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Henderson NL, Padalkar T, Bourne G, Hendrix EK, Williams CP, Odom JN, Triebel K, Rocque GB. Assessing the association between quantity and quality of family caregiver participation in decision-making clinical encounters on patient activation in the metastatic breast cancer setting. Support Care Cancer 2024; 32:422. [PMID: 38858225 PMCID: PMC11164765 DOI: 10.1007/s00520-024-08593-1] [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: 11/28/2023] [Accepted: 05/20/2024] [Indexed: 06/12/2024]
Abstract
OBJECTIVE Caregivers support individuals undergoing cancer treatment by assisting with activities, managing care, navigating healthcare systems, and communicating with care teams. We explored the quality and quantity of caregiver participation during recorded decision-making clinical appointments in women with metastatic breast cancer. METHODS This was a convergent parallel mixed methods study that utilized qualitative and quantitative data collection and analysis. Caregiver participation quality was operationalized using a summative thematic content analysis to identify and sum caregiver actions performed during appointments. Performance of a greater number of actions was considered greater quality of participation. Caregiver participation quantity was measured by calculating the proportion of speaking time. Participation quality and quantity were compared to patient activation, assessed using the Patient Activation Measure 1-month post decision-making appointment. RESULTS Fifty-three clinical encounters between patients with MBC, their caregivers, and oncologists were recorded. Identified caregiver actions included: General Support; Management of Treatment or Medication; Treatment History; Decision-Making; Insurance or Money; Pharmacy; Scheduling; Travel Concerns; General Cancer Understanding; Patient Specific Cancer Understanding; Caregiver-Initiated or Emphasis on Symptom Severity; and Caregiver Back-Up of Patient Symptom Description. Caregivers averaged 5 actions (SD 3): 48% of patient's caregivers had low quality (< 5 actions) and 52% had high quality (> 6 actions) participation. Regarding quantity, caregivers spoke on average for 4% of the encounter, with 60% of caregivers speaking less than 4% of the encounter (low quantity) and 40% of caregivers speaking more than 4% (high quantity). Greater quality and quantity of caregiver participation was associated with greater patient activation. CONCLUSIONS Caregivers perform a variety of actions during oncological decision-making visits aiding both patient and provider. Greater participation in terms of quantity and quality by the caregiver was associated with greater patient activism, indicating a need for better integration of the caregiver in clinical decision-making environments.
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Affiliation(s)
- Nicole L Henderson
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Tanvi Padalkar
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Garrett Bourne
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Emma K Hendrix
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Courtney P Williams
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - J Nicholas Odom
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kristen Triebel
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Gabrielle B Rocque
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
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Poco LC, Malhotra C. More competent informal caregivers reduce advanced cancer patients' unplanned healthcare use and costs. Cancer Med 2024; 13:e7366. [PMID: 38872395 PMCID: PMC11176569 DOI: 10.1002/cam4.7366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 01/15/2024] [Accepted: 05/27/2024] [Indexed: 06/15/2024] Open
Abstract
BACKGROUND Patients with metastatic cancer experience high healthcare use and costs, most of which are unplanned. We aimed to assess whether patients with more competent informal caregivers have lower unplanned healthcare use and costs. METHODS This study used data from a prospective cohort of patients with solid metastatic cancer. Patients and their informal family caregivers were surveyed every 3 months until patients' death. Patients' unplanned healthcare use/costs were examined through hospital records. Caregivers responded to the 4-item Caregiver Competence Scale. First, in a deceased subsample of patients and their caregivers, we used patients' last 2 years of data (226 dyads) to assess the association between caregivers' competency (independent variable) and patients' unplanned healthcare use/costs (outcomes). Next, in a prospective sample of patient-caregiver dyads (up to 15 surveys), we assessed whether patients' functional well-being and psychological distress moderated the association between caregivers' competency and unplanned healthcare use/costs (311 dyads). RESULTS In the deceased subsample, during last 2 years of patients' life, caregivers' higher competency lowered the odds of patients' unplanned healthcare use [OR (CI) = 0.86 (0.75, 0.98), p = 0.03], and was associated with a significant reduction in unplanned healthcare costs [Coeff (CI) = -0.19 (-0.36, -0.01), p = 0.03]. In the prospective sample, patients' functional well-being and psychological distress moderated the association between caregivers' competency and patients' unplanned healthcare use/costs. CONCLUSION With deterioration in patients' condition and an increase in caregiving demands, improving caregivers' competency can reduce patients' unplanned healthcare use and costs. This should be further tested in future trials.
