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Lu SH, Yiin JJ, Lin YP, Lee KC. Effect of a Web-Based Integrative Support Intervention to Improve Family Caregiver Positive Caregiving Experience and Quality of Life: A Randomized Controlled Trial. Cancer Nurs 2024:00002820-990000000-00270. [PMID: 39016271 DOI: 10.1097/ncc.0000000000001387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2024]
Abstract
BACKGROUND Cancer caregivers experience significant stress due to their multifaceted role. Current support methods are limited by unidimensional assessments. OBJECTIVE The aim of this study was to evaluate a Web-based support system aimed at reducing caregiver stress and anxiety, and improving resilience, vigilance, and quality of life, using both subjective and objective measures. METHODS A randomized controlled trial with a single-center, 2-arm parallel design and longitudinal assessment was conducted in Taiwan. Caregivers of patients recently diagnosed with cancer were randomly allocated to either a standard care group or an intervention group that received enhanced nurse-led support. Metrics including psychological resilience, caregiver burden, anxiety, quality of life, stress levels, and vigilance were systematically evaluated on a monthly basis over a period of 5 months, starting from the initial baseline measurement. RESULTS Following the intervention, participants in the intervention group exhibited statistically significant reductions in caregiver burden and anxiety, alongside a notable improvement in resilience. Objective evaluations revealed a significant reduction in stress levels within this group. However, there were no discernible differences in vigilance and quality of life metrics between the intervention and control groups. CONCLUSION The Web-based program effectively reduced caregiver stress and burden, as indicated by multiple metrics. IMPLICATIONS FOR PRACTICE This accessible and efficient Web-based support is beneficial for cancer caregivers facing diverse challenges.
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Affiliation(s)
- Shu-Hua Lu
- Author Affiliations: School of Nursing, China Medical University (Drs Lu, Lin, and Lee); and Department of Neurosurgery, Neurological Institute, Taichung Veterans General Hospital (Dr Yiin), Taichung, Taiwan
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Denham AMJ, Haracz K, Bird ML, Bonevski B, Spratt NJ, Turner A, Chow WZ, Larkin M, Mabotuwana N, Janssen H. Non-pharmacological interventions to improve mental health outcomes among female carers of people living with a neurological condition: a systematic review. Disabil Rehabil 2024:1-18. [PMID: 38859798 DOI: 10.1080/09638288.2024.2360648] [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: 09/22/2023] [Accepted: 05/22/2024] [Indexed: 06/12/2024]
Abstract
PURPOSE This systematic review aims to examine the effectiveness of non-pharmacological interventions for improving mental health outcomes among female carers of people living with a neurological condition. MATERIALS AND METHODS A narrative synthesis of English-language randomized controlled trials was undertaken. RESULTS 18 unique studies were included. Intervention components that were found to have improved mental health outcomes were: delivered in person, to groups, on an intermittent schedule with ≥10 sessions; had a duration between 3-6 months; and were facilitated by research staff or allied health professionals. As the review had few robust studies, results of mental health outcomes reported in studies assessed as low risk of bias were highlighted in the review. Psychoeducation interventions, cognitive behavioural interventions, and support group interventions were found to improve depression. Psychoeducation interventions were also found to improve burden. CONCLUSIONS There is a clear need for adequately powered, high-quality randomised controlled trials to determine the effectiveness of non-pharmacological interventions for female carers of people living with a neurological condition.
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Affiliation(s)
- A M J Denham
- School of Health Sciences, University of Newcastle, Callaghan, Australia
| | - K Haracz
- School of Health Sciences, University of Newcastle, Callaghan, Australia
| | - M L Bird
- School of Health Sciences, University of Tasmania, Hobart, Australia
| | - B Bonevski
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - N J Spratt
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, Australia
- Heart and Stroke Program, Hunter Medical Research Institute, Newcastle, Australia
- Department of Neurology, John Hunter Hospital, Newcastle, Australia
| | - A Turner
- IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, Australia
| | - W Z Chow
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Queenstown, Singapore
| | - M Larkin
- School of Health, Wellbeing & Social Care, The Open University, Milton Keynes, UK
| | - N Mabotuwana
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, Australia
| | - H Janssen
- School of Health Sciences, University of Newcastle, Callaghan, Australia
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, Australia
- Hunter Stroke Service, Hunter New England Local Health District, New Lambton Heights, Australia
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Rosario-Ramos L, Torres-Marrero S, Rivera T, Navedo ME, Burgos R, Garriga M, del Carmen Pacheco M, Lopez B, Torres Y, Torres-Blasco N. Preparing for Cancer: A Qualitative Study of Hispanic Patient and Caregiver Needs. Healthcare (Basel) 2024; 12:1117. [PMID: 38891192 PMCID: PMC11172160 DOI: 10.3390/healthcare12111117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 05/26/2024] [Accepted: 05/28/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND Cancer disproportionately affects Hispanic populations, yet the preparedness of Hispanic caregiver-patient dyads facing cancer remains understudied. This study aims to identify essential components of preparedness needs and inform future psychosocial interventions for this demographic. METHODS Secondary analyses were conducted utilizing focus groups to develop a communication intervention for Hispanic patients and caregivers. Transcripts were qualitatively analyzed using NVivo v12 (2020). RESULTS Analysis revealed symptom management and treatment comprehension as pivotal aspects of preparation. Additionally, preparedness among our sample emerged by addressing the multifaceted dimensions of preparedness, including psychological, emotional, educational, familial, practical, financial, and spiritual aspects. CONCLUSIONS Tailoring interventions encompassing diverse dimensions of preparedness can foster inclusivity and maximize their impact on supportive measures. This underscores the necessity for culturally sensitive approaches when delivering interventions supporting Hispanic individuals navigating the challenges of cancer.
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Affiliation(s)
- Lianel Rosario-Ramos
- School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce 00716, Puerto Rico; (L.R.-R.); (S.T.-M.); (T.R.); (R.B.); (M.G.); (M.d.C.P.); (B.L.); (Y.T.)
| | - Stephanie Torres-Marrero
- School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce 00716, Puerto Rico; (L.R.-R.); (S.T.-M.); (T.R.); (R.B.); (M.G.); (M.d.C.P.); (B.L.); (Y.T.)
| | - Tiffany Rivera
- School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce 00716, Puerto Rico; (L.R.-R.); (S.T.-M.); (T.R.); (R.B.); (M.G.); (M.d.C.P.); (B.L.); (Y.T.)
| | - Maria Elena Navedo
- Department of Medicine, University of Connecticut, Storrs, CT 06269, USA;
| | - Rosael Burgos
- School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce 00716, Puerto Rico; (L.R.-R.); (S.T.-M.); (T.R.); (R.B.); (M.G.); (M.d.C.P.); (B.L.); (Y.T.)
| | - Mayra Garriga
- School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce 00716, Puerto Rico; (L.R.-R.); (S.T.-M.); (T.R.); (R.B.); (M.G.); (M.d.C.P.); (B.L.); (Y.T.)
| | - Maria del Carmen Pacheco
- School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce 00716, Puerto Rico; (L.R.-R.); (S.T.-M.); (T.R.); (R.B.); (M.G.); (M.d.C.P.); (B.L.); (Y.T.)
| | - Betsy Lopez
- School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce 00716, Puerto Rico; (L.R.-R.); (S.T.-M.); (T.R.); (R.B.); (M.G.); (M.d.C.P.); (B.L.); (Y.T.)
| | - Yamilet Torres
- School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce 00716, Puerto Rico; (L.R.-R.); (S.T.-M.); (T.R.); (R.B.); (M.G.); (M.d.C.P.); (B.L.); (Y.T.)
| | - Normarie Torres-Blasco
- School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce 00716, Puerto Rico; (L.R.-R.); (S.T.-M.); (T.R.); (R.B.); (M.G.); (M.d.C.P.); (B.L.); (Y.T.)
