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Adebayo K, Omobowale M, Akinyemi A, Usman R, Olujimi A, Omodara F. "I am the one taking care of her and donating blood": lived experiences of role-routines of hospital-based informal caregiving in Nigeria. Int J Qual Stud Health Well-being 2024; 19:2356928. [PMID: 38773959 PMCID: PMC11123441 DOI: 10.1080/17482631.2024.2356928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 05/14/2024] [Indexed: 05/24/2024] Open
Abstract
PURPOSE Informal caregivers (ICs) in Africa perform a long list of tasks to support hospitalization care. However, available studies are weak in accounting for the experiences of everyday role-routines of hospital-based informal caregiving (HIC) in under-resourced settings. This article explored the experiences of role-routines among informal caregivers in a Nigerian tertiary health facility. METHODS The ethnographic exploratory study relied on primary data collected from 75 participants, including 21 ICs, 15 inpatients, 36 hospital staff, and 3 ad-hoc/paid carers in a tertiary health facility in Southwestern Nigeria. RESULTS ICs perform several essential roles for hospitalized relatives, with each role characterized by a range of tasks. An integrative narrative of everyday routines of HIC as experienced by ICs showed critical complexities and complications involved in seemingly simple tasks of assisting hospitalized relatives with hygiene maintenance, medical investigations, blood donation, resource mobilization, errand-running, patient- and self-care and others. The role-routines are burdensome and ICs' experiences of them revealed the undercurrents of how health systems dysfunctions condition family members to support hospitalization care in Nigeria. CONCLUSION The intensity and repetitive nature of role-routines is suggestive of "routinization of suffering". We recommend the closing of gaps driving hospital-based informal caregiving in Africa's under-resourced settings.
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Affiliation(s)
- Kudus Adebayo
- Institute of African Studies, University of Ibadan, Ibadan, Nigeria
- School of Public Health, University of The Witwatersrand, Johannesburg, South Africa
| | - Mofeyisara Omobowale
- Institute of Child Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | | | - Rukayat Usman
- Institute of African Studies, University of Ibadan, Ibadan, Nigeria
| | - Atinuke Olujimi
- Department of Sociology, University of Ibadan, Ibadan, Nigeria
| | - Funmilayo Omodara
- Institute of Child Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
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Koyu HO, Algül G, Altay N, Kilicarslan E. The effect of psychological resilience and spiritual well-being on the experience of hope in parents of children with cancer. J Pediatr Nurs 2024; 76:e34-e41. [PMID: 38307757 DOI: 10.1016/j.pedn.2024.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 12/15/2023] [Accepted: 01/13/2024] [Indexed: 02/04/2024]
Abstract
PURPOSE Hope in pediatric oncology guides parents as an inner guidance compass through their child's challenging journey toward cancer treatment. This study was designed to examine the effects of psychological resilience, spiritual well-being, and some child- and parent-related factors on parents' experience of hope while their child is undergoing cancer treatment. DESIGN AND METHODS This cross-sectional, correlational study was conducted between March and July 2022 in the pediatric oncology-hematology ward of a university hospital in Turkey. Parents of 120 children with cancer were included in the study. Data were collected using the child and parent questionnaire, Herth Hope Index, Connor-Davidson Resilience Short Form, and Spiritual Well-Being Scale. Correlation and multiple linear regression analysis were used to analyze the data. In addition, the content analysis method was used to analyze the open-ended structured questions. Ethical approval was obtained for the study. RESULTS In the study, 57.5% of the parents who participated were mothers. The mean age of the children was 9.46 ± 5.00 years. 30.8% of the children were diagnosed with Acute Lymphoblastic Leukemia, and the mean duration of treatment was 20.42 ± 13.75 months. According to multiple linear regression analysis, child gender (β = -0.16), number of children (β = -0.16), cancer diagnosis (β = -0.24), resilience (β =0.31), and parental spiritual well-being (β =0.40) were the determinant factors affecting parents' experiences of hope. All these predictors explained 55% of the change in parents' hope levels. In addition, two main themes (increasing and decreasing factors) were identified regarding parents' experiences of hope. CONCLUSIONS Insights from this study have the potential to shape interventions specifically designed to maintain parents' hope throughout their child's cancer treatment journey. IMPLICATIONS FOR PRACTICE This study may provide insights for the design of intervention programs in pediatric oncology hematology wards aimed at strengthening the hope and improving coping mechanisms of parents with children coping with cancer.
