1
|
Welsh ET, McIntosh JE, Vuong A, Cloud ZCG, Hartley E, Boyd JH. Design of Digital Mental Health Platforms for Family Member Cocompletion: Scoping Review. J Med Internet Res 2024; 26:e49431. [PMID: 38959030 DOI: 10.2196/49431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 12/13/2023] [Accepted: 05/04/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic placed an additional mental health burden on individuals and families, resulting in widespread service access problems. Digital mental health interventions suggest promise for improved accessibility. Recent reviews have shown emerging evidence for individual use and early evidence for multiusers. However, attrition rates remain high for digital mental health interventions, and additional complexities exist when engaging multiple family members together. OBJECTIVE As such, this scoping review aims to detail the reported evidence for digital mental health interventions designed for family use with a focus on the build and design characteristics that promote accessibility and engagement and enable cocompletion by families. METHODS A systematic literature search of MEDLINE, Embase, PsycINFO, Web of Science, and CINAHL databases was conducted for articles published in the English language from January 2002 to March 2024. Eligible records included empirical studies of digital platforms containing some elements designed for cocompletion by related people as well as some components intended to be completed without therapist engagement. Platforms were included in cases in which clinical evidence had been documented. RESULTS Of the 9527 papers reviewed, 85 (0.89%) met the eligibility criteria. A total of 24 unique platforms designed for co-use by related parties were identified. Relationships between participants included couples, parent-child dyads, family caregiver-care recipient dyads, and families. Common platform features included the delivery of content via structured interventions with no to minimal tailoring or personalization offered. Some interventions provided live contact with therapists. User engagement indicators and findings varied and included user experience, satisfaction, completion rates, and feasibility. Our findings are more remarkable for what was absent in the literature than what was present. Contrary to expectations, few studies reported any design and build characteristics that enabled coparticipation. No studies reported on platform features for enabling cocompletion or considerations for ensuring individual privacy and safety. None examined platform build or design characteristics as moderators of intervention effect, and none offered a formative evaluation of the platform itself. CONCLUSIONS In this early era of digital mental health platform design, this novel review demonstrates a striking absence of information about design elements associated with the successful engagement of multiple related users in any aspect of a therapeutic process. There remains a large gap in the literature detailing and evaluating platform design, highlighting a significant opportunity for future cross-disciplinary research. This review details the incentive for undertaking such research; suggests design considerations when building digital mental health platforms for use by families; and offers recommendations for future development, including platform co-design and formative evaluation.
Collapse
Affiliation(s)
- Ellen T Welsh
- The Bouverie Centre, School of Psychology and Public Health, La Trobe University, Brunswick, Australia
| | - Jennifer E McIntosh
- The Bouverie Centre, School of Psychology and Public Health, La Trobe University, Brunswick, Australia
| | - An Vuong
- The Bouverie Centre, School of Psychology and Public Health, La Trobe University, Brunswick, Australia
| | - Zoe C G Cloud
- The Bouverie Centre, School of Psychology and Public Health, La Trobe University, Brunswick, Australia
| | - Eliza Hartley
- The Bouverie Centre, School of Psychology and Public Health, La Trobe University, Brunswick, Australia
| | - James H Boyd
- School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| |
Collapse
|
2
|
Tuominen L, Leino-Kilpi H, Poraharju J, Cabutto D, Carrion C, Lehtiö L, Moretó S, Stolt M, Sulosaari V, Virtanen H. Interactive digital tools to support empowerment of people with cancer: a systematic literature review. Support Care Cancer 2024; 32:396. [PMID: 38816629 PMCID: PMC11139693 DOI: 10.1007/s00520-024-08545-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 05/03/2024] [Indexed: 06/01/2024]
Abstract
PURPOSE To identify and synthesise interactive digital tools used to support the empowerment of people with cancer and the outcomes of these tools. METHODS A systematic literature review was conducted using PubMed, CINAHL, Web of Science, Cochrane, Eric, Scopus, and PsycINFO databases in May 2023. Inclusion criteria were patient empowerment as an outcome supported by interactive digital tools expressed in study goal, methods or results, peer-reviewed studies published since 2010 in cancer care. Narrative synthesis was applied, and the quality of the studies was assessed following Joanna Briggs Institute checklists. RESULTS Out of 1571 records screened, 39 studies published in 2011-2022 with RCT (17), single-arm trial (15), quasi-experimental (1), and qualitative designs (6) were included. A total of 30 interactive digital tools were identified to support empowerment (4) and related aspects, such as self-management (2), coping (4), patient activation (9), and self-efficacy (19). Significant positive effects were found on empowerment (1), self-management (1), coping (1), patient activation (2), and self-efficacy (10). Patient experiences were positive. Interactivity occurred with the tool itself (22), peers (7), or nurses (7), physicians (2), psychologists, (2) or social workers (1). CONCLUSION Interactive digital tools have been developed extensively in recent years, varying in terms of content and methodology, favouring feasibility and pilot designs. In all of the tools, people with cancer are either active or recipients of information. The research evidence indicates positive outcomes for patient empowerment through interactive digital tools. Thus, even though promising, there still is need for further testing of the tools.
Collapse
Affiliation(s)
- Leena Tuominen
- Department of Nursing Science, University of Turku, Turku, Finland.
| | - Helena Leino-Kilpi
- University of Turku FI and Wellbeing Services County of Southwest Finland, University of Turku FI, Turku University Hospital, Turku, Finland.
| | - Jeena Poraharju
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Daniela Cabutto
- eHealth Lab Research Group, School of Health Sciences and eHealth Center, Universitat Oberta de Catalunya, Barcelona, Spain
| | - Carme Carrion
- eHealth Lab Research Group, Faculty of Health Sciences Studies, E-Health Center, School of Health Sciences and eHealth Center, Universitat Oberta de Catalunya, Barcelona, Spain
| | - Leeni Lehtiö
- Turku University Library, University of Turku, Turku, Finland
| | - Sónia Moretó
- eHealth Lab Research Group, School of Health Sciences and eHealth Center, Universitat Oberta de Catalunya, Barcelona, Spain
| | - Minna Stolt
- Department of Nursing Science, University of Turku, Turku, Finland
- Wellbeing Services County of Satakunta, Pori, Finland
| | - Virpi Sulosaari
- Health and Well-Being, Turku University of Applied Sciences, Turku, Finland
- Research Advancing Supportive Cancer and Palliative care (CARE) - research group, Turku, Finland
- European Oncology Nursing Society, Brussels, Belgium
| | - Heli Virtanen
- Department of Nursing Science, University of Turku, Turku, Finland
| |
Collapse
|
3
|
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.
Collapse
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.
| |
Collapse
|
4
|
O'Donnell EA, Van Citters AD, Khayal IS, Wilson MM, Gustafson D, Barnato AE, Buccellato AC, Young C, Holthoff MM, Korsunskiy E, Tomlin SC, Cullinan AM, Steinbaugh AC, Hinson JJ, Johnson KR, Williams A, Thomson RM, Haines JM, Holmes AB, Bradley AD, Nelson EC, Kirkland KB. A Web-Based Peer Support Network to Help Care Partners of People With Serious Illness: Co-Design Study. JMIR Hum Factors 2024; 11:e53194. [PMID: 38717809 PMCID: PMC11112480 DOI: 10.2196/53194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 03/20/2024] [Accepted: 03/20/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Care partners of people with serious illness experience significant challenges and unmet needs during the patient's treatment period and after their death. Learning from others with shared experiences can be valuable, but opportunities are not consistently available. OBJECTIVE This study aims to design and prototype a regional, facilitated, and web-based peer support network to help active and bereaved care partners of persons with serious illness be better prepared to cope with the surprises that arise during serious illness and in bereavement. METHODS An 18-member co-design team included active care partners and those in bereavement, people who had experienced serious illness, regional health care and support partners, and clinicians. It was guided by facilitators and peer network subject-matter experts. We conducted design exercises to identify the functions and specifications of a peer support network. Co-design members independently prioritized network specifications, which were incorporated into an early iteration of the web-based network. RESULTS The team prioritized two functions: (1) connecting care partners to information and (2) facilitating emotional support. The design process generated 24 potential network specifications to support these functions. The highest priorities included providing a supportive and respectful community; connecting people to trusted resources; reducing barriers to asking for help; and providing frequently asked questions and responses. The network platform had to be simple and intuitive, provide technical support for users, protect member privacy, provide publicly available information and a private discussion forum, and be easily accessible. It was feasible to enroll members in the ConnectShareCare web-based network over a 3-month period. CONCLUSIONS A co-design process supported the identification of critical features of a peer support network for care partners of people with serious illnesses in a rural setting, as well as initial testing and use. Further testing is underway to assess the long-term viability and impact of the network.
Collapse
Affiliation(s)
- Elizabeth A O'Donnell
- Communications, Marketing and Community Health, Alice Peck Day Memorial Hospital, Lebanon, NH, United States
- The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
| | - Aricca D Van Citters
- The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
| | - Inas S Khayal
- The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
- Dartmouth Cancer Center, Geisel School of Medicine, Dartmouth, Lebanon, NH, United States
| | - Matthew M Wilson
- Palliative Medicine, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
- Section of Palliative Medicine, Dartmouth Health, Lebanon, NH, United States
| | - David Gustafson
- College of Engineering, University of Wisconsin, Madison, WI, United States
| | - Amber E Barnato
- The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
- Palliative Medicine, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
- Section of Palliative Medicine, Dartmouth Health, Lebanon, NH, United States
| | - Andrea C Buccellato
- Dartmouth Cancer Center, Geisel School of Medicine, Dartmouth, Lebanon, NH, United States
| | - Colleen Young
- Mayo Clinic Connect, Mayo Clinic, Rochester, MN, United States
| | - Megan M Holthoff
- The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
| | - Eugene Korsunskiy
- Thayer School of Engineering, Dartmouth College, Hanover, NH, United States
| | - Stephanie C Tomlin
- Patient and Family Advisors, Dartmouth Health, Lebanon, NH, United States
| | - Amelia M Cullinan
- Palliative Medicine, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
- Section of Palliative Medicine, Dartmouth Health, Lebanon, NH, United States
| | | | - Jennifer J Hinson
- Patient and Family Advisors, Dartmouth Health, Lebanon, NH, United States
| | - Kristen R Johnson
- Section of Palliative Medicine, Dartmouth Health, Lebanon, NH, United States
| | - Andrew Williams
- Patient and Family Advisors, Dartmouth Health, Lebanon, NH, United States
| | - Ruth M Thomson
- Palliative Medicine, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
- Section of Palliative Medicine, Dartmouth Health, Lebanon, NH, United States
| | - Janet M Haines
- Patient and Family Advisors, Dartmouth Health, Lebanon, NH, United States
| | - Anne B Holmes
- Patient and Family Advisors, Dartmouth Health, Lebanon, NH, United States
| | - Ann D Bradley
- Patient and Family Advisors, Dartmouth Health, Lebanon, NH, United States
| | - Eugene C Nelson
- The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
| | - Kathryn B Kirkland
- The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
- Palliative Medicine, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
- Section of Palliative Medicine, Dartmouth Health, Lebanon, NH, United States
| |
Collapse
|
5
|
Okere CA, Kvist T, Sak-Dankosky N, Yerris V. Spiritual interventions: Improving the lives of colorectal cancer survivors-A systematic literature review. J Adv Nurs 2024. [PMID: 38632872 DOI: 10.1111/jan.16196] [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: 05/06/2023] [Revised: 03/21/2024] [Accepted: 04/06/2024] [Indexed: 04/19/2024]
Abstract
AIM To systematically review the types of spiritual interventions available for colorectal cancer survivors and determine if they improve their lives. DESIGN Systematic review. DATA SOURCE A thorough literature search was conducted in July 2023 using PRIMO, PubMed/Medline, Cochrane, CINAHL, Scopus, and EMBASE. REVIEW METHODS As an extension of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist, the Synthesis Without Meta-Analysis reporting guideline was employed. A narrative synthesis was used to analyse the data. RESULTS Thirty-five articles were analysed for this study. The findings suggest that psychoeducational intervention, cognitive behavioural therapy intervention, mindfulness intervention, social intervention, and spiritual counselling improved CRC survivor's coping skills, boosted self-esteem, lessened anxiety, instilled hope, enhanced daily functioning, improved survival rates, improved neurological functional status and quality of life (QoL). CONCLUSION There is proof that spiritual interventions help CRC patients and improve their QoL. It has been discovered that spiritual intervention is helpful in the diagnosis, management, and treatment of CRC conditions. IMPACT CRC survivors may have impairments in their physical ability and daily functioning as a result of many symptoms, such as pain, bowel dysfunction, and exhaustion. Furthermore, individuals may encounter difficulties in several aspects of their psychological, emotional, social, and role functioning due to the presence of dread symptoms. Therefore, these study will help CRC survivors To implement spiritual interventions in the management of their long-term care. To cultivate problem-solving abilities, foster self-assurance, and enhance self-awareness. To alleviate symptoms, enhance everyday functioning, and improve QoL. NO INDUCEMENT No financial incentives were used to compensate patients or members of the public for this review.
Collapse
Affiliation(s)
| | - Tarja Kvist
- University of Eastern Finland, Kuopio, Finland
| | | | - Victor Yerris
- Institut Supérieur de Formation Bancaire, Geneva, Switzerland
| |
Collapse
|
6
|
Yang X, Li X, Jiang S, Yu X. Effects of Telemedicine on Informal Caregivers of Patients in Palliative Care: Systematic Review and Meta-Analysis. JMIR Mhealth Uhealth 2024; 12:e54244. [PMID: 38602303 PMCID: PMC11024400 DOI: 10.2196/54244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 02/28/2024] [Accepted: 02/28/2024] [Indexed: 04/12/2024] Open
Abstract
Background Telemedicine technology is a rapidly developing field that shows immense potential for improving medical services. In palliative care, informal caregivers assume the primary responsibility in patient care and often face challenges such as increased physical and mental stress and declining health. In such cases, telemedicine interventions can provide support and improve their health outcomes. However, research findings regarding the use of telemedicine among informal caregivers are controversial, and the efficacy of telemedicine remains unclear. Objective This study aimed to evaluate the impacts of telemedicine on the burden, anxiety, depression, and quality of life of informal caregivers of patients in palliative care. Methods A systematic literature search was conducted using the PubMed, Embase, Web of Science, CENTRAL, PsycINFO, CINAHL Plus with Full Text, CBM, CNKI, WanFang, and VIP databases to identify relevant randomized controlled trials published from inception to March 2023. Two authors independently screened the studies and extracted the relevant information. The methodological quality of the included studies was assessed using the Cochrane risk-of-bias tool. Intervention effects were estimated and sensitivity analysis was conducted using Review Manager 5.4, whereas 95% prediction intervals (PIs) were calculated using R (version 4.3.2) and RStudio. Results A total of 9 randomized controlled trials were included in this study. The meta-analysis indicated that telemedicine has reduced the caregiving burden (standardized mean differences [SMD] -0.49, 95% CI -0.72 to -0.27; P<.001; 95% PI -0.86 to -0.13) and anxiety (SMD -0.23, 95% CI -0.40 to -0.06; P=.009; 95% PI -0.98 to 0.39) of informal caregivers; however, it did not affect depression (SMD -0.21, 95% CI -0.47 to 0.05; P=.11; 95% PI -0.94 to 0.51) or quality of life (SMD 0.35, 95% CI -0.20 to 0.89; P=.21; 95% PI -2.15 to 2.85). Conclusions Although telemedicine can alleviate the caregiving burden and anxiety of informal caregivers, it does not significantly reduce depression or improve their quality of life. Further high-quality, large-sample studies are needed to validate the effects of telemedicine. Furthermore, personalized intervention programs based on theoretical foundations are required to support caregivers.
Collapse
Affiliation(s)
- Xiaoyu Yang
- Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xueting Li
- College of Nursing, China Medical University, Shenyang, China
| | - Shanshan Jiang
- College of Nursing, China Medical University, Shenyang, China
| | - Xinying Yu
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China
| |
Collapse
|
7
|
Coumoundouros C, Farrand P, Sanderman R, von Essen L, Woodford J. "Systems seem to get in the way": a qualitative study exploring experiences of accessing and receiving support among informal caregivers of people living with chronic kidney disease. BMC Nephrol 2024; 25:7. [PMID: 38172754 PMCID: PMC10765659 DOI: 10.1186/s12882-023-03444-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 12/19/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND The well-being of informal caregivers of people living with chronic kidney disease is influenced by their experiences with support, however, few studies have focused on exploring these experiences. This study aimed to explore informal caregivers' experiences accessing and receiving support while caring for someone living with chronic kidney disease. METHODS Informal caregivers of people living with chronic kidney disease (n = 13) in the United Kingdom were primarily recruited via community organisations and social media adverts to participate in semi-structured interviews. Interviews explored support needs, experiences of receiving support from different groups (e.g. healthcare professionals, family/friends), and barriers and facilitators to accessing support. Support was understood as including emotional, practical, and informational support. Data were analysed using reflexive thematic analysis. RESULTS Three themes were generated: (1) "Systems seem to get in the way" - challenges within support systems, illustrating the challenges informal caregivers encountered when navigating complex support systems; (2) Relying on yourself, describing how informal caregivers leveraged their existing skills and networks to access support independently, while recognising the limitations of having to rely on yourself to find support; and (3) Support systems can "take the pressure off", showing how support systems were able to help informal caregivers cope with the challenges they experienced if certain conditions were met. CONCLUSIONS In response to the challenges informal caregivers experienced when seeking support, improvements are needed to better consider informal caregiver needs within healthcare systems, and to develop interventions tailored to informal caregiver needs and context. Within the healthcare system, informal caregivers may benefit from system navigation support and better integration within healthcare teams to ensure their informational support needs are met. New interventions developed to support informal caregivers should fit within their existing support systems and incorporate the qualities of support, such as empathy, that were valued. Additionally, use of an equity framework and user-centered design approaches during intervention development could help ensure interventions are accessible and acceptable.
