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Zhou L, Li Y, Zhang Y, Chen X, Zhang S, Hu X. Perceptions of Telehealth Services Among Rural Lung Cancer Patients in China: A Qualitative Study Using the Technology Acceptance Model. Semin Oncol Nurs 2024; 40:151710. [PMID: 39117510 DOI: 10.1016/j.soncn.2024.151710] [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: 01/15/2024] [Revised: 06/25/2024] [Accepted: 07/17/2024] [Indexed: 08/10/2024]
Abstract
OBJECTIVES To describe the perceptions of telehealth services among lung cancer patients in rural areas of China, as well as to explore the potential of telemedicine to improve long-term health recovery at home for rural lung cancer patients. METHODS A qualitative descriptive study design was used in this study and we conducted semi-structured interviews with 14 rural Chinese lung cancer patients between December 2022 and March 2023. Interview content was analyzed using Nvivo software and a framework analysis was performed using the Technology Acceptance Model to identify meaningful themes. RESULTS Participants identified perceptual and technical factors related to perceived ease of use, benefits and drawbacks related to perceived usefulness, and facilitators and barriers related to intention to use. However, regional and disease features including literacy barriers, medical insurance condition, symptom burden, and rural cultural health seeking behavior conduct must be taken into account. CONCLUSIONS Lung cancer patients in rural China believe that telehealth services could be an alternative solution for addressing health and care needs, but various aspects, such as user interface design, cost-effectiveness, and technological anxiety, need to be optimized. IMPLICATIONS FOR NURSING PRACTICE More highly specialized nursing team, friendly telecare lung function modules, and media technology training courses should be developed for rural lung cancer patients to enhance the quality of their home care, meet their information needs and better control their disease progression.
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Affiliation(s)
- Lin Zhou
- Department of Nursing, West China Hospital, Sichuan University/ West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
| | - Yunhuan Li
- Department of Nursing, West China Hospital, Sichuan University/ West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
| | - Yun Zhang
- Department of Nursing, West China Hospital, Sichuan University/ West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
| | - Xiaoli Chen
- Department of Nursing, West China Hospital, Sichuan University/ West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
| | - Shu Zhang
- Department of Nursing, West China Hospital, Sichuan University/ West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
| | - Xiaolin Hu
- Department of Nursing, West China Hospital, Sichuan University/ West China School of Nursing, Sichuan University, Chengdu, Sichuan, China; Tianfu Jincheng Laboratory, City of Future Medicine, Chengdu, Sichuan, China.
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Zhang T, Zhao B, Chen Y, Zhang C. Effectiveness of e-health interventions for chemotherapy-induced nausea and vomiting: a systematic review and meta-analysis. Support Care Cancer 2024; 32:672. [PMID: 39292323 DOI: 10.1007/s00520-024-08869-6] [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: 05/29/2024] [Accepted: 09/09/2024] [Indexed: 09/19/2024]
Abstract
INTRODUCTION The goal of this systematic review was to examine the effectiveness of e-health interventions for chemotherapy-induced nausea and vomiting (CINV). METHODS A literature search was conducted across the databases of PubMed, Web of Science, Embase, CINAHL, and Cochrane Library from database establishment to 3 March 2024. We included randomized controlled trials in English where the intervention group was via e-health. Two reviewers independently carried out the screening, data extraction, and quality appraisal of the studies. Using Stata 17.0, meta-analyses were conducted to synthesize the effects of outcomes of interest. RESULTS A total of 6663 studies were retrieved, with only 8 RCTs meeting criteria, involving 620 patients. Meta-analysis revealed that e-health interventions significantly reduce CINV severity (MD = - 7.687; 95% CI - 11.903, - 3.326; p < 0.001). However, results regarding CINV incidence reduction and quality of life improvement are inconclusive due to variations in intervention content, modality, and frequency among studies. CONCLUSIONS e-health interventions may reduce the severity and incidence of CINV, while enhancing quality of life. However, the results should be interpreted cautiously. Higher quality studies are needed in the future to further validate the effectiveness of e-health interventions for CINV.
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Affiliation(s)
- Tongyu Zhang
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China
| | - Bingyan Zhao
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China
| | - Yu Chen
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China
| | - Chunmei Zhang
- School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China.
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Chow JYA, Yeo YTT, Goh YS. Effects of Psychoeducation on Caregivers of Individuals Experiencing Schizophrenia: A Systematic Review and Meta-Analysis. Int J Ment Health Nurs 2024. [PMID: 39252184 DOI: 10.1111/inm.13421] [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: 05/31/2024] [Revised: 08/13/2024] [Accepted: 08/23/2024] [Indexed: 09/11/2024]
Abstract
The existing paradigm on recovery in mental health prioritises self-empowerment and person-centred, community-based care, which necessitates family caregivers' collaboration to support individuals with schizophrenia in the community. However, the role of family caregivers is often under-recognised and hence insufficiently supported. This consequently compromises caregivers' well-being and, ultimately, the recovery of individuals with schizophrenia. Although caregiver-targeted psychoeducation may offer practical support, its effectiveness lacks conclusive evidence. This review aimed to evaluate the impacts of psychoeducation on caregiver-related outcomes (caregiver burden, quality of life and expressed emotion). Eight electronic databases were searched from inception to September 2023, supplemented by hand searching of end-reference lists. Two reviewers independently conducted title and abstract screening with predetermined eligibility criteria. A third reviewer was consulted to resolve any discrepancies. A random-effects meta-analysis was performed to estimate pooled effect sizes alongside subgroup and sensitivity analyses where appropriate. Twenty-one studies (totalling 1639 caregivers) were included, based on which psychoeducation contributed to a statistically significant improvement in caregiver-related outcomes. Given substantial heterogeneity, subgroup and sensitivity analyses were done for the durations and the evaluative scales for psychoeducation. Quality appraisal revealed unclear or high bias in most studies. Notwithstanding the heterogeneity, the directions of the effect sizes consistently indicated the effectiveness of psychoeducation across all outcomes. This finding aligned with Lazarus' stress appraisal and coping theory, which states that psychoeducation improves caregivers' knowledge, coping mechanisms and situation appraisal. Our findings offer encouraging evidence to advocate the integration of psychoeducation into healthcare services, but policy-based support is warranted for sustained implementation. Further research is merited to optimise its duration and content and appraise its long-term impacts through disease-specific scales for objective and subjective outcomes.
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Affiliation(s)
- Jin Yin Alicia Chow
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Yu Ting Tracy Yeo
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Yong Shian Goh
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Kuo WY, Chen CY, Wang J, Wang CM, Chen MC, Chang TY. Evaluating the combination of in-person and electronic social networking services for family caregivers of stroke survivors: A quasi-experimental analysis. J Nurs Scholarsh 2024. [PMID: 39187961 DOI: 10.1111/jnu.13022] [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: 05/13/2024] [Revised: 08/05/2024] [Accepted: 08/13/2024] [Indexed: 08/28/2024]
Abstract
INTRODUCTION The effectiveness of health interventions delivered via a combination of in-person and electronic social networking services for caregivers of stroke survivors remains uncertain. This study evaluates the feasibility of implementing educational and peer support programs for these caregivers through such platforms. DESIGN Quasi-experimental design. METHODS This study included 105 caregiver-survivor dyads, with 54 dyads allocated to the intervention group and the remaining 51 to the control group. The LINE intervention comprised a combination of in-person and electronic social networking services including stroke and rehabilitation education, problem-solving skills training, long-term care information support, and 24-h peer and professional support for caregivers. The outcomes were assessed at baseline, after 1 month, and after 3 months, and encompassed caregivers' care burden, depressive symptoms, perceived social support, and quality of life, as well as the rehabilitation adherence and depressive symptoms of stroke survivors. Generalized estimating equations were used to examine group differences. The data were collected between August 2021 and October 2022. RESULTS The average age of the caregivers was 48.3 years. Caregivers in the intervention group reported reduced care burdens and enhanced perceptions of social support and quality of life as compared to those in the control group. Additionally, stroke survivors in the intervention group were less likely to exhibit high-risk depressive symptoms. CONCLUSION Delivering a stroke caregiver support intervention via in-person and electronic social networking services, such as LINE, effectively reduced the care burden for caregivers of stroke survivors. Additionally, it enhanced caregivers' perceived social support and quality of life. CLINICAL RELEVANCE This study demonstrated that caregiver education and peer support programs administered through a combination of in-person and electronic social networking services can serve as an effective support system for the psychosocial health of stroke caregivers. These findings support the integration of such interventions into standard clinical practice by healthcare providers or governmental bodies.
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Affiliation(s)
- Wen-Yu Kuo
- School of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
- Geriatric and Long-Term Care Research Center, Chang Gung University of Science and Technology, Taoyuan, Taiwan
- Department of Physical Therapy, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chen-Yin Chen
- Department of Physical Therapy, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Chang Gung Medical Education Research Centre, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Graduate Institution of Rehabilitation, School of Physical Therapy, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Jeng Wang
- School of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
- Geriatric and Long-Term Care Research Center, Chang Gung University of Science and Technology, Taoyuan, Taiwan
- Department of Nursing, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chin-Man Wang
- Department of Nursing, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Min-Chi Chen
- Biostatistics Consulting Center and Department of Public Health, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Chiayi, Taiwan
- Department of Public Health and Biostatistics Consulting Center, School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ting-Yu Chang
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Neurology, Stroke Section, Chang Gung Memorial Hospital, Taoyuan, Taiwan
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Zhang X, Ren H, Wang C, Zhang Y, Zhou Q, Fan J. The effect of mindfulness-based interventions on mental health outcomes and wellbeing of informal caregivers of people with mental illness: A systematic review and meta-analysis. Int J Ment Health Nurs 2024; 33:797-816. [PMID: 38291626 DOI: 10.1111/inm.13295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 12/13/2023] [Accepted: 01/09/2024] [Indexed: 02/01/2024]
Abstract
The increasing prevalence of mental illness has resulted in a growing burden on informal caregivers. Mindfulness-based interventions, as a form of psychotherapy, have shown efficacy in alleviating psychological stress and enhancing emotional and physical well-being. However, the utilisation of mindfulness-based interventions for informal caregivers of individuals with mental illness remains limited. The aim of the meta-analysis is to evaluate the impact of mindfulness-based interventions on the mental health and well-being among informal caregivers of people with mental illness. A comprehensive literature search was conducted across seven electronic databases (PubMed, Scopus, Web of Science, Cochrane Library, Embase, APA PsycINFO and CINAHL Ultimate) from the inception of these databases until 20 July 2023. Two authors independently screened the studies and extracted the relevant data. The meta-analysis was performed by using Stata 12.0 software, and the effect sizes were calculated utilising standardised mean difference (SMD) along with their corresponding 95% confidence intervals (CI). The meta-analysis included 13 studies with 1007 participants, and the results demonstrated that mindfulness-based interventions were efficacious in reducing stress (SMD = -0.80, 95% CI [-1.33, -0.28], p = 0.003), depression (SMD = -0.43, 95% CI [-0.62, -0.24], p < 0.001) and caregiver burden (SMD = -0.21, 95% CI [-0.40, -0.01], p = 0.038), and enhancing the mindfulness level (SMD = 0.37, 95% CI [0.09, 0.65], P = 0.010) and quality of life (SMD = 0.22, 95% CI [0.04, 0.39], p = 0.015) among informal caregivers of people with mental illness, but not on anxiety reduction (SMD = -0.19, 95% CI [-0.49, 0.10], p = 0.198). Furthermore, future research should aim to employ more rigorous methodologies to confirm the effectiveness.