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Affiliation(s)
- Louisa Camille Poco
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore
| | - Chetna Malhotra
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
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Xu J, Chen Y, Zhao J, Wang J, Chen J, Pan X, Zhang W, Zheng J, Zou Z, Chen X, Zhang Y. Current status of electronic health literacy among pregnant women with gestational diabetes mellitus and their perceptions of online health information: a mixed-methods study. BMC Pregnancy Childbirth 2024; 24:392. [PMID: 38807050 PMCID: PMC11134622 DOI: 10.1186/s12884-024-06594-w] [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: 01/24/2024] [Accepted: 05/20/2024] [Indexed: 05/30/2024] Open
Abstract
BACKGROUND Women diagnosed with gestational diabetes mellitus often rely on internet-based health information for managing their condition. This study aims to investigate the present state of electronic health literacy among women with gestational diabetes mellitus, analyze the influencing factors, and explore their experiences regarding accessing, comprehending, evaluating, and applying online health information pertinent to gestational diabetes mellitus. METHODS A sequential explanatory mixed methods research design was adopted in this study. Initially, 235 women with gestational diabetes mellitus participated in a cross-sectional survey. The research tools included general information and the Chinese version of the electronic Health Literacy Scale (eHEALS). Descriptive analyses were conducted to describe the characteristics of the sample, and multiple linear regression analyses were used to explore the factors influencing electronic health literacy among women with gestational diabetes mellitus. Secondly, 11 women with gestational diabetes mellitus joined semi-structured in-depth interviews to obtain their perceptions about online health information. The data were analyzed using inductive content analysis to develop themes. RESULTS The median score of eHEALS in the Chinese version among 235 women diagnosed with gestational diabetes mellitus was 29 (interquartile range [IQR], 26 to 32). Factors influencing electronic health literacy among these women included accessing health information from medical professionals (β = 0.137, p = 0.029) and utilizing health information from applications (β = 0.159, p = 0.013). From the qualitative phase of the study, four thematic categories emerged: reasons and basis for accessing health information from the Internet; address barriers to accessing and applying online health information; desires for a higher level of online health information services; outcomes of accessing and applying online health information. CONCLUSION The electronic health literacy of women diagnosed with gestational diabetes mellitus remains suboptimal and warrants improvement. The sources of access to health information affect electronic health literacy in women with gestational diabetes mellitus. Moreover, women facing gestational diabetes encounter numerous impediments when attempting to access health-related information online, underscoring the necessity for enhanced online health information services to meet their needs.
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Affiliation(s)
- Jingqi Xu
- School of Nursing, Wuhan University, No. 115, Donghu Road, Wuhan, Hubei, 430071, China
| | - Yujia Chen
- School of Nursing, Wuhan University, No. 115, Donghu Road, Wuhan, Hubei, 430071, China
| | - Jing Zhao
- School of Nursing, Wuhan University, No. 115, Donghu Road, Wuhan, Hubei, 430071, China
| | - Jiarun Wang
- School of Nursing, Wuhan University, No. 115, Donghu Road, Wuhan, Hubei, 430071, China
| | - Jianfei Chen
- School of Nursing, Wuhan University, No. 115, Donghu Road, Wuhan, Hubei, 430071, China
| | - Xinlong Pan
- School of Nursing, Wuhan University, No. 115, Donghu Road, Wuhan, Hubei, 430071, China
| | - Wei Zhang
- School of Nursing, Wuhan University, No. 115, Donghu Road, Wuhan, Hubei, 430071, China
| | - Jin Zheng
- Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan, Hubei, 430079, China.
| | - Zhijie Zou
- School of Nursing, Wuhan University, No. 115, Donghu Road, Wuhan, Hubei, 430071, China.
| | - Xiaoli Chen
- School of Nursing, Wuhan University, No. 115, Donghu Road, Wuhan, Hubei, 430071, China.
| | - Yingzi Zhang
- Magnet Program & Nursing Research Department, UT Southwestern Medical Center, 8200 Brookriver Dr, Dallas, TX, 75247, USA
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Moore C, Gallagher P, Dunne S. Health literacy, eHealth literacy and their association with burden, distress, and self-efficacy among cancer caregivers. Front Psychol 2024; 15:1283227. [PMID: 38434952 PMCID: PMC10904647 DOI: 10.3389/fpsyg.2024.1283227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 02/05/2024] [Indexed: 03/05/2024] Open
Abstract
Purpose Health literacy skills are vital for cancer caregivers in helping cancer survivors to navigate their diagnosis, treatment, and recovery but little is known. This study explored health literacy and eHealth literacy among cancer caregivers and the relationship between health literacy/eHealth literacy and potential associated factors. Methods Informal caregivers who had cared for an individual with cancer completed a survey which collected demographic data and measured caregiver health literacy, eHealth literacy, self-efficacy, burden, and distress. Results Seven percent of caregivers had inadequate health literacy. Caregivers scored lowest on health literacy domains related to caregiver social support, information seeking and understanding care recipient preferences. eHealth literacy was associated with self-efficacy and burden while, different health literacy domains were associated with burden ('Understanding care recipient needs and preferences'), self-efficacy ('Cancer-related communication with the care recipient' and 'Understanding care recipients needs and preferences') and distress ('Proactivity and determination to seek information', 'Understanding care recipient needs and preferences', 'Understanding the healthcare system'). Conclusion Findings highlight key areas of need regarding cancer caregiver health literacy which future research can target. Given the observed relationship between aspects of health literacy and burden, distress and self-efficacy future work could be carried out on how to alleviate high levels of burden and distress and how to enhance self-efficacy among cancer caregivers by addressing health literacy skills. Implications for cancer survivors Findings from this study will inform the development of health literacy interventions to support caregivers to build their health literacy skills and enable this group to better support cancer survivors as a result.