Collapse
Affiliation(s)
- Chelsea Coumoundouros
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Dag Hammarskjölds väg 14B, Uppsala, 751 05, Sweden
- Clinical Education, Development and Research (CEDAR); Psychology, University of Exeter, Exeter, UK
| | - Paul Farrand
- Clinical Education, Development and Research (CEDAR); Psychology, University of Exeter, Exeter, UK
| | - Robbert Sanderman
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Louise von Essen
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Dag Hammarskjölds väg 14B, Uppsala, 751 05, Sweden
| | - Joanne Woodford
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Dag Hammarskjölds väg 14B, Uppsala, 751 05, Sweden.
| |
Collapse
|
8
|
Wang Z, Chen M, Cao Q, Gong J, Zhao J, Lin C, Luo H, Wu X, Chen Y, Li Q. An integrated intervention programme for couples facing colorectal cancer: A randomized controlled trial. Clin Psychol Psychother 2023. [PMID: 37947325 DOI: 10.1002/cpp.2919] [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: 04/24/2023] [Revised: 09/22/2023] [Accepted: 10/03/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Under the guidance of a preliminary Live with Love Conceptual Framework, a Caring for Couples Coping with Colorectal Cancer (4Cs: CRC) programme was designed specifically for colorectal cancer couples. The objectives of this study included examining the efficacy of the programme for couples adapting to colorectal cancer and comparing the effects of different intervention delivery modes (online, face-to-face and blended) on couple outcomes. METHODS A four-arm randomized controlled trial was conducted among Chinese colorectal cancer couples. Couples were randomly assigned to an online intervention, a face-to-face intervention, a blended intervention or a control group. Self-efficacy, dyadic coping, communication and dyadic outcomes (physical and mental health, negative and positive emotions and marital satisfaction) were evaluated at baseline and 6 weeks later. Analysis of variance (ANOVA) and repeated measures ANOVA were employed to assess between-group differences and within-group effects in the four groups, respectively. RESULTS A total of 179 couples completed the 6-week study and post-study assessments. The intervention showed generally medium-to-large effects across multiple measured outcomes, including self-efficacy, dyadic coping, communication, mental health, negative emotions and positive emotions for both patients and spouse caregivers. Additionally, interventions delivered through different modes produced equally significant effects on couple outcomes. CONCLUSIONS The integrated intervention programme is effective in improving cancer adaptation in colorectal cancer couples. Long-term follow-up and a mix of quantitative and qualitative assessments are crucial for further evaluation of the programme. TRIAL REGISTRATION Retroactive registration is under review.
Collapse
Affiliation(s)
- Zhiming Wang
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Meizhen Chen
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Qian Cao
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Jiali Gong
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Jie Zhao
- Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu Province, China
| | - Chunyan Lin
- Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu Province, China
| | - Huamin Luo
- Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu Province, China
| | - Xinyu Wu
- Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu Province, China
| | - Ying Chen
- Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu Province, China
| | - Qiuping Li
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
- Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu Province, China
| |
Collapse
|
9
|
Carr AL, Bilenduke E, Adolf E, Kessler ER, Arch JJ, Ranby KW, Kilbourn K. A pilot randomized study of a telephone-based cognitive-behavioral stress-management intervention to reduce distress in phase 1 oncology trial caregivers. Palliat Support Care 2023; 21:820-828. [PMID: 36994841 PMCID: PMC10544682 DOI: 10.1017/s1478951523000196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
Abstract
OBJECTIVES Caregivers of adult phase 1 oncology trial patients experience high levels of distress and face barriers to in-person supportive care. The Phase 1 Caregiver LifeLine (P1CaLL) pilot study assessed the feasibility, acceptability, and general impact of an individual telephone-based cognitive behavioral stress-management (CBSM) intervention for caregivers of phase I oncology trial patients. METHODS The pilot study involved 4 weekly adapted CBSM sessions followed by participant randomization to 4 weekly cognitive behavioral therapy sessions or metta-meditation sessions. A mixed-methods design used quantitative data from 23 caregivers and qualitative data from 5 caregivers to examine the feasibility and acceptability outcomes. Feasibility was determined using recruitment, retention, and assessment completion rates. Acceptability was assessed with self-reported satisfaction with program content and participation barriers. Baseline to post-intervention changes in caregiver distress and other psychosocial outcomes were assessed for the 8-session intervention. RESULTS The enrollment rate was 45.3%, which demonstrated limited feasibility based on an a priori criterion enrollment rate of 50%. Participants completed an average of 4.9 sessions, with 9/25 (36%) completing all sessions and an 84% assessment completion rate. Intervention acceptability was high, and participants found the sessions helpful in managing stress related to the phase 1 oncology trial patient experience. Participants showed reductions in worry and isolation and stress. SIGNIFICANCE OF RESULTS The P1CaLL study demonstrated adequate acceptability and limited feasibility and provided data on the general impact of the intervention on caregiver distress and other psychosocial outcomes. Caregivers of phase 1 oncology trial patients would benefit from supportive care services; a telephone-based intervention may have more utilization and thus make a larger impact.
Collapse
Affiliation(s)
- Alaina L. Carr
- Department of Psychology, University of Colorado Denver, Denver, CO, USA
- Lombardi Comprehensive Cancer Center, Cancer Prevention and Control, Washington, DC, USA
| | - Emily Bilenduke
- Department of Psychology, University of Colorado Denver, Denver, CO, USA
| | - Esmeralda Adolf
- Department of Psychology, University of Colorado Denver, Denver, CO, USA
| | - Elizabeth R. Kessler
- Division of Medical Oncology, Department of Medicine, University of Colorado, Aurora, CO, USA
| | - Joanna J. Arch
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA
| | - Krista W. Ranby
- Department of Psychology, University of Colorado Denver, Denver, CO, USA
| | - Kristin Kilbourn
- Department of Psychology, University of Colorado Denver, Denver, CO, USA
| |
Collapse
|
10
|
Van Goethem V, Dierickx S, Matthys O, Northouse L, Lund L, Jordan C, Turola E, van der Wel M, Scott D, Harding R, Deliens L, Lapeire L, Hudson P, De Vleminck A, Cohen J. A self-management psychoeducational eHealth program to support and empower people with advanced cancer and their family caregivers: Development using the scrum methodology. Internet Interv 2023; 33:100659. [PMID: 37593143 PMCID: PMC10428037 DOI: 10.1016/j.invent.2023.100659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 07/13/2023] [Accepted: 08/08/2023] [Indexed: 08/19/2023] Open
Abstract
Background eHealth programs could be a flexible and scalable resource to support and empower people with advanced cancer and their family caregivers. A face-to-face intervention that has demonstrated effectiveness is the "FOCUS" program, developed and tested in the USA. Recently the FOCUS program was translated and adapted to the European context as part of an international study in six European countries, resulting in the "FOCUS+" program. FOCUS+ served as the basis for development of the web-based iFOCUS program. Objective We aim to (1) describe the development process of the iFOCUS program, (2) outline the challenges we encountered and how they were overcome, and (3) present findings regarding the acceptability and usability of iFOCUS. Methods We used the four phased agile Scrum methodology to develop iFOCUS and applied set timeframes of rapid program development and evaluation (sprints). Five teams were involved in the development i.e. a core development group, a web development team, an international consortium, audio-visual experts, and potential end-users. Results Development followed seven steps, integrated across the four phases of Scrum: (1) concept design, (2) development of mock-ups, (3) Feedback from the international consortium, (4) technical development of iFOCUS, (5) creating versions for the six participating countries, (6) preliminary testing of iFOCUS and (7) implementing the final version in a randomized controlled trial. User testing included 42 participants (twenty patient-family caregiver dyads and two bereaved family caregivers) who reviewed the iFOCUS program. Users found the iFOCUS program to be acceptable and usable. Feedback mainly focused on text size and fonts. Minor changes to the content, tailoring, and program flow were required. During development we encountered program specific and general challenges. Using the Scrum methodology facilitated iterative development to address these issues. For some challenges, such as tailoring, we had to make pragmatic choices due to time and resource limitations. Conclusions/discussion The development of a tailored, self-managed psychoeducational eHealth program for people with advanced cancer and their family caregivers is an intense process and requires pragmatic choices. By keeping the emphasis on the target population during development, no specific remarks pertaining to advanced cancer were identified. Some challenges we encountered are common to eHealth development, others were related to program specific requirements. Using the Scrum methodology allows teams to efficiently collaborate during program development and increases the flexibility of the development process. Interpersonal contact between research staff and potential end-users is recommended during and after the development of eHealth programs.
Collapse
Affiliation(s)
- Vincent Van Goethem
- Vrije Universiteit Brussel (VUB) & Ghent University, End-of-life Care Research Group, Laarbeeklaan 103, 1090 Brussels, Belgium
- Ghent University, Department of Public Health and Primary Care, C. Heymanslaan 10, 9000 Ghent, Belgium
- Vrije Universiteit Brussel (VUB), Department of Family Medicine and Chronic Care, Laarbeeklaan 103, 1090 Brussels, Belgium
| | - Sigrid Dierickx
- Vrije Universiteit Brussel (VUB) & Ghent University, End-of-life Care Research Group, Laarbeeklaan 103, 1090 Brussels, Belgium
- Ghent University, Department of Public Health and Primary Care, C. Heymanslaan 10, 9000 Ghent, Belgium
- Vrije Universiteit Brussel (VUB), Department of Family Medicine and Chronic Care, Laarbeeklaan 103, 1090 Brussels, Belgium
| | - Orphé Matthys
- Vrije Universiteit Brussel (VUB) & Ghent University, End-of-life Care Research Group, Laarbeeklaan 103, 1090 Brussels, Belgium
- Ghent University, Department of Public Health and Primary Care, C. Heymanslaan 10, 9000 Ghent, Belgium
- Vrije Universiteit Brussel (VUB), Department of Family Medicine and Chronic Care, Laarbeeklaan 103, 1090 Brussels, Belgium
| | | | - Line Lund
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Palliative Care Research Unit, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Catherine Jordan
- University College Dublin, National University of Ireland, Dublin, Ireland
| | - Elena Turola
- Scientific Directorate, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | - David Scott
- The School of Nursing and Midwifery, Queen's University of Belfast, Belfast, United Kingdom
| | - Richard Harding
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, United Kingdom
| | - Luc Deliens
- Vrije Universiteit Brussel (VUB) & Ghent University, End-of-life Care Research Group, Laarbeeklaan 103, 1090 Brussels, Belgium
- Ghent University, Department of Public Health and Primary Care, C. Heymanslaan 10, 9000 Ghent, Belgium
- Vrije Universiteit Brussel (VUB), Department of Family Medicine and Chronic Care, Laarbeeklaan 103, 1090 Brussels, Belgium
| | - Lore Lapeire
- Vrije Universiteit Brussel (VUB) & Ghent University, End-of-life Care Research Group, Laarbeeklaan 103, 1090 Brussels, Belgium
- Ghent University Hospital, Department of Medical Oncology, C. Heymanslaan 10, 9000 Ghent, Belgium
| | | | - Peter Hudson
- Vrije Universiteit Brussel (VUB) & Ghent University, End-of-life Care Research Group, Laarbeeklaan 103, 1090 Brussels, Belgium
- St Vincent's Hospital and the Univeristy of Melbourne, Centre of Palliative Care, Melbourne, Australia
| | - Aline De Vleminck
- Vrije Universiteit Brussel (VUB) & Ghent University, End-of-life Care Research Group, Laarbeeklaan 103, 1090 Brussels, Belgium
- Vrije Universiteit Brussel (VUB), Department of Family Medicine and Chronic Care, Laarbeeklaan 103, 1090 Brussels, Belgium
| | - Joachim Cohen
- Vrije Universiteit Brussel (VUB) & Ghent University, End-of-life Care Research Group, Laarbeeklaan 103, 1090 Brussels, Belgium
- Vrije Universiteit Brussel (VUB), Department of Family Medicine and Chronic Care, Laarbeeklaan 103, 1090 Brussels, Belgium
| |
Collapse
|
11
|
Lamarche J, Cusson A, Nissim R, Avery J, Wong J, Maheu C, Lambert SD, Laizner AM, Jones J, Esplen MJ, Lebel S. It's time to address fear of cancer recurrence in family caregivers: usability study of an virtual version of the Family Caregiver-Fear Of Recurrence Therapy (FC-FORT). Front Digit Health 2023; 5:1129536. [PMID: 37671170 PMCID: PMC10475944 DOI: 10.3389/fdgth.2023.1129536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 06/19/2023] [Indexed: 09/07/2023] Open
Abstract
Background Family caregivers of cancer survivors experience equal or greater levels of fear of cancer recurrence (FCR) than survivors themselves. Some interventions have demonstrated their ability to reduce FCR among cancer survivors and dyads (patient and caregivers). However, to date, no validated intervention exists to focus solely on family caregiver's FCR. Objectives This study aimed to (1) adapt the evidence-based in-person Fear Of Recurrence Therapy (FORT) for family caregivers (referred here in as FC-FORT) and to a virtual delivery format and (2) test its usability when offered virtually. Methods The adaptation of FC-FORT was overseen by an advisory board and guided by the Information Systems Research Framework. Following this adaptation, female family caregivers and therapists were recruited for the usability study. Participants took part in 7 weekly virtual group therapy sessions, a semi-structured exit interview and completed session feedback questionnaires. Therapists were offered a virtual training and weekly supervision. Fidelity of treatment administration was assessed each session. Quantitative data were analyzed using descriptive statistics. Exit interviews were transcribed verbatim using NVivo Transcription and coded using conventional content analysis. Results were presented back to the advisory board to further refine FC-FORT. Results The advisory board (n = 16) met virtually on 7 occasions to adapt FC-FORT (i.e., patient manuals, virtual format) and discuss recruitment strategies. Minor (e.g., revised text, adapted materials to virtual format) and major adaptations (e.g., added and rearranged sessions) were made to FC-FORT and subsequently approved by the advisory board. Four family caregivers and three therapists took part in the first round of the usability testing. Six family caregivers and the same three therapists took part in the second round. Overall, participants were very satisfied with FC-FORT's usability. Qualitative analysis identified 4 key themes: usability of FC-FORT, satisfaction and engagement with content, group cohesion, and impact of FC-FORT. All participants indicated that they would recommend FC-FORT to others as is. Conclusions Using a multidisciplinary advisory board, our team successfully adapted FC-FORT and tested its usability using videoconferencing. Results from this study indicate that the efficacy and acceptability of FC-FORT are now ready to be tested in a larger pilot study.
