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López-Salas M, Yanes-Roldán A, Fernández A, Marín A, Martínez AI, Monroy A, Navarro JM, Pino M, Gómez R, Rodríguez S, Garrido S, Cousillas S, Navas T, Lapeña V, Fernández B. End-of-life care needs in cancer patients: a qualitative study of patient and family experiences. BMC Palliat Care 2024; 23:157. [PMID: 38907206 PMCID: PMC11191331 DOI: 10.1186/s12904-024-01489-1] [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: 02/28/2024] [Accepted: 06/14/2024] [Indexed: 06/23/2024] Open
Abstract
BACKGROUND Cancer is a disease that transcends what is purely medical, profoundly affecting the day-to-day life of both patients and family members. Previous research has shown that the consequences of cancer are greatly aggravated in patients at the end of life, at a time when they must also grapple with numerous unmet needs. The main objective of this study was to obtain more in-depth insight into these needs, primarily in patients with end-stage cancer nearing death. METHODS Semi-structured interviews were conducted in Spain with cancer patients at the end of life (n = 3) and their family members (n = 12). The findings from the interviews were analyzed using qualitative thematic analysis and a grounded theory approach. RESULTS Four major themes emerged from the interviews that explored the needs and concerns of patients with cancer at the end of life: (1) physical well-being (2) emotional well-being (3) social well-being and (4), needs relating to information and autonomous decision-making. The interviews also shed light on the specific needs of family members during this period, namely the difficulties of managing increased caregiver burden and maintaining a healthy work-life balance. CONCLUSIONS A lack of support, information and transparency during a period of immense vulnerability makes the end-of-life experience even more difficult for patients with cancer. Our findings highlight the importance of developing a more in-depth understanding of the needs of this population, so that informed efforts can be made to improve palliative healthcare and implement more comprehensive care and support at the end of life.
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Affiliation(s)
| | | | | | - Ainhoa Marín
- Asociación Española Contra el Cáncer, Madrid, Spain
| | | | - Ana Monroy
- Asociación Española Contra el Cáncer, Madrid, Spain
| | | | - Marta Pino
- Asociación Española Contra el Cáncer, Madrid, Spain
| | - Raquel Gómez
- Asociación Española Contra el Cáncer, Madrid, Spain
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Low CE, Loke S, Rana S, Sim B, Ho CSH. Prevalence and incidence of suicide, suicidal ideation and self-harm in caregivers of cancer patients: A systematic review and meta-analysis. Gen Hosp Psychiatry 2024; 90:35-43. [PMID: 38936297 DOI: 10.1016/j.genhosppsych.2024.06.011] [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: 02/03/2024] [Revised: 06/19/2024] [Accepted: 06/20/2024] [Indexed: 06/29/2024]
Abstract
OBJECTIVE Caregiving burden is set to increase with the rising incidence of cancer globally. The meta-analysis seeks to investigate the prevalence of suicide, suicidal ideation and self-harm among the caregivers of patients with cancer (CPCs). METHODS This PRISMA-adherent systematic review involved a systematic search of PubMed, Embase, Cochrane and PsycINFO for all studies that evaluated the prevalence of suicide, suicidal ideation and self-harm in CPCs. Random effects meta-analyses were used for primary analysis. RESULTS Eleven studies were included. Meta-analyses indicated that the prevalence of suicidal ideation in CPCs was 11% (95%CI:6-18), suicide prevalence was 6% (95%CI:3-12), and self-harm prevalence was 15% (95%CI:8-26). Subgroup analyses revealed that CPCs above the age of 50 experienced a greater prevalence of suicidal ideation (17%, 95%CI:10-28) as compared to CPCs below 50 (6%, 95%CI:3-12). Family caregivers particularly spouses were also found to have a higher prevalence of suicidal ideation (17%, 95%CI:13-23), as compared to children (5%, 95%CI:2-10) or mothers (3%, 95%CI:1-8). Systematic review found that having a pre-existing mental health condition and lower socioeconomic status increased likelihood of suicidality. CONCLUSION We highlight the need for more support of CPCs at risk of suicidality. Additional research is warranted to identify other risk and protective factors.
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Affiliation(s)
- Chen Ee Low
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Sean Loke
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Sounak Rana
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ben Sim
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Cyrus Su Hui Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Psychological Medicine, National University Hospital, Singapore.
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Sun Z, Yang X, Wang Y, Li R, Zhang Y, Li Q, Zhao J. A couple-based unmet supportive care needs intervention for colorectal cancer couples: A preliminary feasibility study. Eur J Oncol Nurs 2024; 70:102608. [PMID: 38795445 DOI: 10.1016/j.ejon.2024.102608] [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: 03/15/2024] [Revised: 05/05/2024] [Accepted: 05/08/2024] [Indexed: 05/28/2024]
Abstract
PURPOSE To support colorectal cancer couples cope with cancer, we developed a couple-based unmet supportive care needs intervention program guided by the Supportive Care Needs Framework and examined the feasibility, acceptability, and initial effects of the unmet supportive care needs program. METHODS The design of a pre-and post-intervention study was conducted among Chinese colorectal cancer couples. The intervention was delivered in five sessions through in-person and telephone interventions combined. To measure program feasibility through recruitment and retention rates, and to test program acceptability through quantitative and qualitative post-intervention program assessments. The complete data (N = 20 pairs) were used to calculate effect sizes to assess the initial intervention effect. RESULTS There was evidence of the feasibility of the intervention program in terms of recruitment (66.7%) and retention (83.3%) rates. Participants' satisfaction with the program also attested to its acceptability. The intervention (Cohen's = 0.15-0.56) had a small-moderate effect size in improving unmet supportive care needs and most cancer-adapted outcomes for colorectal cancer couples, validating the initial effect of the program. CONCLUSIONS The unmet supportive care needs program is feasible, acceptable, and preliminarily effective in supporting Chinese colorectal cancer couples to improve unmet supportive care needs and cancer adaptability, as provided by this study.
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Affiliation(s)
- Zheng Sun
- Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Xueli Yang
- Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Ye Wang
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Rongyu Li
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Yi Zhang
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Qiuping Li
- Affiliated Hospital of Jiangnan University, Wuxi, China; Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China.
| | - Jie Zhao
- Affiliated Hospital of Jiangnan University, Wuxi, China.
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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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5
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Santarpia L, Orefice R, Alfonsi L, Marra M, Contaldo F, Pasanisi F. The Anxiety Burden in Patients with Chronic Intestinal Failure on Long-Term Parenteral Nutrition and in Their Caregivers. Nutrients 2024; 16:1168. [PMID: 38674859 PMCID: PMC11054644 DOI: 10.3390/nu16081168] [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: 02/28/2024] [Revised: 04/09/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024] Open
Abstract
Background and aims: Home parenteral nutrition (HPN) is a life-saving treatment for patients affected by chronic intestinal failure (CIF). Both this clinical condition and its therapy require radical lifestyle modifications, affecting life quality and psychological balance in patients as well as family members. Patient psychological burden has rarely been taken into consideration, not to mention that of caregivers. This study aims to evaluate the levels of anxiety in CIF patients on HPN, and their caregivers, consequently determining their impact on the psychological and physical aspects. Methods: After a brief introductory interview, adult patients on HPN for CIF and their caregivers were asked to fill in the HAMA-A questionnaire. Results: Fifty patients and their respective caregivers were enrolled. Mean HAMA-A scores were similar in patients and caregivers and testified the presence of a mild to severe impact of CIF and HPN in both groups, with a significantly higher impact on female patients and caregivers. After adjusting age, education level, duration of CIF and HPN dependence, and degree of kinship, no differences were revealed in the scores. Conclusions: The study confirms that CIF patients on HPN and their caregivers have a significant anxiety burden independently from the duration of the disease, therefore needing appropriate support.
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Affiliation(s)
- Lidia Santarpia
- Internal Medicine and Clinical Nutrition, Department of Clinical Medicine and Surgery, Federico II University Hospital, 80131 Naples, Italy; (R.O.); (L.A.); (M.M.); (F.P.)
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Ham L, Fransen HP, de Graeff A, Hendriks MP, de Jong WK, Kloover J, Kuip E, Mandigers C, Sommeijer D, van de Poll L, Raijmakers N, van Zuylen L. Relatives' Unmet Needs in the Last Year of Life of Patients With Advanced Cancer: Results of a Dutch Prospective, Longitudinal Study (eQuiPe). J Palliat Care 2024:8258597241239614. [PMID: 38515425 DOI: 10.1177/08258597241239614] [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: 03/23/2024]
Abstract
Objective(s): Unmet needs of relatives of patients with advanced cancer not only reduce their own health-related quality of life, but may also negatively affect patients' health outcomes. The aim of this study was to assess changes in relatives' unmet needs of patients with advanced cancer in the last year of life and to identify differences in unmet needs by gender and type of relationship. Methods: Relatives of patients with advanced cancer in the Netherlands were included in a prospective, longitudinal, observational study. Relatives' unmet needs were measured every 3 months with an adapted version of the Problems and Needs in Palliative Care (PNPC) questionnaire Caregiver form (44 items, 12 domains). Questionnaires completed in the patients' last year of life were analyzed. Change of unmet needs in the last year, and differences in unmet needs by gender and type of relationship were analyzed. Results: A total of 409 relatives were included with a median of 4 unmet needs in the patient's last year. Unmet needs were most prevalent at all time points during the last year in the domains "caring for the patient" (highest need = 35%) and "psychological issues" (highest need = 40%). The number of unmet needs of relatives did not change significantly during the last year of life (P=.807). There were no significant differences in the number of unmet needs between male and female partners and between partners and other relatives. Conclusion: The most unmet needs for relatives were in the domains "caring for the patient" and "psychological issues." Professional support should focus on these items. Within these domains, it seems especially important that relatives get more knowledge and support about what scenarios to expect and how to deal with them.
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Affiliation(s)
- Laurien Ham
- Department of Research & Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, the Netherlands
- Netherlands Association for Palliative Care (PZNL), Utrecht, the Netherlands
| | - Heidi P Fransen
- Department of Research & Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, the Netherlands
- Netherlands Association for Palliative Care (PZNL), Utrecht, the Netherlands
| | - Alexander de Graeff
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Mathijs P Hendriks
- Department of Medical Oncology, Northwest Clinics, Alkmaar, the Netherlands
| | - Wouter K de Jong
- Department of Pulmonology, Hospital Gelderse Vallei, Ede, the Netherlands
| | - Jeroen Kloover
- Department of Pulmonology, Elisabeth-TweeSteden Hospital, Tilburg, the Netherlands
| | - Evelien Kuip
- Department of Medical Oncology and Department of Anesthesiology, Pain and Palliative Care, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Caroline Mandigers
- Department of Internal Medicine, Canisius Wilhelmina Hospital, Nijmegen, the Netherlands
| | - Dirkje Sommeijer
- Department of Medical Oncology, Flevo Hospital, Almere, the Netherlands
| | - Lonneke van de Poll
- Department of Research & Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, the Netherlands
- Department of Medical and Clinical Psychology, CoRPS - Center for Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, the Netherlands
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Natasja Raijmakers
- Department of Research & Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, the Netherlands
- Netherlands Association for Palliative Care (PZNL), Utrecht, the Netherlands
| | - Lia van Zuylen
- Department of Medical Oncology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, the Netherlands
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Belapurkar P, Acharya S, Shukla S, Kumar S, Khurana K, Acharya N. Prevalence of Anxiety, Depression, and Perceived Stress Among Family Caregivers of Patients Diagnosed With Oral Cancer in a Tertiary Care Hospital in Central India: A Cross-Sectional Study. Cureus 2023; 15:e47100. [PMID: 38021994 PMCID: PMC10646617 DOI: 10.7759/cureus.47100] [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: 09/18/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Background and objectives Oral cancer is a significant health issue in India, with one of the highest incidence rates globally. Family caregivers play a crucial role in the care of oral cancer patients, but their mental health often faces challenges. This study aimed to assess the prevalence of anxiety, depression, and perceived stress among family caregivers of oral cancer patients in a tertiary care hospital in central India and explore the associated psychosocial factors. Population and method The study was carried out between March 2023 and August 2023 in a tertiary care hospital in Wardha, Maharashtra. Family caregivers (N=82, mean age = 36.1 (SD 10.5) years) of patients with clinically diagnosed oral cancer were subjected first to structured psychiatric clinical interviews to screen for psychiatric diagnoses and then were given self-reporting questionnaires for socio-demographic data, Beck Depression Inventory (BDI-II) for measuring the emotional, cognitive, and motivational symptoms of depression, Manifest Anxiety Scale (MAS) to assess the degree of anxiety and Perceived Stress Scale-10 (PSS-10) to assess stress level. Data was analysed using IBM SPSS Statistics for Windows, Version 26.0 (Released 2019; IBM Corp., Armonk, New York, United States). Chi-square test and logistic regression analyses were conducted wherever appropriate in order to explore predictive factors of depressive, anxious, or stress symptoms. Result In the studied population, the majority experienced symptoms of depression (65.1%), anxiety (69.5%), and perceived stress (74.7%). Caregivers of patients with advanced oral cancer were found to have a higher likelihood of experiencing depression (χ2 (1) = 16.76, p < .001) and anxiety related to unemployment (χ2 (1) = 10.12, p = .001) or insufficient earnings (χ2 (1) = 28.63, p < .001). Additionally, participants with no or little formal education (χ2 (1) = 4.63, p = 0.031) and lower income (χ2 (1) = 28.63, p < .0001) were significantly more likely to experience distress compared to those with higher levels of education. Conclusion This study highlights the need for comprehensive support systems for family caregivers of oral cancer patients. Educational programs, financial assistance, and mental health services should be tailored to caregivers' specific needs. Early identification and intervention strategies can help mitigate the psychological impact of caregiving. Further research is essential to develop targeted interventions that enhance the well-being of caregivers and improve the quality of life for both patients and caregivers.