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Affiliation(s)
- Xiaofeng Zhang
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Huilin Ren
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Caixia Wang
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Yongping Zhang
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Qilun Zhou
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Jianming Fan
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
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Zhong M, Sun S, Long J, Yuan M, Wang M, Zhang Z. Tools to measure the burden on informal caregivers of cancer patients: A literature review. J Clin Nurs 2024; 33:2949-2970. [PMID: 38528583 DOI: 10.1111/jocn.17112] [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: 11/21/2023] [Revised: 01/23/2024] [Accepted: 03/01/2024] [Indexed: 03/27/2024]
Abstract
OBJECTIVES (1) To describe existing tools to assess the burden of informal caregivers of people with cancer, (2) to describe how these tools have been validated and (3) to describe the areas of interest of existing assessment tool entries. BACKGROUND The caregiver burden of informal caregivers of people with cancer greatly affects their lives. There is a wide variety of relevant assessment tools available, but there are no studies to help researchers to select tools. METHODS A search was conducted using the keywords 'cancer', 'caregiver', 'burden' and 'scale' in Medline (PubMed), CINAHL and EMBASE to include articles that developed or applied tools to assess the burden on informal caregivers of cancer patients. Once eligible tools were identified, we searched their 'primary reference' studies. If the original scale was assessed in a population other than informal caregivers of cancer patients, we again searched for psychometric measures in the population of caregivers of cancer patients. RESULTS This study retrieved 938 articles on developing or applying the informal caregiver burden instrument for cancer patients, including 42 scales. Internal consistency of the original scales ranged from 0.53 to 0.96. Nineteen scales initially developed to assess caregiver burden for patients with dementia, stroke and other disorders were later used for caregivers of cancer patients, eight of which have not yet been validated. Reclassifying all scale domains of concern revealed that scale assessments focused more on caregivers' physical health, emotional state and caregiving tasks. CONCLUSION This review identifies many scales for assessing informal caregiver burden in cancer patients and gives scales recommended. However, a portion still needs to be validated. The development of a new scale proposes to be based on a theoretical framework and to consider dimensions for assessing support resources. IMPACT What problem did the study address?: This paper collates assessment tools on the burden of informal carers of people with cancer. It also provides information on the applicable population, reliability and validity. What were the main findings?: 41 scales could be considered for use, eight of which have not been validated. The scales focus more on assessing caregivers' physical health, emotional state and caregiving tasks, and less on the dimension of support resources. Where and on whom will the research have an impact?: There are implications for informal carers of cancer patients in hospitals or in the community, as well as for relevant researchers. REPORTING METHOD Retrieved with reference to systematic evaluation. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Mingming Zhong
- School of Nursing, Lanzhou University, Lanzhou, Gansu, PR China
- Department of Critical Care Medicine, Lanzhou University First Hospital, Lanzhou, Gansu, PR China
| | - Shanshan Sun
- School of Nursing, Lanzhou University, Lanzhou, Gansu, PR China
- Department of Critical Care Medicine, Lanzhou University First Hospital, Lanzhou, Gansu, PR China
| | - Jianying Long
- School of Nursing, Lanzhou University, Lanzhou, Gansu, PR China
- Department of Critical Care Medicine, Lanzhou University First Hospital, Lanzhou, Gansu, PR China
| | - Mengyuan Yuan
- School of Nursing, Lanzhou University, Lanzhou, Gansu, PR China
- Department of Critical Care Medicine, Lanzhou University First Hospital, Lanzhou, Gansu, PR China
| | - Min Wang
- School of Nursing, Lanzhou University, Lanzhou, Gansu, PR China
- Department of Critical Care Medicine, Lanzhou University First Hospital, Lanzhou, Gansu, PR China
| | - Zhigang Zhang
- School of Nursing, Lanzhou University, Lanzhou, Gansu, PR China
- Department of Critical Care Medicine, Lanzhou University First Hospital, Lanzhou, Gansu, PR China
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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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Kim M, Tan KR, Coombs LA. Efficacy of Web-Based Interventions on Depression and Anxiety in Cancer Caregivers: A Systematic Review and Meta-Analysis. Psychooncology 2024; 33:e9301. [PMID: 39039753 DOI: 10.1002/pon.9301] [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: 06/03/2024] [Accepted: 07/11/2024] [Indexed: 07/24/2024]
Abstract
OBJECTIVE This study aimed to evaluate the effectiveness of web-based interventions in depression and anxiety among informal caregivers of patients with cancer. METHODS Databases such as PubMed, Cochrane, Web of Science, Embase, CINAHL, and PsycINFO were systematically searched from inception to April 15, 2024. Eligible studies encompassed randomized controlled trials (RCTs) focusing on web-based interventions tailored to informal caregivers of patients with cancer. The effect size was calculated as the standardized mean difference (SMD) with a 95% confidence interval (CI) utilizing a random effects model. The risk of bias was assessed independently utilizing Cochrane's Risk of Bias Tool (version 2.0) for RCTs. RESULTS A total of 12 RCTs were incorporated into this meta-analysis. Web-based interventions demonstrated a significant effect in ameliorating depression among informal caregivers of patients with cancer compared to the control group (SMD = -0.21, 95% CI = -0.36 to -0.05, p < 0.01, I2 = 15%). Additionally, a significant effect was also observed in alleviating anxiety (SMD = -0.20, 95% CI = -0.36 to -0.05, p = 0.77, I2 = 0%). CONCLUSIONS Web-based interventions might be effective in reducing depression and anxiety among informal caregivers of patients with cancer. Nevertheless, several studies with an overall high risk of bias were included. As a result of the limited number and heterogeneity of the studies included in the subgroup analysis, deriving definitive conclusions on the most effective intervention components was challenging. Therefore, further studies incorporating high-quality research are warranted.
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Affiliation(s)
- Myoungsuk Kim
- College of Nursing, Kangwon National University, Chuncheon, Republic of Korea
| | - Kelly R Tan
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Lorinda A Coombs
- School of Nursing, University of North Carolina-Chapel Hill, Lineberger Cancer Institute, Chapel Hill, North Carolina, USA
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Zhang S, Zhou L, Yi L, Chen X, Zhang Y, Li J, Zhang Y, Hu X. Comparative efficacy of telehealth interventions on promoting cancer screening: A network meta-analysis of randomized controlled trials. J Nurs Scholarsh 2024; 56:585-598. [PMID: 38691056 DOI: 10.1111/jnu.12974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 03/30/2024] [Accepted: 04/08/2024] [Indexed: 05/03/2024]
Abstract
BACKGROUND Cancer screening is a pivotal method for reducing mortality from disease, but the screening coverage is still lower than expected. Telehealth interventions demonstrated significant benefits in cancer care, yet there is currently no consensus on their impact on facilitating cancer screening or on the most effective remote technology. DESIGN A network meta-analysis was conducted to detect the impact of telehealth interventions on cancer screening and to identify the most effective teletechnologies. METHODS Six English databases were searched from inception until July 2023 to yield relevant randomized controlled trials (RCTs). Two individual authors completed the literature selection, data extraction, and methodological evaluations using the Cochrane Risk of Bias tool. Traditional pairwise analysis and network meta-analysis were performed to identify the overall effects and compare different teletechnologies. RESULTS Thirty-four eligible RCTs involving 131,644 participants were enrolled. Overall, telehealth interventions showed statistically significant effects on the improvement of cancer screening. Subgroup analyses revealed that telehealth interventions were most effective for breast and cervical cancer screening, and rural populations also experienced benefits, but there was no improvement in screening for older adults. The network meta-analysis indicated that mobile applications, video plus telephone, and text message plus telephone were associated with more obvious improvements in screening than other teletechnologies. CONCLUSION Our study identified that telehealth interventions were effective for the completion of cancer screening and clarified the exact impact of telehealth on different cancer types, ages, and rural populations. Mobile applications, video plus telephone, and text message plus telephone are the three forms of teletechnologies most likely to improve cancer screening. More well-designed RCTs involving direct comparisons of different teletechnologies are needed in the future. CLINICAL RELEVANCE Telehealth interventions should be encouraged to facilitate cancer screening, and the selection of the optimal teletechnology based on the characteristics of the population is also necessary.
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Affiliation(s)
- Shu Zhang
- Department of Nursing, West China Hospital, Sichuan University/ West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
| | - Lin Zhou
- Department of Nursing, West China Hospital, Sichuan University/ West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
| | - Li Yi
- Information and Software Engineering College, University of Electronic Science and Technology of China, Chengdu, China
| | - Xiaoli Chen
- Department of Nursing, West China Hospital, Sichuan University/ West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
| | - Yun Zhang
- Department of Nursing, West China Hospital, Sichuan University/ West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
| | - Juejin Li
- Department of Nursing, West China Hospital, Sichuan University/ West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
| | - Yalin Zhang
- Department of Nursing, West China Hospital, Sichuan University/ West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
| | - Xiaolin Hu
- Department of Nursing, West China Hospital, Sichuan University/ West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
- Tianfu Jincheng Laboratory, City of Future Medicine, Chengdu, Sichuan, China
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Lee MMS, Yeoh EK, Wang K, Wong ELY. Caregiver Employees' Mental Well-Being in Hong Kong. Healthcare (Basel) 2024; 12:1013. [PMID: 38786422 PMCID: PMC11121220 DOI: 10.3390/healthcare12101013] [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: 04/07/2024] [Revised: 05/01/2024] [Accepted: 05/11/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND The rapidly aging global population has increased the demand for caregivers. Many caregivers simultaneously engage in paid employment, and the dual role makes the needs of caregiver employees conceivably more remarkable. However, there is a gap in the literature about the specific needs of caregiver employees. METHOD Caregiver employees (n = 1205) across Hong Kong caring for those ≥65 years were recruited for a cross-sectional face-to-face survey from December 2021 to January 2022, to evaluate mental well-being measured by the Short Warwick -Edinburgh Mental Well-being Scale. Univariate and multivariate analyses were conducted; significant variables (p < 0.05) were included in multiple linear regression, along with caregiver-friendly workplace policies' availability, to understand their association with their mental well-being. FINDINGS The mean score of the Short Warwick-Edinburgh Mental Well-being Scale among caregiver employees in this study was 24.9, with 7.2% indicative of probable clinical depression and 10.0% possible mild depression. In addition, the current study showed that 30.2% of the caregiver employees felt distressed about the caregiving role. Among external factors, family support (measured by the Lubben Social Network Scale) and workplace culture (measured by the Marshall Supervision Subscale) positively correlated with mental well-being with regression coefficients of 0.252 (p < 0.001) and 0.482 (p < 0.001), respectively. In the fully adjusted model, a negative regression coefficient was observed for overall spillover (-0.050, p < 0.001) and Short Warwick-Edinburgh Mental Well-being Scale scores, while positive regression coefficients were observed for overall self-rate (0.041, p < 0.001), Lubben (0.124, p < 0.001), and corporate culture (0.365, p < 0.001). Better Short Warwick-Edinburgh Mental Well-being Scale scores were observed when caregiver-friendly workplace policies were clearly stated than when they were made on a case-by-case discretionary basis. CONCLUSIONS Caregiver-friendly workplace policies may be critical to Hong Kong's sustainable future, both economically and socially, as they ensure a healthy and productive workforce to support an aging population.
