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Genter P, Høeg BL, Hamre CJ, Andersen EAW, Dalton SO, Ribers B, Bidstrup PE. Protocol for 'Resilient Caregivers': a randomised trial of a resilience-based intervention for psychologically distressed partner caregivers of patients with cancer. BMJ Open 2021; 11:e048327. [PMID: 34772747 PMCID: PMC8593729 DOI: 10.1136/bmjopen-2020-048327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 10/25/2021] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Intimate partners of patients with cancer often experience significant distress, but there is a lack of psychological interventions that specifically target this population. 'Resilient Caregivers' is a novel resilience-based intervention for distressed partner cancer caregivers. The intervention was developed according to a resilience framework focusing on meta-reflective skills, coping strategies and value clarification. The aim of this study is to evaluate the effectiveness of this intervention in a randomised trial. METHODS AND ANALYSIS Eighty participants will be invited through the Oncology Department at Herlev Hospital, Denmark and randomised to either the intervention or usual care. Participants are eligible if they are partners (married or unmarried) of patients diagnosed with cancer and experience distress (>4 on the distress thermometer). 'Resilient Caregivers' consists of seven manualised group sessions (2.5 hours each), focusing on resilience in relation to being a partner caregiver of a patient with cancer. The primary outcome is symptoms of anxiety, while secondary outcomes include distress, depression, quality of life, sleep quality and resilience. Data will be collected at baseline, 3, 6 and 12 months follow-up using validated scales, and analysed using mixed models for repeated measures. ETHICS AND DISSEMINATION This study will follow the ethical principles in the Declaration of Helsinki and has been reviewed by the Ethics Committee of the Capital Region of Denmark (Journal no. 18055373). Written informed consent will be obtained from all participants. Results will be reported through scientific peer-reviewed journals and relevant conferences. TRIAL REGISTRATION NUMBER NCT04610034.
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Affiliation(s)
- Peter Genter
- Herlev Cancer Counseling Center, Danish Cancer Society, Copenhagen, Denmark
| | - Beverley Lim Høeg
- Psychological Aspects of Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark
| | | | | | - Susanne Oksbjerg Dalton
- Survivorship and Inequality in Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Bjørn Ribers
- Department for the Study of Culture, University of Southern Denmark, Odense, Denmark
| | - Pernille Envold Bidstrup
- Psychological Aspects of Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark
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Persson J, Sheehan OC, Strömberg U, Roth DL. All-cause mortality for cohabiting spouses of stroke survivors: Evidence from Swedish national registries. Top Stroke Rehabil 2020; 28:432-442. [PMID: 33048024 DOI: 10.1080/10749357.2020.1834270] [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: 10/23/2022]
Abstract
BACKGROUND/OBJECTIVES Spousal concordance for cardiovascular risk factors and lifestyle behaviors may affect prevalence rates of diabetes, hypertension, and stroke. Spouses of stroke survivors, therefore, would be expected to have elevated mortality rates, but this has not been established. Thus, the aim of this study was to investigate whether cohabitant spouses of stroke survivors have higher mortality rates compared to a matched reference cohort. METHODS Data for this population-based cohort study were extracted from Swedish national registries from 2010 to 2016. The national sample consisted of 13,049 spouses of first ever stroke survivors and a reference cohort of 51,685 cohabitant individuals from the general population matched by age, gender, and place of residence. Effects on mortality were analyzed using Cox proportional hazard survival analyses. RESULTS Female and male spouses of stroke survivors were found to have 5-year hazard ratios of death of 1.26 (95% confidence interval 1.17, 1.36) and 1.24 (95% confidence interval 1.16, 1.33), respectively, when compared to the reference cohort. Both female and male spouses had higher mortality from diseases in the circulatory system compared to the reference cohort. CONCLUSION Spouses of stroke survivors have higher mortality rates than a matched reference population that persist for a minimum of 5 years. Policy-makers should acknowledge and address the health status of spouses when evaluating and planning the health and social care of stroke survivors.
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Affiliation(s)
- Josefine Persson
- Health Economics and Policy, School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.,Center on Aging and Health, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Orla C Sheehan
- Center on Aging and Health, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ulf Strömberg
- Health Economics and Policy, School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - David L Roth
- Center on Aging and Health, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Persson J, Hensing G, Bonander C. Employment transitions for spouses of stroke survivors: evidence from Swedish national registries. BMC Public Health 2020; 20:1522. [PMID: 33028247 PMCID: PMC7542721 DOI: 10.1186/s12889-020-09625-1] [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: 05/12/2020] [Accepted: 09/29/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The sudden occurrence of stroke often leads to impaired physical, emotional, and cognitive abilities. Many stroke survivors therefore require support from their family members. However, little is known about the effects of a stroke event on the spouses' employment transition probabilities. The aim of this study was twofold 1) to investigate whether a first ever stroke has an effect on employment transition probabilities for employed and unemployed spouses and 2) to analyze whether heterogeneity with respect to age, gender, education and comorbidities influence the size of the effect. METHOD Data for this population-based cohort study were extracted from Swedish national registries from 2005 to 2016. The national sample consisted of 1818 spouses of first ever stroke survivors during 2010 and 2011, and 7399 matched controls that were employed or unemployed during 5 years prior stroke onset. Effects of stroke on spousal employment transitions were analyzed using linear regression, stratified by employment status prior to stroke onset. RESULTS Employed spouses prior stroke onset reduced their employment by - 1.3 percentage points (95% CI, - 2.4, - 0.2). The data also indicated that employed spouses with lower age, comorbid conditions, and low educational attainment may be at even greater risk of transitioning to unemployment. On the other hand, stroke events appear to have limited impact on spouses that were unemployed prior to stroke onset. CONCLUSION The risk of transitioning to unemployment appears to increase after stroke onset for spouses of stroke survivors, and disadvantaged groups may be at even greater risk. Thus, it is important for policy-makers to implement interventions to ensure that these groups of spouses have the possibilities to combine their caregiving role and remaining in the labor market.