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Affiliation(s)
- Hazal Ozdemir Koyu
- Gazi University Nursing Faculty Department of Pediatric Nursing, Ankara, Turkey..
| | | | - Naime Altay
- Gazi University Nursing Faculty Department of Pediatric Nursing, Ankara, Turkey
| | - Ebru Kilicarslan
- Gazi University Nursing Faculty Department of Pediatric Nursing, Ankara, Turkey
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Najjuka SM, Iradukunda A, Kaggwa MM, Sebbowa AN, Mirembe J, Ndyamuhaki K, Nakibuule C, Atuhaire JP, Nabirye E, Namukwaya E, Kiguli S. The caring experiences of family caregivers for patients with advanced cancer in Uganda: A qualitative study. PLoS One 2023; 18:e0293109. [PMID: 37878610 PMCID: PMC10599584 DOI: 10.1371/journal.pone.0293109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 10/05/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND Cancer morbidity and mortality is rising in sub-Saharan Africa. Given this rise, family caregivers play an integral role in provision of quality cancer care services. This study explored the family caregivers (FCGs)/relatives' experiences of caring for patients with advanced cancer (stage 3 or stage 4) in Uganda. METHODS This was a descriptive qualitative study exploring the lived experiences of FCGs of patients with advanced cancer attending care at the Uganda cancer institute. We purposively recruited twelve FCGs and conducted face-to-face in-depth interviews using an interviewer-guided semi-structured questionnaire. Data were analyzed by thematic analysis. RESULTS The age range of participants was 19 to 49 years. Most participants were children of the patients (n = 7), had attained tertiary education (n = 7), and had taken care of their loved ones for at least one year (n = 10). Six themes emerged from data analysis; (i) caring roles, (ii) caring burdens, (iii) role conflict, (iv) health system tensions, (v) support and motivation, (vi) caring benefits, lessons and recommendations. CONCLUSION Study findings highlight the fundamental role of FCGs in the care of their loved ones, and illuminate the neglected physical, psychological and social challenges of family caregivers amidst health system tensions and conflicting roles. The needs of family caregivers should be embedded within cancer care, prevention and control programs particularly in low resource settings.
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Affiliation(s)
| | | | - Mark Mohan Kaggwa
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
- Forensic Psychiatry Program, St Joseph’s Healthcare Hamilton, Hamilton, Ontario, Canada
| | | | - Joy Mirembe
- College of Health Sciences, Makerere University, Kampala, Uganda
| | | | | | | | - Elizabeth Nabirye
- Department of Palliative Care Medicine, College of Health Sciences Makerere University, Kampala, Uganda
| | - Elizabeth Namukwaya
- Department of Palliative Care Medicine, College of Health Sciences Makerere University, Kampala, Uganda
| | - Sarah Kiguli
- Department of Pediatrics and Child Health, College of Health Sciences Makerere University, Kampala, Uganda
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Kramar MJF, García-Caro MP, Ternero AM, Martí-García C. Migrant women caregivers' experiences in end-of-life formal care. Rev Esc Enferm USP 2023; 57:e20230031. [PMID: 37552833 PMCID: PMC10414973 DOI: 10.1590/1980-220x-reeusp-2023-0031en] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 06/01/2023] [Indexed: 08/10/2023] Open
Abstract
OBJECTIVE To describe and understand the experience of Latin American migrant women as caregivers of elderly people in situations of advanced illness and end of life. METHOD Qualitative study using Gadamer's hermeneutic phenomenology. Data were collected in 2019 through 9 semi-structured interviews with Latin American women caregivers, who had cared for people at the end of life, in the Province of Granada (Spain). RESULTS Two themes emerged: "Migrant caregiver at the end of life" and "And now, what should I do?": the impact of the loss at the economic, emotional and labor level. CONCLUSION Care during the end of life of the cared person generates an additional overload to the situation of migrant women. The experience of this stage is related to the bond with the persons cared and their families, which may affect the development of complicated grief and personal problems related to the loss of employment and the absence of economic support.
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Affiliation(s)
| | - María Paz García-Caro
- Universidad de Granada, Facultad de Ciencias de la Salud, Departamento de Enfermería, Granada, España
| | | | - Celia Martí-García
- Universidad de Málaga, Facultad de Ciencias de la Salud, Departamento de Enfermería, Málaga, España
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Ranganathan S, Tomar V, Chino F, Jain B, Patel TA, Dee EC, Mathew A. A burden shared: the financial, psychological, and health-related consequences borne by family members and caregivers of people with cancer in India. Support Care Cancer 2023; 31:420. [PMID: 37354234 DOI: 10.1007/s00520-023-07886-1] [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: 02/12/2023] [Accepted: 06/13/2023] [Indexed: 06/26/2023]
Abstract
In India, approximately 1.4 million new cases of cancer are recorded annually, with 26.7 million people living with cancer in 2021. Providing care for family members with cancer impacts caregivers' health and financial resources. Effects on caregivers' health and financial resources, understood as family and caregiver "financial toxicity" of cancer, are important to explore in the Indian context, where family members often serve as caregivers, in light of cultural attitudes towards family. This is reinforced by other structural issues such as grave disparities in socioeconomic status, barriers in access to care, and limited access to supportive care services for many patients. Effects on family caregivers' financial resources are particularly prevalent in India given the increased dependency on out-of-pocket financing for healthcare, disparate access to insurance coverage, and limitations in public expenditure on healthcare. In this paper, we explore family and caregiver financial toxicity of cancer in the Indian context, highlighting the multiple psychosocial aspects through which these factors may play out. We suggest steps forward, including future directions in (1) health services research, (2) community-level interventions, and (3) policy changes. We underscore that multidisciplinary and multi-sectoral efforts are needed to study and address family and caregiver financial toxicity in India.
