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Samuelsson M, Jakobsson J, Bengtsson M, Lydrup ML, Wennick A. Family members' conceptions of their supportive care needs across the colorectal cancer trajectory - A phenomenographic study. J Adv Nurs 2024. [PMID: 38940487 DOI: 10.1111/jan.16308] [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: 05/03/2023] [Revised: 10/12/2023] [Accepted: 06/15/2024] [Indexed: 06/29/2024]
Abstract
AIM To describe the variations of family members' conceptions of their supportive care needs (SCN) across the colorectal cancer (CRC) trajectory. DESIGN A descriptive qualitative study with a phenomenographic approach. METHOD Individual semi-structured interviews were conducted from May 2022 to October 2022 with 23 family members of persons diagnosed with colorectal cancer. The interviews were analysed using phenomenographic analysis following the Consolidated criteria for reporting qualitative research (COREQ) checklist. RESULTS The phenomenographic analysis resulted in five categories. Not of importance describes family members' needs as unimportant due to the good prognosis and the organization of care and in relation to the needs of others. Only satisfiable by professionals describes information possessed by the healthcare professionals as key, as well as the need for professional counselling for the family members to process their emotions. Managed by themselves describes family members preferring to manage their SCN themselves by turning to the appropriate social support and/or by using coping skills. Understood retrospectively describes SCN as only understandable when things have calmed down and as requiring one's own experience to understand. Left unmet describes SCN as unnoticed by the healthcare professionals or not brought to light by the family members, or family members not knowing where to turn for support. CONCLUSION Supportive care should involve individualized information, proactive and repeated assessments of needs across the trajectory, as well as encouragement of family members to reflect on their needs and to accept support when needed. IMPACT There is a gap in the literature regarding family members' SCN across the CRC trajectory which this study addresses. Findings show five categories of family members' conceptions of their SCN. Those findings could serve as a basis for the development of clinical colorectal supportive care across the cancer trajectory. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Findings show that to offer family members of persons diagnosed with colorectal cancer support only at the time of diagnosis is insufficient. Instead, the healthcare team is recommended to proactively and repeatedly try to identify those in need and the characteristics of their needs. In addition, it is important to offer individualized information and strive to encourage family members to reflect on their situation and to not suppress their own needs if emerging. REPORTING METHOD Reporting adheres to the consolidated criteria for reporting qualitative research (COREQ) checklist. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Maria Samuelsson
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
- Department of Pediatrics, Skåne University Hospital, Malmö, Sweden
| | - Jenny Jakobsson
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
- Department of Surgery and Gastroenterology, Skåne University Hospital, Malmö, Sweden
| | - Mariette Bengtsson
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - Marie-Louise Lydrup
- Department of Surgery and Gastroenterology, Skåne University Hospital, Malmö, Sweden
| | - Anne Wennick
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
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Pettitt NJ, Petrella AR, Neilson S, Topping A, Taylor RM. Psychosocial and Support Needs of the Main Caregiver for Adolescents and Young Adults Undergoing Treatment for Cancer. Cancer Nurs 2024:00002820-990000000-00247. [PMID: 38656263 DOI: 10.1097/ncc.0000000000001352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
BACKGROUND Family relationships and social networks are critically important to adolescents and young adults (AYAs) with cancer, impacting their experience and well-being throughout the cancer trajectory. A cancer diagnosis impacts the development of independence and an adult identity, which can present challenges to psychosocial well-being needs and relationships between caregivers and AYAs. OBJECTIVE The aim of this study was to explore the psychosocial and support needs of the main caregivers of AYAs. METHODS This is a secondary analysis of the BRIGHTLIGHT caregiver survey, exploring items pertaining to support offered/engaged with, appraisal of helpfulness, and caregivers' emotional and psychological distress experience. Descriptive statistics, a correlational analysis, and a 1-way analysis of variance were conducted. RESULTS There were 518 caregiver responses (62%). Over half received information about their caregiving needs, with the majority finding this very/fairly helpful. Most (80%) of those who had not received the information would have valued it. High levels of negative emotional and psychological well-being were reported, with 91% feeling depressed or anxious since the AYAs' diagnosis and 41% always/often experiencing these feelings. Total distress was associated with being younger, a parent, female, and unemployed, and earning a below-average income. CONCLUSIONS The needs of caregivers are broad and multidimensional; however, some characteristics were associated with higher distress. When caregiver-specific information was provided by healthcare professionals, it was well received. IMPLICATIONS FOR PRACTICE Healthcare professionals should consider caregivers' needs individually and provide/signpost to support. Caregivers need to be involved in designing and implementing future research, given the heterogeneity of needs identified.
