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Nguyen HT, Nguyen PTN, Lin CK, Do PM. Association between quality of life and burden of cancer caregivers: An example in a low and middle income country. Eur J Oncol Nurs 2024; 70:102596. [PMID: 38805952 DOI: 10.1016/j.ejon.2024.102596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 03/14/2024] [Accepted: 04/20/2024] [Indexed: 05/30/2024]
Abstract
OBJECTIVE Limited knowledge on burden and quality of life (QoL) among cancer caregivers is available in low and middle income countries. This study aims to investigate the QoL, levels of burden, and their associations among Vietnamese cancer caregivers. METHODS This study was conducted across three hospitals in Vietnam. 348 caregivers were recruited from January to June 2021. Data were collected by using socio-demographic questionnaires, the Zarit Burden Interview scale, and Caregiver Qol Cancer. The association between QoL and burden was analyzed by using multivariate linear regression. RESULTS Older age (p = 0.03), employed (p = 0.01), and care more than 40 h (p = 0.007) were associated with a higher burden, respectively. QoL of financial concern had the lowest score (mean = 48.03, SD = 28.87), compared to the other subscale. Caregivers who had pre-existing health conditions, unstable work, spent more than 40 h per week, and took care dependent cancer patients were associated with a lower overall QoL score. Comparing to caregivers of no burden, those of mild burden had a lower QoL score by 10.70; while those of mild severe burden had the worse QoL (lower by 23.80 scores). CONCLUSIONS Perceptional burden among caregivers is associated with QoL. Further policies are recommended to protect cancer caregivers, to alleviate the caregiving burden, and thus to improve the overall QoL.
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Affiliation(s)
- Hien Thi Nguyen
- Nursing Department, University of Medicine and Pharmacy at Ho Chi Minh City, Viet Nam; School of Nursing, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.
| | | | - Cheng-Kuan Lin
- National Yang Ming Chiao Tung University, International Health Program, College of Medicine, Taiwan; National Yang Ming Chiao Tung University, Institute of Public Health, Taiwan.
| | - Phuong Minh Do
- Nursing Department, University of Medicine and Pharmacy at Ho Chi Minh City, Viet Nam.
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Nielsen IH, Tolver A, Piil K, Kjeldsen L, Grønbæk K, Jarden M. Family caregiver quality of life and symptom burden in patients with hematological cancer: A Danish nationwide cross-sectional study. Eur J Oncol Nurs 2024; 69:102538. [PMID: 38457934 DOI: 10.1016/j.ejon.2024.102538] [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: 06/26/2023] [Revised: 02/05/2024] [Accepted: 02/16/2024] [Indexed: 03/10/2024]
Abstract
OBJECTIVE To investigate the quality of life (QoL) and the impact of caregiving in family caregivers of hematological cancer patients and its association with patient symptom burden. METHODS A cross-sectional study including Danish patients (n = 375) and caregivers (n = 140). Caregivers completed scales for anxiety and depression using the Hospital Anxiety and Depression Scale, sleep quality using the Pittsburgh Sleep Quality Index, health related QoL using the 12-item Short-Form Health Survey, and caregiver roles using the Caregiver Roles and Responsibilities Scale. Patients reported symptoms using the MD Anderson Symptom Inventory. Analysis of covariance was used to examine associations between patient symptom burden and caregivers' QoL outcomes. RESULTS The results show that caregivers experience sleep difficulties, moderate anxiety, and reduced QoL. Patient symptom burden was significantly associated with caregiver anxiety (p = 0.009), and mental well-being (p = 0.002), while patient treatment status was a significant factor associated with caregiver anxiety (p = 0.016), depression (p = 0.009), emotional well-being (p = 0.002), and sleep (p = 0.01). CONCLUSION Caregivers of patients with hematological cancers undergoing active treatment face a high symptom burden, which significantly impacts their QoL, including sleep, psychological well-being, and emotional health. Patients reported a high symptom burden, and patient symptom burden was significantly associated with caregiver QoL. Adequate patient and caregiver support is needed to promote their well-being and mitigate adverse health effects in caregivers, and this should be acknowledged in the context of caring for patients with hematological cancer.
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Affiliation(s)
- Iben Husted Nielsen
- Department of Haematology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.
| | - Anders Tolver
- Department of Mathematical Sciences, Data Science Laboratory, University of Copenhagen, Universitetsparken 5, 2200, Copenhagen, Denmark
| | - Karin Piil
- Department of Oncology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark; Department of Public Health, Aarhus University, Bartholins Allé 2, 8000, Aarhus C, Denmark
| | - Lars Kjeldsen
- Department of Haematology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Kirsten Grønbæk
- Department of Haematology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark; Biotech Research & Innovation Centre (BRIC), University of Copenhagen, Ole Maaløes Vej 5, 2200, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
| | - Mary Jarden
- Department of Haematology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
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Zhang Y, Li J, Zhang Y, Chen C, Guan C, Zhou L, Zhang S, Chen X, Hu X. Mediating effect of social support between caregiver burden and quality of life among family caregivers of cancer patients in palliative care units. Eur J Oncol Nurs 2024; 68:102509. [PMID: 38310666 DOI: 10.1016/j.ejon.2024.102509] [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: 04/13/2023] [Revised: 11/29/2023] [Accepted: 01/09/2024] [Indexed: 02/06/2024]
Abstract
PURPOSE To identify factors influencing the quality of life of family caregivers with terminal cancer in Chinese palliative wards and to test whether social support mediates the relationship between caregiver burden and caregiver quality of life. METHODS A cross-sectional study design was used. Sociodemographic data were collected and the Quality of Life Scale, the Caregiver Burden Scale, and the Social Support Rating Scale were administered to Chinese family caregivers from December 2021 to December 2022. The factors influencing quality of life and caregiver burden were examined using the Mann‒Whitney U test and the Kruskal‒Wallis H test. The mediating role of social support was assessed using the bootstrap method. RESULTS Family caregivers' quality of life in Chinese terminal cancer palliative units was related to caregivers' daily care time, the caregiver-patient relationship, and patient age. Caregiver quality of life was negatively associated with caregiver burden and positively associated with social support. In addition, social support mediated the relationship between caregiver burden and caregiver quality of life. CONCLUSION Social support mediated the impact of caregiver burden on caregiver quality of life. Family, society, and palliative care institutions should be integrated to take actions to reduce family caregiver burden, increase social support, and transfer the positive aspects of specific cultural contexts to the culture of palliative care in general to collaboratively cope with various problems related to end-stage cancer.
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Affiliation(s)
- Yun Zhang
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chendu, Sichuan, PR China
| | - Juejin Li
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chendu, Sichuan, PR China
| | - Yalin Zhang
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chendu, Sichuan, PR China
| | - Chongcheng Chen
- Department of Nephrology, West China Hospital, Sichuan University, Chendu, Sichuan, PR China
| | - Chang Guan
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chendu, Sichuan, PR China
| | - Lin Zhou
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chendu, Sichuan, PR China
| | - Shu Zhang
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chendu, Sichuan, PR China
| | - Xiaoli Chen
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chendu, Sichuan, PR China
| | - Xiaolin Hu
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chendu, Sichuan, PR China; Tianfu Jincheng Laboratory, City of Future Medicine, Chengdu, Sichuan, PR China.
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Yang CF, Tseng CN, Liao YJ, Gao ZX, Chen HP, Chang PC, Lee YH. Experiences of Family Caregivers Providing Home Care to Older Patients With Cancer: A Qualitative Study. J Nurs Res 2023; 31:e300. [PMID: 38015117 DOI: 10.1097/jnr.0000000000000579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Older patients with cancer receive anticancer therapy in outpatient settings, and care-related issues may occur after discharge, which often requires family caregivers (FCs) to play a significant role in providing cancer care at home. However, relatively few studies have been focused on exploring the care experiences of these FCs. PURPOSE The aim of this study was to explore the care experiences of FCs caring for older family members with cancer at home. METHODS A qualitative study design and in-depth individual interviews were used to explore the at-home care experiences of FCs of older patients with cancer. The research was conducted in chemotherapy outpatient settings of a medical center in northern Taiwan. Content analysis was used to analyze data. The analyses focused on first extracting meaningful units from the text and then inducting categories from these units and determining the major themes. RESULTS Twenty FCs were interviewed. The three themes identified included (a) increased information needs and challenges in diet preparation and treatment decision making, (b) personal and patient-induced emotional stress, and (c) life rebalancing through the care experience. CONCLUSIONS/IMPLICATIONS FOR PRACTICE The findings highlight the educational requirements, especially related to meeting personal dietary needs and obtaining psychological support, for FCs caring for older patients with cancer to help them rebalance their life.
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Affiliation(s)
- Cheng-Fang Yang
- PhD, RN, Assistant Professor, Second Degree Bachelor of Science, College of Medicine, National Taiwan University, Taipei, Taiwan; and Adjunct Supervisor, Department of Nursing, National Taiwan University Hospital, Yunlin Branch, Yunlin, Taiwan
| | - Chien-Ning Tseng
- PhD, RN, Assistant Professor, Department of Nursing, Asia Eastern University of Science and Technology, New Taipei, Taiwan
| | - Yuan-Ju Liao
- RN, Doctoral Candidate, Department of Nursing, National Yang Ming Chiao Tung University, Taiwan
| | - Zi-Xuan Gao
- MSN, RN, Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan
| | - Hsiao-Ping Chen
- MSN, RN, Head Nurse, Department of Nursing, College of Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Po-Chih Chang
- BSN, RN, Department of Nursing, College of Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Yun-Hsiang Lee
- PhD, RN, Assistant Professor, School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan; and Adjunct Head Nurse, Department of Nursing, College of Medicine, National Taiwan University Hospital, Taipei, Taiwan
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Shi Y, Dai J, Kuai B, Su X, Yang R, Gong S, Guo Y. Impact of fear of recurrence in patients with cancer on caregivers' psychological health: A meta-analysis. Asia Pac J Oncol Nurs 2023; 10:100299. [PMID: 37780398 PMCID: PMC10534230 DOI: 10.1016/j.apjon.2023.100299] [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: 06/05/2023] [Accepted: 08/21/2023] [Indexed: 10/03/2023] Open
Abstract
Objective This study aims to quantitatively investigate the relationship between fear of cancer recurrence in patients with cancer and their caregivers' psychological health, examining the extent of the impact of this fear on caregivers. Methods We conducted a comprehensive search in PubMed, EMBASE, Cochrane Library, Web of Science, CINAHL, and PsycINFO databases from inception until May 2023 for relevant English publications. Pearson correlation coefficients (r) were utilized as effect sizes to assess the overall relationship between fear of recurrence and psychological outcomes among caregivers of patients with cancer. Results A total of 19 eligible studies were included in the analysis. The findings revealed a moderate positive correlation between fear of recurrence in patients with cancer and caregivers' fear of recurrence and depression. A relatively weaker correlation was observed between patients' fear of recurrence and caregivers' anxiety. Due to considerable heterogeneity (I2 = 91.99%, Q = 212.23), the primary outcome of fear of recurrence in patients with cancer influencing caregivers' fear of recurrence was examined through subgroup analyses. Conclusions Our meta-analysis established a significant positive correlation between fear of recurrence in patients with cancer and negative psychological consequences among caregivers, including recurrence fear, depression, and anxiety. Future research should explore the evolution of adverse psychological outcomes in both patients with cancer and their caregivers over time and delve into the bivariate psychological impact within the patient-caregiver dyads. Systematic review registration PROSPERO, CRD42022383866.