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Affiliation(s)
| | | | - Fumiko Chino
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Radiation Oncology and Affordability Working Group, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Bhav Jain
- Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Tej A Patel
- University of Pennsylvania, Philadelphia, PA, USA
| | - Edward Christopher Dee
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
| | - Aju Mathew
- Department of Oncology, MOSC Medical College, Ernakulam, Kerala, 682311, India
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Determeijer JJ, Leopold SJ, Spijker R, Agyemang C, van Vugt M. Family participation to enhance care and tackle health worker shortages in resource-limited hospitals: A systematic review. J Glob Health 2023; 13:04005. [PMID: 36655879 PMCID: PMC9853090 DOI: 10.7189/13.04005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Background A growing global shortage of health workers is limiting access to health care, especially in resource-limited countries. Family participation in hospital care could enhance care while tackling health worker shortages. With the same resources, it might deliver additional and more personalised care. This review assessed the effect and safety of family participation interventions in the care of hospitalised adults in resource-limited settings and, ultimately, if it is a viable strategy to tackle health worker shortages. Methods For this systematic review, Medline, Embase, CINAHL and the Global Health Library were searched from inception till April 7, 2022. Clinical studies were included if they described a family participation intervention for hospitalised adults, were performed in a low- or middle-income country and reported on a patient-related outcome. Data were collected on patient, family, staff and health service-related outcomes. Risk of bias was assessed with the ROB2 and ROBINS-I tool. Results From 4444 studies, six were included for narrative synthesis, with a total of 1794 participants. Four studies were performed in Asia and two in Africa; all were published between 2017 and 2022. In-hospital family participation interventions aimed at medication administration and adherence, delirium prevention, and palliative cancer care were successful in significantly improving patient outcomes. Involving family in post-stroke rehabilitation interventions showed no significant effect on mortality and long-term disability. Few data were reported on participating family members' outcomes or hospital staffing issues. None of the included studies showed harm from family participation. Conclusions The limited data suggest that family participation can be effective and safe in specific contexts. However, more research is needed to determine the effect of family participation and justify further implementation. Family participation research for enhancing care while tackling health worker shortages should be a collaborative priority of researchers, health care professionals, funding agencies and policymakers. Registration PROSPERO registration No. CRD42020205878.
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Affiliation(s)
- Jim J Determeijer
- Department of Infectious disease, Amsterdam University Medical Centers, Amsterdam, the Netherlands,Department of Public Health, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Stije J Leopold
- Department of Infectious disease, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - René Spijker
- Department of Public Health, Amsterdam University Medical Centers, Amsterdam, the Netherlands,Medical Library, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Charles Agyemang
- Department of Public Health, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Michèle van Vugt
- Department of Infectious disease, Amsterdam University Medical Centers, Amsterdam, the Netherlands,Department of Public Health, Amsterdam University Medical Centers, Amsterdam, the Netherlands
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Nuwamanya S, Nkola R, Najjuka SM, Nabulo H, Al-Mamun F, Mamun MA, Kaggwa MM. Depression in Ugandan caregivers of cancer patients: The role of coping strategies and social support. Psychooncology 2023; 32:113-124. [PMID: 36289590 DOI: 10.1002/pon.6057] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 08/06/2022] [Accepted: 09/28/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND Palliative care services involve the psychological care of the caregivers of cancer patients. Psychological conditions, especially depression among caregivers, distort caregiving roles; thus, it can increase a patient's psychological suffering. OBJECTIVE To determine the prevalence of depression and associated coping strategies among caregivers of cancer patients at a rural cancer care facility. METHODS This cross-sectional study was among 366 caregivers of cancer patients. The data was collected using a pretested questionnaire, where the symptoms of depression were assessed using the Patient Health Questionnaire-9 at a cutoff of 10 out of 27. The coping strategies were assessed based on the Brief-coping orientation to problems experienced Inventory. Logistic regression was used to determine the factors associated with depression. RESULTS The mean age of the participants was 39.01 (±11.50) years; most were females (60.38%). The prevalence of depression was 8.2%. The identified factors associated with increased likelihood of depression were coping strategies: active coping (aOR = 1.55, 95% Confidence Interval (CI) = 1.05-2.28, p = 0.026), denial (aOR = 1.62, 95% CI = 1.20-2.19, p = 0.001), and humor (aOR = 1.43, 95% CI = 1.11-1.84, p = 0.005). However, coping with positive reframing reduced the likelihood of depression (aOR = 0.70, 95% CI = 0.52-0.94, p = 0.019). There was no significant association between depression and social support. CONCLUSION The lower prevalence of depression reported in this study than in the prior Ugandan studies reflects that depression severity among caregivers in rural settings is less prevalent because of the fewer care-associated burdens they experience. Therefore, establishing palliative care near the patients can be a protective factor for caregivers' depression. In addition, the role of social support and coping strategies in depression might be helpful in mental health strategies.