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Affiliation(s)
| | | | | | - Eliza Lai-Yi Wong
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Central Avenue, Hong Kong, China; (M.M.-S.L.); (E.-K.Y.); (K.W.)
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Wang Z, Yu S, Liu Y, Han Y, Zhao W, Zhang W. Effectiveness of family centred interventions for family caregivers: A systematic review and meta-analysis of randomized controlled trials. J Clin Nurs 2024; 33:1958-1975. [PMID: 38439168 DOI: 10.1111/jocn.17091] [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: 07/16/2023] [Revised: 01/11/2024] [Accepted: 02/19/2024] [Indexed: 03/06/2024]
Abstract
AIMS AND OBJECTIVES To examine the effectiveness of family-centred interventions among family caregivers. BACKGROUND Family-centred interventions are an emerging form of intervention that can be effective at improving physical and mental health outcomes for patients and family caregivers. To date, no reviews have examined the effectiveness of family-centred interventions for family caregivers. DESIGN A systematic review, including a meta-analysis, was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA 2020) checklist. METHODS Seven English and two Chinese electronic databases were compressively searched from the outset to March 2023. Two researchers independently reviewed the abstracts and full texts, extracted the data and assessed the risk of bias independently by using the Cochrane 'Risk of bias assessment tool'. RESULTS This systematic review and meta-analysis included 20 articles. The results of the meta-analysis showed that family-centred interventions could significantly improve caregiver burden (p=0.003), quality of life (p = 0.007), depression (p = 0.0002), and stress (p < 0.0001) but not anxiety or family functioning. According to our subgroup analysis, the family-centred empowerment model (p = 0.009) was superior to the other family intervention (p=0.004) in reducing caregiver burden. Family-centred interventions are more effective at reducing the burden of caregiving on family caregivers of adolescent patients (SMD=-0.79, 95% CI[-1.22,-0.36], p = 0.0003) than on adult patients (SMD=-0.37, 95% CI [-0.61,-0.12], p = 0.004). CONCLUSIONS Family-centred interventions could enhance family caregivers' burden, quality of life, stress and depression but had no significant impact on anxiety or family functioning. RELEVANCE TO CLINICAL PRACTICE Family-centred interventions have the potential to improve the health status and caregiving burden of family caregivers. Rigorous and high-quality evidence is needed to confirm the long-term effects of these interventions on family caregivers. TRIAL REGISTRATION DETAILS The protocol has been registered in the PROSPERO international prospective register of systematic reviews (Protocol registration ID: CRD42023453607).
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Affiliation(s)
- Ziqi Wang
- School of Nursing, Jilin University, Changchun, China
| | - Shuanghan Yu
- School of Nursing, Jilin University, Changchun, China
| | - Yantong Liu
- School of Nursing, Jilin University, Changchun, China
| | - Yujie Han
- School of Nursing, Jilin University, Changchun, China
| | - Wei Zhao
- School of Nursing, Jilin University, Changchun, China
| | - Wei Zhang
- School of Nursing, Jilin University, Changchun, China
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12
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Liao X, Wang Z, Zeng Q, Zeng Y. Loneliness and social isolation among informal carers of individuals with dementia: A systematic review and meta-analysis. Int J Geriatr Psychiatry 2024; 39:e6101. [PMID: 38752797 DOI: 10.1002/gps.6101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 05/03/2024] [Indexed: 05/21/2024]
Abstract
OBJECTIVES This systematic review and meta-analysis aimed to determine the prevalence of loneliness and social isolation among informal carers of individuals with dementia and to identify potential influencing factors. METHODS We conducted a comprehensive search across 10 electronic databases, including PubMed, Cochrane, Embase, Web of Science, PsycINFO, CINAHL, Scopus, Chinese Biomedical, China National Knowledge Internet, and WANFANG. Our search strategy covered the inception of the databases up to September 16, 2023, with an updated search conducted on March 8, 2024. Prevalence estimates of loneliness and social isolation, presented with 95% confidence intervals, were synthesized through meta-analysis. Subgroup analyses and meta-regression were employed to explore potential moderating variables and heterogeneity. RESULTS The study encompassed 27 research papers involving 11,134 informal carers from 17 different countries. The pooled prevalence of loneliness among informal carers of individuals with dementia was 50.8% (95% CI: 41.8%-59.8%), while the pooled prevalence of social isolation was 37.1% (95% CI: 26.7%-47.6%). Subgroup analyses and meta-regression indicated that various factors significantly influenced the prevalence of loneliness and social isolation. These factors included the caregiving setting, study design, the intensity of loneliness, geographical location (continent), data collection time, and the choice of assessment tools. CONCLUSIONS This study underscores the substantial prevalence of loneliness and social isolation among informal carers of individuals with dementia. It suggests that policymakers and healthcare providers should prioritize the development of targeted interventions and support systems to alleviate loneliness and social isolation within this vulnerable population.
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Affiliation(s)
- Xinqi Liao
- College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Zhong Wang
- Chengdu Fifth People's Hospital, Chengdu, Sichuan, China
| | - Qinglin Zeng
- Chengdu Fifth People's Hospital, Chengdu, Sichuan, China
| | - Yanli Zeng
- College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
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13
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Sheng L, Zhu Y, Liu Y, Hua H, Zhou J, Ye L. Fear of cancer recurrence and associated factors in family caregivers of patients with hematologic malignancy receiving chemotherapy: A latent profile analysis. Asia Pac J Oncol Nurs 2024; 11:100382. [PMID: 38495640 PMCID: PMC10940887 DOI: 10.1016/j.apjon.2024.100382] [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: 11/02/2023] [Accepted: 01/13/2024] [Indexed: 03/19/2024] Open
Abstract
Objective This study identified the potential subgroups of fear of cancer recurrence (FCR) in family caregivers (FCs) of patients with hematologic malignancies receiving chemotherapy, as well as exploring factors associated with subgroups. Methods This was a cross-sectional study involving 206 pairs of participating patients with hematologic malignancies receiving chemotherapy and their FCs. Using Mplus 8.3 to perform the latent profile analysis of FCs' FCR, the FCs' burden, quality of life, psychological resilience, and anxiety as well as their demographic characteristics were compared between the subgroups, with a logistic regression analysis being applied to examine the factors associated with the FCR subgroups. Results A total of 206 FCs were classified into two subgroups: "a low level of FCR" (Class 1, 65.4%) and "a high level of FCR" (Class 2, 34.6%). Quality of life, anxiety, and frequency of chemotherapy were significantly associated with the two subgroups. Conclusions FCs of patients with hematologic malignancy receiving chemotherapy had two FCR subgroups, "a low level of FCR" and "a high level of FCR", in association with quality of life, anxiety, and frequency of chemotherapy. These findings provide the theoretical foundations for screening the FCR factor of FCs and conducting interventions for them.
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Affiliation(s)
- Li Sheng
- Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Yingying Zhu
- Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Yajiao Liu
- Nursing Department, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Haiying Hua
- Wuxi School of Medicine, Jiangnan University, Wuxi, China
- Department of Hematology, Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Jingfen Zhou
- Department of Hematology, Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Long Ye
- Department of Hematology, Affiliated Hospital of Jiangnan University, Wuxi, China
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Lin D, Liang D, Huang M, Xu X, Bai Y, Meng D. The dyadic effects of family resilience and social support on quality of life among older adults with chronic illness and their primary caregivers in multigenerational families in China: A cross-sectional study. Heliyon 2024; 10:e27351. [PMID: 38463805 PMCID: PMC10923707 DOI: 10.1016/j.heliyon.2024.e27351] [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: 04/27/2022] [Revised: 02/18/2024] [Accepted: 02/28/2024] [Indexed: 03/12/2024] Open
Abstract
Older adults with chronic illness, as well as their primary caregivers in multigenerational families, may experience a complex interplay of factors that affect their quality of life (QOL). However, this interplay is not yet well-characterized for Chinese multigenerational families in particular. In this study, we analyzed how family resilience and social support affect the QOL of both older adults and caregivers in multigenerational Chinese families specifically. We enrolled 258 pairs of older adults with chronic illness and their primary caregivers in a multicenter cross-sectional study conducted in southern China in December 2021. Using the Actor-Partner Interdependence Model (APIM), we then examined the correlation between family resilience, social support, and QOL in dyadic analysis and found that QOL, family resilience, and social support for primary caregivers were better than those of older adults with chronic illness (t = 3.66-16.3, p<0.01). These factors were found to be positively correlated (r = 0.22-0.60, p<0.05), except for the family resilience of primary caregivers and the QOL of older adults with chronic illness (r = -0.14, p = 0.04). Additionally, actor effect results showed that when a dyadic member has high family resilience and objective social support, they tend to have a better QOL (β = 0.5-1.48, P < 0.01). However, partner effect results showed that when the primary caregiver has high family resilience, this is associated with a worse QOL for the older adult (β = -1.06, P < 0.01). Furthermore, we found that objective social support of dyads does not significantly influence their partner's QOL (β = 0.88/0.31, P>0.05) for any pair. This suggests that medical staff should pay attention to the impact of family resilience on the QOL of older adult and caregiver dyads and explore health management plans that focus on binary coping in multigenerational families.
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Affiliation(s)
- Dan Lin
- Nursing College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu province, 210023, China
| | - Dong Liang
- The School of Public Health, Fujian Medical University, Fuzhou, Fujian province, 350122, China
| | - Minqing Huang
- The School of Public Health, Fujian Medical University, Fuzhou, Fujian province, 350122, China
| | - Xinxin Xu
- The School of Public Health, Fujian Medical University, Fuzhou, Fujian province, 350122, China
| | - Yamei Bai
- Nursing College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu province, 210023, China
| | - Dijuan Meng
- Nursing College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu province, 210023, China
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Low NJH, Leow DGW, Klainin-Yobas P. Effectiveness of Technology-Based Psychosocial Interventions on Psychological Outcomes Among Adult Cancer Patients and Caregivers: A Systematic Review and Meta-Analysis. Semin Oncol Nurs 2024; 40:151533. [PMID: 37977974 DOI: 10.1016/j.soncn.2023.151533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 10/12/2023] [Accepted: 10/16/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVE Technology-based psychosocial interventions (TBPIs) have increasingly gained intention. However, the effectiveness of TBPIs on psychological outcomes remains inconclusive. This review aimed to evaluate the effectiveness of TBPIs on health-related quality of life (HRQOL), coping, self-efficacy, and depression among adult cancer patients and caregivers. DATA SOURCES Randomised controlled trials (RCTs) evaluating the effectiveness of TBPIs targeting adult cancer patients, caregivers, or patient-caregiver dyads were included. English articles dated from 2012 to 2022 were retrieved from eight electronic databases, three clinical trial registries, and six grey literature databases. Two reviewers independently screened, appraised, and extracted data. The Cochrane risk of bias assessment tool and GRADE were used to appraise the methodological quality of included studies. Meta-analyses and subgroup analyses were undertaken with statistical pooling of standardized mean differences based on the random-effects model. CONCLUSION Totally, 37 RCTs were included in the review, with 35 trials for meta-analysis. Results demonstrated improvements in HRQOL, self-efficacy, and depression among cancer patients and caregivers with varying pooled effect sizes. Subgroup analyses suggested that dyadic TBPIs were more effective in improving HRQOL among cancer patients and caregivers, compared with those solely targeted at cancer patients or caregivers. IMPLICATION FOR NURSING PRACTICE Findings value-added to the existing evidence base on TBPIs. An interactive patient-caregiver dyadic program integrating TBPIs into routine oncology care is recommended to improve health outcomes for cancer patients and caregivers. Well-designed future RCTs are required to further evaluate the effectiveness of dyadic TBPIs, with emphasis on coping and self-efficacy outcomes among cancer patients and caregivers.