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Affiliation(s)
- Yue Shi
- School of Medicine (School of Nursing), Nantong University, Nantong, China
| | - Jingjing Dai
- Department of Oral Surgery, Affiliated Hospital of Nantong University, Nantong, China
| | - Benxin Kuai
- School of Medicine (School of Nursing), Nantong University, Nantong, China
| | - Xiaoqin Su
- School of Medicine (School of Nursing), Nantong University, Nantong, China
| | - Runze Yang
- School of Medicine (School of Nursing), Nantong University, Nantong, China
| | - Shujin Gong
- School of Medicine (School of Nursing), Nantong University, Nantong, China
| | - Yujie Guo
- School of Medicine (School of Nursing), Nantong University, Nantong, China
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Ahmad AS, Doss JG, Ismail SM, Chen Kiong S, Jelon MA, Thangavalu L, Lay Ling C. Quality of Life vs. Supportive Care Needs for Oral Cancer Caregivers: Are They Related? Curr Oncol 2023; 30:1733-1744. [PMID: 36826095 PMCID: PMC9954937 DOI: 10.3390/curroncol30020134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/24/2023] [Accepted: 01/28/2023] [Indexed: 02/04/2023] Open
Abstract
Caregivers providing care for their family members with oral cancer usually endure the caregiving burden in silence, which affects their quality of life and necessitates the need for supportive care. The aim of this study is to determine the relationship between the quality of life (QOL) of oral cancer caregivers and their supportive care needs (SCN) in Malaysia. The Malaysian versions of the Caregiver Oncology Quality of Life Questionnaire (M-CarGOQoL) and the Comprehensive Needs Assessment Tool for Cancer Caregivers (M-CNAT-C) were self-administered by 56 family caregivers of oral cancer patients from five tertiary hospitals throughout Peninsular Malaysia and Sarawak between October and December 2021. Correlation and multiple regression analyses were employed, and the significance level was set at p < 0.05. The mean score for the QOL of caregivers was 76.16 ± 16.01, with the lowest scores in the psychological well-being (64.87 ± 30.12) and self-esteem (68.64 ± 28.29) domains. The mean score for SCN of caregivers was 36.42 ± 24.16, with the highest scores in the healthcare staff (58.44 ± 33.80) and information (55.35 ± 29.98) domains. The correlation between QOL and SCN was moderately inversed, (r(54) = 0.58, p < 0.01). There was a significant effect of caregiving duration (<3 h/day versus >3 h/day) on the combined dependent variables (QOL and SCN), F(2, 53) = 5.006, p < 0.01, partial η2 = 0.16. QOL and caregiving duration accounted for a significant 43% of SCN, R2 = 0.43, adjusted R2 = 0.41, F(2, 53) = 20.32, p < 0.01. In conclusion, oral cancer caregivers with poorer QOL have higher SCN. It is recommended that oral cancer caregivers be recognized by healthcare providers in order to deliver holistic patient care.
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Affiliation(s)
- Aira Syazleen Ahmad
- Oral Health Program, Ministry of Health, Federal Government Administrative Centre, Putrajaya 62590, Malaysia
- Department of Community Oral Health and Clinical Prevention, Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Jennifer Geraldine Doss
- Department of Community Oral Health and Clinical Prevention, Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia
- Oral Cancer Research & Coordinating Centre, University of Malaya, Kuala Lumpur 50603, Malaysia
- Correspondence: ; Tel.: +603-7967-4805
| | - Siti Mazlipah Ismail
- Department of Oral & Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Shim Chen Kiong
- Department of Oral and Maxillofacial Surgery, Sarawak General Hospital, Kuching 93586, Malaysia
| | - Md Arad Jelon
- Department of Oral and Maxillofacial Surgery, Kuala Lumpur Hospital, Kuala Lumpur 50586, Malaysia
| | - Logesvari Thangavalu
- Department of Oral and Maxillofacial Surgery, National Cancer Institute, Putrajaya 62250, Malaysia
| | - Ch’ng Lay Ling
- Department of Oral and Maxillofacial Surgery, Seberang Jaya Hospital, Perai 13700, Malaysia
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Jibb LA, Nanos SM, Alexander S, Malfitano C, Rydall A, Gupta S, Schimmer AD, Zimmermann C, Hales S, Nissim R, Marmar C, Schultebraucks K, Mah K, Rodin G. Traumatic stress symptoms in family caregivers of patients with acute leukaemia: protocol for a multisite mixed methods, longitudinal, observational study. BMJ Open 2022; 12:e065422. [PMID: 36332954 PMCID: PMC9639100 DOI: 10.1136/bmjopen-2022-065422] [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] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION The diagnosis, progression or recurrence of cancer is often highly traumatic for family caregivers (FCs), but systematic assessments of distress and approaches for its prevention and treatment are lacking. Acute leukaemia (AL) is a life-threatening cancer of the blood, which most often presents acutely, requires intensive treatment and is associated with severe physical symptoms. Consequently, traumatic stress may be common in the FCs of patients with AL. We aim to determine the prevalence, severity, longitudinal course and predictors of traumatic stress symptoms in FCs of patients with AL in the first year after diagnosis, and to understand their lived experience of traumatic stress and perceived support needs. METHODS AND ANALYSIS This two-site longitudinal, observational, mixed methods study will recruit 223 adult FCs of paediatric or adult patients newly diagnosed with AL from two tertiary care centres. Quantitative data will be collected from self-report questionnaires at enrolment, and 1, 3, 6, 9 and 12 months after admission to hospital for initial treatment. Quantitative data will be analysed using descriptive and machine learning approaches and a multilevel modelling (MLM) approach will be used to confirm machine learning findings. Semi-structured qualitative interviews will be conducted at 3, 6 and 12 months and analysed using a grounded theory approach. ETHICS AND DISSEMINATION This study is funded by the Canadian Institutes of Health Research (CIHR number PJT 173255) and has received ethical approval from the Ontario Cancer Research Ethics Board (CTO Project ID: 2104). The data generated have the potential to inform the development of targeted psychosocial interventions for traumatic stress, which is a public health priority for high-risk populations such as FCs of patients with haematological malignancies. An integrated and end-of-study knowledge translation strategy that involves FCs and other stakeholders will be used to interpret and disseminate study results.
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Affiliation(s)
- Lindsay A Jibb
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Stephanie M Nanos
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Sarah Alexander
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Carmine Malfitano
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Anne Rydall
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Sumit Gupta
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Aaron D Schimmer
- Department of Medical Oncology/Hematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Camilla Zimmermann
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Sarah Hales
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Rinat Nissim
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Charles Marmar
- Department of Psychiatry, New York University, New York, New York, USA
| | - Katharina Schultebraucks
- Department of Emergency Medicine, Columbia University Irving Medical Center, New York, New York, USA
- Department of Psychiatry, Columbia University, New York, New York, USA
| | - Kenneth Mah
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Gary Rodin
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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Gan GG, Tey KWF, Mat S, Saad M, Bee PC, Malik RA, Ho GF, Ng CG. Quality of Life of Family Caregivers of Cancer Patients in a Developing Nation. Asian Pac J Cancer Prev 2022; 23:3905-3914. [PMID: 36444604 PMCID: PMC9930968 DOI: 10.31557/apjcp.2022.23.11.3905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Quality of life (QOL) of family caregivers of cancer patients is usually affected due to increase in caregiver burden. Their QOL has not garnered much attention by many including the health professionals and community. This study aims to explore the QOL of family caregivers of cancer patients in a multi-ethnic country in Asia and to investigate its associate factors. METHODS This is a cross-sectional study where family caregivers and patients who were diagnosed of cancers within 12 months were recruited. QOL of caregivers were measured using The Caregiver Quality of Life Index-Cancer (CQOLC). Psychological distress was measured using Hospital anxiety and depressive scale. Logistic regression analysis was performed to determine the related factors of QOL of caregivers. RESULTS A total of 458 patients/caregiver pairs were included. Symptoms of anxiety and depression reported by caregivers were 24.9% and 24.2% respectively. Caregivers of patients with solid tumors have better CQOLC score compared to those who cared for patients with hematological cancers (91.25 vs 86.75). Caregivers of non-Malay ethnicity, those caring for patients with advanced stage cancer and with hematological cancers had significantly poorer QOL. QOL of caregivers are also significantly affected when patients demonstrated anxiety symptoms. CONCLUSION This study provides detailed evaluation of the QOL of caregivers of cancer patients in Malaysia. The significant psychological distress and low caregiver QOL indicate the urgent need for comprehensive supports for caregivers with cancer patients, especially those caring for patients with haematological cancers.