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Affiliation(s)
- Nicola J Pettitt
- Author Affiliations: Corporate Nursing, University Hospitals Birmingham NHS Foundation Trust (Mrs Pettitt and Dr Topping); Institute of Clinical Sciences, University of Birmingham (Drs Neilson and Topping); Cancer Clinical Trials Unit, University College London Hospitals NHS Foundation Trust (Dr Petrella); Centre for Nurse, Midwife and Allied Health Profession led Research (CNMAR), University College London Hospitals NHS Foundation Trust (Dr Taylor); and Department of Targeted Intervention, University College London (Dr Taylor), United Kingdom
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Baudry AS, Delpuech M, Charton E, Hivert B, Carnot A, Ceban T, Dominguez S, Lemaire A, Aelbrecht-Meurisse C, Anota A, Christophe V. Association between emotional competence and risk of unmet supportive care needs in caregivers of cancer patients at the beginning of care. Support Care Cancer 2024; 32:302. [PMID: 38647710 DOI: 10.1007/s00520-024-08510-6] [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: 12/21/2023] [Accepted: 04/15/2024] [Indexed: 04/25/2024]
Abstract
PURPOSE This cross-sectional study explored the associations between intrapersonal and interpersonal emotional competence (EC) and the unmet supportive care needs (SCN), anxiety, and depression of informal caregivers at the beginning of gastrointestinal or haematological cancer care, i.e. during chemotherapy and within 6 months after diagnosis. METHODS The participants completed a self-reported questionnaire, comprising the Short Profile of Emotional Competence (S-PEC), the SCN survey for partners and caregivers (SCNS-P&C), and the Hospital Anxiety and Depression Scale (HADS). Multivariate logistic regression models were performed to explore the influence of EC on unmet SCN and the presence of moderate/severe anxiety or depression. RESULTS Most of the 203 caregivers were women (n = 141, 69.80%) and the partners of patients (n = 148, 73.27%) suffering from gastrointestinal (n = 112, 55.17%) and haematological (n = 91, 44.83%) cancer. Only intrapersonal EC showed a significant influence out of all the dimensions of unmet SCN related to healthcare services and information (odds ratio (OR) = 0.35 [95%CI 0.19; 0.65]), emotional and psychological needs (OR = 0.43 [95%CI 0.25; 0.74]), work and social security (OR = 0.57 [95%CI 0.37; 0.88]), and communication and family support (OR = 0.61 [95%CI 0.39; 0.95]). A one-unit increase in the intrapersonal EC score significantly reduced the probability of anxiety (OR = 0.42, [95%CI 0.26; 0.68]) and depression (OR = 0.34, [95%CI 0.21; 0.55]). CONCLUSION Intrapersonal EC of caregivers is crucial to reduce the risk of unmet SCN, anxiety, and depression from the beginning of care. Identifying caregivers with lower intrapersonal EC may be necessary to increase vigilance from healthcare professionals and psychologists.
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Affiliation(s)
- Anne-Sophie Baudry
- Pôle Cancérologie Et Spécialités Médicales, Centre Hospitalier de Valenciennes, Valenciennes, France.
- Univ. Lille, CNRS, UMR 9193 - SCALab - Sciences Cognitives Et Sciences Affectives, 59000, Lille, France.
- Human and Social Sciences Department, Centre Léon Bérard, Lyon, France.
- Service d'oncologie, Centre Hospitalier de Valenciennes, Avenue Désandrouin - cs 50479, 59322, Valenciennes Cedex, France.
| | - Marion Delpuech
- Human and Social Sciences Department, Centre Léon Bérard, Lyon, France
| | - Emilie Charton
- Human and Social Sciences Department, Centre Léon Bérard, Lyon, France
- Department of Clinical Research and Innovation, Centre Léon Bérard, Lyon, France
| | - Benedicte Hivert
- Service d'Onco-Hématologie, Hôpital Saint Vincent de Paul, GHICL, Lille, France
| | - Aurelien Carnot
- Pôle d'oncologie médicale, Centre Oscar Lambret, Lille, France
| | - Tatiana Ceban
- Service d'Oncologie, Centre Hospitalier de Dunkerque, Dunkerque, France
| | - Sophie Dominguez
- Service d'Onco-Hématologie, Hôpital Saint Vincent de Paul, GHICL, Lille, France
| | - Antoine Lemaire
- Pôle Cancérologie Et Spécialités Médicales, Centre Hospitalier de Valenciennes, Valenciennes, France
| | | | - Amelie Anota
- Human and Social Sciences Department, Centre Léon Bérard, Lyon, France
- Department of Clinical Research and Innovation, Centre Léon Bérard, Lyon, France
- The French National Platform Quality of Life and Cancer, Lyon, France
| | - Veronique Christophe
- Univ. Lille, CNRS, UMR 9193 - SCALab - Sciences Cognitives Et Sciences Affectives, 59000, Lille, France
- Human and Social Sciences Department, Centre Léon Bérard, Lyon, France
- Université Claude Bernard Lyon 1, CRCL, UMR Mixte INSERM 1052-CNRS 5286, Lyon, France
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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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Weng Y, Lin J, Yang T, Lin YA, Chen H, Chen W, Huang F. The dyadic relationship of supportive care needs with quality of life in lung cancer survivor and spousal caregiver couples. Asia Pac J Oncol Nurs 2023; 10:100300. [PMID: 37908225 PMCID: PMC10613913 DOI: 10.1016/j.apjon.2023.100300] [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: 06/10/2023] [Accepted: 08/23/2023] [Indexed: 11/02/2023] Open
Abstract
Objective This study aimed to explore the dyadic interrelationships between supportive care needs (SCNs) and quality of life (QOL) among lung cancer (LC) survivors and their spousal caregivers. Methods In this cross-sectional study, 443 dyads were recruited from three tertiary hospitals in two cities (Fuzhou and Putian) in Fujian Province, China, between May 2020 and May 2021. The study shows that participants completed a sociodemographic information sheet, the SCNs survey, and answered the Chinese version of the World Health Organization Quality of Life-BREF questionnaire by telephone. The data were analyzed using descriptive statistics and Pearson's correlations. This study used the actor-partner interdependence model (APIM) with dyad analysis to examine the effect of LC survivors and spouses unmet SCNs on QOL. Results LC survivor's and spouse's QOL levels were influenced by the level of unmet SCNs (the actor effect). LC survivors unmet SCNs were significantly negatively associated with their spouse's QOL (the partner effect). There were no partner effects between the spouse's unmet SCNs and the LC survivor's QOL. The APIM model produced an acceptable model fit [χ2/df = 2.84 (147), comparative fit index (CFI) = 0.94, Tucker-Lewis index (TLI) = 0.93, root mean square error of approximation (RMSEA) = 0.07]. Conclusions The level of unmet SCNs significantly affected QOL in survivor and spouse dyads. Although partner effects were weaker than actor effects, healthcare providers should develop tailored LC dyadic self- and family-management interventions to provide SCN-driven care to LC survivors and their spouses.