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Affiliation(s)
| | - Darryl Ge Wei Leow
- Staff Nurse, Woodlands Health Campus, Yishun Community Hospital, Singapore
| | - Piyanee Klainin-Yobas
- Associate Professor, Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore
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16
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Nysaeter TM, Olsson C, Sandsdalen T, Hov R, Larsson M. Family caregivers' preferences for support when caring for a family member with cancer in late palliative phase who wish to die at home - a grounded theory study. BMC Palliat Care 2024; 23:15. [PMID: 38212707 PMCID: PMC10782637 DOI: 10.1186/s12904-024-01350-5] [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: 10/24/2023] [Accepted: 01/09/2024] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND Family caregivers are essential in end-of-life care for cancer patients who wish to die at home. The knowledge is still limited regarding family caregivers needs and preferences for support and whether the preferences change during the patient's illness trajectory. Therefore, the aim was to explore family caregivers' preferences for support from home care services over time when caring for a family member with cancer at the end of life who wished to die at home. METHODS A qualitative method was applied according to Grounded Theory. Data was collected longitudinally over the illness trajectory by means of repeated individual interviews (n = 22) with adult family caregivers (n = 11). Sampling, data collection and data analysis were undertaken simultaneously in line with the constant comparative method. RESULTS The findings are captured in the core category "hold out in duty and love". The categories "having control and readiness for action" and "being involved in care" describe the family caregivers' preferences for being prepared and able to handle procedures, medical treatment and care, and to be involved by the healthcare personnel in the patient's care and decision making. The categories "being seen and confirmed" and "having a respite" describe family caregivers' preferences for support according to their own needs to be able to persevere in the situation. CONCLUSION Despite deterioration in the patient's illness and the increasing responsibility family caregiver struggle to hold out and focus on being in the present. Over time together with deterioration in the patient's illness and changes in the situation, they expressed a need for more intense and extensive support from the home care services. To meet the family caregivers' preferences for support a systematic implementation of a person-centred care model and multicomponent psycho- educational interventions performed by nurses can be proposed. Moreover, we suggest developing a tool based on the conceptual model generated in this study to identify and map family caregivers' needs and preferences for support. Such a tool can facilitate communication and ensure person-centred interventions.
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Affiliation(s)
- Toril Merete Nysaeter
- Department of Health and Nursing Sciences, Inland Norway University of Applied Sciences, Elverum, 2400, Norway.
| | - Cecilia Olsson
- Department of Health Sciences, Karlstad University SE, Karlstad, Sweden
- Department of Bachelor Education in Nursing, Lovisenberg Diaconal University College, Oslo, Norway
| | - Tuva Sandsdalen
- Department of Health and Nursing Sciences, Inland Norway University of Applied Sciences, Elverum, 2400, Norway
| | - Reidun Hov
- Department of Health and Nursing Sciences, Inland Norway University of Applied Sciences, Elverum, 2400, Norway
- Centre for Development of Institutional and Home Care Services (USHT), Inland (Hedmark), Hamar, Norway
| | - Maria Larsson
- Department of Health Sciences, Karlstad University SE, Karlstad, Sweden
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Semonella M, Marchesi G, Andersson G, Dekel R, Pietrabissa G, Vilchinsky N. Usability study of SOSteniamoci: An internet-based intervention platform to support informal caregivers in Italy. Digit Health 2024; 10:20552076231225082. [PMID: 38235418 PMCID: PMC10793194 DOI: 10.1177/20552076231225082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 12/19/2023] [Indexed: 01/19/2024] Open
Abstract
Background Providing informal care can be experienced as stressful and lead to caregiver burden. Internet-based interventions, a specific form of eHealth, have proven to be a good option to support informal caregivers. SOSteniamoci, an internet-based intervention already tested in Lithuania, was translated and adapted for Italian caregivers. Objective As many novel eHealth solutions have been rejected by end-users due to usability problems, we aimed to evaluate the usability of the adapted platform, using a computer-based prototype. Methods The following methods and metrics were applied: 1. task analysis, using audio and video recordings that included three usability metrics: task completion rate, frequency of errors, and frequency of help requests; 2. the system usability scale (SUS); and 3. a semi-structured interview to collect additional data about the system's design and overall satisfaction. Results Ten informal caregivers (60% female; age M = 47.8, SD = 15.21) provided insights and suggestions for increasing the usability of the platform. The platform was considered satisfactory, with a mean score on the SUS of 75 (SD = 13.07) out of 100. The task analysis measurements highlighted difficulties in how to log in to the platform, understanding what the intervention is about, and texting the therapist. The same difficulties were also mentioned during the post-experience interview. Thus, improvements were subsequently made to enhance users' experience when navigating the platform. Finally, the platform overall was found to be intuitive and friendly, and the contents were appreciated. Conclusion To maintain participants' engagement and prevent drop-out, it is crucial to test the usability of internet-based interventions. Even though the platform proved to be user-friendly, intuitive and easy to use, several enhancements were implemented based on participants' feedback. Thus, the usability of internet-based interventions should be tested, and end-users must be involved in the development process of such solutions.
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Affiliation(s)
| | - Gloria Marchesi
- Department of Psychology, Catholic University of Sacred Heart, Milan, Italy
| | - Gerhard Andersson
- Department of Behavioural Science and Learning, Linköping University, Linkoping, Sweden
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Rachel Dekel
- School of Social Work, Bar-Ilan University, Ramat Gan, Israel
| | - Giada Pietrabissa
- Department of Psychology, Catholic University of Sacred Heart, Milan, Italy
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, Milan, Italy
| | - Noa Vilchinsky
- Department of Psychology, Bar-Ilan University, Ramat Gan, Israel
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Thyrian JR, Boekholt M, Biernetzky O, Blotenberg I, Teipel S, Killimann I, Hoffmann W. Informal Caregivers of People with Dementia in Germany: Psychosocial Characteristics and Unmet Needs. J Alzheimers Dis 2024; 99:1235-1242. [PMID: 38759002 DOI: 10.3233/jad-231055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2024]
Abstract
Background Caregivers of people with dementia living at home (CPwDh) are likely to be affected by a range of health problems. However, CPwDh are often regarded as accompanying persons and receive less attention in research and care. Little is known about this population and their needs in Germany. However, better knowledge of CPwDH is needed to design effective interventions. Objective The objective of this report is to describe the situation of CPwDh and highlight differences based on sex and living situation. Methods This was a cross-sectional analysis of the psychosocial characteristics of participants in the GAIN trial, a cluster-randomized, controlled intervention trial investigating the effectiveness of a care management program. A total of n = 192 CPwDh were recruited in GP offices, memory clinics or through public campaigns in the German federal state of Mecklenburg-Western Pomerania. The inclusion criteria were an age of 18 years or above, being a CPwDh, written informed consent. In a comprehensive digital assessment, psychosocial variables, burden, and care needs were assessed. Results Partners, women, and people living in the same household represented the majority of caregivers, and their mean number of needs was 8.7. Overall, participants indicated a mild to moderate burden. There are differences in burden based on sex and living situation, with caregivers living with people with dementia showing less burden and different psychosocial demographics. Conclusions There is a need for interventions to reduce caregivers' unmet needs in the CPwDh. Such interventions should consider differences in sex and living situation to better address individual caregiver needs.
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Affiliation(s)
- Jochen René Thyrian
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Greifswald, Germany
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Melanie Boekholt
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Greifswald, Germany
| | - Olga Biernetzky
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Rostock, Germany
| | - Iris Blotenberg
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Greifswald, Germany
| | - Stefan Teipel
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Rostock, Germany
- Department for Psychosomatic and Psychotherapeutical Medicine, Rostock University Medical Center, Rostock, Germany
| | - Ingo Killimann
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Rostock, Germany
- Department for Psychosomatic and Psychotherapeutical Medicine, Rostock University Medical Center, Rostock, Germany
| | - Wolfgang Hoffmann
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Greifswald, Germany
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
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Li Y, Wang Q, Liu C, Hu X. Symptom clusters and their impact on quality of life among Chinese patients with lung cancer: A cross-sectional study. Eur J Oncol Nurs 2023; 67:102465. [PMID: 37956567 DOI: 10.1016/j.ejon.2023.102465] [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: 08/07/2023] [Revised: 10/30/2023] [Accepted: 11/01/2023] [Indexed: 11/15/2023]
Abstract
PURPOSE To investigate the symptom clusters of Chinese patients with lung cancer, and explore their impact on quality of life (QoL) and each of its functioning. METHOD A cross-sectional study was conducted between October 2022 and April 2023 among 219 lung cancer patients at a general hospital in Sichuan Province. Data were collected using a general information questionnaire, the MD Anderson Symptom Inventory, and the EORTC QLQ-C30. R within the RStudio platform was used to conduct descriptive statistics, exploratory factor analysis and multiple regression analysis. RESULTS Psychoneurological, respiratory, gastrointestinal and fatigue-related symptom clusters were identified, each of which was significantly negatively correlated with overall QoL, global health status/QoL and each functioning. The respiratory (β = -0.60, P = 0.02) and fatigue-related symptom cluster (β = -0.86, P = 0.02) were predictors of global health status/QoL; the fatigue-related symptom cluster predicted physical (β = -1.68, P < 0.01), role (β = -1.63, P < 0.01) and cognitive functioning (β = -1.45, P < 0.01); the psychoneurological symptom cluster was a predictor of patients' emotional functioning (β = -1.26, P < 0.01); and the psychoneurological (β = -0.81, P < 0.01) and gastrointestinal symptom cluster (β = -0.60, P = 0.05) predicted social functioning. CONCLUSIONS Respiratory and fatigue-related symptom clusters were strong predictors of global health status/QoL; fatigue-related, psychoneurological and gastrointestinal symptom clusters had a negative impact on patients' functioning. Nurse practitioners should pay more attention to monitoring respiratory and fatigue-related symptom clusters to identify high-risk populations in time, and tailored interventions based on symptom clusters are needed to synergistically reduce the symptom burden, thereby improving patients' QoL.
