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Sun H, Wacharasin C, Hengudomsub P. Change in resilience among spousal caregivers of patients with newly-diagnosed advanced cancer over the first six months posttreatment in China. J Psychosom Res 2024; 183:111538. [PMID: 38823371 DOI: 10.1016/j.jpsychores.2023.111538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 10/13/2023] [Accepted: 10/23/2023] [Indexed: 06/03/2024]
Abstract
OBJECTIVE A longitudinal observational study was conducted and aimed to examine the change in resilience among spousal caregivers of newly-diagnosed advanced cancer patients over the first six months after initial treatment. METHODS In total, 312 Chinese spousal caregivers who were taking care of their patients with newly-diagnosed advanced cancer were recruited. The level of resilience was measured using the Connor-Davidson Resilience Scale at the first month post-initial treatment (T1), three-month post-initial treatment (T2), and six-month post-initial treatment (T3). Latent growth modeling analyses were performed to examine changes in resilience using Mplus 8.3. RESULTS The mean scores of resilience in spousal caregivers were 54.01 ± 7.68 at T1, 56.20 ± 6.38 at T2, and 57.97 ± 6.70 at T3, respectively. Results of latent growth modeling indicated that spousal caregivers showed a significant increase in their resilience scores over the first six months post-treatment (Mean slope = 1.98, p < 0.001). Furthermore, a significant individual variation in the rate of changes in resilience scores allowed spouses to be categorized into two groups: 42.9% participants with fast growth and 57.1% participants with slight growth. CONCLUSION Our findings highlight the importance that new knowledge about change patterns of resilience in the nursing field is beneficial to reveal different psychosomatic health. Acknowledging that resilience is a dynamic process that changes over time, it is crucial for healthcare providers to monitor the psychological adjustment and focus of vulnerable caregivers, particularly spouses.
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Affiliation(s)
- Haiyan Sun
- Faculty of Nursing, Burapha University, Chon Buri 20131, Thailand; School of Nursing, Jiangsu Vocational College of Medicine, Jiangsu 224005, PR China
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Muleiro Alvarez M, Cano-Herrera G, Osorio Martínez MF, Vega Gonzales-Portillo J, Monroy GR, Murguiondo Pérez R, Torres-Ríos JA, van Tienhoven XA, Garibaldi Bernot EM, Esparza Salazar F, Ibarra A. A Comprehensive Approach to Parkinson's Disease: Addressing Its Molecular, Clinical, and Therapeutic Aspects. Int J Mol Sci 2024; 25:7183. [PMID: 39000288 PMCID: PMC11241043 DOI: 10.3390/ijms25137183] [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: 05/22/2024] [Revised: 06/24/2024] [Accepted: 06/27/2024] [Indexed: 07/16/2024] Open
Abstract
Parkinson's disease (PD) is a gradually worsening neurodegenerative disorder affecting the nervous system, marked by a slow progression and varied symptoms. It is the second most common neurodegenerative disease, affecting over six million people in the world. Its multifactorial etiology includes environmental, genomic, and epigenetic factors. Clinical symptoms consist of non-motor and motor symptoms, with motor symptoms being the classic presentation. Therapeutic approaches encompass pharmacological, non-pharmacological, and surgical interventions. Traditional pharmacological treatment consists of administering drugs (MAOIs, DA, and levodopa), while emerging evidence explores the potential of antidiabetic agents for neuroprotection and gene therapy for attenuating parkinsonian symptoms. Non-pharmacological treatments, such as exercise, a calcium-rich diet, and adequate vitamin D supplementation, aim to slow disease progression and prevent complications. For those patients who have medically induced side effects and/or refractory symptoms, surgery is a therapeutic option. Deep brain stimulation is the primary surgical option, associated with motor symptom improvement. Levodopa/carbidopa intestinal gel infusion through percutaneous endoscopic gastrojejunostomy and a portable infusion pump succeeded in reducing "off" time, where non-motor and motor symptoms occur, and increasing "on" time. This article aims to address the general aspects of PD and to provide a comparative comprehensive review of the conventional and the latest therapeutic advancements and emerging treatments for PD. Nevertheless, further studies are required to optimize treatment and provide suitable alternatives.
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Affiliation(s)
- Mauricio Muleiro Alvarez
- Centro de Investigación en Ciencias de la Salud (CICSA), Facultad de Ciencias de la Salud, Universidad Anáhuac Campus México Norte, Huixquilucan 52786, Mexico
| | - Gabriela Cano-Herrera
- Centro de Investigación en Ciencias de la Salud (CICSA), Facultad de Ciencias de la Salud, Universidad Anáhuac Campus México Norte, Huixquilucan 52786, Mexico
| | - María Fernanda Osorio Martínez
- Centro de Investigación en Ciencias de la Salud (CICSA), Facultad de Ciencias de la Salud, Universidad Anáhuac Campus México Norte, Huixquilucan 52786, Mexico
| | | | - Germán Rivera Monroy
- Centro de Investigación en Ciencias de la Salud (CICSA), Facultad de Ciencias de la Salud, Universidad Anáhuac Campus México Norte, Huixquilucan 52786, Mexico
| | - Renata Murguiondo Pérez
- Centro de Investigación en Ciencias de la Salud (CICSA), Facultad de Ciencias de la Salud, Universidad Anáhuac Campus México Norte, Huixquilucan 52786, Mexico
| | - Jorge Alejandro Torres-Ríos
- Centro de Investigación en Ciencias de la Salud (CICSA), Facultad de Ciencias de la Salud, Universidad Anáhuac Campus México Norte, Huixquilucan 52786, Mexico
| | - Ximena A. van Tienhoven
- Centro de Investigación en Ciencias de la Salud (CICSA), Facultad de Ciencias de la Salud, Universidad Anáhuac Campus México Norte, Huixquilucan 52786, Mexico
| | - Ernesto Marcelo Garibaldi Bernot
- Centro de Investigación en Ciencias de la Salud (CICSA), Facultad de Ciencias de la Salud, Universidad Anáhuac Campus México Norte, Huixquilucan 52786, Mexico
| | - Felipe Esparza Salazar
- Centro de Investigación en Ciencias de la Salud (CICSA), Facultad de Ciencias de la Salud, Universidad Anáhuac Campus México Norte, Huixquilucan 52786, Mexico
| | - Antonio Ibarra
- Centro de Investigación en Ciencias de la Salud (CICSA), Facultad de Ciencias de la Salud, Universidad Anáhuac Campus México Norte, Huixquilucan 52786, Mexico
- Secretaria de la Defensa Nacional, Escuela Militar de Graduados en Sanidad, Ciudad de México 11200, Mexico
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Mollaei F, Sharif Nia H, Pouralizadeh M, Karkhah S, Javadi-Pashaki N, Ghorbani Vajargah P. Resilience and related factors in caregivers of adult cancer patients: a systematic review. Ann Med Surg (Lond) 2024; 86:3451-3459. [PMID: 38846864 PMCID: PMC11152843 DOI: 10.1097/ms9.0000000000001469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 10/24/2023] [Indexed: 06/09/2024] Open
Abstract
Background This systematic review aimed to investigate resilience and its related factors in caregivers of adult patients with cancer. Materials and methods A systematic search of online electronic databases including Scopus, PubMed, Web of Science, Iranmedex, and Scientific Information Database (SID) was performed using keywords extracted from Medical Subject Headings such as "Psychological Resilience", "Caregiver", and "Cancer" from the earliest to 6 June 2023. The quality of the studies included in this review was evaluated using the appraisal tool for cross-sectional studies (AXIS tool). Results A total of 2735 caregivers of cancer patients participated in 15 studies. The majority of the studies found that caregivers of cancer patients had high levels of resilience. Factors related to the resilience of cancer patients' caregivers included caregivers' social support, caregivers' quality of life, patients' resilience, caregivers' family function, patients' performance, caregivers' age, caregivers' health status, caregivers' self-esteem, caregivers post-traumatic growth, caregivers religious, caregivers hope, caregivers positive affect, patients age, patients social support, patients resilience support, patients quality of life, caregivers' anxiety, caregivers' depression, caregivers' burden, caregivers level of education, caregivers financial problem, caregivers memory, caregivers negative affect, caregivers post-traumatic stress disorder, maternal distress, and patients post-traumatic stress disorder. Conclusion Therefore, healthcare administrators and policymakers can enhance the resilience of caregivers and the quality of care they provide by instituting ongoing training initiatives focused on evaluating mental well-being and implementing coping strategies for managing stress and depression.
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Affiliation(s)
- Fereshteh Mollaei
- Department of Nursing, Shahid Beheshti School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Hamid Sharif Nia
- Psychosomatic Research Center, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Nursing, Amol School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
| | - Moluk Pouralizadeh
- Department of Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Samad Karkhah
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
- Burn and Regenerative Medicine Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Nazila Javadi-Pashaki
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
- Social Determinants of Health Research Center (SDHRC), Guilan University of Medical Sciences, Rasht, Iran
| | - Pooyan Ghorbani Vajargah
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
- Burn and Regenerative Medicine Research Center, Guilan University of Medical Sciences, Rasht, Iran
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Poco LC, Malhotra C. More competent informal caregivers reduce advanced cancer patients' unplanned healthcare use and costs. Cancer Med 2024; 13:e7366. [PMID: 38872395 PMCID: PMC11176569 DOI: 10.1002/cam4.7366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 01/15/2024] [Accepted: 05/27/2024] [Indexed: 06/15/2024] Open
Abstract
BACKGROUND Patients with metastatic cancer experience high healthcare use and costs, most of which are unplanned. We aimed to assess whether patients with more competent informal caregivers have lower unplanned healthcare use and costs. METHODS This study used data from a prospective cohort of patients with solid metastatic cancer. Patients and their informal family caregivers were surveyed every 3 months until patients' death. Patients' unplanned healthcare use/costs were examined through hospital records. Caregivers responded to the 4-item Caregiver Competence Scale. First, in a deceased subsample of patients and their caregivers, we used patients' last 2 years of data (226 dyads) to assess the association between caregivers' competency (independent variable) and patients' unplanned healthcare use/costs (outcomes). Next, in a prospective sample of patient-caregiver dyads (up to 15 surveys), we assessed whether patients' functional well-being and psychological distress moderated the association between caregivers' competency and unplanned healthcare use/costs (311 dyads). RESULTS In the deceased subsample, during last 2 years of patients' life, caregivers' higher competency lowered the odds of patients' unplanned healthcare use [OR (CI) = 0.86 (0.75, 0.98), p = 0.03], and was associated with a significant reduction in unplanned healthcare costs [Coeff (CI) = -0.19 (-0.36, -0.01), p = 0.03]. In the prospective sample, patients' functional well-being and psychological distress moderated the association between caregivers' competency and patients' unplanned healthcare use/costs. CONCLUSION With deterioration in patients' condition and an increase in caregiving demands, improving caregivers' competency can reduce patients' unplanned healthcare use and costs. This should be further tested in future trials.