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Affiliation(s)
- Gin Gin Gan
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. ,For Correspondence:
| | - Kevin Wen Fei Tey
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Sumaiyah Mat
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Marniza Saad
- Department of Oncology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Ping Chong Bee
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Rozita Abd Malik
- Department of Oncology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Gwo Fuang Ho
- Department of Oncology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Chong Guan Ng
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
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Wang K, Gao X, Sun F, De Fries CM, Levkoff SE. Evaluation of the Reliability and Validity of the Alzheimer's Disease-Related Quality of Life Instrument among Older Adults with Cognitive Impairment in Mainland China. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2022; 65:649-663. [PMID: 34889717 DOI: 10.1080/01634372.2021.2010856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 11/17/2021] [Accepted: 11/22/2021] [Indexed: 06/13/2023]
Abstract
The purpose of this study is to examine the reliability and validity of the ADRQL instrument among older adults with cognitive impairment in mainland China. Three hundred older adults with cognitive impairment and their primary family caregivers from Wuhan participated in structured interviews. Cronbach's α and Kuder-Richardson Formula 20 were used to examine internal consistency reliability. Confirmatory factor analysis, Heterotrait-Monotrait ratios, and ordinary least square regression were used to assess the factorial validity, discriminant validity, and criterion validity. The ADRQL had acceptable reliability and validity, which can be used to assess overall quality of life for this population.
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Affiliation(s)
- Kaipeng Wang
- Graduate School of Social Work, University of Denver, Denver, Colorado, USA
| | - Xiang Gao
- School of Sociology, Huazhong University of Science and Technology, Wuhan, China
| | - Fei Sun
- School of Social Work, Michigan State University, East Lansing, Michigan, USA
| | - Carson M De Fries
- Graduate School of Social Work, University of Denver, Denver, Colorado, USA
| | - Sue E Levkoff
- College of Social Social Work, University of South Carolina, Columbia, South Carolina, USA
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Bilgin A, Ozdemir L, Oksuzoglu OB. Examination of family caregivers of advanced cancer patients within the scope of the cancer family caregiving experience model: An embedded mixed-methods design. Eur J Cancer Care (Engl) 2022; 31:e13659. [PMID: 35843621 DOI: 10.1111/ecc.13659] [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: 12/29/2021] [Revised: 06/21/2022] [Accepted: 07/05/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This study aimed to examine the stressors and contextual factors that affect the quality of life (QoL) of caregivers of advanced cancer patients and to address their caregiving experiences. METHODS The study had an embedded mixed-methods design and was conducted in the medical oncology unit of a training and research hospital in Turkey. In the quantitative phase, 125 patients with advanced cancer and their family caregivers were included. In the qualitative phase, 21 family caregivers were included. The analysis of quantitative data was carried out using SPSS 25.0 statistical program, and qualitative data were carried out using Collaizi's seven-step descriptive analysis approach. QoL was determined as the dependent variable and evaluated with Caregiver QoL Index-Cancer (CQOLC). RESULTS The symptoms, care dependency of patients, and preparedness to the care of caregivers showed a direct impact on the CQOLC. Income level, employment status, and daily caregiving hours demonstrated a direct effect on the CQOLC. Four themes emerged from the interviews: Understanding the dynamics of the caregiving process, losing control of life during the caregiving process, limitation of socio-economic freedom in the caregiving process, and the effort to hold on to life in the caregiving process. CONCLUSION The cancer family caregiving experience model is a useful model for evaluating the QoL of caregivers from a multidimensional perspective. Health care professionals should not forget that the QoL of family caregivers should be evaluated in multiple ways, and education programmes for family members should be structured.
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Affiliation(s)
- Aylin Bilgin
- Faculty of health sciences, Nursing Department, Sakarya University of Applied Sciences, Sakarya, Turkey
| | - Leyla Ozdemir
- Faculty of Nursing, Internal Medicine Nursing Department, Hacettepe University, Ankara, Turkey
| | - Omur Berna Oksuzoglu
- Department of Medical Oncology, Dr Abdurrahman Yurtaslan Oncology Training and Research Hospital, University of Health Science, Ankara, Turkey
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Relationship between spiritual well-being and Health-Related Quality of Life and some related factors in patients with AIDS/HIV. FRONTIERS OF NURSING 2022. [DOI: 10.2478/fon-2022-0007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Objective
The study of effective factors on the quality of life (QoL), as an important criterion, in the outcome of new therapeutic and preventive strategies in human immunodeficiency virus (HIV) has been considered by researchers. To study the relationship between spiritual well-being and Health-Related Quality of Life (HRQoL) and some related factors in patients with Acquired Immunodeficiency Syndrome ([AIDS]/HIV).
Methods
In this cross-sectional study, 224 people were selected as the study population (112 were male and 112 were female) from patients with AIDS/HIV at the Behavioral Counseling Center of Shiraz with available sampling method. The research tool was Palutzian & Ellison well-being scale and QoL Questionnaire (SF-36). Data were analyzed using Pearson correlation test.
Results
There was a significant direct relationship between physical function dimensions (P = 0.003). There was a significant relationship between general well-being, mental well-being, and total spiritual well-being (P < 0.001). There was a statistically significant relationship between the dimensions of QoL and spiritual well-being with some age section of the patients, and their occupation and education (P < 0.001).
Conclusions
Spirituality has an impact on the QoL dimensions. Therefore, HIV positive people's quality of life could be improved by the possibility of the spiritual well-being promotion as a method of adaptation with the disease.
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Cheng Q, Xu B, Ng MS, Duan Y, So WK. Effectiveness of psychoeducational interventions among caregivers of patients with cancer: A systematic review and meta-analysis. Int J Nurs Stud 2021; 127:104162. [DOI: 10.1016/j.ijnurstu.2021.104162] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 10/23/2021] [Accepted: 12/11/2021] [Indexed: 01/23/2023]
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13
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Indicadores e fatores associados à sobrecarga em cuidadores informais de pacientes em radioterapia. ACTA PAUL ENFERM 2021. [DOI: 10.37689/acta-ape/2021ao02924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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14
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Kulkarni SS, Patil C, Anap YS, Tanawade PK, Watve PJ, Pawar AS. Quality of Life of Primary Caregivers Attending a Rural Cancer Centre in Western Maharashtra: A Cross-Sectional Study. Indian J Med Paediatr Oncol 2021. [DOI: 10.1055/s-0041-1735664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Abstract
Introduction Caregiver plays a vital role in taking good care of a cancer patient. But often, the caregiver’s quality of life (QOL) is overlooked.
Objectives This study aimed to understand the Caregiver QOL Index—Cancer (CQOL-C) score of the primary caregivers and to find the significant predictors affecting CQOL-C.
Materials and Methods A cross-sectional study was conducted among the caregivers attending a rural cancer center in western Maharashtra. The primary caregiver is an immediate relative who assists the patient in most routine activities and is not a professional caregiver. A pretested and predesigned questionnaire using the CQOL-C scale was used to interview the caregivers from December 2019 to June 2020. We analyzed the data using Statistical Package of Social Sciences (SPSS) software. Univariate analysis was done using Student’s t-test and a multivariate model was generated using linear regression analysis of the data.
Results A total of 114 caregivers were interviewed. The mean total CQOL-C score was 44.15 ± 17.24 (confidence interval [CI]: 41–47.3). About 71% of the caregivers reported moderate-to-severe hampering of their QOL. The mean CQOL-C scores in caregivers of patients with and without recurrent cancer were 58.24 (CI: 51.66–64.81) and 40.58 (CI: 37.35–43.80), respectively (p < 0.001). The mean CQOL-C scores in caregivers of patients with and without metastatic cancer were 56.68 (CI: 51. 13–62.22) and 39.80 (CI: 36.45–43.14), respectively (p < 0.001). The mean CQOL-C score in caregivers of patients with hematological malignancies was 60.03 (CI: 58.88–61.17) which was significantly higher compared with other sites (p = 0.0257).
Conclusion The majority of the caregivers in our study have moderate-to-severe detrimental QOL. Recurrence of cancer and metastatic cancer at presentation are the two significant factors affecting CQOL-C. There is an unmet need to cater to the primary caregiver’s concerns while we focus on treating cancer patients.
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Affiliation(s)
- Shubham S. Kulkarni
- Department of Palliative Care, Kolhapur Cancer Centre, Kolhapur, Maharashtra, India
| | - Chaitanya Patil
- Department of Pain and Palliative Care, Kolhapur Cancer Centre, Kolhapur, Maharashtra, India
| | - Yogesh S. Anap
- Department of Radiation Oncology, Kolhapur Cancer Centre, Kolhapur, Maharashtra, India
| | - Prasad K. Tanawade
- Department of Radiation Oncology, Kolhapur Cancer Centre, Kolhapur, Maharashtra, India
| | - Parag J. Watve
- Department of Head and Neck Surgery, Kolhapur Cancer Centre, Kolhapur, Maharashtra, India
| | - Aditya S. Pawar
- Department of Medical Oncology, Kolhapur Cancer Centre, Kolhapur, Maharashtra, India
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Morishita-Kawahara M, Tsumura A, Aiki S, Sei Y, Iwamoto Y, Matsui H, Kawahara T. Association between Family Caregivers' Satisfaction with Care for Terminal Cancer Patients and Quality of Life of the Bereaved Family: A Prospective Pre- and Postloss Study. J Palliat Med 2021; 25:81-88. [PMID: 34348046 PMCID: PMC8721504 DOI: 10.1089/jpm.2021.0043] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: The quality of life (QOL) of family caregivers often deteriorates after the death of patients with terminal cancer. Although previous retrospective cross-sectional studies of the bereaved family caregivers of cancer patients have suggested that lower satisfaction with care given to terminal cancer patients was related to lower QOL of the bereaved family caregivers, the retrospective cross-sectional study design has limitations. Objectives: To clarify family caregivers' satisfaction with the care of terminal cancer patients and bereaved family caregivers' QOL. Design: A prospective pre- and postloss study. Setting/Subjects: Family caregivers of terminal cancer patients were recruited from three inpatient hospice/palliative care units in Japan. Measurements: Family caregivers completed questionnaires, including the Family Satisfaction with Advanced Cancer Care (FAMCARE) scale before loss and the 36-item Short-Form Health Survey (SF-36) questionnaire before loss and six months after the patient's death. Results: A total of 114 family caregivers were included in each analysis. After the patient's death, bereaved family caregivers' mental component summary score of SF-36 significantly differed between low- and high-satisfaction caregiver groups (n = 47 in both groups, mean difference = 3.50, p = 0.048). The proportion of family caregivers with depressive symptoms (moderate or worse) at preloss was 41% (25/61) in the low-satisfaction group and 22% (11/51) in the high-satisfaction group. Conclusions: Family caregivers' satisfaction with the care provided to terminal cancer patients at the end of their lives was associated with the bereaved family caregivers' QOL six months postloss. Enhancing family caregivers' satisfaction with care has the potential to improve their postloss QOL.