Collapse
Affiliation(s)
- Jani Lamarche
- Faculty of Social Sciences, School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Angélica Cusson
- Faculty of Social Sciences, School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Rinat Nissim
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Jonathan Avery
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Jiahui Wong
- Cancer Chat De Souza Institute, University Health Network, Toronto, ON, Canada
| | - Christine Maheu
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
| | - Sylvie D Lambert
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
- St. Mary's Research Centre, St. Mary's Hospital Center, Montreal, QC, Canada
| | - Andrea M Laizner
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
- Research Institute of the McGill University Health Centre, McGill University Health Centre, Montreal, QC, Canada
| | - Jennifer Jones
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Mary Jane Esplen
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Sophie Lebel
- Faculty of Social Sciences, School of Psychology, University of Ottawa, Ottawa, ON, Canada
| |
Collapse
|
12
|
Lin Y, Porter LS, Chee W, Alese OB, Curseen KA, Higgins MK, Northouse L, Xiao C. A Web-Based Dyadic Intervention to Manage Psychoneurological Symptoms for Patients With Colorectal Cancer and Their Caregivers: Protocol for a Mixed Methods Study. JMIR Res Protoc 2023; 12:e48499. [PMID: 37379055 PMCID: PMC10365620 DOI: 10.2196/48499] [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: 05/05/2023] [Revised: 05/25/2023] [Accepted: 05/26/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Patients with colorectal cancer (CRC) receiving chemotherapy often experience psychoneurological symptoms (PNS; ie, fatigue, depression, anxiety, sleep disturbance, pain, and cognitive dysfunction) that negatively impact both patients' and their caregivers' health outcomes. Limited information is available on PNS management for CRC patient and caregiver dyads. OBJECTIVE The purposes of this study are to (1) develop a web-based dyadic intervention for patients with CRC receiving chemotherapy and their caregivers (CRCweb) and (2) evaluate the feasibility, acceptability, and preliminary effects of CRCweb among patient-caregiver dyads in a cancer clinic. METHODS A mixed methods approach will be used. Semistructured interviews among 8 dyads will be conducted to develop CRCweb. A single-group pre- and posttest clinical trial will be used to examine the feasibility, acceptability, and preliminary effects of the intervention (CRCweb) among 20 dyads. Study assessments will be conducted before (T1) and after intervention (T2). Content analysis will be performed for semistructured interviews. Descriptive statistics will be calculated separately for patients and caregivers, and pre-post paired t tests will be used to evaluate treatment effects. RESULTS This study was funded in November 2022. As of April 2023, we have obtained institutional review board approval and completed clinical trial registration and are currently recruiting patient-caregiver dyads in a cancer clinic. The study is expected to be completed in October 2024. CONCLUSIONS Developing a web-based dyadic intervention holds great promise to reduce the PNS burden in patients with CRC receiving chemotherapy and their caregivers. The findings from this study will advance intervention development and implementation of symptom management and palliative care for patients with cancer and their caregivers. TRIAL REGISTRATION ClinicalTrials.gov NCT05663203; https://clinicaltrials.gov/ct2/show/NCT05663203. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/48499.
Collapse
Affiliation(s)
- Yufen Lin
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, United States
| | - Laura S Porter
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Duke University, Durham, NC, United States
| | - Wonshik Chee
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, United States
| | - Olatunji B Alese
- Winship Cancer Institute, Emory University, Atlanta, GA, United States
| | | | - Melinda K Higgins
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, United States
| | - Laurel Northouse
- School of Nursing, University of Michigan, Ann Arbor, MI, United States
| | - Canhua Xiao
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, United States
| |
Collapse
|
13
|
Zhai S, Chu F, Tan M, Chi NC, Ward T, Yuwen W. Digital health interventions to support family caregivers: An updated systematic review. Digit Health 2023; 9:20552076231171967. [PMID: 37223775 PMCID: PMC10201006 DOI: 10.1177/20552076231171967] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 04/10/2023] [Indexed: 05/25/2023] Open
Abstract
Objective Chronic diseases are the leading causes of death and disability in the U.S., and disease management largely falls onto patients' family caregivers. The long-term burden and stress of caregiving negatively impact caregivers' well-being and ability to provide care. Digital health interventions have the potential to support caregivers. This article aims to provide an updated review of interventions using digital health tools to support family caregivers and the scope of the Human-Centered Design (HCD) approaches. Methods We conducted a systematic search on July 2019 and January 2021 in PubMed, CINAHL, Embase, Cochrane Library, PsycINFO, ERIC, and ACM Digital Library, limiting to 2014-2021 to identify family caregiver interventions assisted by modern technologies. The Mixed Methods Appraisal Tool and the Grading of Recommendations Assessment, Development and Evaluation were used to evaluate the articles. Data were abstracted and evaluated using Rayyan and Research Electronic Data Capture. Results We identified and reviewed 40 studies from 34 journals, 10 fields, and 19 countries. Findings included patients' conditions and relationships with family caregivers, how the technology is used to deliver the intervention, HCD methods, theoretical frameworks, components of the interventions, and family caregiver health outcomes. Conclusion This updated and expanded review revealed that digitally enhanced health interventions were robust at providing high-quality assistance and support to caregivers by improving caregiver psychological health, self-efficacy, caregiving skills, quality of life, social support, and problem-coping abilities. Health professionals need to include informal caregivers as an essential component when providing care to patients. Future research should include more marginalized caregivers from diverse backgrounds, improve the accessibility and usability of the technology tools, and tailor the intervention to be more culturally and linguistically sensitive.
Collapse
Affiliation(s)
- Shumenghui Zhai
- School of Nursing, University of Washington, Seattle, WA, USA
| | - Frances Chu
- School of Nursing, University of Washington, Seattle, WA, USA
- Providence Health System, Swedish First Hill, Seattle, WA, USA
| | - Minghui Tan
- School of Nursing, Peking Union Medical University, Beijing, China
| | - Nai-Ching Chi
- College of Nursing, University of Iowa, Iowa City, IA, USA
| | - Teresa Ward
- School of Nursing, University of Washington, Seattle, WA, USA
| | - Weichao Yuwen
- School of Nursing & Healthcare Leadership, University of Washington Tacoma, Tacoma, WA, USA
| |
Collapse
|
14
|
Tibell LH, Alvariza A, Kreicbergs U, Wallin V, Steineck G, Holm M. Web-based support for spouses of patients with life-threatening illness cared for in specialized home care - A feasibility study. Palliat Support Care 2022:1-9. [PMID: 36537025 DOI: 10.1017/s1478951522001602] [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: 12/24/2022]
Abstract
OBJECTIVES Psychoeducational interventions for family caregivers have shown to be effective but not possible for all caregivers to attend; thus, web-based interventions may be a complement. This study aimed to evaluate feasibility of a web-based intervention, "narstaende.se," from the perspective of spouses of patients receiving specialized home care. METHODS A website was developed, containing videos with conversations between health-care professionals and family caregivers (actors), informative texts, links to further information, and a chat forum. The aim of the website is to provide support and promote preparedness for caregiving and death, and the content is theoretically and empirically grounded. The study had a descriptive cross-sectional design. Altogether, 26 spouses answered a questionnaire, before accessing the website, and 4 weeks after this, 12 spouses were interviewed. Descriptive statistics and qualitative content analysis were used. RESULTS Spouses experienced the website as being easy to use, welcoming, and with relevant content. Participating spouses would recommend "narstaende.se" to others in similar situations, and the majority found the website introduced timely. Videos seemed easily accessible and were most used, contributing to a feeling of recognition and sharing the situation. The online format was perceived as flexible, but still not all spouses visited the website, stating the desire for support in real life. SIGNIFICANCE OF RESULTS A web-based intervention can be feasible for spouses in specialized home care; however, the digital format is not suitable for everyone. Further research is needed to determine the website's potential to provide support and increase preparedness for family caregivers in general.
Collapse
Affiliation(s)
- Louise Häger Tibell
- The Department of Health Care Science/Palliative Research Centre, Marie Cederschiöld University, Stockholm, Sweden
- Theme Cancer, BES: Breast-Endocrine Tumours and Sarcoma, Karolinska University Hospital, Stockholm, Sweden
| | - Anette Alvariza
- The Department of Health Care Science/Palliative Research Centre, Marie Cederschiöld University, Stockholm, Sweden
- Stockholms Sjukhem, Research and Development Unit/Palliative Care, Stockholms Sjukhem Foundation, Stockholm, Sweden
| | - Ulrika Kreicbergs
- The Department of Health Care Science/Palliative Research Centre, Marie Cederschiöld University, Stockholm, Sweden
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Viktoria Wallin
- The Department of Health Care Science/Palliative Research Centre, Marie Cederschiöld University, Stockholm, Sweden
| | - Gunnar Steineck
- Department of Clinical Cancer Epidemiology, Karolinska Institutet, Stockholm, Sweden
- Division of Clinical Cancer Epidemiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Maja Holm
- The Department of Health Care Science/Palliative Research Centre, Marie Cederschiöld University, Stockholm, Sweden
- Department of Nursing Science, Sophiahemmet University, Stockholm, Sweden
| |
Collapse
|
15
|
Coumoundouros C, Mårtensson E, Ferraris G, Zuidberg JM, von Essen L, Sanderman R, Woodford J. Implementation of e-Mental Health Interventions for Informal Caregivers of Adults With Chronic Diseases: Mixed Methods Systematic Review With a Qualitative Comparative Analysis and Thematic Synthesis. JMIR Ment Health 2022; 9:e41891. [PMID: 36314782 PMCID: PMC9752475 DOI: 10.2196/41891] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 10/25/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Informal caregivers commonly experience mental health difficulties related to their caregiving role. e-Mental health interventions provide mental health support in a format that may be more accessible to informal caregivers. However, e-mental health interventions are seldom implemented in real-world practice. OBJECTIVE This mixed methods systematic review aimed to examine factors associated with the effectiveness and implementation of e-mental health interventions for informal caregivers of adults with chronic diseases. To achieve this aim, two approaches were adopted: combinations of implementation and intervention characteristics sufficient for intervention effectiveness were explored using qualitative comparative analysis, and barriers to and facilitators of implementation of e-mental health interventions for informal caregivers were explored using thematic synthesis. METHODS We identified relevant studies published from January 1, 2007, to July 6, 2022, by systematically searching 6 electronic databases and various secondary search strategies. Included studies reported on the effectiveness or implementation of e-mental health interventions for informal caregivers of adults with cancer, chronic obstructive pulmonary disease, dementia, diabetes, heart disease, or stroke. Randomized controlled trials reporting on caregivers' mental health outcomes were included in a crisp-set qualitative comparative analysis. We assessed randomized controlled trials for bias using the Risk of Bias 2.0 tool, and we assessed how pragmatic or explanatory their trial design was using the Pragmatic Explanatory Continuum Indicator Summary 2 tool. Studies of any design reporting on implementation were included in a thematic synthesis using the Consolidated Framework for Implementation Research to identify barriers to and facilitators of implementation. RESULTS Overall, 53 reports, representing 29 interventions, were included in the review. Most interventions (27/29, 93%) focused on informal cancer or dementia caregivers. In total, 14 reports were included in the qualitative comparative analysis, exploring conditions including the presence of peer or professional support and key persuasive design features. Low consistency and coverage prevented the determination of condition sets sufficient for intervention effectiveness. Overall, 44 reports were included in the thematic synthesis, and 152 barriers and facilitators were identified, with the majority related to the intervention and individual characteristic domains of the Consolidated Framework for Implementation Research. Implementation barriers and facilitators in the inner setting (eg, organizational culture) and outer setting (eg, external policies and resources) domains were largely unexplored. CONCLUSIONS e-Mental health interventions for informal caregivers tend to be well-designed, with several barriers to and facilitators of implementation identified related to the intervention and individual user characteristics. Future work should focus on exploring the views of stakeholders involved in implementation to determine barriers to and facilitators of implementing e-mental health interventions for informal caregivers, focusing on inner and outer setting barriers and facilitators. TRIAL REGISTRATION PROSPERO (International Prospective Register of Systematic Reviews) CRD42020155727; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020155727. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1136/bmjopen-2019-035406.
Collapse
Affiliation(s)
- Chelsea Coumoundouros
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Erika Mårtensson
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.,Centre for Gender Research, Uppsala University, Uppsala, Sweden
| | - Giulia Ferraris
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | | | - Louise von Essen
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Robbert Sanderman
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.,Department of Psychology, Health and Technology, University of Twente, Enschede, Netherlands
| | - Joanne Woodford
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| |
Collapse
|
16
|
Isabel V, Joachim C, Peter H, Chantal VA, Luc D, Aline DV. Support from healthcare professionals in empowering family carers to discuss advance care planning: A population-based survey. Palliat Med 2022; 37:719-729. [PMID: 36349646 DOI: 10.1177/02692163221135032] [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] [Indexed: 11/11/2022]
Abstract
BACKGROUND Family carers have a prominent role in end-of-life care for seriously ill persons. However, most of the Advance Care Planning literature is focused on the role of healthcare professionals. AIMS To investigate (1) what proportion of family carers discussed advance care planning with their relative and associated socio-demographic and clinical characteristics (2) what proportion received support from healthcare professionals for these conversations, (3) what type of support they received and (4) to what extent the type of support received was considered sufficient. DESIGN/PARTICIPANTS Population-based cross-sectional survey in Belgium of bereaved family carers of persons with a serious chronic illness (N = 3000) who died 2-6 months before the sample was drawn, identified through three sickness funds. The survey explored support from healthcare professionals for family carers during the last 3 months of the patient's life. RESULTS Response rate was 55%. The proportion of family carers that engaged in an advance care planning conversation with their relative was 46.9%. Of these family carers, 78.1% received support from a healthcare professional, mostly by doing the advance care planning conversation together (53.8%). Of family carers receiving support from a healthcare professional, 57.4% deemed the support sufficient. CONCLUSION Many family carers engage in advance care planning conversations with their dying relative. Healthcare professionals often support them by performing the advance care planning conversations together. More insight into how family carers can be supported to conduct these advance care planning conversations, both with and without involvement of healthcare professionals, is necessary.
Collapse
Affiliation(s)
- Vandenbogaerde Isabel
- End-of-life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Ghent, Belgium.,Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.,Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel (VUB), Brussel, Belgium
| | - Cohen Joachim
- End-of-life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Ghent, Belgium.,Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel (VUB), Brussel, Belgium
| | - Hudson Peter
- End-of-life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Ghent, Belgium.,Centre for Palliative Care, St Vincents Hospital, The University of Melbourne, Melbourne, Australia
| | | | - Deliens Luc
- End-of-life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Ghent, Belgium.,Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.,Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel (VUB), Brussel, Belgium
| | - De Vleminck Aline
- End-of-life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Ghent, Belgium.,Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel (VUB), Brussel, Belgium
| |
Collapse
|
17
|
Otto AK, Ketcher D, Reblin M, Terrill AL. Positive Psychology Approaches to Interventions for Cancer Dyads: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13561. [PMID: 36294142 PMCID: PMC9602591 DOI: 10.3390/ijerph192013561] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 10/14/2022] [Accepted: 10/16/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE Positive psychology approaches (PPAs) to interventions focus on developing positive cognitions, emotions, and behavior. Benefits of these interventions may be compounded when delivered to interdependent dyads. However, dyadic interventions involving PPAs are relatively new in the cancer context. This scoping review aimed to provide an overview of the available research evidence for use of dyadic PPA-based interventions in cancer and identify gaps in this literature. METHODS Following PRISMA guidelines, we conducted a scoping review of intervention studies that included PPAs delivered to both members of an adult dyad including a cancer patient and support person (e.g., family caregiver, intimate partner). RESULTS Forty-eight studies, including 39 primary analyses and 28 unique interventions, were included. Most often (53.8%), the support person in the dyad was broadly defined as a "caregiver"; the most frequent specifically-defined role was spouse (41.0%). PPAs (e.g., meaning making) were often paired with other intervention components (e.g., education). Outcomes were mostly individual well-being or dyadic coping/adjustment. CONCLUSIONS Wide variability exists in PPA type/function and their targeted outcomes. More work is needed to refine the definition/terminology and understand specific mechanisms of positive psychology approaches.
Collapse
Affiliation(s)
- Amy K. Otto
- University of Minnesota Medical School, Duluth Campus, Duluth, MN 55812, USA
| | - Dana Ketcher
- University of Minnesota Medical School, Duluth Campus, Duluth, MN 55812, USA
| | - Maija Reblin
- College of Medicine, University of Vermont, Burlington, VT 05405, USA
| | - Alexandra L. Terrill
- Department of Occupational & Recreational Therapies, University of Utah, Salt Lake City, UT 84112, USA
| |
Collapse
|
18
|
Feasibility study of a self-guided internet-based intervention for family caregivers of patients with cancer (OAse). Sci Rep 2022; 12:16713. [PMID: 36202913 PMCID: PMC9537301 DOI: 10.1038/s41598-022-21157-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 09/23/2022] [Indexed: 12/05/2022] Open
Abstract
Despite high levels of distress, family caregivers of patients with cancer rarely seek psychosocial support and Internet-based interventions (IBIs) are a promising approach to reduce some access barriers. Therefore, we developed a self-guided IBI for family caregivers of patients with cancer (OAse), which, in addition to patients' spouses, also addresses other family members (e.g., adult children, parents). This study aimed to determine the feasibility of OAse (recruitment, dropout, adherence, participant satisfaction). Secondary outcomes were caregivers’ self-efficacy, emotional state, and supportive care needs. N = 41 family caregivers participated in the study (female: 65%), mostly spouses (71%), followed by children (20%), parents (7%), and friends (2%). Recruitment (47%), retention (68%), and adherence rates (76% completed at least 4 of 6 lessons) support the feasibility of OAse. Overall, the results showed a high degree of overall participant satisfaction (96%). There were no significant pre-post differences in secondary outcome criteria, but a trend toward improvement in managing difficult interactions/emotions (p = .06) and depression/anxiety (p = .06). Although the efficacy of the intervention remains to be investigated, our results suggest that OAse can be well implemented in caregivers’ daily lives and has the potential to improve family caregivers’ coping strategies.