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Affiliation(s)
- Parth Belapurkar
- Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND
| | - Sourya Acharya
- Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND
| | - Samarth Shukla
- Department of Pathology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND
| | - Sunil Kumar
- Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND
| | - Kashish Khurana
- Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND
| | - Neema Acharya
- Department of Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND
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Heidenreich A, Elsner S, Wörler F, Hübner J, Schües C, Rehmann-Sutter C, Katalinic A, Gieseler F. Physicians' perspectives on family caregivers' roles in elderly cancer patients' therapies: a qualitative, interview-based study. Support Care Cancer 2023; 31:387. [PMID: 37296323 DOI: 10.1007/s00520-023-07857-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 05/31/2023] [Indexed: 06/12/2023]
Abstract
PURPOSE Clinical communication and facilitating informed and sound medical decisions become challenging as patients age and suffer from age-associated impairments. Family caregivers are perceived as essential actors in addressing these challenges. Here, we explore physicians' perspectives on family caregivers' roles and their involvement in consultations and therapy decision-making situations of elderly cancer patients. METHODS We examined 38 semi-structured interviews with physicians from different specialities (oncologists, non-oncology specialists, and general practitioners) in Germany who treated elderly cancer patients. Data were analyzed using reflexive thematic analysis. RESULTS We identified five general and distinct perspectives on the involvement of family caregivers in the therapy process. Family caregivers are seen as (1) translators of medical information; (2) providers of support for the patient; (3) providers of information about the patient; (4) stakeholders with relevant points of view regarding the treatment decision; or (5) individuals who have a disruptive influence on the consultation. The interviewed physicians rarely involved family caregivers closely in consultations. CONCLUSIONS Although physicians frequently attribute supportive roles to family caregivers, they rarely include them in consultations. Previous studies have found that a triadic setting is often better suited to agreeing upon a patient-centered and needs-based treatment decision for older cancer patients. We infer that physicians too rarely recognize the potential importance of family caregivers. Educators should further integrate family caregiver involvement and its implications in general medical education and professional training.
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Affiliation(s)
- Andreas Heidenreich
- Institute of Social Medicine and Epidemiology, University of Luebeck, Luebeck, Germany.
| | - Susanne Elsner
- Institute of Social Medicine and Epidemiology, University of Luebeck, Luebeck, Germany
| | - Frank Wörler
- Institute for History of Medicine and Science Studies, University of Luebeck, Luebeck, Germany
| | - Joachim Hübner
- Institute of Social Medicine and Epidemiology, University of Luebeck, Luebeck, Germany
| | - Christina Schües
- Institute for History of Medicine and Science Studies, University of Luebeck, Luebeck, Germany
| | | | - Alexander Katalinic
- Institute of Social Medicine and Epidemiology, University of Luebeck, Luebeck, Germany
| | - Frank Gieseler
- Clinic for Hematology and Oncology, University Hospital Schleswig-Holstein (UKSH), Luebeck, Germany
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Haji Mukhti MI, Ibrahim MI, Tengku Ismail TA, Nadal IP, Kamalakannan S, Kinra S, Abdullah JM, Musa KI. Exploring the Need for Mobile Application in Stroke Management by Informal Caregivers: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12959. [PMID: 36232257 PMCID: PMC9566614 DOI: 10.3390/ijerph191912959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/05/2022] [Accepted: 10/06/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Mobile health (mHealth) has been considered as a prominent concept in digital health and is widely used and easily accessible. Periodic follow-up visits, previously planned procedures, and rehabilitation services for stroke survivors have been cut down during the recent COVID-19 pandemic. Therefore, in this qualitative study we aimed to explore the need for a mobile application in stroke management by informal caregivers. METHODS A phenomenological qualitative study was conducted from November 2020 to June 2021. Thirteen respondents were recruited from two public rehabilitation centers in Kota Bharu, Kelantan, Malaysia. In-depth interviews were conducted. A comprehensive representation of perspectives from the respondents was achieved through purposive sampling. The interviews were conducted in the Kelantanese dialect, recorded, transcribed, and analyzed by using thematic analysis. RESULTS Thirteen participants were involved in the interviews. All of them agreed with the need for a mobile application in stroke management. They believed the future stroke application will help them to seek information, continuous stroke home care, and help in the welfare of caregivers and stroke patients. CONCLUSIONS The current study revealed two themes with respective subthemes that were identified, namely, self-seeking for information and reasons for using a stroke mobile application in the future. This application helps in reducing healthcare costs, enhancing the rehabilitation process, facilitating patient engagement in decision making, and the continuous monitoring of patient health.
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Affiliation(s)
- Muhammad Iqbal Haji Mukhti
- Department of Community Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Mohd Ismail Ibrahim
- Department of Community Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Tengku Alina Tengku Ismail
- Department of Community Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | | | - Sureshkumar Kamalakannan
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, Faculty of Epidemiology and Population Health, Keppel Street, London WC1E 7HT, UK
- Department of Social Work, Education and Wellbeing, Faculty of Health and Life Sciences, Northumbria University, Newcastle NE7 7XA, UK
| | - Sanjay Kinra
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, Faculty of Epidemiology and Population Health, Keppel Street, London WC1E 7HT, UK
| | - Jafri Malin Abdullah
- Department of Neurosciences, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
- Brain and Behaviour Cluster, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
- Department of Neurosciences & Brain and Behaviour Cluster, Hospital Universiti Sains Malaysia, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Kamarul Imran Musa
- Department of Community Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
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Kako J, Kobayashi M, Kanno Y, Kajiwara K, Nakano K, Morikawa M, Matsuda Y, Shimizu Y, Hori M, Niino M, Suzuki M, Shimazu T. Nursing support for symptoms in patients with cancer and caregiver burdens: a scoping review protocol. BMJ Open 2022; 12:e061866. [PMID: 36104140 PMCID: PMC9476151 DOI: 10.1136/bmjopen-2022-061866] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Terminally ill patients with cancer experience a variety of symptoms, and their families experience certain caregiver burdens. Most studies on this topic have focused on the symptoms experienced by patients with cancer. There is little established evidence to show how nursing support affects these symptoms and burdens. Nurses provide support by extrapolating their clinical experience, practical knowledge and insights gained from the treatment phase of patients with cancer, regardless of the existence or degree of evidence. This study presents a scoping review protocol with the aim of categorising the feasibility of nursing support from the initial to the terminal phases in the trajectory of cancer care. METHOD AND ANALYSIS This review will be guided by Arksey and O'Malley's five-stage scoping review framework and Levac's extension. Our research project team will focus on the pain, dyspnoea, nausea and vomiting, constipation, delirium, fatigue and skin disorders experienced by patients with cancer as well as the burdens experienced by caregivers of such patients. All available published articles from database inception to 31 January 2022 will be systematically searched using the following electrical databases: PubMed, CINAHL, CENTRAL in the Cochrane Library and Ichushi-Web of the Japan Medical Abstract Society databases. In addition, we will assess relevant studies from the reference list and manually search each key journal. The formula creation phase of the literature search involves working with a librarian to identify relevant keywords. At least two reviewers will independently screen and review articles and extract data using a data chart form. Results will be mapped according to study design and analysed for adaptation in the field of terminal cancer. ETHICS AND DISSEMINATION This review does not require ethical approval as it is a secondary analysis of pre-existing, published data. The findings will be disseminated through peer-reviewed publications and conference presentations.
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Affiliation(s)
- Jun Kako
- College of Nursing Art and Science, University of Hyogo, Akashi, 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
| | - Kohei Kajiwara
- Japanese Red Cross Kyushu International College of Nursing, Munakata, 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, Kiyose, Japan
| | - Megumi Hori
- Faculty of Nursing, Shizuoka University, Shizuoka, Japan
| | - Mariko Niino
- Center for Cancer Registries, Institute for Cancer Control, National Cancer Center, Chuo-ku, Japan
| | - Miho Suzuki
- Faculty of Nursing and Medical Care, Keio University, Minato-ku, Japan
| | - Taichi Shimazu
- Division of Behavioral Sciences, Institute for Cancer Control, National Cancer Center, Chuo-ku, Japan
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11
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Krishna R, Rajkumar E, Romate J, Allen JG, Monica D. Effect of Carnatic raga-Bilahari based music therapy on anxiety, sleep disturbances and somatic symptoms among caregivers of cancer patients. Heliyon 2022; 8:e10681. [PMID: 36164509 PMCID: PMC9508548 DOI: 10.1016/j.heliyon.2022.e10681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 07/12/2022] [Accepted: 09/13/2022] [Indexed: 12/24/2022] Open
Abstract
Carnatic raga-Bilahari based intervention is a music therapy technique that enhances relaxation and positivity by reducing anxiety. With extensive empirical evidence pointing out the detrimental challenges faced by the caregivers of cancer patients, the present study intends to find out the effectiveness of a Carnatic raga based music therapy on reducing anxiety, sleep disturbances, somatic symptoms and distress level among this population A single group pre-post research design was was used to conduct the study. General Health Questionnaire (GHQ-28) was used as a screening tool to select participants, and 30 participants were chosen using the purposive sampling. These individuals received instruction in listening to Carnatic music (raga-Bilahari), 5 days a week. The vocal and instrumental recordings were given on alternative days with each session lasting 15–30 min over a month of standard care. From the findings it is observed that there is significant decrease in the anxiety (p < 0.001), sleep disturbances (p < 0.001), somatic symptoms (p < 0.001) and distress level (p < 0.001) after the intervention.The study result thus indicates that Carnatic raga-Bilahari-based music intervention is effective among caregivers of cancer patients to reduce anxiety, sleep disturbances, somatic symptoms presentation, and their distress level.
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Affiliation(s)
| | - Eslavath Rajkumar
- Department of Psychology, Central University of Karnataka, Kalaburagi, India
| | - John Romate
- Department of Psychology, Central University of Karnataka, Kalaburagi, India
| | - Joshua George Allen
- Humanities and Applied Sciences, Indian Institute of Management, Pundag, Ranchi, Jharkhand, India
| | - Daniel Monica
- Department of Psychology, Central University of Karnataka, Kalaburagi, India
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Bakırlıoğlu B, Çetinkaya B. Factors affecting sleep quality of mothers of children with chronic illnesses. J Pediatr Nurs 2022; 66:e160-e165. [PMID: 35465997 DOI: 10.1016/j.pedn.2022.04.008] [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: 01/19/2022] [Revised: 03/08/2022] [Accepted: 04/11/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE This present research, mothers of children with chronic illnesses were compared with mothers of children with no chronic illnesses with the aim of determining which factors affect their sleep quality. DESIGN AND METHODS The descriptive-type data obtained from this research were collected from 270 mothers of children with chronic illnesses and 197 mothers of healthy children between November 10 and December 10, 2021. All participants were asked to complete a survey. The data were assessed using IBM SPSS Statistics Version 25 and the chi-square test, Fisher's exact test, t-test, ANOVA (Analysis of Variance), and Logistic Regression Analysis. RESULTS The total mean The Pittsburgh Sleep Quality Index (PSQI) score for mothers of chronically ill children was found to be 9.79 ± 3.68 while it was 6.68 ± 3.62 for mothers of heathy children with a statically significant difference (t = 9.075, p = 0.00). The fact that mothers wake up for the care/treatment of their children due to the onset of an illness was found to be associated with poor sleep quality (OR = 0.388 p = 0.017; OR = 0.178, p = 0.000). CONCLUSIONS In the present study, it was determined that mothers of children with chronic illnesses suffer from sleep problems and that the sleep quality of those mothers varies depending on the illness types of their children. PRACTICE IMPLICATIONS Pediatric nurses are requested to assess the sleep quality of mothers with suitable measurement tools to determine what types of problems affect sleep quality negatively when dealing with children with chronic illnesses in both clinical and non-clinical practices.
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Affiliation(s)
- Burcu Bakırlıoğlu
- Pamukkale University Faculty of Health Sciences, Department of Pediatric Nursing, Denizli, Turkey.
| | - Bengü Çetinkaya
- Pamukkale University Faculty of Health Sciences, Department of Pediatric Nursing, Denizli, Turkey.