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Affiliation(s)
- Yunhuan Li
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, PR China
| | - Qi Wang
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, PR China
| | - Chunhua Liu
- Department of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
| | - Xiaolin Hu
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, PR China; Tianfu Jincheng Laboratory, City of Future Medicine, Chengdu, Chengdu, Sichuan, PR China.
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20
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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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Fraterman I, Wollersheim BM, Tibollo V, Glaser SLC, Medlock S, Cornet R, Gabetta M, Gisko V, Barkan E, di Flora N, Glasspool D, Kogan A, Lanzola G, Leizer R, Mallo H, Ottaviano M, Peleg M, van de Poll-Franse LV, Veggiotti N, Śniatała K, Wilk S, Parimbelli E, Quaglini S, Rizzo M, Locati LD, Boekhout A, Sacchi L, Wilgenhof S. An eHealth App (CAPABLE) Providing Symptom Monitoring, Well-Being Interventions, and Educational Material for Patients With Melanoma Treated With Immune Checkpoint Inhibitors: Protocol for an Exploratory Intervention Trial. JMIR Res Protoc 2023; 12:e49252. [PMID: 37819691 PMCID: PMC10600650 DOI: 10.2196/49252] [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: 05/24/2023] [Revised: 07/12/2023] [Accepted: 08/03/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Since treatment with immune checkpoint inhibitors (ICIs) is becoming standard therapy for patients with high-risk and advanced melanoma, an increasing number of patients experience treatment-related adverse events such as fatigue. Until now, studies have demonstrated the benefits of using eHealth tools to provide either symptom monitoring or interventions to reduce treatment-related symptoms such as fatigue. However, an eHealth tool that facilitates the combination of both symptom monitoring and symptom management in patients with melanoma treated with ICIs is still needed. OBJECTIVE In this pilot study, we will explore the use of the CAPABLE (Cancer Patients Better Life Experience) app in providing symptom monitoring, education, and well-being interventions on health-related quality of life (HRQoL) outcomes such as fatigue and physical functioning, as well as patients' acceptance and usability of using CAPABLE. METHODS This prospective, exploratory pilot study will examine changes in fatigue over time in 36 patients with stage III or IV melanoma during treatment with ICI using CAPABLE (a smartphone app and multisensory smartwatch). This cohort will be compared to a prospectively collected cohort of patients with melanoma treated with standard ICI therapy. CAPABLE will be used for a minimum of 3 and a maximum of 6 months. The primary endpoint in this study is the change in fatigue between baseline and 3 and 6 months after the start of treatment. Secondary end points include HRQoL outcomes, usability, and feasibility parameters. RESULTS Study inclusion started in April 2023 and is currently ongoing. CONCLUSIONS This pilot study will explore the effect, usability, and feasibility of CAPABLE in patients with melanoma during treatment with ICI. Adding the CAPABLE system to active treatment is hypothesized to decrease fatigue in patients with high-risk and advanced melanoma during treatment with ICIs compared to a control group receiving standard care. The Medical Ethics Committee NedMec (Amsterdam, The Netherlands) granted ethical approval for this study (reference number 22-981/NL81970.000.22). TRIAL REGISTRATION ClinicalTrials.gov NCT05827289; https://clinicaltrials.gov/study/NCT05827289. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/49252.
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Affiliation(s)
- Itske Fraterman
- Department of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Barbara M Wollersheim
- Department of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Valentina Tibollo
- Laboratory of Informatics and Systems Engineering for Clinical Research, Istituti Clinici Scientifici Maugeri SpA SB IRCCS, Pavia, Italy
| | - Savannah Lucia Catherina Glaser
- Medical Informatics, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
- Methodology, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Stephanie Medlock
- Medical Informatics, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
- Methodology, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
- Aging and Later Life, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Ronald Cornet
- Medical Informatics, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
- Methodology, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Matteo Gabetta
- BIOMERIS SRL, Pavia, Italy
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy
| | | | - Ella Barkan
- Department of Artificial Intelligence for Accelerated Healthcare and Life Sciences Discovery, IBM Research, IBM R&D Laboratories, Haifa, Israel
| | | | | | - Alexandra Kogan
- Department of Information Systems, University of Haifa, Haifa, Israel
| | - Giordano Lanzola
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy
| | - Roy Leizer
- Department of Information Systems, University of Haifa, Haifa, Israel
| | - Henk Mallo
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, Netherlands
| | - Manuel Ottaviano
- Life Supporting Technologies, Universidad Politécnica de Madrid, Madrid, Spain
| | - Mor Peleg
- Department of Information Systems, University of Haifa, Haifa, Israel
| | - Lonneke V van de Poll-Franse
- Department of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, Netherlands
- Department of Research and Development, Netherlands Comprehensive Cancer Organization, Utrecht, Netherlands
- Department of Medical and Clinical Psychology, Center of Research on Psychological and Somatic Disorders (CoRPS), Tilburg University, Tilburg, Netherlands
| | - Nicole Veggiotti
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy
| | - Konrad Śniatała
- Institute of Computing Science, Poznan University of Technology, Poznan, Poland
| | - Szymon Wilk
- Institute of Computing Science, Poznan University of Technology, Poznan, Poland
| | - Enea Parimbelli
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy
| | - Silvana Quaglini
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy
| | - Mimma Rizzo
- Division of Medical Oncology, Azienda Ospedaliero Universitaria Consorziale Policlinico di Bari, Bari, Italy
| | - Laura Deborah Locati
- Department of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy
- Medical Oncology Unit, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Annelies Boekhout
- Department of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Lucia Sacchi
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy
| | - Sofie Wilgenhof
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, Netherlands
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22
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Özönder Ünal I, Ordu C. Decoding Caregiver Burden in Cancer: Role of Emotional Health, Rumination, and Coping Mechanisms. Healthcare (Basel) 2023; 11:2700. [PMID: 37830736 PMCID: PMC10573024 DOI: 10.3390/healthcare11192700] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/02/2023] [Accepted: 10/06/2023] [Indexed: 10/14/2023] Open
Abstract
This study aimed to elucidate the role of psychological factors in caregiver burden among caregivers of stage 4 cancer patients. Data were collected from 328 caregivers of cancer patients, employing the Zarit Care Burden Scale, Depression-Anxiety-Stress Scale (DASS-42), Dysfunctional Attitudes Scale (DAS-A), Ruminative Thought Style Questionnaire (RTSQ), and Coping Orientation to Problems Experienced Inventory (Brief COPE). Males, spouses, and caregivers of patients with a PEG or tracheostomy, or those diagnosed with pancreatic biliary cancer were found to have a significantly higher risk of caregiver burden. Age, sex, caregiver-patient relationship, caregiving duration, patient's catheter status, cancer types, depression and stress severity, rumination, dysfunctional attitudes, and dysfunctional coping strategies explained 69.7% of the variance in Zarit Care Burden Scale scores (F(14,313) = 51.457, p < 0.001), illustrating their significant predictive relationship with caregiver burden. Moderation analysis revealed significant interactions of emotional coping with depression (b = -0.0524, p = 0.0076) and dysfunctional coping with stress on caregiver burden (b = 0.014, p = 0.006). Furthermore, rumination mediated the relationships between caregiver burden, stress, and depression (p < 0.01). Overall, the results highlight the intricate relationships among caregiver burden, mental health, and coping strategies, suggesting tailored interventions to support caregiver health and quality of care.
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Affiliation(s)
- Ipek Özönder Ünal
- Department of Psychiatry, Tuzla State Hospital, Içmeler Mahallesi, Piri Reis Caddesi, No: 74 Tuzla, Istanbul 34947, Turkey
| | - Cetin Ordu
- Division of Medical Oncology, Department of Internal Medicine, Gayrettepe Florence Nightingale Hospital, Cemil Aslan Güder Sk. No: 8, Beşiktaş, Istanbul 34349, Turkey;
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23
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Kim YM, Lee JE. Dyadic Effects of Psychological Health on Quality of Life in Patients with Colorectal Cancer and Caregivers: A Systematic Review and Meta-Analysis. Semin Oncol Nurs 2023; 39:151477. [PMID: 37495448 DOI: 10.1016/j.soncn.2023.151477] [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: 02/13/2023] [Revised: 05/29/2023] [Accepted: 07/03/2023] [Indexed: 07/28/2023]
Abstract
OBJECTIVES This study aimed to review dyadic research on psychological health and health-related quality of life (HRQL) in patients with colorectal cancer (CRC) and caregivers and examine the pooled partner effects and actor effects based on the Actor-Partner Interdependence Model. DATA SOURCES A systematic review and meta-analysis were conducted. We registered our review protocol with PROSPERO (CRD42021258482). Six databases were searched until June 2021 using the following keywords: colorectal neoplasms, caregivers, depression, anxiety, stress, and quality of life. Two reviewers independently screened 1,597 studies that included both CRC patients and family caregivers. Meta-analyses were performed of the partner and actor effects of psychological health on HRQL in CRC. CONCLUSION Eighteen observational studies involving 2,757 patients with CRC and 2,601 caregivers were included. Regarding partner effects, the distress of patients with CRC affected their family caregivers' distress and burden. There were three types of actor effects among patients with CRC and family caregivers: 1) the social support of patients with CRC affects their level of distress; (2) the distress of patients with CRC affects their HRQL; and (3) caregivers' social support affects their level of distress. This study provides the first comprehensive overview of the dyadic relationships between psychological health and HRQL in patients with CRC and their caregivers. IMPLICATIONS FOR NURSING PRACTICE The development of dyadic interventions for improving psychological health is warranted to help both patients with CRC and their family caregivers live with improved HRQL and well-being.
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Affiliation(s)
- Young Man Kim
- Assistant Professor, College of Nursing, Jeonbuk National University, and Reseach Institute of Nursing Science, Jeonbuk National University, Jeonju-si, Republic of Korea
| | - Jung Eun Lee
- Assistant Professor, University of Rhode Island College of Nursing, Kingston, Rhode Island, USA.
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24
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Buchanan A, Sarfo A, Rangel ML, Nangia J, Badr H. A mixed-methods study to inform development of a caregiver-specific problem list for cancer distress screening. Psychooncology 2023; 32:1578-1585. [PMID: 37698499 DOI: 10.1002/pon.6209] [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: 03/04/2023] [Revised: 08/11/2023] [Accepted: 08/23/2023] [Indexed: 09/13/2023]
Abstract
OBJECTIVE Oncology guidelines for distress management recommend use of the single-item distress thermometer (DT) and accompanying Problem List (PL) to identify patients with high distress levels and their potential sources of distress. However, oncology practices have yet to establish standardized protocols to screen and triage caregivers with high distress levels. With an eye toward integrating caregiver-centered support services into cancer care, this mixed-methods study sought to assess caregiver distress and challenges that may contribute to their distress. METHODS Nineteen caregivers of metastatic breast cancer patients (60% female, 47% ethnic/racial minority) completed an interview and a survey comprised of the DT, the original 39-item PL, and five additional caregiver-specific PL items. RESULTS Caregivers reported moderate distress levels and more than half exceeded the National Comprehensive Cancer Network (NCCN) cut-off, denoting significant distress. There was no association between caregiver distress and the number of items endorsed on the original PL. Qualitative analysis identified nine problem domains as areas of caregiver unmet need needs (i.e., practical challenges, caregiving responsibilities, social/relationship issues, caregiver and patient emotional well-being, caregiver and patient physical well-being, spiritual well-being, and communication). Two of the problem domains (caregiving responsibilities and communication) were not captured in any way by the original PL. CONCLUSION With further research and development, the identified domains could serve as the basis for a caregiver-specific PL to facilitate triage and referral when incorporated as part of routine distress screening.