- Ponce Research Institute, Ponce 00716, Puerto Rico
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Maximiano-Barreto MA, Luchesi BM, Matias M, Chagas MHN. Effects of empathy training on psychological concerns and empathy in caregivers of older people: A randomized, double-blind, crossover, clinical trial with follow-up. Geriatr Nurs 2024; 57:1-10. [PMID: 38452492 DOI: 10.1016/j.gerinurse.2024.02.024] [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: 01/02/2024] [Revised: 02/16/2024] [Accepted: 02/19/2024] [Indexed: 03/09/2024]
Abstract
OBJECTIVES To investigate the effects of empathy training on psychological concerns and empathy in caregivers of older people. METHODS A randomized, double-blind, crossover, clinical trial with follow-up was conducted online. Thirty paid and unpaid caregivers of older people from different regions of Brazil participated in an empathy training program. The caregivers answered a sociodemographic questionnaire and measures for the evaluation of empathy (affective and cognitive domains), burden, the impact of providing care as well as depressive symptoms and psychiatric symptoms before and immediately after training. Empathy and its domains were also assessed at three post-intervention follow-ups. RESULTS Empathy training diminished levels of psychological concerns. Moreover, an increase was found in levels of cognitive empathy 15, 30 and 60 days after the intervention. CONCLUSIONS Empathy training with a focus on cognitive empathy diminished psychological concerns in caregivers of older people and increased the levels of this ability over time. This intervention can be considered a coping strategy for negative impacts related to providing care. CLINICA LTRIAL REGISTRATION RBR-8kjtfx3.
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Affiliation(s)
- Madson Alan Maximiano-Barreto
- Research Group on Mental Health, Cognition and Aging, Department of Psychology Center for Education and Human Sciences. Rodovia Washington Luís, Federal University of São Carlos - UFSCar, km 235, São Carlos, SP CEP: 13565-905, Brazil.
| | - Bruna Moretti Luchesi
- Research Group on Mental Health, Cognition and Aging, Department of Psychology Center for Education and Human Sciences. Rodovia Washington Luís, Federal University of São Carlos - UFSCar, km 235, São Carlos, SP CEP: 13565-905, Brazil; Três Lagoas Campus, Federal University of Mato Grosso do Sul, Três Lagoas, MS, Brazil
| | - Marisa Matias
- Center for Psychology at University of Porto, Porto, Portugal
| | - Marcos Hortes Nisihara Chagas
- Research Group on Mental Health, Cognition and Aging, Department of Psychology Center for Education and Human Sciences. Rodovia Washington Luís, Federal University of São Carlos - UFSCar, km 235, São Carlos, SP CEP: 13565-905, Brazil; Neurociences and Behavioral Sciences Department, University of São Paulo, Ribeirão Preto, SP, Brazil
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Johansson B, Cajander Å, Ahmad A, Ohlsson-Nevo E, Fransson P, Granström B, von Essen L, Langegård U, Pettersson M, Henriksson A, Ehrsson YT. The effect of internet-administered support (carer eSupport) on preparedness for caregiving in informal caregivers of patients with head and neck cancer compared with support as usual: a study protocol for a randomized controlled trial. BMC Cancer 2024; 24:494. [PMID: 38637744 PMCID: PMC11025201 DOI: 10.1186/s12885-024-12273-y] [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: 03/30/2024] [Accepted: 04/16/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Informal caregivers (ICs) of patients with cancer provide essential and mainly uncompensated care. A self-perceived preparedness to care for the patient is associated with a lower caregiver burden, described as the extent to which caregiving is perceived as having adverse effects on IC functioning and well-being. ICs' well-being is associated with patient-perceived quality of care, suggesting that interventions to optimize ICs' health are essential in order to improve patient care. Head and neck cancer (HNC) is the seventh most common malignant disease in the world. The disease and its treatment have a significant negative impact on the patient's health and quality of life. Symptoms usually interfere with swallowing, food and fluid intake, breathing, speaking, and communication. ICs frequently manage patients' symptoms and side effects, especially problems related to nutrition and oral pain, without being properly prepared. Carer eSupport is an Internet-administered intervention, based on focus group discussions with ICs, developed in collaboration with ICs and healthcare professionals, tested for feasibility, and deemed feasible. This study protocol outlines the methods of investigating the effects of Carer eSupport plus support as usual (SAU) on self-reported preparedness for caregiving, caregiver burden, and well-being in the ICs of patients with HNC, compared with ICs receiving SAU only. METHODS AND ANALYSIS In this randomized controlled trial, 110 ICs of patients with HNC, undergoing radiotherapy combined with surgery and/or medical oncological treatment, will be randomized (1:1) to Carer eSupport plus SAU or SAU only. Data will be collected at baseline (before randomization), post-intervention (after 18 weeks), and 3 months after post-intervention. The primary outcome is self-reported preparedness for caregiving. Secondary outcomes are self-reported caregiver burden, anxiety, depression, and health-related quality of life. The effect of Carer eSupport plus SAU on preparedness for caregiving and secondary outcomes, compared with SAU only, will be evaluated by intention to treat analyses using linear regression models, mixed-model regression, or analysis of covariance. DISCUSSION If proven effective, Carer eSupport has the potential to significantly improve ICs' preparedness for caregiving and their wellbeing, thereby improving patient-perceived quality of care and patient wellbeing. TRIAL REGISTRATION ClinicalTrials.gov; NCT06307418, registered 12.03.2024 (https://clinicaltrials.gov/search? term=NCT06307418).
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Affiliation(s)
- Birgitta Johansson
- Department of Immunology, Genetics, and Pathology, Uppsala University, Rudbecklaboratoriet, 75185, Uppsala, Sweden.
| | - Åsa Cajander
- Division of Visual Information and Interaction, Department of Information Technology, Uppsala University, 751 05, Uppsala, Box 337, Sweden
| | - Awais Ahmad
- Division of Visual Information and Interaction, Department of Information Technology, Uppsala University, 751 05, Uppsala, Box 337, Sweden
| | - Emma Ohlsson-Nevo
- Department of Surgery, Faculty of Medicine and Health, Örebro University, 701 82, Örebro, Sweden
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, 701 82, Örebro, Sweden
| | - Per Fransson
- Department of Nursing, Umeå University, 901 87, Umeå, Sweden
| | - Brith Granström
- Department of Diagnostics and Intervention, Umeå University, 901 87, Umeå, Sweden
| | - Louise von Essen
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Dag Hammarskjölds väg 14B, 751 85, Uppsala, Sweden
| | - Ulrica Langegård
- Department of Immunology, Genetics, and Pathology, Uppsala University, Rudbecklaboratoriet, 75185, Uppsala, Sweden
- Department of Oncology, Sahlgrenska University Hospital, 413 45, Gothenburg, Sweden
| | - Mona Pettersson
- Department of Public Health and Caring Sciences, Uppsala University, 751 22, Uppsala, Box 564, Sweden
| | - Anna Henriksson
- Physiotherapy and behavioral medicine, Department of Women's and Children's Health, Uppsala University, 751 22, Uppsala, Box 564, Sweden
- The School of Health, Care and Social Welfare, Mälardalen University, 721 23, Västerås, Box 883, Sweden
| | - Ylva Tiblom Ehrsson
- Department of Surgical Sciences, Section of Otorhinolaryngology and Head & Neck Surgery, Uppsala University, Akademiska sjukhuset, ingång 70, bv, Rudbecklaboratoriet, 75185, Uppsala, Sweden
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Muñoz-Cruz JC, López-Martínez C, Orgeta V, Del-Pino-Casado R. A systematic review and meta-analysis of the association between anxiety symptoms and coping in family carers of dependent people aged 18 and over. Stress Health 2024; 40:e3303. [PMID: 37603011 DOI: 10.1002/smi.3303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 07/31/2023] [Accepted: 08/02/2023] [Indexed: 08/22/2023]
Abstract
Anxiety symptoms are prevalent in family carers of dependent people. Despite accumulating evidence in the area, there are still inconsistent findings on the association between carer anxiety symptoms and coping strategies. The aim of our study was to systematically analyse the relationship between anxiety symptoms and coping strategies in carers of dependent adults aged 18 years and older, and examine possible sources of heterogeneity in the results. The study design was a systematic review and meta-analysis. We searched several international databases (Pubmed, CINAHL, PsycINFO and LILACS) from June 2022 up to February 2023. We followed the preferred reporting items for systematic reviews and meta-analyses statement and performed several subgroup analyses to examine whether study design, cause of dependency and whether or not controlling for various biases influenced results. Forty-one studies were included in the review. We found significant associations between greater use of dysfunctional coping and higher anxiety symptoms. Greater use of problem-focused coping was associated with lower anxiety symptoms in carers of frail older people, but higher anxiety in carers of people surviving cancer. Emotion-focused coping and some of its individual strategies, such as acceptance and positive reappraisal, in probabilistic samples, were associated with lower anxiety symptoms across all groups. Most of the studies included in this review were cross-sectional. Evidence overall indicates that only specific dimensions and strategies of coping are significantly associated with anxiety symptoms in family carers. These findings should be considered when developing future interventions supporting carers.