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Affiliation(s)
- Yunqin Weng
- Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, China
- School of Nursing, Fujian Medical University, Fuzhou, China
| | - Jialing Lin
- School of Nursing, Fujian Medical University, Fuzhou, China
| | - Tianbao Yang
- Affiliated Hospital of Putian University, Putian, Fujian, China
| | - Yu-An Lin
- School of Nursing, Fujian Medical University, Fuzhou, China
| | - Huiping Chen
- Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, China
| | - Weiti Chen
- University of California, Los Angeles, CA, USA
| | - Feifei Huang
- School of Nursing, Fujian Medical University, Fuzhou, China
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Grivel C, Nizet P, Martin M, Pécout S, Lepeintre A, Touchefeu Y, Prot-Labarthe S, Evin A, Huon JF. The experience of being a caregiver of patients with digestive cancer, from patients and caregivers' perception: A mixed study. PLoS One 2023; 18:e0287335. [PMID: 37478058 PMCID: PMC10361535 DOI: 10.1371/journal.pone.0287335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 06/02/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUNDS Caregivers are essential in the care of a patient with digestive cancer. Considering their experience and needs is crucial. OBJECTIVES To explore the experience of caregivers of patients with digestive cancer and to compare the perspectives of patients and caregivers. METHODS A mixed-methods study with a cross-sectional prospective and a comprehensive qualitative dimension was performed in a medical oncology unit in a French tertiary hospital. Dyads made of patients with digestive cancer and their caregiver were recruited. The Caregiver Reaction Assessment (CRA) and the Supportive Care Needs Survey for Partners and Caregivers (SCNS-PC) questionnaires were distributed to caregivers. The CRA was used to measure the caregiver burden and the SCNS-PC was used to identify the unmet supportive care needs of caregivers. Semi-structured interviews with the dyads were conducted. Qualitative interviews addressed various dimensions of the caregiver's experience from each dyad's member perspective. RESULTS Thirty-two caregivers completed the questionnaires. Responses showed high self-esteem, schedule burden, and a need for care and information services. Ten dyads participated in the interviews. Three themes emerged from the caregiver's interviews: illness is an upheaval; loneliness and helplessness are experienced; caring is a natural role with positive outcomes. Four themes emerged from patient's interviews: the caregiver naturally assumes the role and gets closer; he is the patient's anchor; his life is disrupted; anxiety and guilt accompany the desire to protect him. In comparing patient and caregiver data, the main theme of disagreement was their relationship. CONCLUSIONS Caregiver care does not appear to be optimal, particularly in terms of their need for information. Patients have a fairly good representation of their experience, but the caregivers' opinion need to be considered.
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Affiliation(s)
| | - Pierre Nizet
- Nantes Université, CHU Nantes, Pharmacie, Nantes, France
- Nantes Université, University Tours, CHU Nantes, CHU Tours, INSERM, MethodS in Patients-Centered Outcomes and HEalth Research, SPHERE, Nantes, France
| | - Manon Martin
- Nantes Université, CHU Nantes, Pharmacie, Nantes, France
| | - Solange Pécout
- Institut des Maladies de l’Appareil Digestif, Nantes Université, CHU Nantes, Oncologie Digestive, Nantes, France
| | - Aurélie Lepeintre
- Nantes Université, CHU Nantes, Service de soins Palliatifs et de Support, Nantes, France
| | - Yann Touchefeu
- Institut des Maladies de l’Appareil Digestif, Nantes Université, CHU Nantes, Oncologie Digestive, Nantes, France
| | - Sonia Prot-Labarthe
- Nantes Université, CHU Nantes, Pharmacie, Nantes, France
- Université Paris Cité, Inserm, ECEVE, Paris, France
| | - Adrien Evin
- Nantes Université, University Tours, CHU Nantes, CHU Tours, INSERM, MethodS in Patients-Centered Outcomes and HEalth Research, SPHERE, Nantes, France
- Nantes Université, CHU Nantes, Service de soins Palliatifs et de Support, Nantes, France
| | - Jean-François Huon
- Nantes Université, CHU Nantes, Pharmacie, Nantes, France
- Nantes Université, University Tours, CHU Nantes, CHU Tours, INSERM, MethodS in Patients-Centered Outcomes and HEalth Research, SPHERE, Nantes, France
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Baudry AS, Charton E, Piessen G, Vanlemmens L, Cortot A, Ceban T, Anota A, Christophe V. Emotional distress, supportive care needs and age in the prediction of quality of life of cancer patients' caregivers: A cross-sectional study. Eur J Oncol Nurs 2023; 64:102324. [PMID: 37146349 DOI: 10.1016/j.ejon.2023.102324] [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: 10/28/2022] [Revised: 03/03/2023] [Accepted: 03/10/2023] [Indexed: 05/07/2023]
Abstract
INTRODUCTION The existing literature shows a significant impact of cancer on caregivers' quality of life (QoL) and divergent results according to associated factors. To better understand the experience of cancer patients' caregivers, the present study aimed at comparing caregivers' QoL according to cancer care pathway and type of cancer, and at identifying the factors associated with their QoL. METHODS Caregivers were included in the study either during chemotherapy or follow-up to assess their QoL (CARGOQoL), unmet supportive care needs (SCNS-P&C), and anxiety and depression levels (HADS). CARGOQoL scores were then compared using ANOVA or Mann-Whitney non-parametric tests (objective 1). Based on univariate analyses, a multivariate analysis of covariance or linear regression model was performed for each CARGOQoL dimension (objective 2). RESULTS Among 583 participants (57.29% included during the follow-up phase), 523 completed the questionnaires. There was no effect of treatment phase and little effect of cancer site or disease stage on caregivers' QoL. Although significant factors associated with caregivers' QoL varied according to the dimensions assessed, the main associated factors were psychological experience (p < 0.05), satisfaction with the patient's care and supportive care needs (p < 0.01), and age of the patient or caregiver (p < 0.005). CONCLUSION This study shows the necessity to support caregivers during both active treatment and follow-up. It highlights the crucial role of emotional distress, supportive care and age in caregivers' QoL, regardless of the patients' oncological status.