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Hart NH, Crawford-Williams F, Crichton M, Yee J, Smith TJ, Koczwara B, Fitch MI, Crawford GB, Mukhopadhyay S, Mahony J, Cheah C, Townsend J, Cook O, Agar MR, Chan RJ. Unmet supportive care needs of people with advanced cancer and their caregivers: a systematic scoping review. Crit Rev Oncol Hematol 2022; 176:103728. [PMID: 35662585 DOI: 10.1016/j.critrevonc.2022.103728] [Citation(s) in RCA: 67] [Impact Index Per Article: 33.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 05/24/2022] [Accepted: 05/26/2022] [Indexed: 01/11/2023] Open
Abstract
Examining and addressing unmet care needs is integral to improving the provision and quality of cancer services. This review explored the prevalence of unmet supportive care needs, and factors associated with unmet need, in adults with advanced cancers (solid and hematological malignancies) and their caregivers. Electronic databases (PubMed, CINAHL, EMBASE) were searched, producing 85 papers representing 81 included studies. People with advanced cancer reported the highest unmet needs in financial, health system and information, psychological, and physical and daily living domains, whereas caregivers reported the highest unmet needs in psychological, and patient care and support domains. Distress, depression, and anxiety were associated with higher unmet needs across all unmet need domains for people with advanced cancer and their caregivers. Substantial heterogeneity in study populations and methods was observed. Findings from this review can inform targeted strategies and interventions to address these unmet needs in people with advanced cancer.
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Affiliation(s)
- Nicolas H Hart
- Caring Futures Institute, College of Nursing and Health Science, Flinders University, SA, Australia; Exercise Medicine Research Institute, School of Medical and Health Sciences, Edith Cowan University, WA, Australia; Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, QLD, Australia; Institute for Health Research, University of Notre Dame Australia, WA, Australia.
| | - Fiona Crawford-Williams
- Caring Futures Institute, College of Nursing and Health Science, Flinders University, SA, Australia; Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, QLD, Australia
| | - Megan Crichton
- Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, QLD, Australia; Nutrition and Dietetics Research Group, Bond University, QLD, Australia
| | - Jasmine Yee
- Centre for Medical Psychology and Evidence-Based Decision-Making, Faculty of Medicine and Health, University of Sydney, NSW, Australia
| | - Thomas J Smith
- Division of General Internal Medicine, John Hopkins Medical Institutions, Baltimore, MD, USA
| | - Bogda Koczwara
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, SA, Australia; Flinders Cancer and Innovation Centre, Flinders Medical Centre, SA, Australia
| | - Margaret I Fitch
- School of Graduate Studies, Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Gregory B Crawford
- Discipline of Medicine, University of Adelaide, SA, Australia; Northern Adelaide Local Health Network, SA, Australia
| | - Sandip Mukhopadhyay
- Burdwan Medical College, West Bengal, Kolkata, India; Indian Council of Medical Research, National Institute of Cholera and Enteric Diseases, Kolkata, India
| | | | - Chan Cheah
- Internal Medicine, UWA Medical School, University of Western Australia, WA, Australia; Department of Haematology, Sir Charles Gairdner Hospital, WA, Australia; Department of Haematology, Hollywood Private Hospital, WA, Australia
| | | | - Olivia Cook
- McGrath Foundation, NSW, Australia; School of Nursing and Midwifery, Monash University, VIC, Australia
| | - Meera R Agar
- IMPACCT Centre, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Raymond J Chan
- Caring Futures Institute, College of Nursing and Health Science, Flinders University, SA, Australia; Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, QLD, Australia
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Consensus-based recommendations for psychosocial support measures for parents and adult children at the end of life: results of a Delphi study in Germany. Support Care Cancer 2022; 30:669-676. [PMID: 34363494 PMCID: PMC8636430 DOI: 10.1007/s00520-021-06452-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 07/19/2021] [Indexed: 12/15/2022]
Abstract
PURPOSE The availability of psychosocial support measures has a significant impact on the quality of life of terminally ill and dying patients and the burden experienced by their relatives. To date, no intervention has specifically focused on promoting interaction within the dyads of the following: (1) terminally ill adult children and their parents and (2) terminally ill parents and their adult children. A national Delphi study was conducted to provide appropriate recommendations for dyadic psychosocial support measures. METHODS Recommendations were formulated from qualitative interview data on the experiences and wishes of patients and family caregivers within these two dyads. Experts from palliative and hospice care providers rated the relevance and feasibility of 21 recommendations on two 4-point Likert-type scales, respectively. Additional suggestions for improvement were captured via free text fields. Individual items were considered consented when ≥ 80% of participants scored 1 (strongly agree) or 2 (somewhat agree) regarding both relevance and feasibility. RESULTS A total of 27 experts (35% response rate) completed two Delphi rounds. Following the first round, 13 recommendations were adjusted according to participants' comments. After the second round, consensus was achieved for all 21 of the initially presented recommendations. CONCLUSION The Delphi-consented recommendations for parents and adult children at the end of life provide the first guidance for hands-on dyadic psychosocial support measures for parent-adult child relationships, specifically. The next step could involve the structured implementation of the recommendations, accompanied by scientific research. This study was registered on October 27, 2017, with the German Clinical Trials Register (DRKS00013206).
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French C, Lal S, Jones D, Sowerbutts AM, Brundrett D, Burch N, Calvert C, Cooper SC, Donnellan C, Forbes A, Gabe S, Lam C, Major G, Mountford CG, Muggridge R, Natarajan B, Neild P, Rogers D, Sharkey L, Thompson B, Wheatley C, Burden S. Impact of home parenteral nutrition on family members: A national multi-centre cross-sectional study. Clin Nutr 2021; 41:500-507. [PMID: 35007818 DOI: 10.1016/j.clnu.2021.12.030] [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: 10/26/2021] [Revised: 12/17/2021] [Accepted: 12/19/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND & AIMS Home parenteral nutrition (HPN) is a necessary treatment for patients with chronic, type 3, intestinal failure (IF). HPN often requires lifestyle adaptations, which are likely to affect quality of life (QoL) in both patients and family members. The aim of this study was to identify the level of burden on family members who are involved with HPN care and to understand specific factors that contribute to any burden. METHODS Patients over the age of 18 and receiving HPN were identified in IF clinics from multiple centres across the U.K. Eligible patients were asked to complete the parenteral nutrition impact questionnaire (PNIQ) to assess their QoL, while family members were asked to complete the burden scale for family caregivers (BSFC). Logistical regression was undertaken giving adjusted odds ratios (aOR). RESULTS 678 participants completed the survey representing 339 patients with their appointed family member. Mean PNIQ score was 11.53 (S.D. 5.5), representing a moderate impact of HPN on patients' QoL. On the BSFC scale, 23% of family members reported a moderate to very severe subjective burden indicating an increased risk of psychosomatic symptoms. After adjusting for age and gender, predictors of BSFC included: family members self-reported health status using the EuroQol visual analogue scale (aOR 19.91, 95% CI 1.69, 233.99, p = 0.017) and support received by health services (aOR = 5.83, 95% CI = 1.93, 17.56, p = 0.002). Employment status, disease type, number of nights on HPN and length of time on HPN were not associated with BSFC. CONCLUSIONS Family members with a poor health status or lack of support by health service were more likely to have a moderate to very severe subjective burden. Tailored support from the multi-professional IF team may reduce the burden experienced by family members of people dependent on HPN.
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Affiliation(s)
- Chloe French
- School of Health Sciences, University of Manchester, UK
| | - Simon Lal
- Salford Royal Foundation Trust, Salford, UK
| | - Debra Jones
- School of Health Sciences, University of Manchester, UK
| | | | - Diane Brundrett
- London North West University Healthcare NHS Trust, London, UK
| | - Nicola Burch
- University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - Chris Calvert
- Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - Sheldon C Cooper
- University Hospitals Birmingham NHS Trust, Queen Elizabeth Hospital Birmingham, Birmingham, UK
| | - Clare Donnellan
- Leeds Gastroenterology Institute, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Alastair Forbes
- Norwich Medical School, University of East Anglia, Norwich, UK; Institute of Clinical Medicine, University of Tartu, Estonia
| | - Simon Gabe
- London North West University Healthcare NHS Trust, London, UK
| | - Ching Lam
- Northern General Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Giles Major
- School of Medicine, University of Nottingham, Nottingham, UK; Nottingham NIHR Biomedical Research Centre, Nottingham, UK
| | | | - Rebecca Muggridge
- Leicester Royal Infirmary, University Hospitals Leicester NHS Trust, Leicester, UK
| | - Brenavan Natarajan
- Department of Gastroenterology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Penny Neild
- St. Georges University Hospitals NHS Foundation Trust, London, UK
| | - Dan Rogers
- Leicester Royal Infirmary, University Hospitals Leicester NHS Trust, Leicester, UK
| | - Lisa Sharkey
- Department of Gastroenterology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Beth Thompson
- Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | | | - Sorrel Burden
- School of Health Sciences, University of Manchester, UK; Salford Royal Foundation Trust, Salford, UK.
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Cheng HL, Leung DYP, Ko PS, Chung MW, Lam WM, Lam PT, Luk AL, Lam SC. Reliability, validity and acceptability of the traditional Chinese version of the carer support needs assessment tool in Hong Kong palliative care settings. BMC Palliat Care 2021; 20:152. [PMID: 34627225 PMCID: PMC8502334 DOI: 10.1186/s12904-021-00852-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 09/23/2021] [Indexed: 12/04/2022] Open
Abstract
Background Among the few existing needs assessment tools for family carers, the 14-item Carer Support Needs Assessment Tool (CSNAT) is the only brief and holistic needs screening tool designed for everyday use in palliative care practices. The aim of this study was to evaluate the reliability, validity, and acceptability of the traditional Chinese version of the CSNAT in palliative care settings in Hong Kong. Methods This adopted a cross-sectional and correlation design with repeated measures. The participants were 125 family carers of palliative cancer patients and 10 healthcare providers (HCPs) that were recruited from two local hospitals. The evaluation of psychometric properties included the following: (1) content validity through HCPs including frontline physicians, nurses, social workers, and clinical psychologists; (2) construct validity between the CSNAT items and those of the validated tools that measured caregiver burden, social support, and caregiving self-efficacy; and (3) one-week test-retest reliability in a sub-sample of 81 caregivers. The acceptability of the tool was assessed by the carers using several closed-ended questions. Results The content validity index of the CSNAT at the scale level was 0.98. Each item of the CSNAT was significantly and moderately correlated with caregiver burden (Spearman’s r = 0.24 to 0.50) and caregiving self-efficacy (r = − 0.21 to − 0.52), but not for social support. All CSNAT items had fair to moderate test-retest reliability (weighted kappa = 0.21 to 0.48), with the exception of two items “managing your relatives’ symptoms, including giving medicines” and “having time for yourself in the day”. Regarding the acceptability of the CSNAT, almost all HCPs were willing to use the CSNAT for carer assessment and support. 89.6% of the carers demonstrated a comprehensibility of the CSNAT tool and 92.9% felt comfortable answering the questions. Around 90% of the carers agreed to use the tool for screening, discussing needs, and making referrals. Conclusion The traditional Chinese version of the CSNAT is a tool with high validity and acceptability and adequate reliability that measures family carers’ support needs, which should be considered for wide application in local palliative care practices.
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Affiliation(s)
- Hui-Lin Cheng
- School of Nursing, The Hong Kong Polytechnic University, Hom Hung, Kowloon, Hong Kong SAR, China.
| | - Doris Yin Ping Leung
- School of Nursing, The Hong Kong Polytechnic University, Hom Hung, Kowloon, Hong Kong SAR, China
| | - Po Shan Ko
- Nursing Services Division, United Christian Hospital, Hong Kong SAR, China
| | - Ming Wai Chung
- School of Nursing, The Hong Kong Polytechnic University, Hom Hung, Kowloon, Hong Kong SAR, China
| | - Wai Man Lam
- Department of Medicine, Haven of Hope Hospital, Hong Kong SAR, China
| | - Po Tin Lam
- Department of Medicine and Geriatrics, United Christian Hospital, Hong Kong SAR, China
| | - Andrew Leung Luk
- Nethersole Institute of Continuing Holistic Health Education, Hong Kong SAR, China
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Ceylan E, Eskiyurt R, Koc A. Determination of the Problems Experienced by Patients with Chronic Diseases and Their Caregivers During Home Care Process From Nursing Students’ Perspectives: A Phenomenological Study. EURASIAN JOURNAL OF FAMILY MEDICINE 2021. [DOI: 10.33880/ejfm.2021100305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim: This qualitative study was conducted to determine the problems experienced by patients with chronic diseases and their caregivers during the home care process from nursing students' perspectives.
Methods: Phenomenological method of qualitative research was used in the study. Data was gathered via in-depth interviews with seven nursing students who had a family member with chronic disease. Students were asked about the problems they and their family members experienced during the home care process with a semi-structured questionnaire. Data obtained from the interviews were analyzed using content analysis.
Results: As a result of thematic analysis, problems experienced by the patients with chronic diseases and their caregivers during the home care process are grouped under five main themes. These problems were physical problems, social problems, financial problems, psychological problems, and treatment-related problems.
Conclusion: This research revealed that the home care process of patients with chronic diseases causes various problems for both patients and their caregivers. Therefore, it is necessary to be aware of these problems, increase the quality of home care services and ensure the continuity of home care. In this way, physiological, psychological, financial, social, and treatment-related problems can be prevented.
