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Wang Y, Seplaki CL, Norton SA, Williams AM, Kadambi S, Loh KP. Communication between Caregivers of Adults with Cancer and Healthcare Professionals: a Review of Communication Experiences, Associated Factors, Outcomes, and Interventions. Curr Oncol Rep 2024; 26:773-783. [PMID: 38777979 DOI: 10.1007/s11912-024-01550-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2024] [Indexed: 05/25/2024]
Abstract
PURPOSE OF REVIEW Family/unpaid caregivers play an important role in cancer care. This review aims to summarize caregiver communication experiences with healthcare professionals (HCPs). RECENT FINDINGS The Caregiver-Centered Communication model defines five core functions that HCPs should achieve when interacting with caregivers, including fostering relationships, exchanging information, recognizing and responding to caregiver emotions, aiding in decision making, and assisting in patient care management. The literature shows that caregivers have both positive and negative communication experiences with HCPs with respect to these five core functions. Factors at the caregiver (e.g., demographic characteristics, information sources, caregiving duration, health status), patient (e.g., demographic and clinical characteristics), and HCP levels (e.g., time constraints in clinical settings, communication skills) are associated with caregiver-HCP communication quality. Studies further show that these communication experiences may affect caregiver outcomes, including quality of life, mental health, resilience, and satisfaction with cancer care. Moreover, poor quality caregiver-HCP communication is associated with patient readmission to the hospital and unmet care needs. Interventions for caregivers or patient-caregiver dyads have been shown to enhance caregiver confidence and increase their engagement in communication with HCPs. Interventions for HCPs have shown efficacy in improving their communication skills, particularly in involving caregivers in decision-making discussions. Given time constraints during medical visits, we suggest conducting a caregiver assessment by navigators prior to visits to understand their communication needs. Additionally, reimbursing HCPs for time spent communicating with caregivers during visits could be beneficial. More research is needed to better understand how to enhance caregiver-HCP communication quality.
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Affiliation(s)
- Ying Wang
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Christopher L Seplaki
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Sally A Norton
- School of Nursing, University of Rochester Medical Center, Rochester, NY, USA
| | - AnnaLynn M Williams
- Division of Supportive Care in Cancer, Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA
| | - Sindhuja Kadambi
- Division of Hematology/Oncology, Department of Medicine, James P Wilmot Cancer Institute, University of Rochester Medical Center, 601 Elmwood Avenue, Box 704, Rochester, NY, 14642, USA
| | - Kah Poh Loh
- Division of Hematology/Oncology, Department of Medicine, James P Wilmot Cancer Institute, University of Rochester Medical Center, 601 Elmwood Avenue, Box 704, Rochester, NY, 14642, USA.
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Zhang M, Wang X, Shao M, Du R, Zhou H, Zhu J, Zhang H, Ma B, Chen C, Wang T. Supportive care needs and associated factors among caregivers of patients with colorectal cancer: a cross-sectional study. Support Care Cancer 2024; 32:194. [PMID: 38411723 PMCID: PMC10899272 DOI: 10.1007/s00520-024-08390-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: 08/15/2023] [Accepted: 02/16/2024] [Indexed: 02/28/2024]
Abstract
To assess the level of supportive care needs of caregivers of colorectal cancer patients and explore the related key influencing factors. Totaling 283 caregivers of patients with colorectal cancer were investigated in this study. Firstly, caregivers were invited to complete a set of questionnaires, including the general information questionnaire, the Supportive Care Needs Survey-Partners and the Caregivers of cancer patients, the Caregiver Preparedness Scale, the Benefit Finding Scale, and the Comprehensive Score for Financial Toxicity. Univariate and multivariate linear regression were performed to investigate the associated factors of supportive care needs. The caregivers of patients with colorectal cancer have a moderate level of needs, scored at 2.71 ± 0.42. Caregiver preparedness, benefit finding, and financial toxicity were significantly negatively associated with the supportive care needs of caregivers (r = - 0.555, P < 0.001; r = - 0.534, P < 0.001; and r = - 0.615, P < 0.001, respectively). Our multivariate regression analysis identified some factors that directly affected the supportive care needs of caregivers, including the duration of illness, tumor stage, the age and educational level of caregivers, caregiver preparedness, benefit finding, and financial toxicity (R2 = 0.574, F = 23.337, P < 0.001). Supportive care needs are common among caregivers of colorectal cancer patients. Higher caregiver preparedness, benefit finding, and financial toxicity tend to ease these needs. Healthcare workers should have an in-depth understanding of the needs of caregivers of colorectal cancer patients and actively provide targeted financial/informational/technical/emotional support to promote nursing skills and reduce caregivers' burdens.