Collapse
|
19
|
Pang X, Jin Y, Wang H. Effectiveness and moderators of cancer patient-caregiver dyad interventions in improving psychological distress: A systematic review and meta-analysis. Asia Pac J Oncol Nurs 2022; 9:100104. [PMID: 35990241 PMCID: PMC9382138 DOI: 10.1016/j.apjon.2022.100104] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 05/30/2022] [Indexed: 11/27/2022] Open
Abstract
Objective As patients and family caregivers are increasingly viewed as a dyadic whole, growing studies have emerged that identify ways to improve the two parties’ emotional distress. However, the specific effectiveness, quality, and optimal intervention details of these studies are unclear. Our objective is to synthesize the effectiveness of existing dyadic interventions for improving the psychological distress of cancer patient-caregiver dyads and identify potential moderators that influence intervention effectiveness. Methods PubMed, Cochrane Library, Web of Science, CINHAL, Embase, and Clinical Trials were searched to identify all randomized controlled trials from inception until June 2021. Two reviewers performed the process independently. The Cochrane Risk of Bias tool was used for quality assessment. We calculated effect sizes (Hedges’ adjusted g) by standard mean difference. Potential moderators influencing the intervention effects were explored. Results We included 28 articles, of which 12 were available for meta-analysis. In total, 4784 participants were included, who were primarily middle-aged (M = 58 years old), with the highest proportion reporting a diagnosis of “mixed cancer” (30%). Patients’ anxiety (g = −0.31; 95% CI: −0.51 to −0.12; P = 0.001; I2 = 17%) and cancer-related distress (g = −0.32; 95% CI: −0.46 to −0.18; P < 0.0001; I2 = 0%) were statistically significantly improved from baseline to post-intervention. Interventionist, delivery type, duration, and frequency were potential moderators for psychosocial interventions on negative emotions. Conclusions Face-to-face, relatively shorter interventions led by psychologists in moderator analysis seem to have better performance. Cancer dyad-based interventions were efficacious in improving the emotional distress of both parties in the dyad, but the effect was more apparent in patients than in family caregivers. However, the long-term effects were modest for both groups.
Collapse
Affiliation(s)
- Xuenan Pang
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Yanfei Jin
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Honghong Wang
- Xiangya School of Nursing, Central South University, Changsha, China
| |
Collapse
|
20
|
Wan SW, Chng YJD, Lim SH, Chong CS, Pikkarainen M, He HG. A systematic review and meta-analysis on the effectiveness of web-based psychosocial interventions among patients with colorectal cancer. J Adv Nurs 2022; 78:1883-1896. [PMID: 35441711 DOI: 10.1111/jan.15258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 02/14/2022] [Accepted: 03/23/2022] [Indexed: 11/27/2022]
Abstract
AIMS To synthesize the effectiveness of web-based psychosocial interventions on self-efficacy, anxiety, depression, quality of life (QoL), non-specific psychological and cancer-specific distress among patients with colorectal cancer (CRC). DESIGN A systematic review and meta-analysis. DATA SOURCES Six databases (PubMed, PsycINFO, Embase, Scopus, CINAHL and CNKI) were searched from inception to December 2021. REVIEW METHODS Experimental/quasi-experimental studies involving patients with CRC for the improvement of aforementioned outcomes were included. Two reviewers screened and extracted the data, and assessed studies' methodological quality using risk of bias tools. Meta-analyses and narrative syntheses were performed. RESULTS Nineteen studies consisting of 1386 participants were identified. Cognitive-behavioural therapy delivered online was the most common trialled web-based psychosocial intervention. Meta-analyses revealed no positive effect for self-efficacy (standardized mean difference 0.93, 95% CI: 0.52 to 1.35, p < .01) and minimal benefit for QoL (mean difference [MD] 2.83, 95% CI: -0.31 to 5.98, p = .08) but significant positive effects for anxiety (MD -2.23, 95% CI: -3.31 to -1.14, p < .01) and depression (MD -2.84, 95% CI: -4.09 to -1.59, p < .01) among CRC survivors in the intervention group as compared with the control group. Narrative synthesis suggested possible benefits in reducing distress. CONCLUSION Web-based psychosocial interventions are promising alternatives to conventional delivery methods in reducing patients' anxiety, depression and distress. However, evidence on self-efficacy and QoL remains inconsistent. More adequately powered, well-designed trials with targeted and theory-based interventions are required to ascertain findings. IMPACT By highlighting the potential of web-based psychosocial interventions in reducing anxiety and depression among CRC survivors, this review has put forth beneficial information supporting the use and acceptance of web-based care delivery in light of COVID-19 restrictions and nationwide lockdowns. Meanwhile, the paucity of empirical support reflects the necessity of more extensive research to test and improve other health outcomes. PROSPERO registration number: CRD42021261396.
Collapse
Affiliation(s)
- Su Wei Wan
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- National University Health System, Singapore
| | | | - Siew Hoon Lim
- Nursing Division (Research), Singapore General Hospital, Singapore
| | - Choon Seng Chong
- National University Health System, Singapore
- Division of Colorectal Surgery and Surgical Oncology, Department of Surgery, National University Cancer Institute, National University Hospital, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Minna Pikkarainen
- Chalmers University of Technology, Goteborg, Sweden
- Oslomet, Oslo Metropolitan University, Oslo, Norway
- University of Oulu, Oulu, Finland
| | - Hong-Gu He
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- National University Health System, Singapore
| |
Collapse
|
21
|
Kamen CS, Hastert TA, Mulvaney M, Hosea F, VanBergen AM, Fakih A, Larkin K, Killingsworth E, Thompson HS. Community-Driven Identification and Adaptation of a Cancer Caregiving Intervention for LGBTQIA Populations. Front Oncol 2022; 12:873491. [PMID: 35800052 PMCID: PMC9253545 DOI: 10.3389/fonc.2022.873491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 05/27/2022] [Indexed: 12/03/2022] Open
Abstract
Background Lesbian, gay, bisexual, transgender, and other LGBTQIA cancer patients experience significant disparities in cancer-related outcomes. Their relationships may not be acknowledged in care systems designed to serve primarily heterosexual and cisgender (H/C) patients, and resources for partners and caregivers of H/C patients may not address the needs of LGBTQIA caregivers. Tailored interventions are needed to address disparities in LGBTQIA patients and caregivers. Methods To address this gap, researchers from Karmanos Cancer Institute in Detroit, MI and Wilmot Cancer Institute in Rochester, NY worked with a cancer action council (CAC) of LGBTQIA stakeholders with lived experience of cancer in a community-academic partnership. This group used the ADAPT-ITT model to guide their process of assessing needs in this community, identifying evidence-based interventions that could be adapted to meet those needs, and beginning the process of adapting an existing intervention to meet the needs of a new population. Results In the Assessment phase of the model, CAC members shared their own experiences and concerns related to cancer and identified cancer caregiving as a priority area for intervention. In the Decision-Making phase of the model, researchers and CAC members performed a review of the literature on interventions that reported outcomes for cancer caregiver, identifying 13 promising interventions. Each of these interventions was evaluated over a series of meetings using a scoring rubric. Based on this rubric, the FOCUS intervention was established as an appropriate target for adaptation to the LGBTQIA population. In the first stage of the Adaptation phase, CAC members reacted to the intervention content and identified principal components for adaptation. Conclusion While the FOCUS intervention adaptation is still in process, this manuscript can serve as a guide for others establishing community-academic partnerships to adapt interventions, as well as those developing interventions and resources for LGBTQIA persons coping with cancer.
Collapse
Affiliation(s)
- Charles S. Kamen
- Cancer Control Unit, Department of Surgery, University of Rochester, Rochester, NY, United States
- *Correspondence: Charles S. Kamen,
| | - Theresa A. Hastert
- Karmanos Cancer Institute, Department of Oncology, Wayne State University, Detroit, MI, United States
| | - Megan Mulvaney
- Karmanos Cancer Institute, Department of Oncology, Wayne State University, Detroit, MI, United States
| | - Forrest Hosea
- Karmanos Cancer Institute, Department of Oncology, Wayne State University, Detroit, MI, United States
| | - Alexandra M. VanBergen
- Cancer Control Unit, Department of Surgery, University of Rochester, Rochester, NY, United States
| | - Ali Fakih
- Karmanos Cancer Institute, Department of Oncology, Wayne State University, Detroit, MI, United States
| | - Knoll Larkin
- National LGBT Cancer Network, New York, NY, United States
| | | | - Hayley S. Thompson
- Karmanos Cancer Institute, Department of Oncology, Wayne State University, Detroit, MI, United States
| |
Collapse
|
22
|
Caregiver burden in the advanced stage cancer Patient's caregiver: A concept analysis. Eur J Oncol Nurs 2022; 60:102152. [DOI: 10.1016/j.ejon.2022.102152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 04/01/2022] [Accepted: 06/07/2022] [Indexed: 11/17/2022]
|
23
|
Goria S, Girgis A, Shaw J, Przezdziecki A, Levesque J, Bamgboje‐Ayodele A. A Delphi‐based approach to developing the contents of an online resource, Care Assist, for male caregivers of women with breast cancer. Psychooncology 2022; 31:1474-1482. [PMID: 35575006 PMCID: PMC9543824 DOI: 10.1002/pon.5962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/19/2022] [Accepted: 05/05/2022] [Indexed: 11/30/2022]
Abstract
Objective Informal male caregivers of women with breast cancer (BC) have significant psychological, emotional, and social burdens that are inadequately addressed by current face‐to‐face interventions. Online interventions overcome barriers that limit engagement with face‐to‐face interventions. This study aimed to develop the contents of Care Assist, an online supportive care resource for male caregivers of BC patients, through expert consensus. Methods A Delphi study comprising two survey rounds and an expert consultation was conducted. In Round 1, experts in BC care rated the importance of 25 content items. In Round 2, they re‐rated content items that failed to reach consensus (i.e. 80% agreement) in Round 1 or were newly developed. Free‐text responses were also collected. During expert consultation, the resource was reviewed and revised for clarity. Iterative refinement followed all rounds. Quantitative data was analysed descriptively, and qualitative data was analysed using content analysis. Results Twenty‐two experts participated and reached consensus on 96% of items, with 217 comments provided on: (a) the perceived benefits of Care Assist to caregivers and care recipients, (b) recommendations of newly suggested content items, wording, and use of external links, and (c) concerns regarding information overload and need for tailoring. The expert consultation comments focused on clarifying scope, wording, and information tailoring. Conclusion The rigorous Delphi process resulted in the content for a comprehensive online supportive care intervention for male caregivers. Information overload can be minimised through self‐identification of needs and utilisation of eHealth to personalise the resource for the heterogeneous male caregiver population.
Collapse
Affiliation(s)
- Sandra Goria
- Ingham Institute for Applied Medical Research Sydney Australia
- South Western Sydney Clinical School Faculty of Medicine and Health University of New South Wales Liverpool Australia
| | - Afaf Girgis
- Ingham Institute for Applied Medical Research Sydney Australia
- South Western Sydney Clinical School Faculty of Medicine and Health University of New South Wales Liverpool Australia
| | - Joanne Shaw
- Psycho‐oncology Co‐operative Research Group (PoCoG) University of Sydney Sydney Australia
| | - Astrid Przezdziecki
- South Western Sydney Clinical School Faculty of Medicine and Health University of New South Wales Liverpool Australia
- Liverpool Hospital South Western Sydney Local Health District Liverpool Australia
| | - Janelle Levesque
- School of Psychological Sciences Faculty of Medicine Nursing and Health Sciences Monash University Melbourne Australia
| | - Adeola Bamgboje‐Ayodele
- Ingham Institute for Applied Medical Research Sydney Australia
- South Western Sydney Clinical School Faculty of Medicine and Health University of New South Wales Liverpool Australia
- School of Medical Sciences Biomedical Informatics and Digital Health Faculty of Medicine and Health University of Sydney Sydney Australia
| |
Collapse
|
24
|
Wittmann D, Mehta A, Bober SL, Zhu Z, Daignault-Newton S, Dunn RL, Braun TM, Carter C, Duby A, Northouse LL, Koontz BF, Glodé LM, Brandon J, Bangs R, McPhail J, McPhail S, Arab L, Paich K, Skolarus TA, An LC, Nelson CJ, Saigal CS, Chen RC, Mulhall JP, Hawley ST, Hearn JWD, Spratt DE, Pollack CE. TrueNTH Sexual Recovery Intervention for couples coping with prostate cancer: Randomized controlled trial results. Cancer 2022; 128:1513-1522. [PMID: 34985771 DOI: 10.1002/cncr.34076] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 11/22/2021] [Accepted: 11/30/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Despite significant sexual dysfunction and distress after localized prostate cancer treatment, patients typically receive only physiologic erectile dysfunction management. The authors performed a randomized controlled trial of an online intervention supporting couples' posttreatment recovery of sexual intimacy. METHODS Patients treated with surgery, radiation, or combined radiation and androgen deprivation therapy who had partners were recruited and randomized to an online intervention or a control group. The intervention, tailored to treatment type and sexual orientation, comprised 6 modules addressing expectations for sexual and emotional sequelae of treatment, rehabilitation, and guidance toward sexual intimacy recovery. Couples, recruited from 6 sites nationally, completed validated measures at the baseline and 3 and 6 months after treatment. Primary outcome group differences were assessed with t tests for individual outcomes. RESULTS Among 142 randomized couples, 105 patients (mostly surgery) and 87 partners completed the 6-month survey; this reflected challenges with recruitment and attrition. There were no differences between the intervention and control arms in Patient-Reported Outcomes Measurement Information System Global Satisfaction With Sex Life scores 6 months after treatment (the primary outcome). Three months after treatment, intervention patients and partners reported more engagement in penetrative and nonpenetrative sexual activities than controls. More than 73% of the intervention participants reported high or moderate satisfaction with module content; more than 85% would recommend the intervention to other couples. CONCLUSIONS Online psychosexual support for couples can help couples to connect and experience sexual pleasure early after treatment despite patients' sexual dysfunction. Participants' high endorsement of the intervention reflects the importance of sexual health support to couples after prostate cancer treatment. LAY SUMMARY This study tested a web-based program supporting couples' sexual recovery of sexual intimacy after prostate cancer treatment. One hundred forty-two couples were recruited and randomly assigned to the program (n = 60) or to a control group (n = 82). The program did not result in improvements in participants' satisfaction with their sex life 6 months after treatment, but couples in the intervention group engaged in sexual activity sooner after treatment than couples in the control group. Couples evaluated the program positively and would recommend it to others facing prostate cancer treatment.
Collapse
Affiliation(s)
- Daniela Wittmann
- Department of Urology, University of Michigan, Ann Arbor, Michigan
| | - Akanksha Mehta
- Department of Urology, Emory University, Atlanta, Georgia
| | - Sharon L Bober
- Sexual Health Program, Dana-Farber Cancer Institute, Boston, Massachusetts
- Department of Psychiatry, Harvard University, Boston, Massachusetts
| | - Ziwei Zhu
- Department of Urology, University of Michigan, Ann Arbor, Michigan
| | | | - Rodney L Dunn
- Department of Urology, University of Michigan, Ann Arbor, Michigan
| | - Thomas M Braun
- Department of Urology, University of Michigan, Ann Arbor, Michigan
| | - Caroline Carter
- Department of Urology, University of Michigan, Ann Arbor, Michigan
| | - Ashley Duby
- Department of Urology, University of Michigan, Ann Arbor, Michigan
| | | | - Bridget F Koontz
- Department of Radiation Oncology, Duke University, Durham, North Carolina
| | - L Michael Glodé
- School of Medicine, Medical Oncology, University of Colorado, Aurora, Colorado
| | | | | | | | | | - Lenore Arab
- Department of Urology, University of California Los Angeles, Los Angeles, California
| | | | - Ted A Skolarus
- Department of Urology, University of Michigan, Ann Arbor, Michigan
- VA Health Services Research & Development, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan
| | - Lawrence C An
- Department of Urology, University of Michigan, Ann Arbor, Michigan
| | - Christian J Nelson
- Male Sexual and Reproductive Medicine Program, Memorial Sloan Kettering, New York, New York
- Psychiatry Service, New York, New York
| | - Christopher S Saigal
- Department of Urology, University of California Los Angeles, Los Angeles, California
| | - Ronald C Chen
- Department of Urology, University of California Los Angeles, Los Angeles, California
| | - John P Mulhall
- Center for Sexual and Reproductive Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Sarah T Hawley
- Department of Urology, University of Michigan, Ann Arbor, Michigan
| | - Jason W D Hearn
- Department of Urology, University of Michigan, Ann Arbor, Michigan
- Department of Radiation Oncology, Duke University, Durham, North Carolina
| | - Daniel E Spratt
- Department of Urology, University of Michigan, Ann Arbor, Michigan
- Department of Radiation Oncology, Duke University, Durham, North Carolina
| | - Craig E Pollack
- Department of Health Policy and Management I School of Medicine, Johns Hopkins University, Baltimore, Maryland
| |
Collapse
|
25
|
Xu T, Qin Y, Ou X, Zhao X, Wang P, Wang M, Yue P. End-of-life communication experiences within families of people with advanced Cancer in China: A qualitative study. Int J Nurs Stud 2022; 132:104261. [DOI: 10.1016/j.ijnurstu.2022.104261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 04/13/2022] [Accepted: 04/17/2022] [Indexed: 12/24/2022]
|
26
|
Implementation of patient-reported outcome measures into health care for men with localized prostate cancer. Nat Rev Urol 2022; 19:263-279. [PMID: 35260844 DOI: 10.1038/s41585-022-00575-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2022] [Indexed: 11/12/2022]
Abstract
Measuring treatment-related quality of life (QOL) has become an increasingly requisite component of delivering high-quality care for patients with prostate cancer. Patient-reported outcome measures (PROMs) have, therefore, become an important tool for understanding the adverse effects of radical prostate cancer treatment and have been widely integrated into clinical practice. By providing real-time symptom monitoring and improved clinical feedback to patients and providers, PRO assessment has led to meaningful gains in prostate cancer care delivery and quality improvement worldwide. By providing an avenue for benchmarking, collaboration and population health monitoring, PROMs have delivered substantial improvements beyond providing individual symptom feedback. However, multilevel barriers exist that need to be addressed before the routine implementation of PROMs is achieved. Improvements in collection, interpretation, standardization and reporting will be crucial for the continued implementation of PROM instruments in prostate cancer pathways.
