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Siminoff LA, Wilson-Genderson M, Chwistek M, Thomson M. The cancer caregiving burden trajectory over time: varying experiences of perceived versus objectively measured burden. Oncologist 2024; 29:629-637. [PMID: 38652165 PMCID: PMC11224987 DOI: 10.1093/oncolo/oyae069] [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: 11/08/2023] [Accepted: 03/20/2024] [Indexed: 04/25/2024] Open
Abstract
INTRODUCTION The objective of this study was to comprehensively understand the burden experienced by caregivers (CGs) providing home-based, end-of-life care to patients with cancer. We examined the relationship between objective and subjective burden including whether and how burden changes over time. METHODS A case series of terminal cancer patient-caregiver dyads (n = 223) were recruited from oncology clinics and followed for 12 months or until patient death. Data were collected every other week and in-person from CGs in their homes using quantitative surveys, diaries, and monthly structured observations. RESULTS Bivariate correlations revealed a significant association between subjective burden and activities of daily living (ADLs), instrumental activities of daily living (IADL), high-intensity tasks, and time spent on ADLs; these correlations varied over time. Models examining the slope of subjective burden revealed little systematic change; spouse caregiver and patient functional limitations were positively, and Black caregiver was negatively associated with subjective burden. Generally, the slopes for measures of objective burden were significant and positive. Models showed subjective burden was positively associated with most measures of objective burden both within caregiver (concurrent measures were positively associated) and between CGs (those with higher subjective also had higher objective). CONCLUSIONS Cancer caregiving is dynamic; CGs must adjust to the progression of the patient's disease. We found an association between subjective and objective burden both within and between CGs. Black CGs were more likely to report lower subjective burden compared to their White counterparts. More detailed investigation of the sociocultural components that affect caregiver experience of burden is needed to better understand how and where to best intervene with targeted supportive care services.
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Affiliation(s)
- Laura A Siminoff
- College of Public Health, Social and Behavioral Sciences, Temple University, Philadelphia, PA, United States
| | - Maureen Wilson-Genderson
- College of Public Health, Social and Behavioral Sciences, Temple University, Philadelphia, PA, United States
| | - Marcin Chwistek
- Fox Chase Cancer Center/Temple University Health, Philadelphia, PA, United States
| | - Maria Thomson
- Department of Health Behavior and Policy, School of Population Health, Virginia Commonwealth University, Richmond, VA, United States
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Gemito L, Alves E, Moreira J, Marques MF, Caldeira E, Ferreira R, Bico I, Pinho L, Fonseca C, Sousa L, Lopes M. Programmes Addressed to Informal Caregivers' Needs: A Systematic Literature Review. Geriatrics (Basel) 2024; 9:71. [PMID: 38920427 PMCID: PMC11202834 DOI: 10.3390/geriatrics9030071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 05/17/2024] [Accepted: 05/28/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND Addressing informal caregivers' needs is essential for ensuring quality healthcare and promoting citizen-centred care. This systematic review assessed current knowledge about programmes aimed at meeting the needs of informal caregivers of adults who are dependent on others for daily life activities. METHODS Following the PRISMA guidelines, the electronic databases EBSCOhost Research Platform, MEDLINE, CINAHL, Scopus, Web of Science and The Virtual Health Library were searched for randomized experimental studies published between 2012 and 2022 that implemented programmes addressing informal caregivers' needs to improve their experiences, health, and well-being. Quality was assessed using the standardized critical evaluation tools from the Joanna Briggs Institute. Two independent investigators performed the eligibility assessment and data extraction. Quantitative data on the effectiveness of interventions were collected, and the content of each intervention was synthesized and aggregated into categories, through narrative synthesis. RESULTS The majority of the included studies (n = 16) were conducted in European countries and implemented a structured intervention programme compared to the provision of usual care. The studies were of fair to high methodological quality, with a higher risk of bias related to blinding. The results supported the achievement of favourable health outcomes among informal caregivers, namely improvements in mental health (n = 3) and quality of life (n = 3) and a decrease in psychological symptomatology (n = 5) and burden (n = 3). None of the interventions reported adverse outcomes; however, five studies did not describe significant differences in the outcomes assessed after the implementation of the programmes. Interventions focusing on training and educating caregivers (n = 14) and cognitive-behavioural strategies (n = 7) were the most common, while programmes focusing on emotional and psychological support as a resource to improve caregivers' psychological outcomes were scarce. CONCLUSIONS This systematic review adds to the growing body of evidence and insight showing that programmes that address informal caregivers' needs seem to contribute to better physical and psychological health outcomes through the promotion of caregivers' educational support and the implementation of cognitive-behavioural strategies. Future research should implement methodologically robust cross-country programmes tailored to informal caregivers' physical, emotional, psychosocial, societal, and educational needs throughout the care trajectory.
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Affiliation(s)
- Laurência Gemito
- São João de Deus School of Nursing, University of Évora, 7000-811 Évora, Portugal; (L.G.); (E.A.); (J.M.); (M.F.M.); (E.C.); (I.B.); (C.F.); (M.L.)
- Comprehensive Health Research Centre (CHRC), 7000-811 Évora, Portugal; (R.F.)
| | - Elisabete Alves
- São João de Deus School of Nursing, University of Évora, 7000-811 Évora, Portugal; (L.G.); (E.A.); (J.M.); (M.F.M.); (E.C.); (I.B.); (C.F.); (M.L.)
- Comprehensive Health Research Centre (CHRC), 7000-811 Évora, Portugal; (R.F.)
| | - José Moreira
- São João de Deus School of Nursing, University of Évora, 7000-811 Évora, Portugal; (L.G.); (E.A.); (J.M.); (M.F.M.); (E.C.); (I.B.); (C.F.); (M.L.)
- Comprehensive Health Research Centre (CHRC), 7000-811 Évora, Portugal; (R.F.)
| | - Maria Fátima Marques
- São João de Deus School of Nursing, University of Évora, 7000-811 Évora, Portugal; (L.G.); (E.A.); (J.M.); (M.F.M.); (E.C.); (I.B.); (C.F.); (M.L.)
- Comprehensive Health Research Centre (CHRC), 7000-811 Évora, Portugal; (R.F.)
| | - Ermelinda Caldeira
- São João de Deus School of Nursing, University of Évora, 7000-811 Évora, Portugal; (L.G.); (E.A.); (J.M.); (M.F.M.); (E.C.); (I.B.); (C.F.); (M.L.)
- Comprehensive Health Research Centre (CHRC), 7000-811 Évora, Portugal; (R.F.)
| | - Rogério Ferreira
- Comprehensive Health Research Centre (CHRC), 7000-811 Évora, Portugal; (R.F.)
- School of Health of Beja, Polytechnic Institute of Beja, 7800-111 Beja, Portugal
| | - Isabel Bico
- São João de Deus School of Nursing, University of Évora, 7000-811 Évora, Portugal; (L.G.); (E.A.); (J.M.); (M.F.M.); (E.C.); (I.B.); (C.F.); (M.L.)
- Comprehensive Health Research Centre (CHRC), 7000-811 Évora, Portugal; (R.F.)
| | - Lara Pinho
- São João de Deus School of Nursing, University of Évora, 7000-811 Évora, Portugal; (L.G.); (E.A.); (J.M.); (M.F.M.); (E.C.); (I.B.); (C.F.); (M.L.)
- Comprehensive Health Research Centre (CHRC), 7000-811 Évora, Portugal; (R.F.)
| | - César Fonseca
- São João de Deus School of Nursing, University of Évora, 7000-811 Évora, Portugal; (L.G.); (E.A.); (J.M.); (M.F.M.); (E.C.); (I.B.); (C.F.); (M.L.)
- Comprehensive Health Research Centre (CHRC), 7000-811 Évora, Portugal; (R.F.)
| | - Luís Sousa
- Comprehensive Health Research Centre (CHRC), 7000-811 Évora, Portugal; (R.F.)
- School of Health Atlântica (ESSATLA), Atlântica University, 2730-036 Barcarena, Portugal
| | - Manuel Lopes
- São João de Deus School of Nursing, University of Évora, 7000-811 Évora, Portugal; (L.G.); (E.A.); (J.M.); (M.F.M.); (E.C.); (I.B.); (C.F.); (M.L.)
- Comprehensive Health Research Centre (CHRC), 7000-811 Évora, Portugal; (R.F.)
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Bahrami M, Sebzari AR, Nasiri A. Caregivers' demands: caring atmosphere expected by cancer patients' caregivers-a qualitative content analysis. Support Care Cancer 2024; 32:389. [PMID: 38802620 DOI: 10.1007/s00520-024-08575-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 05/13/2024] [Indexed: 05/29/2024]
Abstract
PURPOSE Family caregivers play a critical role in providing care for patients with cancer. However, the quality of their caregiving can be greatly impacted if the demands and expectations they experience are not identified. Therefore, this study aimed to explore the demands and perceived expectations of caregivers while caring for cancer patients. METHODS This qualitative study was conducted from June 2022 to September 2023. Face-to-face and in-depth semi-structured interviews were conducted to collect the experiences of 19 Iranian family caregivers of patients with cancer. Purposive sampling was used to select the participants. The interviews were analyzed using conventional content analysis and the rigor of the study was ensured by employing Lincoln and Guba's criteria. RESULTS Three main themes and six subthemes were identified through data analysis. The themes that emerged from the caregivers' experiences included the following: (1) ambiguity in the healthcare system, (2) need for empathetic communication, and (3) forgotten caregivers in the healthcare system. CONCLUSION Caregivers often feel overlooked, resulting in unfulfilled needs and expectations. It is imperative to explore potential solutions that provide caregivers information, empathetic communication, and support. Nurses, as key members of the healthcare team, should play a significant role in addressing this problem.
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Affiliation(s)
- Mahnaz Bahrami
- Student Research Committee, Department of Medical-Surgical Nursing, School of Nursing & Midwifery, Birjand University of Medical Sciences, Birjand, Iran
| | - Ahmad Reza Sebzari
- Department of Internal Medicine, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Ahmad Nasiri
- Department of Medical-Surgical Nursing, School of Nursing & Midwifery, Birjand University of Medical Sciences, Birjand, Iran.
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Wang J, Duan Y, Geng L, Li X, Yue S, Liu H. Trajectory of Caregiver Burden and Associated Factors in Family Caregivers of Individuals with Colorectal Cancer: A Longitudinal, Observational Multicenter Study. Patient Prefer Adherence 2024; 18:879-892. [PMID: 38645699 PMCID: PMC11033041 DOI: 10.2147/ppa.s451487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 04/11/2024] [Indexed: 04/23/2024] Open
Abstract
Purpose To (1) investigate the changes in 5 domains (lack of family support, impact on finance, impact on daily schedule, impact on health, and self-esteem) of family caregiver (FC) burden and overall burden for first diagnosed colorectal cancer; (2) exploring changes in FC burden for colorectal cancer patients over time and analyze the trajectory and sub-trajectories of FC burden; and (3) identify the FC-related and patient-related factors most associated with the overall FC burden and each of its sub-trajectories. Patients and methods This study is a descriptive longitudinal study. A convenience sampling method was used to recruit patients with colorectal cancer and their primary FCs from seven hospitals. Results A total of 185 pairs of first diagnosed colorectal cancer patient and their FC were investigated for 4 times. The results reveal the overall burden and 5 domains of burden showed a trend of increasing first and then decreasing, and the burden was the heaviest at the time in the middle of chemotherapy. In the course of time, the aspect that caused the greatest amount of burden on average transitioned from the "effect on daily schedule" (range= 3.3 and 3.9) to the "effect on finances" (range= 3.1 to 3.4). Conclusion Almost 88% of FCs have a either a moderate or a high level of burden. The quality of life of patients and the self-efficacy, social support and care ability of FCs have a great impact on the overall FC burden and each sub-trajectory.