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Affiliation(s)
- Chloe Moore
- School of Psychology, Dublin City University, Dublin, Ireland
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Rooha A, Shetty S, Bajaj G, Jacob NL, George VM, Bhat JS. Development and validation of educational multimedia to promote public health literacy about healthy cognitive aging. Health Expect 2023; 26:2571-2583. [PMID: 37635370 PMCID: PMC10632613 DOI: 10.1111/hex.13857] [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: 05/25/2023] [Revised: 07/31/2023] [Accepted: 08/16/2023] [Indexed: 08/29/2023] Open
Abstract
OBJECTIVES Health literacy (HL) about healthy cognitive aging is essential in preventing cognitive decline and promoting cognitive well-being. It is important that one such HL module should be scientifically designed, delivered in a technically sound manner to the audience, and specific to the context. The present study thus aimed at developing and validating educational multimedia about cognitive health. METHODS The study followed a methodological framework and was carried out across three phases, that is, identification of themes, development and validation of educational script and design, and validation of educational multimedia. The module was scripted based on the Integrated HL framework and the recommendations made during the modified nominal group technique among the research team. Seven speech-language pathologists (SLPs), with expertise in the field of cognitive sciences, and 15 representatives of the general public validated the module using the Educational Content Validation Instrument in Health and the Patient Education Materials Assessment Tool for Audiovisual Materials questionnaire. RESULTS The scientific content of the educational script received satisfactory agreements among the experts (content validity index [CVI]: 0.93) and representatives of the general public (CVI: 0.86). The technical aspects of the educational multimedia were rated to have high understandability (experts: 92.8%; representatives of general public: 98.8%) and actionability (experts and representatives of general public 100%). CONCLUSION Overall, the developed educational multimedia scored optimally with respect to the objective, structure, relevance of the content, actionability and understandability of the multimedia. The developed module holds the potential to be used at community and national level health educational programs or awareness campaigns to enhance public knowledge and beliefs pertaining to cognitive health. PATIENT OR PUBLIC CONTRIBUTION SLPs with expertise in the field of cognitive science and representatives from the general public were included to validate and obtain feedback on the developed educational multimedia.
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Affiliation(s)
- Aysha Rooha
- Department of Audiology and Speech Language PathologyKasturba Medical College, Mangalore, Manipal Academy of Higher EducationManipalKarnatakaIndia
| | - Shreya Shetty
- Department of Audiology and Speech Language PathologyKasturba Medical College, Mangalore, Manipal Academy of Higher EducationManipalKarnatakaIndia
| | - Gagan Bajaj
- Department of Audiology and Speech Language PathologyKasturba Medical College, Mangalore, Manipal Academy of Higher EducationManipalKarnatakaIndia
| | - Nidhi L. Jacob
- Department of Audiology and Speech Language PathologyKasturba Medical College, Mangalore, Manipal Academy of Higher EducationManipalKarnatakaIndia
| | - Vinitha M. George
- Department of Audiology and Speech Language PathologyNational Institute of Speech and HearingTrivandrumKeralaIndia
| | - Jayashree S. Bhat
- Department of Audiology and Speech Language PathologyNitte Institute of Speech and Hearing, DeralakatteMangaloreKarnatakaIndia
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Brunt LJ, Rivalland A, Panek-Hudson Y, Krishnasamy M. An Integrative Review of the Support Needs of Informal Caregivers of Hematological Cancer Patients in the Period Immediately Following Discharge From Inpatient to Outpatient Care. Cancer Nurs 2023:00002820-990000000-00186. [PMID: 37962212 DOI: 10.1097/ncc.0000000000001292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
BACKGROUND Preparing informal caregivers for a patient's transition to outpatient care is an important component of safe, quality hematological cancer care. The development of many novel therapies and emerging treatments has created opportunities to address the needs of informal caregivers following the discharge of patients from inpatient settings. OBJECTIVE To review and synthesize the literature on the needs of informal caregivers of patients with a hematological malignancy postdischarge from inpatient care. INTERVENTIONS/METHODS Integrative review methodology was used to explore the body of evidence available. This included a quality appraisal of qualitative, quantitative, and mixed-methods research findings, subsequent data extraction, and inductive thematic synthesis. RESULTS One thousand eight articles were screened with 10 included in the review. Key insights into the needs of caregivers entering the outpatient setting were identified and grouped into key subheadings: Encountering complex emotions knowing what to know, little time for yourself, and collateral impact. CONCLUSION Findings convey the complex and multiple needs of informal caregivers of hematological cancer patients. With a growing population of people with hematological malignancies and innovations in outpatient cancer therapies, there is a pressing need to codesign interventions to support their caregivers. IMPLICATIONS FOR PRACTICE This review has identified a need for more robust research to coproduce interventions in collaboration with caregivers. In addition, interventions developed from further research should be tested in quality implementation science studies to determine their feasibility, sustainability, and impact on outcomes that matter to hematological cancer caregivers.