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Affiliation(s)
- Louisa Camille Poco
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore
| | - Chetna Malhotra
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
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Stover AD, Shulkin J, Lac A, Rapp T. A meta-analysis of cognitive reappraisal and personal resilience. Clin Psychol Rev 2024; 110:102428. [PMID: 38657292 DOI: 10.1016/j.cpr.2024.102428] [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: 09/26/2023] [Revised: 03/21/2024] [Accepted: 04/04/2024] [Indexed: 04/26/2024]
Abstract
Cognitive reappraisal, an adaptive emotion regulation strategy that involves subjectively reinterpreting stressful and adverse experiences in a more positive manner, can enhance personal resilience. Personal resilience is a constellation of attributes that facilitate successful coping and an expeditious return to adaptive functioning after exposure to stress or adversity. This meta-analysis evaluated the association between cognitive reappraisal and personal resilience. A systematic and exhaustive search identified 64 independent samples from 55 studies (N = 29,824) that examined the correlation between cognitive reappraisal and personal resilience. A random-effects model revealed a positive summary effect (r = 0.47, p < .001), indicating that higher cognitive reappraisal was associated with higher personal resilience. Six potential meta-moderators were tested: culture, age, name of the cognitive reappraisal measure, name of the personal resilience measure, study design, and publication period. After two extreme effect size outliers were omitted, tests of publication bias did not reveal any publication bias in this line of research. This quantitative synthesis offers compelling evidence showing that cognitive reappraisal skills operate as a protective strategy against stress and adversity and, therefore, enhance personal resilience. The protective benefits of cognitive reappraisal in relation to personal resilience are relatively robust, as the correlations were statistically significant for all subgroups in the meta-moderation analyses.
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Affiliation(s)
- Alexander D Stover
- Department of Psychology, University of Colorado Colorado Springs, 1420 Austin Bluffs Parkway, Colorado Springs, CO 80918, United States of America.
| | - Josh Shulkin
- Department of Psychology, University of Colorado Colorado Springs, 1420 Austin Bluffs Parkway, Colorado Springs, CO 80918, United States of America
| | - Andrew Lac
- Department of Psychology, University of Colorado Colorado Springs, 1420 Austin Bluffs Parkway, Colorado Springs, CO 80918, United States of America
| | - Timothy Rapp
- Department of Psychology, University of Colorado Colorado Springs, 1420 Austin Bluffs Parkway, Colorado Springs, CO 80918, United States of America
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Zhou Z, Jiang W, Liu M, Xue T, Li X, Jiang Y. The relationship between family resilience, post-traumatic growth, and caregiver burden among family caregivers of stroke survivors: a cross-sectional study. PSYCHOL HEALTH MED 2024:1-14. [PMID: 38712657 DOI: 10.1080/13548506.2024.2350701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 04/28/2024] [Indexed: 05/08/2024]
Abstract
The study aimed to explore the relationship between family resilience, post-traumatic growth(PTG), and caregiver burden among family caregivers of stroke survivors. Researchers conducted a cross-sectional study to recruit 253 family caregivers of stroke survivors from a public hospital in Shandong Province, China. Caregivers completed sociodemographic information, the Shortened Chinese Version of the Family Resilience Assessment Scale, the Post-traumatic Growth Inventory, and the Zarit Caregiver Burden Interview. We used Amos 24.0 to construct structural equation models and examine the mediating effects of stroke survivors' post-traumatic growth. Family resilience was positively associated with post-traumatic growth, and both family resilience and post-traumatic growth were negatively associated with caregiver burden. Post-traumatic growth partially mediated the relationship between family resilience and caregiver burden, and the mediating effect accounted for 21.27% of the total effect. Targeted interventions should address family resilience and post-traumatic growth as protective factors of caregiver burden.
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Affiliation(s)
- Zhenfeng Zhou
- School of Nursing, Qingdao University, Qingdao, China
| | - Wenbin Jiang
- Department of Nursing, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Meiyan Liu
- School of Nursing, Qingdao University, Qingdao, China
| | - Ting Xue
- Department of Nursing, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xiao Li
- School of Nursing, Qingdao University, Qingdao, China
| | - Yongmei Jiang
- Department of Nursing, The Affiliated Hospital of Qingdao University, Qingdao, China
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Liu Z, Jia C, Yue L, Zhou Y, Wang S, Yao N. Care stressors and perceived stress among family caregivers of Chinese older adults with disabilities: The mediation effect of resilience. Geriatr Nurs 2024; 56:252-258. [PMID: 38387149 DOI: 10.1016/j.gerinurse.2024.02.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 02/05/2024] [Accepted: 02/08/2024] [Indexed: 02/24/2024]
Abstract
OBJECTIVES Guided by the Stress Process Model, this study examined the mediating effect of resilience on the relationship between care stressors and perceived caregiving stress. METHODS Data were based on 234 older adults with disabilities and their caregivers from 6 urban districts and 6 rural counties from Jinan, China. Descriptive analysis, analysis of variance, ordinary least squares regression, and mediation analysis were performed. RESULTS Perceived stress among family caregivers of Chinese older adults with disabilities was affected by the physical and mental health of both themselves and the care recipients, as well as care intensity and financial difficulties. Resilience played a partial mediating role in the associations among three stressors (i.e. older adults' disability levels, number of chronic diseases, and caregivers' self-reported mental) and perceived caregiving stress. CONCLUSIONS Enhanced resilience aids caregivers' adaptation to their roles, suggesting the need for societal, spiritual, emotional, and behavioral resilience training.
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Affiliation(s)
- Zeyu Liu
- The First Clinical College of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, 250012, China
| | - Congxi Jia
- Weifang Health Supervision Institute, Weifang, Shandong, 261000, China
| | - Lirong Yue
- Jinzhong Development and Reform Commission, Jin Zhong, Shanxi, 030600, China
| | - Yuanjin Zhou
- Steve Hicks School of Social Work, University of Texas at Austin, Austin, Texas, 78705, USA
| | - Shuangshuang Wang
- School of Public Administration, Southwest Jiaotong University, No. 111, North Section I, Second Ring Road, Chengdu, 610031, China.
| | - Nengliang Yao
- Home Centered Care Institute, Schaumburg, IL, 60173, USA
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Fonseca-Baeza S, García-Alandete J, Marco JH, Pérez Rodríguez S, Baños RM, Guillén V. Difficulties in emotional regulation mediates the impact of burden on quality of life and mental health in a sample of family members of people diagnosed with Borderline Personality Disorder. Front Psychol 2023; 14:1270379. [PMID: 38054179 PMCID: PMC10694221 DOI: 10.3389/fpsyg.2023.1270379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 11/06/2023] [Indexed: 12/07/2023] Open
Abstract
Background Although it has been suggested that family members of persons suffering from Borderline Personality Disorder (BPD) endure high levels of burden, however, the process and the impact of this burden in their lives, and specifically the relation between the burden and emotional regulation has not been broadly investigated among this population. The main objective of this study is to examine the impact of burden on quality of life and depression, anxiety and stress, as mediated by difficulties in emotional regulation in family members of persons diagnosed with BPD. Method Participants were 167 family members of persons diagnosed with BPD. The Burden Assessment Scale, Difficulties in Emotion Regulation Scale, Multicultural Quality of Life Index, and Depression Anxiety Stress Scale-21 were filled out. Mediation analysis was conducted using the Maximum Likelihood estimator, bootstrap method and listwise deletion for missing data. Results Burden showed a significant, negative effect on quality of life and positive on depression, anxiety and stress. Difficulties in emotion regulation significantly mediated these relations. After accounting for the mediating role of difficulties in emotion regulation, burden still had an impact on quality of life, depression, anxiety and stress. Women showed a higher level in both burden and stress than men. The caregivers with secondary and higher studies showed higher levels in burden than those with no studies. Not significant differences in burden, emotion regulation, depression, anxiety and stress were found related to marital status. Conclusion Difficulties in emotion regulation mediate the relations between burden and quality of life, depression, anxiety, and stress. Family members could engage in group interventions designed specifically for family members of people with BPD, oriented toward understanding the disorder or learning skills.
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Affiliation(s)
- Sara Fonseca-Baeza
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Joaquín García-Alandete
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - José Heliodoro Marco
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Madrid, Spain
| | - Sandra Pérez Rodríguez
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Rosa M. Baños
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Madrid, Spain
| | - Verónica Guillén
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Madrid, Spain
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Limonero JT, Maté-Méndez J, Gómez-Romero MJ, Mateo-Ortega D, González-Barboteo J, Bernaus M, López-Postigo M, Sirgo A, Viel S, Sánchez-Julve C, Bayés R, Gómez-Batiste X, Tomás-Sábado J. Family caregiver emotional distress in advanced cancer: the DME-C scale psychometric properties. BMJ Support Palliat Care 2023; 13:e177-e184. [PMID: 33277319 PMCID: PMC10646856 DOI: 10.1136/bmjspcare-2020-002608] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 11/03/2020] [Accepted: 11/16/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND Family caregivers of patients with advanced illness at end of life often report high levels of emotional distress. To address this emotional distress is necessary to have adequate and reliable screening tools. AIM This study analyses the psychometric properties and clinical utility of the Family Caregiver Emotional Detection Scale for caregivers of patients with end-stage cancer (DME-C, Spanish acronym) who are receiving palliative care (PC). DESIGN Multicentre, cross-sectional study. SETTINGS/PARTICIPANTS Family caregivers of patients with advanced cancer at end of life receiving palliative treatment were interviewed to explore their emotional distress through the DME-C scale and other instruments measuring anxiety and depression (Hospital Anxiety and Depression Scale (HADS)), distress thermometer (DT) and overload (B), as well as a clinical psychological assessment (CPA). RESULTS 138 family caregivers, 85 (61.6%) female and 53 (38.4%) male, with an average age of 59.69±13.3 participated in the study. The reliability of the scale, as measured by Cronbach's alpha, was 0.76, and its stability over time was 0.734. Positive, significant correlations were found between the DME-C and the scores for anxiety and depression registered on the HADS scale, as well as with the total result of this latter scale and the results for B, the DT and the CPA. A statistical analysis of the receiver-operating characteristic curves showed that the scale has a sensitivity and specificity of 75%, and that the cut-off point for the detection of emotional distress was a score ≥11. Fifty-four per cent of the caregivers displayed emotional distress according to this scale. CONCLUSIONS The DME-C displays good psychometric properties. It is simple, short, reliable and easy to administer. We believe that the instrument is useful for the detection of emotional distress in the family caregivers of hospitalised patients suffering from end-stage illnesses and receiving PC.