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Affiliation(s)
- Jing Wang
- Department of Nursing, Peking University Third Hospital, Beijing, People’s Republic of China
| | - Yi Duan
- School of Nursing, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
| | - Liangrong Geng
- School of Nursing, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
| | - Xiaoyu Li
- Center for Treatment of Undiagnosed Diseases, the First Affiliated Hospital of Nanchang University, Jiangxi Province, People’s Republic of China
| | - Shujin Yue
- School of Nursing, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
| | - Hongxia Liu
- School of Nursing, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
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Garcia ACM, Silva CDP, Paiva EMDC, Meireles E, Nogueira DA, Wong C. Evidence of validity and accuracy for the Mindful Self-Care Scale-Brief among family caregivers of people with cancer in Brazil: A cross-sectional study. Palliat Support Care 2024:1-9. [PMID: 38404212 DOI: 10.1017/s147895152400021x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
OBJECTIVES This study aimed to evaluate the evidence of validity and accuracy for the Mindful Self-Care Scale-Brief (B-MSCS) in Brazil among family caregivers of people with cancer. METHODS This was a cross-sectional study with a sample of 203 family caregivers of people with cancer. The instruments used in this study were the following: B-MSCS, Brief Resilience Scale, and Brief Scale for Spiritual/Religious Coping. Exploratory factor analysis was carried out using the principal axis factoring method and direct oblimin oblique rotation, and confirmatory factor analysis using the robust weighted least squares means and variance adjusted estimation method and GEOMIM oblique rotation. The internal consistency of the latent factors was measured using Cronbach's alpha coefficients. RESULTS The 6-factor model showed good fit to the data, with satisfactory reliability indices and adequate representation of the scale's internal structure. The results that can support arguments in favor of validity evidence based on internal structure for the B-MSCS-Brazilian version (BR) relate to a 19-item version which, grouped into 6 latent factors, explained 46.47% of the variance. The factor solution reproduced 79.2% of the theoretically expected structure and 5 items were excluded. The Cronbach's alpha coefficient of the factors in the B-MSCS-BR ranged from 0.58 to 0.84. Positive religious/spiritual coping had a direct association with the B-MSCS-BR factors, with the exception of the Physical Care factor (r = 0.033, p = 0.635). Negative spiritual/religious coping was inversely associated with the Mindful Relaxation (r = -0.160, p = 0.023), Supportive Relationships (r = -0.142, p = 0.043), and Mindful Awareness factors (r = -0.140, p = 0.045). There were no associations between the B-MSCS-BR factors and resilience. SIGNIFICANCE OF RESULTS The findings reveal that the B-MSCS (19-item) is a valid, reliable, and culturally-appropriate instrument to examine the practice of mindful self-care by family caregivers of people with cancer in Brazil.
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Affiliation(s)
- Ana Cláudia Mesquita Garcia
- Interdisciplinary Center for Studies in Palliative Care, School of Nursing, Federal University of Alfenas, Alfenas, MG, Brazil
| | - Cremilson de Paula Silva
- Interdisciplinary Center for Studies in Palliative Care, School of Nursing, Federal University of Alfenas, Alfenas, MG, Brazil
| | - Eliza Mara das Chagas Paiva
- Interdisciplinary Center for Studies in Palliative Care, School of Nursing, Federal University of Alfenas, Alfenas, MG, Brazil
| | - Everson Meireles
- Health Sciences Center, Federal University of Recôncavo da Bahia, Santo Antônio de Jesus, BA, Brazil
| | | | - Claudia Wong
- Department of Health and Physical Education, The Education University of Hong Kong, Ting Kok, Hong Kong
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Gül İ, Toygar İ, Usta Yeşilbalkan Ö. Support needs of carers of cancer patients and the effects of the patient's age and cancer type on their needs. Eur J Oncol Nurs 2024; 68:102468. [PMID: 37988773 DOI: 10.1016/j.ejon.2023.102468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 10/18/2023] [Accepted: 11/09/2023] [Indexed: 11/23/2023]
Abstract
PURPOSE This study aimed to investigate support needs of carers of cancer patients and the effects of the patient's age and cancer type on their needs. METHODS In this descriptive and comparative study, the data were collected from the carers (n = 120) of the patient admitted to inpatient and outpatient clinics of a university hospital between June 2021 and October 2022. Patient identification form, carer identification form, and Carer Support Needs Assessment Tool (CSNAT) were used for data collection. The comparisons of the support needs were done for the carers according to the patient's age (<65 versus ≥65 years) and cancer type (hematological malignancies versus solid tumors). RESULTS Caring duration (19.78 ± 29.64 vs 10.33 ± 18.77 months) and caring hours per week (47.58 ± 26.90 vs 32.75 ± 25.75 h) were high in those caring for older adults. Carers of older adults need more support in providing personal care for their relatives (eg dressing, washing, toileting) (X2 = 8.000, p = 0.005). Carers of patients with hematological malignancies need more support in understanding their relative's illness (X2 = 6.136, p = 0.013), having time themselves in the day (X2 = 4.089, p = 0.043), managing their relative's symptoms, including giving medicines? (X2 = 5.263, p = 0.022), and their beliefs or spiritual concerns (X2 = 4.728, p = 0.030) compared to the carers of the patients with solid tumors. CONCLUSION The support needs of the carers vary depending on the patient's age and cancer type. Carers of older adults and patients with hematological malignancies need more support.
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Affiliation(s)
- İrem Gül
- Ege University Faculty of Nursing, Medical Nursin Department, İzmir, Turkey.
| | - İsmail Toygar
- Muğla Sıtkı Koçman University, Fethiye Faculty of Health Sciences, Muğla, Turkey.
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Reuvers MJP, Burgers VWG, Vlooswijk C, Verhees B, Husson O, van der Graaf WTA. Same Journey, Different Paths: Caregiver Burden among Informal Caregivers of Adolescent and Young Adult Patients with an Uncertain or Poor Cancer Prognosis (UPCP). J Clin Med 2023; 13:158. [PMID: 38202165 PMCID: PMC10780166 DOI: 10.3390/jcm13010158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 12/21/2023] [Accepted: 12/25/2023] [Indexed: 01/12/2024] Open
Abstract
A minority of adolescent and young adult cancer patients (AYA) live with an uncertain or poor prognosis (UPCP). Caring for a young, advanced cancer patient can lead to caregiver burden. This study aims to provide insight into burden on informal caregivers of AYA cancer patients with UPCP. In-depth, semistructured interviews were conducted with parents (n = 12), siblings (n = 7), friends (n = 7), and partners (n = 13). Thematic analysis was performed to derive themes from the data. Participants reported sleeping problems and stress. They struggle with uncertainty, fear, loss, and negative emotions. Family life is altered due to solely taking care of the children, but also the AYA. Contact with friends and family is changed. The relationship to the AYA can shift positively (e.g., becoming closer) or negatively (e.g., more conflict or no longer being attracted). Participants were under pressure, having to take on many responsibilities and multiple roles. In the financial domain, they report less income and often must continue working. A high amount of caregiver burden is experienced among informal caregivers of AYAs with UPCP. Yet only part of the impact appears to be age specific. Specific, age-adjusted interventions can be developed to lower the burden.
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Affiliation(s)
- Milou J. P. Reuvers
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, 1006 BE Amsterdam, The Netherlands; (V.W.G.B.); (O.H.)
- Department of Medical Oncology, Netherlands Cancer Institute—Antoni van Leeuwenhoek, 1006 BE Amsterdam, The Netherlands;
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
| | - Vivian W. G. Burgers
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, 1006 BE Amsterdam, The Netherlands; (V.W.G.B.); (O.H.)
- Department of Medical Oncology, Netherlands Cancer Institute—Antoni van Leeuwenhoek, 1006 BE Amsterdam, The Netherlands;
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
| | - Carla Vlooswijk
- Department of Research and Development, Netherlands Comprehensive Cancer Organization, 3511 DT Utrecht, The Netherlands
| | - Bram Verhees
- Hoestie Foundation, 5616 JX Eindhoven, The Netherlands
| | - Olga Husson
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, 1006 BE Amsterdam, The Netherlands; (V.W.G.B.); (O.H.)
- Department of Medical Oncology, Netherlands Cancer Institute—Antoni van Leeuwenhoek, 1006 BE Amsterdam, The Netherlands;
- Department of Surgical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
| | - Winette T. A. van der Graaf
- Department of Medical Oncology, Netherlands Cancer Institute—Antoni van Leeuwenhoek, 1006 BE Amsterdam, The Netherlands;
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
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Erbay Dalli Ö, Bulut H. Level of caregiving burden and affecting factors in family caregivers of patients with lung cancer: A cross-sectional study. Support Care Cancer 2023; 32:60. [PMID: 38145998 DOI: 10.1007/s00520-023-08259-4] [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: 09/19/2023] [Accepted: 12/15/2023] [Indexed: 12/27/2023]
Abstract
PURPOSE To determine the caregiving burden level and affecting factors of family members caring for patients with lung cancer (LC). METHODS This study used a cross-sectional design and a convenience sampling method. The study was conducted between April 2023 and August 2023 with the LC patients (n = 448) and their caregivers (n = 448) who met the inclusion criteria and were followed up in seven clinics of a specialized hospital for pulmonary diseases in Turkey. Data were collected by using (1) a demographic questionnaire (for patient and caregiver), (2) the Zarit Burden Interview (ZBI), (3) the Beck Depression Inventory (BDI), and (4) the Caregiver Quality of Life Index-Cancer (CQoLC). RESULTS The study included 448 caregivers, with a mean age of 45.09 ± 13.48 years, and 71.4% were female. The mean ZBI score of 31.45 ± 16.71 indicated mild to moderate burden. Pearson correlation analysis showed that caregivers' depression levels increased and quality of life decreased significantly as the care burden increased. Multiple regression analysis indicated a significant relationship between the caregiver burden and the patient's age (p < 0.05), caregiver's chronic disease (p < 0.05), type of treatment given to the patient (p < 0.05), patient's metastasis status (p < 0.05) and caregiver's quality of life (p < 0.01). CONCLUSION The fact that most of the risk factors identified in this study are non-modifiable highlights the necessity of identifying caregiver burden early by nurses and initiating the appropriate support processes.
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Affiliation(s)
- Öznur Erbay Dalli
- Bursa Uludag University Faculty of Health Sciences, Department of Internal Medicine Nursing, Nilüfer, BURSA, Turkey, 16059.
| | - Hülya Bulut
- Health Sciences University Izmir Dr Suat Seren Chest Diseases and Surgery Training and Research Hospital, Konak, İZMİR, Turkey, 35170
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Chien SC, Chang YH, Yen CM, Onthoni DD, Wu IC, Hsu CC, Chiou HY, Chung RH. Exploring concepts and trends in informal caregiver burden: systematic review using citation network and content analysis. Aging Clin Exp Res 2023; 35:2873-2885. [PMID: 37907665 DOI: 10.1007/s40520-023-02582-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 09/26/2023] [Indexed: 11/02/2023]
Abstract
BACKGROUND With the increase in the aging population, informal caregivers have become an essential pillar for the long-term care of older individuals. However, providing care can have a negative impact and increase the burden on caregivers, which is a cause for concern. OBJECTIVE This study aimed to comprehensively depict the concept of "informal caregiver burden" through bibliometric and content analyses. METHODS We searched the Web of Science (WoS) database to obtain bibliometric data and included only papers published between 2013 and 2022. We used content analysis to extract and identify the core concepts within the text systematically. RESULTS Altogether, 934 papers were included in the bibliometric analysis, from which we selected 19 highly impactful papers for content analysis. The results indicate that researchers have focused on exploring the factors that impact informal caregiver burden. Meanwhile, there has been a widespread discussion regarding the caregiver burden among those caring for recipients with specific illnesses, such as dementia, Alzheimer's disease, and cancer, as these illnesses can contribute to varying levels of burden on informal caregivers. In addition, questionnaires and interviews emerged as the predominant methods for data collection in the realm of informal caregiver research. Furthermore, we identified 26 distinct assessment tools specifically tailored for evaluating burden, such as caregiver strain index (CSI). CONCLUSION For future studies, we suggest considering the intersectionality of factors contributing to the burden on informal caregivers. This approach could enhance the well-being of both caregivers and older care recipients.