Keywords: caregivers, chronic disease, family health, home care, nursing students
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Affiliation(s)
- Erdal Ceylan
- Department of Nursing, Ankara Yıldırım Beyazıt University, Faculty of Health Sciences
| | - Reyhan Eskiyurt
- Department of Nursing, Ankara Yıldırım Beyazıt University, Faculty of Health Sciences
| | - Aysegul Koc
- Department of Nursing, Ankara Yıldırım Beyazıt University, Faculty of Health Sciences
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Experiences of older patients with cancer from the radiotherapy pathway - A qualitative study. Eur J Oncol Nurs 2021; 53:101999. [PMID: 34294576 DOI: 10.1016/j.ejon.2021.101999] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 06/21/2021] [Accepted: 07/07/2021] [Indexed: 11/23/2022]
Abstract
PURPOSE To explore and describe experiences of older patients with cancer throughout their radiotherapy treatment, from diagnosis until follow-up after treatment. METHODS Individual interviews were conducted to explore different phases of radiotherapy. Interviews were recorded and transcribed verbatim. Inductive content analysis was applied. Each interview was coded separately. Then to the codes were analyzed further, and an overall theme was developed. RESULTS Twelve older patients with cancer, (7 male, 5 female) aged ≥ 65 related their experiences from radiotherapy treatment. A main theme describes the essence of their experiences; Understanding "just enough". The theme comprises five main categories: Understandable, adapted information is crucial for trusting health services; Previous experiences influence patients' perception and understanding; Involvement of next of kin is crucial to patients' comprehension; Professional treatment decisions and well-organized treatment determines satisfaction and Experiences of cooperation and coordination of services affects dependability. CONCLUSIONS Findings from this study describe how understanding "just enough" - not too much nor too little - may assist older patients with cancer in participating in treatment decisions, preventing false beliefs, feeling reassured during treatment and in navigating the complex health care system. Next of kin are important assets for older patients with cancer in understanding "just enough". Cancer nurses may map comprehension of information, as well as reveal patients' previous experiences.
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Factors associated with informal caregiving and its effects on health, work, and social activities of adult informal caregivers in Malaysia: findings from the National Health and Morbidity Survey 2019. BMC Public Health 2021; 21:1033. [PMID: 34074275 PMCID: PMC8170800 DOI: 10.1186/s12889-021-11022-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 05/05/2021] [Indexed: 12/13/2022] Open
Abstract
Background The increase in the elderly population, chronic and degenerative diseases, as well as accidents at work and on the road in Malaysia would result in an increased demand for informal care. This paper aimed to determine the associated factors of informal caregiving and its effects on health, work and social activities of adult informal caregivers in Malaysia. Methods The data from the 2019 National Health and Morbidity Survey (NHMS), a nationwide cross-sectional survey with a two-stage stratified random sampling design, was used in this research. The study included respondents who were 18 years and older (n = 11,674). Data were obtained via face-to-face interviews using validated questionnaires. Descriptive and complex sample logistic regression analyses were employed as appropriate. Results 5.7% of the adult population were informal caregivers. Provision of informal care were significantly associated with the female sex (OR = 1.52, 95% CI [1.21, 1.92]), those aged 36–59 years (OR = 1.61, 95% CI [1.15, 2.25]), and those who reported illness in the past 2 weeks (OR = 1.79, 95% CI [1.38, 2.33]). The risk of having their health affected were associated with female caregivers (OR = 3.63, 95% CI [1.73, 7.61]), those who received training (OR = 2.10, 95% CI [1.10, 4.00]) and those who provided care for 2 years or more (OR = 1.91, 95% CI [1.08, 3.37]). The factors associated with the effects on work were ethnicity, received training and had no assistance to provide the care. In terms of effect on social activities, female caregivers (OR = 1.96, 95% CI [1.04, 3.69]) and caregivers who received training were more likely (OR = 2.19, 95% CI [1.22, 3.93]) to have their social activities affected. Conclusion Our study revealed that sex, age, and self-reported illness were factors associated with being an informal caregiver in Malaysia. Informal caregivers faced effects on their health, work, and social activities which may be detrimental to their well-being. This understanding is crucial for planning support for caregivers.
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Fringer A, Stängle S, Bischofberger I, Büche D, Praxmarer R, Ch Ott S, Schnepp W. Experiences of relatives with outpatient palliative care: a cross-sectional study. Int J Palliat Nurs 2021; 26:230-237. [PMID: 32584687 DOI: 10.12968/ijpn.2020.26.5.230] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
AIM The authors aimed to evaluate the experiences of the relatives of dying people, both in regard to benefits and special needs, when supported by a mobile palliative care bridging service (MPCBS), which exists to enable dying people to stay at home and to support patients' relatives. DESIGN A cross-sectional survey. METHODS A standardised survey was performed, asking 106 relatives of dying people about their experiences with the MPCBS (response rate=47.3%). Descriptive statistics were analysed using SPSS 23. FINDINGS Many relatives (62.5%) reported that their dying relations when discharged from a facility to stay at home were not symptom-free. The MPCBS helped relatives maintain home care, and this was reported to be helpful. Support provided by the MPCBS made it easier for 77.6% of relatives to adjust care as soon as situations changed, and helped ensure that symptoms could be better controlled, at least for 68.2% of relatives. Younger relatives felt more encouraged by the MPCBS to care for their relatives dying at home.
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Affiliation(s)
- André Fringer
- Professor for Family-Centered Care; Co-Head MSc Nursing and Co-Head Research Unit Nursing, ZHAW Zurich University of Applied Sciences, School of Health Professions, Institute of Nursing, Winterthur, Switzerland and Witten/Herdecke University, Faculty of Health, Department of Nursing Science, Witten, Germany
| | - Sabrina Stängle
- Research Associate, ZHAW Zurich University of Applied Sciences, School of Health Professions, Institute of Nursing, Winterthur, Switzerland and Witten/Herdecke University, Faculty of Health, Department of Nursing Science, Witten, Germany
| | - Iren Bischofberger
- Professor for Applied Research and Clinical Excellence in Nursing, Kalaidos University of Applied Sciences, Department of Health Science, Zurich, Switzerland
| | - Daniel Büche
- Head Physician Palliative Care Centre, Cantonal Hospital St.Gallen, St. Gallen, Switzerland
| | - Renate Praxmarer
- Co-Head of Palliative Bridge Service, Cancer League of Eastern Switzerland, Bern, Switzerland
| | - Stefan Ch Ott
- Professor of Economics, FHS St.Gallen University of Applied Sciences, Department of Economics, St.Gallen, Switzerland
| | - Wilfried Schnepp
- Head of the Department for Family-Oriented and Community Care, Witten/Herdecke University, Faculty of Health, Department of Nursing Science, Witten, Germany
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Samuelsson M, Wennick A, Jakobsson J, Bengtsson M. Models of support to family members during the trajectory of cancer: A scoping review. J Clin Nurs 2021; 30:3072-3098. [PMID: 33973285 DOI: 10.1111/jocn.15832] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/31/2021] [Accepted: 04/19/2021] [Indexed: 12/15/2022]
Abstract
AIMS AND OBJECTIVES To map the existing literature on support models provided to family members during the cancer trajectory. BACKGROUND Cancer diagnosis, treatment and survivorship have a profound influence on the surrounding family members. This scoping review is part of the development of a support model for family members of persons diagnosed with colorectal cancer. DESIGN The method was guided by the Arksey and O'Malley framework, described in the Joanna Briggs Institute guidelines, and the reporting is compliant with PRISMA-ScR Checklist. Searches were conducted in PubMed, CINAHL and PsycINFO from November 2019-February 2020 with no limitation in publication year or study design. Complementing searches were conducted in reference lists and for grey literature, followed by an additional search in September 2020. Inclusion criteria were primary research about support provided by health care, to family members, during cancer, of an adult person, in Swedish or English, of moderate or high methodological quality. Quality was assessed using the Joanna Briggs Institute critical appraisal tools. Data were extracted using a charting form. RESULT A total of 32 studies were included in the review describing 39 support models. CONCLUSION The mapping of the existing literature resulted in the identification of three themes of support models: psychoeducation, caregiver training and psychological support. In addition, that future research should target a specific diagnosis and trajectory phase as well as include family members and intervention providers in model development. RELEVANCE FOR CLINICAL PRACTICE Knowledge from the literature on both the needs of the family members and existing support models should be incorporated with the prerequisites of clinical practice. Clinical practice should also be complemented with structured assessments of family members' needs conducted regularly.
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Affiliation(s)
- Maria Samuelsson
- Faculty of Health and Society, Department of Care Science, Malmö University, Malmö, Sweden.,Department of Pediatrics, Skåne University Hospital, Malmö, Sweden
| | - Anne Wennick
- Faculty of Health and Society, Department of Care Science, Malmö University, Malmö, Sweden
| | - Jenny Jakobsson
- Faculty of Health and Society, Department of Care Science, Malmö University, Malmö, Sweden
| | - Mariette Bengtsson
- Faculty of Health and Society, Department of Care Science, Malmö University, Malmö, Sweden
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Weaver R, O'Connor M, Halkett GK, Carey Smith R. The unmet needs of carers of patients diagnosed with sarcoma: A qualitative study. Psychooncology 2021; 30:1095-1103. [PMID: 33544399 DOI: 10.1002/pon.5651] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 02/02/2021] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Sarcoma is a rare cancer that may result in reduced mobility, social isolation, poorer mental health, and ongoing medical issues for patients. Family carers play a crucial role in supporting patients throughout their sarcoma journey. Despite the aggressive and debilitating nature of the disease, the unmet needs of these carers are yet to be explored. The aim of this study was to explore the unmet needs of carers of patients diagnosed with sarcoma. METHODS An exploratory qualitative research design with a social constructionist epistemology was used. Participants were carers of patients diagnosed with a sarcoma (n = 33). Semi-structured interviews were conducted with carers of patients who completed treatment for sarcoma and also bereaved carers (BC). Interviews were transcribed verbatim and analysed using thematic analysis. FINDINGS Four overarching themes were identified: support with medical aspects of caregiving, support for self, needing information about the patient, and financial support. Participants recognised that they needed psychosocial support, however, many were reluctant to access support as they perceived this to be prioritising their own needs instead of the patients'. They also needed more information about the patients' disease and how to navigate the health system. CONCLUSIONS Family carers for patients with sarcoma have onerous responsibilities that affect their ability to access care for themselves and their family. Providing more holistic patient care and carer-specific information and training could reduce carer burden. Establishing support groups specific to carers and BC of patients diagnosed with sarcoma could provide opportunities for social interaction and psychosocial support.
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Affiliation(s)
- Rhys Weaver
- Curtin School of Nursing, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Moira O'Connor
- Curtin School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia.,WA Centre for Cancer Prevention Research Unit (WACPRU), Curtin University, Perth, Western Australia, Australia
| | - Georgia Kb Halkett
- Curtin School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia.,WA Centre for Cancer Prevention Research Unit (WACPRU), Curtin University, Perth, Western Australia, Australia
| | - Richard Carey Smith
- Department of Orthopaedic Surgery, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.,Perth Children's Hospital, Perth, Western Australia, Australia.,Perth Orthopaedic and Sports Medicine Centre, Perth, Western Australia, Australia
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Farahani MA, Bahloli S, JamshidiOrak R, Ghaffari F. Investigating the needs of family caregivers of older stroke patients: a longitudinal study in Iran. BMC Geriatr 2020; 20:313. [PMID: 32859159 PMCID: PMC7456020 DOI: 10.1186/s12877-020-01670-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 07/23/2020] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND The high burden of care associated with older stroke patients is a factor that threatens the health of family caregivers. Identifying the needs of family caregivers in this group of patients can help provide effective solutions. The present study aimed to determine the needs of family caregivers of older stroke patients. METHODS The sample size of this longitudinal study included 200 family caregivers of older stroke patients from two hospitals in Iran. Data collection included demographics, responses to family caregivers' needs questionnaires, and the Barthel Index which was taken in four stages including admission time, pre-discharge, two weeks and 12 weeks post-discharge. RESULTS The results showed that all participants at all stages of the study identified "respect for the patient when providing education, treatment, or rehabilitation" as one of their needs. There was a statistically significant relationship between the older adult survivor's age and the number of family caregivers' needs two weeks post-discharge (p = 0.012) and 12 weeks post-discharge (p = 0.008). There was a significant relationship between the patient's hospitalization period and the number of caregivers' needs three months after the patient's discharge (p = 0.028), and a significant statistical relationship between the pre-discharge physiotherapy of the patients and the number of their caregivers' needs during the two weeks post-discharge (p = 0.018). There was also a statistically significant relationship between the patient's level of dependence and the number of caregivers' needs (p = 0.0001). On the contrary, there was no significant relationship between the sex, place of living, and underlying disease history of the patient and the number of caregivers' needs (p > 0.05). CONCLUSION The results of the present research indicate that the total number of caregivers' needs decreases with increasing duration of the disease. However, respite and care provision planning by other family members, seeking assistance from professional caregivers, and the search for community support resources can help reduce the burden of care of caregivers and give them the opportunity to meet their needs in different dimensions of patient care provided.
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Affiliation(s)
- Mansoureh Ashghali Farahani
- Nursing Care Research Center (NCRC), School of Nursing and Midwifery, Iran University of Medical Sciences, Rashid Yasemi St, Valiasr Ave, Tehran, Iran
| | - Shiva Bahloli
- School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Roohangiz JamshidiOrak
- Department of Statistics & Mathematics, School of Health Management and Information Sciences, Iran University of Medical Sciences, Rashid-Yasemi Street, Vali'asr Avenue, Tehran, Iran
| | - Fatemeh Ghaffari
- Nursing Care Research Center, Health Research Institute, Babol University of Medical Sciences, Shahid Motahari St, Ramsar, Babol, Mazandaran, ZIP Code 4691714141, Iran.