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Affiliation(s)
- Joaquín T Limonero
- School of Psychology, Stress and Health Research Group, Universitat Autonoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Catalunya, Spain
| | - Jorge Maté-Méndez
- School of Psychology, Stress and Health Research Group, Universitat Autonoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Catalunya, Spain
- Psycho-oncology Care Unit, Institut Catala d' Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
| | - María José Gómez-Romero
- School of Psychology, Stress and Health Research Group, Universitat Autonoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Catalunya, Spain
- Psychology Unit, Egarsat, Mutua Colaboradora con la Seguridad Social nº 276, Terrassa, Barcelona, Spain
| | - Dolors Mateo-Ortega
- Palliative Care Unit, Consorci Sanitari de Terrassa, Terrassa, Catalunya, Spain
| | - Jesús González-Barboteo
- Palliative Care Unit, Institut Catala d' Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Montserrat Bernaus
- Palliative Care Unit, Consorci Corporació Sanitària Parc Taulí de Sabadell, Sabadell, Barcelona, Spain
| | - Montserrat López-Postigo
- Palliative Care Unit, Consorci Corporació Sanitària Parc Taulí de Sabadell, Sabadell, Barcelona, Spain
| | - Agustina Sirgo
- Psycho-oncology Unit, Oncology Department, University Hospital Sant Joan de Reus, Reus, Barcelona, Spain
| | - Silvia Viel
- School of Psychology, Stress and Health Research Group, Universitat Autonoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Catalunya, Spain
- Member of the Group of Psychologists of the Catalan-Balearic Society for Palliative Care, Barcelona, Spain
| | - Cruz Sánchez-Julve
- Palliative Care Unit, Sant Camil Hospital-Residence Foundation-Sant Pere de Ribes, Sant Pere de Ribes, Barcelona, Spain
| | - Ramon Bayés
- School of Psychology, Stress and Health Research Group, Universitat Autonoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Catalunya, Spain
| | - Xavier Gómez-Batiste
- The 'Qualy' Observatory. WHO Collaborating Centre for Public Health Palliative Care Programmes, Institut Catala d' Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
- Chair of Palliative Care, University of Vic, Vic, Barcelona, Spain
| | - Joaquín Tomás-Sábado
- University of Gimbernat and Tomas Cerda School of Nursing, Sant Cugat del Vallés, Barcelona, Spain
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Zhang Y, Tang R, Bi L, Wang D, Li X, Gu F, Han J, Shi M. Effects of family-centered positive psychological intervention on psychological health and quality of life in patients with breast cancer and their caregivers. Support Care Cancer 2023; 31:592. [PMID: 37750931 DOI: 10.1007/s00520-023-08053-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 09/15/2023] [Indexed: 09/27/2023]
Abstract
PURPOSE Positive psychological intervention could improve individual's psychological health and quality of life. This study aimed to examine the effectiveness of family-centered positive psychological intervention on resilience, hope, perceived benefits, and quality of life in breast cancer patients and their caregivers. METHODS A two-group, randomized controlled study, including 98 dyads of breast cancer patients and caregivers, was conducted. Dyads were randomly assigned to intervention (n = 49) and control (n = 49) groups. Both the control and intervention groups received 4 weeks of health education, while the intervention group additionally received a 4-week family-centered positive psychological intervention. Outcome measures compared at baseline (T1), immediately after the intervention (T2), and at 1-month follow-up (T3), included validated measures of resilience (Connor-Davidson Resilience Scale), hope (Herth Hope Index), perceived benefits (Perceived Benefits of Diagnosis and Treatment of Breast Cancer, Positive Aspects of Caregiving), and quality of life (Functional Assessment of Cancer Therapy-Breast, Caregiver Quality of Life Scale). RESULTS Resilience, hope, perceived benefits, and quality of life of dyads were significantly higher in the intervention group than those in the control group at T2 and T3 (all p < 0.05). Linear mixed model analysis demonstrated a significant interaction effect of group × time × role (p = 0.007) on hope and a significant difference in the improvement of hope (p < 0.05) between patients and their caregivers. CONCLUSIONS Our family-centered positive psychological intervention was effective in improving psychological health and quality of life for breast cancer patients and caregivers. This study provides evidence for the effectiveness of positive clinical psychological interventions. TRIAL REGISTRATION ChiCTR2300072809.
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Affiliation(s)
- Yao Zhang
- School of Nursing, Xuzhou Medical University, 209 Tongshan Road (221004), Xuzhou, China
| | - Ruijin Tang
- School of Nursing, Xuzhou Medical University, 209 Tongshan Road (221004), Xuzhou, China
| | - Liuna Bi
- School of Nursing, Xuzhou Medical University, 209 Tongshan Road (221004), Xuzhou, China
| | - Dan Wang
- Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Xiaoxu Li
- Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Feng Gu
- Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Jing Han
- School of Nursing, Xuzhou Medical University, 209 Tongshan Road (221004), Xuzhou, China.
| | - Ming Shi
- First Clinical College, Xuzhou Medical University, 209 Tongshan Road (221004), Xuzhou, China.
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11
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Kirk DL, Kabdebo I, Whitehead L. Prevalence of distress and its associated factors among caregivers of people diagnosed with cancer: A cross-sectional study. J Clin Nurs 2022; 31:3402-3413. [PMID: 34894019 PMCID: PMC9787485 DOI: 10.1111/jocn.16167] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 11/17/2021] [Accepted: 12/01/2021] [Indexed: 12/30/2022]
Abstract
AIMS AND OBJECTIVES To (i) determine prevalence of distress among caregivers of people living with cancer, (ii) describe caregivers' most commonly reported problems and (iii) investigate which factors were associated with caregivers' distress. BACKGROUND The psychological distress associated with a cancer diagnosis jointly impacts those living with cancer and their caregivers(s). As the provision of clinical support moves towards a dyadic model, understanding the factors associated with caregivers' distress is increasingly important. DESIGN Cross-sectional study. METHODS Distress screening data were analysed for 956 caregivers (family and friends) of cancer patients accessing the Cancer Council Western Australia information and support line between 1 January 2016 and 31 December 2018. These data included caregivers' demographics and reported problems and their level of distress. Information related to their care recipient's cancer diagnosis was also captured. Caregivers' reported problems and levels of distress were measured using the distress thermometer and accompanying problem list (PL) developed by the National Comprehensive Cancer Network. A partial-proportional logistic regression model was used to investigate which demographic factors and PL items were associated with increasing levels of caregiver distress. Pearlin's model of caregiving and stress process was used as a framework for discussion. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist was followed. RESULTS Nearly all caregivers (96.24%) recorded a clinically significant level of distress (≥4/10) and two thirds (66.74%) as severely distressed (≥7/10). Being female, self-reporting sadness, a loss of interest in usual activities, sleep problems or problems with a partner or children were all significantly associated with increased levels of distress. CONCLUSIONS Caregivers of people with cancer reporting emotional or familial problems may be at greater risk of moderate and severe distress. RELEVANCE TO CLINICAL PRACTICE Awareness and recognition of caregiver distress are vital, and referral pathways for caregivers are the important area of development.
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Affiliation(s)
- Deborah L. Kirk
- School of Nursing and MidwiferyEdith Cowan UniversityJoondalupWestern AustraliaAustralia
| | - Istvan Kabdebo
- School of Nursing and MidwiferyEdith Cowan UniversityJoondalupWestern AustraliaAustralia
| | - Lisa Whitehead
- School of Nursing and MidwiferyEdith Cowan UniversityJoondalupWestern AustraliaAustralia
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12
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Zhang Q, Song D, Liu Y, Chang L, Li C, Li Y. Sleep quality, caregiver burden, and individual resilience among parents of children with epilepsy. Epilepsy Behav 2022; 135:108873. [PMID: 35973374 DOI: 10.1016/j.yebeh.2022.108873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 08/03/2022] [Accepted: 08/03/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE Parents caring for children with epilepsy have poor sleep quality and experience a certain level of caregiving burden. Individual resilience is a crucial psychological variable that contributes to health during extraordinary challenges. This study aimed to determine the relationships among individual resilience, caregiver burden, and sleep quality. METHODS This was a descriptive cross-sectional study with a convenience sample, following the STROBE guidelines. One hundred and ninety-one parents of children with epilepsy were invited to participate in the study. Of these, 173 participants completed measures of sleep quality, caregiver burden, and individual resilience. Path analysis was performed to probe the indirect relationship between individual resilience and sleep quality via caregiver burden. RESULTS Correlation analysis revealed that individual resilience total scores were significantly and marginally negatively correlated with caregiver burden and sleep quality total scores (r = -0.215, P <.01; r = -0.250, P <.01). Moreover, there was a significant moderate positive correlation between the total caregiver burden scores and total sleep quality scores (r = 0.389, P <.001). The path model showed that individual resilience is indirectly associated with sleep quality via caregiver burden. CONCLUSION The higher the level of individual resilience, the less the caregiver burden and the better the sleep quality for parents of children with epilepsy.
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Affiliation(s)
- Qin Zhang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province 250012, China
| | - Dongyu Song
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province 250012, China
| | - Yuzhou Liu
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province 250012, China
| | - Lixia Chang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province 250012, China
| | - Chenglin Li
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province 250012, China
| | - Yuli Li
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province 250012, China.
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13
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Cheng HY, Li Y, Chau JPC, Chair SY. Influence of psychological responses of caregiving on the perceived health of family caregivers to acute stroke survivors. Medicine (Baltimore) 2022; 101:e30778. [PMID: 36197251 PMCID: PMC9509108 DOI: 10.1097/md.0000000000030778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Family caregivers provide round-the-clock care to their family members who had a stroke. The detrimental effects of caregiving on caregiver's health would lead to the abandonment of caregiver role and institutionalization of stroke survivors. This study aims to determine the factors associated with the perceived health status of family caregivers to stroke survivors. This study conducted a secondary analysis of the baseline data of 142 family caregivers of stroke survivors nested within a longitudinal randomized controlled trial. Potential factors were identified according to the Pittsburgh Mind-Body Center model and were analyzed with hierarchical multiple regression models. The results indicated that stroke caregivers exhibited comparable perceived physical health with general population but poorer perceived mental health. Severity of depressive symptoms (β = -0.37, P < .001) remained the strongest and most significant factor associated with perceived mental health, followed by confidence in problem-solving (β = -0.21, P < .05). Moreover, caregiving competence (β = 0.29, P < .001) was the sole significant psychological factor associated with perceived physical health. Caregiving competence, problem-solving abilities, and severity of depressive symptoms are significant modifiable correlates of the perceived health of caregivers. Intervention for improving these psychological responses of caregivers is suggested incorporated in stroke rehabilitation programs.
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Affiliation(s)
- Ho Yu Cheng
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- *Correspondence: Ho Yu Cheng, The Nethersole School of Nursing, 8/F, Esther Lee Building, The Chinese University of Hong Kong, Shatin, N. T., Hong Kong SAR, China (e-mail: )
| | - Yating Li
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Janita Pak-Chun Chau
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Sek Ying Chair
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
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14
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Gérain P, Zech E. Are caregiving appraisal and relationship quality key mediators in informal caregiving burnout? A structural equation modelling study in Belgium and France. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e2433-e2444. [PMID: 34914143 DOI: 10.1111/hsc.13684] [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: 11/20/2020] [Revised: 11/28/2021] [Accepted: 12/06/2021] [Indexed: 06/14/2023]
Abstract
Informal caregivers are key players in maintaining chronically ill patients at home but often experience negative consequences such as informal caregiver burnout. The processes by which determinants related to informal care and their personal and social resources affect the caregiver's risk of burnout remains little investigated. Recent theoretical works have suggested that two mediators could play an important role in understanding how these risks and resources influence informal caregiver burnout: by deteriorating how they view their role (caregiving appraisal) and by weakening the relationship with the care-recipient (relationship quality). The present study aimed at exploring the impact of the care-recipient's dependency (WHODAS), the caregiver's emotional intelligence (TEIQue-SF), and loneliness (UCLALS) on informal caregiver burnout (MBI-ICg). This association was explored both directly and through the mediation of caregiving appraisal (measured by subjective burden, ZBI) and relationship quality. To do so, a sample of 444 French-speaking informal caregivers completed online questionnaires from November 2017 to August 2018. Structural equation modelling (SEM) was performed to test the mediation model. As a result, the caregiving appraisal appears as a key mediator between determinants and informal caregiver burnout, whereas the relationship quality had a lower predictive value. Among the determinants, emotional intelligence was the strongest protective factor and the care-recipient's dependency was the strongest risk factor. But beyond this association, the perception informal caregivers have of their role (their caregiving appraisal) is a key mediator between these determinants and informal caregiver burnout, which emphasizes the importance of subjectivity in building risk and protective profiles.