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Affiliation(s)
| | | | - Vasiliki Orgeta
- Division of Psychiatry, University College London, London, UK
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Mooney KH, Coombs LA, Whisenant MS, Wilson CM, Moraitis AM, Steinbach MN, Sloss EA, Lloyd JLE, Alekhina N, Berry PH, Kang Y, Iacob E, Donaldson GW. Impact of an automated, remote monitoring and coaching intervention in reducing hospice cancer family caregiving burden: A multisite randomized controlled trial. Cancer 2024; 130:1171-1182. [PMID: 38009953 DOI: 10.1002/cncr.35131] [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: 07/17/2023] [Revised: 09/29/2023] [Accepted: 11/01/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND Care for those with life-limiting cancer heavily involves family caregivers who may experience significant physical and emotional burden. The purpose of this study was to test the impact of Symptom Care at Home (SCH), an automated digital family caregiver coaching intervention, during home hospice, when compared to usual hospice care (UC) on the primary outcome of overall caregiver burden. Secondary outcomes included Caregiver Burden at weeks 1 and 8, Mood and Vitality subscales, overall moderate-to-severe caregiving symptoms, and sixth month spouse/partner bereavement outcomes. METHODS Using a randomized, multisite, nonblinded controlled trial, 332 cancer family caregivers were enrolled and analyzed (159 SCH vs. 173 UC). Caregivers were primarily White (92%), female (69%), and spouse caregivers (53%). Caregivers provided daily reports on severity levels (0-10 scale) for their anxiety, depressed mood, fatigue, disturbed sleep, and caregiving interference with normal activities. These scores combined constituted the Caregiver Burden primary outcome. Based on reported symptoms, SCH caregivers received automated, tailored coaching about improving their well-being. Reports of moderate-to-severe caregiving symptoms also triggered hospice nurse notification. Secondary outcomes of Mood and Vitality were subcomponents of the Caregiver Burden score. A combined bereavement adjustment tool captured sixth month bereavement. RESULTS The SCH intervention reduced overall Caregiver Burden compared to UC (p < .001), with a 38% reduction at 8 weeks and a medium-to-large effect size (d = .61). SCH caregivers experienced less (p < .001) disruption in both Mood and Vitality. There were higher levels of moderate-to-severe caregiving symptoms overtime in UC (OR, 2.722). All SCH caregivers benefited regardless of caregiver: sex, caregiver relationship, age, patient diagnosis and family income. SCH spouse/partner caregivers achieved better sixth month bereavement adjustment than UC (p < .007). CONCLUSIONS The SCH intervention significantly decreased caregiving burden over UC and supports the maintenance of family caregiver mood and vitality throughout caregiving with extended benefit into bereavement.
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Affiliation(s)
- Kathi H Mooney
- Huntsman Cancer Institute, Salt Lake City, Utah, USA
- University of Utah, Salt Lake City, Utah, USA
| | - Lorinda A Coombs
- University of North Carolina Chapel Hill, Chapel Hill, North Carolina, USA
| | | | | | | | - Mary N Steinbach
- Huntsman Cancer Institute, Salt Lake City, Utah, USA
- University of Utah, Salt Lake City, Utah, USA
| | | | - Jennifer L E Lloyd
- Huntsman Cancer Institute, Salt Lake City, Utah, USA
- University of Utah, Salt Lake City, Utah, USA
| | | | | | | | - Eli Iacob
- University of Utah, Salt Lake City, Utah, USA
| | - Gary W Donaldson
- Huntsman Cancer Institute, Salt Lake City, Utah, USA
- University of Utah, Salt Lake City, Utah, USA
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Muñoz-Cruz JC, López-Martínez C, Orgeta V, Del-Pino-Casado R. Subjective caregiver burden and coping in family carers of dependent adults and older people: A systematic review and meta-analysis. Stress Health 2024:e3395. [PMID: 38491958 DOI: 10.1002/smi.3395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 02/16/2024] [Accepted: 03/01/2024] [Indexed: 03/18/2024]
Abstract
Subjective caregiver burden is highly prevalent in family caregivers. Despite several studies investigating the relationship between subjective caregiver burden and coping strategies, results remain inconsistent. The aim of our study was to systematically review current literature on the relationship between subjective caregiver burden and coping in family carers of dependent adults and older people. A secondary objective was to analyse possible sources of heterogeneity in the estimated effect. The study design was a systematic review with meta-analysis following Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA) guidelines. We searched several international databases (CINAHL, LILACS, PsycINFO and PubMed) up to February 2024. We performed several subgroup analyses to examine whether study design, methodological quality or care recipient dependency influenced results. Of the 1064 records identified in our search, a total of 80 studies met inclusion criteria. We found a significant association between greater use of dysfunctional coping and higher levels of subjective caregiver burden (r ‾ $\overline{r}$ = 0.400; 95% CI = 0.315, 0.478); higher use of second-order active coping was significantly associated with lower caregiver burden (r ‾ $\overline{r}$ = -0.213; 95% CI = -0.316, -0.105). Problem-focused coping showed no statistically significant association with levels of subjective burden; emotion-focused coping was associated with caregiver burden only after controlling for confounding variables (r ‾ $\overline{r}$ = -0.258; 95% CI = -0.441, -0.055); several individual strategies of this dimension such as acceptance (r ‾ $\overline{r}$ = -0.135; 95% CI = -0.238, -0.028), positive reappraisal (r ‾ $\overline{r}$ = -0.178; 95% CI = -0.255, -0.099) and religious coping (r ‾ $\overline{r}$ = -0.083; 95% CI = -0.162, -0.002), were associated with lower burden. We found that several dimensions of coping strategies are significantly associated with levels of subjective caregiver burden experienced by carers. These results can inform future research evaluating the effectiveness of interventions aimed at improving carers' mental health.
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Affiliation(s)
| | | | - Vasiliki Orgeta
- Division of Psychiatry, University College London, London, UK
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Cheng Q, Ng MSN, Choi KC, Chen Y, Liu G, So WKW. A Mobile Instant Messaging-Delivered Psychoeducational Intervention for Cancer Caregivers: A Randomized Clinical Trial. JAMA Netw Open 2024; 7:e2356522. [PMID: 38386323 PMCID: PMC10884881 DOI: 10.1001/jamanetworkopen.2023.56522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2024] Open
Abstract
Importance Psychoeducational interventions (PEIs), which provide both information and emotional and psychosocial support, may address the unmet needs of the caregivers of adolescent and young adult patients with cancer. Objective To explore the effects of an instant messaging-delivered PEI on anxiety, depression, quality of life (QOL), and coping and determine whether the intervention reduces caregivers' unmet needs. Design, Setting, and Participants This randomized clinical trial using an intention-to-treat protocol was conducted from April 1 to September 14, 2022, in a tertiary cancer hospital in China and included caregivers of patients diagnosed with cancer at age 15 to 39 years recruited using convenience sampling. Intervention Caregivers were allocated 1:1 using a randomized block scheme to the intervention or control group. The intervention group received a 5-week PEI and usual care, whereas the control group received only usual care. The PEI was delivered through articles and calls through an instant messaging application. Main Outcomes and Measures The primary outcomes were changes in the levels of caregivers' anxiety and depression, measured using the 7-Item Generalized Anxiety Disorder Scale and the Patient Health Questionnaire 9, respectively. The secondary outcomes were changes in the levels of caregivers' QOL, coping, and unmet needs. Results Of the 160 participants, 92 (57.5%) were male; mean (SD) age was 40.27 (8.33) years. Compared with the control group, the intervention group had significantly greater reduction in severity of anxiety (B = -3.231; 95% CI, -4.746 to -1.716; P < .001) and depression (B = -3.253; 95% CI, -5.052 to -1.454; P < .001), smaller reduction in QOL (B = 13.574; 95% CI, 0.488-26.661; P = .04), and greater reduction in unmet needs (B = -12.136; 95% CI, -18.307 to -5.965; P < .001) after the intervention. Twelve weeks after baseline, the intervention group demonstrated a significantly greater reduction only in severity of anxiety (B = -1.890; 95% CI, -3.382 to -0.397; P = .01). Conclusions and Relevance In this randomized clinical trial of a mobile instant messaging-delivered PEI, caregivers' unmet needs, anxiety, and depression decreased significantly and QOL declined at a significantly slower rate immediately after the intervention in the intervention group compared with the control group. A sustained effect on anxiety was observed 12 weeks after baseline. Trial Registration Chinese Clinical Trial Registry identifier: ChiCTR2200055951.