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24
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Bijnsdorp FM, Pasman HRW, Boot CRL, van Hooft SM, van Staa A, Francke AL. Profiles of family caregivers of patients at the end of life at home: a Q-methodological study into family caregiver' support needs. BMC Palliat Care 2020; 19:51. [PMID: 32316948 PMCID: PMC7175554 DOI: 10.1186/s12904-020-00560-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 04/08/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Family caregivers of patients at the end of life often experience care-related burden. To prevent caregiver burden and to enhance the capacity to provide care it is important to have insight in their support needs. The purpose of this study was to identify profiles of family caregivers who provide care to patients at the end of life at home. METHODS A Q-methodological study was conducted in which family caregivers ranked 40 statements on support needs and experiences with caregiving. Thereafter they explained their ranking in an interview. By-person factor analysis was used to analyse the rankings and qualitative data was used to support the choice of profiles. A set of 41 family caregivers with a variety on background characteristics who currently or recently provided care for someone at the end of life at home were included. RESULTS Four distinct profiles were identified; profile (1) those who want appreciation and an assigned contact person; profile (2) was bipolar. The positive pole (2+) comprised those who have supportive relationships and the negative pole (2-) those who wish for supportive relationships; profile (3) those who want information and practical support, and profile (4) those who need time off. The profiles reflect different support needs and experiences with caregiving. CONCLUSIONS Family caregivers of patients at the end of life have varying support needs and one size does not fit all. The profiles are relevant for healthcare professionals and volunteers in palliative care as they provide an overview of the main support needs among family caregivers of patients near the end of life. This knowledge could help healthcare professionals giving support.
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Affiliation(s)
- Femmy M Bijnsdorp
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health research institute, Expertise Center for Palliative Care, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.
| | - H Roeline W Pasman
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health research institute, Expertise Center for Palliative Care, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - Cécile R L Boot
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - Susanne M van Hooft
- Research Centre Innovations in Care, Rotterdam University, Rotterdam, The Netherlands
| | - AnneLoes van Staa
- Research Centre Innovations in Care, Rotterdam University, Rotterdam, The Netherlands.,Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Anneke L Francke
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health research institute, Expertise Center for Palliative Care, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.,Nivel, Netherlands institute for health services research, Utrecht, The Netherlands
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25
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Schuit AS, Holtmaat K, Hooghiemstra N, Jansen F, Lissenberg-Witte BI, Coupé VMH, Verdonck-de Leeuw IM. Efficacy and cost-utility of the eHealth self-management application 'Oncokompas', helping partners of patients with incurable cancer to identify their unmet supportive care needs and to take actions to meet their needs: a study protocol of a randomized controlled trial. Trials 2020; 21:124. [PMID: 32005280 PMCID: PMC6995084 DOI: 10.1186/s13063-019-4037-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Accepted: 12/29/2019] [Indexed: 01/04/2023] Open
Abstract
Background Incurable cancer does not only affect patients, it also affects the lives of their partners. Many partners take on caregiving responsibilities. The burden of these caregiving tasks are often associated with physical, psychological, and social difficulties and many partners have unmet supportive care needs. Oncokompas is an eHealth self-management application to support partners in finding and obtaining optimal supportive care, tailored to their quality of life and personal preferences. A randomized controlled trial will be carried out to determine the efficacy and cost-utility of Oncokompas. Methods A total of 136 adult partners of patients with incurable cancer will be included. Partners will be randomly assigned to the intervention group, which directly gets access to Oncokompas, or the waiting-list control group, which gets access to Oncokompas after three months. The primary outcome measure is caregiver burden. Secondary outcome measures comprise self-efficacy, health-related quality of life, and costs. Measures will be assessed at baseline, two weeks after randomization, and three months after the baseline measurement. Discussion This study will result in evidence on the efficacy and cost-utility of Oncokompas among partners of patients with incurable cancer, which might lead to implementation of Oncokompas as a health service for partners of patients with incurable cancer. Trial registration Netherlands Trial Register, NTR 7636. Registered on 23 November 2018.
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Affiliation(s)
- Anouk S Schuit
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioural and Movement Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.,Cancer Center Amsterdam (CCA), Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Karen Holtmaat
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioural and Movement Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.,Cancer Center Amsterdam (CCA), Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Nienke Hooghiemstra
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioural and Movement Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.,Cancer Center Amsterdam (CCA), Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Femke Jansen
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioural and Movement Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.,Cancer Center Amsterdam (CCA), Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.,Otolaryngology - Head and Neck Surgery, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Birgit I Lissenberg-Witte
- Department of Epidemiology and Biostatistics, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Veerle M H Coupé
- Department of Epidemiology and Biostatistics, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Irma M Verdonck-de Leeuw
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioural and Movement Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands. .,Cancer Center Amsterdam (CCA), Amsterdam Public Health Research Institute, Amsterdam, The Netherlands. .,Otolaryngology - Head and Neck Surgery, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
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26
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Fekih-Romdhane F, Henchiri H, Ridha R, Rahal K, Labbane R, Cheour M. Cancer du sein chez la femme : évaluation du niveau de fardeau chez les conjoints. PSYCHO-ONCOLOGIE 2020. [DOI: 10.3166/pson-2019-0092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Introduction : Les conjoints de patientes atteintes de cancer du sein représenteraient souvent la première source de soutien de leurs femmes et seraient lourdement sollicités dans la prise en charge aux différents stades de la maladie. Nous nous proposons à travers ce travail d’étudier le niveau de fardeau chez des conjoints de femmes souffrant de cancer du sein et d’analyser l’association entre le niveau de fardeau, la détresse psychologique du conjoint, les données relatives au cancer du sein et les données sociodémographiques chez cette population.
Méthode : Il s’agit d’une étude transversale réalisée auprès des patientes atteintes de cancer du sein, suivies en ambulatoire, ayant été accompagnées par leurs conjoints en consultation. Le recueil des données s’est fait au moyen d’une fiche qui comportait les données sociodémographiques et cliniques, la mesure de la détresse psychologique à l’aide de l’échelle Depression, Anxiety and Stress Scales et l’évaluation du fardeau au moyen de l’inventaire du fardeau de Zarit.
Résultats : L’âge moyen des patientes incluses était de 53,64 ans. La majorité des couples vivaient en milieu urbain (74 %) et avaient un niveau socioéconomique moyen (76 %). La maladie était à un stade avancé dans 36 % des cas, et un traitement chirurgical a été réalisé dans 84 % des cas. La majorité des conjoints présentaient un niveau élevé de détresse psychologique : 46 % avaient une dépression modérée à sévère, 60 % avaient une anxiété modérée à sévère et 51 % avaient un stress modéré à sévère. Le score médian de fardeau était de 35, avec des extrêmes de 15 et 64. Un niveau de fardeau élevé était significativement associé à la profession de la patiente, au niveau scolaire et à la profession du conjoint, au stade du cancer, à la présence de douleur et de fatigue, au traitement chirurgical et aux scores de dépression, de stress et d’anxiété.
Conclusion : Détecter un éventuel fardeau ressenti par le conjoint en dépistant la population à risque et le prendre en charge de manière adéquate permettraient de garantir une meilleure adhésion aux soins de leurs épouses aux différents stades de la maladie.
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27
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Payne JB, Dance KV, Farone M, Phan A, Ho CD, Gutierrez M, Chen L, Flowers CR. Patient and caregiver perceptions of lymphoma care and research opportunities: A qualitative study. Cancer 2019; 125:4096-4104. [PMID: 31355929 PMCID: PMC6819209 DOI: 10.1002/cncr.32401] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 05/06/2019] [Accepted: 06/14/2019] [Indexed: 08/30/2023]
Abstract
BACKGROUND Although the number of lymphoma survivors has increased, the needs and research priorities of survivors and their caregivers rarely are examined and addressed. Determining the needs and priorities for this population requires an assessment of the attitudes and experiences of patients and caregivers. The authors conducted a qualitative study with lymphoma survivors and their caregivers to determine care needs and research priorities. METHODS In the first phase, 2 semistructured focus groups were conducted with 15 lymphoma survivors and their caregivers. In phase 2, a total of 19 individual semistructured telephone interviews were conducted with lymphoma survivors and their caregivers. In both phases, participants discussed cancer experiences and research priorities. All interviews were transcribed. MAXQDA software (version 18.0.8) was used for coding and identifying themes. RESULTS The majority of participants felt disconnected from their clinical care team due to a lack of communication. Focus group participants noted a lack of information regarding diagnoses, treatment, research, and survivorship care. Participants coped with fear through strong social support and fostering relationships with their clinical care teams. Some caregivers felt completely ignored by clinicians. Participants expressed interest in research, but had difficulty finding relevant studies. Several interviewees desired holistic and survivorship-oriented research and more studies regarding quality of life and mental health. CONCLUSIONS The results of the current study identified unmet needs in clinical care and patient-oriented research, including needs for a focus on quality of life after treatment, communication between patients and the scientific community, and emotional well-being. Health care professionals can use these data to provide care delivery, supportive services, and research that meets the needs of lymphoma survivors and their caregivers.
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Affiliation(s)
- Jackelyn B. Payne
- Department of Hematology and Medical Oncology, Emory University – Winship Cancer Institute, Atlanta, GA
- Stony Brook University
| | - Kaylin V. Dance
- Department of Hematology and Medical Oncology, Emory University – Winship Cancer Institute, Atlanta, GA
- Rollins School of Public Health, Emory University
| | - Monique Farone
- Department of Hematology and Medical Oncology, Emory University – Winship Cancer Institute, Atlanta, GA
- Rollins School of Public Health, Emory University
| | - Anh Phan
- Department of Hematology and Medical Oncology, Emory University – Winship Cancer Institute, Atlanta, GA
- Rollins School of Public Health, Emory University
| | - Cathy D. Ho
- Department of Hematology and Medical Oncology, Emory University – Winship Cancer Institute, Atlanta, GA
| | | | - Lillian Chen
- Department of Hematology and Medical Oncology, Emory University – Winship Cancer Institute, Atlanta, GA
- Rollins School of Public Health, Emory University
| | - Christopher R. Flowers
- Department of Hematology and Medical Oncology, Emory University – Winship Cancer Institute, Atlanta, GA
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Kilic ST, Oz F. Family Caregivers' Involvement in Caring with Cancer and their Quality of Life. Asian Pac J Cancer Prev 2019; 20:1735-1741. [PMID: 31244294 PMCID: PMC7021632 DOI: 10.31557/apjcp.2019.20.6.1735] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Indexed: 01/28/2023] Open
Abstract
Background: Cancer is a chronic disease and a major health problem. It affects both patients and their family
caregivers multidimensionally. The family caregivers may be affected by not only the disease process but also hospital
policies, economic difficulties, accessibility and communication of health care service and can be in need of help.
This process may affect their quality of life. However, there have not been enough studies on quality of life of family
caregivers of patients with cancer in Turkish culture. Therefore, this study aimed to evaluate the quality of life of
family caregivers of patients with cancer in Turkey. Objectives: The purpose of study was to evaluate the quality of
life of family caregivers with cancer patients in Turkey. Methods: Participants consist of the family caregivers who
volunteered to take part in this descriptive study from 11 hospitals (n =378) which has a daily chemotherapy units
and located within the boundaries of Ankara, Turkey. ‘Sociodemographic Characteristic Form’ and ‘Quality of Life
Scale-Family Version were used as data collection tool. The Kruskal-Wallis and Mann-Whitney U, tests were used
for data analysis. Resultes:It is found that there are statistically significant difference among the factors of gender,
employment status, income level, and whether caregivers reside with their patients. Family caregivers’ quality of life is
negatively affected during the caregiving process (p < 0.05). Conclusion: The results indicate that family caregivers’
quality of life are negatively affected to care process. The results of this research are important as they highlight the
need to also consider family caregivers’ quality of life when caring for patients, and study highlight possible areas in
which support can be provided for family caregivers of cancer patients in Turkey.