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Affiliation(s)
- Simpson Nuwamanya
- Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Rahel Nkola
- Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.,African Centre for Suicide Prevention and Research, Mbarara, Uganda
| | | | - Harriet Nabulo
- Department of Nursing, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Firoj Al-Mamun
- CHINTA Research Bangladesh, Savar, Dhaka, Bangladesh.,Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, Bangladesh.,Department of Public Health, University of South Asia, Dhaka, Bangladesh
| | - Mohammed A Mamun
- CHINTA Research Bangladesh, Savar, Dhaka, Bangladesh.,Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, Bangladesh
| | - Mark Mohan Kaggwa
- Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.,African Centre for Suicide Prevention and Research, Mbarara, Uganda.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
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Guan T, Qan’ir Y, Conklin JL, Zimba CC, Bula A, Jumbo W, Wella K, Mapulanga P, Bingo SA, Chilemba E, Haley J, Montano NP, Bryant AL, Song L. Systematic review of psychosocial interventions for adult cancer patients and their family caregivers in Sub-Saharan Africa. Glob Public Health 2023; 18:2199062. [PMID: 37054448 PMCID: PMC10623887 DOI: 10.1080/17441692.2023.2199062] [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: 11/14/2022] [Accepted: 03/30/2023] [Indexed: 04/15/2023]
Abstract
Cancer is becoming a public health issue in the Sub-Saharan Africa (SSA). This systematic review aims to synthesise psychosocial interventions and their effects on the health outcomes of adult cancer patients and their family caregivers in SSA. We identified eligible publications in English language from PubMed, Cumulative Index of Nursing and Allied Health Literature Plus with Full Text, Embase, APA PsycInfo, Scopus, and African Index Medicus databases. We included psychosocial interventions targeted adult cancer patients/survivors or their family caregivers in SSA. This review identified five psychosocial interventions from six studies that support adult cancer patients and their family caregivers in SSA. The interventions focused on providing informational, psycho-cognitive, and social support. Three interventions significantly improved quality of life outcomes for cancer patients and their caregivers. Significant gaps exist between the rapidly increasing cancer burdens and the limited psychosocial educational interventions supporting adult cancer patients and their families in SSA. The reviewed studies provide preliminary evidence on development and testing interventions that aim to improve patients' and caregivers' quality of life.
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Affiliation(s)
- Ting Guan
- School of Social Work, Syracuse University, Syracuse, NY, USA
| | - Yousef Qan’ir
- Faculty of Nursing, Applied Science Private University, Amman, Jordan
| | - Jamie L. Conklin
- Health Sciences Library, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Agatha Bula
- University of North Carolina at Chapel Hill Project, Lilongwe, Malawi
| | - Wongani Jumbo
- University of North Carolina at Chapel Hill Project, Lilongwe, Malawi
| | | | | | | | | | - Jennifer Haley
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Ashley Leak Bryant
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lixin Song
- School of Nursing, UT Health San Antonio, San Antonio, TX, USA
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Kaggwa MM, Najjuka SM, Bongomin F, Mamun MA, Griffiths MD. Prevalence of depression in Uganda: A systematic review and meta-analysis. PLoS One 2022; 17:e0276552. [PMID: 36264962 PMCID: PMC9584512 DOI: 10.1371/journal.pone.0276552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 10/09/2022] [Indexed: 11/07/2022] Open
Abstract
Background Depression is one of the most studied mental health disorders, with varying prevalence rates reported across study populations in Uganda. A systematic review and meta-analysis was carried out to determine the pooled prevalence of depression and the prevalence of depression across different study populations in the country. Methods Papers for the review were retrieved from PubMed, Scopus, PsycINFO, African Journal OnLine, and Google Scholar databases. All included papers were observational studies regarding depression prevalence in Uganda, published before September 2021. The Joanna Briggs Institute Checklist for Prevalence Studies was used to evaluate the risk of bias and quality of the included papers, and depression pooled prevalence was determined using a random-effects meta-analysis. Results A total of 127 studies comprising 123,859 individuals were identified. Most studies were conducted among individuals living with HIV (n = 43; 33.9%), and the most frequently used instrument for assessing depression was the Depression sub-section of the Hopkins Symptom Checklist (n = 34). The pooled prevalence of depression was 30.2% (95% confidence interval [CI]: 26.7–34.1, I2 = 99.80, p<0.001). The prevalence of depression was higher during the COVID-19 pandemic than during the pre-pandemic period (48.1% vs. 29.3%, p = 0.021). Refugees had the highest prevalence of depression (67.6%; eight studies), followed by war victims (36.0%; 12 studies), individuals living with HIV (28.2%; 43 studies), postpartum or pregnant mothers (26.9%; seven studies), university students (26.9%; four studies), children and adolescents (23.6%; 10 studies), and caregivers of patients (18.5%; six studies). Limitation Significantly high levels of heterogeneity among the studies included. Conclusion Almost one in three individuals in Uganda has depression, with the refugee population being disproportionately affected. Targeted models for depression screening and management across various populations across the country are recommended. Trial registration Protocol registered with PROSPERO (CRD42022310122).