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Affiliation(s)
- Laura J Brunt
- Author Affiliations: Department of Clinical Haematology, The Royal Melbourne Hospital, City Campus (Mss Brunt, Rivalland, and Panek-Hudson); and Department of Clinical Haematology (Mss Brunt, Rivalland, and Panek-Hudson) and Academic Nursing Unit (Dr Krishnasamy), Peter MacCallum Cancer Centre, Parkville; and Sir Peter MacCallum Departments of Oncology and Nursing, The University of Melbourne (Dr Krishnasamy); and Victorian Comprehensive Cancer Centre Alliance (Dr Krishnasamy), Melbourne, Victoria, Australia
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Kolunsağ S, Ardıç A. Health Literacy of Caregivers. Home Healthc Now 2023; 41:277-281. [PMID: 37682742 DOI: 10.1097/nhh.0000000000001191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/10/2023]
Abstract
Caregivers have an important role in supporting the health of individuals who are dependent for cognitive or physical reasons. Health literacy levels of caregivers affect quality of care and health outcomes. The purpose of this descriptive study was to assess health literacy in the caregivers of home care patients. The participants were caregivers aged 18 to 65 (N = 140). Data collected included sociodemographic characteristics, The Lawton Instrumental Activities of Daily Living Scale and The Adult Health Literacy Scale. The mean age of participants in the study was 48 years and 74% were women. The health literacy score was 16.77±3.31. A significant relationship was found between health literacy and education level (p = .000), working status (p = .012), and perception of income (p = .016). Education level was the only predictor of health literacy by logistic regression analysis. Studies aimed at determining health knowledge, skill deficiencies, and education needs of caregivers can provide important information to protect and improve the health of individuals in need of care and increase their quality of life.
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Yuen EYN, Wilson C, Livingston PM, White V, McLeod V, Dufton PH, Hutchinson AM. Caregiver and care recipient health literacy, social support and connectedness on caregiver psychological morbidity: A cross-sectional dyad survey. Psychooncology 2023; 32:1257-1267. [PMID: 37430441 DOI: 10.1002/pon.6177] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 05/24/2023] [Accepted: 05/26/2023] [Indexed: 07/12/2023]
Abstract
BACKGROUND Caregivers play an important role supporting people diagnosed with cancer, yet report significant unmet information and support needs that impact on their psychological wellbeing. Health literacy and social connectedness are key factors that influence wellbeing, yet few studies have examined their relative role in psychological wellbeing of carers. This study investigated relationships between caregiver and care recipient health literacy, social support, and social connectedness on psychological morbidity in a cancer setting. METHODS This cross-sectional study included 125 caregiver-cancer care recipient dyads. Participants completed the Health Literacy Survey-EU-Q16, Social Connectedness Scale-Revised, the Medical Outcomes Study-Social Support Survey, and the Depression, Anxiety and Stress Scale-21 (DASS21). Relationships between factors were examined using hierarchical multiple regression with care recipient factors entered at Step 1 and caregiver factors at Step 2. RESULTS Most caregivers provided care for their spouse (69.6%); caregivers mean total DASS21 score was 24.38 (SD = 22.48). Mean DASS21 subscale scores for depression, anxiety, stress in caregivers were 4.02 (SD = 4.07), 2.7 (SD = 3.64), and 5.48 (SD = 4.24) respectively, suggesting normal range of depression and stress, and mild anxiety. Care recipients had a diagnosis of breast (46.4%), gastrointestinal (32.8%), lung (13.6%), or genitourinary (7.2%) cancer, and a mean DASS21 score of 31.95 (SD = 20.99). Mean DASS21 subscale scores for depression, anxiety, stress in care recipients were 5.10 (SD = 4.18), 4.26 (SD = 3.65), and 6.62 (SD = 3.99) respectively, suggesting mild depression and anxiety, and normal stress scores. Regression analyses showed that only caregiver factors (age, illness/disability, health literacy and social connectedness) were independent predictors of caregiver psychological morbidity (F [10,114] = 18.07, p < 0.001). CONCLUSION(S) Only caregiver, and not care recipient, factors were found to influence caregiver psychological morbidity. While both health literacy and social connectedness influenced caregiver psychological morbidity, perceived social connectedness had the strongest influence. Interventions that ensure caregivers have adequate health literacy skills, as well as understand the value of social connection when providing care, and are supported to develop skills to seek support, have the potential to promote optimal psychological wellbeing in cancer caregivers.