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Affiliation(s)
- Shuo-Chen Chien
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, 350, Taiwan
| | - Yu-Hung Chang
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, 350, Taiwan
| | - Chia-Ming Yen
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Yunlin County, 632, Taiwan
| | - Djeane Debora Onthoni
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, 350, Taiwan
| | - I-Chien Wu
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, 350, Taiwan
| | - Chih-Cheng Hsu
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, 350, Taiwan
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Yunlin County, 632, Taiwan
| | - Hung-Yi Chiou
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, 350, Taiwan
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Ren-Hua Chung
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, 350, Taiwan.
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Zhao X, Cheng F, Gao Y, Wang Q, Zhao Y, Li P. Association between adult attachment style, communication patterns and caregiver burden in parents of children with solid tumors: A cross-sectional study. Eur J Oncol Nurs 2023; 67:102437. [PMID: 37879195 DOI: 10.1016/j.ejon.2023.102437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 09/27/2023] [Accepted: 10/01/2023] [Indexed: 10/27/2023]
Abstract
PURPOSE The primary purpose of this cross-sectional study was to delve into the connections among adult attachment styles, communication patterns, and caregiver burden within the sample of parents caring for children diagnosed with solid tumors. METHODS A sample of 456 parents responsible for the care of children with solid tumors was conveniently recruited from a pediatric oncology ward at a tertiary hospital from September 2021 to September 2022. The data collection process included a questionnaire on general information, the Caregiver Burden Inventory, the Adult Attachment Questionnaire Short Form, and the Communication Pattern Questionnaire. RESULTS The findings demonstrated a strong and positive connection between caregiver burden and attachment avoidance, whereas no considerable association was observed for attachment anxiety. Attachment avoidance exhibited a positive link with communication patterns and caregiver burden, and a noteworthy inverse correlation with attachment anxiety. Additionally, communication patterns were uncovered as a mediator in the association between attachment avoidance and caregiver burden. CONCLUSIONS This study underscores the role of communication patterns as mediators between attachment avoidance and caregiver burden among parents of children with solid tumors. These outcomes emphasize the significance of considering attachment styles and communication patterns when comprehending caregiver burden, and can guide the development of targeted interventions to provide support for parents within this challenging context.
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Affiliation(s)
- Xiangyu Zhao
- School of Nursing and Rehabilitation, Shandong University, 44 Wenhua West Road, Jinan, Shandong, 250012, PR China
| | - Fangfang Cheng
- Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, 440 Jiyan Road, Jinan, Shandong, 250117, PR China
| | - Yiming Gao
- School of Nursing and Rehabilitation, Shandong University, 44 Wenhua West Road, Jinan, Shandong, 250012, PR China
| | - Qing Wang
- School of Nursing and Rehabilitation, Shandong University, 44 Wenhua West Road, Jinan, Shandong, 250012, PR China
| | - Yiwen Zhao
- School of Nursing and Rehabilitation, Shandong University, 44 Wenhua West Road, Jinan, Shandong, 250012, PR China
| | - Ping Li
- School of Nursing and Rehabilitation, Shandong University, 44 Wenhua West Road, Jinan, Shandong, 250012, PR China.
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11
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Thomas Hebdon MC, Cloyes KG, Vega M, Rosenkranz SJ, Reblin M, Tay D, Mooney K, Ellington L. Hospice Family Caregivers' Uncertainty, Burden, and Unmet Needs in Prospective Audio Diaries. J Hosp Palliat Nurs 2023; 25:321-329. [PMID: 37851960 PMCID: PMC10843703 DOI: 10.1097/njh.0000000000000975] [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] [Indexed: 10/20/2023]
Abstract
Hospice cancer caregivers' (HCCs') burden and unmet needs are well documented in the literature through retrospective, standardized self-report surveys. Hospice cancer caregiver daily experiences of burden and unmet needs are rarely captured within a real-time context. The purpose of this secondary data analysis was to characterize HCCs' day-to-day burden and unmet needs with prospective HCC (N = 50) audio diary data between hospice enrollment and patient death. Uncertainty theory provided a framework for analysis. Diaries were transcribed, analyzed deductively and inductively, and organized thematically. Uncertainty in day-to-day experiences was an important driver of HCC burden and unmet needs. Unmet needs included unclear/unmet expectations regarding hospice care team support; not understanding the extent of HCC role and involvement; and communication challenges with hospice team members. Sources of HCCs' burden were dissonance between how they "should" feel and how they actually felt; feeling alone/having no outlet to express feelings; concerns about their own health and subsequent patient impact; and feeling helpless/occupying a liminal space. Uncertainty surrounding HCCs' experiences encompassed interactions with hospice care teams and the nature of end-of-life caregiving with symptom management, the dying process, and the HCC role. Hospice care teams can respond to uncertainty through assessment, understanding, and recognition of the daily context of HCCs.
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Affiliation(s)
| | | | | | | | | | - Djin Tay
- University of Utah, College of Nursing
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12
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Kajiwara K, Kobayashi M, Morikawa M, Kanno Y, Nakano K, Matsuda Y, Shimizu Y, Shimazu T, Kako J. Nursing Support for Caregiver Burden in Family Caregivers of Patients With Cancer: A Scoping Review. Am J Hosp Palliat Care 2023:10499091231215808. [PMID: 37963324 DOI: 10.1177/10499091231215808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023] Open
Abstract
Purpose: To identify nursing support for caregiver burden in family caregivers of patients with cancer. Methods: This scoping review was guided by Arksey and O'Malley's six-stage scoping review framework. All available published articles from database inception to July 31, 2023 were systematically searched through PubMed, CINAHL, CENTRAL, and Ichushi-Web of the Japan Medical Abstract Society databases with additional relevant studies from the article list. Each key journal was manually searched. Results: Overall, 502 articles were screened, and 34 were finally included. The results of the qualitative thematic analysis were categorized into 7 components of nursing support: psychological and educational support, psychological and educational support using mainly non-face-to-face (Information and Communication Technology), psychological and educational support mainly using non-face-to-face (telephone) methods, mindfulness to support, support aimed at reducing caregiver stress, support for both patients and caregivers, and others. Of the 34 studies, 23 were randomized controlled trials (RCT), and the remaining 11 were non-RCTs. Conclusion: The results of the scoping review categorized nursing support for caregiver burden in the family caregivers of patients with cancer into 7 components. Future research should examine the feasibility of implementing these components.
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Affiliation(s)
- Kohei Kajiwara
- Japanese Red Cross Kyushu International College of Nursing, Munakata, Japan
| | - Masamitsu Kobayashi
- Graduate of Nursing Science, St. Luke's International University, Chuo-ku, Japan
| | | | - Yusuke Kanno
- Nursing Science, Tokyo Medical and Dental University, Bunkyo-ku, Japan
| | - Kimiko Nakano
- Clinical Research Center for Developmental Therapeutics, Tokushima University Hospital, Tokushima, Japan
| | - Yoshinobu Matsuda
- Department of Psychosomatic Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Japan
| | - Yoichi Shimizu
- School of Nursing, National College of Nursing, Japan , Kiyose, Japan
| | - Taichi Shimazu
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, National Cancer Center, Chuo-ku, Tokyo, Japan
| | - Jun Kako
- Graduate School of Medicine, Mie University, Tsu, Japan
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13
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Kim YM, Lee JE. Dyadic Effects of Psychological Health on Quality of Life in Patients with Colorectal Cancer and Caregivers: A Systematic Review and Meta-Analysis. Semin Oncol Nurs 2023; 39:151477. [PMID: 37495448 DOI: 10.1016/j.soncn.2023.151477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 05/29/2023] [Accepted: 07/03/2023] [Indexed: 07/28/2023]
Abstract
OBJECTIVES This study aimed to review dyadic research on psychological health and health-related quality of life (HRQL) in patients with colorectal cancer (CRC) and caregivers and examine the pooled partner effects and actor effects based on the Actor-Partner Interdependence Model. DATA SOURCES A systematic review and meta-analysis were conducted. We registered our review protocol with PROSPERO (CRD42021258482). Six databases were searched until June 2021 using the following keywords: colorectal neoplasms, caregivers, depression, anxiety, stress, and quality of life. Two reviewers independently screened 1,597 studies that included both CRC patients and family caregivers. Meta-analyses were performed of the partner and actor effects of psychological health on HRQL in CRC. CONCLUSION Eighteen observational studies involving 2,757 patients with CRC and 2,601 caregivers were included. Regarding partner effects, the distress of patients with CRC affected their family caregivers' distress and burden. There were three types of actor effects among patients with CRC and family caregivers: 1) the social support of patients with CRC affects their level of distress; (2) the distress of patients with CRC affects their HRQL; and (3) caregivers' social support affects their level of distress. This study provides the first comprehensive overview of the dyadic relationships between psychological health and HRQL in patients with CRC and their caregivers. IMPLICATIONS FOR NURSING PRACTICE The development of dyadic interventions for improving psychological health is warranted to help both patients with CRC and their family caregivers live with improved HRQL and well-being.
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Affiliation(s)
- Young Man Kim
- Assistant Professor, College of Nursing, Jeonbuk National University, and Reseach Institute of Nursing Science, Jeonbuk National University, Jeonju-si, Republic of Korea
| | - Jung Eun Lee
- Assistant Professor, University of Rhode Island College of Nursing, Kingston, Rhode Island, USA.
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14
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van Puffelen AJ, van der Sar LJ, Moerman F, Eicher M, Oldenmenger WH. Cancer care during the Covid-19 pandemic from the perspective of patients and their relatives: A qualitative study. Heliyon 2023; 9:e19752. [PMID: 37809531 PMCID: PMC10559054 DOI: 10.1016/j.heliyon.2023.e19752] [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: 05/31/2023] [Revised: 08/17/2023] [Accepted: 08/31/2023] [Indexed: 10/10/2023] Open
Abstract
Objective The Covid -19 pandemic has had a major influence on the organization of cancer care. Little is known about how patients with cancer and their relatives experienced this period. This study explored these experiences and levels of distress and resilience of Dutch cancer patients and their family caregivers during the Covid-19 pandemic. Methods The qualitative design included in-depth interviews with cancer patients and their family caregivers to explore their experiences. The distress thermometer (NCCN-DT) and resilience questionnaire (CD-RISC2) were used for contextualizing. Data were analyzed by thematic analysis and descriptive statistics. Results 40 patients with breast cancer, lung cancer, colorectal cancer, or melanoma who received active systemic anti-cancer therapy, were included with a median age of 60 years[SD11.1]. We also included fourteen family caregivers with a median age of 60 years [SD8.6].Five themes were identified: (1) Living with cancer during Covid-19, (2) Changes in cancer care, (3) Information and support, (4) Safety inside the hospital, and (5) Impact of vaccination. The mean score of NCCN-DT was 2.9[SD2.4] for patients and 4.3[SD2.7] for family caregivers. Mean score of CD-RISC2 was 6.6[SD1.4] for patients and 7.2[SD1] for family caregivers. Conclusions Patients felt vulnerable during the pandemic and were strict in following the safety precautions. The limited companionship of family caregivers was experienced as the biggest restraint. In general, they felt safe inside the hospital. Vaccination brought some relief. Patients were satisfied with the provided support, but areas were identified which are amenable for redesigning care processes.