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Affiliation(s)
- Miki Morishita-Kawahara
- Department of Gerontological Nursing, School of Nursing, Tokyo Women's Medical University, Tokyo, Japan.,Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Akemi Tsumura
- Yokohama Children's Hospice Project, Yokohama, Japan
| | - Sayo Aiki
- Department of Palliative Care, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Yoshie Sei
- Department of Nursing, Shizuoka Cancer Center, Shizuoka, Japan
| | - Yumiko Iwamoto
- Department of Nursing, Shizuoka Cancer Center, Shizuoka, Japan
| | | | - Takuya Kawahara
- Clinical Research Promotion Center, The University of Tokyo Hospital, Tokyo, Japan
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Cengiz Z, Turan M, Olmaz D, Erce Ç. Care Burden and Quality of Life in Family Caregivers of Palliative Care Patients. JOURNAL OF SOCIAL WORK IN END-OF-LIFE & PALLIATIVE CARE 2021; 17:50-63. [PMID: 33691608 DOI: 10.1080/15524256.2021.1888844] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
This research was conducted for the purpose of examining the care burden and quality of life in family caregivers of palliative care patients. The research design was a descriptive correlational study conducted with the caregivers of 163 patients residing in palliative care units. Data were collected via a demographic survey, The Zarit Burden Interview (ZBI) and the World Health Organization Quality of Life Assessment (WHOQOL). The results showed that there was a negative correlation between ZBI and WHOQOL scores. Further, there was a significant negative correlation between many subdimensions of the ZBI (general quality of life, general perception of health, being satisfied with daily life skills, home conditions, energy and self-satisfaction) and the WHOQOL. Quality of life thus appeared to be reduced in family members with a high level of care burden and that the quality of life of caregivers depends on the individual characteristics of the caregiver. Social workers, nurses and physicians should regularly assess the burden and quality of life of caregivers.
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Affiliation(s)
- Zeliha Cengiz
- Department of Fundamentals Nursing, Faculty of Nursing, Inonu University, Malatya, Turkey
| | - Mensure Turan
- SBU Gazi Yasargil Education And Research Hospital, Diyarbakır, Turkey
| | - Dilek Olmaz
- General Intensive Care Unit, Tunceli State Hospital, Tunceli, Turkey
| | - Çiğdem Erce
- Palliative Care Unit, Malatya Local Health Authority Malatya Training Research Hospital, Malatya, Turkey
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17
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Palacio Gonzalez C, Roman-Calderón JP, Limonero JT. The relationship between positive aspects of caring, anxiety and depression in the caregivers of cancer patients: The mediational role of burden. Eur J Cancer Care (Engl) 2020; 30:e13346. [PMID: 33037849 DOI: 10.1111/ecc.13346] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 07/13/2020] [Accepted: 08/17/2020] [Indexed: 01/13/2023]
Abstract
OBJECTIVE The aim of this study was to examine how the burden of caregivers of patients with an advanced oncological illness mediates the relationship between positive aspects of care, depression and anxiety. METHODS Quantitative study with a cross-sectional design. One hundred informal adult caregivers of patients with advanced oncological illness who attended the pain and palliative care unit or the psychological unit at the Instituto de Cancerologia Clinica las Americas (Medellin, Colombia) completed self-report assessments including positive aspects of care (PAC), burden and anxiety/depression measured using the HADS (Hospitalized Anxiety Depression Scale). The partial least squares Structural Equation Modelling (PLS-SEM) approach was selected to validate the hypotheses of the study. RESULTS Most of the participants were women (86%), with a mean age of 46.52 years (SD=15.05). Most of the participants reported experiencing both PAC and anxiety. They also scored low for burden. PAC exerted a negative effect on Burden, whereas Burden contributed positively to Anxiety and Depression. The indirect impact of PAC on Anxiety and Depression was significant p < .00. CONCLUSIONS Positive aspects of care in advanced cancer caregivers constitutes a protective factor against caregiver's burden, depression and anxiety. Health staff can promote caregivers' adaptation and wellbeing emphasizing these PAC.
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Affiliation(s)
- Carolina Palacio Gonzalez
- Instituto de Cancerología, Clínica las Americas, Medellín, Colombia.,Research Group on Stress and Health, School of Psychology, Autonomous University of Barcelona, Barcelona, Spain.,Pain and Palliative Care Group, School of Health Sciences, Universidad Pontificia Bolivariana in Medellín, Medellín, Colombia
| | | | - Joaquín T Limonero
- Research Group on Stress and Health, School of Psychology, Autonomous University of Barcelona, Barcelona, Spain
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Esselen K, Sinno A, Varughese J, Wethington S, Prendergast E, Chu C. Social needs in gynecologic oncology: A Society of Gynecologic Oncology (SGO) clinical practice statement. Gynecol Oncol 2020; 158:521-525. [DOI: 10.1016/j.ygyno.2020.06.497] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 06/18/2020] [Indexed: 01/22/2023]
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19
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Ehmann AT, Mahler C, Klafke N. Validation of a German version of the Caregiver Quality of Life Index-Cancer (CQOLC) in a sample of significant others of breast and gynaecologic cancer patients. ACTA ACUST UNITED AC 2020; 33:15. [PMID: 32691260 PMCID: PMC7371772 DOI: 10.1186/s41155-020-00155-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 07/08/2020] [Indexed: 12/22/2022]
Abstract
There is no disease-specific instrument to measure the quality of life of significant others of cancer patients in Germany. In this study, we evaluated the reliability and construct validity of a German version of the Caregiver Quality of Life Index-Cancer (CQOLC) in a sample of 212 caregivers of breast and gynaecologic cancer patients. The CQOLC was administered along with the World Health Organization Quality of Life short version (WHOQOL-BREF) to caregivers of patients taking part in a randomized-controlled intervention study. Data of 212 caregivers were gained at the baseline of the study. Internal consistency was determined by Cronbach’s α. Construct validity was examined by conducting a confirmatory factor analysis (CFA) and hypothesis testing. Correlations between change scores with patients’ global health-related quality of life (HRQoL) were calculated for three time points to evaluate the responsiveness. The three subscales “burden”, “disruptiveness”, and “financial concerns” indicate to a good reliability of the instrument (Cronbach’s α ranged between 0.754 and 0.832), while the subscale “positive adaptation” demonstrated low reliability (α = 0.579). A CFA based on data from the whole set of CQOLC items resulted in CFI levels < .90, and a CFA without problematic items resulted in CFI levels also < .90. The construct validity of the CQOLC could be approved by a moderate to high convergence with close variables as the global HRQoL. Mean differences between caregivers of curatively or palliatively treated patients were nonsignificant (p = 0.959) at T1. Correlations for responsiveness were low with correlation coefficients ranging from 0.030 to 0.326. These data indicate that additional research is needed to further verify the validity of the instrument. The German scale of the CQOLC might be appropriate for clinical and research use, if the wording of some items is refined and if content validity is also assessed by caregivers themselves. The assessment of cancer patients’ caregiver’s quality of life can contribute to a better understanding of the effects of patient-oriented interventions including also closely involved next of kin’s around the cancer patients.
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Affiliation(s)
- Anna Tamara Ehmann
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, 72074, Tübingen, Wilhelmstraße 27, Germany
| | - Cornelia Mahler
- Department of Nursing Science, University Hospital Tübingen, Hoppe-Seyler-Straße 9, 72076, Tübingen, Germany
| | - Nadja Klafke
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany.
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20
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La IS, Johantgen M, Storr CL, Cagle JG, Zhu S, Ross A. Spirituality among family caregivers of cancer patients: The Spiritual Perspective Scale. Res Nurs Health 2020; 43:407-418. [PMID: 32515862 DOI: 10.1002/nur.22044] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 04/09/2020] [Accepted: 05/19/2020] [Indexed: 12/22/2022]
Abstract
Spirituality is a critical resource for family caregivers of patients with cancer. However, studies on spirituality are hampered because measures of spirituality lack consistency and have not been validated in cancer caregivers. This study examined the validity of the Spiritual Perspective Scale (SPS) among cancer caregivers and explored whether measurement bias may influence differences in spirituality across caregiver and patient characteristics. In this secondary analysis, 124 caregivers of cancer patients were used to evaluate the validity of the 10-item SPS. A multiple indicators multiple causes model was applied to explore differences in the association between a latent spirituality factor and characteristics of caregivers and patients. Overall reliability of the SPS was adequate (Cronbach's α = .95). The SPS scores were predictive of higher meaning and purpose (r = .32, p = .004) and lower depression (r = -.22, p = .046) at 3-month follow-up. Construct validity of the SPS with a single-factor structure was supported in cancer caregivers. Adjusting for a direct effect of race did not alter the pattern of results, and caregivers who were older, female, ethnic minorities, less-educated, affiliated with a religion, and who provided care to another individual in addition to the patient had greater levels of spirituality. This study provides evidence for psychometric validation of the SPS in cancer caregivers. Understanding differences in caregivers' spirituality by using the SPS with psychometrically acceptable properties and minimal measurement bias deserves more attention to optimize spirituality assessment and support in cancer caregiving.