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Affiliation(s)
- Eva Y N Yuen
- School of Nursing and Midwifery, Centre for Quality and Patient Safety, Institute for Health Transformation, Deakin University, Burwood, Victoria, Australia
- Centre for Quality and Patient Safety - Monash Health Partnership, Deakin University, Burwood, Victoria, Australia
- School of Psychology and Public Health, LaTrobe University, Bundoora, Victoria, Australia
- Psycho-Oncology Research Unit, Olivia Newton John Cancer, Wellness and Research Centre, Austin Health, Heidelberg, Victoria, Australia
| | - Carlene Wilson
- School of Psychology and Public Health, LaTrobe University, Bundoora, Victoria, Australia
- Psycho-Oncology Research Unit, Olivia Newton John Cancer, Wellness and Research Centre, Austin Health, Heidelberg, Victoria, Australia
- Centre for Epidemiology and Biostatistics, University of Melbourne, Melbourne, Victoria, Australia
| | - Patricia M Livingston
- School of Nursing and Midwifery, Centre for Quality and Patient Safety, Institute for Health Transformation, Deakin University, Burwood, Victoria, Australia
| | - Victoria White
- School of Psychology, Deakin University, Burwood, Victoria, Australia
| | - Vicki McLeod
- Oncology Department, Monash Health, Clayton, Victoria, Australia
| | - Polly H Dufton
- Department of Nursing, University of Melbourne, Parkville, Victoria, Australia
- Olivia Newton-John Cancer, Wellness and Research Centre, Austin Health, Heidelberg, Victoria, Australia
| | - Alison M Hutchinson
- School of Nursing and Midwifery, Centre for Quality and Patient Safety, Institute for Health Transformation, Deakin University, Burwood, Victoria, Australia
- Centre for Quality and Patient Safety - Barwon Health Partnership, Deakin University, Geelong, Victoria, Australia
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Papadakos J, Ugas M, Quartey NK, Papadakos C(T, Giuliani ME. Assessing the Comprehensive Training Needs of Informal Caregivers of Cancer Patients: A Qualitative Study. Curr Oncol 2023; 30:3845-3858. [PMID: 37185404 PMCID: PMC10137188 DOI: 10.3390/curroncol30040291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/15/2023] [Accepted: 03/23/2023] [Indexed: 04/03/2023] Open
Abstract
Introduction: The increasing demand for cancer services is projected to overwhelm the cancer care system, leading to a potential shortfall in human resource capacity. Informal caregivers (unpaid family/friend caregivers of cancer patients) provide a significant amount of care to patients and the cancer care system could not cope without them. The aim of this study was to analyze the needs of informal caregivers (CGs) through interviews with cancer patients and CGs, and to assess the content and utility of a comprehensive caregiver training course. Methods: Cancer patients and CGs were recruited from an academic cancer centre to elicit their thoughts and perceptions of cancer CG education needs through a qualitative, phenomenological design using semi-structured interviews and a curriculum review activity. Results: Six patients and seven CGs were interviewed. Patients averaged 53.8 years of age and CGs averaged 53.1 years. Caregiver participants reported that they were unprepared for their caregiving role. Depending on the severity of the disease, CGs reported significant emotional strain. Most participants wanted more practical information, and all expressed the desire for greater social support for CGs. While there were differences in terms of desired modality (e.g., online, in-person), support for greater CG education was strong. Discussion: CGs experience a significant learning curve and receive little to no direct training or education to help them acquire the knowledge and skills they need to support a cancer patient. This is especially challenging for new CGs, for whom emotional and informational needs are particularly acute. Participants shared a great deal of endorsement for a comprehensive training course for new CGs. Given the multiple demands on their time, some participants suggested that consideration be made to establish synchronous classes. Participants held that having the course take place (online or in-person) at a specific time, on a specific date could help CGs prioritize their learning. Participants also endorsed the idea of “required” learning because even though CGs may recognize that a course could be beneficial, some may lack the motivation to participate unless it was “prescribed” to them by a healthcare provider.