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Affiliation(s)
- Qinqin Cheng
- Hunan Cancer Hospital, Changsha, Hunan, China
- Nethersole School of Nursing, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
| | - Marques Shek Nam Ng
- Nethersole School of Nursing, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
| | - Kai Chow Choi
- Nethersole School of Nursing, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
| | - Yongyi Chen
- Hunan Cancer Hospital, Changsha, Hunan, China
| | - Gaoming Liu
- Hunan Cancer Hospital, Changsha, Hunan, China
| | - Winnie Kwok Wei So
- Nethersole School of Nursing, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
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10
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Sang E, Hirschman KB, Bowles KH. Feasibility, usability, and acceptability of psychoeducational videoconferencing interventions for informal caregivers: A systematic review of randomized controlled trials. Res Nurs Health 2024; 47:60-81. [PMID: 38069607 PMCID: PMC10841701 DOI: 10.1002/nur.22358] [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: 05/27/2023] [Revised: 11/14/2023] [Accepted: 11/16/2023] [Indexed: 01/19/2024]
Abstract
Psychoeducational videoconferencing interventions bypass traditional in-person barriers to attendance and are effective in improving caregiving skills, self-care, and wellness among informal caregivers. Information on their feasibility, usability, and acceptability from the caregivers' perspective is needed to inform future designs and developments. This systematic review follows PRISMA 2020 guidelines to integrate this information. Five databases were systematically searched for relevant randomized control trials published between January 2012 and December 2022. Reference lists were cross-checked for additional studies. Relevant studies were appraised and had their data extracted. This review contains 14 randomized controlled trials. Retention rates ranged from 55.56% to 100%, and major reasons for withdrawing include deteriorating patient health, lack of interest, and technical difficulties (feasibility). Caregivers found the videoconference technology usable, although participants in one intervention experienced poor connectivity and persistent technical issues (usability). Most caregivers were satisfied with videoconferencing interventions, found their content applicable to their situation, and appreciated their structure (acceptability). Those in videoconferencing group interventions were satisfied with small caregiver group sizes (acceptability). Adding respite care to interventions and incorporating short and regular videoconferencing sessions may improve feasibility. Ensuring small group sizes in videoconferencing group interventions and using participatory design may enhance acceptability. Advocacy is needed for employees identifying as informal caregivers to receive employer support and for quality connectivity within underserved areas. This may improve the feasibility and usability of interventions, allowing caregivers to receive the support they need. In future studies, power analyses and recruiting more caregivers may better assess feasibility.
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Affiliation(s)
- Elaine Sang
- NewCourtland Center for Transitions and Health, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Karen B. Hirschman
- NewCourtland Center for Transitions and Health, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Kathryn H. Bowles
- NewCourtland Center for Transitions and Health, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Oh J, An J, Park K, Park Y. Psychosocial interventions for people with amyotrophic lateral sclerosis and motor neuron disease and their caregivers: a scoping review. BMC Nurs 2024; 23:75. [PMID: 38287331 PMCID: PMC10823680 DOI: 10.1186/s12912-024-01721-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 01/07/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND As amyotrophic lateral sclerosis/motor neuron disease (ALS/MND) is a fatal progressive neurodegenerative disorder, patients experience severe impairments, with patients and family caregivers facing emotional distress and exhaustion. Several psychosocial interventions are aimed at providing tailored support for ALS/MND patients and caregivers. The aim of this study was to conduct a scoping review and present a comprehensive overview of psychosocial interventions designed for individuals and families affected by ALS/MND, while also pinpointing research gaps. METHODS This scoping review utilized Arksey and O'Malley's methodological framework to investigate psychosocial interventions designed for individuals with ALS/MND and their families. The study adhered to the PRISMA-ScR checklist for reporting. RESULTS A total of 27 articles describing 25 interventions met the inclusion criteria. The predominant interventions observed in the research encompassed education-related strategies, closely followed by behavior therapy, counseling, social support interventions, and psychotherapy interventions. Across the majority of the studies, findings indicated promising feasibility and acceptability of these interventions. Notably, a significant proportion of quantitative investigations yielded one or more statistically significant effects, while qualitative studies consistently reported favorable outcomes, including enhancements in well-being and heightened awareness of individual circumstances. CONCLUSIONS Given the progressive and debilitating nature of this condition, coupled with the absence of a cure, the adoption of a psychosocial approach can prove beneficial for both ALS/MND patients and their families. However, high-quality RCTs with a large sample size are recommended to examine and confirm the effectiveness.
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Affiliation(s)
- Juyeon Oh
- College of Nursing, Dankook University, 119 Dandae-Ro, Dongnam-Gu, Cheonan-Si, Chungcheongnam-Do, 31116, South Korea
| | - Jiwon An
- Department of Nursing, Far East University, 76-32, Daehak-Gil, Gamgok-Myeon, , Eumseong-Gun, Chungcheongbuk-Do, 27601, South Korea
| | - Kyongok Park
- Department of Nursing, Gangneung-Wonju National University, 150, Namwon-Ro, Heungeop-Myeon, Wonju-Si, Gangwon-Do, 26403, South Korea
| | - Youngok Park
- Department of Nursing, Gangneung-Wonju National University, 150, Namwon-Ro, Heungeop-Myeon, Wonju-Si, Gangwon-Do, 26403, South Korea.
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Zhang Q, Chen J, Fang K, Liu Q, Zhang P, Bai J, Zhang C. Psychological experiences of family caregivers of patients with breast cancer: Protocol for a meta-synthesis. Nurs Open 2024; 11:e2064. [PMID: 38268260 PMCID: PMC10701291 DOI: 10.1002/nop2.2064] [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: 03/08/2023] [Revised: 10/26/2023] [Accepted: 11/19/2023] [Indexed: 01/26/2024] Open
Abstract
AIM The number of breast cancer patients is increasing, but there are insufficient sources of information for their family caregivers. The purpose of this systematic review was to elaborate the psychologically realistic experiences and corresponding needs of family members of patients with breast cancer in the course of their experience in the disease which may provide them with effective, targeted intervention strategies to improve their quality of life. DESIGN Protocol for a meta-synthesis. METHODS We will search the Chinese databases (i.e., China National Knowledge Infrastructure, VIP Database and Wanfang Database) and the English databases (i.e., PubMed, Embase, Web of Science, the Cochrane Library, CINAHL and PsycINFO). Qualitative studies from the above databases, studying the psychological experiences of family members of patients with breast cancer, will be searched comprehensively. The quality of the study will be evaluated by two reviewers independently using the Joanna Briggs Institute (JBI) critical appraisal tools for qualitative study, and any disagreements will be discussed and judged by the third reviewer. Data will be extracted using JBI standardized data extraction tool. Then, the literature will be compared and analysed, and the raw results summarized using the JBI meta-aggregation tool. The reliability and credibility of the overall quality of the included studies will be assessed by using the JBI ConQual approach. RESULTS N/A. No Patient or Public Contribution. PROSPERO REGISTRATION NUMBER REDACTED.