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Affiliation(s)
- Ashley Buchanan
- Department of Psychology & Neuroscience, Baylor University, Waco, Texas, USA
| | - Astrid Sarfo
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Maria Lizette Rangel
- Margaret M. and Albert B. Alkek Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Julie Nangia
- Lester & Sue Smith Breast Center, Baylor College of Medicine, Houston, Texas, USA
- Dan L Duncan Comprehensive Cancer Center, Houston, Texas, USA
| | - Hoda Badr
- Margaret M. and Albert B. Alkek Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
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25
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Wilson CM, Arena SK, Boright L, Duplissis N, Hilliker M, Krupa J. Evaluation of a Physical Therapist-Delivered Technology Literacy Algorithm and Protocol for Older Adults: A Pilot Study. Cureus 2023; 15:e47865. [PMID: 38021598 PMCID: PMC10680407 DOI: 10.7759/cureus.47865] [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] [Accepted: 10/27/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Technology literacy is the ability to comfortably understand, use, and navigate digital devices. It is considered a "super social determinant of health", and yet 39% of adults aged 65+ report not using a smartphone, and 25% of seniors still lack internet access. The purpose of this study was to examine the applicability of a physical therapist-delivered clinical assessment tool related to technological literacy and to identify relationships between technology utilization and perceptions related to sociodemographic factors in community-dwelling older adults. Methods A prospective mixed-methods observational-descriptive study where physical therapists (PTs) administered a newly designed technology literacy algorithm to older adults and evaluated the results of the algorithm. A convenience sample of 30 participants aged 65 and older was evaluated for their technology literacy. The exclusion criteria were if the person had a vision deficit, lived in a nursing home or extended care facility, was unable to fluently read and understand the English language, or was not willing to have an in-home visit by a licensed PT. After informed consent was obtained, the participant completed a Past Experience with Technology Questionnaire assessing participant confidence with technology usage and a demographic questionnaire. A PT data collector visited participants' homes and administered a novel technology literacy algorithm. The PTs also provided subjective feedback after patient visits as to their perceptions of the algorithm. Inferential statistics were performed for key variables, including a Kruskal-Wallis test being utilized for variables with three or more levels and a two-sample Wilcoxon test being utilized for variables with two levels. The binary results were evaluated with chi-squared tests. Trends in distribution and measures of central tendency were analyzed for demographic data. Statistical significance was set at P<0.05 with a confidence interval of 95%. Results Participants (n=30) were evenly distributed with regard to age, and 66% of people had a college degree. Most were female, of the white race, and retired. There were statistically significant relationships between older age and decreased comfort level with using the internet (P=0.30) and sending messages (P=0.31), with individuals 80+ years old having a mean confidence of 6.78 out of 10. A statistically significant relationship was also found between higher income and increased confidence in browsing the internet (P = 0.07). Most qualitative data from physical therapist experiences included positive trends such as ease of use, efficiency, and confidence instilled. Constructive feedback included a lack of resources to assist with more advanced technology-related needs and recommendations to refine the algorithm when advanced needs were identified. Conclusion Technology literacy is a vital component of accessing health and medical care and maximizing the quality of that care, especially in the older adult population. The tools created may assist clinicians with identifying and addressing issues related to technology in older adults. This may help a patient navigate health issues that require the use of technology in their home. This study provided evidence that a PT-administered algorithm may be feasible to address technology literacy issues in the homes of older adults.
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Affiliation(s)
- Christopher M Wilson
- Physical Therapy, Oakland University, Rochester, USA
- Physical Medicine and Rehabilitation, Corewell Health, Southfield, USA
| | - Sara K Arena
- Physical Therapy, Oakland University, Rochester, USA
| | - Lori Boright
- Physical Therapy, Oakland University, Rochester, USA
| | | | | | - John Krupa
- Physical Therapy, Oakland University, Rochester, USA
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26
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Lamarche J, Cusson A, Nissim R, Avery J, Wong J, Maheu C, Lambert SD, Laizner AM, Jones J, Esplen MJ, Lebel S. It's time to address fear of cancer recurrence in family caregivers: usability study of an virtual version of the Family Caregiver-Fear Of Recurrence Therapy (FC-FORT). Front Digit Health 2023; 5:1129536. [PMID: 37671170 PMCID: PMC10475944 DOI: 10.3389/fdgth.2023.1129536] [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: 12/22/2022] [Accepted: 06/19/2023] [Indexed: 09/07/2023] Open
Abstract
Background Family caregivers of cancer survivors experience equal or greater levels of fear of cancer recurrence (FCR) than survivors themselves. Some interventions have demonstrated their ability to reduce FCR among cancer survivors and dyads (patient and caregivers). However, to date, no validated intervention exists to focus solely on family caregiver's FCR. Objectives This study aimed to (1) adapt the evidence-based in-person Fear Of Recurrence Therapy (FORT) for family caregivers (referred here in as FC-FORT) and to a virtual delivery format and (2) test its usability when offered virtually. Methods The adaptation of FC-FORT was overseen by an advisory board and guided by the Information Systems Research Framework. Following this adaptation, female family caregivers and therapists were recruited for the usability study. Participants took part in 7 weekly virtual group therapy sessions, a semi-structured exit interview and completed session feedback questionnaires. Therapists were offered a virtual training and weekly supervision. Fidelity of treatment administration was assessed each session. Quantitative data were analyzed using descriptive statistics. Exit interviews were transcribed verbatim using NVivo Transcription and coded using conventional content analysis. Results were presented back to the advisory board to further refine FC-FORT. Results The advisory board (n = 16) met virtually on 7 occasions to adapt FC-FORT (i.e., patient manuals, virtual format) and discuss recruitment strategies. Minor (e.g., revised text, adapted materials to virtual format) and major adaptations (e.g., added and rearranged sessions) were made to FC-FORT and subsequently approved by the advisory board. Four family caregivers and three therapists took part in the first round of the usability testing. Six family caregivers and the same three therapists took part in the second round. Overall, participants were very satisfied with FC-FORT's usability. Qualitative analysis identified 4 key themes: usability of FC-FORT, satisfaction and engagement with content, group cohesion, and impact of FC-FORT. All participants indicated that they would recommend FC-FORT to others as is. Conclusions Using a multidisciplinary advisory board, our team successfully adapted FC-FORT and tested its usability using videoconferencing. Results from this study indicate that the efficacy and acceptability of FC-FORT are now ready to be tested in a larger pilot study.
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Affiliation(s)
- Jani Lamarche
- Faculty of Social Sciences, School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Angélica Cusson
- Faculty of Social Sciences, School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Rinat Nissim
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Jonathan Avery
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Jiahui Wong
- Cancer Chat De Souza Institute, University Health Network, Toronto, ON, Canada
| | - Christine Maheu
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
| | - Sylvie D Lambert
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
- St. Mary's Research Centre, St. Mary's Hospital Center, Montreal, QC, Canada
| | - Andrea M Laizner
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
- Research Institute of the McGill University Health Centre, McGill University Health Centre, Montreal, QC, Canada
| | - Jennifer Jones
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Mary Jane Esplen
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Sophie Lebel
- Faculty of Social Sciences, School of Psychology, University of Ottawa, Ottawa, ON, Canada
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27
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Son EH, Wallen GR, Flynn S, Yang L, Lee LJ. Patterns of health-promoting behaviors and associated factors in family caregivers of people receiving cancer treatment: A latent class profile analysis. Psychooncology 2023; 32:1038-1047. [PMID: 37157152 PMCID: PMC10590684 DOI: 10.1002/pon.6145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 04/02/2023] [Accepted: 04/10/2023] [Indexed: 05/10/2023]
Abstract
OBJECTIVE Family caregivers tend to neglect their health while prioritizing the needs of their care recipients. Identifying subgroups of caregivers based on the patterns of health-promoting behaviors (HPBs) may help develop tailored interventions for them, yet little is known. The purpose of this study was: (1) to identify latent classes with distinct patterns of HPBs in family caregivers of people with cancer; and (2) to investigate factors associated with the latent class membership. METHODS We performed a cross-sectional data analysis using the baseline dataset from a longitudinal survey study that assessed HPBs of family caregivers of individuals who received cancer treatment at a national research hospital (N = 124). Latent class profile analysis was conducted to identify latent classes based on the subdomains of the Health-Promoting Lifestyle Profile II, followed by multinomial logistic regression analysis to investigate factors associated with the latent class membership. RESULTS Three latent classes were identified: a high level of HPB (Class 1, 25.8%); a moderate level of HPB (Class 2, 53.2%); and a low level of HPB (Class 3, 21.0%) of HPBs. Controlling for caregiver age and sex, caregiver burden due to lack of family support, perceived stress, self-efficacy and body mass index were factors associated with the latent class membership. CONCLUSIONS HPBs of our caregiver sample appeared in relatively stable patterns at different levels. Higher caregiver burden and perceived stress and lower self-efficacy were associated with the lower practice of HPBs overall. Our findings may serve as a reference for screening caregivers who need support and developing person-centered interventions.
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Affiliation(s)
- Elisa H. Son
- Translational Biobehavioral and Health Disparities Branch, National Institutes of Health (NIH) Clinical Center, Bethesda, Maryland, USA
| | - Gwenyth R. Wallen
- Translational Biobehavioral and Health Disparities Branch, National Institutes of Health (NIH) Clinical Center, Bethesda, Maryland, USA
| | - Sharon Flynn
- National Heart, Lung, and Blood Institute, NIH, Bethesda, Maryland, USA
| | - Li Yang
- Translational Biobehavioral and Health Disparities Branch, National Institutes of Health (NIH) Clinical Center, Bethesda, Maryland, USA
| | - Lena J. Lee
- Translational Biobehavioral and Health Disparities Branch, National Institutes of Health (NIH) Clinical Center, Bethesda, Maryland, USA
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Shaffer KM, Turner KL, Siwik C, Gonzalez BD, Upasani R, Glazer JV, Ferguson RJ, Joshua C, Low CA. Digital health and telehealth in cancer care: a scoping review of reviews. Lancet Digit Health 2023; 5:e316-e327. [PMID: 37100545 PMCID: PMC10124999 DOI: 10.1016/s2589-7500(23)00049-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 01/06/2023] [Accepted: 02/23/2023] [Indexed: 04/28/2023]
Abstract
The COVID-19 pandemic necessitated remote cancer care delivery via the internet and telephone, rapidly accelerating an already growing care delivery model and associated research. This scoping review of reviews characterised the peer-reviewed literature reviews on digital health and telehealth interventions in cancer published from database inception up to May 1, 2022, from PubMed, Cumulated Index to Nursing and Allied Health Literature, PsycINFO, Cochrane Reviews, and Web of Science. Eligible reviews conducted a systematic literature search. Data were extracted in duplicate via a pre-defined online survey. Following screening, 134 reviews met the eligibility criteria. 77 of those reviews were published since 2020. 128 reviews summarised interventions intended for patients, 18 addressed family caregivers, and five addressed health-care providers. 56 reviews did not target a specific phase of the cancer continuum, whereas 48 reviews tended to address the active treatment phase. 29 reviews included a meta-analysis, with results showing positive effects on quality of life, psychological outcomes, and screening behaviours. 83 reviews did not report intervention implementation outcomes but when reported, 36 reported acceptability, 32 feasibility, and 29 fidelity outcomes. Several notable gaps were identified in these literature reviews on digital health and telehealth in cancer care. No reviews specifically addressed older adults, bereavement, or sustainability of interventions and only two reviews focused on comparing telehealth to in-person interventions. Addressing these gaps with rigorous systematic reviews might help guide continued innovation in remote cancer care, particularly for older adults and bereaved families, and integrate and sustain these interventions within oncology.