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Affiliation(s)
- In Seo La
- University of Maryland School of Nursing, Baltimore, Maryland
| | - Meg Johantgen
- University of Maryland School of Nursing, Baltimore, Maryland
| | - Carla L Storr
- University of Maryland School of Nursing, Baltimore, Maryland
| | - John G Cagle
- University of Maryland School of Social Work, Baltimore, Maryland
| | - Shijun Zhu
- University of Maryland School of Nursing, Baltimore, Maryland
| | - Alyson Ross
- National Institutes of Health Clinical Center, Bethesda, Maryland
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Abstract
Family caregivers provide substantial care for patients with advanced cancer, while suffering from hidden morbidity and unmet needs. The objectives of this review were to examine risk factors associated with caregiving for patients with advanced cancer, evaluate the evidence for pertinent interventions, and provide a practical framework for palliative care of caregivers in oncology settings. We reviewed studies examining the association of factors at the level of the caregiver, patient, caregiver-patient relationship, and caregiving itself, with adverse outcomes. In addition, we reviewed randomized controlled trials of interventions targeting the caregiver, the caregiver-patient dyad, or the patient and their family. Risk factors for adverse mental health outcomes included those related to the patient's declining status, symptom distress, and poor prognostic understanding; risk factors for adverse bereavement outcomes included unfavorable circumstances of the patient's death. Among the 16 randomized trials, the most promising results showed improvement of depression resulting from early palliative care interventions; results for quality of life were generally nonsignificant or showed an effect only on some subscales. Caregiving outcomes included burden, appraisal, and competence, among others, and showed mixed findings. Only three trials measured bereavement outcomes, with mostly nonsignificant results. On the basis of existent literature and our clinical experience, we propose the CARES framework to guide care for caregivers in oncology settings: Considering caregivers as part of the unit of care, Assessing the caregiver's situation and needs, Referring to appropriate services and resources, Educating about practical aspects of caregiving, and Supporting caregivers through bereavement. Additional trials are needed that are powered specifically for caregiver outcomes, use measures validated for advanced cancer caregivers, and test real-world interventions.
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Affiliation(s)
- Sorayya Alam
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,University of Toronto, Toronto, Ontario, Canada
| | - Breffni Hannon
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,University of Toronto, Toronto, Ontario, Canada
| | - Camilla Zimmermann
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,University of Toronto, Toronto, Ontario, Canada
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Factors associated with quality of life of adult patients with acute leukemia and their family caregivers in China: a cross-sectional study. Health Qual Life Outcomes 2020; 18:8. [PMID: 31910863 PMCID: PMC6947991 DOI: 10.1186/s12955-020-1269-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 01/02/2020] [Indexed: 12/24/2022] Open
Abstract
Background Acute leukemia (AL) not only impairs the quality of life (QOL) of patients, but also affects that of their family caregivers (FCs). Studies on QOL of AL patients and their FCs are limited. This study aimed to evaluate the QOL of AL patients and their FCs, and to explore the factors associated with QOL of patients and of FCs. Methods A multicenter cross-sectional study was conducted. The QOL of 196 patient–FC dyads was assessed. The Functional Assessment of Cancer Therapy-Leukemia (FACT-Leu) was used for patients, and the 36-item Short-Form Health Survey (SF-36) was used for FCs. Independent-samples t-tests or one-way analysis of variance were used to compare QOL subscale scores between groups with different sociodemographic/clinical characteristics. Multiple regression analysis was conducted to identify the factors associated with QOL of AL patients and their FCs. Results The total FACT-Leu score for AL patients was 76.80 ± 16.44, and the physical component summary (PCS) and mental component summary (MCS) scores for FCs were 64.67 ± 15.44 and 52.50 ± 13.49, respectively. All QOL subscales for patients (t = 12.96–34.73, p < 0.001) and FCs (t = 2.55–14.36, p < 0.05), except role emotional (t = − 0.01, p = 0.993), were lower than those reported in previous studies. Sex, employment, and chemotherapy were significantly associated with total FACT-Leu score in AL patients (p < 0.05). Age, sex, marital status, education, employment, and relationship to patients were significantly associated with SF-36 PCS or MCS (p < 0.05). Conclusions AL patients and their FCs both have lower QOL than the population in previous studies. These findings suggest that not only AL patients’ physical and mental health but also overall family QOL should be assessed. Interventions supporting patient–FC dyads should be developed to improve their QOL.
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The relationship between the positive aspects of caring and the personal growth of caregivers of patients with advanced oncological illness : Postraumattic growth and caregiver. Support Care Cancer 2019; 28:3007-3013. [PMID: 31823055 DOI: 10.1007/s00520-019-05139-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Accepted: 10/16/2019] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Examine the relationship between the positive aspects of care and the personal growth of caregivers of patients with advanced oncological illness. METHODS This research was a quantitative study with a transversal design. One hundred (100) informal caregivers filled out self-applied questionnaire on resilience, aspects of care, emotional distress, spirituality, and posttraumatic growth. Descriptive statistics were applied to the data, later correlation, and regression, and comparative analyses were conducted. RESULTS The participants were mainly women (86%) with an average care period of 12 months. The average age was 46.52 years. The highest scores were evidenced in positive aspects of caretaking, spirituality, personal growth, and distress, while the lowest score was seen in questions related to resilience. There was a negative inverse correlation among emotional distress, resilience, spirituality, and posttraumatic growth (p < .05) and a positive correlation among resilience, spirituality, posttraumatic growth, and the positive aspects of caretaking (p < .01). There were significant differences among the items related to emotional distress, resilience, and posttraumatic growth. The linear regression analysis showed that as resilience, spirituality, and the positive aspects of care increased, so did posttraumatic growth. SIGNIFICANT RESULTS To promote the perception of benefits among caregivers, resilience and the identification of meaning in the caregiving experience of patients with advanced oncological illness can be considered protective factors favoring adaptation and reducing negative moods.
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Impact of informal cancer caregiving across the cancer experience: A systematic literature review of quality of life. Palliat Support Care 2019; 18:220-240. [DOI: 10.1017/s1478951519000622] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractObjectiveInformal caregiving may likely increase as the number of cancer survivors grows. Caregiving responsibilities can impact caregivers’ quality of life (QOL). Understanding the current state of the science regarding caregiving QOL could help inform future research and intervention development.MethodsA systematic literature review in PubMed/Medline examined research on QOL among informal cancer caregivers and related psychosocial health outcomes. Original research articles in English, published between 2007 and 2017 about caregivers (aged >18 years) of adult cancer patients in the United States were included. Abstracted articles were categorized according to caregiving recipient's phase of survivorship (acute, middle to long-term, end of life/bereavement).ResultsOf 920 articles abstracted, 60 met inclusion criteria. Mean caregiver age ranged from 37 to 68 with the majority being female, non-Hispanic white, with at least a high school degree, and middle income. Almost half of the studies focused on caregivers who provided care for survivors from diagnosis through the end of active treatment. Studies examined physical health, spirituality, psychological distress, and social support. Differences in QOL were noted by caregiver age, sex, and employment status.Significance of ResultsAdditional research includes the examination of the needs of diverse cancer caregivers and determines how additional caregiver characteristics (e.g., physical functioning, financial burden, etc.) affect QOL. This includes studies examining caregiver QOL in the phases following the cessation of active treatment and assessments of health systems, support services, and insurance to determine barriers and facilitators needed to meet the immediate and long-term needs of cancer caregivers.
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Validation of the caregiver oncology quality of life questionnaire in Portuguese caregivers of myeloma patients. Palliat Support Care 2019; 18:178-185. [PMID: 31317865 DOI: 10.1017/s1478951519000476] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Cancer diagnosis affects patients, their families, and their caregivers in particular. This study focused on the validation of the CareGiver Oncology Quality of Life (CarGOQoL) questionnaire in Portuguese caregivers of patients with multiple myeloma, from the caregiver's point of view. METHOD This was a cross-sectional study with 146 caregivers of patients with multiple myeloma from outpatient medical oncology and clinical hematology consultations from five hospitals in north and central Portugal. Participants were assessed on quality of life (QoL), psychological morbidity and social support. RESULT The Portuguese version maintains 17 of the original 29 items version, maintaining general coherence and a dimensional structure that is clinically interpretable. Reliability findings indicated good internal consistency for the total scale (0.86) and respective subscales (0.75 to 0.88), which is in agreement with the alpha values from the previous CarGOQoL validation study for the corresponding subscales (0.74 to 0.89) and total scale (0.90). SIGNIFICANCE OF RESULTS The CarGOQoL is a reliable and valid tool for clinical trials and intervention programs to assess QoL in caregivers of myeloma patients. Future studies should validate the adapted version in caregivers of other types of cancer patients including other chronic diseases.
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27
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Determinants of quality of life among family caregivers of adult cancer patients in a resource-limited setting. Support Care Cancer 2019; 28:1295-1304. [PMID: 31240464 DOI: 10.1007/s00520-019-04947-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 06/18/2019] [Indexed: 12/15/2022]
Abstract
PURPOSE In resource-limited settings, family caregivers (FCGs) of adult cancer patients (ACPs) function in a context marred by high patient symptom burden, limited cancer care services and support and high caregiving burden. Despite this predicament, little is known about the quality of life (QoL) of FCGs in these settings. The study aimed to explore the determinants of QoL among FCGs of ACPs in Uganda. METHODS A cross-sectional design was used to collect data from 284 FCGs of ACPs. The study questionnaire was composed of the Katz Index, Family Pain Questionnaire, modified Chronic Pain Self-efficacy Scale and the Caregiver Quality of Life-Index-Cancer. RESULTS The mean age of FCGs was 36 ± 13.8 years. Most ACPs had stage 3 or 4 cancer (56%), severe pain (66.2%), reported moderate pain relief (51.1%) and were on chemotherapy (60.9%). The overall QoL of FCGs (70.2 ± 20.3) was moderate and 46.8% had low QoL. Most FCGs had high positive adaptation or financial concerns (55.3%) and low QoL in terms of burden (50.7%), disruptiveness (53.5%) and support (56.7%). The main determinants of overall QoL were FCGs' knowledge and self-eficacy for cancer pain management. The determinants of burden, disruptiveness, support and positive adaptations and financial concerns are reported. CONCLUSION The key determinants of the QoL of FCGs were knowledge and self-efficacy for cancer pain management. In Uganda and similar settings, interventions to build FCGs capacity in cancer-related pain and other symptom management may help to enhance the QoL of FCGs and the ACPs.