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Affiliation(s)
- Menghan Zhang
- The College of Nursing and Health of Zhengzhou University, Zhengzhou, 450001, China
| | - Xin Wang
- The College of Nursing and Health of Zhengzhou University, Zhengzhou, 450001, China
| | - Mengwei Shao
- The College of Nursing and Health of Zhengzhou University, Zhengzhou, 450001, China
| | - Ruofei Du
- The College of Nursing and Health of Zhengzhou University, Zhengzhou, 450001, China
- Academy of Medical Sciences of Zhengzhou University, Zhengzhou, 450001, China
| | - Huiyue Zhou
- Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510000, China
| | - Jizhe Zhu
- The College of Nursing and Health of Zhengzhou University, Zhengzhou, 450001, China
| | - Haoning Zhang
- The College of Nursing and Health of Zhengzhou University, Zhengzhou, 450001, China
| | - Bin Ma
- School of Medical, Molecular and Forensic Sciences, Murdoch University, Perth, 6149, Australia
| | - Changying Chen
- Department of Quality Control, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.
| | - Tao Wang
- The College of Nursing and Health of Zhengzhou University, Zhengzhou, 450001, China.
- Telethon Kids Institute, Perth, WA, 6872, Australia.
- Medical School, University of Western Australia, Perth, WA, 6872, Australia.
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Samuelsson M, Wennick A, Bengtsson M, Lydrup ML, Jakobsson J. Translation, cultural adaptation, and psychometric testing of the Supportive care needs survey for partners and caregivers for Swedish family members of persons diagnosed with colorectal cancer. J Patient Rep Outcomes 2023; 7:100. [PMID: 37819416 PMCID: PMC10567617 DOI: 10.1186/s41687-023-00636-1] [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: 05/03/2023] [Accepted: 09/15/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Colorectal cancer is the third most common cancer diagnosis globally and is increasing in both incidence and prevalence. Despite evidence showing that family members of persons diagnosed with cancer have supportive care needs, no validated questionnaire measuring the needs of family members of persons diagnosed with CRC exists in Swedish. Thus, the objective of the present study was to translate, culturally adapt, and evaluate the psychometric properties the Supportive Care Needs Survey - Partners and Caregivers 45. METHODS The translation and cultural adaptation followed a systematic yet iterative process. Firstly, the questionnaire was translated using a forward-backward approach. Secondly, face and content validity and comprehensibility were evaluated by two expert panels of colorectal cancer specialist nurses and family members, respectively. Lastly, the psychometric properties, validity, and reliability of the translated questionnaire were evaluated among 45 Swedish family members of persons diagnosed with colorectal cancer. RESULTS The face, content, and construct validity of the translated questionnaire were evaluated as satisfying. Moreover, psychometric evaluations showed high data quality and satisfactory internal consistency. However, the results also revealed unsolved issues regarding relevance, targeting, and internal consistency, as well as a probable scaling failure. CONCLUSION The translated and adapted questionnaire can be used to identify family members unmet needs of support throughout the colorectal cancer trajectory. The questionnaire showed promising validity and reliability in the target population. However, it needs to be further evaluated in a larger sample, preferably involving factor analysis and stability over time.
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Affiliation(s)
- Maria Samuelsson
- Faculty of Health and Society, Department of Care Science, Malmö University, Jan Waldenströms gata 25, 205 06, Malmö, Sweden.
- Department of Pediatrics, Skåne University Hospital, Malmö, Sweden.
| | - Anne Wennick
- Faculty of Health and Society, Department of Care Science, Malmö University, Jan Waldenströms gata 25, 205 06, Malmö, Sweden
| | - Mariette Bengtsson
- Faculty of Health and Society, Department of Care Science, Malmö University, Jan Waldenströms gata 25, 205 06, Malmö, Sweden
| | - Marie-Louise Lydrup
- Department of Surgery and Gastroenterology, Skåne University Hospital, Malmö, Sweden
| | - Jenny Jakobsson
- Faculty of Health and Society, Department of Care Science, Malmö University, Jan Waldenströms gata 25, 205 06, Malmö, Sweden
- Department of Surgery and Gastroenterology, Skåne University Hospital, Malmö, Sweden
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Zhou S, Zhao Q, Weng H, Wang N, Wu X, Li X, Zhang L. Translation, cultural adaptation and validation of the Chinese version of the Carer Support Needs Assessment Tool for family caregivers of cancer patients receiving home-based hospice care. BMC Palliat Care 2021; 20:71. [PMID: 34011333 PMCID: PMC8136129 DOI: 10.1186/s12904-021-00766-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 05/10/2021] [Indexed: 11/10/2022] Open
Abstract
Background Family caregivers need to be supported in caring for patients at the end of life, but practical tools to assess their support needs have been missing in China. So this study aimed to culturally adapt and validate the Carer Support Needs Assessment Tool (CSNAT). Methods Cross-cultural adaptation of the original CSNAT for a Chinese setting was performed according to Brislin’s translation guidelines. A pilot study was conducted with 15 Chinese family caregivers of cancer patients receiving hospice home care and 5 medical staff. A cross-sectional survey of 205 family caregivers was conducted from December 2018 to May 2019 at a home-based hospice care institute in Shenzhen, China. The validation procedure comprised the establishment of (1) content validity by a group of six experts; (2) face validity by 15 family caregivers; (3) criterion validity by calculating Spearman’s correlations between the CSNAT and caregiving burden, caregiving preparedness and quality of life scales; (4) internal consistency using Cronbach’s alpha. Results The CSNAT demonstrated good face validity and good content validity. CSNAT scores showed clear positive correlations with caregiving burden and negative correlations with preparedness for caregiving and quality of life. Internal consistency was high (Cronbach’s alpha = 0.899), although such reliability testing is not recommended for this tool. Conclusions The Chinese version of the CSNAT is a valid tool that is appropriate for identifying needs of family caregivers of cancer patients in home-based hospice care.