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Affiliation(s)
- Mark Mohan Kaggwa
- Department of Psychiatry, Mbarara University of Science & Technology, Mbarara, Uganda
- African Centre for Suicide Prevention and Research, Mbarara, Uganda
- Department of Psychiatry and Behavioural Neurosciences, Forensic Psychiatry Program, McMaster University, Hamilton, Ontario, Canada
- * E-mail:
| | - Sarah Maria Najjuka
- School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Felix Bongomin
- Department of Medical Microbiology & Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda
| | - Mohammed A. Mamun
- CHINTA Research Bangladesh, Savar, Dhaka, Bangladesh
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, Bangladesh
| | - Mark D. Griffiths
- Psychology Department, Nottingham Trent University, Nottingham, United Kingdom
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Alfaro-Díaz C, Svavarsdottir EK, Esandi N, Klinke ME, Canga-Armayor A. Effectiveness of Nursing Interventions for Patients With Cancer and their Family Members: A Systematic Review. JOURNAL OF FAMILY NURSING 2022; 28:95-114. [PMID: 35057657 DOI: 10.1177/10748407211068816] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Cancer diagnosis poses enormous physical and psychosocial challenges for both the affected person and their families. This systematic review identifies the characteristics and effectiveness of nursing interventions offered to adult patients with cancer and their families. Five databases were searched, and 19 studies published from 2009 to 2020 were included. Interventions were categorized as follows: (a) interventions with supporting and cognitive components (n = 3), (b) interventions that included skills training for the caregiver (n = 3), (c) interventions to enhance care through managing symptoms (n = 8), (d) interventions focusing on the dyad or family-patient relationship (n = 4), and (e) interventions targeted to the patient's condition (n = 1). The results of this review offer an overview from which to carry out new studies and are useful for providing future directions within family nursing practice, taking into account the impact that the family has on the disease and the consequences the condition may bring to the whole family.
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Affiliation(s)
- Cristina Alfaro-Díaz
- Universidad de Navarra, Pamplona, Spain
- Navarra Institute for Health Research, Pamplona, Spain
| | | | - Nuria Esandi
- Universidad de Navarra, Pamplona, Spain
- Navarra Institute for Health Research, Pamplona, Spain
| | - Marianne E Klinke
- University of Iceland, Reykjavik, Iceland
- Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland
| | - Ana Canga-Armayor
- Universidad de Navarra, Pamplona, Spain
- Navarra Institute for Health Research, Pamplona, Spain
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Castro AR, Arnaert A, Moffatt K, Kildea J, Bitzas V, Tsimicalis A. Developing an mHealth Application to Coordinate Nurse-Provided Respite Care Services for Families Coping With Palliative-Stage Cancer: Protocol for a User-Centered Design Study. JMIR Res Protoc 2021; 10:e34652. [PMID: 34898464 PMCID: PMC8713105 DOI: 10.2196/34652] [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: 11/02/2021] [Accepted: 11/15/2021] [Indexed: 11/13/2022] Open
Abstract
Background Patients living with palliative-stage cancer frequently require intensive care from their family caregivers. Without adequate community support services, patients are at risk of receiving inadequate care, and family caregivers are at risk for depression and poor health. For such families, in-home respite care can be invaluable, particularly when the services are flexible and staffed by trusted care providers, such as nurses. Other industries are using mobile apps to make services more flexible. However, few apps have been developed to coordinate nurse-provided respite care services, and to our knowledge, none have been designed in conjunction with families affected by cancer. Objective The aim of this study is to develop a mobile health (mHealth) app prototype for coordinating flexible and trusted in-home respite care services provided by nurses to families coping with palliative-stage cancer in Québec, Canada. Methods This user-centered design research comprises the core component of the iRespite Services iRépit research program. For this study, we are recruiting 20 nurses, 15 adults with palliative-stage cancer, and 20 of their family caregivers, from two palliative oncology hospital departments and one palliative home-care community partner. Overseen by an Expert Council, remote data collection will occur over three research phases guided by the iterative Information Systems Research Framework: Phase 1, brainstorming potential app solutions to challenging respite care scenarios, for better supporting the respite needs of both family caregivers and care recipients; Phase 2, evaluating low-fidelity proofs of concept for potential app designs; and Phase 3, usability testing of a high-fidelity interactive proof of concept that will then be programmed into an app prototype. Qualitative and quantitative data will be descriptively analyzed within each phase and triangulated to refine the app features. Results We anticipate that preliminary results will be available by Spring 2022. Conclusions An app prototype will be developed that has sufficient complimentary evidence to support future pilot testing in the community. Such an app could improve the delivery of community respite care services provided to families with palliative-stage cancer in Québec, supporting death at home, which is where most patients and their families wish to be. International Registered Report Identifier (IRRID) PRR1-10.2196/34652
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Affiliation(s)
- Aimee R Castro
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
| | - Antonia Arnaert
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
| | - Karyn Moffatt
- School of Information Studies, McGill University, Montreal, QC, Canada
| | - John Kildea
- Gerald Bronfman Department of Oncology, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Vasiliki Bitzas
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
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Turan GB, Dayapoğlu N, Özer Z. Evaluation of care burden and caregiving preparedness in caregivers of patients with epilepsy: A sample in eastern Turkey. Epilepsy Behav 2021; 124:108370. [PMID: 34717246 DOI: 10.1016/j.yebeh.2021.108370] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 09/23/2021] [Accepted: 09/25/2021] [Indexed: 10/20/2022]