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Affiliation(s)
- Anne-Sophie Baudry
- Pôle Cancérologie et Spécialités Médicales - Centre Hospitalier de Valenciennes, France; Univ. Lille, CNRS, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, F-59000, Lille, France; Human and Social Sciences Department - Centre Léon Bérard, Lyon, France.
| | - Emilie Charton
- Human and Social Sciences Department - Centre Léon Bérard, Lyon, France
| | - Guillaume Piessen
- Univ. Lille, CNRS, Inserm, CHU Lille, UMR9020-U1277 - CANTHER - Cancer Heterogeneity, Plasticity and Resistance to Therapies, F-59000, Lille, France; Department of Digestive and Oncological Surgery, Claude Huriez University Hospital, F-59000, Lille, France
| | | | - Alexis Cortot
- Univ. Lille, Department of Thoracic Oncology, Albert Calmette University Hospital, Lille, France
| | - Tatiana Ceban
- Service D'Oncologie, Centre Hospitalier de Dunkerque, France
| | - Amelie Anota
- Human and Social Sciences Department - Centre Léon Bérard, Lyon, France; French National Platform Quality of Life and Cancer, France; Department of Clinical Research and Innovation, Centre Léon Bérard, Lyon, France
| | - Véronique Christophe
- Univ. Lille, CNRS, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, F-59000, Lille, France; Human and Social Sciences Department - Centre Léon Bérard, Lyon, France; Université Claude Bernard Lyon 1, Centre de Recherche en Cancérologie de Lyon - UMR Inserm 1052 - CNRS 5286 - UCBL - CLB, Lyon, France.
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Oakley-Girvan I, Yunis R, Fonda SJ, Neeman E, Liu R, Aghaee S, Ramsey ME, Kubo A, Davis SW. A novel smartphone application for the informal caregivers of cancer patients: Usability study. PLOS DIGITAL HEALTH 2023; 2:e0000173. [PMID: 36867639 PMCID: PMC9983832 DOI: 10.1371/journal.pdig.0000173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 11/29/2022] [Indexed: 03/04/2023]
Abstract
Informal caregivers are a critical source of support for cancer patients. However, their perspectives are not routinely collected, despite health impacts related to the burden of caregiving. We created the TOGETHERCare smartphone application (app) to collect observer-reported outcomes regarding the cancer patient's health and caregiver's perceptions of their own mental and physical health, and to provide tips and resources for self-care and patient care. We enrolled 54 caregivers between October 2020 and March 2021 from Kaiser Permanente Northern California (KPNC), an integrated healthcare system. Fifty caregivers used the app for approximately 28 days. Usability and acceptability were assessed using questions from the Mobile App Rating Scale (MARS), the System Usability Scale (SUS), the Net Promoter Score (NPS), and semi-structured interviews. The caregivers' mean age was 54.4 years, 38% were female and 36% were non-White. The SUS total mean score was 83.4 (SD = 14.2), for a percentile rank of 90-95 ("excellent"). Median MARS responses to the functionality questions were also high. The NPS score of 30 at the end of the study indicated that most caregivers would recommend the app. Themes from semi-structured interviews were consistent across the study period and indicated that the app was easy to use and helpful. Caregivers indicated a need for feedback from the app, suggested some changes to the wording of questions, the app's visuals, and timing of notifications. This study demonstrated that caregivers are willing to complete frequent surveys about themselves and their patients. The app is unique because it provides a remote method to collect caregivers' observations about the patient that may be useful for clinical care. To our knowledge, TOGETHERCare is the first mobile app developed specifically to capture adult cancer patient symptoms from the informal caregiver's perspective. Future research will examine whether use of this app can help improve patient outcomes.
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Affiliation(s)
| | - Reem Yunis
- Medable Inc., Palo Alto, California, United States of America
| | | | - Elad Neeman
- Kaiser Permanente Northern California, San Francisco Medical Center, San Francisco, California, United States of America
| | - Raymond Liu
- Kaiser Permanente Northern California, San Francisco Medical Center, San Francisco, California, United States of America
- Kaiser Permanente Northern California, Division of Research, Oakland, California, United States of America
| | - Sara Aghaee
- Kaiser Permanente Northern California, Division of Research, Oakland, California, United States of America
| | - Maya E. Ramsey
- Kaiser Permanente Northern California, Division of Research, Oakland, California, United States of America
| | - Ai Kubo
- Kaiser Permanente Northern California, Division of Research, Oakland, California, United States of America
| | - Sharon W. Davis
- Medable Inc., Palo Alto, California, United States of America
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Guerra-Martín MD, Casado-Espinosa MDR, Gavira-López Y, Holgado-Castro C, López-Latorre I, Borrallo-Riego Á. Quality of Life in Caregivers of Cancer Patients: A Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1570. [PMID: 36674325 PMCID: PMC9863368 DOI: 10.3390/ijerph20021570] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/11/2023] [Accepted: 01/12/2023] [Indexed: 06/17/2023]
Abstract
(1) Background: Cancer constitutes one of the principal causes of morbi-mortality in the world and generates an important loss of patients' self-sufficiency. People who are their caregivers usually become the main care providers, which impacts their quality of life; (2) Aim: Analyze the different problems (physical, emotional, social, and financial) faced by people who are caregivers of adults with cancer and describe the strategies required to improve their quality of life; (3) Method: A literature review was conducted on the following database: PubMed, Cinahl, PsycINFO, and Scopus. The following eligibility criteria were specified: (a) research studies of quantitative, qualitative, or mixed methods, (b) consistent with objective, and (c) published in the English language or Spanish during the last five years; (4) Results: 36 studies were selected from those found in the literature. Regarding the problems mentioned: eight studies described physical issues, 26 emotional effects, 10 social implications, and seven financial strains. Twenty-eight studies described strategies to improve the quality of life of caregivers; (5) Conclusions: Caregivers are usually women around the age of 50. Problems faced are mostly emotional in nature, followed by social, physical, and financial ones. In order to cope with this burden, there are some strategies that can be developed to help to build skills to manage both the disease and the impact derived from it, therefore improving their quality of life.