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Affiliation(s)
- Pierre Gérain
- SCALab - CNRS UMR 9193, University of Lille, Lille, France
- Psychological Sciences Research Institute, UCLouvain, Louvain-la-Neuve, Belgium
| | - Emmanuelle Zech
- Psychological Sciences Research Institute, UCLouvain, Louvain-la-Neuve, Belgium
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15
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Tan DGH, Boo BMB, Chong CS, Tan MMLL, Wong BS. Effectiveness of home-based, non-exercise interventions for dementia: A systematic review. Front Aging Neurosci 2022; 14:846271. [PMID: 36034133 PMCID: PMC9403464 DOI: 10.3389/fnagi.2022.846271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 07/18/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction Dementia is a neurodegenerative condition characterized by cognitive decline and increased functional dependency. With most persons living with dementia (PLWDs) residing at home, home-based interventions provide a convenient and individualized alternative for person-centered care. Most of the evidence focused on specific interventions or exercise-based activities; there remains a gap in understanding the impacts of a broader range of non-exercise interventions on PLWDs and their caregivers. This review aimed to understand the impacts of home-based, non-exercise interventions on the behavioral, functional, cognitive, and mood outcomes of PLWDs, and their caregiver's quality of life (QoL), burden and mood. Methods Search for studies published up to June 2020 was conducted on CINAHL, PsycArticles, PubMed, SAGE Journals, Science Direct, and Web of Science. A search was also done manually based on the bibliographies of selected articles. The inclusion criteria for the systematic review were: (i) participants with a medical diagnosis of dementia, (ii) participants who resided at own home, (iii) intervention in the home setting, (iv) investigate interventions other than physical exercise, (v) randomized controlled trials (RCTs) or quasi-experimental studies, and (vi) full-text study published in English and in a peer-reviewed journal. Results and discussion Eighteen studies consisting of 14 RCTs and 4 quasi-experimental studies were included. Interventions included were occupational therapy, cognitive rehabilitation, tailored activity program, cognitive stimulation therapy, personalized reminiscence, music therapy, reality orientation, biobehavioral and multicomponent interventions. Results were mixed, but important intervention features were highlighted. Personalized activities for PLWDs that are aligned to their interest and ability appeared to contribute to intervention effectiveness especially in reducing behavioral symptoms and improving functional status. Involvement of caregivers in interventions is another feature of effective interventions for both the PLWDs and the caregivers' QoL, provided it is not deemed demanding or challenging to the caregivers. The inclusion of caregiver's education was effective in reducing caregivers' burden, particularly when the interventions improved the PLWD's functional status.
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Affiliation(s)
- Davynn Gim Hoon Tan
- Health and Social Sciences, Singapore Institute of Technology, Singapore, Singapore
| | | | - Cheyenne Shuen Chong
- Health and Social Sciences, Singapore Institute of Technology, Singapore, Singapore
| | | | - Boon-Seng Wong
- Health and Social Sciences, Singapore Institute of Technology, Singapore, Singapore
- Department of Physiology, National University of Singapore, Singapore, Singapore
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16
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Sorayyanezhad A, Nikpeyma N, Nazari S, Sharifi F, Sarkhani N. The relationship of caregiver strain with resilience and hardiness in family caregivers of older adults with chronic disease: a cross-sectional study. BMC Nurs 2022; 21:184. [PMID: 35821036 PMCID: PMC9277877 DOI: 10.1186/s12912-022-00966-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 06/30/2022] [Indexed: 11/23/2022] Open
Abstract
Background Providing long-term home care to older adults with chronic diseases may endanger the physical, mental, social, and spiritual health of caregivers and lead to care strain. Objective This study aimed to assess the relationship of caregiver strain with resilience and hardiness in family caregivers of older adults with chronic disease. Methodology This cross-sectional correlational study was conducted in 2020–2021 in Tehran. Participants were 230 family caregivers randomly recruited from 8 urban health care centers. Data were collected using a personal characteristics questionnaire, the Modified Caregiver Strain Index, Connor-Davidson Resilience Scale, Family Hardiness Index, and the data were analyzed by using SPSS 22 version. Pearson’s correlation coefficient was applied for data analysis. P-values ≤0.05 were considered significant. Results A total of 230 caregivers participated in the study. The mean age of participants was (46.65 ± 13.63) years and most of them were female (73.9%). Mean scores of caregiver strain, resilience, and hardiness in family caregivers were 16.23 ± 4.5, 39.89 ± 10.9, and 31.21 ± 7.79, respectively. Pearson correlation showed a significant and inverse correlation between caregiver strain and resilience (r = -0.310, P = 0.002), and also a significant and inverse relationship between caregiver strain and hardiness (r = -0.276, P = 0.001). Conclusion In this study, family caregivers had moderate caregiver strain, low resilience, and high hardness. Caregiver strain in family caregivers of older adults with chronic disease is an important health issue associated with resilience and hardiness. To promote health, effective adaptation to long-term care, and reduce caregiver strain, designing effective interventions to increase resilience and hardiness in family caregivers seems necessary.
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Affiliation(s)
- Ashkan Sorayyanezhad
- Department of Community Health and Geriatric Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, 1419732171, Iran
| | - Nasrin Nikpeyma
- Department of Community Health and Geriatric Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, 1419732171, Iran.
| | - Shima Nazari
- Department of Psychiatric Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Sharifi
- Elderly Health Research Center, Endocrine Population Sciences Institute, Endocrinology, and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Naeimeh Sarkhani
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
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17
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ERDUR E, YILDIRIM ÖA, KÖMEK H, POYRAZ K, ÇELİK M, YAMAN M. Evaluation of caregiver burden of cancer patients and impact of this burden on caregiver's quality of life. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2022. [DOI: 10.32322/jhsm.1025215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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18
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Mamom J, Daovisan H. Listening to Caregivers' Voices: The Informal Family Caregiver Burden of Caring for Chronically Ill Bedridden Elderly Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:567. [PMID: 35010827 PMCID: PMC8744801 DOI: 10.3390/ijerph19010567] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/22/2021] [Accepted: 12/30/2021] [Indexed: 02/01/2023]
Abstract
The informal family caregiver burden (IFCB) for chronically ill bedridden elderly patients (CIBEPs) is a major issue worldwide. It is a significant challenge due to the ongoing increased palliative care in the family setting; therefore, we explored the IFCB of caring for CIBEPs in Thailand. This article utilized a qualitative method, the total interpretive structural modeling (TISM) approach, with purposive sampling of thirty respondents between September and December 2020. The data were analyzed using cross-impact matrix multiplication applied to classification (MICMAC) to determine the relationship between the driving and dependence power of the enabling factors. The IFCB of the palliative care of CIBEPs was associated with primary care, nursing, extrinsic monitoring and complication prevention. The results showed that the IFCB involves taking responsibility, daily workload, follow-up caring, caring tasks, caregiving strain, financial distress, patient support, external support and caregiving strategy; thus, assistance with taking responsibility, extrinsic monitoring and follow-up care daily tasks may reduce the caregiver burden.
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Affiliation(s)
- Jinpitcha Mamom
- Department of Adult Nursing and the Aged, Faculty of Nursing, Thammasat University, Khlong Luang, Pathum Thani 12121, Thailand
- Excellence Center in Creative Engineering Design and Development, Faculty of Engineering, Thammasat University, Khlong Luang, Pathum Thani 12121, Thailand
| | - Hanvedes Daovisan
- Human Security and Equity Research Unit, Chulalongkorn University Social Research Institute, Chulalongkorn University, Bangkok 10330, Thailand;
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19
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Dionne-Odom JN, Azuero A, Taylor RA, Wells RD, Hendricks BA, Bechthold AC, Reed RD, Harrell ER, Dosse CK, Engler S, McKie P, Ejem D, Bakitas MA, Rosenberg AR. Resilience, preparedness, and distress among family caregivers of patients with advanced cancer. Support Care Cancer 2021; 29:6913-6920. [PMID: 34031751 PMCID: PMC9733586 DOI: 10.1007/s00520-021-06265-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 04/30/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Resilience has been proposed as a primary factor in how many family caregivers of patients with advanced cancer are able to resist psychological strain and perform effectively in the role while bearing a high load of caregiving tasks. To evaluate this hypothesis, we examined whether self-perceived resilience is associated with distress (anxiety and depressive symptoms), caregiver preparedness, and readiness for surrogate decision-making among a racially diverse sample of family caregivers of patients with newly diagnosed advanced cancer. METHODS Secondary analysis of baseline data from two small-scale, pilot clinical trials that both recruited family caregivers of patients with newly diagnosed advanced cancer. Using multivariable linear regression, we analyzed relationships of resilience as a predictor of mood, caregiving preparedness, and readiness for surrogate decision-making, controlling for sociodemographics. RESULTS Caregiver participants (N = 112) were mean 56 years of age and mostly female (76%), the patient's spouse/partner (52%), and White (56%) or African-American/Black (43%). After controlling for demographics, standardized results indicated that higher resilience was relevantly associated with higher caregiver preparedness (beta = .46, p < .001), higher readiness for surrogate decision-making (beta = .20, p < .05) and lower anxiety (beta = - .19, p < .05), and depressive symptoms (beta = - .20, p < .05). CONCLUSIONS These results suggest that resilience may be critical to caregivers' abilities to manage stress, be effective sources of support to patients, and feel ready to make future medical decisions on behalf of patients. Future work should explore and clinicians should consider whether resilience can be enhanced in cancer caregivers to optimize their well-being and ability to perform in the caregiving and surrogate decision-making roles.
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Affiliation(s)
| | - Andres Azuero
- School of Nursing, University of Alabama At Birmingham, Birmingham, AL, USA
| | - Richard A Taylor
- School of Nursing, University of Alabama At Birmingham, Birmingham, AL, USA
| | - Rachel D Wells
- School of Nursing, University of Alabama At Birmingham, Birmingham, AL, USA
| | - Bailey A Hendricks
- School of Nursing, University of Alabama At Birmingham, Birmingham, AL, USA
| | - Avery C Bechthold
- School of Nursing, University of Alabama At Birmingham, Birmingham, AL, USA
| | - Rhiannon D Reed
- Comprehensive Transplant Institute, University of Alabama At Birmingham, Birmingham, AL, USA
| | - Erin R Harrell
- Department of Psychology, University of Alabama, Tuscaloosa, AL, USA
| | - Chinara K Dosse
- School of Nursing, University of Alabama At Birmingham, Birmingham, AL, USA
| | - Sally Engler
- School of Nursing, University of Alabama At Birmingham, Birmingham, AL, USA
| | - Peggy McKie
- School of Nursing, University of Alabama At Birmingham, Birmingham, AL, USA
| | - Deborah Ejem
- School of Nursing, University of Alabama At Birmingham, Birmingham, AL, USA
| | - Marie A Bakitas
- School of Nursing, University of Alabama At Birmingham, Birmingham, AL, USA
| | - Abby R Rosenberg
- Division of Hematology-Oncology, Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA
- Cambia Palliative Care Center of Excellence, University of Washington, Seattle, WA, USA
- Palliative Care and Resilience Lab, Seattle Children's Research Institute, Seattle, WA, USA
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20
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Fernández-Portero C, Alarcón D, Gallardo-Flores A, Amián JG, Sánchez-Medina JA. Effectiveness of a Mindfulness-Based Intervention Program for Women Family Caregivers of Older Adults. Healthcare (Basel) 2021; 9:healthcare9091216. [PMID: 34574990 PMCID: PMC8465928 DOI: 10.3390/healthcare9091216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 09/13/2021] [Accepted: 09/13/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The objective of this study was to analyze the effectiveness of a mindfulness-based intervention program for the promotion of well-being and health in family caregivers. METHODS The participants were 111 family women caregivers aged between 33 and 75 years old. This was a double-blinded randomized controlled trial. The mindfulness intervention program lasted 12 weeks. The experimental group underwent mindfulness and acceptance-based interventions (MABIs). The control group performed physical activity training. RESULTS A cross-lagged panel analysis was computed with the two waves of health, well-being, burden and resilience and age in years and intervention as predictors. The cross-lagged path model fit well χ2 (8) = 7.179, p = 0.51, root mean square error of approximation (RMSEA) = 0.00, comparative fit index (CFI) = 1.00, standardized root mean square residual (SRMR) = 0.05. The mindfulness intervention program was a significant predictor accounting for decreasing health problems (β = -0.292, p < 0.01) and burden (β = -0.190, p < 0.01) and increasing well-being (β = 0.107, p < 0.05) at post-test. CONCLUSIONS Mindfulness-based intervention programs are effective in coping with the burden of family caregivers and, in turn, in promoting resilience, well-being and health among caregivers. Our findings encourage clinical uses of mindfulness interventions to promote health.