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Affiliation(s)
- Kelly M Shaffer
- Center for Behavioral Health and Technology, School of Medicine, University of Virginia, Charlottesville, VA, USA.
| | - Kea L Turner
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Chelsea Siwik
- Osher Center for Integrative Health, University of California San Francisco, San Francisco, CA, USA
| | - Brian D Gonzalez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Rujula Upasani
- Center for Behavioral Health and Technology, School of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Jillian V Glazer
- Center for Behavioral Health and Technology, School of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Robert J Ferguson
- Division of Hematology/Oncology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Catherine Joshua
- Center for Behavioral Health and Technology, School of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Carissa A Low
- Division of Hematology/Oncology, University of Pittsburgh, Pittsburgh, PA, USA
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29
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Factors associated with the perceptions of eHealth technology of Chinese nurses and nursing students. Nurse Educ Pract 2023; 69:103605. [PMID: 37028224 DOI: 10.1016/j.nepr.2023.103605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 02/01/2023] [Accepted: 03/04/2023] [Indexed: 03/16/2023]
Abstract
AIM The current study sought to assess the perceptions of eHealth technology of nurses and nursing students in China and to examine the association between these perceptions and demographic factors. BACKGROUND Despite the increasing use of eHealth technologies in China and across the globe, the perceptions of practicing and student nurses remain minimally explored. Findings from such an inquiry can potentially inform actions and policies to improve the uptake of eHealth technologies among Chinese nurses. DESIGN This was a cross-sectional study with a real-time online survey. METHODS A convenience sample of 1338 nurses and nursing students from Mainland China participated in the study. Their perceptions of eHealth technology were collected using the Chinese version of the Perceptions of eHealth Technology Scale. The Kruskal-Wallis test and multiple linear regression analysis were used to examine the relationship between demographic variables (age group, gender, occupation, education level, position and clinical experience) and perceptions of eHealth technology. All study procedures adhered to the STROBE guidelines. RESULTS Most participants were aged between 20 and 29 (55.8%). Nearly half (42.5%) were frontline clinical nursing staff, some were nursing students (36.2%), academic nursing staff (12.3%) and clinical nursing management staff (9.0%). Regardless of the differences in their demographic characteristics, the participants had higher mean scores in "Perception of eHealth applications" and lower mean scores in "Knowledge of eHealth technology". Participants with doctoral degree had a higher mean total score and higher sub-scale scores in knowledge of eHealth technology, perception of the advantages of eHealth technology and perception of eHealth applications; and the lowest scores in perception of the disadvantages of eHealth technology and perception of eHealth applications. Occupation, position and clinical experience were found to be the demographic characteristics associated with eHealth perceptions, before adjusting for age and gender. Education level was associated with eHealth perceptions regardless of adjustment. CONCLUSION Overall, participants had higher scores on perceptions of eHealth applications but lower scores on knowledge of eHealth technology. Considering the association between education and all subscales and overall scores, it may be essential to implement continuing professional education for nurses to improve their knowledge of eHealth applications. Encouragement to use available eHealth digital technologies may also be helpful to improve perceptions of eHealth.
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Acquati C, Head KJ, Rand KL, Alwine JS, Short DN, Cohee AA, Champion VL, Draucker CB. Psychosocial Experiences, Challenges, and Recommendations for Care Delivery among Partners of Breast Cancer Survivors: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2786. [PMID: 36833489 PMCID: PMC9956235 DOI: 10.3390/ijerph20042786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 01/28/2023] [Accepted: 01/30/2023] [Indexed: 06/18/2023]
Abstract
For women diagnosed with breast cancer, partners are consistently identified as the primary support person. Despite growing consensus about the psychosocial experience and unmet needs of cancer caregivers, limited evidence exists about strategies to offer partner-centered care across the cancer continuum. This study describes challenges endured by partners of breast cancer survivors (BCS), strategies implemented to manage these experiences, and recommendations for healthcare providers to inform targeted psychosocial care. Using convenience sampling, 22 partners of female BCS were recruited and completed semi-structured interviews. Conventional content analysis was used to code and synthesize findings. Participants described undergoing five experiences in their role as romantic partners: (a) assuming the role of caregiver, (b) becoming healthcare advocates for BCS, (c) connecting emotionally with the partner, (d) managing their own painful emotions, and (e) connecting with others for support. Experience-specific coping strategies and recommendations were identified. Romantic partners face multiple transitions across the cancer care continuum, which warrant investigation to sustain their well-being and active participation in illness management. Psychosocial interventions for this group will benefit from flexible implementation and attention to care delivery, mental health, and supportive/social needs.
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Affiliation(s)
- Chiara Acquati
- Graduate College of Social Work, University of Houston, Houston, TX 77004, USA
- Tilman J. Fertitta Family College of Medicine, University of Houston, Houston, TX 77004, USA
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Katharine J. Head
- Department of Communication Studies, School of Liberal Arts, Indiana University-Purdue University Indianapolis, Indianapolis, IN 46202, USA
| | - Kevin L. Rand
- School of Science, Indiana University-Purdue University Indianapolis, Indianapolis, IN 46202, USA
| | | | | | - Andrea A. Cohee
- School of Nursing, Indiana University, Indianapolis, IN 46202, USA
- Melvin and Bren Simon Comprehensive Cancer Center, Indiana University, Indianapolis, IN 46202, USA
| | - Victoria L. Champion
- School of Nursing, Indiana University, Indianapolis, IN 46202, USA
- Melvin and Bren Simon Comprehensive Cancer Center, Indiana University, Indianapolis, IN 46202, USA
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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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Bisht J, Rawat P, Sehar U, Reddy PH. Caregivers with Cancer Patients: Focus on Hispanics. Cancers (Basel) 2023; 15:626. [PMID: 36765585 PMCID: PMC9913516 DOI: 10.3390/cancers15030626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/12/2023] [Accepted: 01/17/2023] [Indexed: 01/20/2023] Open
Abstract
Cancer is a public health concern and causes more than 8 million deaths annually. Cancer triggers include population growth, aging, and variations in the prevalence and distribution of the critical risk factors for cancer. Multiple hallmarks are involved in cancer, including cell proliferation, evading growth suppressors, activating invasion and metastasis, resisting cell death, enabling replicative immortality, reprogramming energy metabolism, and evading immune destruction. Both cancer and dementia are age-related and potentially lethal, impacting survival. With increasing aging populations, cancer and dementia cause a burden on patients, family members, the health care system, and informal/formal caregivers. In the current article, we highlight cancer prevalence with a focus on different ethnic groups, ages, and genders. Our article covers risk factors and genetic causes associated with cancer and types of cancers and comorbidities. We extensively cover the impact of cancer in Hispanics in comparison to that in other ethnic groups. We also discuss the status of caregivers with cancer patients and urgent needs from the state and federal support for caregivers.
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Affiliation(s)
- Jasbir Bisht
- Department of Pediatrics, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - Priyanka Rawat
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - Ujala Sehar
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - P. Hemachandra Reddy
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
- Department of Speech, Language and Hearing Sciences, School Health Professions, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
- Department of Public Health, School of Population and Public Health, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
- Neurology, Departments of School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
- Nutritional Sciences Department, College of Human Sciences, Texas Tech University, Lubbock, TX 79409, USA
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Cham CQ, Ibrahim N, Siau CS, Kalaman CR, Ho MC, Yahya AN, Visvalingam U, Roslan S, Abd Rahman FN, Lee KW. Caregiver Burden among Caregivers of Patients with Mental Illness: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2022; 10:healthcare10122423. [PMID: 36553947 PMCID: PMC9777672 DOI: 10.3390/healthcare10122423] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/24/2022] [Accepted: 11/25/2022] [Indexed: 12/05/2022] Open
Abstract
Due to the increasing importance of caregivers in the treatment outcomes of patients with mental illness, this study aimed to systematically review studies investigating the former's caregiver burden and determine its prevalence. An open search, without filters, was conducted. Articles were selected from Medline, Scopus, and PubMed from inception to 30 April 2022 using the PRISMA protocol. Subgroup analyses examined the between-group differences by study setting, measurements used, and disorder type. A total of 5034 caregivers from 23 countries were included in this review. Thirty-nine studies were included in the systematic review, and, among them, twenty-six were deemed eligible for meta-analysis. The overall pooled prevalence of caregiver burden among caregivers of individuals with mental illness was 31.67% (95% CI = 26.22-37.12). Pooled prevalence was the highest among care recipients receiving treatment in a hospital setting (36.06%; 95% CI = 22.50-49.63), followed by the community and clinic settings. Caregiver prevalence values were higher for burden measured using the Zarit Burden Interview (38.05%; 95% CI = 27.68-48.43). compared with other instruments, and for carers of care recipients with psychosis (35.88%; 95% CI = 27.03-44.72) compared with those without. Thus, targeted interventions should focus on caregivers of patients in hospital settings and with psychotic symptoms.
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Affiliation(s)
- Choy Qing Cham
- Center for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia; (C.Q.C.); (C.R.K.)
| | - Norhayati Ibrahim
- Center for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia; (C.Q.C.); (C.R.K.)