Collapse
|
27
|
Matthys O, Dierickx S, Deliens L, Lapeire L, Hudson P, Van Audenhove C, De Vleminck A, Cohen J. How are family caregivers of people with a serious illness supported by healthcare professionals in their caregiving tasks? A cross-sectional survey of bereaved family caregivers. Palliat Med 2022; 36:529-539. [PMID: 35090372 DOI: 10.1177/02692163211070228] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Due to medical advances and an increasingly ageing population, the number of people living with a serious illness is rising. This has major implications for the burden on family members of assisting with care. Support of family caregivers by healthcare professionals is needed to ensure they can provide quality care for people with serious illness. AIM To investigate how family caregivers of people with serious illness are supported by healthcare professionals in their caregiving tasks. DESIGN/PARTICIPANTS Population-based cross-sectional survey of bereaved family caregivers of people with serious illness (N = 3000) who cared for a person who had died 2-6 months before the sample was drawn (November 2019), as identified through three sickness funds in Flanders, Belgium. The survey explored support from healthcare professionals for family caregivers 3 months prior to bereavement. RESULTS Response rate was 55.0%. Most family caregivers received support from one or more healthcare professionals for family caregiving tasks, ranging from 71% for promoting social interaction to 95% for managing symptoms. The type of support mostly involved providing information. Use of palliative care services was the strongest predictor of such support across physical, psychosocial and practical tasks. CONCLUSION Most family caregivers of those with serious illness get some form of support from healthcare professionals for their tasks. However, an empowering support strategy for example one aimed at increasing self-efficacy of the family caregiver is rare and end-of-life communication between healthcare professionals and family caregivers needs improvement.
Collapse
Affiliation(s)
- Orphé Matthys
- End-of-life Care Research Group, Vrije Universiteit Brussel (VUB), Brussel, Belgium.,Ghent University, Ghent, Belgium.,Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Sigrid Dierickx
- End-of-life Care Research Group, Vrije Universiteit Brussel (VUB), Brussel, Belgium.,Ghent University, Ghent, Belgium.,Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Luc Deliens
- End-of-life Care Research Group, Vrije Universiteit Brussel (VUB), Brussel, Belgium.,Ghent University, Ghent, Belgium.,Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.,Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel (VUB), Brussel, Belgium
| | - Lore Lapeire
- Department of Medical Oncology, Ghent University Hospital, Ghent, Belgium
| | - Peter Hudson
- End-of-life Care Research Group, Vrije Universiteit Brussel (VUB), Brussel, Belgium.,Ghent University, Ghent, Belgium.,Centre for Palliative Care, The University of Melbourne, Melbourne, VIC, Australia
| | | | - Aline De Vleminck
- End-of-life Care Research Group, Vrije Universiteit Brussel (VUB), Brussel, Belgium.,Ghent University, Ghent, Belgium.,Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel (VUB), Brussel, Belgium
| | - Joachim Cohen
- End-of-life Care Research Group, Vrije Universiteit Brussel (VUB), Brussel, Belgium.,Ghent University, Ghent, Belgium.,Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel (VUB), Brussel, Belgium
| |
Collapse
|
28
|
Bodschwinna D, Lorenz I, Bauereiß N, Gündel H, Baumeister H, Hönig K. A psycho-oncological online intervention supporting partners of patients with cancer (PartnerCARE): Results from a randomized controlled feasibility trial. Psychooncology 2022; 31:1230-1242. [PMID: 35233880 DOI: 10.1002/pon.5917] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 02/18/2022] [Accepted: 02/27/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Partners of cancer patients are the primary supporters and burdened at the same time. Support for partners is hitherto scarce and existing offers are rarely used. The PartnerCARE online intervention was specifically developed to address the caregiving partners' needs. This two-arm parallel randomized controlled trial evaluates the feasibility, acceptability, and potential efficacy of PartnerCARE. METHODS Sixty German-speaking partners of patients with various cancer entities were randomized into two conditions: intervention group with PartnerCARE (N=30) or waitlist-control group (N=30). Participants completed online questionnaires at baseline (T0), post-treatment (T1) and four-months follow-up (T2). Feasibility and acceptability outcomes included dropout rates, use and acceptance of PartnerCARE, individual user/e-coach feedback as well as negative effects. Relevant efficacy outcomes were assessed to test for potential intervention effects. RESULTS Recruitment success illustrates demand for and acceptability of PartnerCARE. Satisfaction with the intervention was high (CSQ-I, T1: M=24.66, SD=6.42) and 73.3 % of participants completed the intervention. Study dropout rate was low (T1: 17%, T2: 29%). More positive than negative side effects of the intervention were identified, and negative ones were mainly related to 'intrapersonal change'. For efficacy outcomes we found effects over time, with strongest effects within the intervention group from T0 to T1 in psychological distress (d=0.73, 95%-CI: [0.34; 1.12]) and anxiety (0.66, [0.26; 1.04]), but no group effects were significant at T1 and T2. CONCLUSIONS PartnerCARE is feasible, acceptable and potentially efficacious. Based on received feedback, PartnerCARE is currently undergoing further development and subsequently efficacy will be investigated in a randomized controlled trial. This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
- Daniela Bodschwinna
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Ulm, Germany.,Comprehensive Cancer Center Ulm (CCCU), Germany
| | - Inga Lorenz
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Ulm, Germany
| | - Natalie Bauereiß
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Germany
| | - Harald Gündel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Ulm, Germany
| | - Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Germany
| | - Klaus Hönig
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Ulm, Germany.,Comprehensive Cancer Center Ulm (CCCU), Germany
| |
Collapse
|
29
|
Zhang Y, Mohile S, Culakova E, Norton S, Loh KP, Kadambi S, Kehoe L, Grossman VA, Vogel VG, Burnette BL, Bradley TP, Flannery M. The shared uncertainty experience of older adults with advanced cancer and their caregivers. Psychooncology 2022; 31:1041-1049. [PMID: 35112424 DOI: 10.1002/pon.5895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 01/13/2022] [Accepted: 01/21/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE One primary source of psychological distress in patients with cancer and their caregivers is uncertainty. However, the uncertainty trajectory and its relationship between older adults with advanced cancer and their caregivers have rarely been examined. This study describes the uncertainty trajectory in patient-caregiver dyads, explores the effect of geriatric assessment (GA) intervention on trajectory, and examines the interdependent relationship of uncertainty. METHODS This secondary analysis used longitudinal data from a national cluster-randomized controlled trial examining a GA intervention compared to usual care. Participants completed the modified 9-item Mishel Uncertainty in Illness Scale at enrollment, 4-6 weeks, 3 months, and 6 months. The dyadic growth model and cross-lagged actor-partner interdependence model were used. RESULTS A total of 397 dyads (patient age M=76.81 ± SD5.43; caregiver age M=66.69 ± SD12.52) were included. Both had a trend of decreased uncertainty over time (b=-0.16, p<.01). There was a greater decrease in uncertainty among caregivers in the GA group than those in the usual care group (b=-0.46, p=.02). For both patients and caregivers, their past uncertainty was a significant predictor of their own current uncertainty (i.e. actor effect, p<.01). The individual's past uncertainty was a significant predictor of the other dyad member's current uncertainty (i.e. partner effect, p<.05), indicating an interdependent relationship between patient and caregiver uncertainty over time. CONCLUSIONS Findings suggest patient and caregiver function as a unit with uncertainty levels affecting each other. Future interventions could build on GA to address uncertainty for older patients with advanced cancer and caregivers. BACKGROUND In the United States, there were approximately 1,898,160 new cancer cases reported in 2021; 60% of these cases are associated with individuals 65 years and older.1 Family members and friends often assume caregiving roles to complement the roles of the healthcare team, especially for older patients.2 Diagnosis and treatment of advanced cancer brings substantial stress for both patients and their caregivers.3 Prior studies have shown that older patients experience substantial adverse physical and psychological conditions, such as symptom burden, diminished quality of life, and distress.4-7 Similarly, caregivers also suffer distress, depression, significant caregiving burden, and impaired quality of life.2,8-10 Among the myriad psychosocial experiences, uncertainty, defined as the inability to navigate illness-related events and unfamiliar treatment strategies through decision-making or disease understanding, is a common psychological reaction in patients and caregivers.11,12 Evidence shows that unrelieved uncertainty is associated with decreased quality of life and poor psychological adjustment in older patients with cancer.13,14 Like other stressors, uncertainty affects both members of the patient-caregiver dyad. Previous studies identified uncertainty as a core overarching theme in the cancer experience and reported high uncertainty levels among caregivers.12,15,16 This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
- Yingzi Zhang
- School of Nursing, University of Rochester Medical Center, Rochester, New York, USA
| | - Supriya Mohile
- Division of Hematology/Oncology, Department of Medicine, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York, USA
| | - Eva Culakova
- Division of Hematology/Oncology, Department of Medicine, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York, USA
| | - Sally Norton
- School of Nursing, University of Rochester Medical Center, Rochester, New York, USA
| | - Kah Poh Loh
- Division of Hematology/Oncology, Department of Medicine, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York, USA
| | - Sindhuja Kadambi
- Division of Hematology/Oncology, Department of Medicine, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York, USA
| | - Lee Kehoe
- Department of Surgery, Cancer Control, University of Rochester Medical Center, Rochester, New York, USA
| | - Valerie Aarne Grossman
- SCOREboard patient and caregiver advocacy group, University of Rochester Medical Center, Rochester, New York, USA
| | - Victor G Vogel
- Geisinger Cancer Institute NCORP, Danville, Pennsylvania, USA
| | - Brian L Burnette
- Cancer Research of Wisconsin and Northern Michigan, Green Bay, Wisconsin, USA
| | | | - Marie Flannery
- School of Nursing, University of Rochester Medical Center, Rochester, New York, USA
| |
Collapse
|
30
|
Feasibility, Acceptability, and Clinical Significance of a Dyadic, Web-Based, Psychosocial and Physical Activity Self-Management Program (TEMPO) Tailored to the Needs of Men with Prostate Cancer and Their Caregivers: A Multi-Center Randomized Pilot Trial. Curr Oncol 2022; 29:785-804. [PMID: 35200566 PMCID: PMC8871005 DOI: 10.3390/curroncol29020067] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 01/12/2022] [Accepted: 01/18/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Prostate cancer is the most common cancer diagnosis among men. Family caregivers (often female spouses) play a key role in ensuring patients’ needs are met, frequently assuming their role with no formal training, which can contribute to a high burden. The purpose of this study was to pilot TEMPO—the first dyadic, Tailored, wEb-based, psychosocial and physical activity self-Management PrOgram for men with prostate cancer and their caregivers. Methods: 49 men with prostate cancer and their caregivers were randomized to TEMPO or usual care. Baseline and follow-up questionnaires were completed to assess feasibility, acceptability, and clinical significance. A priori benchmarks for these outcomes were set. Thirteen exit interviews were conducted to further explore acceptability. Results: Feasibility benchmarks were met with the exception for recruitment with on average 6.1 dyads recruited/month (benchmark: 8 dyads/month). Benchmarks of acceptability focused on attrition (<25%) and system usability, which were met. Using the strict criteria for adherence of 100% of the module viewed and participants spending at least 15 min on the module, 45% of participants were adherent. The clinical significance on anxiety and quality of life was supported for caregivers, and mostly supported for the men with prostate cancer. Conclusion: This pilot trial was successful, with minor modifications needed prior to a large trial.
Collapse
|
31
|
Ayyoubzadeh SM, Shirkhoda M, R Niakan Kalhori S, Mohammadzadeh N, Zakerabasali S. A Smartphone Remote Monitoring App to Follow Up Colorectal Cancer Survivors: Requirement Analysis. JMIR Cancer 2022; 8:e18083. [PMID: 34989685 PMCID: PMC8771344 DOI: 10.2196/18083] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 03/24/2020] [Accepted: 10/03/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Colorectal cancer survivors face multiple challenges after discharge. eHealth may potentially support them by providing tools such as smartphone apps. They have lots of capabilities to exchange information and could be used for remote monitoring of these patients. OBJECTIVE In this study, we addressed the required features for apps designed to follow up colorectal cancer patients based on survivors' and clinical experts' views. METHODS A mixed methods study was conducted. Features of related apps were extracted through the literature; the features were categorized, and then, they were modified. A questionnaire was designed containing the features listed and prioritized based on the MoSCoW (Must have, Should have, Could have, Won't have) technique and an open question for each category. The link to the questionnaire was shared among clinical experts in Iran. The answers were analyzed using the content validity ratio (CVR), and based on the value of this measure, the minimum feature set of a monitoring app to follow up patients with colorectal cancer was addressed. In addition, a telephone interview with colorectal cancer survivors was conducted to collect their viewpoints regarding a remote monitoring system for colorectal cancer cases. RESULTS The questionnaire contained 10 sections evaluating 9 categories of features. The questionnaire was completed by 18 experts. The minimum set of features in the app was identified as patient information registration, sign and symptom monitoring, education, reminders, and patient evaluation (0.42 < CVR < 0.85). Features including physical activity, personalized advice, and social network did not achieve the minimum score (-0.11 < CVR < 0.39). We interviewed 9 colorectal cancer survivors. Information registration, sign and symptom monitoring, education, and personalized advice were the features with high priority from the survivors' perspectives. Scheduling, shopping, and financial support features were emphasized by survivors in the interview. CONCLUSIONS The requirement set could be used to design an app for the targeted population or patients affected by other cancers. As the views from both survivors and clinical experts were considered in this study, the remote system may more adequately fulfill the need for follow-up of survivors. This eases the patients' and health care providers' communication and interaction.
Collapse
Affiliation(s)
- Seyed Mohammad Ayyoubzadeh
- Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Shirkhoda
- Department of Surgery, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
| | - Sharareh R Niakan Kalhori
- Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran.,Peter L. Reichertz Institute for Medical Informatics, Technical University Braunschweig and Hannover Medical School, Braunschweig, Germany
| | - Niloofar Mohammadzadeh
- Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Somayyeh Zakerabasali
- Clinical Education Research Center, Health Human Resources Research Center, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
32
|
Matthys O, De Vleminck A, Dierickx S, Deliens L, Van Goethem V, Lapeire L, Groenvold M, Lund L, Arnfeldt CM, Sengeloev L, Pappot H, Johnsen AT, Guerin S, Larkin PJ, Jordan C, Connolly M, D'Alton P, Costantini M, Di Leo S, Guberti M, Turola E, van der Heide A, Witkamp E, Rietjens J, van der Wel M, Brazil K, Prue G, Reid J, Scott D, Bristowe K, Harding R, Normand C, May P, Cronin C, Northouse L, Hudson P, Cohen J. Effectiveness of a nurse-delivered (FOCUS+) and a web-based (iFOCUS) psychoeducational intervention for people with advanced cancer and their family caregivers (DIAdIC): study protocol for an international randomized controlled trial. BMC Palliat Care 2021; 20:193. [PMID: 34963453 PMCID: PMC8713043 DOI: 10.1186/s12904-021-00895-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 12/10/2021] [Indexed: 11/21/2022] Open
Abstract
Background Worldwide, millions of people with advanced cancer and their family caregivers are experiencing physical and psychological distress. Psychosocial support and education can reduce distress and prevent avoidable healthcare resource use. To date, we lack knowledge from large-scale studies on which interventions generate positive outcomes for people with cancer and their informal caregivers’ quality of life. This protocol describes the DIAdIC study that will evaluate the effectiveness of two psychosocial and educational interventions aimed at improving patient-family caregiver dyads’ emotional functioning and self-efficacy. Methods We will conduct an international multicenter three-arm randomized controlled trial in Belgium, Denmark, Ireland, Italy, The Netherlands, and the United Kingdom. In each country, 156 dyads (936 in total) of people with advanced cancer and their family caregiver will be randomized to one of the study arms: 1) a nurse-led face-to-face intervention (FOCUS+), 2) a web-based intervention (iFOCUS) or 3) a control group (care as usual). The two interventions offer tailored psychoeducational support for patient-family caregiver dyads. The nurse-led face-to-face intervention consists of two home visits and one online video session and the web-based intervention is completed independently by the patient-family caregiver dyad in four online sessions. The interventions are based on the FOCUS intervention, developed in the USA, that addresses five core components: family involvement, optimistic outlook, coping effectiveness, uncertainty reduction, and symptom management. The FOCUS intervention will be adapted to the European context. The primary outcomes are emotional functioning and self-efficacy of the patient and the family caregiver, respectively. The secondary outcomes are quality of life, benefits of illness, coping, dyadic communication, and ways of giving support of the patient and family caregiver. Discussion DIAdIC aims to develop cost-effective interventions that integrate principles of early palliative care into standard care. The cross-country setup in six European countries allows for comparison of effectiveness of the interventions in different healthcare systems across Europe. By focusing on empowerment of the person with cancer and their family caregiver, the results of this RCT can contribute to the search for cost-effective novel interventions that can relieve constraints on professional healthcare. Trial registration Registration on ClinicalTrials.gov on 12/11/2020, identifier NCT04626349. Date and version identifier 20211209_DIAdIC_Protocol_Article. Supplementary Information The online version contains supplementary material available at 10.1186/s12904-021-00895-z.