Abstract
AIM This study was conducted to evaluate the care burden and caregiving preparedness in caregivers of patients with epilepsy. METHODS This descriptive, cross-sectional study evaluated the caregivers of patients with epilepsy who were referred to the neurology outpatient clinic of a university hospital in Erzurum, eastern Turkey, between February 2020 and February 2021. The study was carried out with 147 volunteers among the patients with epilepsy who were referred to the neurology outpatient clinic between the specified dates. The data were collected with Caregiver Question Form, the Brief Disability Questionnaire (BDQ), the Burden Interview (BI), and the Preparedness for Caregiving Scale (PCS). RESULTS The mean BI score of the caregivers who participated in the study was 43.14 ± 18.08, their mean PCS score was 14.12 ± 7.76, and their mean BDQ score was 10.53 ± 4.65. In the regression analysis conducted, it was found that being married, having little knowledge of patient care, undertaking all of the roles in caregiving and having caregiving duration of 24 months and longer had a negative effect on PCS total score, while having an undergraduate degree and higher had a positive significant effect. It was found that having an undergraduate degree and higher had a negative effect on BI total score, while all of the roles undertaken in caregiving had a positive significant effect on BI total score. It was found that PCS had a negative significant effect on BI total score (p < 0.001). CONCLUSION Caregivers of patients with epilepsy had a moderate level of burden and caregiving preparedness, and the patients cared for had a moderate level of disability. Caregiver burden increased as disability of patients with epilepsy and the tasks undertaken in caregiving increased, whereas burden decreased as caregiver education and caregiving preparedness increased.
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Affiliation(s)
| | | | - Zülfünaz Özer
- Department of Nursing, Faculty of Health Sciences, Istanbul Sabahattin Zaim University, Istanbul, Turkey
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Ozdemir Koyu H, Tas Arslan F. The effect of physical and psychosocial symptoms on caregiver burden of parents of children with cancer. Eur J Cancer Care (Engl) 2021; 30:e13513. [PMID: 34632650 DOI: 10.1111/ecc.13513] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 08/25/2021] [Accepted: 09/24/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the effects of parent's characteristics, physical and psychosocial symptoms, and child-related factors on caregiver burden of parents of children with cancer. METHODS This is a descriptive and cross-sectional study that included 172 parents of children with cancer. This study was performed between February and July 2019 in three major paediatric haematology and oncology units located in the centre of Turkey. Data were collected by using the descriptive information form, Pittsburgh Sleep Quality Index, Piper Fatigue Scale, Beck Depression Inventory, Trait Scale of the State-Trait Anxiety Inventory, Multidimensional Scale of Perceived Social Support and Zarit Caregiver Burden Scale. For data analysis, average and percentage calculations and multiple linear regression analyses were used. RESULTS It was found that most of parents had poor sleep quality, moderate depression, fatigue, anxiety, high social support and moderate to severe caregiver burden. It was found that low education level, poor sleep quality, depression, trait anxiety, social support among the factors related to the parents, and the type of treatment and duration of the treatment from the factors related to the child had an effect on the caregiver burden. It was determined that the effective predictive factors explained 73.5% of the parents' caregiver burden. CONCLUSION Caregiver burden is influenced by the parent- and child-related factors. Paediatric oncology nurses should plan interventions that support parents to cope with the caregiver burden during their children's cancer experience.
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Affiliation(s)
- Hazal Ozdemir Koyu
- Nursing Faculty, Department of Child Health and Diseases Nursing, Selcuk University, Konya, Turkey
| | - Fatma Tas Arslan
- Nursing Faculty, Department of Child Health and Diseases Nursing, Selcuk University, Konya, Turkey
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Interventions to Improve the Preparedness to Care for Family Caregivers of Cancer Patients: A Systematic Review and Meta-analysis. Cancer Nurs 2021; 45:E689-E705. [PMID: 34608043 PMCID: PMC9028302 DOI: 10.1097/ncc.0000000000001014] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Background Preparedness for caregiving could balance the negative impacts of caregiving. The interventions aimed at increasing readiness among the caregivers are important during the illness period for both patients and their caregivers. Objectives The aims of this study were to review the interventions applied to the caregivers of cancer patients and to examine the effects of these interventions on the preparedness to care. Methods The ScienceDirect, Scopus, CENTRAL, Web of Science, MEDLINE, and PubMed were searched for relevant studies published between 2000 and 2020. The methodological quality was assessed using the Quality Assessment Tool for Quantitative Studies. The statistical analyses were performed using the Comprehensive Meta-Analysis software version 3.0. The publication bias was assessed using the Egger test, for funnel plots. Results Eleven studies were selected for the meta-analysis, including those about psychoeducation programs (n = 5), education programs (n = 3), supportive programs (n = 2), and a self-care support program for the caregivers (n = 1). The methodological quality assessment revealed 2 studies as “strong.” The results indicated an increase in the caregivers’ preparedness to care after the interventions. The subgroup analysis revealed that the programs with higher ratios of female caregivers were more effective. Conclusion The interventions applied to the family caregivers can exert beneficial effects on caregivers’ preparedness to care. Nonetheless, future studies should focus on methodological issues, such as randomization and blinding. Implications for Practice Nurse-driven interventions may be used as a useful strategy to improve the preparedness to care among the caregivers of cancer patients. The male caregivers should be closely followed by healthcare professionals for knowledge and support needs.