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Affiliation(s)
- Sevcan Toptas Kilic
- Hacettepe University Faculty of Nursing, Psychiatric Nursing Department, Ankara, Turkey.
| | - Fatma Oz
- Near East University, Faculty of Nursing, Mersin, Turkey
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Kadoyama KL, Noble BN, Izumi S, Fromme EK, Tjia J, McPherson ML, Candrian CB, McGregor JC, Ku IY, Furuno JP. Frequency and Documentation of Medication Decisions on Discharge from the Hospital to Hospice Care. J Am Geriatr Soc 2019; 67:1258-1262. [DOI: 10.1111/jgs.15860] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 02/06/2019] [Accepted: 02/06/2019] [Indexed: 01/24/2023]
Affiliation(s)
- Kirsten L. Kadoyama
- Department of Pharmacy Practice; Oregon State University/Oregon Health & Science University College of Pharmacy; Portland Oregon
| | - Brie N. Noble
- Department of Pharmacy Practice; Oregon State University/Oregon Health & Science University College of Pharmacy; Portland Oregon
| | - Shigeko Izumi
- Oregon Health & Science University School of Nursing; Portland Oregon
| | - Erik K. Fromme
- Department of Psychosocial Oncology and Palliative Care; Dana-Farber Cancer Institute; Boston Massachusetts
- Ariadne Labs at Brigham and Women's Hospital and the Harvard T. H. Chan School of Public Health; Boston Massachusetts
| | - Jennifer Tjia
- Department of Quantitative Health Sciences; University of Massachusetts Medical School; Worcester Massachusetts
| | - Mary Lynn McPherson
- Department of Pharmacy Practice and Science; University of Maryland School of Pharmacy; Baltimore Maryland
| | - Carey B. Candrian
- Division of General Internal Medicine, Department of Medicine; University of Colorado School of Medicine; Aurora Colorado
| | - Jessina C. McGregor
- Department of Pharmacy Practice; Oregon State University/Oregon Health & Science University College of Pharmacy; Portland Oregon
| | - In Young Ku
- Department of Pharmacy Practice; Oregon State University/Oregon Health & Science University College of Pharmacy; Portland Oregon
| | - Jon P. Furuno
- Department of Pharmacy Practice; Oregon State University/Oregon Health & Science University College of Pharmacy; Portland Oregon
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Paramedics providing palliative care at home: A mixed-methods exploration of patient and family satisfaction and paramedic comfort and confidence. CAN J EMERG MED 2019; 21:513-522. [PMID: 30739628 DOI: 10.1017/cem.2018.497] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Paramedics Providing Palliative Care at Home was launched in two provinces, including a new clinical practice guideline, database, and paramedic training. The aim of this study was to evaluate patient/family satisfaction and paramedic comfort and confidence. METHODS In Part A, we gathered perspectives of patients/families via surveys mailed at enrolment and telephone interviews after an encounter. Responses were reported descriptively and by thematic analysis. In Part B, we surveyed paramedics online pre- and 18 months post-launch. Comfort and confidence were scored on a 4-point Likert scale, and attitudes on a 7-point Likert scale, reported as the median (interquartile range [IQR]); analysis with Wilcoxon ranked sum/thematic analysis of free text. RESULTS In Part A, 67/255 (30%) enrolment surveys were returned. Three themes emerged: fulfilling wishes, peace of mind, and feeling prepared for emergencies. In 18 post-encounter interviews, four themes emerged: 24/7 availability, paramedic professionalism and compassion, symptom relief, and a plea for program continuation. Thematic saturation was reached with little divergence. In Part B, 235/1255 (18.9%) pre- and 267 (21.3%) post-surveys were completed. Comfort with providing palliative care without transport improved post launch (p = < 0.001) as did confidence in palliative care without transport (p = < 0.001). Respondents strongly agreed that all paramedics should be able to provide basic palliative care. CONCLUSIONS After implementation of the multifaceted Paramedics Providing Palliative Care at Home Program, paramedics describe palliative care as important and rewarding. The program resulted in high patient/family satisfaction; simply registering provides peace of mind. After an encounter, families particularly noted the compassion and professionalism of the paramedics.
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Jolliffe RC, Durrant JR, Seers HE, Churchward SF, Griffiths M, Naidoo M, Ben-Arye E, Polley MJ, Zollman C. Impact of Penny Brohn UK's Living Well Course on Informal Caregivers of People with Cancer. J Altern Complement Med 2018; 24:974-980. [PMID: 30247959 DOI: 10.1089/acm.2018.0195] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVES This study evaluated the change in the concerns, wellbeing, and lifestyle behaviors of informal caregivers of people with cancer attending Penny Brohn UK's Living Well Course (LWC), a self-management education intervention. DESIGN A pre-postcourse design collected self-reported quantitative and qualitative data from informal caregivers attending a LWC. SETTING/LOCATION Penny Brohn UK is a United Kingdom-based charity (not-for-profit) providing specialist integrative, whole person support, free of charge, to people affected by cancer. SUBJECTS Informal caregivers taking part in a Penny Brohn UK LWC between June 2014 and May 2016 attending alongside the person with cancer. INTERVENTION The LWC is a structured 15 h, multimodal group self-management educational course, designed to help people affected by cancer learn tools and techniques to help build resilience. Trained facilitators deliver LWCs to around 12 people with various types and stages of cancer and their informal caregivers. OUTCOME MEASURES Measure Yourself Concern and Wellbeing (MYCaW) completed precourse and at 6 weeks postcourse; and bespoke 6-week follow-up Patient Reported Experience Measure. RESULTS Four hundred eighty informal caregivers attended a LWC June 2014 to May 2016. One hundred eighteen completed a 6-week follow-up MYCaW: MYCaW Concerns 1 and 2 showed statistically significant improvements (p < 0.0001), there was no significant improvement in wellbeing. Informal caregivers' most reported concerns relating to themselves were psychological and emotional issues (59%). The primary concern of the caregiver for the care recipient was related to the physical health of the person with cancer (40%). Eighty-seven percent of responding informal caregivers stated that the LWC enabled health self-management. CONCLUSIONS The LWC was followed by an improvement in informal caregivers' concerns, and increased self-management of their own health needs. More studies, with larger sample size, are needed to explore if better self-management by informal caregivers may also lead to improvements in patients' health and wellbeing.
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Affiliation(s)
| | | | | | | | | | | | - Eran Ben-Arye
- 2 Integrative Oncology Program, The Oncology Service and Lin Medical Center , Clalit Health Services, Haifa, Israel .,3 Faculty of Medicine, Technion-Israel Institute of Technology , Haifa, Israel
| | - Marie J Polley
- 4 Department of Life Sciences, Faculty of Science and Technology, University of Westminster , London, United Kingdom
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Røen I, Stifoss-Hanssen H, Grande G, Brenne AT, Kaasa S, Sand K, Knudsen AK. Resilience for family carers of advanced cancer patients-how can health care providers contribute? A qualitative interview study with carers. Palliat Med 2018; 32:1410-1418. [PMID: 29852808 DOI: 10.1177/0269216318777656] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Caring for advanced cancer patients affects carers' psychological and physical health. Resilience has been defined as "the process of adapting well in the face of adversity, trauma, tragedy, threats or even significant sources of threat." AIM The aim of this study was to explore factors promoting carer resilience, based on carers' experiences with and preferences for health care provider support. DESIGN Qualitative, semi-structured, individual interviews with family carers of advanced cancer patients were performed until data saturation. The interviews were recorded, transcribed, and analyzed using systematic text condensation. SETTING/PARTICIPANTS Carers ( n = 14) of advanced cancer patients, not receiving curative treatment, admitted to an integrated curative and palliative care cancer outpatient clinic or to a university hospital cancer clinic, were included. RESULTS 14 carers of advanced cancer patients were included; 7 men, 7 women, and mean age of 59 years; 3 were bereaved; 12 were partners; 5 had young and teenage children. Four main resilience factors were identified: (1) being seen and known by health care providers-a personal relation; (2) availability of palliative care; (3) information and communication about illness, prognosis, and death; and (4) facilitating a good carer-patient relation. CONCLUSION Health care providers may enhance carers' resilience by a series of simple interventions. Education should address carers' support needs and resilience. Systematic assessment of carers' support needs is recommended. Further investigation is needed into how health care providers can help carers and patients communicate about death.
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Affiliation(s)
- Ingebrigt Røen
- 1 European Palliative Care Research Centre (PRC), Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,2 St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Hans Stifoss-Hanssen
- 3 Center of Diakonia and Professional Practice, VID Specialized University, Oslo, Norway
| | - Gunn Grande
- 4 Division of Nursing, Midwifery and Social Work, The University of Manchester, Manchester, England
| | - Anne-Tove Brenne
- 1 European Palliative Care Research Centre (PRC), Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,5 Cancer Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Stein Kaasa
- 1 European Palliative Care Research Centre (PRC), Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,6 Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Kari Sand
- 1 European Palliative Care Research Centre (PRC), Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Anne Kari Knudsen
- 1 European Palliative Care Research Centre (PRC), Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,6 Department of Oncology, Oslo University Hospital, Oslo, Norway
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Wang T, Molassiotis A, Chung BPM, Tan JY. Unmet care needs of advanced cancer patients and their informal caregivers: a systematic review. BMC Palliat Care 2018; 17:96. [PMID: 30037346 PMCID: PMC6057056 DOI: 10.1186/s12904-018-0346-9] [Citation(s) in RCA: 335] [Impact Index Per Article: 55.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 06/25/2018] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND This systematic review aimed to identify the unmet care needs and their associated variables in patients with advanced cancer and informal caregivers, alongside summarizing the tools used for needs assessment. METHODS Ten electronic databases were searched systematically from inception of each database to December 2016 to determine eligible studies. Studies that considered the unmet care needs of either adult patients with advanced cancer or informal caregivers, regardless of the study design, were included. The Mixed Methods Appraisal Tool was utilized for quality appraisal of the included studies. Content analysis was used to identify unmet needs, and descriptive analysis was adopted to synthesize other outcomes. RESULTS Fifty studies were included, and their methodological quality was generally robust. The prevalence of unmet needs varied across studies. Twelve unmet need domains were identified in patients with advanced cancer, and seven among informal caregivers. The three most commonly reported domains for patients were psychological, physical, and healthcare service and information. The most prominent unmet items of these domains were emotional support (10.1-84.4%), fatigue (18-76.3%), and "being informed about benefits and side-effects of treatment" (4-66.7%). The most commonly identified unmet needs for informal caregivers were information needs, including illness and treatment information (26-100%) and care-related information (21-100%). Unmet needs of patients with advanced cancer were associated with their physical symptoms, anxiety, and quality of life. The most commonly used instruments for needs assessment among patients with advanced cancer were the Supportive Care Needs Survey (N = 8) and Problems and Needs in Palliative Care questionnaire (N = 5). The majority of the included studies investigated unmet needs from the perspectives of either patients or caregivers with a cross-sectional study design using single time-point assessments. Moreover, significant heterogeneity, including differences in study contexts, assessment methods, instruments for measurement, need classifications, and reporting methods, were identified across studies. CONCLUSION Both advanced cancer patients and informal caregivers reported a wide range of context-bound unmet needs. Examining their unmet needs on the basis of viewing patients and their informal caregivers as a whole unit will be highly optimal. Unmet care needs should be comprehensively evaluated from the perspectives of all stakeholders and interpreted by using rigorously designed mixed methods research and longitudinal studies within a given context.
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Affiliation(s)
- Tao Wang
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Alex Molassiotis
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Betty Pui Man Chung
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Jing-Yu Tan
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
- College of Nursing and Midwifery, Charles Darwin University, Darwin, Australia
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Ashrafian S, Feizollahzadeh H, Rahmani A, Davoodi A. The Unmet Needs of the Family Caregivers of Patients with Cancer Visiting a Referral Hospital in Iran. Asia Pac J Oncol Nurs 2018; 5:342-352. [PMID: 29963598 PMCID: PMC5996589 DOI: 10.4103/apjon.apjon_7_18] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Objective: The complex process of taking care of patients with cancer can affect various aspects of the needs and health of their family caregivers. The present study aims to determine the unmet needs of the family caregivers of patients with cancer and to compare it according to background variables. Methods: The present descriptive study recruited 200 family caregivers of patients with cancer visiting a referral hospital in Iran. Sampling was carried out through the convenience method. Data were collected using Shin's comprehensive needs assessment tool in seven domains (health and psychological problems, family/social support, healthcare staff, information, religious/spiritual support, hospital facilities/services, and practical support). Results: The mean (±standard deviation) of the total scores of the unmet needs of the family caregivers was 81.73 (±16.82), with a possible range of 0–123. A significant percentage of the family caregivers of patients with cancer had unmet needs in all of the seven domains with different severities. The mean scores were higher in the information, healthcare staff (physicians and nurses), and health and psychological problems domains as compared to the other domains. Conclusions: The results showed that the majority of the family caregivers of patients with cancer have many unmet needs, which should be addressed by professional care providers through the development of holistic care programs targeting family caregivers by focusing on information needs and a proper communication process.
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Affiliation(s)
- Shima Ashrafian
- Department of Medical-Surgical Nursing, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hossein Feizollahzadeh
- Department of Medical-Surgical Nursing, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Azad Rahmani
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Arefeh Davoodi
- Department of Medical-Surgical Nursing, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
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Acute impact of home parenteral nutrition in patients with late-stage cancer on family caregivers: preliminary data. Support Care Cancer 2017; 26:667-671. [PMID: 28921385 DOI: 10.1007/s00520-017-3884-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 09/11/2017] [Indexed: 01/06/2023]
Abstract
PURPOSE Since there is no information regarding quality of life of caregivers assisting patients with advanced malignancy on home parenteral nutrition, herewith we report a preliminary series of 19 patients who received total parenteral nutrition at home under the strict supervision of their relatives. METHODS The relatives of 19 incurable patients with cancer-related cachexia, discharged from the hospital with a home parenteral nutrition program, were prospectively studied. They filled out a validated questionnaire, the Family Strain Questionnaire Short Form, prior to patient discharge and after 2 weeks of home care. The questionnaire included 30 items, which explored different domains regarding the superimposed burden on caregivers in relation to the assistance given to their relatives. RESULTS Our findings show that the basal level of strain was relatively high (about three quarters of positive answers) but did not increase after 2 weeks of home care. Similarly, there was no difference in the nutritional status and quality of life of the patients. Eight patients and their relatives could be also analyzed after 2 months and the results maintained unchanged. CONCLUSION This preliminary investigation shows that home parenteral nutrition does not exacerbate the level of strain on caregivers involved in surveillance of such a supportive intervention. It is possible that the perception of an active contribution to the benefit of patients, who maintained unchanged their nutritional status and quality of life, could gratify caregivers despite the objective burden in the constant supervision of administering Parenteral Nutrition.