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Affiliation(s)
- María Dolores Guerra-Martín
- Department of Nursing, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain
| | | | - Yelena Gavira-López
- Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain
| | | | | | - Álvaro Borrallo-Riego
- Department of Nursing, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain
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10
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Zhang JM, Zhang MR, Yang CH, Li Y. The meaning of life according to patients with advanced lung cancer: a qualitative study. Int J Qual Stud Health Well-being 2022; 17:2028348. [PMID: 35103558 PMCID: PMC8925916 DOI: 10.1080/17482631.2022.2028348] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Purpose This qualitative study explores the meaning of life and end-of-life coping strategies among patients in China with advanced lung cancer. Methods We conducted in-depth interviews with 21 hospitalized patients with advanced lung cancer and analysed the data using the 7-step Colaizzi method. Results The analysis revealed themes in patients’ experiences and feelings about living with a terminal illness. These include: 1) The core of the meaning of life is “self-iteration,” which includes self-recognition and cherishing life; 2) The existence form of the meaning of life is “yu-wei,” including self-reliance and altruism; 3) The meaning of life is embodied in three levels: the past, present, and future. The past includes gratitude, guilt and remorse, and avoidance; the present includes using the support system, positive response, independence, and integrity; the future includes accompanying relatives, preparing for death, living a high quality of life, and worrying. Conclusion Meaning of life is a multidimensional and diverse concept among patients with advanced lung cancer. Medical care providers and family members can provide targeted professional guidance and psychological support according to patients’ characteristics to help them discover their meaning of life, improve their quality of life, and achieve a positive end-of-life perspective.
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Affiliation(s)
- Jin Mei Zhang
- Department of Nursing, Shanghai Pulmonary Hospital, Tongji University, Shanghai, China.,Department of Respiratory Medicine, Hongkou Branch of Changhai Hospital, Naval Medical University, Shanghai, China
| | - Mei Rong Zhang
- Department of Nursing, Shanghai Yangpu District Mental Health Centre, Shanghai, China
| | - Chun Hong Yang
- Department of Pediatrics, The First Affiliated Hospital of China Medical University, Liaoning, China
| | - Yumei Li
- Department of Nursing, Shanghai Pulmonary Hospital, Tongji University, Shanghai, China
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11
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Christophe V, Anota A, Vanlemmens L, Cortot A, Ceban T, Piessen G, Charton E, Baudry AS. Unmet supportive care needs of caregivers according to medical settings of cancer patients: a cross-sectional study. Support Care Cancer 2022; 30:9411-9419. [PMID: 36205779 DOI: 10.1007/s00520-022-07379-7] [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: 03/21/2022] [Accepted: 09/26/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE The objectives of this study were to compare the unmet supportive care needs (SCN) of caregivers and describe the 10 most frequent of them according to various cancer settings: phase of cancer care pathway (i.e., treatment vs. follow-up), cancer site (i.e., breast, digestive, or lung cancer), and cancer status (i.e., metastatic vs. non-metastatic). METHODS Participants completed a self-reported questionnaire to assess their unmet SCN (SCNS-P&C). According to their cancer settings, non-parametric ANOVA or Mann-Whitney tests were performed to compare the SCNS-P&C scores. The prevalence of caregivers with unmet SCN was described using percentages. RESULTS Among 583 participants, 516 caregivers (88.5%) completed the SCNS-P&C questionnaire. Most patients had digestive (47.3%), non-metastatic cancer (67.6%) and were recruited during the follow-up phase (56.2%). The results revealed no significant difference in SCNS-P&C scores according to cancer settings except for caregivers of patients with metastatic cancer, who reported more unmet SCN related to health care service and information needs. The more qualitative item per item analysis seems to indicate the existence of five frequently unsatisfied SCN across situations, especially concerns about the recurrence and reduction of stress in patients, with variable ranking among the most unmet SCN. CONCLUSION Although there was no significant difference in unmet SCN scores between medical settings, examining the prevalence of unmet SCN helps identify the issues to focus on when supporting caregivers and developing dedicated consultations or interventions for them.
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Affiliation(s)
- Véronique Christophe
- CNRS, UMR 9193, SCALab, Sciences Cognitives et Sciences Affectives, Université de Lille, Rue du Barreau, BP 60149, 59653, Lille, Villeneuve d'Ascq cedex, France.
- Human and Social Sciences Department, Centre Léon Bérard, Lyon, France.
- Université Claude Bernard Lyon 1 , Centre de Recherche en Cancérologie de Lyon - UMR Inserm 1052 - CNRS 5286 - UCBL - CLB, Lyon, France.
| | - Amelie Anota
- Human and Social Sciences Department, Centre Léon Bérard, Lyon, France
- Department of Clinical Research and Innovation, Centre Léon Bérard, Lyon, France
- French National Platform Quality of Life and Cancer, Besançon, France
| | | | - Alexis Cortot
- Department of Thoracic Oncology, Albert Calmette University Hospital, Univ. Lille, Lille, France
| | - Tatiana Ceban
- Service d'Oncologie, Centre Hospitalier de Dunkerque, Dunkerque, France
| | - Guillaume Piessen
- CNRS, Inserm, CHU Lille, UMR9020-U1277, CANTHER, Cancer Heterogeneity, Plasticity and Resistance to Therapies, University Lille, F-59000, Lille, France
- Department of Digestive and Oncological Surgery, Claude Huriez University Hospital, University Lille, 59000, Lille, France
| | - Emilie Charton
- Human and Social Sciences Department, Centre Léon Bérard, Lyon, France
| | - Anne-Sophie Baudry
- CNRS, UMR 9193, SCALab, Sciences Cognitives et Sciences Affectives, Université de Lille, Rue du Barreau, BP 60149, 59653, Lille, Villeneuve d'Ascq cedex, France.