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Shin J, Ko H, Lee JW, Kim K, Song YM. Influence of time lapse after cancer diagnosis on the association between unmet needs and quality of life in family caregivers of Korean cancer patients. Eur J Cancer Care (Engl) 2019; 28:e13089. [PMID: 31087428 DOI: 10.1111/ecc.13089] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 10/21/2018] [Accepted: 03/29/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This study explored the association between healthcare needs and quality of life (QoL) of Korean cancer family caregivers according to the time lapse after cancer diagnosis. METHODS Self-administered comprehensive needs assessment tool and EuroQol-5-dimension index for 686 cancer family caregivers were classified into four groups according to time lapse after cancer diagnosis (≤12, 13-36, 37-60,>60 months). We estimated the association between unmet needs and QoL by multiple linear regression analyses after adjusting for age, sex, cancer site and caregivers' comorbid conditions. RESULTS Female or elder caregivers had lower QoL and higher unmet needs. The highest unmet needs existed in healthcare staff domain followed by information/education domain persistently along all periods. QoL of caregivers was significantly associated with family/social support and health/psychological problem during the time lapse of ≤12 months as well as >60 months. Practical support was consistently associated with QoL across all time lapses. Religious/spiritual support and hospital facilities and services showed significant association with QoL only in ≤12 months and >60 months respectively. CONCLUSIONS The QoL of Korean cancer family caregivers was differentially associated with their unmet needs according to the time lapse after cancer diagnosis and by specific domains of needs.
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Affiliation(s)
- Jinyoung Shin
- Department of Family Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Hyeonyoung Ko
- Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jeong-Won Lee
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kihyun Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yun-Mi Song
- Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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29
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Acquati C, Kayser K. Dyadic Coping Across the Lifespan: A Comparison Between Younger and Middle-Aged Couples With Breast Cancer. Front Psychol 2019; 10:404. [PMID: 30941068 PMCID: PMC6433932 DOI: 10.3389/fpsyg.2019.00404] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 02/11/2019] [Indexed: 11/28/2022] Open
Abstract
The association between dyadic coping and adjustment to cancer has been well-established. However, a significant gap in the literature is the understanding of how the life stage of couples may influence their dyadic coping and the accompanying quality of life. Although younger couples have been identified at higher risk for poor coping because of less collaborative behaviors and higher vulnerability to stress, only a limited number of studies have addressed younger women's coping with breast cancer in the context of close relationships. The present study addressed the differential impact of the illness on the quality of life and dyadic coping behaviors of younger and middle-aged dyads and the influence of relational mutuality on couples' coping in the two groups. A sample of 86 couples participated in a cross-sectional study; 35 younger couples were compared to 51 middle-aged dyads. Patients and partners completed measures of quality of life, dyadic coping, and mutuality. Independent-samples t-tests were used to examine differences in the two groups, while the Actor-Partner Interdependence Model (APIM) identified actor and partner effects of relational mutuality on dyadic coping. Younger women and their partners reported statistically significant worse quality of life and dyadic coping scores than the middle-age group. For younger couples, positive and negative coping styles were the result of both actor and partner effects of mutuality. The study highlighted the more negative impact of breast cancer on the quality of life of younger patients and partners. It also revealed a stronger influence of each partner's relational mutuality compared to the middle-age group in predicting both adaptive and maladaptive coping behavior. Future studies should continue to examine the developmental trajectory of dyadic coping across the lifespan in order to develop psychosocial interventions to promote younger dyads' coping efforts.
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Affiliation(s)
- Chiara Acquati
- Graduate College of Social Work, University of Houston, Houston, TX, United States
| | - Karen Kayser
- Renato LaRocca Chair of Oncology Social Work, Kent School of Social Work, University of Louisville, Louisville, KY, United States
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30
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Goldzweig G, Schapira L, Baider L, Jacobs JM, Andritsch E, Rottenberg Y. Who will care for the caregiver? Distress and depression among spousal caregivers of older patients undergoing treatment for cancer. Support Care Cancer 2019; 27:4221-4227. [PMID: 30840135 DOI: 10.1007/s00520-019-04711-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 02/22/2019] [Indexed: 12/22/2022]
Abstract
PURPOSE Although it is accepted that in general spousal caregivers of patients with cancer are under high emotional and physical strain, little is known about the quality of life specifically among spousal caregivers of older cancer patients. The aim of the current study is to explore the emotional toll of spousal caregivers of cancer patients aged 65-85 years. METHODS This study surveyed 242 spousal caregivers of patients ≥ 65 years old, diagnosed with cancer, treated with curative or palliative intent, and within 6 months of treatment at enrollment. Standardized measures completed by the caregivers included depression measure (Geriatric Depression Scale); distress (Distress Thermometer); and social support (the Cancer Perceived Agents of Social Support). Logistic regression analyses were used in order to identify the predictor of clinical depression and distress. The analyses were adjusted for patient (sociodemographic, functional performance, and medical status) and caregiver (sociodemographic and social support) factors. RESULTS Among the caregivers, the frequencies of clinical depression and distress were 16.5% and 28% respectively. Increasing patient age and time from diagnosis were associated with reduced levels of caregiver depression. Higher levels of friends and spousal support (support from the patients) were associated with non-clinical levels of depression and distress. CONCLUSION Increasing patient age and caregiver's perceived spousal support may both have a positive effect on caregivers' levels of depression. This can be utilized by clinicians in the process of empowering older patients and their spousal caregivers to confront the challenges of cancer treatment into advanced old age.
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Affiliation(s)
- Gil Goldzweig
- School of Behavioral Sciences, The Academic College of Tel-Aviv Yaffo, Rabenu-Yeruham Street 14, 6818211, Tel-Aviv, Israel.
| | - L Schapira
- Stanford University School of Medicine, Palo Alto, CA, USA
| | - L Baider
- Assuta Medical Center, Oncology Institute, Tel-aviv, Israel
| | - J M Jacobs
- Department of Geriatrics and Geriatric Rehabilitation, Hadassah University Hospital, Jerusalem, Israel
| | - E Andritsch
- Division of Clinical Oncology, The medical University of Graz, Graz, Austria
| | - Y Rottenberg
- Sharett Oncology Institute, Hadassah University Hospital, Jerusalem, Israel
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31
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Castellanos EH, Dietrich MS, Bond SM, Wells N, Schumacher K, Ganti AK, Murphy BA. Impact of patient symptoms and caregiving tasks on psychological distress in caregivers for head and neck cancer (HNC). Psychooncology 2019; 28:511-517. [PMID: 30578599 DOI: 10.1002/pon.4968] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 11/15/2018] [Accepted: 11/23/2018] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To determine the association of caregiving task burden and patient symptom burden with psychological distress among caregivers of head and neck cancer (HNC) patients. METHODS Adults with HNC and their primary caregivers were included. Patient symptom burden was assessed with the Vanderbilt Head and Neck Symptom Survey-2.0. Caregiving task burden was quantified as task number and task difficulty/distress using the HNC Caregiving Task Inventory. Psychological distress was measured with the Profile of Mood States-Short Form. Two-step clustering analysis was conducted for patient symptom burden, caregiving task burden, and psychological distress. Associations of the resultant clusters of task burden and patient symptoms with caregiver distress were tested using logistic regressions. RESULTS Eighty-nine HNC caregivers and 84 patients were included. Among patients, two clusters of symptom burden were found (51% mod-high, 49% low). Among caregivers, two clusters of caregiving task burden (40% mod-high, 60% low) and caregiver psychological distress (40% mod-high, 60% low) were found. Caregivers with mod-high task numbers and task difficulty/distress reported higher levels of psychological distress. After controlling for caregiver number of tasks, respective difficulty/distress, and patient symptom burden, caregiver perceived task difficulty/distress had the strongest association with caregiver psychological distress (adjusted OR = 3.83; 95% CI, 1.0-14.64; P = 0.049). CONCLUSIONS Psychological distress in HNC caregivers is associated with caregiving task burden, with caregivers experiencing high task difficulty/distress at greatest risk. Further study of the caregiver and task characteristics leading to psychological distress should inform supportive interventions for HNC patients and caregivers.
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Affiliation(s)
- Emily H Castellanos
- Division of Hematology/Oncology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Mary S Dietrich
- Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.,Department of Biostatistics, Vanderbilt University School of Nursing, Nashville, Tennessee, USA
| | - Stewart M Bond
- William F. Connell School of Nursing, Boston College, Boston, Massachusetts, USA
| | - Nancy Wells
- Department of Biostatistics, Vanderbilt University School of Nursing, Nashville, Tennessee, USA
| | - Karen Schumacher
- Department of Physiological Nursing, UCSF School of Nursing, San Francisco, California, USA
| | - Apar Kishor Ganti
- Division of Oncology-Hematology, Department of Internal Medicine, VA Nebraska Western Iowa Health Care System, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Barbara A Murphy
- Division of Hematology/Oncology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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32
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Bradley N, Lloyd‐Williams M, Dowrick C. Effectiveness of palliative care interventions offering social support to people with life-limiting illness-A systematic review. Eur J Cancer Care (Engl) 2018; 27:e12837. [PMID: 29573500 PMCID: PMC6001732 DOI: 10.1111/ecc.12837] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2018] [Indexed: 11/03/2022]
Abstract
Individuals managing the challenges of life-limiting illness require adequate social support to maintain quality of life. Qualitative research reports that patients value highly the social support obtained in palliative care interventions such as day care and group therapies. This systematic review aims to summarise existing quantitative evidence on palliative care interventions that facilitate social support. Research literature was systematically searched using electronic databases and key journals. Searches returned a total of 6,247 unique titles of which sixteen were eligible for inclusion. Interventions include group therapies, group practical interventions and palliative day care. Outcome measures and study designs were heterogeneous. Only one study used a validated outcome measure of social support. Benefits were influenced by participant characteristics such as baseline distress. Partial economic evaluation was attempted by two studies. Methodological challenges include attrition and use of outcome measures that were insensitive to change. Statistically significant results were reported in psychological and physical domains. Evidence is limited due to methodological issues and a scarcity of quantitative research, particularly regarding long-term benefits and cost-effectiveness. Interventions may be more beneficial to some groups than others.