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Aparicio M, Centeno C, Carrasco JM, Barbosa A, Arantzamendi M. What are families most grateful for after receiving palliative care? Content analysis of written documents received: a chance to improve the quality of care. BMC Palliat Care 2017; 16:47. [PMID: 28874150 PMCID: PMC5586049 DOI: 10.1186/s12904-017-0229-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 08/15/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Family members are involved in the care of palliative patients at home and therefore, should be viewed as important sources of information to help clinicians better understand the quality palliative care service patients receive. The objective of the study was to analyse what is valued most by family carers undergoing bereavement of a palliative care home service in order to identify factors of quality of care. METHODS Qualitative exploratory study based on documentary analysis. Content analysis of 77 gratitude documents received over 8 years by a palliative home service in Odivelas, near Lisbon (Portugal) was undertaken, through an inductive approach and using investigator triangulation. Frequency of distinct categories was quantitatively defined. RESULTS Three different content categories emerged from the analysis: a) Recognition of the care received and the value of particular aspects of care within recognised difficult situations included aspects such as kindness, listening, attention to the family, empathy, closeness, affection and the therapeutic relationships established (63/77 documents); b) Family recognition of the achievements of the palliative care team (29/77) indicated as relief from suffering for the patient and family, opportunity of dying at home, help in facing difficult situations, improvement in quality of life and wellbeing, and feeling of serenity during bereavement; c) Messages of support (45/77) related to the need of resources provided. The relational component emerges as an underlying key aspect of family carers' experience with palliative care home service. CONCLUSION Family carers show spontaneous gratitude for the professionalism and humanity found in palliative care. The relational component of care emerges as key to achieve a high quality care experience of palliative care homes service, and could be one indicator of quality of palliative care.
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Affiliation(s)
- María Aparicio
- St John’s Hospice, London, UK
- Universidad de Navarra, ICS, ATLANTES, Campus Universitario, 31080 Pamplona, España
| | - Carlos Centeno
- Universidad de Navarra, ICS, ATLANTES, Campus Universitario, 31080 Pamplona, España
- Clínica Universidad de Navarra, Departamento de Medicina Paliativa, Avenidad Pío XII, 31080 Pamplona, España
- IdiSNA, Instituto de Investigación Sanitaria de Navarra, Grupo: Medicina paliativa, Pamplona, España
| | - José Miguel Carrasco
- Universidad de Navarra, ICS, ATLANTES, Campus Universitario, 31080 Pamplona, España
- IdiSNA, Instituto de Investigación Sanitaria de Navarra, Grupo: Medicina paliativa, Pamplona, España
| | - Antonio Barbosa
- Centre for Bioethics, Faculty of Medicine, University of Lisboa, Lisbon, Portugal
| | - María Arantzamendi
- Universidad de Navarra, ICS, ATLANTES, Campus Universitario, 31080 Pamplona, España
- IdiSNA, Instituto de Investigación Sanitaria de Navarra, Grupo: Medicina paliativa, Pamplona, España
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Witt K, Stümpel J, Woopen C. Caregiver burden and the medical ethos. MEDICINE, HEALTH CARE, AND PHILOSOPHY 2017; 20:383-391. [PMID: 28204949 DOI: 10.1007/s11019-017-9757-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Are physicians sometimes morally required to ease caregiver burden? In our paper we defend an affirmative answer to this question. First, we examine the well-established principle that medical care should be centered on the patient. We argue that although this principle seems to give physicians some leeway to lessen caregivers' suffering, it is very restrictive when spelled out precisely. Based on a critical analysis of existing cases for transcending patient-centeredness we then go on to argue that the medical ethos should indeed contain a rule requiring physicians to alleviate caregiver burden under certain circumstances. Finally, we apply our findings to deep brain stimulation (DBS) for Parkinson's disease. We present empirical data from a recent study of DBS indicating that spousal caregivers of Parkinson patients treated with DBS are sometimes deeply troubled by the effects of the therapy and discuss what moral obligations the treating physicians may have in such cases.
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Affiliation(s)
- Karsten Witt
- Institut für Philosophie, Universität Duisburg-Essen, Universitätsstr. 12, 45141, Essen, Germany.
| | - Johanne Stümpel
- Forschungsstelle Ethik, Uniklinik Köln, Universitätsstr. 91, 50931, Köln, Germany
| | - Christiane Woopen
- Forschungsstelle Ethik, Uniklinik Köln, Universitätsstr. 91, 50931, Köln, Germany
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Mosher CE, Ott MA, Hanna N, Jalal SI, Champion VL. Development of a Symptom Management Intervention: Qualitative Feedback From Advanced Lung Cancer Patients and Their Family Caregivers. Cancer Nurs 2017; 40:66-75. [PMID: 26925990 PMCID: PMC5001932 DOI: 10.1097/ncc.0000000000000350] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Little is known about cancer patient and family caregiver preferences for the content and format of nonpharmacologic interventions. Revising interventions based on patient and caregiver feedback before implementation may improve intervention feasibility and acceptability, especially in the context of advanced-stage cancer. OBJECTIVES The aim of the study was to obtain feedback from patients with advanced-stage, symptomatic lung cancer and their family caregivers on the content and format of a nonpharmacologic symptom management intervention under development. The intervention blended evidence-based cognitive-behavioral and emotion-focused strategies to reduce physical and psychological symptoms. METHODS Semistructured qualitative interviews were conducted with 21 patients with advanced-stage, symptomatic lung cancer and caregivers. Participants reviewed handouts regarding intervention components and provided feedback. RESULTS Patients and caregivers desired intervention components that addressed the patient's high symptom burden such as education regarding treatment adverse effects and the provision of various coping tools. Offering interventions with a brief or flexible length and delivering them via telephone were other suggestions for enhancing intervention acceptability. Participants also preferred an equal focus on patient and caregiver concerns and a more positive intervention framework. CONCLUSIONS Intervention preferences of patients with advanced-stage lung cancer and caregivers underscore the severity of the disease and treatment process and the need to adapt interventions to patients with high symptom burden. These preferences may be incorporated into future intervention trials to improve participant recruitment and retention. IMPLICATIONS FOR PRACTICE Nurses can modify interventions to meet the needs of patients with advanced-stage, symptomatic lung cancer and caregivers. For example, flexibility regarding intervention content and length may accommodate those with significant symptoms.
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Affiliation(s)
- Catherine E Mosher
- Author Affiliations: Department of Psychology, Indiana University-Purdue University Indianapolis (Dr Mosher); and Departments of Pediatrics (Dr Ott) and Medicine (Drs Hanna and Jalal), School of Medicine, and School of Nursing (Dr Champion), Indiana University, Indianapolis
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Morris M, Marshall-Lucette S. The Experience of Myeloma Caregivers During Home-Based Oral Chemotherapy Treatment: A Qualitative Study. Semin Oncol Nurs 2017; 33:362-371. [PMID: 28751188 DOI: 10.1016/j.soncn.2017.05.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The primary aim of this qualitative study was to explore myeloma carers/caregivers experience during outpatient-based oral treatment for patients with multiple myeloma (MM). DATA SOURCES Literature review. In-depth, open-ended interviews of seven purposively selected caregivers of MM patients in the United Kingdom. CONCLUSION Findings showed that carers were involved in practical and emotional caregiving activities, assisting the patient with managing complex oral combination treatments, and monitoring side effects. Care-giving activities continued after treatment, and experiences were described within the context of the MM journey and fear and uncertainty about the future. Caregivers also experienced a range of emotions, which they often kept hidden from the MM patients and other family members. Difficulties balancing caring responsibilities, particularly for those with jobs, were expressed. IMPLICATIONS FOR NURSING PRACTICE Nurses need to understand the importance of considering carers' involvement when assessing patients, and the need to address caregivers' continuing support and information needs. Problems navigating health and social care processes should be anticipated, and nurses can direct the carers to appropriate resources to meet their needs.
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Austin L, Ewing G, Grande G. Factors influencing practitioner adoption of carer-led assessment in palliative homecare: A qualitative study of the use of the Carer Support Needs Assessment Tool (CSNAT). PLoS One 2017. [PMID: 28622348 PMCID: PMC5473540 DOI: 10.1371/journal.pone.0179287] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Informal caregivers play a pivotal role in supporting patients approaching the end of life. The Carer Support Needs Assessment Tool (CSNAT) is designed to facilitate person-centred assessment and support through a process that is practitioner-facilitated, but carer-led. This study explored practitioners' experiences of implementing the CSNAT in palliative homecare. METHODS We conducted qualitative interviews/focus groups with 20 practitioners in one UK hospice homecare service (18 nurses, two healthcare assistants) before and after the implementation of the CSNAT. Thematic analysis of the data was underpinned by framework analysis. RESULTS Not all practitioners appreciated that using the CSNAT required a shift towards a more person-centred approach to assessment; consequently they tagged the tool onto their existing practitioner-led practice. Practitioners who did use the CSNAT as intended were able to act as role models and support their colleagues in making this transition. Practitioners' comments revealed a number of contradictions: 1) Most felt that they 'already do' identify carer support needs, but feared using the CSNAT could increase their workload; 2) some worried about introducing the CSNAT 'too soon', but recognised that it was 'too late' once patients were close to the end of life; 3) whilst practitioners stated 'they were there for the family as well as the patient', care provision was overtly centred around patients. CONCLUSION This study provides vital insights into barriers and facilitators to implementing the CSNAT as part of a person-centred approach to assessment. The findings identified the training and support required to help practitioners make this transition to this new way of working.
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Affiliation(s)
- Lynn Austin
- Centre for Primary Care, Faculty of Biological, Medical and Health Sciences, The University of Manchester, Manchester, United Kingdom
- * E-mail:
| | - Gail Ewing
- Centre for Family Research, University of Cambridge, Cambridge, United Kingdom
| | - Gunn Grande
- Division of Nursing, Midwifery and Social Work, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
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Ullrich A, Ascherfeld L, Marx G, Bokemeyer C, Bergelt C, Oechsle K. Quality of life, psychological burden, needs, and satisfaction during specialized inpatient palliative care in family caregivers of advanced cancer patients. BMC Palliat Care 2017; 16:31. [PMID: 28486962 PMCID: PMC5424283 DOI: 10.1186/s12904-017-0206-z] [Citation(s) in RCA: 102] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 04/28/2017] [Indexed: 11/15/2022] Open
Abstract
Background This pilot study aimed to investigate quality of life, psychological burden, unmet needs, and care satisfaction in family caregivers of advanced cancer patients (FCs) during specialized inpatient palliative care (SIPC) and to test feasibility and acceptance of the questionnaire survey. Methods During a period of 12 weeks, FCs were recruited consecutively within 72 h after the patient’s admission. They completed validated scales on several outcomes: quality of life (SF-8), distress (DT), anxiety (GAD-7), depression (PHQ-9), supportive needs (FIN), palliative care outcome (POS), and satisfaction with care (FAMCARE-2). We used non-parametric tests, t-tests and correlation analyses to address our research questions. Results FCs showed high study commitment: 74 FCs were asked to participate whereof 54 (73%) agreed and 51 (69%) returned the questionnaire. Except for “bodily pain”, FCs’ quality of life (SF-8) was impaired in all subscales. Most FCs (96%) reported clinically significant own distress (DT), with sadness, sorrows and exhaustion being the most distressing problems (80–83%). Moderate to severe anxiety (GAD-7) and depression (PHQ-9) were prevalent in 43% and 41% of FCs, respectively. FCs scored a mean number of 16.3 of 20 needs (FIN) as very or extremely important (SD 3.3), 20% of needs were unmet in >50% of FCs. The mean POS score assessed by FCs was 16.6 (SD 5.0) and satisfaction (FAMCARE-2) was high (73.4; SD 8.3). Conclusions This pilot study demonstrated feasibility of the questionnaire survey and showed relevant psychosocial burden and unmet needs in FCs during SIPC. However, FCs’ satisfaction with SIPC seemed to be high. A current multicenter study evaluates these findings longitudinally in a large cohort of FCs.
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Affiliation(s)
- Anneke Ullrich
- Department of Oncology, Haematology and Bone Marrow Transplant, Palliative Care Unit, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany. .,Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
| | - Lilian Ascherfeld
- Department of Oncology, Haematology and Bone Marrow Transplant, Palliative Care Unit, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Gabriella Marx
- Department of Palliative Medicine, University Medical Center Göttingen, Von-Siebold-Str. 3, 37075, Göttingen, Germany
| | - Carsten Bokemeyer
- Department of Oncology, Haematology and Bone Marrow Transplant, Palliative Care Unit, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Corinna Bergelt
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Karin Oechsle
- Department of Oncology, Haematology and Bone Marrow Transplant, Palliative Care Unit, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
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Burridge L, Mitchell G, Jiwa M, Girgis A. Helping lay carers of people with advanced cancer and their GPs to talk: an exploration of Australian users' views of a simple carer health checklist. HEALTH & SOCIAL CARE IN THE COMMUNITY 2017; 25:357-365. [PMID: 26694537 DOI: 10.1111/hsc.12312] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/21/2015] [Indexed: 06/05/2023]
Abstract
The lay caregiving role is integral to advanced cancer care but places carers' health at risk. A supportive General Practitioner (GP) can help primary lay carers manage their health, if they disclose their concerns. A Needs Assessment Tool for Caregivers (NAT-C) was developed for carers to self-complete and use as the basis of a GP consultation, then tested in a randomised controlled trial. This paper reports a qualitative research study to determine the usefulness and acceptability of the NAT-C in the Australian primary care setting. Convenience samples of 11 carers and 5 GPs were interviewed between September 2010 and December 2011 regarding their experiences with and perceptions of the NAT-C. Open-ended questions were used, and the transcripts were analysed qualitatively to identify themes and patterns. Three major themes were identified: (a) Acceptability of the intervention; (b) Impact of the intervention on the GP-patient relationship; and (c) Place of the intervention in advanced cancer care. This simple checklist was acceptable to carers, although some were uncertain about the legitimacy of discussing their own needs with their GP. Carer-patients could not be certain whether a GP would be willing or equipped to conduct a NAT-C-based consultation. Such consultations were acceptable to most GPs, although some already used a holistic approach while others preferred brief symptom-based consultations. Although the NAT-C was acceptable to most carers and GPs, supportive consultations take time. This raises organisational issues to be addressed so carers can seek and benefit from their GP's support.