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Affiliation(s)
- Andrea J. van Puffelen
- Erasmus MC Cancer Institute, University Medical Center Rotterdam, Department of Medical Oncology, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands
| | - Lisa J. van der Sar
- Erasmus MC Cancer Institute, University Medical Center Rotterdam, Department of Medical Oncology, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands
| | - Frederique Moerman
- Erasmus MC Cancer Institute, University Medical Center Rotterdam, Department of Medical Oncology, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands
| | - Manuela Eicher
- Institute of Higher Education and Research in Healthcare (IUFRS), Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Lausanne University Hospital (CHUV) Department of Oncology, Lausanne, Switzerland
| | - Wendy H. Oldenmenger
- Erasmus MC Cancer Institute, University Medical Center Rotterdam, Department of Medical Oncology, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands
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15
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Badger TA, Segrin C, Crane TE, Morrill KE, Sikorskii A. Social determinants of health, psychological distress, and caregiver burden among informal cancer caregivers of cancer survivors during treatment. J Psychosoc Oncol 2023; 42:333-350. [PMID: 37609806 PMCID: PMC10884349 DOI: 10.1080/07347332.2023.2248486] [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] [Indexed: 08/24/2023]
Abstract
OBJECTIVE This study compared three ethnic/racial groups of informal cancer caregivers on social determinants of health and tested social determinants of health as predictors of psychological distress and caregiver burden. METHODS This study was a secondary analysis of baseline data of a sequential multiple assignment randomized trial (SMART) testing symptom management interventions with caregiver-survivor dyads. Caregivers completed baseline measures of social determinants of health (SDoH), functional limitations, psychological distress, and caregiver burden. Hispanic, non-Hispanic White, and non-Hispanic other races caregivers were compared on these variables. Multivariate tests of associations between SDoH and caregiver burden and psychological distress were conducted in structural equation modeling with caregiver burden and psychological distress as latent variables. RESULTS Hispanic caregivers reported significantly higher caregiver burden, specifically for finances, family, and schedules. Caregiver burden was significantly predicted by having income barely or not meeting needs, being female, socially isolated, married, Hispanic, and having poor physical functioning. Significant predictors of caregivers' psychological distress: being female, being socially isolated, and having poor physical functioning. CONCLUSION Hispanic caregivers experience significant challenges associated with caregiver burden, especially if they are female, socially isolated, and have poor physical functioning. Assessment of these SDoH is important in caregiver health to provide supportive care during caregiving. CLINICAL TRIAL REGISTRATION NUMBER NCT03743415 www.clinicaltrials.gov.
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Affiliation(s)
- Terry A. Badger
- Department of Psychiatry and Mel and Enid Zuckerman College of Public Health, College of Nursing, 1305 N. Martin Avenue, University of Arizona, Tucson AZ 85721
| | - Chris Segrin
- Department of Communication, University of Arizona
| | - Tracy E. Crane
- Miller School of Medicine, Division of Medical Oncology, Sylvester Comprehensive Cancer Center, University of Miami
| | - Kristin E. Morrill
- Community and Systems Health Science Division, College of Nursing, University of Arizona
| | - Alla Sikorskii
- Department of Psychiatry, College of Osteopathic Medicine, Michigan State University, 909 Wilson Road, Road 321, East Lansing, MI 48824
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Goto H. Outcomes of Cancer Patients Who Seek Outpatient Visits Despite Post-chemotherapy Decline. Cureus 2023; 15:e42969. [PMID: 37671222 PMCID: PMC10475344 DOI: 10.7759/cureus.42969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2023] [Indexed: 09/07/2023] Open
Abstract
INTRODUCTION The medical needs of cancer patients are complex and increase with the disease's progression. However, Japan's aging population and increased medical needs have produced challenges like a shortage of hospital beds. Therefore, patients who have completed chemotherapy are recommended home-based care or referred to local palliative care facilities, especially when cancer treatment is no longer a viable option and outpatient visits become unfeasible. However, some patients still strive to continue outpatient visits, which could result in increased pain and possible urgent hospitalization. These patients may spend their final days in the hospital, which may not have been their desired outcome. Therefore, we examined the outcomes of patients who were recommended home-based care. METHODS The study population comprised 34 cancer patients undergoing treatment at the Oncology Outpatient Department of Edogawa Hospital who were recommended home-based care owing to their difficulty attending outpatient visits. Data regarding home-based care recommendations were obtained from the lists of medical social welfare interventions and hospitalized patients. Patients were classified based on whether they opted for home-based care and their caregivers' caregiving capacity. Survival was analyzed using the Kaplan-Meier curve and the log-rank test, and the groups were compared using Fisher's exact test. RESULTS The median interval between the initial consultation with an oncologist and the date of recommendation for home-based care was six and a half months. Home-based care was mostly recommended because of the progression of cachexia (23 cases) and the worsening of symptoms (11 cases). The median survival for the groups with cachexia and worsening symptoms was 25 days and 35 days, respectively. Ten patients refused home-based care. Of them, six refused it because they wished to continue with outpatient visits. Of the home-based care group (24 patients), only one required an emergency room (ER) visit, while four of the non-home-based care group required ER visits. Regarding end-of-life care, 19 from the home-based care group and four from the non-home-based care group received end-of-life care at home. Additionally, one of the two patients who lived alone and two of the six patients whose caregivers were deemed to have insufficient caregiving capacity received end-of-life care at home. Of the remaining 24 patients, 22 received end-of-life care at home. CONCLUSION The short survival period of the group with cachexia indicates that it would be beneficial for patients, their family members, and home-based care providers to facilitate earlier referral to home-based care. However, while home-based care is beneficial for patients who wish to spend their final days at home and for their family members, short-term and achievable goals, such as attending the next outpatient visit, may alleviate anxiety in cancer patients and enable them to live their daily lives without constant awareness of death. Additionally, while non-home-based care could lead to extended pain due to the lack of readily accessible medical personnel, ER visits, and hospital-based end-of-life care, home-based care can be mentally and physically strenuous for the primary caregiver. Therefore, comprehensive information about palliative care options should be provided early on during the outpatient visits of cancer patients who wish for home-based care for informed decision-making.
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Affiliation(s)
- Hiroaki Goto
- Oncology and Hematology, Edogawa Hospital, Tokyo, JPN
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17
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Grivel C, Nizet P, Martin M, Pécout S, Lepeintre A, Touchefeu Y, Prot-Labarthe S, Evin A, Huon JF. The experience of being a caregiver of patients with digestive cancer, from patients and caregivers' perception: A mixed study. PLoS One 2023; 18:e0287335. [PMID: 37478058 PMCID: PMC10361535 DOI: 10.1371/journal.pone.0287335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 06/02/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUNDS Caregivers are essential in the care of a patient with digestive cancer. Considering their experience and needs is crucial. OBJECTIVES To explore the experience of caregivers of patients with digestive cancer and to compare the perspectives of patients and caregivers. METHODS A mixed-methods study with a cross-sectional prospective and a comprehensive qualitative dimension was performed in a medical oncology unit in a French tertiary hospital. Dyads made of patients with digestive cancer and their caregiver were recruited. The Caregiver Reaction Assessment (CRA) and the Supportive Care Needs Survey for Partners and Caregivers (SCNS-PC) questionnaires were distributed to caregivers. The CRA was used to measure the caregiver burden and the SCNS-PC was used to identify the unmet supportive care needs of caregivers. Semi-structured interviews with the dyads were conducted. Qualitative interviews addressed various dimensions of the caregiver's experience from each dyad's member perspective. RESULTS Thirty-two caregivers completed the questionnaires. Responses showed high self-esteem, schedule burden, and a need for care and information services. Ten dyads participated in the interviews. Three themes emerged from the caregiver's interviews: illness is an upheaval; loneliness and helplessness are experienced; caring is a natural role with positive outcomes. Four themes emerged from patient's interviews: the caregiver naturally assumes the role and gets closer; he is the patient's anchor; his life is disrupted; anxiety and guilt accompany the desire to protect him. In comparing patient and caregiver data, the main theme of disagreement was their relationship. CONCLUSIONS Caregiver care does not appear to be optimal, particularly in terms of their need for information. Patients have a fairly good representation of their experience, but the caregivers' opinion need to be considered.
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Affiliation(s)
| | - Pierre Nizet
- Nantes Université, CHU Nantes, Pharmacie, Nantes, France
- Nantes Université, University Tours, CHU Nantes, CHU Tours, INSERM, MethodS in Patients-Centered Outcomes and HEalth Research, SPHERE, Nantes, France
| | - Manon Martin
- Nantes Université, CHU Nantes, Pharmacie, Nantes, France
| | - Solange Pécout
- Institut des Maladies de l’Appareil Digestif, Nantes Université, CHU Nantes, Oncologie Digestive, Nantes, France
| | - Aurélie Lepeintre
- Nantes Université, CHU Nantes, Service de soins Palliatifs et de Support, Nantes, France
| | - Yann Touchefeu
- Institut des Maladies de l’Appareil Digestif, Nantes Université, CHU Nantes, Oncologie Digestive, Nantes, France
| | - Sonia Prot-Labarthe
- Nantes Université, CHU Nantes, Pharmacie, Nantes, France
- Université Paris Cité, Inserm, ECEVE, Paris, France
| | - Adrien Evin
- Nantes Université, University Tours, CHU Nantes, CHU Tours, INSERM, MethodS in Patients-Centered Outcomes and HEalth Research, SPHERE, Nantes, France
- Nantes Université, CHU Nantes, Service de soins Palliatifs et de Support, Nantes, France
| | - Jean-François Huon
- Nantes Université, CHU Nantes, Pharmacie, Nantes, France
- Nantes Université, University Tours, CHU Nantes, CHU Tours, INSERM, MethodS in Patients-Centered Outcomes and HEalth Research, SPHERE, Nantes, France
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18
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Mooney K, Whisenant MS, Wilson CM, Coombs LA, Lloyd J, Alekhina N, Sloss EA, Steinbach M, Moraitis AM, Berry P, Iacob E, Donaldson G. Technology-Assisted mHealth Caregiver Support to Manage Cancer Patient Symptoms: A Randomized Controlled Trial. J Pain Symptom Manage 2023; 66:33-43. [PMID: 36889453 DOI: 10.1016/j.jpainsymman.2023.02.320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/24/2023] [Accepted: 02/26/2023] [Indexed: 03/08/2023]
Abstract
CONTEXT Caregivers managing symptoms of family members with cancer during home hospice care, often feel ill-prepared and need patient care coaching. OBJECTIVES This study tested the efficacy of an automated mHealth platform that included caregiver coaching on patient symptom care and nurse notifications of poorly controlled symptoms. The primary outcome was caregiver perception of patients' overall symptom severity throughout hospice care and at weeks one, two, four, and eight. Secondary outcomes compared individual symptom severity. METHODS Caregivers (n = 298) were randomly assigned to the Symptom Care at Home (SCH) intervention (n = 144) or usual hospice care (UC) (n = 154). All caregivers placed daily calls to the automated system that assessed the presence and severity of 11 end-of-life patient physical and psychosocial symptoms. SCH caregivers received automated coaching on symptom care based on reported patient symptoms and their severity. Moderate-to-severe symptoms were also relayed to the hospice nurse. RESULTS The SCH intervention produced a mean overall symptom reduction benefit, over UC, of 4.89 severity points (95% CI 2.86-6.92) (P < 0.001), with a moderate effect size (d = 0.55). The SCH benefit also occurred at each timepoint (P < 0.001- 0.020). There was a 38% reduction in days reporting moderate-to-severe patient symptoms compared to UC (P < 0.001) with 10/11 symptoms significantly reduced in SCH compared to UC. CONCLUSION Automated mHealth symptom reporting by caregivers, paired with tailored caregiver coaching on symptom management and nurse notifications, reduces cancer patients' physical and psychosocial symptoms during home hospice, providing a novel and efficient approach to improving end-of-life care.
