | - Rebecca Vue
- Department of Pediatrics, Blood and Marrow Transplantation Program, University of Michigan, Ann Arbor, Michigan, USA
| | - Grant Chappell
- Department of Pediatrics, Blood and Marrow Transplantation Program, University of Michigan, Ann Arbor, Michigan, USA
| | - Amanda Mazzoli
- Department of Pediatrics, Blood and Marrow Transplantation Program, University of Michigan, Ann Arbor, Michigan, USA
| | - Afton L Hassett
- Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan, USA
| | - David A Hanauer
- Michigan Institute for Clinical and Health Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Sun Young Park
- School of Information, University of Michigan, Ann Arbor, Michigan, USA
- Stamps School of Arts and Design, University of Michigan, Ann Arbor, Michigan, USA
| | - Barton Debra
- School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
| | - Sung Won Choi
- Department of Pediatrics, Blood and Marrow Transplantation Program, University of Michigan, Ann Arbor, Michigan, USA
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Li Q, Xu Y, Lin Y, Chen Y. Validating the Chinese version of the Cancer Survivors' Partners Unmet Needs measure (C-CaSPUN) and exploring unmet needs in Chinese cancer survivor-family caregiver dyads. Eur J Cancer Care (Engl) 2020; 30:e13341. [PMID: 33090586 DOI: 10.1111/ecc.13341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 08/10/2020] [Accepted: 08/17/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To evaluate the psychometric properties of the C-CaSPUN in Chinese family caregivers (FCs) of cancer survivors (CaS) and to compare the unmet needs of CaS-FC dyads. METHODS A questionnaire survey, consisting of five Chinese version measurement scales, was used to collect data from CaS-FC dyads. Statistical methods used included exploratory factor analysis (EFA), confirmatory factor analysis (CFA), Cronbach's α, intraclass correlation coefficient (ICC) and Pearson's correlation. RESULTS Participants consisted of 610 survivor-caregiver dyads. EFA and CFA established the four-factor construct C-CaSPUN, comprising relationship impact and life perspective, information and health care, quality of life (QoL) and survivorship care. All of the C-CaSPUN scales had good internal reliability (Cronbach's α ≥ 0.752). The ICC for test-retest ranged from 0.645 to 0.782 at the scale level, with an average ICC value of 0.653. The concurrent validity was evidenced by C-CaSPUN being negatively associated with SF-12 MCS and positively related to anxiety and/or depression. In addition, the correlation coefficient scores between C-CaSPUN factors and the C-CaSUN total scale ranged from moderate to good (r = 0.505-0.671). CONCLUSIONS Study findings may support the reliability and validity of the C-CaSPUN in measuring the unmet needs of FCs of Chinese CaS.
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Affiliation(s)
- Qiuping Li
- Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | | | - Yi Lin
- Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Ying Chen
- Affiliated Hospital, Jiangnan University, Wuxi, China
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Olver I, Keefe D, Herrstedt J, Warr D, Roila F, Ripamonti CI. Supportive care in cancer—a MASCC perspective. Support Care Cancer 2020; 28:3467-3475. [DOI: 10.1007/s00520-020-05447-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 03/30/2020] [Indexed: 01/18/2023]
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The Lived Experiences of Family Caregivers of Persons Dying in Home Hospice: Support, Advocacy, and Information Urgently Needed. J Hosp Palliat Nurs 2020; 22:145-151. [PMID: 32011356 DOI: 10.1097/njh.0000000000000632] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Death in America is changing from hospital to home, which demands complex skills by family caregivers. However, information from family members about the challenges of providing home hospice care until death is scant. To understand the challenges a family caregiver confronts when he/she decides to deliver hospice care and during the actual delivery of the hospice care, we used descriptive phenomenology methods to document the experience of 18 family caregivers as they delivered home hospice care. We learned the decision to begin home hospice was made by a physician, followed frequently by family resistance and refusal to assist. Family caregiver burden is enormous, compounded by fatigue, sleeplessness, and confusion on issues such as morphine dosage and administration. The stages and process of dying, such as transition, baffled family caregivers. All family caregivers agree financial and emotion support, empathic advocacy, and affirmation of their worth are needed to sustain them to care for the dying. The peacefulness following offering a home death comes at a high price to family caregivers. Evidence is needed from a randomized controlled trial as to effectiveness of advocacy support for family caregivers to increase their resiliency and higher probability of a good death for the dying.
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