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Affiliation(s)
- Letitia Burridge
- School of Medicine, The University of Queensland, Royal Brisbane and Women's Hospitals, Herston, Queensland, Australia
| | - Geoffrey Mitchell
- School of Medicine, The University of Queensland, Royal Brisbane and Women's Hospitals, Herston, Queensland, Australia
| | - Moyez Jiwa
- School of Medicine Sydney, Melbourne Clinical School, University of Notre Dame, Australia
| | - Afaf Girgis
- Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, University of New South Wales, Sydney, New South Wales, Australia
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Bainbridge D, Bryant D, Seow H. Capturing the Palliative Home Care Experience From Bereaved Caregivers Through Qualitative Survey Data: Toward Informing Quality Improvement. J Pain Symptom Manage 2017; 53:188-197. [PMID: 27720792 DOI: 10.1016/j.jpainsymman.2016.08.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 07/26/2016] [Accepted: 08/04/2016] [Indexed: 11/18/2022]
Abstract
CONTEXT Measuring palliative care experience using patient-reported outcomes is becoming important for assessing and improving quality, although most validated outcome tools solely use scaled questions. OBJECTIVES We analyzed open-text survey responses from bereaved caregivers to identify strengths and weaknesses in the quality of end-of-life care services and to assess the usefulness of qualitative survey data for quality improvement. METHODS This was a retrospective observational study involving bereaved caregivers of decedents who had received palliative home care services in one of six health care regions in Ontario, Canada. Using the U.K.'s validated Views of Informal Carers-Evaluation of Services survey, respondents were asked what was good and what was bad about the services provided in the last three months of life as separate open-text questions. A qualitative constant comparison approach was used to derive themes from the responses. RESULTS Among 330 caregivers who completed the survey, 271 (82%) caregivers responded to the open-text questions: 93% of those commented on something that was good about care and 55% on something that was bad. The care experiences were generally positive, with the exception of specific individuals or settings that were perceived as adverse. The qualitative data were more informative about deficiencies in care compared with the quantitative data. CONCLUSION The qualitative survey data in this study provided key recommendations toward making care more responsive to the needs of dying patients and their families. Capturing the narrative responses of bereaved caregivers is feasible and informative for palliative care program development.
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Affiliation(s)
- Daryl Bainbridge
- Department of Oncology, McMaster University, Hamilton, Ontario, Canada; Juravinski Cancer Centre, Hamilton, Ontario, Canada.
| | | | - Hsien Seow
- Department of Oncology, McMaster University, Hamilton, Ontario, Canada; Juravinski Cancer Centre, Hamilton, Ontario, Canada; Escarpment Cancer Research Institute, Hamilton, Ontario, Canada
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Selamat Din SH, Nik Jaafar NR, Zakaria H, Mohamed Saini S, Ahmad SNA, Midin M. Anxiety Disorders in Family Caregivers of Breast Cancer Patients Receiving Oncologic Treatment in Malaysia. Asian Pac J Cancer Prev 2017; 18:465-471. [PMID: 28345831 PMCID: PMC5454744 DOI: 10.22034/apjcp.2017.18.2.465] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background: Anxiety is recognized as a normal psychological reaction of those caring for cancer patients. However, anxiety disorders in caregivers may interfere with their care-giving role and require further clinical attention. Objectives: To determine the prevalence and associated factors of anxiety disorders among caregivers of breast cancer patients receiving oncologic treatment in Kuala Lumpur Hospital. Methodology: A cross-sectional study was conducted on 130 caregiver-patient dyads, recruited by non-random sampling at Kuala Lumpur Hospital. Data were collected in 2 stages: 1) the caregivers were screened for psychological distress using the Depression, Anxiety, Stress, Scale (DASS-21) while other related factors for the patients and their caregivers were obtained; 2) the identified distressed caregivers (n=64) were then administered the Mini International Neuropsychiatric Interview (MINI) to diagnose anxiety disorders. Results: A total of 11.5% (n=15) of the caregivers reported suffering from anxiety disorders. Bivariate analysis found duration of caregiving (OR=3.31; CI=2.21-11.93), shared caregiving (OR=4.07; CI=1.34-12.36), and patients’ treatment type (OR=3.42; CI=1.92-12.76) were significantly associated with anxiety disorders (p value <0.05), with shared caregiving and patient’s treatment type remaining significant using logistic regression (p value < 0.05, R2 = 0.255). Conclusions: Every one in ten of the caregivers in this study had a diagnosable anxiety disorder, associated with certain care-giving factors and patients’ treatment. This should alert clinicians to such risk and indicates psychological support needs for family caregivers.
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Affiliation(s)
- Siti Hazrah Selamat Din
- Department of Psychiatry and Mental Health, Hospital Tuanku Jaafar, Seremban, Negeri Sembilan, Malaysia.
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Lee EJ, Pieczynski J, DeDios-Stern S, Simonetti C, Lee GK. Gender differences in caregiver strain, needs for support, social support, and quality of life among spousal caregivers of persons with multiple sclerosis. Work 2016; 52:777-87. [PMID: 26599674 DOI: 10.3233/wor-152205] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Caregivers of individuals with MS may experience unique caregiver strain due to the age at onset and progressive nature of the disease. Additionally, because MS is more prevalent in women, men often become spousal caregivers. However, gender differences in psychosocial adjustment among caregivers have not been fully explored. OBJECTIVE The purpose of this study was to explore gender differences in the need for various supports and type of social support needed, caregiver strain, and quality of life among caregivers for individuals with MS. METHODS 106 caregivers participated in this study. Independent sample t-tests and multiple regression analyses were conducted to examine gender differences in strain, need for supports, social support, and quality of life. RESULTS Analyses revealed gender difference among important psychosocial variables. Specifically, women reported higher levels of caregiver strain, higher needs for emotional support, and higher perceived social support. Additionally, multiple regression analyses revealed an inverse relationship between expressed emotional needs and quality of life for men, but not for women. CONCLUSIONS MS caregivers experience significant strain that diminishes quality of life. Social support and needs fulfillment can act to buffer this stress; however, results indicate that this varies by gender, with gender differences observed in strain, perceived support, and expressed needs among MS caregivers. The study implications for rehabilitation research are discussed.
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Affiliation(s)
- Eun-Jeong Lee
- Department of Psychology, Illinois Institute of Technology, Chicago, IL, USA
| | - Jessica Pieczynski
- Department of Psychology, Illinois Institute of Technology, Chicago, IL, USA
| | | | | | - Gloria K Lee
- Department of Counseling, Educational Psychology & Special Education, Michigan State University, East Lansing, MI, USA
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Martín JM, Olano-Lizarraga M, Saracíbar-Razquin M. The experience of family caregivers caring for a terminal patient at home: A research review. Int J Nurs Stud 2016; 64:1-12. [DOI: 10.1016/j.ijnurstu.2016.09.010] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 09/13/2016] [Accepted: 09/13/2016] [Indexed: 11/25/2022]
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Mosher CE, Winger JG, Hanna N, Jalal SI, Einhorn LH, Birdas TJ, Ceppa DP, Kesler KA, Schmitt J, Kashy DA, Champion VL. Randomized Pilot Trial of a Telephone Symptom Management Intervention for Symptomatic Lung Cancer Patients and Their Family Caregivers. J Pain Symptom Manage 2016; 52:469-482. [PMID: 27401514 PMCID: PMC5075493 DOI: 10.1016/j.jpainsymman.2016.04.006] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 03/18/2016] [Accepted: 04/27/2016] [Indexed: 10/21/2022]
Abstract
CONTEXT Lung cancer is one of the most common cancers affecting both men and women and is associated with high symptom burden and psychological distress. Lung cancer patients' family caregivers also show high rates of distress. However, few interventions have been tested to alleviate significant problems of this population. OBJECTIVES This study examined the preliminary efficacy of telephone-based symptom management (TSM) for symptomatic lung cancer patients and their family caregivers. METHODS Symptomatic lung cancer patients and caregivers (n = 106 dyads) were randomly assigned to four sessions of TSM consisting of cognitive-behavioral and emotion-focused therapy or an education/support condition. Patients completed measures of physical and psychological symptoms, self-efficacy for managing symptoms, and perceived social constraints from the caregiver; caregivers completed measures of psychological symptoms, self-efficacy for helping the patient manage symptoms and managing their own emotions, perceived social constraints from the patient, and caregiving burden. RESULTS No significant group differences were found for all patient outcomes and caregiver self-efficacy for helping the patient manage symptoms and caregiving burden at two- and six-weeks post-intervention. Small effects in favor of TSM were found regarding caregiver self-efficacy for managing their own emotions and perceived social constraints from the patient. Study outcomes did not significantly change over time in either group. CONCLUSION Findings suggest that our brief telephone-based psychosocial intervention is not efficacious for symptomatic lung cancer patients and their family caregivers. Next steps include examining specific intervention components in relation to study outcomes, mechanisms of change, and differing intervention doses and modalities.
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Affiliation(s)
- Catherine E Mosher
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA.
| | - Joseph G Winger
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA
| | - Nasser Hanna
- Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Shadia I Jalal
- Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA; Richard L. Roudebush Veterans Affairs Medical Center, Indianapolis, Indiana, USA
| | - Lawrence H Einhorn
- Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Thomas J Birdas
- Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - DuyKhanh P Ceppa
- Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Kenneth A Kesler
- Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Jordan Schmitt
- Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA; Richard L. Roudebush Veterans Affairs Medical Center, Indianapolis, Indiana, USA
| | - Deborah A Kashy
- Department of Psychology, Michigan State University, East Lansing, Michigan, USA
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Experiences of Parents and General Practitioners with End-of-Life Care in Adolescents and Young Adults with Cancer. J Adolesc Young Adult Oncol 2016; 5:64-8. [DOI: 10.1089/jayao.2015.0009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Tjia J, Ellington L, Clayton MF, Lemay C, Reblin M. Managing Medications During Home Hospice Cancer Care: The Needs of Family Caregivers. J Pain Symptom Manage 2015; 50:630-41. [PMID: 26159294 PMCID: PMC4649436 DOI: 10.1016/j.jpainsymman.2015.06.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Revised: 06/01/2015] [Accepted: 06/02/2015] [Indexed: 10/23/2022]
Abstract
CONTEXT Family caregivers (FCGs) are often at the frontline of symptom management for patients with advanced illness in home hospice. FCGs' cognitive, social, and technical skills in complex medication management have been well studied in the literature; however, few studies have tested existing frameworks in clinical cases in home hospice. OBJECTIVES This study sought to assess the applicability of caregiver medication management skills framework by Lau et al. in the context of family caregiving in home hospice to further the understanding of FCGs' essential medication management skills. METHODS This was a secondary data analysis of 18 audio recorded home hospice visits transcribed verbatim; deductive content analysis of caregiver-nurse interactions was conducted. The target sample included FCGs of hospice patients who had cancer diagnoses in hospices located in the greater urban area of the Rocky Mountain West. Caregiver medication management skills were identified and categorized into the five domains of caregiver expertise. Exemplars of each domain were identified. RESULTS An average of four medications (SD = 3.5) was discussed at each home hospice visit. Medication knowledge skills were observed in most home hospice visits (15 of 18). Teamwork skills were observed in 11 of 18 cases, followed by organizational and personhood skills (10 of 18). Symptom management skills occurred in 12 of 18 cases. An additional two subconstructs of the personhood domain-1) advocacy for the caregiver and 2) skills in discontinuing medications-were proposed. CONCLUSION These findings support framework by Lau et al. for caregiver medication management skills and expands on the existing domains proposed. Future interventions to assess FCGs' skills are recommended.
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Affiliation(s)
- Jennifer Tjia
- University of Massachusetts Medical School, Worcester, Massachusetts, USA.
| | | | | | - Celeste Lemay
- University of Massachusetts Medical School, Worcester, Massachusetts, USA
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Rha SY, Park Y, Song SK, Lee CE, Lee J. Caregiving burden and the quality of life of family caregivers of cancer patients: the relationship and correlates. Eur J Oncol Nurs 2015; 19:376-82. [DOI: 10.1016/j.ejon.2015.01.004] [Citation(s) in RCA: 99] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 01/06/2015] [Accepted: 01/15/2015] [Indexed: 01/20/2023]
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