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Affiliation(s)
- Cristina Fernández-Portero
- Deparment of Social Antropology, Psychology and Public Health, Pablo de Olavide University, 41013 Sevilla, Spain; (C.F.-P.); (J.G.A.); (J.A.S.-M.)
| | - David Alarcón
- Deparment of Social Antropology, Psychology and Public Health, Pablo de Olavide University, 41013 Sevilla, Spain; (C.F.-P.); (J.G.A.); (J.A.S.-M.)
- Correspondence: ; Tel.: +34-95-4977-406
| | - Ana Gallardo-Flores
- Deparment of Social Work and Social Services, Pablo de Olavide University, 41013 Sevilla, Spain;
| | - Josue G. Amián
- Deparment of Social Antropology, Psychology and Public Health, Pablo de Olavide University, 41013 Sevilla, Spain; (C.F.-P.); (J.G.A.); (J.A.S.-M.)
| | - Jose A. Sánchez-Medina
- Deparment of Social Antropology, Psychology and Public Health, Pablo de Olavide University, 41013 Sevilla, Spain; (C.F.-P.); (J.G.A.); (J.A.S.-M.)
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21
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Shimizu Y, Hayashi A, Maeda I, Miura T, Inoue A, Takano M, Aoyama M, Matsuoka YJ, Morita T, Kizawa Y, Tsuneto S, Shima Y, Masukawa K, Miyashita M. Changes in depressive symptoms among family caregivers of patients with cancer after bereavement and their association with resilience: A prospective cohort study. Psychooncology 2021; 31:86-97. [PMID: 34343380 PMCID: PMC9292523 DOI: 10.1002/pon.5783] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 07/21/2021] [Accepted: 07/27/2021] [Indexed: 11/29/2022]
Abstract
Objectives To elucidate changes in depressive symptoms after bereavement and the impact of pre‐loss resilience on such changes and on the extent of complicated grief and posttraumatic growth. Methods Prospective cohort surveys were provided to family caregivers of patients with cancer in four palliative care units (PCUs) before and after bereavement. Pre‐loss Connor–Davidson Resilience Scale scores, pre‐ and post‐loss Patient Health Questionnaire‐9 scores, post‐loss Brief Grief Questionnaire scores, and the expanded Posttraumatic Growth Inventory scores were determined. Results Out of 186 bereaved family caregivers, 71 (38.2%) responses were analyzed, among which 47% pre‐loss and 15% post‐loss responses suggested to be a high risk for major depressive disorder (MDD). Approximately 90% of family caregivers at a high risk for post‐loss MDD were already at a high risk for pre‐loss MDD. Even after adjustment of the background variables as covariates, the interaction effect between family caregivers' pre‐loss depressive symptoms and resilience on post‐loss depressive symptoms was observed (F = 7.29; p < 0.01). Moreover, pre‐loss resilience was not associated with other bereavement outcome measures. Conclusions Among family caregivers of patients with cancer in PCUs, 47% and 15% had high risk for MDD before and after bereavement, respectively. Moreover, pre‐loss resilience mitigated post‐loss depressive symptoms among family caregivers who had high risk for MDD before bereavement. However, considering the study's small sample size, further research is needed.
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Affiliation(s)
- Yoichi Shimizu
- Department of Nursing, National Cancer Center Hospital, Tokyo, Japan.,Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Akitoshi Hayashi
- Department of Palliative Care, St. Luke's International Hospital, Tokyo, Japan
| | - Isseki Maeda
- Department of Palliative Care, Senri-Chuo Hospital, Toyonaka, Japan
| | - Tomofumi Miura
- Department of Palliative Medicine, National Cancer Center Hospital East, Kashiwa, Japan
| | - Akira Inoue
- Department of Palliative Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Mayuko Takano
- Department of Nursing, St. Luke's International Hospital, Tokyo, Japan
| | - Maho Aoyama
- Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yutaka J Matsuoka
- Division of Health Care Research, Center for Public Health Sciences, National Cancer Center Japan, Tokyo, Japan
| | - Tatsuya Morita
- Division of Palliative and Supportive Care, Seirei Mikatahara General Hospital, Hamamatsu, Japan
| | - Yoshiyuki Kizawa
- Department of Palliative Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Satoru Tsuneto
- Department of Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yasuo Shima
- Department of Palliative Medicine, Tsukuba Medical Center Hospital, Tsukuba, Japan
| | - Kento Masukawa
- Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Mitsunori Miyashita
- Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Japan
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22
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Krok D, Zarzycka B, Telka E. The Religious Meaning System and Resilience in Spouse Caregivers of Cancer Patients: A Moderated Mediation Model of Hope and Affect. JOURNAL OF RELIGION AND HEALTH 2021; 60:2960-2976. [PMID: 34041684 PMCID: PMC8270831 DOI: 10.1007/s10943-021-01278-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 05/06/2021] [Indexed: 06/12/2023]
Abstract
The character of the relationship between religiosity and resilience depends to a large extent on mediation and moderation mechanisms which rely on cognitive and emotional processes. Research conducted within hope theory and the broaden and build theory indicates that hope and affect can mediate and moderate this relationship. The present study explored whether the relationship of the religious meaning system with resilience in spouse caregivers of cancer patients can be mediated by hope and simultaneously moderated by positive and negative affect. A total of 241 spouse caregivers completed a set of questionnaires. The results revealed that hope mediated the relationship between the religious meaning system and resilience. Furthermore, positive affect but not negative affect moderated the indirect effect of the religious meaning system to resilience through hope.
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Affiliation(s)
- Dariusz Krok
- Institute of Psychology, University of Opole, Plac Staszica 1, 45-052, Opole, Poland
| | - Beata Zarzycka
- Institute of Psychology, John Paul II Catholic University of Lublin, Lubin, Poland
| | - Ewa Telka
- The Maria Sklodowska-Curie Cancer Center, Institute of Oncology in Gliwice, Gliwice, Poland
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23
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van Roij J, Brom L, Sommeijer D, van de Poll-Franse L, Raijmakers N. Self-care, resilience, and caregiver burden in relatives of patients with advanced cancer: results from the eQuiPe study. Support Care Cancer 2021; 29:7975-7984. [PMID: 34215933 PMCID: PMC8549961 DOI: 10.1007/s00520-021-06365-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 06/13/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE Relatives are often involved in caregiving for patients with advanced cancer and carry a heavy burden. Self-care and resilience might be beneficial to enhance their wellbeing and burden-bearing capacity. This study assessed the engagement in self-care and resilience in relatives of patients with advanced cancer and its association with their caregiver burden. METHODS This study analyzed baseline data of the eQuiPe study, a prospective longitudinal, multicenter, observational study on quality of care and life of patients with advanced cancer and their relatives in which self-care (Self-care Practices Scale), resilience (Connor-Davidson Resilience Scale), and caregiver burden (Zarit Burden Interview (ZBI)) of relatives were included. Their scores were compared with a gender- and age-matched normative population. Multivariable logistic regression analysis was performed to assess the association between self-care and resilience with caregiver burden. RESULTS Most of the 746 relatives were the patient's partner (78%) and 54% reported to be an informal caregiver of the patient. The median hours of caregiving a week for all relatives was 15 and 11% experienced high caregiver burden (ZBI > 20). Relatives who reported a high caregiver burden engaged less often in self-care (OR = .87) and were less resilient (OR = .76) compared to relatives with low/medium caregiver burden. Relatives with high caregiver burden were younger (OR = .96), highly educated (OR = 2.08), often reported to be an informal caregiver of the patient (OR = 2.24), and were less well informed about the importance of self-care (OR = .39). CONCLUSION A significant number of relatives of patients with advanced cancer experienced high caregiver burden. As more self-care and resilience were associated with lower experienced caregiver burden, creating awareness of the beneficial potential of self-care is important. Future studies should illuminate the causal relation. TRIAL REGISTRATION NUMBER NTR6584 (date of registration: 30 June 2017).
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Affiliation(s)
- Janneke van Roij
- Research & Development, Netherlands Comprehensive Cancer Organization (IKNL), PO box 19079, 3501 DB, Utrecht, The Netherlands.,CoRPS-Center of Research On Psychology in Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.,Netherlands Association for Palliative Care (PZNL), Utrecht, The Netherlands.,Libra Rehabilitation and Audiology, Tilburg, The Netherlands
| | - Linda Brom
- Research & Development, Netherlands Comprehensive Cancer Organization (IKNL), PO box 19079, 3501 DB, Utrecht, The Netherlands.,Netherlands Association for Palliative Care (PZNL), Utrecht, The Netherlands
| | - Dirkje Sommeijer
- Department of Medical Oncology, Amsterdam University Medical Center, Amsterdam, The Netherlands.,Department of Medical Oncology, Almere, The Netherlands
| | - Lonneke van de Poll-Franse
- Research & Development, Netherlands Comprehensive Cancer Organization (IKNL), PO box 19079, 3501 DB, Utrecht, The Netherlands.,CoRPS-Center of Research On Psychology in Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.,Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Natasja Raijmakers
- Research & Development, Netherlands Comprehensive Cancer Organization (IKNL), PO box 19079, 3501 DB, Utrecht, The Netherlands. .,Netherlands Association for Palliative Care (PZNL), Utrecht, The Netherlands.
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24
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Ruiz BO, Zerbetto SR, Galera SAF, Barcellos Fontanella BJ, Gonçalves AMDS, Protti-Zanatta ST. Family resilience: perception of family members of psychoactive substance dependents. Rev Lat Am Enfermagem 2021; 29:e3449. [PMID: 34190940 PMCID: PMC8253349 DOI: 10.1590/1518-8345.3816.3449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Accepted: 11/02/2020] [Indexed: 12/02/2022] Open
Abstract
Objective: to understand the perception of family members of psychoactive substance
dependents on the elements of the functioning of their family in family
resilience. Method: a qualitative approach study, based on the theoretical interpretive framework
of family resilience from a systemic perspective. The participants were
eleven family members of psychoactive substance dependents from a
Psychosocial Care Center - Alcohol and Drugs, from a city in the state of
São Paulo. For data collection, semi-structured interview, genogram and
ecomap were used. Data analysis was based on the Content Analysis technique,
thematic category. Results: from the interviews, three thematic categories were formulated: mobilization
in search of support and social support; positive perspectives that would
strengthen the family, and assertive communication. These categories point
to references to the mobilization and unity of the family in search of
social support in the intra-family, extended family and extra-family
contexts and positive perspectives, such as persistence, perseverance, hope,
faith and religiousness. Conclusion: the situation of having a psychoactive substance dependent in the family
seemed to mobilize coping devices and attempts to overcome them through the
resilience forces. The results may favor the daily clinical reasoning of the
health professionals, helping them to recognize and value the identified
resilience attributes.
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Affiliation(s)
| | | | - Sueli Aparecida Frari Galera
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
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25
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Xue M, Zhai X, Liu S, Xu N, Han J, Zhou M. The experience of family caregivers of patients receiving home nasogastric tube feeding in China: A descriptive qualitative study. J Hum Nutr Diet 2021; 35:14-22. [PMID: 33908101 PMCID: PMC9291130 DOI: 10.1111/jhn.12908] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 03/18/2021] [Accepted: 04/20/2021] [Indexed: 11/30/2022]
Abstract
Background The value of caregivers with respect to ensuring safety during home nasogastric tube (NGT) feeding is increasingly acknowledged. However, little attention has been given to the experience of caregivers. Methods A qualitative descriptive design using semi‐structured interviews via purposive sampling at a comprehensive hospital in China was employed. Family caregivers of patients with home NGT feeding were recruited. Interviews were recorded, transcribed verbatim and analysed qualitatively using inductive content analysis. Results Thirteen family caregivers of patients with home NGT feeding were interviewed. Four main themes were generated: negative experience (uncertainty and ambivalence, transition gaps between hospitals and home care services), new role: adapting to the lifestyle (participating in decision‐making, being responsible for everything, adjusting own life to NGT feeding), perceived benefit of caregiving (personal growth, development of positive attitudes and achievements) and expectations (expectations from continuity health system services, expectations from social support). Conclusions The present study highlights the vulnerability and perceived benefits embedded in the role of a family caregiver. Improving communication and standardising practices between home and hospitals should be considered.