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Affiliation(s)
| | - Jianfei Chen
- School of NursingWuhan UniversityWuhanHubei ProvinceChina
| | - Kui Fang
- Department of NeurosurgeryThe First Hospital of China Medical UniversityShenyangLiaoningChina
| | - Qianqian Liu
- Thyroid and Breast SurgeryZhongnan Hospital of Wuhan UniversityWuhanHubeiChina
| | - Pan Zhang
- Department of GastroenterologyZhongnan Hospital of Wuhan UniversityWuhanHubeiChina
| | - Jinbing Bai
- Nell Hodgson Woodruff School of NursingEmory UniversityAtlantaGeorgiaUSA
| | - Chunhua Zhang
- Nursing DepartmentZhongnan Hospital of Wuhan UniversityWuhanHubeiChina
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13
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Gopal DP, Ahmad T, Efstathiou N, Guo P, Taylor SJC. What is the evidence behind cancer care reviews, a primary care cancer support tool? A scoping review. J Cancer Surviv 2023; 17:1780-1798. [PMID: 36066766 PMCID: PMC9446647 DOI: 10.1007/s11764-022-01251-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 08/19/2022] [Indexed: 12/11/2022]
Abstract
PURPOSE A "cancer care review" (CCR) is a conversation between a patient recently diagnosed with cancer and primary care practitioner soon after a diagnosis of cancer in the UK. This scoping review aimed to identify: methodology and validated outcome measures used to evaluate CCRs, the impact of CCRs on quality of life or symptoms, and the views of patients, their carers and healthcare professionals on CCRs. METHODS A scoping review was performed and five databases (MEDLINE, Embase, PsychINFO, Scopus, Web of Science, Google Scholar) were searched systematically from January 2000 to March 2022. RESULTS Of 4133 articles, ten met the inclusion criteria. These included surveys, qualitative research on stakeholders' views and a small study evaluating group consultation CCRs. There were no studies on methodology to evaluate CCRs or the impact of CCRs on patient quality of life or symptoms. Some primary care professionals felt CCRs were a tick-box exercise, and that they had inadequate time to deliver care, compounded by inadequate primary-secondary care coordination and lack of expertise which was echoed by patients. Interviews with patients found few recalled CCRs and those that recalled CCRs did, did not find them particularly helpful. Partners of patients would welcome CCRs to raise personal health concerns and remain updated on patient care. CONCLUSIONS Further studies should identify the role that stakeholders believe they should have in CCRs, improve care coordination between primary care and secondary care and how to support caregivers. IMPLICATIONS FOR CANCER SURVIVORS There is currently insufficient evidence to support the use of CCRs in general practice.
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Affiliation(s)
- Dipesh P Gopal
- Centre for Primary Care, Wolfson Institute of Population Health, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, England.
- School of Nursing and Midwifery, Institute of Clinical Sciences, University of Birmingham, Birmingham, UK.
| | - Tahania Ahmad
- Centre for Primary Care, Wolfson Institute of Population Health, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, England
| | - Nikolaos Efstathiou
- School of Nursing and Midwifery, Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
| | - Ping Guo
- School of Nursing and Midwifery, Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
| | - Stephanie J C Taylor
- Centre for Primary Care, Wolfson Institute of Population Health, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, England
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14
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Chen D, Liu Q, Zhang L, Qian H. Effectiveness of Dyadic Psychoeducational Intervention on Cancer Patients and Their Caregivers: A Systematic Review and Meta-analysis. Cancer Nurs 2023:00002820-990000000-00197. [PMID: 38011076 DOI: 10.1097/ncc.0000000000001307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
BACKGROUND Dyadic psychoeducational intervention targets the dyads of cancer patients and caregivers as active participants in partnership, which can potentially address the needs and challenges faced by patients with cancer and their caregivers. However, there is insufficient evidence on the effectiveness of the intervention on psychological health and illness-related outcomes among the dyads. OBJECTIVE To systematically examine the dyadic psychoeducational intervention of cancer patients and their caregivers on psychological health and illness-related outcomes. METHODS Cochrane Library, EMBASE, CINAHL, PsycINFO, PubMed, Web of Science, and 4 Chinese databases were searched from inception to May 29, 2022. Two investigators independently extracted data and evaluated methodological quality. RevMan 5.4 was used for meta-analysis; heterogeneity was evaluated using Higgins' I2 (%). Standardized mean difference (SMD) with a 95% confidence interval (CI) was used to assess the effects. RESULTS Eight randomized controlled trials that involved 1234 dyads were collected. Meta-analysis showed that the intervention was effective in reducing the dyadic depression (patients' SMD, -0.41 [95% CI, -0.78 to -0.04; P = .03]; caregivers' SMD, -0.70 [95% CI, -1.31 to -0.09; P = .03]). It also improved caregivers' quality of life (SMD, -0.29 [95% CI, -0.56 to -0.03; P = .03]), whereas no significant effect was found on patients' quality of life. Dyadic results including anxiety, self-efficacy, disease communication, and appraisals of illness/caregiving were observed. CONCLUSION Dyadic psychoeducational intervention reduced the dyadic depression. It also improved caregivers' quality of life. IMPLICATIONS FOR PRACTICE Nurses can apply dyadic psychoeducational intervention in clinical practice. More studies are needed to draw higher-quality conclusions and investigate the effects on psychological health and illness-related outcomes in cancer patients and caregivers.
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Affiliation(s)
- Daoming Chen
- Author Affiliations: Department of Operating Room, The Affiliated Hospital of Xuzhou Medical University (Ms Chen), Xuzhou; and School of Nursing, Medical College, Soochow University (Ms Liu and Dr Zhang); and Department of Respiratory, The First Affiliated Hospital of Soochow University (Ms Qian), Suzhou, Jiangsu, People's Republic of China
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15
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Hoseinpour F, Ghahari S, Motaharinezhad F, Binesh M. Supportive Interventions for Caregivers of Individuals With Multiple Sclerosis: A Systematic Review. Int J MS Care 2023; 25:266-272. [PMID: 37969907 PMCID: PMC10634599 DOI: 10.7224/1537-2073.2022-083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
BACKGROUND Caregivers of individuals with multiple sclerosis (MS) are key members of the treatment team. Their needs and challenges should be met as interventions can be effective in improving not only their own health, well-being, and quality of life but also that of those they care for. The aim of this systematic review was to investigate supportive interventions for caregivers of individuals with MS. METHODS We conducted a database search of PubMed, Google Scholar, Science Direct, Scopus, and the Cochrane Library from 2000 to 2021. English-language studies that examined interventions administered directly to caregivers of individuals with MS and evaluated various outcomes were included. The Downs and Black checklist was used to assess the methodological quality of included studies. RESULTS Twenty of 367 relevant papers fit the eligibility criteria outlined in the methods of this study and were subsequently selected for this review. Of the included studies, there was a notable variance in key characteristics such as methods, outcome measures, sample size, and procedures. Supportive interventions, psychoeducational group interventions, and behavioral-adaptive therapies were the 3 main categories of interventions reviewed; however, each study had a significant correlation between the intervention and outcomes. CONCLUSIONS Despite the small sample size in this study, this review showed that various intervention models that target caregivers of individuals with MS have been successful.
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Affiliation(s)
- Fatemeh Hoseinpour
- From the Department of Occupational Therapy, School of Rehabilitation Sciences, Semnan University of Medical Sciences, Semnan, Iran (FH, MB)
| | - Setareh Ghahari
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada (SG)
| | - Fatemeh Motaharinezhad
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran (FM)
| | - Maryam Binesh
- From the Department of Occupational Therapy, School of Rehabilitation Sciences, Semnan University of Medical Sciences, Semnan, Iran (FH, MB)
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16
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Al-Nawafleh AH, Altarawneh FZ. Nursing students perspectives of psychosocial care: cross-sectional study. BMC Nurs 2023; 22:392. [PMID: 37853417 PMCID: PMC10585772 DOI: 10.1186/s12912-023-01548-7] [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: 05/17/2023] [Accepted: 10/01/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND Psychosocial care is an integral component of holistic nursing practices. This study aimed to examine how fourth-year nursing students at Mutah University perceive various care characteristics, specifically psychosocial care. METHODS A quantitative cross-sectional study was conducted using the Caring Dimension Inventory (CDI). Data were obtained from 105 nursing students before graduating from a Jordanian public educational institution. Data analyzed using the scoring of CDI and descriptive statistics. RESULTS The mean scores in the professional and technical domain of care were statistically higher for fourth-year nursing students (4.69 ± 0.25). This exceeded their scores in the psychosocial domain of care (3.37 ± 1.20). This suggests that fourth-year nursing students prioritize professional and technical care over psychosocial care. CONCLUSIONS Fourth-year nursing students tended to perceive the technical aspects of care as more significant than the psychosocial aspects. This highlights the need for nursing schools and healthcare providers to reconsider their focus and prioritize the importance of psychosocial care.