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Affiliation(s)
- Josefine Persson
- Health Economics and Policy, School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
| | - Gunnel Hensing
- Insurance Medicine, School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Carl Bonander
- Health Economics and Policy, School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
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Sone T, Nakaya N, Tomata Y, Nakaya K, Hoshi M, Tsuji I. Spouse's functional disability and mortality: The Ohsaki Cohort 2006 Study. Geriatr Gerontol Int 2019; 19:774-779. [PMID: 31245916 PMCID: PMC6852102 DOI: 10.1111/ggi.13709] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 04/18/2019] [Accepted: 05/08/2019] [Indexed: 12/11/2022]
Abstract
Aim Caregiver burden is known to negatively affect a partner's health. Given the important role of physical and mental stress in mortality, a higher caregiver burden might be associated with an increased incidence of fatal events. However, previous studies of the effects of the partner's caregiving on mortality have shown inconsistent results. Thus, the purpose of the present longitudinal study was to determine if there is an association between a spouse's functional disability and mortality in the older Japanese population. Methods A baseline survey was carried out with 7598 participants in 2006. Information on the date of functional disability, death or emigration was retrieved from the Ohsaki City government. Functional disability was defined as receiving a certification for long‐term care insurance in Japan. After a follow‐up period of a maximum of 87 months, 1316 of the participants died and Cox regression analysis with adjustment for confounding factors was used to assess mortality after the incidence of functional disability in a spouse. Results The multivariate adjusted hazard ratio for mortality was 1.78 (95% confidence interval 1.52–2.08, P < 0.01) in those whose spouses had functional disabilities compared with those with spouses who did not have functional disabilities. The mortality was consistently higher, irrespective of age group or sex. Conclusions These results imply that caregiver burden might increase stress responses and lead to increased mortality; therefore, enhancement of support systems, including long‐term care, housing and livelihood support services, for those with disability and their spouses might be important for preventing deaths. Geriatr Gerontol Int 2019; 19: 774–779.
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Affiliation(s)
- Toshimasa Sone
- Department of Rehabilitation, Faculty of Health Science, Tohoku Fukushi University, Sendai, Japan.,Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine, Sendai, Japan
| | - Naoki Nakaya
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.,Department of Health Sciences, Saitama Prefectural University, Koshigaya, Japan
| | - Yasutake Tomata
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine, Sendai, Japan
| | - Kumi Nakaya
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Masayuki Hoshi
- Department of Rehabilitation, Takahata Public Hospital, Takahata, Japan
| | - Ichiro Tsuji
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine, Sendai, Japan
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Nakaya N, Sone T, Tomata Y, Nakaya K, Hoshi M, Shimizu K, Tsuji I. All-cause mortality among Japanese whose cohabiting partners are diagnosed with cancer: the Ohsaki Cohort 2006 study. Acta Oncol 2019; 58:425-431. [PMID: 30663926 DOI: 10.1080/0284186x.2018.1562208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND It has been noted that not only adverse psychosocial health effects but also mortality might increase for a person living with a spouse with cancer. This study examined the association between a partner's cancer diagnosis and mortality among a Japanese population. METHODS In December 2006, a survey was conducted on participants aged 40 years or older who were residing in northeastern Japan. We identified couples using municipality-specific household ID numbers by searching public records and confirmed partner's cancer diagnosis after the baseline measurement using regional cancer registration information. After following up for a maximum of 4.0 years with the participants regarding mortality and emigration by reviewing the Residential Registry Record, we used Cox's proportional hazards regression to estimate the hazard ratio (HR) of all-cause mortality. RESULTS We identified 25,938 participants (12,969 pairs) and included them in the analyses. A total of 1,308 (5.0%) participants had partners with a cancer diagnosis after baseline. The study found no association between a partner's cancer diagnosis and all-cause mortality; multivariable HRs of all-cause mortality for individuals in exposed subjects compared with those in unexposed subjects were 1.35 (95% confidence interval [CI] = 0.99-1.83; p = .055). Contrarily, sensitivity analyses of mortality attributed to having partners diagnosed with cancer based on the time since entry showed that all-cause mortality significantly increased only within one year from spouse cancer diagnosis; HR = 2.18 (95% CI = 1.44-3.30; p < .01). CONCLUSIONS Our findings reveal that the mortality rate from partner's cancer diagnosis was significantly high during the early period of diagnosis and multidisciplinary teams for cancer treatment might be important for preventing death among the partner.
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Affiliation(s)
- Naoki Nakaya
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Toshimasa Sone
- Department of Rehabilitation, Faculty of Health Science, Tohoku Fukushi University, Sendai, Japan
| | - Yasutake Tomata
- Division of Epidemiology Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine, Sendai, Japan
| | - Kumi Nakaya
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Masayuki Hoshi
- Department of Rehabilitation, Takahata Public Hospital, Takahata, Japan
| | - Ken Shimizu
- Department of Psycho-oncology, National Cancer Center Hospital, Chuo-ku, Japan
| | - Ichiro Tsuji
- Division of Epidemiology Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine, Sendai, Japan
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