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Affiliation(s)
- Min Xue
- Qilu Hospital, Shandong University, Jinan, China.,Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | | | - Sihan Liu
- Qilu Hospital, Shandong University, Jinan, China
| | - Nana Xu
- Qilu Hospital, Shandong University, Jinan, China
| | - Jing Han
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Min Zhou
- Qilu Hospital, Shandong University, Jinan, China
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26
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Impact of the caregiver burden on the effectiveness of a home-based palliative care program: A mediation analysis. Palliat Support Care 2021; 18:332-338. [PMID: 31559939 DOI: 10.1017/s1478951519000749] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The growing aging population and the high prevalence of several concomitant chronic diseases have contributed to the elevated rates of caregiver burden and suffering in patients. In turn, intending to relieve unnecessary pain in patients, there has been a rapid growth of outpatient palliative care programs. However, little has been studied about caregiver burden as a relevant factor potentially affecting the effectiveness of these programs. This study aimed to determine the extent of caregiver burden as a possible mediator on the effectiveness of a home-based palliative care program. METHOD Sixty-six palliative patients (56% women; mean age + SD = 71, 6 ± 17.7) and their caregivers were assessed with measures for physical, emotional, and psychological symptoms before and 1 month after the start of a home-based palliative care program. RESULTS The association between caregiver burden and palliative outcomes was corroborated with a categorical regression model (p < 0.01). Caregiver burden was found to be a significant mediator in the relationship between outcome measures for palliative care at baseline and after 1 month of enrollment in the program. SIGNIFICANCE OF RESULTS To our knowledge, this is the first study to assess the role of caregiver burden in the effectiveness of a home-based palliative care program. Although further work is required, the results indicate that a patient-focused intervention does not have the same beneficial effect if the caregiver burden is not addressed. Future home-based palliative care programs should focus on caregivers as well as patients, with particular attention to psychosocial intervention on caregivers.
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del-Pino-Casado R, Priego-Cubero E, López-Martínez C, Orgeta V. Subjective caregiver burden and anxiety in informal caregivers: A systematic review and meta-analysis. PLoS One 2021; 16:e0247143. [PMID: 33647035 PMCID: PMC7920375 DOI: 10.1371/journal.pone.0247143] [Citation(s) in RCA: 77] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 02/02/2021] [Indexed: 12/12/2022] Open
Abstract
There is increasing evidence that subjective caregiver burden is an important determinant of clinically significant anxiety in family carers. This meta-analysis aims to synthesise this evidence and investigate the relationship between subjective caregiver burden and anxiety symptoms in informal caregivers. We searched PubMed, CINAHL and PsycINFO up to January 2020. Combined estimates were obtained using a random-effects model. After screening of 4,312 articles, 74 studies (with 75 independent samples) were included. There was a large, positive association between subjective caregiver burden and anxiety symptoms (r = 0.51; 95% CI = 0.47, 0.54; I2 = 0.0%). No differences were found in subgroup analyses by type of study design (cross-sectional vs. longitudinal), sampling, control of confounders or care-recipient characteristics. Subjective caregiver burden is an important risk factor for anxiety in informal caregivers. Targeting subjective caregiver burden could be beneficial in preventing clinically significant anxiety for the increasing number of family carers worldwide.
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Affiliation(s)
- Rafael del-Pino-Casado
- Faculty of Health Sciences, Department of Nursing, University of Jaén, Jaén, Andalusia, Spain
- * E-mail:
| | - Emilia Priego-Cubero
- Faculty of Health Sciences, Department of Nursing, University of Jaén, Jaén, Andalusia, Spain
| | - Catalina López-Martínez
- Faculty of Health Sciences, Department of Nursing, University of Jaén, Jaén, Andalusia, Spain
| | - Vasiliki Orgeta
- Division of Psychiatry, University College London, London, United Kingdom
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28
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Predictive model of psychological distress in family caregivers of patients with cancer: a cross-sectional study. Support Care Cancer 2021; 29:5091-5101. [PMID: 33598735 DOI: 10.1007/s00520-021-06022-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 01/21/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE To examine a predictive theoretical model of psychological distress based on the following variables reflected on family caregivers of patients with cancer: the unmet supportive care needs, subjective caregiving burden, social support, and the positive aspects of caregiving. METHODS A cross-sectional descriptive study was conducted on a sample of 484 dyads of patients and their family caregivers. The caregivers completed structured questionnaires designed to measure psychological distress, unmet supportive care needs, subjective caregiving burden, positive aspects of caregiving, and social support. Patients' demographic variables and medical data were collected from a medical record review. We used a structural equation modeling to test the predictive theoretical model. RESULTS Path analysis results partially supported the proposed model with satisfactory fit indices. Specifically, family caregivers with an increasing number of unmet needs or a heavier caregiving burden were more likely to have more severe psychological distress. Bootstrapping results supported that the caregiving burden and social support were significant mediators. Greater unmet supportive care needs predicted higher psychological distress through increasing caregiving burden. Stronger social support predicted lower psychological distress through decreasing caregiving burden. Positive aspects of caregiving predicted lower caregiving burden through the increasing perceived social support, which in turn eliminated psychological distress. CONCLUSIONS Unmet supportive care needs could cause psychological distress through increasing caregiving burden. The positive aspects of caregiving reduced caregiving burden through increasing social support, which subsequently alleviated psychological distress. Interventions that aim to satisfy supportive care needs, to reduce caregiving burden, and to strengthen social support ties may boost the mental health of family caregivers.
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29
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Sun H, Qin Y, Hengudomsub P. Factors associated with resilience in spousal caregivers of patients with cancer: An integrative review. Nurs Open 2021; 8:2131-2141. [PMID: 33465282 PMCID: PMC8363360 DOI: 10.1002/nop2.771] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 11/26/2020] [Accepted: 12/16/2020] [Indexed: 12/11/2022] Open
Abstract
Aim To explore resilience and associated factors in spousal caregivers of patients with cancer. Design An integrative review. Methods This review used the standardized critical appraisal instruments developed by the Joanna Briggs Institute and was conducted by researching the electronic databases of Cochrane, CINAHL, ProQuest, Science Direct, PubMed, Scopus, EBSCO and Google Scholar. The articles were published in English with full text from January 2010 to January 2020. Results According to data retrieval, 26 articles were finally selected. From this review, resilience was typically measured by using exact resilience scales (i.e. Connor‐Davidson or Wagnild Resilience Scales) or using other variables to indicate either more positive psychological outcomes or less negative psychological outcomes. For factors associated with resilience, these were classified as individual internal and external factors. Internal factors included caregiver burden, psychological distress, coping strategies and other factors, whereas social support, couple interaction, patient health status and other parameters were considered external factors. Conclusions Resilience plays an important role in promoting positive adaptation in spite of adversity among the spousal caregivers of patients with cancer. Due to the uniqueness of resilience among spousal caregivers, ways to assess resilience and identify its associated factors deserve more attention and careful consideration.
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Affiliation(s)
- Haiyan Sun
- School of Nursing, Jiangsu Vocational College of Medicine, Jiangsu, China
| | - Yang Qin
- School of Nursing, Jiangsu Vocational College of Medicine, Jiangsu, China
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30
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Merlo EM, Stoian AP, Motofei IG, Settineri S. Clinical Psychological Figures in Healthcare Professionals: Resilience and Maladjustment as the "Cost of Care". Front Psychol 2020; 11:607783. [PMID: 33335503 PMCID: PMC7736062 DOI: 10.3389/fpsyg.2020.607783] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 10/23/2020] [Indexed: 11/30/2022] Open
Abstract
Background: The health professionals are involved in the paths of care for patients with different medical conditions. Their life is frequently characterized by psychopathological outcomes so that it is possible to identify consistent burdens. Besides the possibility to develop pathological outcomes, some protective factors such as resilience play a fundamental role in facilitating the adaptation process and the management of maladaptive patterns. Personal characteristics and specific indexes such as burdens and resilience are essential variables useful to study in-depth ongoing conditions and possible interventions. The study was aimed at highlighting the presence and the relations among factors as personal variables, burdens, and resilience, to understand health professionals' specific structure and functions. Methods: The observation group was composed of 210 participants, 55 males (26.2%), and 155 females (73.8%), aged from 18 to 30 years old with a mean age of 25.92 years old (SD = 3.33). The study considered personal characteristics of the subjects, such as age, gender, years of study, days of work per week, hours of work per week, and years of work. Our study had been conducted with the use of measures related to burdens (Caregivers Burden Inventory) and resilience (Resilience Scale for Adults). Results: The performed analyses consisted of descriptive statistics, correlations, and regressions among the considered variables. Several significant correlations emerged among personal characteristics, CBI, and RSA variables. Specifically, age and work commitment indexes appeared to be significantly related to the development of burdens, differently from the years of study. Significant correlations emerged among personal and RSA variables, indicating precise directions for both domains. Age and gender were identified as predictors to perform multivariate regression analyses concerning CBI factors. Significant dependence relations emerged with reference to all CBI variables. Conclusion: Pathological outcomes and resilience factors represent two sides of the health professionals' experiences, also known as “invisible patients.” Greater knowledge about present conditions and future possibilities is a well-known need in literature so that the current analyses considered fundamental factors. In line with state of the art, future studies are needed in order to deepen elusive phenomena underlying maladjustment.
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Affiliation(s)
- Emanuele Maria Merlo
- Department of Cognitive Sciences, Psychology, Educational and Cultural Studies (COSPECS), University of Messina, Messina, Italy.,CRISCAT (International Research Center for Theoretical and Applied Cognitive Sciences), University of Messina and Universitary Consortium of Eastern Mediterranean, Noto (CUMO), Noto, Italy
| | - Anca Pantea Stoian
- Faculty of General Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,National Institute of Diabetes, Nutrition and Metabolic Diseases "N. C. Paulescu," Bucharest, Romania
| | - Ion G Motofei
- Faculty of General Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Salvatore Settineri
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
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31
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Üzar-Özçeti̇n YS, Dursun Sİ. Quality of life, caregiver burden, and resilience among the family caregivers of cancer survivors. Eur J Oncol Nurs 2020; 48:101832. [DOI: 10.1016/j.ejon.2020.101832] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 08/17/2020] [Accepted: 09/10/2020] [Indexed: 10/23/2022]
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Informal caregiver well-being during and after patients' treatment with adjuvant chemotherapy for colon cancer: a prospective, exploratory study. Support Care Cancer 2020; 29:2481-2491. [PMID: 32935205 PMCID: PMC7981306 DOI: 10.1007/s00520-020-05738-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 09/04/2020] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Caring for a significant other during cancer treatment can be demanding. Little is known about the well-being of informal caregivers of patients with colon cancer. This study aims to examine informal caregiver well-being during adjuvant chemotherapy for colon cancer. MATERIAL AND METHODS This exploratory longitudinal, prospective study measured the course of informal caregiver burden (Self-Perceived Pressure of Informal Care), distress (Hospital Anxiety and Depression Scale), health-related quality of life (RAND-36), marital satisfaction (Maudsley Marital Questionnaire), social support (Social Support List - Discrepancies), fatigue (Abbreviated Fatigue Questionnaire), and self-esteem (Caregiver Reaction Assessment) before (T0), during (T1), and after (T2) patients' treatment. RESULTS Baseline data of 60 out of 76 eligible dyads (79%) were analyzed. Mean levels of informal caregiver burden and distress improved significantly over time, as did their health-related quality of life and perceived social support. At baseline, 30% and 26.7% of informal caregivers reported moderate-to-high levels of burden and clinically relevant levels of distress, respectively, which changed to 20% and 18.8% at T2. Informal caregiver burden and distress at baseline were the strongest predictors of informal caregiver burden and distress during and following patients' treatment, respectively. CONCLUSION When informal caregivers and patients experience problems before start of adjuvant chemotherapy, problems seem to improve over time. Approximately 20% of informal caregivers remain burdened and distressed after patients' end of treatment. Paying attention to baseline distress and burden seems indicated, as these were strong predictors of informal caregivers' well-being during and after treatment.