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Affiliation(s)
- Sijia Zhou
- Shenzhen People's Hospital, The Second Clinical Medical College of Jinan University, Shenzhen, Guangdong, China
| | - Qianqian Zhao
- School of Nursing, Southern Medical University, 1023 Sha Tai South Road, Bai Yun District, Guangzhou, 510515, Guangdong Province, China
| | - Huimin Weng
- Shenzhen People's Hospital, The Second Clinical Medical College of Jinan University, Shenzhen, Guangdong, China
| | - Ning Wang
- School of Nursing, Southern Medical University, 1023 Sha Tai South Road, Bai Yun District, Guangzhou, 510515, Guangdong Province, China
| | - Xia Wu
- School of Nursing, Southern Medical University, 1023 Sha Tai South Road, Bai Yun District, Guangzhou, 510515, Guangdong Province, China
| | - Xinxin Li
- School of Nursing, Southern Medical University, 1023 Sha Tai South Road, Bai Yun District, Guangzhou, 510515, Guangdong Province, China
| | - Lili Zhang
- School of Nursing, Southern Medical University, 1023 Sha Tai South Road, Bai Yun District, Guangzhou, 510515, Guangdong Province, China.
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Niu A, Guo C, Zhong D, He G, Zhong W, Wang L, Chen Y, Shang L, Fu J. Identifying the Unmet Supportive Care Needs, with Concomitant Influencing Factors, in Family Caregivers of Cancer Patients in China. Asia Pac J Oncol Nurs 2021; 8:276-286. [PMID: 33850961 PMCID: PMC8030597 DOI: 10.4103/apjon.apjon_52_20] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 08/19/2020] [Indexed: 12/24/2022] Open
Abstract
Objective The objective of the study is to assess the unmet needs of cancer caregivers and to identify the possible predictors of their supportive care needs in China. Methods This multicenter, cross-sectional study enrolled 449 cancer patients' family caregivers' dyads. Patients provided general information and Karnofsky performance status (KPS); caregivers provided general information and completed a survey of Chinese version of the Supportive Care Needs Survey-Partners and Caregivers Scale. The independent samples t-test, one-way analysis of variance, and multiple stepwise regression were used to analyze the factors that influence the needs of caregivers. Results A proportion of caregivers who had no needs were 5.6%. A proportion of caregivers with ≥ 5 moderate or high unmet needs and with ≥ 10 moderate or high unmet needs were 77.7% and 63.2%, respectively. Healthcare services and information needs and communication and relationship needs were the most prominent areas of caregivers' unmet needs. The item "Finding out about financial support and government benefits for you and/or the person with cancer" was the highest level of unmet needs at 78.6%. The level of unmet needs was related to the patient's physical function (KPS score), caregiver's educational levels, financial burden of healthcare, as well as the level of burden related to caregiving (working status, caring for others, caregiving experience, and total caregiving time). Conclusions The level of unmet needs of family caregivers of cancer patients in China was higher. In clinical practice, more attention should be paid to family caregivers who take care of the patient with poor physical function, those who are highly educated, faced with higher financial burden of healthcare, and are currently working, as well as those who need to take care of others, spend more time caregiving, and have no caregiving experience.