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Affiliation(s)
- Kathi Mooney
- College of Nursing and Huntsman Cancer Institute (KM, JL, MS) University of Utah, Salt Lake City, Utah, USA.
| | - Meagan S Whisenant
- Cizik School of Nursing (M.S.W.), University of Texas Health Science Center, Houston, Texas, USA
| | - Christina M Wilson
- School of Nursing (C.M.W.), University of Alabama, Birmingham, Alabama, USA
| | - Lorinda A Coombs
- School of Nursing (L.A.C.), University of North Carolina, Chapel Hill, North Carolina, USA
| | - Jennifer Lloyd
- College of Nursing and Huntsman Cancer Institute (KM, JL, MS) University of Utah, Salt Lake City, Utah, USA
| | - Natalya Alekhina
- College of Nursing (N.A., E.A.S., A.M.M., P.B., E.I.), University of Utah, Salt Lake City, Utah, USA
| | - Elizabeth A Sloss
- College of Nursing (N.A., E.A.S., A.M.M., P.B., E.I.), University of Utah, Salt Lake City, Utah, USA
| | - Mary Steinbach
- College of Nursing and Huntsman Cancer Institute (KM, JL, MS) University of Utah, Salt Lake City, Utah, USA
| | - Ann Marie Moraitis
- College of Nursing (N.A., E.A.S., A.M.M., P.B., E.I.), University of Utah, Salt Lake City, Utah, USA
| | - Patricia Berry
- College of Nursing (N.A., E.A.S., A.M.M., P.B., E.I.), University of Utah, Salt Lake City, Utah, USA
| | - Eli Iacob
- College of Nursing (N.A., E.A.S., A.M.M., P.B., E.I.), University of Utah, Salt Lake City, Utah, USA
| | - Gary Donaldson
- School of Medicine (G.D.), University of Utah, Salt Lake City, Utah, USA
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19
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Alanazi MO, Patano A, Bente G, Mason A, Goldstein D, Parsnejad S, Wyatt G, Lehto R. Nature-Based Virtual Reality Feasibility and Acceptability Pilot for Caregiver Respite. Curr Oncol 2023; 30:5995-6005. [PMID: 37504309 PMCID: PMC10378650 DOI: 10.3390/curroncol30070448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 06/14/2023] [Accepted: 06/20/2023] [Indexed: 07/29/2023] Open
Abstract
Home-based informal caregivers (CGs), such as the family members and friends of cancer patients, often suffer averse emotional symptoms, such as anxiety and depression, due to the burden associated with providing care. The natural environment has been valued as a healing sanctuary for easing emotional pain, promoting calmness, relaxation, and restoration. The use of virtual reality (VR) nature experiences offers an alternative option to CGs to manage emotional symptoms and improve their quality of life. The aim of this mixed-method pilot was to evaluate the feasibility and acceptability of a nature-based VR experience for home-based CGs. Nine informal CGs participated in a 10 min nature-based VR session and completed feasibility, acceptability, and VR symptom measures in the laboratory. Semi-structured interviews with five of the CGs provided qualitative data regarding their experiences with VR. The CGs (mean age 64.78 years) were mostly female (n = 7). Our analysis showed high feasibility (15.11 ± 1.76; range 0-16) and acceptability (15.44 ± 1.33; range 0-16), as well as low VR Symptoms (1.56 ± 1.33; range 0-27). Participants primarily expressed positive perceptions regarding VR feasibility and acceptability during interviews. Our findings show promise for the use of VR nature experiences. In the next phase of the study, the intervention will be tested on home-based informal CGs of patients at end of life.
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Affiliation(s)
- Mohammed Owayrif Alanazi
- College of Nursing, Michigan State University, East Lansing, MI 48824, USA
- Department of Nursing, College of Applied Medical Sciences, University of Bisha, Bisha 61922, Saudi Arabia
| | - Arienne Patano
- College of Nursing, Michigan State University, East Lansing, MI 48824, USA
| | - Gary Bente
- College of Communication Arts & Sciences, Michigan State University, East Lansing, MI 48824, USA
| | - Andrew Mason
- College of Engineering, Michigan State University, East Lansing, MI 48824, USA
| | - Dawn Goldstein
- College of Nursing, Michigan State University, East Lansing, MI 48824, USA
| | - Sina Parsnejad
- Texas Instruments, 1001 Winstead Dr #305, Cary, NC 27513, USA
| | - Gwen Wyatt
- College of Nursing, Michigan State University, East Lansing, MI 48824, USA
| | - Rebecca Lehto
- College of Nursing, Michigan State University, East Lansing, MI 48824, USA
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20
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Reuvers MJP, Gedik A, Way KM, Elbersen-van de Stadt SM, van der Graaf WTA, Husson O. Caring for Adolescents and Young Adults (AYA) with Cancer: A Scoping Review into Caregiver Burdens and Needs. Cancers (Basel) 2023; 15:3263. [PMID: 37370873 DOI: 10.3390/cancers15123263] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 06/14/2023] [Accepted: 06/19/2023] [Indexed: 06/29/2023] Open
Abstract
AYAs with cancer (aged 15 to 39 at primary diagnosis) form a specific group within oncology, and there is limited information on the impact on their informal caregivers. This scoping review aimed to gain insight into the burden on caregivers of AYAs with cancer and identify the unmet needs they might have. Eligible articles focused on impacts in one of the domains of caregiver burden (physical, psychological, social, on schedule, financial) or unmet needs. In all domains of caregiver burden, impact was reported by caregivers. Caregiving leads to physical problems (such as sleep problems) and psychological symptoms (e.g., depression, anxiety, and negative emotions). Loneliness is reported, and little peer-support. Many different tasks and roles must be undertaken, which is perceived as challenging. In addition, there is a financial impact and there are unmet needs to be met. Several domains of the lives of caregivers of AYA cancer patients are negatively affected by the disease. Some of these are age-specific, and tailored to a particular group of caregivers (parents, partners, or friends). AYA cancer patients represent a wide age range, resulting in the engagement of many different caregivers. Future research will need to take this into account in order to adequately provide support.
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Affiliation(s)
- Milou J P Reuvers
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, 1006 BE Amsterdam, The Netherlands
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
| | - Asiye Gedik
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
| | - Kirsty M Way
- School of Heath Sciences, University of Southampton, Southampton SO17 1BJ, UK
| | | | - Winette T A van der Graaf
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, 1006 BE Amsterdam, The Netherlands
| | - Olga Husson
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
- Department of Surgical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
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21
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Reblin M, Iacob E, Tay DL, Li H, Hebdon MCT, Beck A, Donaldson G, Cloyes KG, Ellington L. Family Caregiver Reports of Their Own and Patient Symptoms in Cancer Home Hospice Approaching End-of-Life. Am J Hosp Palliat Care 2023; 40:508-516. [PMID: 35689339 PMCID: PMC9734284 DOI: 10.1177/10499091221108119] [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] [Indexed: 12/14/2022] Open
Abstract
Context: Family caregivers assume the primary responsibility of assessing and managing hospice cancer patient symptoms while simultaneously managing their own wellbeing and symptoms. Objectives: Describe caregivers' assessment of hospice cancer patient and their own symptoms during the last 60 days of patient life, and assess the relationship between patient and caregiver symptoms over time. Methods: Caregiver symptom report of self and cancer home hospice patient symptom data were collected via telephone in the final 60 days of patient life. Descriptive data on symptom severity and prevalence were summarized. Exploratory Factor Analysis was used to group individual symptoms. Factors representing patient symptoms, caregiver symptoms, and caregiver outlook were analyzed using mixed-effects analysis to determine relationships between factors and change in relationship between factors over time. Results: Data from 61 patient-caregiver dyads are presented. At least 1 day of moderate-to-severe symptoms were reported in the majority of dyads. Significant auto-regressive associations were found, namely previous factor scores for an individual positively predicted the next factor scores for that individual. Previous caregiver report of patient symptoms was also positively associated with the next report of caregiver symptoms; previous caregiver report of their own symptoms were negatively associated with their next report of patient symptoms. Patient and caregiver symptoms and caregiver outlook worsened over time and the relationship between patient and caregiver symptoms strengthened closer to death. Conclusion: Our findings may guide hospice care team responses to caregiver and patient symptoms to promote individual level and unit level functioning.
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Affiliation(s)
- Maija Reblin
- School of Medicine, University of Vermont, Burlington, VT, USA
| | - Eli Iacob
- College of Nursing, University of Utah, Salt Lake City, UT, USA
| | - Djin L. Tay
- College of Nursing, University of Utah, Salt Lake City, UT, USA
| | - Hui Li
- College of Nursing, University of Utah, Salt Lake City, UT, USA
| | | | - Anna Beck
- Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Gary Donaldson
- College of Nursing, University of Utah, Salt Lake City, UT, USA
| | | | - Lee Ellington
- College of Nursing, University of Utah, Salt Lake City, UT, USA
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22
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Mehnert-Theuerkauf A, Hufeld JM, Esser P, Goerling U, Hermann M, Zimmermann T, Reuter H, Ernst J. Prevalence of mental disorders, psychosocial distress, and perceived need for psychosocial support in cancer patients and their relatives stratified by biopsychosocial factors: rationale, study design, and methods of a prospective multi-center observational cohort study (LUPE study). Front Psychol 2023; 14:1125545. [PMID: 37151329 PMCID: PMC10157044 DOI: 10.3389/fpsyg.2023.1125545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 03/31/2023] [Indexed: 05/09/2023] Open
Abstract
Background Despite remarkable progress, cancer remains a life-threatening disease for millions of people worldwide, also resulting in significant psychosocial limitations. High-quality, comprehensive cancer care requires patient and family involvement and the provision of needs-based, targeted psychosocial services. Although progress has been made in understanding the occurrence of mental comorbidity and psychosocial distress in cancer patients, comparatively little is known about the course of psychological comorbidity and psychosocial distress in early survivorship among patients and their families. We therefore aim to estimate the prevalence of mental disorders according to the DSM-5, psychosocial distress, perceived needs for psychosocial support and utilization of psychosocial support offers in newly diagnosed cancer patients and their relatives, taking into account potential contributing biopsychosocial factors for the occurrence of psychological comorbidity. Methods/design This study follows a prospective multi-center observational cohort design across four measurement time points: within 2 months after cancer diagnosis (t1), and in the follow-up period at 6 months (t2), at 12 months (t3), and at 18 months (t4) after t1. Patients older than 18 years who have a confirmed initial diagnosis of a malignant solid tumor and are scheduled for cancer treatment at one of the participating cancer centers are eligible for study participation. Relatives of eligible patients are also eligible for study participation if they are older than 18 years. Patients are interviewed using the Structured Clinical Interview for DSM-5 Disorders (SCID-5-CV). In addition, patients and relatives receive a set of validated questionnaires at each measurement time point, covering comorbid conditions and functional performance, perceived psychological distress and quality of life, partnership aspects and social relationships, supportive care needs and use of psychosocial support services, health literacy, and health behavior and meaning in life. Discussion This prospective multi-center observational cohort study has a major focus on increasing quality of care and quality of life in cancer survivors through providing rigorous longitudinal data for the development and implementation of target group-specific psychosocial support services. Trial registration NCT04620564, date of registration 9/11/2020; DKG OnkoZert: Registrier-No.: ST-U134, date of registration 5/11/2021.