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Affiliation(s)
- N. Bradley
- Academic Palliative and Supportive Care Studies GroupInstitute of Psychology Health and SocietyUniversity of LiverpoolLiverpoolUK
| | - M. Lloyd‐Williams
- Academic Palliative and Supportive Care Studies GroupInstitute of Psychology Health and SocietyUniversity of LiverpoolLiverpoolUK
| | - C. Dowrick
- Academic Palliative and Supportive Care Studies GroupInstitute of Psychology Health and SocietyUniversity of LiverpoolLiverpoolUK
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33
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Lau BHP, Chow AYM, Wong DFK, Chan JSM, Chan CHY, Ho RTH, So TH, Lam TC, Lee VHF, Lee AWM, Chow SF, Chan CLW. Study protocol of a randomized controlled trial comparing integrative body-mind-spirit intervention and cognitive behavioral therapy in fostering quality of life of patients with lung cancer and their family caregivers. ACTA ACUST UNITED AC 2018; 15:258-276. [PMID: 29400621 DOI: 10.1080/23761407.2018.1435325] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Compared to cancers at other sites, lung cancer often results in greater psychosocial distress to both the patients and their caregivers, due to the poor prognosis and survival rate, as well as the heavy symptom burden. In recent years, making protocols of proposed or on-going studies publicly available via clinical trial registries and/or peer-reviewed journals has benefited health sciences with timely communication of the latest research trends and improved transparency in reporting. However, such practice is yet to be a common sight in evidence-informed social work. Hence, this paper discusses the value of publishing protocols in social work research and presents the protocol of a randomized controlled trial that compares the effectiveness of integrative body-mind-spirit intervention with cognitive behavioral therapy for enhancing quality of life of patients with lung cancer and their family caregivers. The data collection process was still on-going at the time of manuscript submission.
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Affiliation(s)
- Bobo Hi-Po Lau
- a Department of Social Work & Social Administration , University of Hong Kong , Pokfulam , Hong Kong
| | - Amy Y M Chow
- a Department of Social Work & Social Administration , University of Hong Kong , Pokfulam , Hong Kong
| | - Daniel F K Wong
- a Department of Social Work & Social Administration , University of Hong Kong , Pokfulam , Hong Kong
| | - Jessie S M Chan
- a Department of Social Work & Social Administration , University of Hong Kong , Pokfulam , Hong Kong
| | - Celia H Y Chan
- a Department of Social Work & Social Administration , University of Hong Kong , Pokfulam , Hong Kong
| | - Rainbow T H Ho
- a Department of Social Work & Social Administration , University of Hong Kong , Pokfulam , Hong Kong
| | - Tsz-Him So
- b Department of Clinical Oncology , University of Hong Kong , Pokfulam , Hong Kong
| | - Tai-Chung Lam
- b Department of Clinical Oncology , University of Hong Kong , Pokfulam , Hong Kong
| | - Victor Ho-Fun Lee
- b Department of Clinical Oncology , University of Hong Kong , Pokfulam , Hong Kong
| | - Anne W M Lee
- b Department of Clinical Oncology , University of Hong Kong , Pokfulam , Hong Kong
| | | | - Cecilia L W Chan
- a Department of Social Work & Social Administration , University of Hong Kong , Pokfulam , Hong Kong
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34
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Douglas SL, Daly BJ, Lipson AR. Relationship Between Physical and Psychological Status of Cancer Patients and Caregivers. West J Nurs Res 2017; 38:858-73. [PMID: 27231088 DOI: 10.1177/0193945916632531] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to describe the relationship between patient physical and emotional status and caregiver mood state for patients with advanced cancer. Data were collected from 299 cancer patients and their caregivers from a cancer center. We used a longitudinal design and collected data through interviews. The relationships between patient and caregiver emotional states over time were moderate and statistically significant at all three points in time (p values = .012-.0001). Patient physical and emotional status predicted caregiver mood state at all points in time (βs = -.22 to -.25) and caregiver mood state at baseline predicted patient emotional status at 3 months (β = -.16, p = .013). Relationships between patient emotional status and caregiver mood state were moderately strong. Addressing the emotional needs of both patients and caregivers has the potential to yield improved emotional outcomes for both over time.
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Affiliation(s)
| | | | - Amy R Lipson
- Case Western Reserve University, Cleveland, OH, USA
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35
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Tan JY, Molassiotis A, Lloyd-Williams M, Yorke J. Burden, emotional distress and quality of life among informal caregivers of lung cancer patients: An exploratory study. Eur J Cancer Care (Engl) 2017; 27. [PMID: 28417550 DOI: 10.1111/ecc.12691] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2017] [Indexed: 12/15/2022]
Abstract
This study was conducted to explore the interrelationships among caregiver burden, emotional status and quality of life (QoL) in caregivers of lung cancer patients, and to identify whether caregiver burden and health status are associated with patient emotional status and QoL. Forty-three dyads of lung cancer patients and their caregivers were included for analysis. Caregiver-reported outcomes were measured by Caregiver Burden Scale (CBS), Caregivers Quality of Life Index-Cancer (CQOLC) and Hospital Anxiety and Depression Scale (HADS), while patient-reported outcomes were collected by HADS and Lung Cancer Symptom Scale (LCSS). The majority of the CBS and CQOLC scores were significantly higher in anxious and depressed caregivers than non-anxious and non-depressed caregivers (p < .01 or .05). Caregivers of depressed patients experienced significantly greater emotional distress than those of non-depressed patients (p < .01). Significantly positive associations were identified among most of the CBS, CQOLC and caregiver HADS scores. Patient LCSS scores were positively correlated with the CBS and caregiver HADS scores, and patient HADS scores were also positively related to caregiver HADS scores. The close interrelationships between caregiver and patient health outcomes provide evidence that lung cancer patients and their caregivers should be viewed as a unit in future supportive service models.
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Affiliation(s)
- J-Y Tan
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong.,School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK
| | - A Molassiotis
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong.,School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK
| | - M Lloyd-Williams
- Institute of Psychology Health and Society, University of Liverpool, Liverpool, UK
| | - J Yorke
- School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK.,The Christie NHS Foundation Trust, Manchester, UK
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36
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Yu H, Li L, Liu C, Huang W, Zhou J, Fu W, Ma Y, Li S, Chang Y, Liu G, Wu Q. Factors associated with the quality of life of family caregivers for leukemia patients in China. Health Qual Life Outcomes 2017; 15:55. [PMID: 28330476 PMCID: PMC5363014 DOI: 10.1186/s12955-017-0628-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 03/14/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The leukemia affects not only the quality of life (QOL) of patients with the disease but also that of their family caregivers (FCs). The research studies on QOL of FCs for leukemia patients are limited. This study aimed to evaluate the QOL of FCs for leukemia patients in Heilongjiang province, China. METHODS A cross-sectional questionnaire survey was undertaken with 309 FCs for leukemia patients recruited from three hospitals in Heilongjiang province. The QOL of the participants was assessed using the Chinese version of WHOQOL-BREF. Multivariate regression models were established to determine the predictors of the QOL of FCs, including the socio-economic characteristics of patients and FCs, and the emotional distress, social support and family functions of FCs. RESULTS The FCs had low QOL scores in all four domains: 12.7 ± 2.8 for physical, 12.2 ± 2.5 for psychological, 13.2 ± 2.9 for social and 11.3 ± 2.5 for environment. Social support is a major predictor of the QOL of FCs, with a standardized β coefficient of "high support" ranging from 0.41 to 0.58 for the four domains, followed by family function (β = 0.37 ~ 0.44 for psychological, social and environmental domains). The FCs who were older, highly educated, had no religious belief, suffered from a higher level of emotional distress, and provided care to younger patients and the patients without insurance coverage had lower QOL than the others. CONCLUSION The study provides some important insights into the QOL of FCs for leukemia patients. The QOL of FCs for leukemia patients is low and low levels of support to FCs are a major predictor of low QOL of FCs.
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Affiliation(s)
- Hongjuan Yu
- Department of Hematology, the First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, 150001, China
| | - Limin Li
- Department of Hematology, the First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, 150001, China
| | - Chaojie Liu
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, 3086, Australia
| | - Weidong Huang
- School of Health Management, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin, 150086, China.
| | - Jin Zhou
- Department of Hematology, the First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, 150001, China
| | - Wenqi Fu
- School of Health Management, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin, 150086, China
| | - Yi Ma
- School of Health Management, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin, 150086, China
| | - Si Li
- Department of Hematology, the First Hospital of Harbin, Harbin, Heilongjiang, 100730, China
| | - Yuying Chang
- Department of Hematology, the Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, 150081, China
| | - Guoxiang Liu
- School of Health Management, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin, 150086, China.
| | - Qunhong Wu
- School of Health Management, Harbin Medical University, 157 Baojian Road, Nangang District, Harbin, 150086, China.
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37
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Almutairi KM, Alodhayani AA, Alonazi WB, Vinluan JM. Assessment of Health-Related Quality of Life Among Caregivers of Patients with Cancer Diagnosis: A Cross-Sectional Study in Saudi Arabia. JOURNAL OF RELIGION AND HEALTH 2017; 56:226-237. [PMID: 27236467 DOI: 10.1007/s10943-016-0261-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
A descriptive cross-sectional survey was conducted over 5 months in two tertiary hospitals in Riyadh, Saudi Arabia. The 5-month period was from November 2014 to March 2015. The survey instrument used was a Short-Form Health Survey SF-36 (the RAND 36-item) questionnaire that measure QOL of the caregivers. Our study subjects included 289 randomly selected Saudi caregivers. Almost all the mean scores were increased (higher than 50) with the exception of levels of energy/fatigue. Role functioning/physical scored the highest (81.02 ± 35.33) followed by physical functioning (76.34 ± 29.83). Other domains of QOL scored (71.02 ± 35.33) for the role functioning/emotional; pain (71.15 ± 28.48), emotional well-being (60.58 ± 18.44); social functioning (58.39 ± 25.83), and general health (54.32 ± 17.08). In multivariate regression analysis, the model predicts that the contributions of age, gender, and the cancer type of patients were a statistically significant predictor with the QOL domains of caregivers. Cancer caregivers in Saudi Arabia caring for patients more than 1 year after diagnosis reported favorable QOL. Factors associated with QOL domains included age, gender of the caregivers, and the types of cancer patients. These findings are encouraging as a baseline for providing more information to future studies in QOL of caregivers.