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Measuring the Burden on Family Caregivers of People With Cancer: Cross-cultural Translation and Psychometric Testing of the Caregiver Reaction Assessment-Indonesian Version. Cancer Nurs 2021; 44:37-44. [PMID: 31348026 PMCID: PMC7713759 DOI: 10.1097/ncc.0000000000000733] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Supplemental digital content is available in the text. Background The Caregiver Reaction Assessment (CRA) is considered one of the well-developed instruments for measuring the multidimensional burden of family caregivers. To date, there is no available validated instrument to assist healthcare professionals in measuring the caregiver’s burden in Indonesia. Objective To translate the CRA from English into Indonesian and to conduct psychometric testing of this CRA–Indonesian version (CRA-ID) with family caregivers of patients with cancer. Methods Cross-cultural translation and psychometric testing were conducted. Confirmatory factor analysis and exploratory factor analysis were performed to check, explore, and confirm the best model for the CRA-ID; internal consistency was also measured. Results A total of 451 respondents participated, of whom 40 were involved in the feasibility testing. Confirmatory factor analysis with the original factors of the CRA revealed that the fit was not satisfactory, and adaptation was needed. Through exploratory factor analysis, the best model fit was developed, and confirmatory factor analysis was performed again. Five factors from the original instrument were confirmed with an explained variance of 54.89%. Almost all items in the CRA-ID appeared to have a similar structure as the original version. Cronbach's α's ranged between .64 and .81. Conclusions The CRA-ID appeared to be feasible, valid, and reliable for measuring the burden of family caregivers of patients with cancer in Indonesia. Implications for Practice Nurses can use the CRA-ID to measure family caregivers’ burden. Its availability in the Indonesian language enhances the opportunity to conduct international comparisons of family caregiver burden using the same instrument.
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Lemetti T, Partanen E, Hupli M, Haavisto E. Cancer patients' experiences of realization of relatives' participation in hospital care: a qualitative interview study. Scand J Caring Sci 2020; 35:979-987. [PMID: 33107636 DOI: 10.1111/scs.12918] [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: 02/12/2020] [Accepted: 10/05/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Relatives' participation in the care of patients with cancer in hospital is essential to both patients and relatives. Although the meaning of relatives' participation has been recognized, knowledge about how patients experience this participation is rare. AIMS To describe the experiences of patients with cancer of the realization of relatives' participation in the hospital care. MATERIALS & METHODS A qualitative study with semi-structured interviews of patients with cancer (n=21) were conducted. Data was analyzed using inductive thematic analysis. RESULTS Three main themes were identified among patients' experiences: Relative as part of the patient's care, Relative supporting patient's coping process, and Hospital enabling or preventing relatives' participation. The relatives were available for patients in seeking information and in the decision-making process. They helped with the daily needs of the patient, and supported patients emotionally and by managing everyday life at home. The behavior and attitudes of the healthcare professionals and the special nature of the hospital played a central role in the experiences. CONCLUSION The role of relatives is an important part of the coping process and care of patients with cancer in the hospital.
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Affiliation(s)
- Terhi Lemetti
- Department of Nursing Science, University of Turku, Turku, Finland.,Helsinki University Hospital, Helsinki, Finland
| | - Elli Partanen
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Maija Hupli
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Elina Haavisto
- Department of Nursing Science, University of Turku, Turku, Finland.,Hospital District of Satakunta, Pori, Finland
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Kusi G, Boamah Mensah AB, Boamah Mensah K, Dzomeku VM, Apiribu F, Duodu PA, Adamu B, Agbadi P, Bonsu KO. The experiences of family caregivers living with breast cancer patients in low-and middle-income countries: a systematic review. Syst Rev 2020; 9:165. [PMID: 32703259 PMCID: PMC7379811 DOI: 10.1186/s13643-020-01408-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 06/10/2020] [Indexed: 01/23/2023] Open
Abstract
INTRODUCTION Caregivers of women with breast cancer in low-and-middle-income countries experience significant physical and economic burdens. The review aimed to map the evidence of studies that had reported on the experiences of family caregivers of women diagnosed with breast cancer. METHODS A systematic literature search was conducted in CINAHL, PubMed, PsycINFO, Scopus, and Web of Science databases using a combination of key search terms and medical subject heading terms such as "family caregiver," "breast cancer," "home care," "low-and-middle-income countries," "experience," "effect," and "coping mechanism." A total of 1781 articles were retrieved and screened. Nineteen studies addressing caregiving experiences were included in the final review based on the inclusion and exclusion criteria. RESULTS The systematic review yielded 19 studies that focused on caregivers' motivation, needs of caregivers, intervention for caregivers, and consequences of caregiving. The most significant correlates of the quality of life among caregivers were disease severity, functional status of patients, and family income. The challenges encountered by caregivers were mostly psychosocial. CONCLUSIONS Caregivers play a crucial role in the management of women with breast cancer. However, they are faced with increasing challenges in their caregiving roles. Understanding the nature and extent of the burden experienced by family caregivers in developing countries will facilitate the development of appropriate interventions that can help improve caregivers' quality of life. Gaps in recent studies were identified, and suggestions for future research were also addressed in this review. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42019118391.