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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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Brain Tumor at Diagnosis: From Cognition and Behavior to Quality of Life. Diagnostics (Basel) 2023; 13:diagnostics13030541. [PMID: 36766646 PMCID: PMC9914203 DOI: 10.3390/diagnostics13030541] [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: 01/12/2023] [Revised: 01/30/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The present narrative review aims to discuss cognitive-emotional-behavioral symptoms in adults with brain tumors at the time of diagnosis. METHODS The PubMed database was searched considering glioma, pituitary adenoma, and meningioma in adulthood as pathologies, together with cognitive, neuropsychological, or behavioral aspects. RESULTS Although a significant number of studies describe cognitive impairment after surgery or treatment in adults with brain tumors, only few focus on cognitive-emotional-behavioral symptoms at diagnosis. Furthermore, the importance of an effective communication and its impact on patients' quality of life and compliance with treatment are seldom discussed. CONCLUSIONS Adults with brain tumors have needs in terms of cognitive-emotional-behavioral features that are detectable at the time of diagnosis; more research is needed to identify effective communication protocols in order to allow a higher perceived quality of life in these patients.
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Fernandes JB, Domingos J, Castro C, Simões A, Fernandes S, Almeida AS, Bernardes C, Miranda L, Risso S, Ferreira R, Baixinho CL, Silvestre M, Godinho C. Needs and expectations of family caregivers of cancer patients in palliative care: A study protocol. Front Psychol 2023; 13:1071711. [PMID: 36687876 PMCID: PMC9853914 DOI: 10.3389/fpsyg.2022.1071711] [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: 10/16/2022] [Accepted: 12/19/2022] [Indexed: 01/07/2023] Open
Abstract
Cancer has an associated burden that continues to grow, affecting patients, family caregivers, and the individual's community. The family caregivers' unmet needs may harmfully jeopardize their well-being and the patient's health outcomes. Therefore, it is essential to understand the needs and expectations of family caregivers of cancer patients to develop and improve care practices. The present study aims to explore the needs and expectations of family caregivers of cancer patients in palliative care. This qualitative, descriptive exploratory study will use purposive sampling to recruit family caregivers and healthcare professionals from the palliative care units of two hospital centers in Lisbon and Tagus Valley. First, the Focus group will be performed until data saturation occurs. Then, a conventional thematic analysis will be applied to analyze data with the help of the coding software QDA Miner Lite database. This study's findings will help identify gaps in care and provide data that can support healthcare professionals in providing evidence-based centered care to family caregivers. It can also generate knowledge that may help stakeholders to develop a comprehensive support system for cancer survivors in palliative care and their family caregivers.
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Affiliation(s)
- Júlio Belo Fernandes
- Escola Superior de Saúde Egas Moniz, Almada, Portugal,Grupo de Patologia Médica, Nutrição e Exercício Clínico (PaMNEC), Almada, Portugal,Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Almada, Portugal,*Correspondence: Júlio Belo Fernandes,
| | - Josefa Domingos
- Grupo de Patologia Médica, Nutrição e Exercício Clínico (PaMNEC), Almada, Portugal,Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Almada, Portugal
| | - Cidália Castro
- Escola Superior de Saúde Egas Moniz, Almada, Portugal,Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Almada, Portugal
| | - Aida Simões
- Escola Superior de Saúde Egas Moniz, Almada, Portugal,Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Almada, Portugal
| | | | - Ana Silva Almeida
- Department of Nursing, Centro Hospitalar de Setúbal E.P.E., Setúbal, Portugal
| | - Catarina Bernardes
- Escola Superior de Saúde Egas Moniz, Almada, Portugal,Grupo de Patologia Médica, Nutrição e Exercício Clínico (PaMNEC), Almada, Portugal,Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Almada, Portugal
| | - Luís Miranda
- Escola Superior de Saúde Egas Moniz, Almada, Portugal,Department of Nursing, Centro Hospitalar Barreiro Montijo E.P.E., Barreiro, Portugal
| | - Sandra Risso
- Escola Superior de Saúde Egas Moniz, Almada, Portugal,Department of Nursing, Centro Hospitalar Barreiro Montijo E.P.E., Barreiro, Portugal
| | - Rogério Ferreira
- Departamento de Saúde, Instituto Politécnico de Beja, Escola Superior de Saúde, Beja, Portugal,Comprehensive Health Research Center, Évora, Portugal