Collapse
Affiliation(s)
- Orphé Matthys
- End-of-life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels, Belgium.
| | - Aline De Vleminck
- End-of-life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels, Belgium
| | - Sigrid Dierickx
- End-of-life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels, Belgium
| | - Luc Deliens
- End-of-life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels, Belgium
| | - Vincent Van Goethem
- End-of-life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels, Belgium
| | - Lore Lapeire
- Department of Medical Oncology, Ghent University Hospital, Ghent, Belgium
| | - Mogens Groenvold
- Department of Public Health, University of Copenhagen and Palliative Care Research Unit, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Line Lund
- Department of Public Health, University of Copenhagen and Palliative Care Research Unit, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Caroline Moeller Arnfeldt
- Department of Public Health, University of Copenhagen and Palliative Care Research Unit, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Lisa Sengeloev
- Department of Oncology, Herlev Gentofte University Hospital, Herlev, Denmark
| | - Helle Pappot
- Department of Oncology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | | | - Suzanne Guerin
- UCD School of Psychology, University College Dublin, Belfield, Ireland
| | - Philip J Larkin
- Palliative and Supportive Care Service, Chair of Palliative Care Nursing, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Catherine Jordan
- UCD School of Psychology, University College Dublin, Belfield, Ireland
| | - Michael Connolly
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Paul D'Alton
- UCD School of Psychology, University College Dublin, Belfield, Ireland
| | - Massimo Costantini
- Scientific Directorate, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Silvia Di Leo
- Psycho-oncology Unit, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Monica Guberti
- Nursing & Health Care Professions Directorate, Azienda USL-IRCCS, Reggio Emilia, Italy
| | - Elena Turola
- Scientific Directorate, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Agnes van der Heide
- Deparmtent of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Erika Witkamp
- Deparmtent of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Judith Rietjens
- Deparmtent of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Maaike van der Wel
- Deparmtent of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Kevin Brazil
- School of Nursing and Midwifery, Queen's University of Belfast, 97 Lisburn Road, Belfast, Northern Ireland, BT9 7BL, UK
| | - Gillian Prue
- School of Nursing and Midwifery, Queen's University of Belfast, 97 Lisburn Road, Belfast, Northern Ireland, BT9 7BL, UK
| | - Joanne Reid
- School of Nursing and Midwifery, Queen's University of Belfast, 97 Lisburn Road, Belfast, Northern Ireland, BT9 7BL, UK
| | - David Scott
- School of Nursing and Midwifery, Queen's University of Belfast, 97 Lisburn Road, Belfast, Northern Ireland, BT9 7BL, UK
| | - Katherine Bristowe
- King's College London, Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, Cicely Saunders Institute, London, UK
| | - Richard Harding
- King's College London, Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, Cicely Saunders Institute, London, UK
| | - Charles Normand
- Centre for Health Policy and Management, Trinity College Dublin, Dublin, Ireland.,Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, London, UK
| | - Peter May
- Centre for Health Policy and Management, Trinity College Dublin, Dublin, Ireland.,The Irish Longitudinal Study on Ageing, Dublin, Ireland
| | - Catherine Cronin
- Centre for Health Policy and Management, Trinity College Dublin, Dublin, Ireland
| | | | - Peter Hudson
- Centre for Palliative Care, St Vincent's Hospital, Melbourne, Australia.,Vrije University Brussels (VUB), Brussels, Belgium
| | - Joachim Cohen
- End-of-life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels, Belgium
| |
Collapse
|
33
|
Lapid MI, Atherton PJ, Kung S, Clark MM, Sloan JA, Whitford KJ, Hubbard JM, Gentry MT, Miller JJ, Rummans TA. A feasibility study of virtual group therapy to improve quality of life of cancer caregivers. J Psychosoc Oncol 2021; 40:854-867. [PMID: 34842060 DOI: 10.1080/07347332.2021.2000550] [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: 10/19/2022]
Abstract
BACKGROUND Cancer caregiving can negatively impact the quality of life (QOL) of the caregiver. In-person interventions for improving coping skills have been shown to be effective in improving QOL for caregivers. OBJECTIVES This pilot project explored the feasibility and acceptability of a virtual group therapy intervention to improve short-term cancer caregiver QOL. METHODS Caregivers of cancer patients were enrolled in a structured multidisciplinary intervention of eight virtual group therapy sessions provided over four weeks between September 9, 2013 and November 17, 2014. Group sessions were led by trained facilitators and included components of physical therapy, occupational therapy, psychosocial education, cognitive-behavioral intervention, supportive discussion, spiritual reflection, and mindfulness therapy. Feasibility was based on acceptable number of recruited participants per session; acceptability was defined using attendance and 80% QOL completion rates. QOL domains and symptom burden were assessed using validated single items. RESULTS The 20 cancer caregivers who enrolled were mostly older (80% were ≥ 65 years), female (76.5%), married to the patient (88.2%), Caucasian (100%), and highly educated (100%). 60% attended one to five sessions, 15% attended six to eight sessions, and 25% attended no sessions. Thirty percent completed pre- and post- intervention ratings of QOL items. SIGNIFICANCE OF RESULTS Findings suggested that a virtual group therapy intervention is feasible for the cancer caregivers in this study. Although not statistically significant, the caregivers reported higher QOL and less symptom burden in multiple domains after participating in the virtual group therapy intervention.
Collapse
Affiliation(s)
- Maria I Lapid
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | - Pamela J Atherton
- Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, USA
| | - Simon Kung
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | - Matthew M Clark
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | - Jeff A Sloan
- Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, USA
| | - Kevin J Whitford
- Division of Hospital Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Joleen M Hubbard
- Department of Medical Oncology, Mayo Clinic, Rochester, Minnesota, USA
| | - Melanie T Gentry
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | - Janis J Miller
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, USA
| | - Teresa A Rummans
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA.,Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, Florida, USA
| |
Collapse
|
34
|
Su Z, Li X, McDonnell D, Fernandez AA, Flores BE, Wang J. Technology-Based Interventions for Cancer Caregivers: Concept Analysis. JMIR Cancer 2021; 7:e22140. [PMID: 34783664 PMCID: PMC8663574 DOI: 10.2196/22140] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 12/01/2020] [Accepted: 10/13/2021] [Indexed: 01/16/2023] Open
Abstract
Background Cancer is a taxing chronic disease that demands substantial care, most of which is shouldered by informal caregivers. As a result, cancer caregivers often have to manage considerable challenges that could result in severe physical and psychological health consequences. Technology-based interventions have the potential to address many, if not all, of the obstacles caregivers encounter while caring for patients with cancer. However, although the application of technology-based interventions is on the rise, the term is seldom defined in research or practice. Considering that the lack of conceptual clarity of the term could compromise the effectiveness of technology-based interventions for cancer caregivers, timely research is needed to bridge this gap. Objective This study aims to clarify the meaning of technology-based interventions in the context of cancer caregiving and provide a definition that can be used by cancer caregivers, patients, clinicians, and researchers to facilitate evidence-based research and practice. Methods The 8-step concept analysis method by Walker and Avant was used to analyze the concept of technology-based interventions in the context of cancer caregiving. PubMed, PsycINFO, CINAHL, and Scopus were searched for studies that examined technology-based interventions for cancer caregivers. Results The defining attributes of technology-based interventions were recognized as being accessible, affordable, convenient, and user-friendly. On the basis of insights gained on the defining attributes, antecedents to, and consequences of technology-based interventions through the concept analysis process, technology-based interventions were defined as the use of technology to design, develop, and deliver health promotion contents and strategies aimed at inducing or improving positive physical or psychological health outcomes in cancer caregivers. Conclusions This study clarified the meaning of technology-based interventions in the context of cancer caregiving and provided a clear definition that can be used by caregivers, patients, clinicians, and researchers to facilitate evidence-based oncology practice. A clear conceptualization of technology-based interventions lays foundations for better intervention design and research outcomes, which in turn have the potential to help health care professionals address the needs and preferences of cancer caregivers more cost-effectively.
Collapse
Affiliation(s)
- Zhaohui Su
- Center on Smart and Connected Health Technologies, School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Xiaoshan Li
- Program of Public Relations and Advertising, Beijing Normal University-Hong Kong Baptist University United International College, Zhuhai, China
| | - Dean McDonnell
- Department of Humanities, Institute of Technology, Carlow, Ireland
| | - Andrea A Fernandez
- School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Bertha E Flores
- School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Jing Wang
- Florida State University College of Nursing, Tallahassee, FL, United States
| |
Collapse
|
35
|
The efficacy of web or mobile-based interventions to alleviate emotional symptoms in people with advanced cancer: a systematic review and meta-analysis. Support Care Cancer 2021; 30:3029-3042. [PMID: 34735601 DOI: 10.1007/s00520-021-06496-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 08/09/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE This review aims to critically evaluate the efficacy of web or mobile-based (WMB) interventions impacting emotional symptoms in patients with advanced cancer. METHOD Articles published from 1991 to 2019 were identified using PubMed, PsycINFO, CINAHL, and Scopus. Only interventions involving adults with advanced cancer using a WMB intervention to manage emotional symptoms were included. Risk of bias was assessed using ROBINS-I and ROB2 tools. Studies that reported mean symptom scores were pooled using a random-effects model, and standardized mean difference (SMD) and 95% CIs were calculated. RESULTS Twenty-three of the 1177 screened studies met the inclusion criteria, and a total sample of 2558 patients were included. The sample was 57% female, and 33% had advanced cancer with mean age of 57.15 years. Thirteen studies evaluated anxiety, nineteen evaluated depression, and eleven evaluated distress. Intervention components included general information, tracking, communication, multimedia choice, interactive online activities, tailoring/feedback, symptom management support content, and self-monitoring. Overall pooled results showed that WMB interventions' effects on decreasing anxiety (SMD - 0.20, - 0.45 to 0.05, I2 = 72%), depression (SMD - 0.10, - 0.30 to 0.11, I2 = 73%), and distress (SMD - 0.20, - 0.47 to 0.06, I2 = 60%) were not significant for randomized controlled trials (RCTs). In contrast, WMB interventions significantly decreased symptoms of anxiety (p = .002) in a sub-group analysis of non-RCTs. CONCLUSION This meta-analysis demonstrated that WMB interventions were not efficacious in alleviating emotional symptoms in adults with advanced cancer. Considering the diversity of interventions, the efficacy of WMB interventions and its impacts on emotional symptoms should be further explored.
Collapse
|
36
|
Interventions to Improve Self-Efficacy in Colorectal Cancer Patients and/or Caregivers: A Systematic Review and Meta-Analysis. JOURNAL OF ONCOLOGY 2021; 2021:4553613. [PMID: 34707659 PMCID: PMC8545593 DOI: 10.1155/2021/4553613] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 09/28/2021] [Indexed: 01/30/2023]
Abstract
Objective High levels of self-efficacy (SE) in colorectal cancer (CRC) patients and/or caregivers enable patients to cope with cancer, reduce caregiver burden, and promote quality of life (QOL) in patients and caregivers alike. This review aims to (a) identify the SE theory sources covered by SE interventions or interventions, including targeting improved SE for CRC patients and/or caregivers, to guide future development of SE interventions; and (b) explore intervention effects based on SE theory through meta-analysis. Methods Using five electronic databases—CINAHL, Cochrane Library, Embase, PsycINFO, and PubMed—a systematic search was performed in April 2021 to identify English or Chinese literature that studied improving SE interventions for CRC patients and/or caregivers. Manual screening of the articles' references list was also performed. Results A total of 18 studies were found to be suitable and included in this review. Of the 18 studies that were included, 10 randomized controlled trials (RCTs) studies with 917 participants were eligible for meta-analysis. Interventions provide support for SE drawing on different sources of information. Performance accomplishment (PA) is the key source, with vicarious experience (VE) and verbal persuasion (VP) assisting in improving PA. Reducing negative emotional arousal (NEA) and improving positive emotional arousal (PEA) are also indispensable factors in improving SE. The meta-analysis results show that interventions based on the SE theory can bring about positive effects for CRC patients and/or caregivers. Conclusions Different sources of information aimed at improving SE, covered by the interventions, including PA, VE, VP, NEA, and PEA, have been explored. Positive intervention outcomes that focused on improving SE for CRC patients and/or caregivers were identified and highlighted. For future SE interventions, we advocate choosing combination sources of SE information to design interventions. It is recommended that future SE improvement interventions should focus on improving PA, supplemented by increasing VE, while reducing NEA and providing useful VP.
Collapse
|
37
|
Matthew AG, Trachtenberg LJ, Yang ZG, Robinson J, Petrella A, McLeod D, Walker L, Wassersug R, Elliott S, Ellis J, Jamnicky L, Fleshner N, Finelli A, Singal R, Brock G, Jarvi K, Bender J, Elterman D. An online Sexual Health and Rehabilitation eClinic (TrueNTH SHAReClinic) for prostate cancer patients: a feasibility study. Support Care Cancer 2021; 30:1253-1260. [PMID: 34463836 PMCID: PMC8407130 DOI: 10.1007/s00520-021-06510-4] [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: 04/23/2021] [Accepted: 08/15/2021] [Indexed: 11/29/2022]
Abstract
Purpose The primary objective was to determine the feasibility of implementing the TrueNTH SHAReClinic as a pan-Canadian sexual health and rehabilitation intervention for patients treated for localized prostate cancer. Methods The feasibility study was designed to evaluate the accessibility and acceptability of the intervention. Participants from five institutions across Canada were enrolled to attend one pre-treatment and five follow-up online clinic visits over 1 year following their prostate cancer (PC) treatment. Results Sixty-five patients were enrolled in the intervention. Website analytics revealed that 71% completed the intervention in its entirety, including the educational modules, with an additional 10% completing more than half of the intervention. Five thousand eighty-three views of the educational modules were made along with 654 views of the health library items. Over 1500 messages were exchanged between participants and their sexual health coaches. At 12 months, the intervention received an overall average participant rating of 4.1 out of 5 on a single item satisfaction measure. Conclusion Results support the TrueNTH SHAReClinic as highly acceptable to participants as defined by intervention adherence and engagement. The TrueNTH SHAReClinic demonstrated promise for being a feasible and potentially resource-efficient approach to effectively improving the sexual well-being of patients after PC treatment.