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Affiliation(s)
- Anja Mehnert-Theuerkauf
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Julia Marie Hufeld
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Peter Esser
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Ute Goerling
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Charité Comprehensive Cancer Center, Berlin, Germany
| | - Myriel Hermann
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Charité Comprehensive Cancer Center, Berlin, Germany
| | - Tanja Zimmermann
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Hannah Reuter
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Jochen Ernst
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
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23
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Rivera-Rivera JN, Borger T, Sizemore Y, Burris JL. Similarities and differences across the underlying dimensions of social functioning in rural and nonrural cancer survivors: A mixed-methods study. J Rural Health 2023; 39:434-443. [PMID: 36315053 PMCID: PMC10038817 DOI: 10.1111/jrh.12721] [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] [Indexed: 11/07/2022]
Abstract
PURPOSE For cancer survivors, social functioning greatly influences other quality of life dimensions. While there is potential for differences in social functioning to vary as a function of geographic residence, few studies examine the social functioning of rural cancer survivors specifically. This study aims to help fill this gap. METHODS This was an embedded mixed-methods study where all participants completed a questionnaire, and some were purposively selected to complete an interview to gather more information about social functioning (ie, social roles, activities, network, support, and constraint). Participants (n = 93; 63% rural) were recruited through a state cancer registry and cancer care facility. Participants were predominately White, non-Hispanic (92.47%), roughly half female (54.84%), and on average, diagnosed in the past two years (SD = 1.68), and 61.45 (SD = 10.87) years old. FINDINGS Few differences in the social functioning of rural and nonrural participants were found on questionnaires, though rural participants reported larger networks and more overall support. Across groups, common themes in the interview data were the experience of both social support (eg, instrumental support) and social constraint (eg, others minimizing participants' problems or sharing their own negative experiences). CONCLUSIONS This was the first cancer survivorship study to thoroughly examine social functioning by geographic residence. Rural cancer survivors described some unique strengths, but major group differences were not apparent. All participants highlighted situations when others, even with good intentions, were unhelpful to them. Future interventions to improve social functioning could work to dispel the belief that cancer survivors should handle their cancer on their own.
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Affiliation(s)
| | - Tia Borger
- University of Kentucky Department of Psychology, Lexington, KY
- University of Kentucky Markey Cancer Center, Lexington, KY
| | - Yancey Sizemore
- University of Kentucky Department of Psychology, Lexington, KY
| | - Jessica L. Burris
- University of Kentucky Department of Psychology, Lexington, KY
- University of Kentucky Markey Cancer Center, Lexington, KY
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24
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Yuen EY, Wilson C, Livingston PM, White VM, McLeod V, Hutchinson AM. Burden prediction in cancer caregivers: role of social support and connectedness. BMJ Support Palliat Care 2023:spcare-2022-004070. [PMID: 36746609 DOI: 10.1136/spcare-2022-004070] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 01/11/2023] [Indexed: 02/08/2023]
Abstract
OBJECTIVES Caregivers play a key role in providing support to people with cancer. However, caregiving can be stressful and demanding, resulting in perceived caregiver burden. Social connectedness is considered partially independent from social support, yet few studies have examined whether social connectedness impacts caregiver burden. The current study sought to examine: (a) associations among social support, social connectedness and burden in a sample of cancer caregivers and (b) the mediating effect of social connectedness on the relationship between social support and caregiver burden. METHODS A descriptive cross-sectional study was conducted. Data were collected as part of a larger project. The sample included 125 caregiver-cancer care recipient dyads. Caregivers completed the Social Connectedness Scale-Revised, the Medical Outcomes Study-Social Support Survey and the Zarit Burden Interview. Descriptive statistics, hierarchical multiple regression and mediation analyses were used to examine relationships between variables. RESULTS Correlation analyses showed higher perceived social support and social connectedness were significantly correlated with lower-reported caregiver burden (p<0.05). The hierarchical regression model showed that both social support and social connectedness were independent predictors of caregiver burden (p<0.001). Social connectedness partially mediated the relationship between social support and caregiver burden. CONCLUSIONS This study provides new evidence that social support buffers the negative effects of burden in caregivers, suggesting these are potentially modifiable factors of caregiver burden. Increased understanding of the factors that contribute to burden among cancer caregivers will inform targeted supportive care strategies to improve psychological health and well-being in this underserved group.
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Affiliation(s)
- Eva Yn Yuen
- School of Nursing and Midwifery, Deakin University, Burwood, Victoria, Australia
- Centre for Quality and Patient Safety, Institute for Health Transformation, Burwood, VIC, Australia
- Centre for Quality and Patient Safety - Monash Health Partnership, Monash Health, Clayton, VIC, Australia
| | - Carlene Wilson
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
- Psycho-Oncology Research Unit, Austin Health, Heidelberg, Victoria, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | | | - Victoria M White
- School of Psychology, Deakin University, Burwood, Victoria, Australia
| | - Vicki McLeod
- Oncology Unit, Monash Health, Melbourne, Victoria, Australia
| | - Alison M Hutchinson
- School of Nursing and Midwifery, Deakin University, Burwood, Victoria, Australia
- Centre for Quality and Patient Safety-Barwon Health Partnership, Barwon Health, Geelong, Victoria, Australia
- Centre for Quality and Patient Safety, Institute for Health Transformation, Deakin University, Burwood, VIC, Australia
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25
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Secinti E, Fischer IC, Brennan EA, Christon L, Balliet W. The efficacy of psychosocial interventions for cancer caregiver burden: A systematic review and meta-analysis of randomized controlled trials. Clin Psychol Rev 2023; 99:102237. [PMID: 36516641 DOI: 10.1016/j.cpr.2022.102237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 10/13/2022] [Accepted: 11/24/2022] [Indexed: 12/05/2022]
Abstract
Caregivers of adults with cancer often provide prolonged demanding assistance (e.g., physical, emotional) to their loved ones, resulting in caregiver burden. This meta-analytic review examined the efficacy of psychosocial interventions in reducing caregiver burden in caregivers of adults with cancer. Randomized controlled trials (RCTs) were identified from six electronic databases and clinical trial registries. Random-effects meta-analyses were conducted for subgroups of interventions and control conditions. Overall, 90 records describing 50 RCTs showed that psychosocial interventions reduced caregiver burden compared to passive controls (e.g. wait-list) at post-intervention (g = 0.26, 95%CI [0.12, 0.40]), but not at the first follow-up (g = 0.10, 95%CI [-0.05, 0.24]). Subgroup analyses showed that compared to passive controls, therapeutic counseling and skills training interventions significantly reduced caregiver burden at post-intervention, whereas psycho-education/support interventions did not significantly reduce burden. Very few RCTs examined intervention efficacy compared to active controls (e.g., psycho-education/support). The evidence grade ranged from very low to moderate due to inconsistency and imprecision of the results. Therapeutic counseling and skills training interventions appear efficacious in improving caregiver burden at post-intervention, although these improvements attenuate over time. Rigorous trials examining intervention effects on long-term outcomes are needed to better understand the effective mechanisms to sustain reduction in caregiver burden.
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Affiliation(s)
- Ekin Secinti
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA.
| | - Ian C Fischer
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | - Emily A Brennan
- MUSC Libraries, Medical University of South Carolina, Charleston, SC, USA
| | - Lillian Christon
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Wendy Balliet
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
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26
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Chong E, Crowe L, Mentor K, Pandanaboyana S, Sharp L. Systematic review of caregiver burden, unmet needs and quality-of-life among informal caregivers of patients with pancreatic cancer. Support Care Cancer 2023; 31:74. [PMID: 36544073 PMCID: PMC9771849 DOI: 10.1007/s00520-022-07468-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 11/07/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE Informal caregivers play an important supportive care role for patients with cancer. This may be especially true for pancreatic cancer which is often diagnosed late, has a poor prognosis and is associated with a significant symptom burden. We systematically reviewed the evidence on caregiver burden, unmet needs and quality-of-life of informal caregivers to patients with pancreatic cancer. METHOD PubMed, Medline, CINAHL and Embase databases were systematically searched on 31 August 2021. Qualitative and quantitative data on informal caregivers' experiences were extracted and coded into themes of burden, unmet needs or quality-of-life with narrative synthesis of the data undertaken. RESULTS Nine studies (five qualitative, four quantitative), including 6023 informal caregivers, were included in the review. We categorised data into three key themes: caregiver burden, unmet needs and quality-of-life. Data on caregiver burden was organised into a single subtheme relating to symptom management as a source of burden. Data on unmet needs was organised into three subthemes need for: better clinical communication; support and briefings for caregivers; and help with navigating the health care system. Data on quality-of-life indicate large proportions of informal caregivers experience clinical levels of anxiety (33%) or depression (12%-32%). All five qualitative studies were graded as good quality; three quantitative studies were poor quality, and one was fair quality. CONCLUSION High-quality pancreatic cancer care should consider the impacts of informal caregiving. Prospective longitudinal studies examining multiple dimensions of caregiver burden, needs, and quality-of-life would be valuable at informing supportive care cancer delivery to pancreatic cancer informal caregivers.
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Affiliation(s)
- Eric Chong
- Surgical and Translational Research Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Lisa Crowe
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle University, Newcastle, UK
| | - Keno Mentor
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle University, Newcastle, UK ,Department of Hepatobiliary, Pancreatic and Transplant Surgery, Freeman Hospital, Tyne and Wear, Newcastle Upon Tyne, UK
| | - Sanjay Pandanaboyana
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle University, Newcastle, UK ,Department of Hepatobiliary, Pancreatic and Transplant Surgery, Freeman Hospital, Tyne and Wear, Newcastle Upon Tyne, UK
| | - Linda Sharp
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle University, Newcastle, UK
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27
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Du K, Pan YY, Yan WW. Qualitative descriptive study during the COVID-19 pandemic on the needs of informal caregivers of Chinese minors who underwent craniopharyngioma surgery. J Pediatr Nurs 2023; 68:e87-e95. [PMID: 36437132 DOI: 10.1016/j.pedn.2022.11.016] [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: 04/30/2022] [Revised: 11/16/2022] [Accepted: 11/16/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE To determine the needs of informal caregivers during the long-term health management of minors who have undergone craniopharyngioma surgery. Design and methodology This is a qualitative and descriptive research study. Purposive sampling was used to select participants, and semi-structured interviews were conducted to explore the needs of 21 informal caregivers for postoperative minors. Due to the COVID-19 pandemic, the respondents were provided with the options of online video call or offline one-on-one interviews. Following this, a content analysis method was conducted. RESULTS Four themes and 14 sub-themes were extracted from the results of the study, including needs for relieving psychological stress (including psychological pressure on both minors and on caregivers); requirement for on-campus assistance (physical activity, eliminating verbal violence in schools, special education needs for child, healthcare services provided by school hospitals); demands for medical help (acquiring medical knowledge, need for medication management, convenience and reliable access to medical services, need for technological development, expectations of multidisciplinary cooperation, the necessity of health review reminders); and the desire for financial aid (charity platform assistance, inclination of government policy). CONCLUSIONS In China, informal caregivers of young patients with onset craniopharyngioma require both the multidisciplinary cooperation of medical institutions and the multi-departmental cooperation of society. Information and medical technology advancements may benefit families with young patients. Improving community hospitals' medical services and encouraging the practical use of online medical treatment and prescriptions are both necessary in the context of COVID-19. PRACTICE IMPLICATIONS By identifying the needs of informal caregivers, medical professionals are able to develop care plans and interventions aimed at reducing the burden of care for minors who have undergone craniopharyngioma surgery.