| | - Cristina Lavareda Baixinho
- Nursing School of Lisbon, Lisbon, Portugal,Nursing Research, Innovation and Development Center of Lisbon (CIDNUR), Lisbon, Portugal
| | - Milene Silvestre
- Department of Nursing, Centro Hospitalar Barreiro Montijo E.P.E., Barreiro, Portugal
| | - Catarina Godinho
- Escola Superior de Saúde Egas Moniz, Almada, Portugal,Grupo de Patologia Médica, Nutrição e Exercício Clínico (PaMNEC), Almada, Portugal,Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Almada, Portugal
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13
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Postavaru GI, McDermott H, Biswas S, Munir F. Receiving and breaking bad news: A qualitative study of family carers managing a cancer diagnosis and interactions with healthcare services. J Adv Nurs 2022; 79:2211-2223. [PMID: 36565239 DOI: 10.1111/jan.15554] [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: 05/21/2022] [Revised: 11/27/2022] [Accepted: 12/11/2022] [Indexed: 12/25/2022]
Abstract
AIMS To explore family carer experiences of managing the process of receiving and breaking bad news about cancer. BACKGROUND Family carers' experiences of bad news are underrepresented in the literature. This study involved oncology staff with personal experience of caregiving and carers to develop broader insights into the range of needs and difficulties experienced by family members in the process of managing a cancer diagnosis. This can help facilitate subsequent interactions with healthcare professionals and improve continuity of care. DESIGN This is a descriptive qualitative study informed by the theory of social constructionism. Data were analysed using template analysis. METHODS Data were collected using semi-structured interviews and focus groups with 4 healthcare professionals and 17 family carers between January and July 2018. A purposive sampling strategy was used. Interviews were transcribed verbatim to explore participant experiences and perspectives on family carers managing a cancer diagnosis. FINDINGS Three key themes were identified: (1) receiving the bad news; (2) management of bad news and (3) interaction with healthcare and support services. These and associated subthemes are discussed, with recommendations for future research and practice. CONCLUSIONS There was variability in the experiences and needs of carers involved in receiving and breaking the bad news. IMPACT Although family members experienced a multitude of difficult emotions when the bad news was shared, they were not often able to discern help from healthcare professionals with sharing the diagnosis with the patient and others. This impacted on access to and use of healthcare and support services. Individualized approaches to communication are needed to enable carers to seek support and provide perspectives on the patient home environment and family structure. This can help tailor breaking the bad news and care plans. PUBLIC CONTRIBUTION Anonymised results were shared with family carers to validate the congruency of the codes with their experiences.
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Affiliation(s)
| | | | - Sanchia Biswas
- Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
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14
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Vasquez TS, Bylund CL, Fisher CL, Paige SR. Validation of the transactional eHealth literacy instrument with cancer caregivers. PEC INNOVATION 2022; 1:100075. [PMID: 37213773 PMCID: PMC10194196 DOI: 10.1016/j.pecinn.2022.100075] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 07/27/2022] [Accepted: 08/17/2022] [Indexed: 05/23/2023]
Abstract
Objective Family members are important sources of support for patients with cancer. They access, evaluate, and engage with online information and discuss it with a cancer clinician. This study validates the 4-dimensions, 18-item Transactional eHealth Literacy Instrument (TeHLI) and proposed to include Clinical eHealth Literacy as a 5th dimension. Methods The Leukemia & Lymphoma Society (LLS) disseminated an online survey to 121 family member caregivers between March-June 2020. We conducted confirmatory factor analyses (1) to examine model fit for the 4-factor TeHLI in the cancer caregiver population, and (2) to examine the model fit when adding the 5th factor. Results The 4-dimension model yielded acceptable model fit (RMSEA = 0.09; 90% CI = 0.08-0.11; CFI = 0.98; TLI = 0.98; SRMR = 0.07). The 5-dimension model also yielded acceptable model fit (RMSEA = 0.08; 90% CI = 0.07-0.10; CFI = 0.97; TLI = 0.97; SRMR = 0.08), supporting the expansion of the TeHLI within this population. Conclusion The five-dimension TeHLI is a valid and reliable measure of eHealth literacy among blood cancer caregiver populations. Innovation The TeHLI can be used as an outcome measure for communication skills training for caregivers, patients, and clinicians.