- Human and Social Sciences Department, Centre Léon Bérard, Lyon, France.
- Pôle Cancérologie et Spécialités Médicales, Centre Hospitalier de Valenciennes, Valenciennes, France.
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12
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Zhu S, Yang C, Chen S, Kang L, Li T, Li J, Li L. Effectiveness of a perioperative support programme to reduce psychological distress for family caregivers of patients with early-stage lung cancer: study protocol for a randomised controlled trial. BMJ Open 2022; 12:e064416. [PMID: 35998958 PMCID: PMC9403120 DOI: 10.1136/bmjopen-2022-064416] [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: 12/09/2022] Open
Abstract
INTRODUCTION Family caregivers play a key role in providing ongoing long-term care and assistance to their loved ones during cancer treatment. However, family caregivers of patients with lung cancer are frequently unprepared for their roles and they may undergo psychological distress, thus reducing their own quality of life while affecting patients' health outcomes. Interventions that specifically target this population are lacking. This study aims to evaluate the effectiveness of a perioperative support programme on family caregivers of patients with early-stage lung cancer. METHODS AND ANALYSIS This study is guided by the Stress-Coping Model. Family caregivers of patients diagnosed with early-stage lung cancer and those who are scheduled for lung resection treatment will be invited to participate. Participants will be randomised to groups that either receive the perioperative support programme or usual care. The intervention consists of four face-to-face intervention sessions during the hospital stay and two weekly telephone follow-up sessions after discharge. Primary and secondary outcomes will be assessed at baseline and at 4 and 12 weeks after the intervention. Primary outcomes will include psychological distress and secondary outcomes will include caregiving burden, quality of life, coping style and social support. Generalised estimation equation model will be used to analyse the intervention effects. ETHICS AND DISSEMINATION The study was approved by the Ethics Committee of the Second Xiangya Hospital of Central South University (LYG2022003). The authors will disseminate the study's findings by publishing them in international scientific journals. TRIAL REGISTRATION NUMBER ChiCTR2200058280.
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Affiliation(s)
- Song Zhu
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, China
- Department of Thoracic Surgery, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Chen Yang
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Shihao Chen
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Lu Kang
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, China
- Department of Thoracic Surgery, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Tong Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, China
- Department of Thoracic Surgery, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jina Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, China
- Department of Thoracic Surgery, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Lezhi Li
- Xiangya Nursing School, Central South University, Changsha, Hunan, China
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13
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Silveira A, Sequeira T, Gonçalves J, Lopes Ferreira P. Patient reported outcomes in oncology: changing perspectives-a systematic review. Health Qual Life Outcomes 2022; 20:82. [PMID: 35597948 PMCID: PMC9124403 DOI: 10.1186/s12955-022-01987-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 05/10/2022] [Indexed: 12/24/2022] Open
Abstract
In public health context, oncology is associated with severe negative impact on patients and on their relatives’ quality of life. Over the last decades, survival has remained at 50% worldwide for some tumor locations. Patient reported outcomes (PROs) assessment and, the corresponding use in clinical practice, help establishing patient individualized profiling involving caregivers. The purpose of this systematic review was to examine critical success factors for PROs assessment in daily clinical oncology practice. Additionally, we investigated how PROs collection can change oncology perspectives for patients and caregivers. According to PRISMA guidelines, 83 studies were included in this systematic review, whether related with implementation in daily clinical practice or associated with its use in oncology. PROs assessment gathers multi-professional teams, biomedical and clinical expertise, patients, families and caregivers. Institutional involvement, first line for caregiver’s adherence, team continuous formation, encompassing training and support, design of clear workflows, continuous monitoring, and data analysis are crucial for implementation. PROs measures are decisive in oncology. Several items were improved, including caregiver–patient–physician communication, patient risk groups identification, unmet problems and needs detection, disease course and treatment tracking, prognostic markers, cost-effectiveness measurement and comfort/support provision for both patients and caregivers. Routine assessment and implementation of PROs in clinical practice are a major challenge and a paradigm transformation for future.
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Affiliation(s)
- Augusta Silveira
- Health Sciences Faculty, Fernando Pessoa University (UFP-FCS), Rua Carlos da Maia, 296, 4200-150, Porto, Portugal.,Centre for Health Studies and Research of University of Coimbra, Centre for Innovative Biomedicine and Biotechnology, Avenida Dias da Silva, 165, 3004-512, Coimbra, Portugal
| | - Teresa Sequeira
- Health Sciences Faculty, Fernando Pessoa University (UFP-FCS), Rua Carlos da Maia, 296, 4200-150, Porto, Portugal.,Centre for Health Studies and Research of University of Coimbra, Centre for Innovative Biomedicine and Biotechnology, Avenida Dias da Silva, 165, 3004-512, Coimbra, Portugal
| | - Joaquim Gonçalves
- 2Ai - Applied Artificial Intelligence Laboratory, School of Technology of Polytechnic Institute of Cávado and Ave, R. de São Martinho, 4750-810, Vila Frescainha, Barcelos, Portugal
| | - Pedro Lopes Ferreira
- Centre for Health Studies and Research of University of Coimbra, Centre for Innovative Biomedicine and Biotechnology, Avenida Dias da Silva, 165, 3004-512, Coimbra, Portugal. .,Faculty of Economics, University of Coimbra, Av. Dr. Dias da Silva, 165, 3004-512, Coimbra, Portugal.