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Affiliation(s)
- Ahmad H Al-Nawafleh
- Department of Adult Health Nursing, Faculty of Nursing, Mutah University, Mutah, 61710, Jordan.
| | - Falah Zaal Altarawneh
- Falah Zaal Altarawneh (MSN, RN), Department of Community Health, Faculty of Nursing, Mutah University, Mutah, 61710, Jordan
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17
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Phiri L, Li WHC, Cheung AT, Phiri PGMC. Effectiveness of psychoeducation interventions in reducing negative psychological outcomes and improving coping skills in caregivers of children with cancer: A systematic review and meta-analysis. Psychooncology 2023; 32:1514-1527. [PMID: 37639282 DOI: 10.1002/pon.6208] [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: 02/10/2023] [Revised: 08/08/2023] [Accepted: 08/09/2023] [Indexed: 08/29/2023]
Abstract
PURPOSE Psychoeducation interventions (PEIs) have been used as an adjunct treatment for negative psychological outcomes in caregivers of children with cancer. This systematic review and meta-analysis aimed to evaluate the evidence on the effectiveness of PEIs in reducing anxiety and depressive symptoms and improving health-related quality of life (HRQoL) and coping skills in caregivers of children with cancer. METHOD Ten English databases were searched to identify studies on PEIs for caregivers of children with cancer. Studies inclusion criteria were as follows: (1) participants who were caregivers of children with cancer receiving treatment; (2) psychoeducational interventions assessing anxiety, depressive symptoms, HRQoL, and coping outcomes; and (3) usual care, waitlist, or active control as a control group. Meta-analysis and narrative synthesis were used to analyse data. RESULTS Fourteen randomised control trials were included. PEIs have a beneficial effect on anxiety levels (SMD: -0.59, 95% CI [-0.92, -0.25], p = 0.0007), quality of life (SMD: -0.31, 95% CI [-0.00, -0.61], p = 0.05) and depressive symptoms (SMD: -1.18, 95% CI [-2.08, -0.28], p = 0.01) immediately post-intervention. The effect of PEIs was maintained at long-term follow-up on depressive symptoms (SMD: -0.52, 95% CI [-1.54, -0.36], p = 0.0004). Similarly, the synthesised data suggest that PEIs are effective in improving coping skills. CONCLUSION The review provides evidence that PEIs effectively reduce negative psychological outcomes and improve coping skills in caregivers of children with cancer. However, due to methodological flaws and heterogeneity of the interventions evaluated, more research is needed to determine the most effective PEI design and improve the quality of evidence.
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Affiliation(s)
- Lophina Phiri
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - William Ho Cheung Li
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ankie Tan Cheung
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Patrick G M C Phiri
- Institute of Applied Technology, Fatima College of Health Sciences, Al Ain, United Arab Emirates
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Review of psychological interventions in patients with cancer. Support Care Cancer 2023; 31:210. [PMID: 36913136 DOI: 10.1007/s00520-023-07675-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 03/07/2023] [Indexed: 03/14/2023]
Abstract
OBJECTIVE Cancer is one of the leading causes of mortality in the world and also causes morbidity and deterioration in the mental health of patients and their caregivers. The most commonly reported psychological symptoms include anxiety, depression, and the fear of recurrence. The purpose of this narrative review is to elaborate and discuss the effectiveness of the different interventions employed and their utilities in clinical practice. METHODS Scopus and PubMed databases were searched, with a timeframe from 2020 to 2022, to identify randomised controlled trials, meta-analyses, and reviews and reported using PRISMA guidelines. Articles were searched by the following keywords: "cancer, psychology, anxiety, and depression". An additional search was performed with the keywords "cancer, psychology, anxiety, depression, and [intervention name]". The most popular psychological interventions were included in these search criteria. RESULTS A total of 4829 articles were retrieved by the first preliminary search. After reducing duplicates, 2964 articles were assessed for inclusion according to eligibility criteria. After the full-text screening, 25 final articles were chosen. To systematise psychological interventions as described in the literature, the authors have divided them into 3 broad categories, each type targeting a specific domain of mental health: cognitive-behavioural, mindfulness, and relaxation. CONCLUSION The most efficient psychological therapies, as well as therapies which require more extensive research, were outlined in this review. The authors discuss the necessity of primary assessment of patients and whether they require the help of a specialist. With the limitations of the potential risk of bias, an overview of different therapies and interventions targeting various psychological symptoms is outlined.
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Cheng Q, Ng MSN, Chen Y, Li X, Liu G, Zhang M, So WKW. The Feasibility and Acceptability of a Needs-Oriented Psychoeducational Intervention Among Caregivers of Adolescent and Young Adult Cancer Patients: A Pilot Randomized Controlled Trial. Cancer Nurs 2023; Publish Ahead of Print:00002820-990000000-00109. [PMID: 36840979 DOI: 10.1097/ncc.0000000000001209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
BACKGROUND Little is known about the psychoeducational interventions for caregivers of adolescent and young adult (AYA) cancer patients. OBJECTIVE To evaluate the feasibility and acceptability of a needs-oriented psychoeducational intervention among caregivers of AYA cancer patients. METHODS In this 2-arm (parallel-group), pilot randomized controlled trial, participants were randomized to the intervention or control group. Participants in the control group received usual care, whereas those in the intervention group received a needs-oriented psychoeducational intervention via WeChat as well as the usual care. Feasibility was evaluated on recruitment, attrition, and adherence rates and the data collection process. Acceptability was assessed based on participants' satisfaction with and perceived usefulness of the intervention, collected using a questionnaire. In addition, a semistructured interview was conducted to explore their experiences. RESULTS Twenty-four caregivers of AYA cancer patients were recruited, with a consent rate of 61.5%. The attrition and response rates 5 weeks after baseline were 8.3% and 91.7%. Among the 12 participants in the intervention group, 10 (83.3%) completed all of the 5 weekly sessions. Most of the participants were satisfied with the program and perceived its usefulness. The semistructured interviews revealed 3 major categories: facilitators of participation, perception of the intervention, and perceived benefits. CONCLUSIONS The needs-oriented psychoeducational intervention delivered through WeChat is feasible for and acceptable to caregivers of AYA cancer patients. A full-scale study is warranted to examine the effects of this intervention on caregivers' health outcomes. IMPLICATIONS FOR PRACTICE The WeChat-based, needs-oriented psychoeducational intervention may be beneficial to improve caregivers' health outcomes.
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Affiliation(s)
- Qinqin Cheng
- Author Affiliations: The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China (Ms Cheng, Dr Ng, Ms Zhang, and Dr So); and Hunan Cancer Hospital, Changsha, Hunan, People's Republic of China (Drs Chen, Li and Liu)
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Liu Q, Ye F, Jiang X, Zhong C, Zou J. Effects of psychosocial interventions for caregivers of breast cancer patients: A systematic review and meta-analysis. Heliyon 2023; 9:e13715. [PMID: 36852078 PMCID: PMC9957758 DOI: 10.1016/j.heliyon.2023.e13715] [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: 08/28/2022] [Revised: 01/12/2023] [Accepted: 02/09/2023] [Indexed: 02/16/2023] Open
Abstract
Aim The aim of this review was to determine whether the caregivers of breast cancer patients who undergo psychosocial interventions report improvements in quality of life (QOL), depression, and anxiety. Methods This systematic review was conducted in accordance with the PRISMA guidelines. A systematic search was conducted in the CINAHL, Embase, PsycINFO, PubMed, Web of Science, CNKI and Wanfang databases from inception until March 1, 2022. Randomized controlled trials (RCTs) and quasiexperimental studies involving psychosocial interventions for caregivers of breast cancer patients were included. Cochrane's risk of bias tool and the Joanna Briggs Institute checklist were used to assess the risk of bias. Results This systematic review included eight original studies involving 528 caregivers of breast cancer patients. According to the meta-analyses, psychosocial interventions contributed significantly to improvements in QOL (SMD = 1.00, 95% CI [0.47, 1.54], p < 0.01), depression (SMD = -0.72, 95% CI [-1.02, -0.42], p < 0.01) and anxiety (SMD = -0.56, 95% CI [-0.86, -0.27], p < 0.01). Significant differences of psychosocial interventions on the QOL of caregivers were found in face-to-face and mixed-method psychosocial interventions (SMD = 0.97, 95% CI [0.19,1.75], p = 0.02; SMD = 1.45, 95% CI [0.86,2.05], p < 0.01) in the ≥3 months subgroup (SMD = 1.22, 95% CI [0.58,1.86], p < 0.01) but not in the spouses or partners subgroup (SMD = 0.83, 95% CI [-0.10,1.75], p = 0.08). Conclusions This systematic review revealed that breast cancer patients' caregivers who undergo psychosocial interventions report improvements in QOL and reduced levels of depression and anxiety. It is worthwhile to use face-to-face methods when psychosocial interventions are conducted for caregivers. Future studies should examine long-term psychosocial interventions for spouses or partners of breast cancer patients. However, because of the limited number of original studies and the low quality of some included studies, the results should be treated cautiously. To increase solid evidence in this field, higher quality, more original studies are needed.