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Affiliation(s)
- Taylor S. Vasquez
- University of Florida, College of Journalism and Communications, USA
- Corresponding author at: University of Florida, 1885 Stadium Road, Gainesville, FL 32607, USA
| | - Carma L. Bylund
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, USA
| | - Carla L. Fisher
- University of Florida, College of Journalism and Communications, USA
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, USA
| | - Samantha R. Paige
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, USA
- Johnson & Johnson, Inc., Health & Wellness Solutions, New Brunswick, New Jersey, USA
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15
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Marshall-McKenna R, Kotronoulas G, Kokoroskos E, Granados AG, Papachristou P, Papachristou N, Collantes G, Petridis G, Billis A, Bamidis PD. A multinational investigation of healthcare needs, preferences, and expectations in supportive cancer care: co-creating the LifeChamps digital platform. J Cancer Surviv 2022:10.1007/s11764-022-01289-7. [DOI: 10.1007/s11764-022-01289-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 10/25/2022] [Indexed: 11/13/2022]
Abstract
Abstract
Purpose
This study is to evaluate healthcare needs, preferences, and expectations in supportive cancer care as perceived by cancer survivors, family caregivers, and healthcare professionals.
Methods
Key stakeholders consisted of cancer survivors diagnosed with breast cancer, prostate cancer, or melanoma; adult family caregivers; and healthcare professionals involved in oncology. Recruitment was via several routes, and data were collected via either online surveys or telephone interviews in Greece, Spain, Sweden, and the UK. Framework analysis was applied to the dataset.
Results
One hundred and fifty-five stakeholders participated: 70 cancer survivors, 23 family caregivers, and 62 healthcare professionals (13 clinical roles). Cancer survivors and family caregivers’ needs included information and support on practical/daily living, as frustration was apparent with the lack of follow-up services. Healthcare professionals agreed on a multidisciplinary health service with a “focus on the patient” and availability closer to home. Most healthcare professionals acknowledged that patient-reported outcomes may provide “better individualised care”. Cancer survivors and family caregivers generally felt that the digital platform would be useful for timely personalised support and aided communication. Healthcare professionals were supportive of the “proactive” functionality of the platform and the expected advantages. Anticipated challenges were integration obstacles such as workload/infrastructure and training/support in using the new technology.
Conclusions
Obtaining key stakeholders’ insights provided a foundation for action to further co-create the LifeChamps digital platform to meet needs and priorities and deliver enhanced supportive care to “older” cancer survivors.
Implications for cancer survivors
Co-creation provided insight into gaps where digital support may enhance health and well-being.
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16
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Wirtz MA, Soellner R. Gesundheitskompetenz. DIAGNOSTICA 2022. [DOI: 10.1026/0012-1924/a000299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Markus Antonius Wirtz
- Forschungsmethoden in den Gesundheitswissenschaften, Fakultät für Mathematik, Naturwissenschaften und Technik, Pädagogische Hochschule Freiburg, Deutschland
| | - Renate Soellner
- Institut für Psychologie, Universität Hildesheim, Deutschland
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17
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Coyne E, Winter N, Carlini J, Robertson J, Dieperink K. Developing video resources to reduce the burden of caring for persons with brain cancer. Eur J Oncol Nurs 2022; 60:102187. [DOI: 10.1016/j.ejon.2022.102187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 07/21/2022] [Accepted: 07/27/2022] [Indexed: 11/04/2022]
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18
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Wittenberg E, Goldsmith JV, Beltran E. Collective caregivers: A novel examination of health literacy management approaches. PATIENT EDUCATION AND COUNSELING 2022; 105:2497-2503. [PMID: 34801338 DOI: 10.1016/j.pec.2021.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 11/02/2021] [Accepted: 11/08/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Health literacy and communication skills are necessary for family caregivers who often work in pairs, known as collective caregiving. Health literacy management is a relational process where communication between caregivers can be a barrier or pathway to improving or co-creating health literacy. The purpose of this study was to examine how collective caregivers manage health literacy. METHODS Semi-structured interviews were conducted separately for 42 caregiving pairs (n = 84). The interview guide was developed using a cancer caregiver health literacy framework. Caregiving pairs were placed into one of three collective caregiving communication patterns (absolute concordant, semi-concordant, absolute discordant). Interviews were audio-recorded, transcribed, and a thematic analysis was performed by independent coders. RESULTS The analysis revealed three different health literacy management approaches: a defined approach where caregiver roles were clearly designated (absolute concordant pairs); a contrasting approach where one caregiver was the health literacy expert (semi-concordant pairs); an independent approach characterized by individual information seeking, processing, and patient/provider engagement (absolute discordant pairs). CONCLUSIONS Health literacy support should address aspects of the family system such as caregiver-caregiver communication which influence variance in health literacy management. Practice implications Our study can inform provider communication and healthcare interventions aimed at supporting health literacy for caregivers.
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Affiliation(s)
- Elaine Wittenberg
- California State University Los Angeles, Department of Communication Studies, Los Angeles, CA, USA.
| | - Joy V Goldsmith
- University of Memphis, Department of Communication and Film, Memphis, TN, USA
| | - Emeline Beltran
- California State University Los Angeles, Department of Communication Studies, Los Angeles, CA, USA
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