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Affiliation(s)
- Kun Du
- Emergency Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yuan Yuan Pan
- Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
| | - Wen Wen Yan
- Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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28
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Uneno Y, Kotera Y, Fujisawa D, Kataoka Y, Kosugi K, Murata N, Kessoku T, Ozaki A, Miyatake H, Muto M. Development of a novel COMPAssion focused online psyChoTherapy for bereaved informal caregivers: the COMPACT feasibility trial protocol. BMJ Open 2022; 12:e067187. [PMID: 36549732 PMCID: PMC9772635 DOI: 10.1136/bmjopen-2022-067187] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION An easy-to-access and effective psychotherapy for bereaved informal caregivers has not been established. People with higher self-compassion status tend to have lower bereavement related grief, psychotherapy focused on self-compassion can be promising for this population. This study aimed to examine the feasibility of online self-compassion focused psychotherapy for bereaved informal caregivers. METHOD AND ANALYSIS A total of 60 study participants will undergo an intervention programme comprising online sessions of 2 hours per week for five consecutive weeks and undertake postsession work. The intervention personnel will comprise psychologists who have received more than 10 hours of structured training. The primary endpoint will be assessed on the intervention completion rate, with secondary endpoints consisting of the Complicated Grief Questionnaire, Patient Health Questionnaire-9, Generalised Anxiety Disorder-7, Brief Resilience Scale and Self-Compassion Scale. Evaluations will be conducted preintervention, immediately after intervention, and 4 and 12 weeks after intervention. ETHICS AND DISSEMINATION This study has been reviewed and approved by the Ethics Committee of the Kyoto University Graduate School and Faculty of Medicine, Kyoto University Hospital, Japan (Approved ID: C1565). The results of this study will be disseminated through publication in a peer-reviewed journal and conference presentations. TRIAL REGISTRATION NUMBER UMIN000048554.
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Affiliation(s)
- Yu Uneno
- Department of Therapeutic Oncology, Kyoto University, Graduate School of Medicine, Kyoto, Japan
| | - Yasuhiro Kotera
- Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - Daisuke Fujisawa
- Department of Neuropsychiatry and Palliative Care Center, Keio University School of Medicine, Tokyo, Japan
| | - Yuki Kataoka
- Department of Internal Medicine, Kyoto Min-Iren Asukai Hospital, Kyoto, Japan
- Scientific Research Works Peer Support Group (SRWS-PSG), Osaka, Japan
- Section of Clinical Epidemiology, Department of Community Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Department of Healthcare Epidemiology, Kyoto University Graduate School of Medicine / School of Public Health, Kyoto, Japan
| | - Kazuhiro Kosugi
- Department of Palliative Medicine, National Cancer Center Hospital East, Kashiwa, Japan
| | - Nanami Murata
- Medical School, Wakayama Medical University, Wakayama, Japan
| | - Takaomi Kessoku
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine Graduate School of Medicine, Yokohama, Japan
- Department of Palliative Medicine, Yokohama City University Hospital, Yokohama, Japan
| | - Akihiko Ozaki
- Department of Breast Surgery, Jyoban Hospital of Tokiwa Foundation, Fukushima, Japan
| | | | - Manabu Muto
- Department of Therapeutic Oncology, Kyoto University, Graduate School of Medicine, Kyoto, Japan
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29
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Howard AF, Lynch K, Thorne S, Porcino A, Lambert L, De Vera MA, Wolff AC, Hedges P, Beck SM, Torrejón MJ, Kelly MT, McKenzie M. Occupational and Financial Setbacks in Caregivers of People with Colorectal Cancer: Considerations for Caregiver-Reported Outcomes. Curr Oncol 2022; 29:8180-8196. [PMID: 36354706 PMCID: PMC9689650 DOI: 10.3390/curroncol29110646] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 10/28/2022] [Indexed: 01/14/2023] Open
Abstract
Family caregivers of patients with cancer provide substantial physical, emotional, and functional care throughout the cancer trajectory. While caregiving can create employment and financial challenges, there is insufficient evidence to inform the development of caregiver-reported outcomes (CROs) that assess these experiences. The study purpose was to describe the occupational and financial consequences that were important to family caregivers of a patient with colorectal cancer (CRC) in the context of public health care, which represent potential considerations for CROs. In this qualitative Interpretive Description study, we analyzed interview data from 78 participants (25 caregivers, 37 patients, and 16 healthcare providers). Our findings point to temporary and long-term occupational and financial setbacks in the context of CRC. Caregiving for a person with CRC involved managing occupational implications, including (1) revamping employment arrangements, and (2) juggling work, family, and household demands. Caregiver financial struggles included (1) responding to financial demands at various stages of life, and (2) facing the spectre of lifelong expenses. Study findings offer novel insight into the cancer-related occupational and financial challenges facing caregivers, despite government-funded universal health care. Further research is warranted to develop CRO measures that assess the multifaceted nature of these challenges.
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Affiliation(s)
- A. Fuchsia Howard
- School of Nursing, The University of British Columbia, Vancouver, BC V6T 2B5, Canada
- Correspondence:
| | - Kelsey Lynch
- School of Nursing, The University of British Columbia, Vancouver, BC V6T 2B5, Canada
| | - Sally Thorne
- School of Nursing, The University of British Columbia, Vancouver, BC V6T 2B5, Canada
| | | | - Leah Lambert
- School of Nursing, The University of British Columbia, Vancouver, BC V6T 2B5, Canada
- BC Cancer, Vancouver, BC V5Z 4C2 Canada
| | - Mary A. De Vera
- Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Angela C. Wolff
- School of Nursing, Trinity Western University, Langley, BC V2Y 1Y1, Canada
| | | | - Scott M. Beck
- School of Nursing, The University of British Columbia, Vancouver, BC V6T 2B5, Canada
- BC Cancer, Vancouver, BC V5Z 4C2 Canada
| | | | - Mary T. Kelly
- School of Nursing, The University of British Columbia, Vancouver, BC V6T 2B5, Canada
| | - Michael McKenzie
- BC Cancer, Vancouver, BC V5Z 4C2 Canada
- Faculty of Medicine, The University of British Columbia, Vancouver, BC V6T 1Z3, Canada
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30
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Johnston EA, Goodwin BC, Myers L, March S, Aitken JF, Chambers SK, Dunn J. Support-seeking by cancer caregivers living in rural Australia. Aust N Z J Public Health 2022; 46:850-857. [PMID: 36121279 DOI: 10.1111/1753-6405.13304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 06/01/2022] [Accepted: 07/01/2022] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE Rural cancer caregivers report poor wellbeing and high unmet needs for support. This study investigates sources of support sought by cancer caregivers living in rural Australia, and factors associated with support-seeking. METHODS Informal caregivers of people with cancer completed a questionnaire assessing sociodemographic characteristics, caregiver factors and support-seeking. Descriptive statistics, bivariate analyses and logistic regression were used to identify common sources of support and factors associated with support-seeking. Alluvial and radar plots were used to identify and describe support-seeking profiles. FINDINGS Of 244 rural caregivers, 64% reported seeking support for themselves, 72% for the cancer patient, and 22% did not seek any support. The most common sources of support were general practitioners and online. Higher caregiver burden, higher income, caring for someone with anxiety/depression or caring for someone who has difficulty completing their usual activities were associated with seeking support from a greater number of sources. The 'No support-seekers' profile had the highest proportions of caregivers who were male, caring for someone <12 months post-diagnosis and lower income earners. CONCLUSIONS Many rural caregivers seek support for themselves and the cancer patient, commonly from medical and online sources. IMPLICATIONS FOR PUBLIC HEALTH Further work may be needed to reduce caregiver burden and support caregivers who are male, caring for someone recently diagnosed, and those with lower incomes.
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Affiliation(s)
- Elizabeth A Johnston
- Viertel Cancer Research Centre, Cancer Council Queensland, Queensland.,School of Exercise and Nutrition Sciences, Queensland University of Technology, Queensland.,Population Health Program, QIMR Berghofer Medical Research Institute, Queensland
| | - Belinda C Goodwin
- Viertel Cancer Research Centre, Cancer Council Queensland, Queensland.,Centre for Health Research, University of Southern Queensland, Queensland
| | - Larry Myers
- Viertel Cancer Research Centre, Cancer Council Queensland, Queensland.,School of Psychology and Wellbeing, University of Southern Queensland, Queensland
| | - Sonja March
- Centre for Health Research, University of Southern Queensland, Queensland.,School of Psychology and Wellbeing, University of Southern Queensland, Queensland
| | - Joanne F Aitken
- Viertel Cancer Research Centre, Cancer Council Queensland, Queensland.,Centre for Health Research, University of Southern Queensland, Queensland.,School of Public Health and Social Work, Queensland University of Technology, Queensland.,School of Public Health, The University of Queensland, Queensland
| | - Suzanne K Chambers
- Faculty of Health Sciences, Australian Catholic University, Queensland.,St Vincent's Health Network Sydney, New South Wales.,Menzies Health Institute Queensland, Griffith University, Queensland
| | - Jeff Dunn
- Viertel Cancer Research Centre, Cancer Council Queensland, Queensland.,Centre for Health Research, University of Southern Queensland, Queensland.,Faculty of Health Sciences, Australian Catholic University, Queensland.,Menzies Health Institute Queensland, Griffith University, Queensland.,Exercise Medicine Research Institute, Edith Cowan University, Western Australia.,Prostate Cancer Foundation of Australia, New South Wales
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31
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Thomson MD, Genderson MW, Siminoff LA. Understanding cancer caregiver burden over time: Dyadic assessments of family cohesion, conflict and communication. PATIENT EDUCATION AND COUNSELING 2022; 105:1545-1551. [PMID: 34728096 PMCID: PMC9001744 DOI: 10.1016/j.pec.2021.10.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 09/01/2021] [Accepted: 10/09/2021] [Indexed: 05/28/2023]
Abstract
OBJECTIVE Previously we identified three distinct cancer communication concordance groups among cancer patient-caregiver dyads. This secondary analysis examined patient and caregiver reports of family functioning (cohesion and conflict) as associated with cancer communication concordance and assessed each as independent predictors of perceived caregiver burden among hematological cancer caregivers. METHODS A case series of hematological cancer patient-caregiver dyads (n = 171) were recruited from oncology clinics in Virginia and Pennsylvania and followed for 2 years. Using the previously identified communication groups this analysis prospectively examines patient and caregiver perceptions of family cohesion and conflict and the association with burden over time. RESULTS Caregiver burden decreased over time. Caregiver, but not patient perceptions of family cohesion decreased over time; decreased cohesion and increased conflict was associated with greater cancer communication discordance. CONCLUSIONS This work lends further support to the use of cancer communication congruence typologies for identifying potentially vulnerable dyads. Discordant cancer communication and declining caregiver perceptions of family cohesion may represent opportunities to intervene using family focused supportive services. PRACTICE IMPLICATIONS Only caregiver perceptions of family functioning were associated with burden therefore identifying and supporting those caregivers with worsening communication and family function is important.