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Affiliation(s)
- Qin Liu
- Sichuan Vocational College of Health and Rehabilitation, Zigong 643000, Sichuan, China
| | - Fang Ye
- Sichuan Vocational College of Health and Rehabilitation, Zigong 643000, Sichuan, China
| | - Xiaolian Jiang
- West China Hospital/West China School of Nursing, Sichuan University, Chengdu 610000, Sichuan, China
| | - Changtao Zhong
- Zigong Fourth People's Hospital, Zigong 643000, Sichuan, China
| | - Jinmei Zou
- Sichuan Vocational College of Health and Rehabilitation, Zigong 643000, Sichuan, China
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Kusi G, Atenafu EG, Boamah Mensah AB, Lee CT, Viswabandya A, Puts M, Mayo S. The effectiveness of psychoeducational interventions on caregiver-oriented outcomes in caregivers of adult cancer patients: A systematic review and meta-analysis. Psychooncology 2023; 32:189-202. [PMID: 36251609 DOI: 10.1002/pon.6050] [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: 05/10/2022] [Revised: 09/23/2022] [Accepted: 10/09/2022] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Cancer caregiving can result in increased psychosocial distress and poor health-related quality of life (QOL). Psychoeducation has been shown to be effective in enhancing caregiving-oriented outcomes. A systematic assessment of the overall effect of psychoeducational intervention (PEI) and identification of individual intervention characteristics that may contribute to the effectiveness of PEI is needed. METHODS For this meta-analysis, relevant articles were identified through electronic databases using key search terms and their medical subject heading such as "family caregiver," "cancer," and "psychoeducational intervention." RESULTS Twenty-eight controlled trials with 3876 participants were included. PEIs had beneficial effect on depression (Standardized Mean Difference [SMD] -0.26; 95% CI = -0.50 to -0.01, p < 0.04), anxiety (SMD -0.41; 95% CI = -0.82 to 0.01, p < 0.05), caregiver burden (SMD -0.84; 95% CI = -1.22 to -0.46, p < 0.0001) and QOL (SMD 0.59, 95% CI 0.24-0.93; p < 0.0009) at the immediate post-intervention period. At longer-term follow-up, the effectiveness of PEI was maintained on QOL (SMD 0.39, 95% CI = -0.00 to -0.77, p < 0.05), and anxiety (SMD -0.57; 95% CI = -1.09 to -0.06, p < 0.03). Moderation analysis showed that intervention characteristics such as studies conducted in high-income countries, group intervention and studies that focused on specific and mixed cancers explain some of the high variations observed among the included studies. CONCLUSIONS PEI may benefit caregivers of cancer patients through the significant effects on caregiver burden, QOL, anxiety, and depression. The findings from the moderation analysis may be important for the design of future interventions.
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Affiliation(s)
- Grace Kusi
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.,Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Eshetu G Atenafu
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | | | | | - Auro Viswabandya
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Martine Puts
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.,Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Samantha Mayo
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.,Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
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22
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Halkett GKB, Lobb EA, Phillips JL, McDougall E, Clarke J, Campbell R, Dhillon HM, McGeechan K, Hudson P, King A, Wheeler H, Kastelan M, Long A, Nowak AK. Carer preparedness improved by providing a supportive educational intervention for carers of patients with high-grade glioma: RCT results. J Neurooncol 2023; 161:501-513. [PMID: 36658381 PMCID: PMC9992082 DOI: 10.1007/s11060-023-04239-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 12/24/2022] [Indexed: 01/21/2023]
Abstract
BACKGROUND High-grade glioma (HGG) is a rapidly progressing and debilitating disease. Family carers take on multiple responsibilities and experience high levels of distress. We aimed to deliver a nurse-led intervention (Care-IS) to carers to improve their preparedness to care and reduce distress. METHODS We conducted a randomised controlled trial (ACTRN:12612001147875). Carers of HGG patients were recruited during patients' combined chemoradiation treatment. The complex intervention comprised four components: (1) initial telephone assessment of carer unmet needs; (2) tailored hard-copy resource folder; (3) home visit; and, (4) monthly telephone support for up to 12 months. Primary outcomes included preparedness for caregiving and distress at 2, 4, 6 and 12 months. Intervention effects were estimated using linear mixed models which included a time by group interaction. Secondary outcomes included anxiety, depression, quality of life, carer competence and strain. RESULTS We randomised 188 carers (n = 98 intervention, n = 90 control). The intervention group reported significantly higher preparedness for caregiving at 4 months (model β = 2.85, 95% CI 0.76-4.93) and all follow-up timepoints including 12 months (model β = 4.35, 95% CI 2.08-6.62), compared to the control group. However, there was no difference between groups in carer distress or any secondary outcomes. CONCLUSIONS This intervention was effective in improving carer preparedness. However, carer distress was not reduced, potentially due to the debilitating/progressive nature of HGG and ongoing caring responsibilities. Future research must explore whether carer interventions can improve carer adjustment, self-efficacy and coping and how we support carers after bereavement. Additionally, research is needed to determine how to implement carer support into practice.
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Affiliation(s)
- Georgia K B Halkett
- Curtin School of Nursing/Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, GPO Box U1987, Bentley, Perth, WA, 6005, Australia.
| | - Elizabeth A Lobb
- Calvary Health Care Kogarah, Sydney, NSW, Australia.,School of Medicine, The University of Notre Dame, Sydney, NSW, Australia.,Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Jane L Phillips
- Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia.,School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Emma McDougall
- Curtin School of Nursing/Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, GPO Box U1987, Bentley, Perth, WA, 6005, Australia
| | - Jenny Clarke
- Curtin School of Nursing/Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, GPO Box U1987, Bentley, Perth, WA, 6005, Australia
| | - Rachel Campbell
- Psycho-Oncology Cooperative Research Group, School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia
| | - Haryana M Dhillon
- Psycho-Oncology Cooperative Research Group, School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia.,Centre for Medical Psychology & Evidence-Based Decision-Making, University of Sydney, Sydney, NSW, Australia
| | - Kevin McGeechan
- School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Peter Hudson
- Centre for Palliative Care St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia.,Department of Nursing, University of Melbourne, Melbourne, VIC, Australia.,Vrije University Brussels, Brussels, Belgium
| | - Anne King
- Cancer Network Western Australia, North Metropolitan Health Service, Perth, WA, Australia
| | - Helen Wheeler
- Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - Marina Kastelan
- Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards, NSW, Australia.,The Brain Cancer Group, North Shore Private Hospital, St Leonards, NSW, Australia
| | - Anne Long
- Department of Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
| | - Anna K Nowak
- Department of Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia.,Medical School, University of Western Australia, Nedlands, WA, Australia
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23
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van Hof KS, Hoesseini A, Verdonck-de Leeuw IM, Jansen F, Leemans CR, Takes RP, Terhaard CHJ, Baatenburg de Jong RJ, Sewnaik A, Offerman MPJ. Self-efficacy and coping style in relation to psychological distress and quality of life in informal caregivers of patients with head and neck cancer: a longitudinal study. Support Care Cancer 2023; 31:104. [PMID: 36622506 PMCID: PMC9829635 DOI: 10.1007/s00520-022-07553-x] [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: 10/10/2022] [Accepted: 12/19/2022] [Indexed: 01/10/2023]
Abstract
OBJECTIVE In order to understand how informal caregivers of head and neck cancer (HNC) patients deal with the consequences of the disease, we investigated their self-efficacy and coping style in relation to symptoms of anxiety and depression (distress) and quality of life (QoL) over time. In addition, factors associated with self-efficacy and coping style were investigated. METHODS A total of 222 informal caregivers and their related HNC patients were prospectively followed as part from the multicenter cohort NETherlands QUality of life and Biomedical cohort studies In Cancer (NET-QUBIC). Self-efficacy and coping style were measured at baseline, and distress and QoL at baseline and 3, 6, 12, and 24 months after treatment. RESULTS Informal caregivers had a high level of self-efficacy comparable with patients. Caregivers used "seeking social support," "passive reacting," and "expression of emotions" more often than patients. Factors associated with self-efficacy and coping were higher age and lower education. Higher self-efficacy was related with better QoL and "active tackling" was associated with less depression symptoms. "Passive reacting" and "expression of emotions" were associated with higher psychological distress and reduced QoL. CONCLUSION Among informal caregivers of HNC patients, higher self-efficacy and "active tackling" were associated with better functioning over time, while "passive reacting" and "expression of negative emotions" were associated with worse functioning. Awareness of the differences in self-efficacy skills and coping and their relationship with QoL and psychological distress will help clinicians to identify caregivers that may benefit from additional support that improve self-efficacy and "active tackling" and reduce negative coping styles.