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Affiliation(s)
- Aifang Niu
- Department of Internal Medicine, 947 Army Hospital, Kashgar, China
| | - Chunyong Guo
- Department of Internal Medicine, 947 Army Hospital, Kashgar, China
| | - Daozhu Zhong
- Department of Internal Medicine, 947 Army Hospital, Kashgar, China
| | - Guirong He
- Department of Internal Medicine, 947 Army Hospital, Kashgar, China
| | - Wenbo Zhong
- Department of Internal Medicine, Xinjiang Military District General Hospital, Urumqi, Xinjiang, China
| | - Lanmei Wang
- Department of Internal Medicine, 947 Army Hospital, Kashgar, China
| | - Yu Chen
- Department of Internal Medicine, 947 Army Hospital, Kashgar, China
| | - Lei Shang
- Department of Preventive Medicine, Air Force Medical University, Xi'an, Shaanxi, China
| | - Jufang Fu
- Nursing Department, Shenzhen University General Hospital, Shenzhen, Guangdong, China
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Predictive model of psychological distress in family caregivers of patients with cancer: a cross-sectional study. Support Care Cancer 2021; 29:5091-5101. [PMID: 33598735 DOI: 10.1007/s00520-021-06022-1] [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: 09/03/2020] [Accepted: 01/21/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE To examine a predictive theoretical model of psychological distress based on the following variables reflected on family caregivers of patients with cancer: the unmet supportive care needs, subjective caregiving burden, social support, and the positive aspects of caregiving. METHODS A cross-sectional descriptive study was conducted on a sample of 484 dyads of patients and their family caregivers. The caregivers completed structured questionnaires designed to measure psychological distress, unmet supportive care needs, subjective caregiving burden, positive aspects of caregiving, and social support. Patients' demographic variables and medical data were collected from a medical record review. We used a structural equation modeling to test the predictive theoretical model. RESULTS Path analysis results partially supported the proposed model with satisfactory fit indices. Specifically, family caregivers with an increasing number of unmet needs or a heavier caregiving burden were more likely to have more severe psychological distress. Bootstrapping results supported that the caregiving burden and social support were significant mediators. Greater unmet supportive care needs predicted higher psychological distress through increasing caregiving burden. Stronger social support predicted lower psychological distress through decreasing caregiving burden. Positive aspects of caregiving predicted lower caregiving burden through the increasing perceived social support, which in turn eliminated psychological distress. CONCLUSIONS Unmet supportive care needs could cause psychological distress through increasing caregiving burden. The positive aspects of caregiving reduced caregiving burden through increasing social support, which subsequently alleviated psychological distress. Interventions that aim to satisfy supportive care needs, to reduce caregiving burden, and to strengthen social support ties may boost the mental health of family caregivers.
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Karacan Y, Akkus Y, Ozcelik ET, Ali R. Identification of Psychological and Social Problems in Caregivers of Individuals Diagnosed with Hematologic Malignancy. Asia Pac J Oncol Nurs 2021; 8:204-210. [PMID: 33688570 PMCID: PMC7934589 DOI: 10.4103/apjon.apjon_53_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 08/13/2020] [Indexed: 11/16/2022] Open
Abstract
Objective: Caring for patients with hematological malignancy could lead to many problems in different aspects regarding the lives of caregivers. However, there is limited data on the emotional and social problems of caregivers, who deal with patients of hematological malignancy. The aim of this study is to determine the emotional and social problems in caregivers of individuals diagnosed with hematological malignancy. Methods: The study was carried out descriptively to identify the emotional and social problems in the relatives of the patients diagnosed with hematological malignancy as their caregivers, as well as the factors affecting these problems. The data of the study were collected with the Introductory Information Form and Identification of Emotional and Social Problems Form that were administered to the relatives of the patients. The data were evaluated by using Spearman's Rho correlation analysis and the Logit analysis in Statistical Package for the Social Sciences software. Results: Among the caregivers, 59.8% were in the age group of 30–51 years, and 66.2% were female. Of the caregivers, 70.1% had difficulty in fulfilling their responsibilities. Spiritual distress had the highest score among the emotional problems, and experiencing caregiver strain had the highest score among the social problems. In the Logit model, the changes in the professional life was the variable that affects the emotional and social problems the most and significantly. In addition, emotional problems were affected by the financial problems at a statistically significant level. Conclusions: In this study, it is suggested that the caregivers should be provided with certain conveniences in their professional lives based on the fact that the problem, which affected emotional and social problems the most, is the change in the professional life; it is recommended that further studies should be carried out on the caregivers.
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Affiliation(s)
- Yasemin Karacan
- Division of Nursing, Health Science Faculty, Bursa Uludag University, Bursa, Turkey
| | - Yeliz Akkus
- Division of Nursing, Faculty of Health Science, Kafkas University, Kars, Turkey
| | | | - Ridvan Ali
- Department of Hematology, Bursa Uludag University, Bursa, Turkey
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