Collapse
Affiliation(s)
- A G Matthew
- Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, 700 University Avenue, 6th Floor, Room 6-817, Toronto, ON, M5G 1Z6, Canada.
| | - L J Trachtenberg
- Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, 700 University Avenue, 6th Floor, Room 6-817, Toronto, ON, M5G 1Z6, Canada
| | - Z G Yang
- Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, 700 University Avenue, 6th Floor, Room 6-817, Toronto, ON, M5G 1Z6, Canada
| | - J Robinson
- Department of Oncology, University of Calgary, Calgary, AB, Canada
| | - A Petrella
- Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, 700 University Avenue, 6th Floor, Room 6-817, Toronto, ON, M5G 1Z6, Canada
| | - D McLeod
- Dalhousie University, Halifax, NS, Canada
| | - L Walker
- Department of Oncology, University of Calgary, Calgary, AB, Canada
| | - R Wassersug
- Cellular and Physiological Sciences, University of British Columbia, Vancouver, BC, Canada
| | - S Elliott
- Departments of Urologic Sciences, Vancouver Prostate Centre, Vancouver, BC, Canada
| | - J Ellis
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - L Jamnicky
- Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, 700 University Avenue, 6th Floor, Room 6-817, Toronto, ON, M5G 1Z6, Canada
| | - N Fleshner
- Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, 700 University Avenue, 6th Floor, Room 6-817, Toronto, ON, M5G 1Z6, Canada
| | - A Finelli
- Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, 700 University Avenue, 6th Floor, Room 6-817, Toronto, ON, M5G 1Z6, Canada
| | - R Singal
- Toronto East Health Network Michael Garron Hospital, Toronto, ON, Canada
| | - G Brock
- Department of Surgery, Western University, London, ON, Canada
| | - K Jarvi
- Department of Surgery, Mount Sinai Hospital, Toronto, ON, Canada
| | - J Bender
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - D Elterman
- Division of Urology, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
38
|
Douglas SL, Plow M, Packer T, Lipson AR, Lehman MJ. Psychoeducational Interventions for Caregivers of Persons With Multiple Sclerosis: Protocol for a Randomized Trial. JMIR Res Protoc 2021; 10:e30617. [PMID: 34435971 PMCID: PMC8430872 DOI: 10.2196/30617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 06/28/2021] [Accepted: 07/06/2021] [Indexed: 11/13/2022] Open
Abstract
Background Of the approximately 1 million people living with multiple sclerosis in the United States, more than half receive informal, unpaid care or support from family or friends (caregivers). These caregivers report high levels of stress, anxiety, and negative emotions. Few researchers have conducted psychoeducational interventions for these caregivers. Objective This paper presents a protocol for a randomized clinical trial that aims to test the efficacy of two interventions for improving stress, anxiety, depression, and negative emotions for caregivers of persons with multiple sclerosis. Methods Participants included any self-identified family or friend caregiver of a person with multiple sclerosis. Data collection began in April 2021 and is expected to continue until November 2021. Participants will be randomized to receive either a website-only or a website-coaching intervention delivered for 6 weeks. Data will be collected at baseline, 6 weeks after baseline (after delivery of intervention), and 6 weeks later. Results The protocol was approved by the institutional review board of the Case Western Reserve University on January 21, 2021 (protocol 20201484). As of May 2021, 66 participants were enrolled. Conclusions Our findings will have implications for identifying the efficacy of two types of interventions developed for caregivers of persons with multiple sclerosis to reduce negative psychological outcomes associated with caregiving. Trial Registration ClinicalTrials.gov NCT04662008; http://clinicaltrials.gov/ct2/show/NCT04662008 International Registered Report Identifier (IRRID) DERR1-10.2196/30617
Collapse
Affiliation(s)
- Sara L Douglas
- School of Nursing, Case Western Reserve University, Cleveland, OH, United States
| | - Matthew Plow
- School of Nursing, Case Western Reserve University, Cleveland, OH, United States
| | - Tanya Packer
- School of Occupational Therapy, Dalhousie University, Halifax, NS, Canada.,School of Health Administration, Dalhousie University, Halifax, NS, Canada
| | - Amy R Lipson
- School of Nursing, Case Western Reserve University, Cleveland, OH, United States
| | - Michelle J Lehman
- School of Occupational Therapy, Dalhousie University, Halifax, NS, Canada
| |
Collapse
|
39
|
A pilot randomized clinical trial of a teamwork intervention for heart failure care dyads. Heart Lung 2021; 50:877-884. [PMID: 34407481 DOI: 10.1016/j.hrtlng.2021.07.008] [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: 01/22/2021] [Revised: 06/24/2021] [Accepted: 07/26/2021] [Indexed: 01/31/2023]
Abstract
BACKGROUND Dyadic heart failure (HF) management can improve outcomes for patients and caregivers and can be enhanced through eHealth interventions. OBJECTIVE To evaluate the feasibility, acceptability, and preliminary efficacy of an eHealth dyadic teamwork intervention, compared to an attention control condition. METHODS We recruited 29 HF patient-caregiver dyads from inpatient units and randomized dyads to an intervention or a control group. We calculated enrollment and retention rates, described acceptability using interview and questionnaire data, and computed intervention effect sizes. RESULTS 37% of eligible dyads agreed to participate and 93% of randomized participants completed follow-up questionnaires. Participants found both study conditions to be acceptable. Between-group effect sizes suggested that the intervention led to improvements in relationship quality, self-efficacy, and quality of life for patients and caregivers. CONCLUSIONS Dyadic recruitment from acute care settings is challenging. Findings provide initial evidence that our intervention can contribute to better health outcomes for HF dyads.
Collapse
|
40
|
Kim S, Aceti M, Baroutsou V, Bürki N, Caiata-Zufferey M, Cattaneo M, Chappuis PO, Ciorba FM, Graffeo-Galbiati R, Heinzelmann-Schwarz V, Jeong J, Jung MM, Kim SW, Kim J, Lim MC, Ming C, Monnerat C, Park HS, Park SH, Pedrazzani CA, Rabaglio M, Ryu JM, Saccilotto R, Wieser S, Zürrer-Härdi U, Katapodi MC. Using a Tailored Digital Health Intervention for Family Communication and Cascade Genetic Testing in Swiss and Korean Families With Hereditary Breast and Ovarian Cancer: Protocol for the DIALOGUE Study. JMIR Res Protoc 2021; 10:e26264. [PMID: 34114954 PMCID: PMC8235289 DOI: 10.2196/26264] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 02/09/2021] [Accepted: 02/25/2021] [Indexed: 02/06/2023] Open
Abstract
Background In hereditary breast and ovarian cancer (HBOC), family communication of genetic test results is essential for cascade genetic screening, that is, identifying and testing blood relatives of known mutation carriers to determine whether they also carry the pathogenic variant, and to propose preventive and clinical management options. However, up to 50% of blood relatives are unaware of relevant genetic information, suggesting that potential benefits of genetic testing are not communicated effectively within family networks. Technology can facilitate communication and genetic education within HBOC families. Objective The aims of this study are to develop the K-CASCADE (Korean–Cancer Predisposition Cascade Genetic Testing) cohort in Korea by expanding an infrastructure developed by the CASCADE (Cancer Predisposition Cascade Genetic Testing) Consortium in Switzerland; develop a digital health intervention to support the communication of cancer predisposition for Swiss and Korean HBOC families, based on linguistic and cultural adaptation of the Family Gene Toolkit; evaluate its efficacy on primary (family communication of genetic results and cascade testing) and secondary (psychological distress, genetic literacy, active coping, and decision making) outcomes; and explore its translatability using the reach, effectiveness, adoption, implementation, and maintenance framework. Methods The digital health intervention will be available in French, German, Italian, Korean, and English and can be accessed via the web, mobile phone, or tablet (ie, device-agnostic). K-CASCADE cohort of Korean HBOC mutation carriers and relatives will be based on the CASCADE infrastructure. Narrative data collected through individual interviews or mini focus groups from 20 to 24 HBOC family members per linguistic region and 6-10 health care providers involved in genetic services will identify the local cultures and context, and inform the content of the tailored messages. The efficacy of the digital health intervention against a comparison website will be assessed in a randomized trial with 104 HBOC mutation carriers (52 in each study arm). The translatability of the digital health intervention will be assessed using survey data collected from HBOC families and health care providers. Results Funding was received in October 2019. It is projected that data collection will be completed by January 2023 and results will be published in fall 2023. Conclusions This study addresses the continuum of translational research, from developing an international research infrastructure and adapting an existing digital health intervention to testing its efficacy in a randomized controlled trial and exploring its translatability using an established framework. Adapting existing interventions, rather than developing new ones, takes advantage of previous valid experiences without duplicating efforts. Culturally sensitive web-based interventions that enhance family communication and understanding of genetic cancer risk are timely. This collaboration creates a research infrastructure between Switzerland and Korea that can be scaled up to cover other hereditary cancer syndromes. Trial Registration ClinicalTrials.gov NCT04214210; https://clinicaltrials.gov/ct2/show/NCT04214210 and CRiS KCT0005643; https://cris.nih.go.kr/cris/ International Registered Report Identifier (IRRID) PRR1-10.2196/26264
Collapse
Affiliation(s)
- Sue Kim
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, Republic of Korea
| | - Monica Aceti
- Department of Clinical Research, University of Basel, Basel, Switzerland
| | - Vasiliki Baroutsou
- Department of Clinical Research, University of Basel, Basel, Switzerland
| | - Nicole Bürki
- Women's Clinic and Gynecological Oncology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Maria Caiata-Zufferey
- La Scuola Universitaria Professionale della Svizzera Italiana (SUPSI), Manno, Switzerland
| | - Marco Cattaneo
- Department of Clinical Research, University of Basel, Basel, Switzerland
| | - Pierre O Chappuis
- Unit of Oncogenetics, Division of Oncology, Division of Genetic Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Florina M Ciorba
- Department of Mathematics and Computer Science, University of Basel, Basel, Switzerland
| | | | - Viola Heinzelmann-Schwarz
- Women's Clinic and Gynecological Oncology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Joon Jeong
- Department of Surgery, Gangnam Severance Hospital, College of Medicine, Yonsei University, Seoul, Republic of Korea
| | - MiSook M Jung
- College of Nursing, Chungnam National University, Deajeon, Republic of Korea
| | - Sung-Won Kim
- Dairim St Mary's Hospital, Seoul, Republic of Korea
| | - Jisun Kim
- Department of Surgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Republic of Korea
| | - Myong Cheol Lim
- Division of Tumor Immunology, Center for Gynecologic Cancer Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea
| | - Chang Ming
- Department of Clinical Research, University of Basel, Basel, Switzerland
| | | | - Hyung Seok Park
- Department of Surgery, Gangnam Severance Hospital, College of Medicine, Yonsei University, Seoul, Republic of Korea
| | - Sang Hyung Park
- Department of Computer Science, Yonsei University, Seoul, Republic of Korea
| | - Carla A Pedrazzani
- Department of Clinical Research, University of Basel, Basel, Switzerland
| | - Manuela Rabaglio
- University Clinic for Medical Oncology, Inselspital, Bern, Switzerland
| | - Jai Min Ryu
- Department of Surgery, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Republic of Korea
| | - Ramon Saccilotto
- Department of Clinical Research, University of Basel, Basel, Switzerland
| | - Simon Wieser
- School of Management and Law, Winterthur Institute of Health Economics, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Ursina Zürrer-Härdi
- Medical Oncology and Hematology, Kantonsspital Winterthur, Winterthur, Switzerland
| | - Maria C Katapodi
- Department of Clinical Research, University of Basel, Basel, Switzerland
| |
Collapse
|
41
|
Saeidzadeh S, Kamalumpundi V, Chi NC, Nair R, Gilbertson-White S. Web and mobile-based symptom management interventions for physical symptoms of people with advanced cancer: A systematic review and meta-analysis. Palliat Med 2021; 35:1020-1038. [PMID: 33840271 DOI: 10.1177/02692163211006317] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Symptom management is a critical aspect of comprehensive palliative care for people with advanced cancer. Web and mobile-based applications are promising e-Health modalities that can facilitate timely access to symptom management interventions for this population. AIM To evaluate the efficacy of web and mobile-based symptom management interventions in alleviating physical symptom burden in people with advanced cancer. DESIGN A systematic review and meta-analysis was conducted. PROSPERO ID = CRD42020155295. DATA SOURCES We searched databases including PubMed, PsycINFO, and CINAHL from 1991 until 2019. Inclusion criteria were: adults with advanced cancer, web or mobile-based interventions targeting symptom management, and report of physical symptom data. Risk of bias was assessed using the ROBINS-I and RoB2. Using RevMan, standardized mean difference (SMD) and 95% confidence intervals were calculated. Heterogeneity was assessed using the I2 statistic. An assessment of interventions was conducted by evaluating the delivery mode, duration, and evaluation of application feature and theoretical elements. RESULTS A total of 19 studies are included in the systematic review and 18 in the meta-analysis. Majority of the studies were deemed to have high risk of bias. Most of the interventions used a web-application for delivering their education (n = 17). While the interventions varied regarding duration and content, they were mainly guided by a symptom management theory. Web and mobile-based interventions significantly improved the overall physical symptom burden (SMD = -0.18; 95% CI = -0.28 to -0.09; I2 = 0%; p = 0.0002). CONCLUSIONS Web and mobile-based intervention are efficacious in decreasing the overall physical symptom burden in people with advanced cancer.
Collapse
Affiliation(s)
| | | | - Nai-Ching Chi
- College of Nursing, University of Iowa, Iowa City, IA, USA
| | - Rajeshwari Nair
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA.,The Center for Comprehensive Access and Delivery Research and Evaluation, Iowa City Veterans Affairs Healthcare System, Iowa City, IA, USA
| | - Stephanie Gilbertson-White
- College of Nursing, University of Iowa, Iowa City, IA, USA.,Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| |
Collapse
|
42
|
Gabriel I, Creedy D, Coyne E. Feasibility of a socio-spiritual intervention to improve quality of life of adult Nigerians with cancer and their family caregivers: Protocol for a randomised controlled trial. Contemp Clin Trials Commun 2021; 22:100802. [PMID: 34195469 PMCID: PMC8233201 DOI: 10.1016/j.conctc.2021.100802] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 06/08/2021] [Accepted: 06/12/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Despite high psychosocial needs that negatively affect the quality of life of adults living with cancer and their family caregivers, there is a lack of interventions that are culturally sensitive to low-income countries. This protocol tests the feasibility of a randomised controlled trial on the efficacy of a socio-spiritual intervention to improve the quality of life of adult Nigerians living with cancer and their family caregivers. METHODS/DESIGN This two-arm trial will recruit 152 adults with cancer and their family caregivers (76 dyads). Participants will be recruited from a clinical facility in Zaria, Kaduna State, Nigeria. Eligible participants will be randomly assigned to either the intervention or control group at a 1:1 ratio. The intervention consists of four weekly face-to-face sessions with a focus on spirituality, social support, and information needs. Control participants will receive usual care. Outcome measures include feasibility, spiritual need, social need, information, cancer health literacy, and quality of life collected at baseline and immediate post-intervention. DISCUSSION Nigeria has the highest rate of extreme poverty globally with high rates of cancer mortality. Testing the feasibility of social-spiritual interventions in resource poor settings is important to establish preliminary efficacy and sustainability. Family-centred interventions for adults living with cancer and their family caregivers can strengthen their coping capabilities. If this intervention is feasible and effective, it could be implemented both in clinical practice and communities in other low and middle income countries.
Collapse
Affiliation(s)
- Israel Gabriel
- Griffith University, Logan Campus, 68 University Dr, Meadowbrook, QLD 4131, Australia
- Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | - Debra Creedy
- Griffith University, Logan Campus, 68 University Dr, Meadowbrook, QLD 4131, Australia
| | - Elisabeth Coyne
- Griffith University, Logan Campus, 68 University Dr, Meadowbrook, QLD 4131, Australia
| |
Collapse
|
43
|
Juraskova I, Laidsaar-Powell R, Keast R, Schofield P, Costa DS, Kay J, Turner S, Koczwara B, Saunders C, Jefford M, Yates P, Boyle F, White K, Miller A, Morton RL, Butt Z, Butow P. eTRIO trial: study protocol of a randomised controlled trial of online education modules to facilitate effective family caregiver involvement in oncology. BMJ Open 2021; 11:e043224. [PMID: 34049902 PMCID: PMC8166623 DOI: 10.1136/bmjopen-2020-043224] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE Informal family caregivers play a crucial role in cancer care. Effective caregiver involvement in cancer care can improve both patient and caregiver outcomes. Despite this, interventions improving the caregiver involvement are sparse. This protocol describes a randomised controlled trial evaluating the combined effectiveness of novel online caregiver communication education modules for: (1) oncology clinicians (eTRIO) and (2) patients with cancer and caregivers (eTRIO-pc). METHODS AND ANALYSIS Thirty medical/radiation/surgical oncology or haematology doctors and nurses will be randomly allocated to either intervention (eTRIO) or control (an Australian State Government Health website on caregivers) education conditions. Following completion of education, each clinician will recruit nine patient-caregiver pairs, who will be allocated to the same condition as their recruiting clinician. Eligibility includes any new adult patient diagnosed with any type/stage cancer attending consultations with a caregiver. Approximately 270 patient-caregiver pairs will be recruited. The primary outcome is caregiver self-efficacy in triadic (clinician-patient-caregiver) communication. Patient and clinician self-efficacy in triadic communication are secondary outcomes. Additional secondary outcomes for clinicians include preferences for caregiver involvement, perceived module usability/acceptability, analysis of module use, satisfaction with the module, knowledge of strategies and feedback interviews. Secondary outcomes for caregivers and patients include preferences for caregiver involvement, satisfaction with clinician communication, distress, quality of life, healthcare expenditure, perceived module usability/acceptability and analysis of module use. A subset of patients and caregivers will complete feedback interviews. Secondary outcomes for caregivers include preparedness for caregiving, patient-caregiver communication and caring experience. Assessments will be conducted at baseline, and 1 week, 12 weeks and 26 weeks post-intervention. ETHICS AND DISSEMINATION Ethical approval has been received by the Sydney Local Health District Human Research Ethics Committee (REGIS project ID number: 2019/PID09787), with site-specific approval from each recruitment site. Protocol V.7 (dated 1 September 2020) is currently approved and reported in this manuscript. Findings will be disseminated via presentations and peer-reviewed publications. Engagement with clinicians, media, government, consumers and peak cancer groups will facilitate widespread dissemination and long-term availability of the educational modules. TRIAL REGISTRATION NUMBER ACTRN12619001507178.