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33
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Lee EE, Lee SY. Caregiving experiences of Korean family caregivers of cancer patients: An integrative literature review. Psychooncology 2020; 29:1486-1503. [PMID: 32720400 DOI: 10.1002/pon.5498] [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: 01/24/2020] [Revised: 07/09/2020] [Accepted: 07/22/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The purpose of this study was to describe the experiences of Korean family caregivers of patients with cancer by reviewing recent literature. METHODS Five electronic databases were searched-MEDLINE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PubMed for English literature, and Korean Information Service System (KISS), and Research Information Sharing Service (RISS) for Korean literature for articles published from January 2010 to March 2020 using the key words cancer, caregiver, and Korean. Twenty-six articles met the inclusion criteria and remained in the final review. RESULTS No intervention study was found and most of studies were quantitative without theoretical/conceptual framework. All the studies were conducted with Koreans living in Korea. No previous study has been conducted with Koreans living in the U.S. or other countries. Most studies focused on caregivers' quality of life, burden, unmet needs, and resilience/adaptation/post-traumatic growth. CONCLUSIONS Comprehensive intervention studies focused on improving quality of life, burden, and adaptation to their complex roles as caregivers in the context of Korean culture would be helpful. Further research is needed in examining the caregiver-patient dyad interactions longitudinally to understand the dynamic complicated processes of caregiving.
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Affiliation(s)
- Eunice E Lee
- School of Nursing, University of California, Los Angeles, California, USA
| | - Shin-Young Lee
- Department of Nursing, Chosun University, Gwangju, Republic of Korea
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34
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Propiedades psicométricas de una escala de resiliencia en cuidadores familiares de adultos mayores. ACTA COLOMBIANA DE PSICOLOGIA 2020. [DOI: 10.14718/acp.2020.23.2.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
El cuidado de un adulto mayor se ha estudiado no solo como una circunstancia generadora de estrés y deterioro del bienestar para el cuidador, sino también, desde la perspectiva de la psicología positiva, como la disposición de los cuidadores para reaccionar de manera resiliente ante las dificultades experimentadas. El objetivo del presente estudio fue realizar la validación de constructo del Inventario de Resiliencia (IRES) mediante algunos procedimientos exploratorios y confirmatorios. Para ello, se colectaron datos de dos muestras independientes de cuidadores familiares de adultos mayores en la ciudad de Hermosillo, México: la primera con 125 cuidadores de 19 a 73 años (Medad = 47.8, DE = 12) para los análisis factoriales exploratorios; y la segunda con 160 cuidadores de 19 a 82 años (Medad = 48.7, DE = 13) para los análisis factoriales confirmatorios. Los análisis revelaron dos dimensiones claras y robustas estadísticamente en el IRES con 12 ítems: la resiliencia instrumental y la resiliencia emocional. En conclusión, la presente investigación muestra que el IRES es un instrumento válido para la medición de la resiliencia en una población mexicana de cuidadores familiares de adultos mayores.
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35
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Abstract
Palliative care (PC) is an approach to the care of persons affected by serious illness that focuses on reducing suffering by addressing medical, psychosocial, and spiritual needs. Persons living with Parkinson disease have PC needs that begin at the time of diagnosis and continue throughout the course of the illness including nonmotor symptom burden, caregiver distress, grief, and increased mortality. Primary PC refers to essential PC skills that may be practiced by nonpalliative medicine specialists to improve outcomes for their patients.
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Affiliation(s)
- Hillary D Lum
- Division of Geriatric Medicine, Department of Medicine, University of Colorado Denver, University of Colorado Anschutz Medical Campus, Mail Stop C-293, 12631 East 17th Avenue, Aurora, CO 80045, USA; Eastern Colorado VA Geriatric Research Education and Clinical Center, Aurora, CO, USA
| | - Benzi M Kluger
- Department of Neurology, University of Colorado Denver, University of Colorado Anschutz Medical Campus, Mail Stop B-185, 12631 East 17th Avenue, Aurora, CO 80045, USA.
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36
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DURAN SONGÜL, Kaynak S, Karadas A. Palyatif bakım hastasına bakım verenlerde depresyon, anksiyete ve stres düzeyi: tanımlayıcı-kesitsel tipte bir çalışma. FAMILY PRACTICE AND PALLIATIVE CARE 2019. [DOI: 10.22391/fppc.532571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Abbasi A, Mirhosseini S, Basirinezhad MH, Ebrahimi H. Relationship between caring burden and quality of life in caregivers of cancer patients in Iran. Support Care Cancer 2019; 28:4123-4129. [PMID: 31872293 DOI: 10.1007/s00520-019-05240-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 12/10/2019] [Indexed: 01/04/2023]
Abstract
PURPOSE Cancer is associated with social, economic, and emotional consequences. Cancer caregivers would face high caring burden predisposing them to stress, depression, and decreased quality of life. This study aimed to determine the relationship between the quality of life and caring burden among cancer patients' caregivers in Iran. METHODS This cross-sectional study was performed on 154 caregivers for cancer patients referred to Imam Hossein Hospital of Shahroud city. Accessible sampling method was used to recruit the participants in this study. Data collection tools included a form for recording demographic characteristics, the SF-36 quality of life questionnaire, and the Novak & Guest caring burden inventory. The data was collected by self-reporting and was then analyzed using descriptive and inferential statistics (multivariate linear regression analysis and Pearson correlation coefficient). RESULTS The mean age of the caregivers was 41.30 ± 13.12 years old. The participants' average scores of caring burden and quality of life were 55.85 ± 20.33 (range between 24 and 120, moderate score of 48 to 71) and 59.79 ± 19.65, respectively. There was a significant reduction in the caregivers' quality of life with increasing of the care burden. Moreover, married caregivers have better quality of life and along with increasing of their income, their quality of life decreases. CONCLUSION Cancer patients' caregivers are prone to burden of care which affects their quality of life. Therefore, it is recommended to reduce the caring burden and improve the quality of life of the caregivers by providing appropriate mental, psychological, and social supports.
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Affiliation(s)
- Ali Abbasi
- Department of Nursing, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | | | - Mohammad Hasan Basirinezhad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Ebrahimi
- Department of Nursing, Randomized Controlled Trial Research Center, Shahroud University of Medical Sciences, 7th Sq. Shahroud University of Medical Sciences, Shahroud, Iran.
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Palacio G C, Krikorian A, Gómez-Romero MJ, Limonero JT. Resilience in Caregivers: A Systematic Review. Am J Hosp Palliat Care 2019; 37:648-658. [DOI: 10.1177/1049909119893977] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Background: Resilience is a multidimensional construct that explains why people facing the consequences of adversity and stress can have a positive outcome, emphasizing adjustment to experiences that are perceived as threatening. Objective: The aim of this study is to review the construct of resilience and associated variables in caregivers of patients with chronic, advanced illness and at the end of life. Methods: The review included studies published between January 2009 and January 2019, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guide reporting. The Medline, ScienceDirect, HINARI, PsychINFO, and SciELO databases were used for bibliographic exploration to identify research studies that examined the impact of resilience on adaptation and overall well-being in caregivers of patients with chronic and advanced illness. Results: A total of 23 quantitative and qualitative studies were identified whose aim was to describe the role of resilience in adaptation and coping in caregivers. In these studies, resilience was associated with a positive impact on the quality of life and emotional distress. Communication and social support increase resilient coping strategies. In most selected articles, the sampling strategy used was convenience sampling. Data collection used evaluation scales related to resilience and associated variables for quantitative studies, and semistructured interviews were used for qualitative studies. Conclusion: Promoting a resilient coping style in caregivers reduces the distress that normally results from illness-related changes in the biopsychosocial and spiritual dimensions. A resilient coping style can diminish the risk of stress and burden, and promote adaptation in the caregiver.
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Affiliation(s)
- Carolina Palacio G
- Instituto de Cancerología, Clínica las Americas, Medellín, Colombia
- School of Psychology, Universidad Autónoma de Barcelona, Barcelona, Spain
- Pain and Palliative Care Group, School of Health Sciences, Universidad Pontificia Bolivariana in Medellín, Colombia
- Research Group on Stress and Health, School of Psychology, Autonomous University of Barcelona, Barcelona, Spain
| | - Alicia Krikorian
- Pain and Palliative Care Group, School of Health Sciences, Universidad Pontificia Bolivariana in Medellín, Colombia
| | - María José Gómez-Romero
- School of Psychology, Universidad Autónoma de Barcelona, Barcelona, Spain
- Research Group on Stress and Health, School of Psychology, Autonomous University of Barcelona, Barcelona, Spain
- Egarsat Mutua Colaboradora con la Seguridad Social n 276, Terrassa, Barcelona, Spain
| | - Joaquín T. Limonero
- School of Psychology, Universidad Autónoma de Barcelona, Barcelona, Spain
- Research Group on Stress and Health, School of Psychology, Autonomous University of Barcelona, Barcelona, Spain
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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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Limonero JT, Maté-Méndez J, Mateo D, Gómez-Romero MJ, González-Barboteo J, Cladellas R, Ferris FD, Gómez-Batiste X. Caregiver emotional distress: external open-behaviour signs. BMJ Support Palliat Care 2019; 12:e585-e591. [PMID: 31239258 DOI: 10.1136/bmjspcare-2019-001774] [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] [Received: 01/22/2019] [Revised: 05/02/2019] [Accepted: 05/29/2019] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To determine whether specific external signs of emotional distress (ESED) can be an indirect measure of emotional distress in caregivers. METHODS A cross-sectional multicentre design was used. 148 primary caregivers of advanced cancer patients attended in four Spanish palliative care units participated in this study. The emotional distress of caregivers was measured using both the Emotional Distress of Caregivers Scale and a psychological interview. Health professionals collected data using a standard clinical interview process after a brief training period. RESULTS More than half the caregivers (60%) presented with emotional distress. A positive correlation (r=0.566) was found between the intensity of ESED and emotional distress per se. Caregivers who presented emotional distress showed more ESED than those that did not (p<0.01). The study found significant differences for the categories 'visible signs of sadness, fear, crying, feeling overwhelmed' (p<0.001), 'difficulty in separating from the patient: family refuses to let the patient make decisions and insists on care' (p<0.001) and 'visible signs of anger, irritability or frequent disagreement with therapeutic measures' (p<0.001). No significant differences were found with respect to gender. The set of items to measure these external signs presented an adequate reliability assessed using Cronbach's alpha (α=0.773). CONCLUSIONS The assessment of ESED in caregivers could serve as a useful method to assess their emotional distress. Incorporating the systematic assessment of these external signs as part of the assessment of the emotional distress of primary caregivers could improve the overall assessment and treatment provided to these caregivers.