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Affiliation(s)
- Maria D Thomson
- Department of Health Behavior and Policy, Virginia Commonwealth University, 830 East Main Street, Richmond, VA 23219, USA.
| | - Maureen Wilson Genderson
- College of Public Health and Social and Behavioral Sciences, Temple University, Philadelphia, USA
| | - Laura A Siminoff
- College of Public Health and Social and Behavioral Sciences, Temple University, Philadelphia, USA
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See F, Teo I, Malhotra C. Longitudinal trajectories of caregiving experiences among primary informal caregivers of patients with metastatic solid cancer (Stage IV). Psychooncology 2022; 31:1161-1168. [PMID: 35199404 DOI: 10.1002/pon.5904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 12/14/2021] [Accepted: 02/11/2022] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Cancer is a significant cause of mortality worldwide. The diagnosis of advanced cancer affects both patients and their family caregivers. Understanding the course of both negative and positive experiences of caregiving provides a more comprehensive understanding of the caregiving experience. The study aims to identify joint trajectories of burden and esteem among family caregivers of patients with solid metastatic cancer, and to identify caregiver characteristics that predict membership for each delineated trajectory. METHODS A prospective longitudinal study of 346 informal family caregivers of patients with solid metastatic cancer were recruited between July 2016 and December 2019. Surveys were conducted every 3 months for 2 years. We assessed caregiver burden and positive aspects of caregiving using the modified Caregiver Reaction Assessment. We estimated the joint trajectories for these outcomes using group-based multi-trajectory modelling. RESULTS We identified 4 trajectories describing caregivers with 1) low burden, moderate esteem (38.3%), 2) low burden, high esteem (20.3%), 3) high burden, low esteem (16.4%), 4) high burden, high esteem (24.9%). Compared to the "low burden, high esteem" trajectory, male and non-spousal caregivers were more likely to experience high burden and esteem while caregivers from low socioeconomic status were more likely to belong to trajectories with a high burden. CONCLUSION Recognising caregivers at high risk of belonging to trajectories with high burden or low esteem may enable healthcare professionals to anticipate and provide appropriate support to mitigate the impact of negative outcomes.
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Affiliation(s)
- Faith See
- Lien Center for Palliative Care, Duke-NUS Medical School, Blk 541 Pasir Ris St 51 #04-14, Singapore, 169857
| | - Irene Teo
- Lien Center for Palliative Care, Duke-NUS Medical School, 8 College Rd, Singapore
| | - Chetna Malhotra
- Lien Center for Palliative Care, Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore National Cancer Center, 8 College Road, Level 4, Singapore
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King JJ, Segrin C, Badger TA, Thomson CA. Exploring the relationship between loneliness, spirituality, and health-related quality of life in Hispanic cancer caregivers. Support Care Cancer 2022; 30:4781-4788. [PMID: 35142912 PMCID: PMC9046141 DOI: 10.1007/s00520-022-06800-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 12/31/2021] [Indexed: 12/24/2022]
Abstract
Caregivers of cancer patients find it challenging to perform their roles and to meet the demands of caregiving. Spirituality has been investigated as a potential coping strategy employed by caregivers, yet spirituality and related practices vary among cultural groups. In this study, we investigated the relationship between spirituality and health-related quality of life (HRQOL) and evaluated mediation effects of loneliness on this relationship. The sample was 234 lower socioeconomic status (SES) Hispanic caregivers of breast cancer survivors using existing data from the Support for Latinas with Breast Cancer and Their Intimate and Family Partners study, funded by the American Cancer Society (Badger, PI). A cross-sectional analysis was conducted at baseline, using self-reported spirituality, loneliness, and HRQOL data collected from 2012 to 2017. The exposures and outcomes were assessed using the Spiritual Well-Being Scale, the Social Isolation-Short Form 8a PROMIS Item Bank v2.0 scale, and the Global Health Scale PROMIS v.1.0/1.1 scale. Descriptive and mediation analyses using the Preacher and Hayes' approach were conducted to estimate the direct effect of spirituality on HRQOL and the indirect effect of spirituality through mediation of loneliness in relation to HRQOL. A positive association between spirituality and HRQOL was found, whereas loneliness was inversely associated with HRQOL (b = - .18, SE = .03, p < .0001). Age did not function as a moderator of the spirituality-HRQOL association in any of the models tested, but in the model testing mediation, loneliness was shown to mediate the association between spirituality and HRQOL (b = - .17, p < .0001). These results suggest that spirituality may be beneficial to HRQOL in caregivers of Hispanic breast cancer survivors, due in part to reduced loneliness among more spiritual caregivers.
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Affiliation(s)
- Jennifer J King
- Department of Health Promotion Sciences, University of Arizona, Mel and Enid Zuckerman College of Public Health, 1295 N. Martin Ave., Drachman Hall, A260, PO Box: 245209, Tucson, AZ, 85719, USA.
| | - Chris Segrin
- College of Social and Behavioral Sciences, University of Arizona, Tucson, AZ, USA
| | - Terry A Badger
- College of Nursing, University of Arizona, Tucson, AZ, USA
| | - Cynthia A Thomson
- Department of Health Promotion Sciences and the University of Arizona Cancer Center, University of Arizona, Tucson, AZ, USA
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The Relationship between Cancer Caregiver Burden and Psychological Outcomes: The Moderating Role of Social Connectedness. Curr Oncol 2021; 29:14-26. [PMID: 35049676 PMCID: PMC8775135 DOI: 10.3390/curroncol29010002] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 12/03/2021] [Accepted: 12/14/2021] [Indexed: 11/18/2022] Open
Abstract
The present study: (a) examined the extent of caregiver burden and psychological wellbeing and (b) tested whether social connectedness moderated the association between caregiver burden and psychological symptoms in caregivers of people with cancer. The cross-sectional survey study included 189 cancer caregivers (mean age = 36.19 years, standard deviation = 11.78; 80.4% female). Data were collected on caregiver burden, social connectedness, and depression and anxiety. Moderation analysis was conducted to examine the effect of social connectedness on the relationship between caregiver burden and depression and anxiety. Caregiver burden was positively associated with depression and anxiety symptoms. Controlling for significant demographic and caregiver characteristics, the moderation model showed as perceived social connectedness increased, the relationship between caregiver burden and depression decreased (β = −0.007, se = 0.004, 95% CI: −0.014, 0.000, p = 0.05). By contrast, social connectedness did not moderate the association between caregiver burden and anxiety. Findings have implications for the management of depression in cancer caregivers. Social connectedness appears to provide a protective buffer from the negative impacts of caregiving, providing increased psychological resources to manage the burden associated with caregiving, resulting in lower depression. Research on strategies to improve caregiver wellbeing through enhancing engagement with social networks in ways that improve perceived sense of connectedness with others is warranted.
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Lehto RH, Wyatt G, Sender J, Miller SE. An Evaluation of Natural Environment Interventions for Informal Cancer Caregivers in the Community. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111124. [PMID: 34769643 PMCID: PMC8583496 DOI: 10.3390/ijerph182111124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 10/19/2021] [Indexed: 11/17/2022]
Abstract
Home-based informal caregiving by friends and family members of patients with cancer is be-coming increasingly common globally with rates continuing to rise. Such caregiving is often emo-tionally and cognitively demanding, resulting in mental exhaustion and high perceived burden. Support for caregivers may be fostered by engagement with the natural environment. Interaction with nature is associated with mental health benefits such as stress reduction and improved well-being. The purpose of this paper was to evaluate the state of the science regarding the use of nat-ural environment interventions to support caregivers of cancer patients in the community. A comprehensive scoping review using the Arksey and O’Malley framework and the Preferred Re-porting Items for Systematic Reviews and Meta-analyses assessed natural environment therapies and mental health outcomes among cancer caregivers. Databases searched included CINAHL, PubMed, Scopus, Cochrane, and Alt HealthWatch. Findings recovered a total of five studies over a 10-year period that met criteria, demonstrating a lack of empirical evidence addressing this po-tential resource to support caregivers. Often, study appraisal was not on nature exposure, but ra-ther other aspects of the projects such as program evaluation, exercise, or complementary thera-pies. Both qualitative and quantitative designs were used but sample sizes were small. Caregivers experienced beneficial results across the various studies and future work could enhance these findings.
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Affiliation(s)
- Rebecca H. Lehto
- College of Nursing, Michigan State University, East Lansing, MI 48824, USA; (G.W.); (J.S.)
- Correspondence:
| | - Gwen Wyatt
- College of Nursing, Michigan State University, East Lansing, MI 48824, USA; (G.W.); (J.S.)
| | - Jessica Sender
- College of Nursing, Michigan State University, East Lansing, MI 48824, USA; (G.W.); (J.S.)
| | - Sara E. Miller
- Department of Human Development and Family Studies, Pennsylvania State University, State College, PA 16802, USA;
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Thana K, Sikorskii A, Lehto R, Given C, Wyatt G. Burden and psychological symptoms among caregivers of patients with solid tumor cancers. Eur J Oncol Nurs 2021; 52:101979. [PMID: 34058683 DOI: 10.1016/j.ejon.2021.101979] [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: 02/25/2021] [Revised: 05/08/2021] [Accepted: 05/17/2021] [Indexed: 12/30/2022]
Abstract
PURPOSE To evaluate factors associated with burden reported by caregivers of people undergoing treatment for solid tumor cancers. METHODS A secondary analysis of baseline data collected in a cancer symptom management trial was conducted guided by the Organizing Framework for Caregiver Interventions. A total of 349 caregivers completed the Caregiver Reaction Assessment Tool evaluating caregiver burden; Bayliss Comorbidity Tool; and PROMIS-29 version1.0-Anxiety and Depression Short Forms. Multivariable linear models were used to examine the associations of Caregiver Reaction Assessment Tool subscales (caregiver self-esteem, family support, financial, schedule, and health burden) with caregiver sociodemographic characteristics, comorbidities, anxiety, and depression. RESULTS The majority of caregivers were female and spouses/partners who resided with the patient. Being female, Asian, a spouse of the patient, employed, and having a higher level of anxiety and depressive symptoms were significantly associated with lower caregiver self-esteem, and higher perceived schedule and health burden. Caregiver anxiety and depressive symptoms were also significantly associated with lack of family support and higher financial burden. CONCLUSIONS Clinicians should consider factors that contribute to higher perceived burden for caregivers when they are engaged in home-based supportive care for patients undergoing cancer treatment.
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Affiliation(s)
- Kanjana Thana
- Faculty of Nursing, Chiang Mai University, 100/406 Inthawarorod Rd., Maung, Chiangmai, 50200 , Thailand.
| | - Alla Sikorskii
- Department of Psychiatry, Michigan State University, 909 Fee Road Room 321-A, East Lansing, MI, 48824, USA.
| | - Rebecca Lehto
- College of Nursing, Michigan State University, 1355 Bogue Street #C344, East Lansing, MI, 48824, USA.
| | - Charles Given
- College of Nursing, Michigan State University, 1355 Bogue Street #C344, East Lansing, MI, 48824, USA.
| | - Gwen Wyatt
- College of Nursing, Michigan State University, 1355 Bogue Street #C344, East Lansing, MI, 48824, USA.
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