Collapse
Affiliation(s)
- Ilona Juraskova
- School of Psychology, Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), The University of Sydney, Faculty of Science, Camperdown, New South Wales, Australia
| | - R Laidsaar-Powell
- School of Psychology, Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), The University of Sydney, Faculty of Science, Camperdown, New South Wales, Australia
| | - Rachael Keast
- School of Psychology, Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), The University of Sydney, Faculty of Science, Camperdown, New South Wales, Australia
| | - Penelope Schofield
- Department of Psychology, and Iverson Health Innovation Research Institute, Swinburne University, Melbourne, Victoria, Australia
- Behavioural Sciences Unit, Health Services Research and Implementation Sciences, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
| | - Daniel Sj Costa
- Pain Management Research Institute, Royal North Shore Hospital, St Leonards, New South Wales, Australia
- School of Psychology, The University of Sydney, Camperdown, New South Wales, Australia
| | - Judy Kay
- School of Computer Science, The University of Sydney, Faculty of Engineering, Sydney, New South Wales, Australia
| | - Sandra Turner
- Department of Radiation Oncology, Westmead Hospital, Westmead, New South Wales, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Bogda Koczwara
- Flinders University School of Medicine, Adelaide, South Australia, Australia
| | - Christobel Saunders
- Division of Surgery, School of Medicine, The University of Western Australia, Perth, Western Australia, Australia
| | - Michael Jefford
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Patsy Yates
- Centre for Cancer and Palliative Care Outcomes, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Frances Boyle
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Patricia Ritchie Centre for Cancer Care & Research, Mater Hospital, Sydney, New South Wales, Australia
| | - Kate White
- Susan Wakil School of Nursing and Midwifery, Cancer Nursing Research Unit, University of Sydney, Faculty of Medicine and Health, Camperdown, New South Wales, Australia
| | - Annie Miller
- Cancer Information and Support Services Division, Cancer Council New South Wales, Woolloomooloo, New South Wales, Australia
| | - Rachael L Morton
- NHMRC Clinical Trials Centre, The University of Sydney, Faculty of Medicine and Health, Camperdown, New South Wales, Australia
| | - Zoe Butt
- School of Psychology, Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), The University of Sydney, Faculty of Science, Camperdown, New South Wales, Australia
| | - Phyllis Butow
- School of Psychology, Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), The University of Sydney, Faculty of Science, Camperdown, New South Wales, Australia
| |
Collapse
|
44
|
Shariati E, Dadgari A, Talebi SS, Mahmoodi Shan GR, Ebrahimi H. The Effect of the Web-Based Communication between a Nurse and a Family Member on the Perceived Stress of the Family Member of Patients with Suspected or Confirmed COVID-19: A Parallel Randomized Clinical Trial. Clin Nurs Res 2021; 30:1098-1106. [PMID: 34044625 DOI: 10.1177/10547738211017688] [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: 11/16/2022]
Abstract
The aim of this study was to identify the effect of web-based communication between a nurse and a family member of a patient with COVID-19 on his/her perceived stress. In this multicenter parallel randomized controlled trial, 67 family members of COVID-19 patients admitted to the Intensive Care Unit (ICU) were investigated. In the intervention group, web-based communication was performed for four consecutive days for 10 to 15 minutes. The Perceived Stress Scale (PSS-14) were completed in both groups before and after the intervention. Mean and standard deviation of perceived stress scores in the two groups were not significantly different (p = 0.26) before the intervention; however, after the intervention, the mean PSS-14 in the intervention group was significantly lower than that of the control group (p < 0.001). Due to the need to follow the physical and social distancing to protect against Coronavirus disease, the use of web-based communication recommended in future studies.
Collapse
Affiliation(s)
- Esmail Shariati
- The Student Research Committee, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Ali Dadgari
- School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Seyedeh Solmaz Talebi
- Department of Epidemiology, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran
| | | | - Hossein Ebrahimi
- Center for Health-Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
| |
Collapse
|
45
|
Lambert SD, Duncan LR, Ellis J, Robinson JW, Sears C, Culos-Reed N, Matthew A, De Raad M, Schaffler JL, Mina DS, Saha-Chaudhuri P, McTaggart-Cowan H, Peacock S. A study protocol for a multicenter randomized pilot trial of a dyadic, tailored, web-based, psychosocial, and physical activity self-management program (TEMPO) for men with prostate cancer and their caregivers. Pilot Feasibility Stud 2021; 7:78. [PMID: 33743804 PMCID: PMC7980105 DOI: 10.1186/s40814-021-00791-6] [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: 10/15/2020] [Accepted: 02/08/2021] [Indexed: 01/21/2023] Open
Abstract
Background Prostate cancer predisposes patients and caregivers to a wide range of complex physical and psychosocial challenges, and interventions must incorporate a wide range of self-management strategies to help patients and their caregivers effectively cope with cancer challenges. To palliate this need, our team recently developed and evaluated the initial acceptability of a dyadic, Tailored, wEb-based, psychosocial, and physical activity self-Management PrOgram (TEMPO). TEMPO is a 10-week, interactive, web-based intervention consisting of five modules designed to help dyads manage their physical and psychosocial needs. It aims to teach dyads new self-management strategies and encourages them to increase their physical activity (PA) levels, mainly through walking and strength-based exercises. Initial acceptability evaluation of TEMPO revealed high user satisfaction, in addition to having a number of potential benefits for participants. After integrating suggested changes to TEMPO, the proposed pilot study aims to further test the acceptability and feasibility of TEMPO. Methods This study is a multicenter, stratified, parallel, two-group, pilot randomized control trial (RCT), where patient–caregiver dyads are randomized (stratified by anxiety level) to receive (a) TEMPO or (b) usual care. Participants (n goal = 40) are recruited across Canada at participating cancer centers and through self-referral (e.g., online recruitment). Patient inclusion criteria are (a) having received prostate cancer treatment within the past 2 years or scheduled to receive treatment, (b) identified a primary caregiver willing to participate in the study, and (c) has access to the Internet. Eligible caregivers are those identified by the patient as his primary source of support. Dyads complete a baseline questionnaire (T1) and another one 3 months later (T2) assessing various aspects of physical and emotional functioning (e.g., the Medical Outcomes Study (MOS) 12-item Short Form Health Survey (SF-12), the Hospital Anxiety and Depression Scale (HADS), and the Perceived Stress Scale (PSS)), self-management behaviors (e.g., the Health Education Impact Questionnaire (heiQ)), physical activity (the International Physical Activity Questionnaires (IPAQ) and the Multidimensional Self-efficacy for Exercise Scale (MSES)), and dyadic coping (the Dyadic Coping Inventory (DCI)). Dyads that used TEMPO are also asked to participate in a semi-structured exit interview exploring their overall experience with the program. Discussion This feasibility analysis will begin to develop the knowledge base on TEMPO’s value for men with prostate cancer and their caregivers to inform a larger trial. Trial registration NCT04304196 Supplementary Information The online version contains supplementary material available at 10.1186/s40814-021-00791-6.
Collapse
Affiliation(s)
- Sylvie D Lambert
- Ingram School of Nursing, McGill University, Montreal, Quebec, Canada. .,St. Mary's Research Centre, Montreal, Quebec, Canada.
| | - Lindsay R Duncan
- Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada
| | - Janet Ellis
- Department of Psychiatry, University of Toronto, Toronto, Canada.,Psychosocial Care in Trauma, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - John Wellesley Robinson
- Department of Psychology, University of Calgary, Calgary, Canada.,Department of Oncology, University of Calgary, Calgary, Canada
| | | | - Nicole Culos-Reed
- Health and Exercise Psychology, Faculty of Kinesiology, University of Calgary, Calgary, Canada.,Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Psychosocial Resources, Tom Baker Cancer Centre, Cancer Care, Alberta Health Services, Edmonton, Canada
| | - Andrew Matthew
- Faculty of Medicine, Department of Surgery, University of Toronto, Toronto, Canada.,Department of Psychiatry, University of Toronto, Toronto, Canada.,Department of Surgery, Princess Margaret Cancer Centre, Toronto, Canada
| | - Manon De Raad
- St. Mary's Research Centre, Montreal, Quebec, Canada
| | | | - Daniel Santa Mina
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada.,Toronto General Hospital, Toronto, Canada
| | | | - Helen McTaggart-Cowan
- Canadian Centre for Applied Research in Cancer Control, Toronto, Canada.,Cancer Control Research, BC Cancer, Vancouver, Canada
| | - Stuart Peacock
- Canadian Centre for Applied Research in Cancer Control, Toronto, Canada.,Cancer Control Research, BC Cancer, Vancouver, Canada.,Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| |
Collapse
|
46
|
Personalized Prechemotherapy Education Reduces Peri-Chemotherapy Anxiety in Colorectal Cancer Patients. DISEASE MARKERS 2021; 2021:6662938. [PMID: 34007345 PMCID: PMC8110412 DOI: 10.1155/2021/6662938] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 02/26/2021] [Accepted: 03/06/2021] [Indexed: 12/28/2022]
Abstract
Objective To evaluate the effect of personalized prechemotherapy education in the reduction of peri-chemotherapy anxiety in patients with colorectal cancer. Methods Patients admitted to the Department of Oncology with a diagnosis of stage III or IV colorectal cancer and scheduled for initial chemotherapy from January 1, 2017, to June 30, 2019, were retrieved. Patients in the educated group completed the GAD-7 form to evaluate their anxiety level at admission and 14 days after personalized prechemotherapy education, the educator team of which included both physician and nurse staff. Patients in the control group only completed GAD-7 forms at admission and 14 days thereafter without personalized education. Results Three hundred and sixty-four patients were enrolled for analysis, including 127 patients who received personalized prechemotherapy education and 237 patients who did not receive education. There were no significant differences in age, gender, education level, or pretreatment GAD-7 scores between the two groups, but significantly lower posttreatment GAD-7 score, and fewer medium to severe posttreatment anxiety patients in the educated group. Conclusion Personalized prechemotherapy education involving physician for medical treatment and nursing staff for peri-treatment care, in contrast to traditional brief discussion with physicians during clinic visits and unified informed consent before treatments, may reduce peri-chemotherapy anxiety more efficiently.
Collapse
|
47
|
Thomas Hebdon MC, Coombs LA, Reed P, Crane TE, Badger TA. Self-efficacy in caregivers of adults diagnosed with cancer: An integrative review. Eur J Oncol Nurs 2021; 52:101933. [PMID: 33799022 DOI: 10.1016/j.ejon.2021.101933] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 03/03/2021] [Accepted: 03/04/2021] [Indexed: 02/02/2023]
Abstract
PURPOSE Cancer caregivers experience health challenges related to their caregiving role, and self-efficacy can contribute to health outcomes through behavioral, environmental, and personal factors. The purpose of this integrative review was to examine self-efficacy in caregivers of adults diagnosed with cancer, including its association with health factors. METHOD A systematic search of PubMed, CINAHL, and PsychInfo yielded 560 articles. Following duplicate removal, 232 articles were screened for inclusion criteria with 71 articles remaining for final review. RESULTS Studies were generally quantitative (n = 67), with predominantly female (n = 55), White (n = 36) caregivers, between the ages of 45-60 (n = 48). Self-efficacy was significantly associated with quality of life, caregiver function, social support, hope, depression, anxiety, and burden as a predictor, mediator, and outcome. Physical health and social determinants of health (social support and financial well-being) were addressed among fewer studies than mental and emotional health outcomes. CONCLUSIONS Addressing self-efficacy in diverse populations and within physical, mental, and social health contexts will enhance understanding of how self-efficacy impacts caregivers of adults diagnosed with cancer. Nurses and other health care professionals can then effectively address supportive needs of caregivers in the personal, behavioral, and environmental domains.
Collapse
Affiliation(s)
| | - Lorinda A Coombs
- University of North Carolina Chapel Hill, School of Nursing, Lineberger Comprehensive Cancer Center, USA.
| | - Pamela Reed
- University of Arizona College of Nursing, 1305 N. Martin Ave., Tucson, AZ, 85721, USA.
| | - Tracy E Crane
- University of North Carolina Chapel Hill, School of Nursing, Lineberger Comprehensive Cancer Center, USA.
| | - Terry A Badger
- University of North Carolina Chapel Hill, School of Nursing, Lineberger Comprehensive Cancer Center, USA.
| |
Collapse
|
48
|
Sharma A, Saneha C, Phligbua W. Effects of Dyadic Interventions on Quality of Life among Cancer Patients: An Integrative Review. Asia Pac J Oncol Nurs 2021; 8:115-131. [PMID: 33688560 PMCID: PMC7934590 DOI: 10.4103/apjon.apjon_63_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 10/16/2020] [Indexed: 11/17/2022] Open
Abstract
Interventions delivered to cancer patients along with their caregiver as a unit of care indicates dyadic intervention. With the shift of care to home, dyadic interventions are being popular among cancer care. This review aims to identify the dyadic interventions targeting quality of life (QOL) of cancer patient. The current review examined different dyadic interventions for cancer patients from January 2009 to January 2020. PubMed, Psych-info, and CINAHL databases were searched, and 27 studies were included in the review. There were different dyadic interventions for cancer patients including skill based, psychosocial (psycho-educational, educational, counseling), yoga, mindfulness, coping, dance, writing, training along with education, and counseling. Interventions were different in mode of delivery, duration, and delivery personnel. Interventions had improved some aspects of QOL among cancer patients as well as caregivers. Although some aspects of QOL were improved, precise dose and use of different approaches together could be integrated to develop further interventions. Further intervention based on strong theoretical framework guided by the standard protocol is recommended.
Collapse
Affiliation(s)
- Abha Sharma
- Faculty of Nursing, Mahidol University, Thailand
| | | | | |
Collapse
|
49
|
Abstract
PURPOSE OF REVIEW Cancer diagnosis and treatment can have long-lasting psychological and physical consequences that affect both patients and their intimate partners. Improved understanding of extant dyadic interventions in the context of cancer, and how access to these may be enhanced through web-based technologies, introduce new directions for how cancer-related psychological distress for couples may be ameliorated. RECENT FINDINGS Couples are negatively impacted by cancer, both individually, and as a dyad. Bolstering techniques to support effective communication about common cancer-related concerns and support for adjusting to new roles and responsibilities may help to strengthen the couple's relationship so partners are better able to cope with cancer. Although there are various intervention options available for couples dealing with cancer, many pose barriers to participation because of constraints on time and/or distance. However, online interventions have been shown to be effective, both in easing psychological distress and reducing participant burden. SUMMARY Couples dealing with cancer experience psychological distress and must learn to navigate changing roles and responsibilities in the face of the disease. Online interventions offer flexible and innovative platforms and programs that help to address couples' educational needs while strengthening dyadic coping.
Collapse
|
50
|
Boyko RM, Sodhi S, Herman DJ. Evaluation of an Online Home Caregiver Support Program for Non-Professional Caregivers of Patients With Palliative Care Needs. Am J Hosp Palliat Care 2020; 38:1099-1105. [PMID: 33078620 DOI: 10.1177/1049909120968257] [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: 11/16/2022] Open
Abstract
BACKGROUND Caring for loved ones with palliative needs can be very stressful for carers'. To address this growing issue, an online Home Caregiver Support Program course was created to provide information to non-professional home caregivers about end-of-life care. OBJECTIVES To measure non-professional caregivers' perceived level of competence in addressing physical, psychological, social, and spiritual needs before and after completing online training modules. METHODS Learners rated their competence before and after completing online modules addressing 4 key dimensions relevant to palliative caregivers. Self-ratings of competence were assessed through surveys, completed before and after the online modules. Scores from before and after each module were compared to determine if the online course had increased participant competence. The Wilcoxon signed rank test was used to analyze participant responses to the pre- and post-survey questions. RESULTS A total of 176 participants who completed one or more of the online modules between July 2017-December 2018, 70 (40%) of the participants completed at least one pre- and post-module survey and did not declare themselves as a professional caregiver. Participating in the online Home Caregiver Support Program increased participants' ratings of perceived competence in all domains (p < .01). This significance was maintained when professional caregivers were added to our analysis. CONCLUSION After the completing the modules, participants' self-ratings of perceived competence increased suggesting that participants completing the online program had improved knowledge in addressing the physical, psychological, social, and spiritual challenges faced by non-professional caregivers.
Collapse
Affiliation(s)
- Robert M Boyko
- 12366Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Sukhmani Sodhi
- 12366Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Dakoda J Herman
- 12366Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|