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Affiliation(s)
- Joaquín T Limonero
- School of Psychology. Stress and Health Research Group, Universitat Autonoma de Barcelona Facultat de Psicologia, Bellaterra, Spain
| | - Jorge Maté-Méndez
- School of Psychology. Stress and Health Research Group, Universitat Autonoma de Barcelona Facultat de Psicologia, Bellaterra, Spain.,Psycho-oncology Care Unit, Institut Catala d' Oncologia, L'Hospitalet de Llobregat, Spain
| | - Dolors Mateo
- Palliative Care Unit, Consorci Sanitari de Terrassa, Terrassa, Spain
| | - María José Gómez-Romero
- School of Psychology. Stress and Health Research Group, Universitat Autonoma de Barcelona Facultat de Psicologia, Bellaterra, Spain.,Psychology Unit, Egarsat, Mutua Colaboradora con la Seguridad Social nº 276, Terrassa, Spain
| | | | - Ramon Cladellas
- School of Psychology. Stress and Health Research Group, Universitat Autonoma de Barcelona Facultat de Psicologia, Bellaterra, Spain
| | - Frank D Ferris
- Palliative Medicine, Research & Education, OhioHealth, Columbus, Ohio, USA
| | - Xavier Gómez-Batiste
- The 'Qualy' Observatory. WHO Collaborating Centre for Public Health Palliative Care Programmes, Institut Catala d' Oncologia, L'Hospitalet de Llobregat, Spain.,Chair of Palliative Care, University of Vic, Vic, Spain
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Quiñoa-Salanova C, Porta-Sales J, Monforte-Royo C, Edo-Gual M. The experiences and needs of primary family caregivers of patients with multiple myeloma: A qualitative analysis. Palliat Med 2019; 33:500-509. [PMID: 30761947 DOI: 10.1177/0269216319830017] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Family caregivers play a key role in the lives of patients with multiple myeloma. However, very little is known about the impact that the disease (its diagnosis, course and prognosis) has on the main family caregiver. AIM To achieve a deeper understanding of the lived experience of individuals who are the primary caregiver of a relative with multiple myeloma and to shed light on their needs. DESIGN Interpretative phenomenological study. SETTING AND PARTICIPANTS A total of 12 individuals who were the main family caregivers of a relative with multiple myeloma who was under outpatient follow-up at a cancer unit in Barcelona were recruited via purposive sampling until data saturation was reached. In semi-structured in-depth interviews, participants described their experiences of caring for their relative with multiple myeloma. Interviews were recorded, transcribed and analysed using ATLAS.ti v7.2. The seven steps proposed by Colaizzi were used for data analysis, and the relationships among emerging themes were examined. FINDINGS Four main themes emerged: (a) a new life, adapting to the disease, (b) commitment to the patient, (c) the emotional sphere and (d) experiences in relation to the care and support received. The analysis also revealed a core overarching theme: uncertainty. CONCLUSION Primary family caregivers experienced intense uncertainty, and they described a strong need to air their feelings. Specific practical initiatives, targeting both health-related and logistical aspects of care, need to be developed in order to support family caregivers of myeloma patients.
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Affiliation(s)
- Carmen Quiñoa-Salanova
- 1 Department of Nursing, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain.,2 Consorci Corporació Sanitària Parc Taulí, Sabadell, Spain
| | - Josep Porta-Sales
- 3 Palliative Care Service, Institut Català d'Oncologia (ICO), Barcelona, Spain.,4 Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.,5 Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Cristina Monforte-Royo
- 1 Department of Nursing, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Montserrat Edo-Gual
- 6 Department of Nursing, Escola Universitària d'Infermeria Gimbernat, Barcelona, Spain
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Oechsle K. Current Advances in Palliative & Hospice Care: Problems and Needs of Relatives and Family Caregivers During Palliative and Hospice Care-An Overview of Current Literature. Med Sci (Basel) 2019; 7:medsci7030043. [PMID: 30871105 PMCID: PMC6473856 DOI: 10.3390/medsci7030043] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 03/01/2019] [Accepted: 03/05/2019] [Indexed: 12/18/2022] Open
Abstract
Palliative and hospice care aims to improve quality of life of patients’ relatives, but still little is known about their specific problems and needs. We present a comprehensive literature update. Narrative review to present an expert overview of peer-reviewed, English-written original research publications and reviews on psychosocial and existential problems, supportive needs as well as interventions for relatives during the patients’ disease trajectory published between January 2017 and November 2018. A total of 64 publications were included. Relatives report high rates of psychological and existential distress, burden and psychological morbidity during the total disease trajectory of the patient. In addition, relatives report an alarmingly high number of unmet needs with information being the central issue. Relatives’ problems and needs are part of complex systems influenced by various socio-demographic factors and patient–relatives-interactions and dependency between different psychological phenomena. First support interventions for relatives during disease trajectory have proven feasible and secondary data from randomized studies suggest beneficial effects of providing early palliative care also for relatives. Relatives should be addressed to a still larger extent in the daily practice of palliative and hospice care, thus further research to reveal more detailed systematic information is needed to improve relatives’ psychological burden and quality of life.
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Affiliation(s)
- Karin Oechsle
- Palliative Care Unit, Department of Oncology, Hematology and BMT, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany.
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Li Y, Qiao Y, Luan X, Li S, Wang K. Family resilience and psychological well-being among Chinese breast cancer survivors and their caregivers. Eur J Cancer Care (Engl) 2019; 28:e12984. [PMID: 30628124 DOI: 10.1111/ecc.12984] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Revised: 11/17/2018] [Accepted: 12/11/2018] [Indexed: 11/30/2022]
Abstract
Walsh's family resilience theory indicated that families could foster resilient outcomes among their members when they are facing changes or crises. However, little is known about family resilience and psychological well-being among Chinese breast cancer survivors and their caregivers. Therefore, this study aimed to examine the direct and indirect relationships between family resilience, breast cancer survivors' post-traumatic growth (PTG), quality of life (QOL), and their principal caregivers' caregiver burden. A total of 108 breast cancer survivors/principal caregivers pairs completed a cross-sectional questionnaire survey in a comprehensive cancer of a public hospital in Shandong Province, China. The structural equation modelling (SEM) results showed that family resilience had direct and indirect effects on QOL and caregiver burden, and it was positively related to the PTG of the survivors. The survivors' PTG was positively related to their QOL, and their QOL was negatively associated with caregiver burden. Therefore, a better understanding of how family resilience contributes to PTG and QOL of the survivors and caregiver burden could help clinicians tailor interventions to enhance interventions aimed at improving both survivors' and caregivers' well-being.
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Affiliation(s)
- Yuli Li
- School of Nursing, Shandong University, Jinan, China
| | - Yuanjing Qiao
- Shandong University of Traditional Chinese Medicine School of Nursing, Jinan, China
| | | | - Shaojie Li
- Shandong University of Traditional Chinese Medicine School of Nursing, Jinan, China
| | - Kefang Wang
- School of Nursing, Shandong University, Jinan, China
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Li Y, Wang K, Yin Y, Li Y, Li S. Relationships between family resilience, breast cancer survivors’ individual resilience, and caregiver burden: A cross-sectional study. Int J Nurs Stud 2018; 88:79-84. [DOI: 10.1016/j.ijnurstu.2018.08.011] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 07/13/2018] [Accepted: 08/27/2018] [Indexed: 10/28/2022]
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Røen I, Stifoss-Hanssen H, Grande G, Brenne AT, Kaasa S, Sand K, Knudsen AK. Resilience for family carers of advanced cancer patients-how can health care providers contribute? A qualitative interview study with carers. Palliat Med 2018; 32:1410-1418. [PMID: 29852808 DOI: 10.1177/0269216318777656] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Caring for advanced cancer patients affects carers' psychological and physical health. Resilience has been defined as "the process of adapting well in the face of adversity, trauma, tragedy, threats or even significant sources of threat." AIM The aim of this study was to explore factors promoting carer resilience, based on carers' experiences with and preferences for health care provider support. DESIGN Qualitative, semi-structured, individual interviews with family carers of advanced cancer patients were performed until data saturation. The interviews were recorded, transcribed, and analyzed using systematic text condensation. SETTING/PARTICIPANTS Carers ( n = 14) of advanced cancer patients, not receiving curative treatment, admitted to an integrated curative and palliative care cancer outpatient clinic or to a university hospital cancer clinic, were included. RESULTS 14 carers of advanced cancer patients were included; 7 men, 7 women, and mean age of 59 years; 3 were bereaved; 12 were partners; 5 had young and teenage children. Four main resilience factors were identified: (1) being seen and known by health care providers-a personal relation; (2) availability of palliative care; (3) information and communication about illness, prognosis, and death; and (4) facilitating a good carer-patient relation. CONCLUSION Health care providers may enhance carers' resilience by a series of simple interventions. Education should address carers' support needs and resilience. Systematic assessment of carers' support needs is recommended. Further investigation is needed into how health care providers can help carers and patients communicate about death.
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Affiliation(s)
- Ingebrigt Røen
- 1 European Palliative Care Research Centre (PRC), Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,2 St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Hans Stifoss-Hanssen
- 3 Center of Diakonia and Professional Practice, VID Specialized University, Oslo, Norway
| | - Gunn Grande
- 4 Division of Nursing, Midwifery and Social Work, The University of Manchester, Manchester, England
| | - Anne-Tove Brenne
- 1 European Palliative Care Research Centre (PRC), Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,5 Cancer Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Stein Kaasa
- 1 European Palliative Care Research Centre (PRC), Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,6 Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Kari Sand
- 1 European Palliative Care Research Centre (PRC), Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Anne Kari Knudsen
- 1 European Palliative Care Research Centre (PRC), Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,6 Department of Oncology, Oslo University Hospital, Oslo, Norway
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Chen YL, Lu MH, Weng LT, Lin C, Huang PW, Wang CH, Pan HH. A Correlational Study of Acute Stress and Resilience Among Hospitalized Burn Victims Following the Taiwan Formosa Fun Coast Explosion. Clin Nurs Res 2018; 29:523-529. [PMID: 30094998 DOI: 10.1177/1054773818793599] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Although the survival rate of burn patients in the Formosa Fun Coast Explosion disaster increased significantly, for patients facing long-term rehabilitation, there remained great stress. Therefore, the aim of this study was to explore the predictors of resilience among burn patients in this major disaster. We conducted a cross-sectional, descriptive study in a medical center in northern Taiwan, with a total of 30 burn patients enrolled. Patients' demographics were collected, and the Resilience Scale and Perceived Stress Scale were administered. Multivariate statistical analysis by stepwise and linear regression was used to test these predictors of resilience. The results showed that perceived stress was the key predictor of resilience in the stepwise regression analysis and by adjusting variables including stress level, gender, and education level. These results indicate that the stress level of burn patients should be determined first to provide more targeted methods for reducing stress and improving resilience.
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Affiliation(s)
- Ya-Lin Chen
- Tri-Service General Hospital, National Defense Medical Center, Taipei City, Taiwan, ROC
| | - Ming-Hsiu Lu
- Tri-Service General Hospital, National Defense Medical Center, Taipei City, Taiwan, ROC
| | - Ling-Tzu Weng
- Tri-Service General Hospital, National Defense Medical Center, Taipei City, Taiwan, ROC
| | - Chin Lin
- Tri-Service General Hospital, National Defense Medical Center, Taipei City, Taiwan, ROC
| | | | - Chih-Hsin Wang
- Tri-Service General Hospital, National Defense Medical Center, Taipei City, Taiwan, ROC
| | - Hsueh-Hsing Pan
- Tri-Service General Hospital, National Defense Medical Center, Taipei City, Taiwan, ROC
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