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Affiliation(s)
- Kira S. van Hof
- grid.508717.c0000 0004 0637 3764Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, Erasmus University Medical Center, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
| | - Arta Hoesseini
- grid.508717.c0000 0004 0637 3764Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, Erasmus University Medical Center, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
| | - Irma M. Verdonck-de Leeuw
- grid.16872.3a0000 0004 0435 165XDepartment of Otorhinolaryngology and Head and Neck Surgery, Cancer Center Amsterdam, Amsterdam UMC, Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands ,grid.16872.3a0000 0004 0435 165XCancer Center Amsterdam, Treatment and Quality of Life, Amsterdam, The Netherlands ,grid.12380.380000 0004 1754 9227Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Van der Boechorststraat 7–9, Amsterdam, The Netherlands ,Amsterdam Public Health, Mental Health, Amsterdam, The Netherlands
| | - Femke Jansen
- grid.16872.3a0000 0004 0435 165XDepartment of Otorhinolaryngology and Head and Neck Surgery, Cancer Center Amsterdam, Amsterdam UMC, Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands ,grid.12380.380000 0004 1754 9227Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Van der Boechorststraat 7–9, Amsterdam, The Netherlands
| | - C. René Leemans
- grid.16872.3a0000 0004 0435 165XDepartment of Otorhinolaryngology and Head and Neck Surgery, Cancer Center Amsterdam, Amsterdam UMC, Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Robert P. Takes
- grid.10417.330000 0004 0444 9382Department of Otolaryngology and Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Chris H. J. Terhaard
- grid.7692.a0000000090126352Department of Radiation Oncology, University Medical Center, Utrecht, The Netherlands
| | - Robert J. Baatenburg de Jong
- grid.508717.c0000 0004 0637 3764Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, Erasmus University Medical Center, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
| | - Aniel Sewnaik
- grid.508717.c0000 0004 0637 3764Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, Erasmus University Medical Center, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
| | - Marinella P. J. Offerman
- grid.508717.c0000 0004 0637 3764Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, Erasmus University Medical Center, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
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24
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Engin E, Cam MO, Demirkol H, Dogan O. The Effect of Psychoeducation on Care Burden Applied to Mothers of Children Who Underwent Allogeneic Bone Marrow Transplantation in Turkey: A Quasi-Experimental Study. Semin Oncol Nurs 2022; 38:151342. [PMID: 36244886 DOI: 10.1016/j.soncn.2022.151342] [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: 05/09/2022] [Revised: 08/26/2022] [Accepted: 09/09/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVES The purpose of this study was to examine at the effect of psychoeducation on the care burden for mothers whose children underwent allogeneic bone marrow transplantation (Allo-BMT). DATA SOURCES The single group, quasi-experimental study was conducted in a children's BMT unit in the Aegean Region of Turkey. No sampling method was used, and the study sample consisted of 21 mothers who fulfilled the inclusion criteria of turning 18 years old, volunteering for study participation, speaking and understanding Turkish, and having a child who had undergone Allo-BMT. The psychoeducation covered the following topics: (i) Allo-BMT and Child Care After Transplantation, (ii) Feelings Concerning the Disease and the Role of Caregiver, (iii) Stress and Anger Management, and (iv) Family-Spousal and Social Relations. The care burden was measured using the Clinically Adapted Zarit Burden Interview (CA-ZBI). Data analysis was performed on SPSS 20.0 software using repeated measures of analysis of variance (ANOVA) and Bonferroni adjusted post hoc test. After the psychoeducation, a significant difference was found between pretest (26.85 ± 12.9) and posttest (20.42 ± 12.66) care burden of mean scores (P < .05). In addition, a significant difference was found between pretest and follow-up test (20.52 ± 11.49) mean scores of care burden (P < .05). CONCLUSION The psychoeducation reduced the care burden experienced by the mothers of the children who underwent Allo-BMT and this positive impact lasted for a month. IMPLICATIONS FOR NURSING PRACTICE Nurses, especially consultation liaison psychiatric nurses, can provide similar psychoeducation to caregivers in BMT units, assisting them in protecting their physical and mental health by reducing their care burden.
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Affiliation(s)
- Esra Engin
- Professor, Nursing Faculty, Psychiatric and Mental Health Nursing Department, Ege University, Izmir, Turkey
| | - Mahire Olcay Cam
- Professor, Nursing Faculty, Psychiatric and Mental Health Nursing Department, Ege University, Izmir, Turkey
| | - Hacer Demirkol
- Faculty of Health Sciences, Psychiatric and Mental Health Nursing Department, Bozok University, Yozgat, Turkey.
| | - Ozenir Dogan
- Faculty of Medicine Hospital, Psychiatry Department, Ege University, Izmir, Turkey
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25
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Wang J, Coyte PC, Shao D, Zhen X, Zhao N, Sun C, Sun X. The Relationship between the Unmet Needs of Chinese Family Caregivers and the Quality of Life of Childhood Cancer Patients Undergoing Inpatient Treatment: A Mediation Model through Caregiver Depression. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10193. [PMID: 36011824 PMCID: PMC9408546 DOI: 10.3390/ijerph191610193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/15/2022] [Accepted: 08/16/2022] [Indexed: 06/15/2023]
Abstract
A large proportion of the global burden of childhood cancer arises in China. These patients have a poor quality of life (QoL) and their family caregivers have high unmet needs. This paper examined the association between the unmet needs of family caregivers and the care recipient’s QoL. A total of 286 childhood cancer caregivers were included in this cross-sectional study. Unmet needs and depression among caregivers were assessed by the Comprehensive Needs Assessment Tool for Cancer Caregivers (CNAT-C) and the Patient Health Questionnaire (PHQ-9), respectively. The patient’s QoL was proxy-reported by the Pediatric Quality of Life Inventory Measurement Models (PedsQL 3.0 scale Cancer Module). Descriptive analyses, independent Student’s t-tests, one-way ANOVA, and mediation analyses were performed. The mean scores (standard deviations) for unmet needs, depression, and QoL were 65.47 (26.24), 9.87 (7.26), and 60.13 (22.12), respectively. A caregiver’s unmet needs (r = −0.272, p < 0.001) and depression (r = −0.279, p < 0.001) were negatively related to a care recipient’s QoL. Depression among caregivers played a mediating role in the relationship between a caregiver’s unmet needs and a care recipient’s QoL. As nursing interventions address depression among caregivers, it is important to standardize the programs that offer psychological support to caregivers.
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Affiliation(s)
- Jiamin Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 2S8, Canada
| | - Peter C. Coyte
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 2S8, Canada
| | - Di Shao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China
| | - Xuemei Zhen
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China
| | - Ni Zhao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China
| | - Chen Sun
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China
| | - Xiaojie Sun
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China
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