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Affiliation(s)
- Khalid M Almutairi
- Department of Community Health Science, College of Applied Medical Science, King Saud University, Riyadh, Saudi Arabia.
| | - Abdulaziz A Alodhayani
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Wadi B Alonazi
- College of Business Administration, King Saud University, Riyadh, Saudi Arabia
| | - Jason M Vinluan
- Department of Community Health Science, College of Applied Medical Science, King Saud University, Riyadh, Saudi Arabia
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38
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Balfe M, Maguire R, Hanly P, Butow P, O'Sullivan E, Timmons A, Gooberman-Hill R, Sharp L. Distress in long-term head and neck cancer carers: a qualitative study of carers' perspectives. J Clin Nurs 2016; 25:2317-27. [DOI: 10.1111/jocn.13242] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Myles Balfe
- National Cancer Registry of Ireland; Cork Airport Business Park; Cork Ireland
| | | | - Paul Hanly
- National College of Ireland; Dublin Ireland
| | - Phyllis Butow
- Centre for Medical Psychology; University of Sydney; Sydney NSW Australia
| | | | - Aileen Timmons
- National Cancer Registry of Ireland; Cork Airport Business Park; Cork Ireland
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39
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Francis LE, Kypriotakis G, O'Toole EE, Rose JH. Cancer patient age and family caregiver bereavement outcomes. Support Care Cancer 2016; 24:3987-96. [PMID: 27129838 DOI: 10.1007/s00520-016-3219-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 04/17/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE This study drew on life course theory to argue that the strains of cancer caregiving and bereavement are modified by the age of the patient. We expected that caregivers of middle-aged patients would be more distressed than caregivers of older patients. METHODS This panel study conducted 199 interviews with family caregivers of advanced cancer patients; first following diagnosis and again shortly after the patient's death. RESULTS Among caregivers of middle-aged patients (40-59), grief mediated the relationship between baseline caregiving and bereavement depressed mood, with grief increasing risk of depression in bereavement. Among caregivers of young-old patients (60-79), grief had a suppressor effect on the relationship between caregiving and bereavement depressed mood, showing greater distress during caregiving than at bereavement. CONCLUSIONS Caregiving for middle-aged cancer patients may increase the risk for severe grief and depression, whereas caregivers of young-old cancer patients appeared to experience relief at bereavement. After bereavement, continued observation may be warranted for caregivers of a middle-aged patient; grief, added to the ongoing demands of their lives (which may include those left behind by a middle-aged patient), may put such caregivers at risk for greater psychological and emotional distress.
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Affiliation(s)
- Linda E Francis
- Department of Criminology, Anthropology and Sociology, RT1736, Cleveland State University, 2121 Euclid Avenue, Cleveland, OH, 44115, USA.
| | - Georgios Kypriotakis
- Department of Behavioral Sciences, UT MD Anderson Cancer Center, 1155 Pressler St. Rm# CPB3.3236, Houston, TX, 77030, USA
| | - Elizabeth E O'Toole
- Medicine-Geriatrics and Palliative Care, Case Western Reserve University at MetroHealth, 2500 MetroHealth Dr, R255, Cleveland, OH, 44109-1998, USA
- Medicine-Geriatrics and Palliative Care, Case Western Reserve University at MetroHealth, 2500 Metrohealth Drive R245A, Cleveland, OH, 44109-1998, USA
| | - Julia Hannum Rose
- Medicine-Geriatrics and Palliative Care, Case Western Reserve University at MetroHealth, 2500 MetroHealth Dr, R255, Cleveland, OH, 44109-1998, USA
- Medicine-Geriatrics and Palliative Care, Case Western Reserve University at MetroHealth, 2500 Metrohealth Drive R245A, Cleveland, OH, 44109-1998, USA
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40
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Lim HA, Tan JY, Chua J, Yoong RK, Lim SE, Kua EH, Mahendran R. Quality of life of family caregivers of cancer patients in Singapore and globally. Singapore Med J 2016; 58:258-261. [PMID: 27090600 DOI: 10.11622/smedj.2016083] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Family caregivers of cancer patients often suffer from impaired quality of life (QOL) due to stress arising from the responsibility of caregiving. Most research on such QOL impairments was conducted in Western populations. Thus, this exploratory study sought to (a) examine the QOL levels of family caregivers of cancer patients in an Asian population in Singapore, in relation to caregivers from other countries within and outside of Asia; and (b) investigate the association between sociodemographic factors and QOL impairments in family caregivers in Singapore. METHODS A total of 258 family caregivers of cancer patients who were receiving outpatient treatment completed the Caregiver Quality of Life Index-Cancer (CQOLC) and a sociodemographic survey. We compared the published CQOLC total scores from Turkey, Iran, Taiwan, South Korea, the United Kingdom, the United States and Canada with the Singapore dataset and examined the demographic relationships. RESULTS Caregivers in Singapore and Asia had lower CQOLC total scores than their Western counterparts. Caregivers who were male, of Chinese ethnicity, had parental relationships with their care recipient, or cared for advanced-stage cancer patients were found to have impaired QOL. CONCLUSION The findings of this study highlight possible areas in which support can be provided for family caregivers of cancer patients, and underscore the need to reconcile cultural diversity, values, societal expectations and demographic characteristics in Singapore.
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Affiliation(s)
- Haikel A Lim
- Department of Psychological Medicine, National University of Singapore, Singapore.,Duke-NUS Medical School, Singapore
| | - Joyce Ys Tan
- Department of Psychological Medicine, National University of Singapore, Singapore
| | - Joanne Chua
- Department of Psychological Medicine, National University Hospital, Singapore
| | - Russell Kl Yoong
- Department of Psychological Medicine, National University of Singapore, Singapore
| | - Siew Eng Lim
- Department of Haematology-Oncology, National University Cancer Institute, Singapore
| | - Ee Heok Kua
- Department of Psychological Medicine, National University of Singapore, Singapore.,Department of Psychological Medicine, National University Hospital, Singapore
| | - Rathi Mahendran
- Department of Psychological Medicine, National University of Singapore, Singapore.,Duke-NUS Medical School, Singapore.,Department of Psychological Medicine, National University Hospital, Singapore
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41
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Quality of life discordance between terminal cancer patients and family caregivers: a multicenter study. Support Care Cancer 2016; 24:2853-60. [PMID: 26838021 DOI: 10.1007/s00520-016-3108-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 01/26/2016] [Indexed: 01/15/2023]
Abstract
BACKGROUND Research studies on quality of life (QOL) discordance between cancer patients and family caregivers are limited, and the results are inconsistent. The objective of this study was to examine QOL discordance between patients and family caregivers in a hospice setting and to identify factors associated with the discordance. METHODS We enrolled 178 patient-family caregiver pairs from six tertiary hospital hospice palliative care units in South Korea in this cross-sectional study. To establish groupings based on patient and family caregiver QOL levels, we measured the QOL of patient and family caregiver pairs using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 15 for Palliative Care and the Caregiver QOL Index-Cancer, respectively. Pairs were categorized into the following three groups: both good QOL pairs, only poor patient QOL, and only poor family caregiver QOL. Factors associated with only poor patient or only poor family caregiver QOL were compared to both good QOL pairs. A stepwise multivariate regression model was used to identify relevant factors. RESULTS The QOL of family caregivers did not correlate significantly (P = 0.227) with QOL in terminally ill cancer patients. As well, poor emotional function in patients was the only significant factor associated with the only poor patient QOL group [adjusted odds ratio (aOR), 4.1; 95 % confidence interval (CI), 1.5-11.5]. However, emotionally distressed family caregivers (aOR, 10.2; 95 % CI, 2.8-37.5), family caregivers who professed a religion (aOR, 4.1; 95 % CI, 1.5-11.3), and family caregivers with low social support (aOR, 3.9; 95 % CI, 1.5-10.6) were independent predictors for the only poor family caregiver QOL group. CONCLUSIONS Assessing the respective emotional status of both the patient and family caregiver is needed in hospice care to reduce the gap in QOL between the two groups. Further, more attention should be paid to the lack of social support for family caregivers.
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Choi YS, Hwang SW, Hwang IC, Lee YJ, Kim YS, Kim HM, Youn CH, Ahn HY, Koh SJ. Factors associated with quality of life among family caregivers of terminally ill cancer patients. Psychooncology 2015; 25:217-24. [DOI: 10.1002/pon.3904] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 05/23/2015] [Accepted: 06/15/2015] [Indexed: 11/07/2022]
Affiliation(s)
- Youn Seon Choi
- Department of Family Medicine; Korea University Guro Hospital; Seoul South Korea
| | - Sun Wook Hwang
- Department of Family Medicine; Catholic University St. Paul's Hospital; Seoul South Korea
| | - In Cheol Hwang
- Department of Family Medicine; Gachon University Gil Medical Center; Incheon South Korea
| | - Yong Ju Lee
- Department of Palliative Medicine; Catholic University Seoul St. Mary's Hospital; Seoul South Korea
| | - Young Sung Kim
- Department of Family Medicine; Ilsan Hospital; Goyang South Korea
| | - Hyo Min Kim
- Department of Family Medicine; Kyungpook National University Medical Center; Daegu South Korea
| | - Chang Ho Youn
- Department of Family Medicine; Kyungpook National University Medical Center; Daegu South Korea
| | - Hong Yup Ahn
- Department of Statistics; Dongguk University; Seoul South Korea
| | - Su-Jin Koh
- Division of Hematology and Oncology, Department of Internal Medicine; Ulsan University Hospital; Ulsan South Korea
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