- Institute of Islam Hadhari, Universiti Kebangsaan Malaysia, Bangi 43600, Malaysia
- Correspondence:
| | - Ching Sin Siau
- Center for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia;
| | - Clarisse Roswini Kalaman
- Center for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia; (C.Q.C.); (C.R.K.)
| | - Meng Chuan Ho
- Centre for Pre-U Studies, UCSI University (Springhill Campus), Port Dickson 71010, Malaysia;
| | - Amira Najiha Yahya
- Department of Educational Psychology & Counselling, Faculty of Education, Universiti Malaya, Kuala Lumpur 50603, Malaysia;
| | - Uma Visvalingam
- Department of Psychiatry, Hospital Putrajaya, Putrajaya 62250, Malaysia;
| | - Samsilah Roslan
- Department of Foundation of Education, Faculty of Educational Studies, Universiti Putra Malaysia, Serdang 43400, Malaysia;
| | - Fairuz Nazri Abd Rahman
- Psychiatry Department, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia;
| | - Kai Wei Lee
- Department of Medical Microbiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor 43400, Malaysia;
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Schuit AS, Rienks MM, Hooghiemstra N, Jansen F, Lissenberg-Witte BI, Cuijpers P, Leeuw IMVD, Holtmaat K. Reach and efficacy of the eHealth application Oncokompas, facilitating partners of incurably ill cancer patients to self-manage their caregiver needs: a randomized controlled trial. Support Care Cancer 2022; 30:10191-10201. [PMID: 36367563 PMCID: PMC9650170 DOI: 10.1007/s00520-022-07441-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 10/30/2022] [Indexed: 11/13/2022]
Abstract
Abstract
Purpose
Many partners of incurably ill cancer patients experience caregiver burden. The eHealth application “Oncokompas” supports these partners to manage their caregiver needs and to find optimal supportive care for themselves. The aim of this randomized controlled trial (RCT) was to investigate the reach of Oncokompas and its efficacy on caregiver burden, self-efficacy, and health-related quality of life (HRQOL).
Methods
The reach was estimated based on eligibility, participation rate, and an evaluation of the recruitment process. Efficacy on caregiver burden was measured using the Caregiver Strain Index + (CSI +). Secondary outcomes were self-efficacy (General Self-Efficacy Scale (GSE)) and HRQOL (EQ-5D VAS). Assessments were scheduled at baseline, 2 weeks after randomization and 3 months after baseline. Linear mixed models were used to compare longitudinal changes between the experimental and control group from baseline to the 3-month follow-up.
Results
The reach, in terms of eligibility and participation rate, was estimated at 83–91%. Partners were most likely reached via palliative care consultants, patient organizations, and palliative care networks. In the one-and-a-half-year recruitment period and via the 101 organizations involved, 58 partners were included. There were no significant effects of Oncokompas on caregiver burden, self-efficacy, or HRQOL.
Conclusion
The reach of Oncokompas among interested individuals was high, but the difficulties that were encountered to include partners suggest that the reach in real life may be lower. This study showed no effect of Oncokompas on caregiver burden, self-efficacy, or HRQOL in partners of incurably ill cancer patients.
Relevance
The results of this study may be used in the process of developing, efficacy testing, and implementing eHealth applications for caregivers of incurably ill cancer patients.
Trial registration
Netherlands Trial Register identifier: NTR7636/NL7411. Registered on November 23, 2018 (https://www.trialregister.nl/).
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The Impact of Depression on Quality of Life in Caregivers of Cancer Patients: A Moderated Mediation Model of Spousal Relationship and Caring Burden. Curr Oncol 2022; 29:8093-8102. [PMID: 36354699 PMCID: PMC9688944 DOI: 10.3390/curroncol29110639] [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: 08/12/2022] [Revised: 09/14/2022] [Accepted: 10/25/2022] [Indexed: 11/06/2022] Open
Abstract
Family caregivers play an important role in managing and supporting cancer patients. Although depression in family caregivers is known to negatively affect caregiver health, the mechanism by which it affects caregivers is not clear. The purpose of this study was to explore the influence of depression on quality of life (QoL) in family caregivers of patients with cancer. Specifically, this study examined (1) whether caring burden mediates the relationship between depression and QoL, and (2) how this mediating effect varies depending on the caregiver's relationship with the patient. This study performed a secondary analysis on cross-sectional survey data. Ninety-three family caregivers of cancer patients were included in the study. Moderated mediation analyses were conducted using PROCESS macro with the regression bootstrapping method. The moderated mediation models and the indirect effect of caregiver depression on QoL through caring burden were significantly different depending on caregivers' relationships with patients (i.e., spousal or non-spousal). Specifically, the indirect effect of caregiver depression on QoL was greater for the patient's spouse than for other family caregivers. Healthcare providers should focus on identifying caregivers' depression and relationship with the patient and offer tailored support and intervention to mitigate the caring burden and improve the caregivers' QoL.
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Mirhosseini S, Heshmati Nabavi F, Behnam Vashani H, Vaghee S. Evaluating the effect of online psychoeducational support group on perceived stress in family caregivers of COVID-19 survivors. OMEGA-JOURNAL OF DEATH AND DYING 2022:302228221126219. [PMID: 36069743 DOI: 10.1177/00302228221126219] [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: 11/16/2022]
Abstract
INTRODUCTION This study aimed to determine the effect of an online psychoeducational support group on the perceived stress of caregivers of coronavirus disease 2019 (COVID-19) survivors. METHODS This randomized clinical trial included 70 caregivers of COVID-19 survivors discharged from Imam Reza Hospital in Mashhad, Iran in 2021. The intervention group received a psychoeducational support training program for stress management through six online group sessions (each 35-45 minutes) in a week. An expert psychiatric nurse provided this program on WhatsApp immediately after the patient's discharge from the hospital. The participants completed the Perceived Stress Scale (PSS-14) before starting the intervention and 1 week after that. Data analysis was conducted by descriptive and inferential statistics, including Chi-square, Fisher's exact test, independent, and paired t-test. RESULTS Both groups were homogeneous in terms of demographic variables of survivors and caregivers. In terms of the PSS, there was no significant difference between the two groups before the intervention (p=0.28). The pre- and post-intervention scores of PSS in the intervention group were 39.57 ± 5.89 and 35.48 ± 5.68, respectively, indicating a significant decrease (p<0.001). Also, the pre- and post-intervention differences between the intervention and control groups were -4.08 ± 3.52 and -0.11 ± 2.66, respectively, indicating a greater decrease in the total PSS of the intervention group (p < 0.001). CONCLUSION The family caregivers of COVID-19 survivors suffered from psychological distress during their patient care. It is recommended to perform online psychoeducational support group interventions for these individuals based on psychological and educational support program.
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Affiliation(s)
| | - Fatemeh Heshmati Nabavi
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamidreza Behnam Vashani
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Saeed Vaghee
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Goria S, Girgis A, Shaw J, Przezdziecki A, Levesque J, Bamgboje‐Ayodele A. A Delphi‐based approach to developing the contents of an online resource, Care Assist, for male caregivers of women with breast cancer. Psychooncology 2022; 31:1474-1482. [PMID: 35575006 PMCID: PMC9543824 DOI: 10.1002/pon.5962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/19/2022] [Accepted: 05/05/2022] [Indexed: 11/30/2022]
Abstract
Objective Informal male caregivers of women with breast cancer (BC) have significant psychological, emotional, and social burdens that are inadequately addressed by current face‐to‐face interventions. Online interventions overcome barriers that limit engagement with face‐to‐face interventions. This study aimed to develop the contents of Care Assist, an online supportive care resource for male caregivers of BC patients, through expert consensus. Methods A Delphi study comprising two survey rounds and an expert consultation was conducted. In Round 1, experts in BC care rated the importance of 25 content items. In Round 2, they re‐rated content items that failed to reach consensus (i.e. 80% agreement) in Round 1 or were newly developed. Free‐text responses were also collected. During expert consultation, the resource was reviewed and revised for clarity. Iterative refinement followed all rounds. Quantitative data was analysed descriptively, and qualitative data was analysed using content analysis. Results Twenty‐two experts participated and reached consensus on 96% of items, with 217 comments provided on: (a) the perceived benefits of Care Assist to caregivers and care recipients, (b) recommendations of newly suggested content items, wording, and use of external links, and (c) concerns regarding information overload and need for tailoring. The expert consultation comments focused on clarifying scope, wording, and information tailoring. Conclusion The rigorous Delphi process resulted in the content for a comprehensive online supportive care intervention for male caregivers. Information overload can be minimised through self‐identification of needs and utilisation of eHealth to personalise the resource for the heterogeneous male caregiver population.
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Affiliation(s)
- Sandra Goria
- Ingham Institute for Applied Medical Research Sydney Australia
- South Western Sydney Clinical School Faculty of Medicine and Health University of New South Wales Liverpool Australia
| | - Afaf Girgis
- Ingham Institute for Applied Medical Research Sydney Australia
- South Western Sydney Clinical School Faculty of Medicine and Health University of New South Wales Liverpool Australia
| | - Joanne Shaw
- Psycho‐oncology Co‐operative Research Group (PoCoG) University of Sydney Sydney Australia
| | - Astrid Przezdziecki
- South Western Sydney Clinical School Faculty of Medicine and Health University of New South Wales Liverpool Australia
- Liverpool Hospital South Western Sydney Local Health District Liverpool Australia
| | - Janelle Levesque
- School of Psychological Sciences Faculty of Medicine Nursing and Health Sciences Monash University Melbourne Australia
| | - Adeola Bamgboje‐Ayodele
- Ingham Institute for Applied Medical Research Sydney Australia
- South Western Sydney Clinical School Faculty of Medicine and Health University of New South Wales Liverpool Australia
- School of Medical Sciences Biomedical Informatics and Digital Health Faculty of Medicine and Health University of Sydney Sydney Australia
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Dosil-Santamaria M, Ozamiz-Etxebarria N, Idoiaga Mondragon N, Reyes-Sosa H, Santabárbara J. Emotional State of Mexican University Students in the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:2155. [PMID: 35206340 PMCID: PMC8871678 DOI: 10.3390/ijerph19042155] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/10/2022] [Accepted: 02/11/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND Since the WHO declared the COVID-19 crisis a pandemic in March 2020, the young population is suffering from a range of psychological symptoms. The present study measured symptoms of stress, anxiety and depression in university students of Saltillo, Mexico, using the Depression and Anxiety Stress Scale-21 (DASS-21). METHODS The DASS-21 scale and an ad hoc questionnaire were used to collect sociodemographic information. RESULTS The results show that the students who participated in this study suffer from high levels of stress, anxiety and depression. In terms of sociodemographic variables, women, people suffering from a chronic disease and people living with a chronic disease had the highest levels of stress, anxiety and depression, and people who live with a chronically ill person, people who have had the COVID-19 disease and those who have had someone close to them fall sick have had more stress, anxiety and depression than the rest. Another finding of the present study is that university students who believe that others comply with COVID-19 safety measures have significantly lower anxiety and depression than those who believe that others do not comply. CONCLUSIONS It is concluded that university students are a psychologically vulnerable group in the face of the pandemic.
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Affiliation(s)
- Maria Dosil-Santamaria
- Department of Research and Diagnostic Methods in Education, University of the Basque Country UPV/EHU, 48940 Leioa, Spain;
| | - Naiara Ozamiz-Etxebarria
- Department of Psychosocial Processes and Health, University of the Basque Country UPV/EHU, 48940 Leioa, Spain;
| | - Nahia Idoiaga Mondragon
- Department of Developmental and Educational Psychology, University of the Basque Country UPV/EHU, 48940 Leioa, Spain
| | - Hiram Reyes-Sosa
- Department of Social Psychology, Universidad Autónoma de Coahuila, Saltillo 25280, Mexico;
| | - Javier Santabárbara
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation, 28029 Madrid, Spain;
- Department of Microbiology, Pediatrics, Radiology and Public Health, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain
- Aragonese Institute of Health Sciences (IIS Aragón), 50009 Zaragoza, Spain
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