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14
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Kumar S, Lee NK, Pinkerton E, Wroblewski KE, Lengyel E, Tobin M. Resilience: a mediator of the negative effects of pandemic-related stress on women's mental health in the USA. Arch Womens Ment Health 2022; 25:137-146. [PMID: 34651237 PMCID: PMC8516405 DOI: 10.1007/s00737-021-01184-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 09/23/2021] [Indexed: 12/23/2022]
Abstract
The role of resilience in mediating the negative effects of the COVID-19 pandemic on the mental health of US women is poorly understood. We examined socioeconomic factors associated with low resilience in women, the relationship of low resilience with psychiatric morbidity, and the mediating role of resilience in the relationship between pandemic-related stress and other coincident psychiatric morbidities. Using a quota-based sample from a national panel, we conducted a web-based survey of 3200 US women in April 2020. Weighted, multivariate logistic regression was used to model the odds of pandemic-related stress, and coincident depression and anxiety symptoms among those with and without low resilience. Structural equation modeling was used to evaluate resilience as a mediator of the relationship between pandemic-related stress and other coincident psychiatric morbidities. Risk factors for low resilience included younger age, lower household income, lower education, unemployment, East/Southeast Asian race, unmarried/unpartnered status, and higher number of medical comorbidities. Low resilience was significantly associated with greater odds of depression symptoms (OR = 3.78, 95% CI [3.10-4.60]), anxiety symptoms (OR = 4.17, 95% CI [3.40-5.11]), and pandemic-related stress (OR = 2.86, 95% CI [2.26-3.26]). Resilience acted as a partial mediator in the association between pandemic-related stress and anxiety symptoms (proportion mediated = 0.23) and depression symptoms (proportion mediated = 0.28). In the early days of the COVID-19 pandemic, low resilience mediated the association between pandemic-related stress and psychiatric morbidity. Strategies proven to enhance resilience, such as cognitive behavioral therapy, mindfulness-based stress reduction, and addressing socioeconomic factors, may help mitigate mental health outcomes.
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Affiliation(s)
- Shivani Kumar
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, 5841 S. Maryland Ave, Chicago, IL, MC307760637, USA
| | - Nita Karnik Lee
- Department of Obstetrics and Gynecology/Section of Gynecologic Oncology, The University of Chicago, Chicago, IL, USA
| | - Elizabeth Pinkerton
- Department of Obstetrics and Gynecology, The University of Chicago, Chicago, IL, USA
| | - Kristen E Wroblewski
- Department of Public Health Sciences, The University of Chicago, Chicago, IL, USA
| | - Ernst Lengyel
- Department of Obstetrics and Gynecology/Section of Gynecologic Oncology, The University of Chicago, Chicago, IL, USA
| | - Marie Tobin
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, 5841 S. Maryland Ave, Chicago, IL, MC307760637, USA.
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15
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Pan YC, Lin YS. Systematic Review and Meta-Analysis of Prevalence of Depression Among Caregivers of Cancer Patients. Front Psychiatry 2022; 13:817936. [PMID: 35633789 PMCID: PMC9133351 DOI: 10.3389/fpsyt.2022.817936] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 03/03/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Caregivers of cancer patients commonly experience depressive symptoms due to the heavy burden of caregiving responsibility. OBJECTIVE This meta-analysis examined the prevalence of depression among caregivers of cancer patients. METHODS We included 85 studies covering 23,317 participants published between 2001 and 2021 (25 countries) that reported the prevalence of depression among caregivers of cancer patients. We examined the pooled prevalence of depression and hypothesized moderators, including year, age, sex, geographic regions, percentage of spousal caregivers, depression measures, and cancer stage. RESULTS All 85 effect sizes included 6,077 caregivers of patients with depression. The weighted average prevalence of depression was 25.14% (95% CI, 21.42-29.27%) among caregivers. The prevalence rates were moderated by geographic region, patients' cancer stage, and measures for depression. The prevalence rates also varied among the different measures assessing depression. The prevalence rate decreased with the mean age of the caregivers and the percentage of spousal caregivers. CONCLUSIONS This study revealed a high prevalence of depression among caregivers of cancer patients. The prevalence rates also varied with the study design, demographics of caregivers, and patients' medical information. These findings highlight that psychological support and intervention may be crucial for patients and their caregivers in clinical practice.
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Affiliation(s)
- Yuan-Chien Pan
- Department of Psychology, National Taiwan University, Taipei, Taiwan
| | - Yaw-Sheng Lin
- Department of Psychology, National Taiwan University, Taipei, Taiwan
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16
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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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17
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Drageset S, Austrheim G, Ellingsen S. Quality of life of women living with metastatic breast cancer and receiving palliative care: A systematic review. Health Care Women Int 2021; 42:1044-1065. [PMID: 33798012 DOI: 10.1080/07399332.2021.1876063] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The quality of life (QoL) of women living with metastatic breast cancer and receiving palliative care needs more attention. We reviewed published studies (1992-2019) examining QoL of women receiving palliative care. The findings were interpreted according to the World Health Organization's (WHO) definition of palliative care. Four themes emerged: (1) the impact of medical treatment on pain relief; (2) the need for psychosocial attention and support; (3) the necessity of an interdisciplinary approach; (4) ambiguous understanding of the term palliative care. A common understanding of the term palliative care and more research is needed to enhance the QoL of women living with metastatic breast cancer.
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Affiliation(s)
- Sigrunn Drageset
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway.,Faculty of Health Studies, VID Specialized University - Haraldsplass, Bergen, Norway
| | - Gunhild Austrheim
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Sidsel Ellingsen
- Faculty of Health Studies, VID Specialized University - Haraldsplass, Bergen, Norway.,Faculty of Health Studies and Global Public Health and Primary Care, University of Bergen, Bergen, Norway
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18
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Valero-Cantero I, Wärnberg J, Carrión-Velasco Y, Martínez-Valero FJ, Casals C, Vázquez-Sánchez MÁ. Predictors of sleep disturbances in caregivers of patients with advanced cancer receiving home palliative care: A descriptive cross-sectional study. Eur J Oncol Nurs 2021; 51:101907. [PMID: 33636585 DOI: 10.1016/j.ejon.2021.101907] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 01/30/2021] [Accepted: 02/02/2021] [Indexed: 01/07/2023]
Abstract
PURPOSE To evaluate the quality of sleep in caregivers of patients with advanced cancer receiving home palliative care, basing the analysis on subjective and objective measures, and to develop a predictive model of sleep disturbances among this population. METHOD A descriptive cross-sectional study was conducted in six clinical management units within primary healthcare centres. Data were obtained during a period of six months, from a sample population of 41 caregivers. The Pittsburgh Sleep Quality Index (PSQI) and a 7-day accelerometry evaluation were performed to assess sleep quality. Daytime sleepiness, caregiver strain and quality of life were also evaluated. RESULTS According to the PSQI, 90.2% of participants had poor sleep quality. The average duration of night-time sleep, measured by accelerometry and the PSQI, was 6 h. Taking PSQI as the dependent variable, the study model predicted 40.7% of the variability (p < 0.01). The variables "Caregiver strain" and "Daily hours dedicated to care" produced the following results: B coefficient 0.645; p = 0.001; and B coefficient 0.230; p = 0.010, respectively. CONCLUSIONS The caregivers presented significant health-related alterations, including sleep disturbances, which were directly related to two variables: the index of caregiver strain and the number of hours per day dedicated to providing care.
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Affiliation(s)
- Inmaculada Valero-Cantero
- Nurse Case Manager, Puerta Blanca Clinical Management Unit, Malaga-Guadalhorce Health District, Malaga, Spain.
| | - Julia Wärnberg
- Professor at the Department of Nursing, Faculty of Health Sciences, University of Malaga and Malaga Biomedical Research Institute (IBIMA), Malaga, Spain; CIBER Fisiopatología de La Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
| | - Yolanda Carrión-Velasco
- Nurse Case Manager, Tiro Pichón Clinical Management Unit, Malaga-Guadalhorce Health District, Malaga, Spain.
| | | | - Cristina Casals
- Professor at the Department of Physical Education, MOVE-IT Research Group, University of Cadiz, Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital, Cadiz, Spain.
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19
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Kisch AM, Bergkvist K, Alvariza A, Årestedt K, Winterling J. Family caregivers' support needs during allo-HSCT-a longitudinal study. Support Care Cancer 2020; 29:3347-3356. [PMID: 33125539 PMCID: PMC8062346 DOI: 10.1007/s00520-020-05853-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 10/22/2020] [Indexed: 01/04/2023]
Abstract
PURPOSE The study aimed to explore family caregivers' support needs prior to allo-HSCT, how these change over time and whether they are associated with demographic factors and caregiver outcome. METHODS This longitudinal repeated measure study included 87 family caregivers of allo-HSCT recipients: 63% were partners, 74% women, 65% lived with the recipient, and their mean age was 54 years. They completed the 14-item Carer Support Needs Assessment Tool (CSNAT) and caregiver outcome measures (caregiver burden, anxiety, depression, preparedness for caregiving and general health) prior to allo-HSCT and 3, 6 and 16 weeks later. RESULTS The two top support needs prior to allo-HSCT were 'knowing what to expect in the future' (79%) and 'dealing with your own feelings' (70%). Several support needs were associated with younger age and not being a partner, while higher needs implied worse caregiver outcomes for at least one of the outcomes prior to transplantation. Most support needs remained the same at the last follow-up. CONCLUSION The findings that high support needs are often associated with worse caregiver outcomes and most support needs do not diminish over time indicate that more attention should be placed on the situation of family caregivers.
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Affiliation(s)
- Annika M Kisch
- Haematology Department, Lund University Hospital, Lund, Sweden. .,Institute of Health Sciences, Lund University, Lund, Sweden.
| | - Karin Bergkvist
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Sophiahemmet University, Stockholm, Sweden
| | - Anette Alvariza
- Department of Health Care Sciences/Palliative Research Centre, Ersta Sköndal Bräcke University College, Stockholm, Sweden
| | - Kristofer Årestedt
- Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden.,The Research Section, Region Kalmar County, Kalmar, Sweden
| | - Jeanette Winterling
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Medical Unit Hematology, Theme Cancer, Karolinska University Hospital, Stockholm, Sweden
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20
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A randomized clinical trial assessing a pragmatic intervention to improve supportive care for family caregivers of patients with lung cancer. Palliat Support Care 2020; 19:146-153. [PMID: 32924913 DOI: 10.1017/s1478951520000711] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVE Family caregivers (FCs) of cancer patients often experience high distress. This randomized clinical trial assessed the feasibility and preliminary effects of an intervention to improve FC supportive care. METHOD A pragmatic and minimal intervention to improve FC supportive care was developed and pretested with FCs, oncology team, and family physicians to assess its relevance and acceptability. Then, FCs of lung cancer patients were randomized to the intervention or the control group. The intervention included (1) systematic FC distress screening and problem assessment in the first months after their relative cancer diagnosis, and every 2 months after; (2) privileged contact with an oncology nurse to address FC problems, provide emotional support and skills to play their caregiving role; (3) liaison with the family physician of FCs reporting high distress (distress thermometer score ≥4/10) to involve them in the provision of supportive care. Distress, the primary outcome, was measured every 3 months, for 9 months. Secondary outcomes included quality of life, caregiving preparedness, and perceived burden. At the end of their participation, a purposive sample of FC from the experimental group was individually interviewed to assess the intervention usefulness. Content analysis was performed. RESULTS A total of 109 FCs participated in the trial. FC distress decreased over time, but this reduction was observed in both groups. Similar results were found for secondary outcomes. However, FCs who received the intervention felt better prepared in caregiving than controls (p = 0.05). All 10 interviewed FCs valued the intervention, even though they clearly underused it. Knowing they could contact the oncology nurse served as a security net. SIGNIFICANCE OF RESULTS Although the intervention was not found effective, some of its aspects were positively perceived by FCs. As many of them experience high distress, an improved intervention should be developed to better support them.
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