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Affiliation(s)
- Grace Kusi
- Department of Nursing, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Department of Obstetrics and Gynecology, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Adwoa Bemah Boamah Mensah
- Department of Nursing, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Kofi Boamah Mensah
- Oncology Directorate, Komfo Anokye Teaching Hospital, Kumasi, Ghana
- Department of Pharmacy Practice, Faculty of Pharmacy and Pharmaceutical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Veronica Millicent Dzomeku
- Department of Nursing, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Felix Apiribu
- Department of Nursing, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Precious Adade Duodu
- Department of Nursing, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Bakinam Adamu
- Department of Nursing, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Pascal Agbadi
- Department of Nursing, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Kwadwo Osei Bonsu
- Department of Pharmacy Practice, Faculty of Pharmacy and Pharmaceutical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Lee Wong C, Choi KC, Mei Nok Lau, Lam KL, Wei So WK. Caregiving burden and sleep quality amongst family caregivers of Chinese male patients with advanced cancer: A cross-sectional study. Eur J Oncol Nurs 2020; 46:101774. [PMID: 32460141 DOI: 10.1016/j.ejon.2020.101774] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 03/15/2020] [Accepted: 05/10/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE To examine the level of caregiving burden and sleep quality as well as their interrelationship amongst family caregivers of Chinese male patients with advanced cancer. METHOD A cross-sectional study was conducted in Hong Kong. The Caregiver Reaction Assessment (CRA) and the Pittsburgh Sleep Quality Index (PSQI) were used to measure caregiving burden and sleep quality of the family caregivers. RESULTS A total of 96 family caregivers were recruited. Disrupted schedule (3.8; SD = 0.8) was rated as the most affected consequence of caregiving burden. Around 78.1% of the caregivers suffered from sleep problems. Hierarchical multiple regression revealed that health problems due to caregiving burden was independently associated with poor sleep quality after controlling for socio-demographic characteristics of both patients and caregivers (regression coefficient, B = 2.09, P = 0.012). CONCLUSIONS Caregiving burden amongst family caregivers of male patients with advanced cancer was remarkably high and associated with poor sleep quality. Strategies aiming to alleviate caregiving burden of caregivers may help break this vicious cycle to enhance the sleep quality of caregivers. Results also underscore the need to assess and develop intervention to relieve caregiving burden for family caregivers of cancer patients.
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Affiliation(s)
- Cho Lee Wong
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
| | - Kai Chow Choi
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
| | - Mei Nok Lau
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
| | - Ka Ling Lam
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
| | - Winnie Kwok Wei So
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
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Kizza IB, Muliira JK. The Influence of a Home-Based Education Intervention on Family Caregivers' Knowledge and Self-Efficacy for Cancer Pain Management in Adult Patients Within a Resource-Limited Setting. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2019; 34:1150-1159. [PMID: 30187440 DOI: 10.1007/s13187-018-1421-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Cancer-related pain is prevalent and has debilitating effects on patients and their family. The effects of cancer pain can be curtailed if the family members caring for the patient receive essential support to enhance their capabilities for cancer pain management. Little has been done to study the available support to family caregivers (FCGs) towards pain management in adult cancer patients (ACPs) living in resource-limited countries where the burden of cancer is on the rise. This study evaluated the influence of an education intervention delivered in the home setting on FCGs' knowledge and self-efficacy (SE) for pain management in ACPs. One-group pre-/post-test design was used in a sample of 54 FCGs who had been caring for ACPs suffering from pain for at least 1 month. Data were collected using the Family Pain Questionnaire and Caregiver Pain Management SE Scale. The FCGs' mean knowledge score post-intervention (26.69 ± 10) was higher than the baseline (45 ± 12.9), and the difference was statistically significant (t = 10.382, p = 0.000, CI = 17.12-25.43). Additionally, the FCGs' mean SE score post-intervention (1003.30 ± 191) was higher than the baseline (648.3 ± 273.4), and the difference was statistically significant (t = - 8.52, p = 0.000, CI = - 438.6-- 271.4). The home-based education intervention significantly and positively influenced the FCGs' knowledge and SE for pain management while at home. Cancer pain management educational interventions delivered at home should be considered as one of the strategies for enhancing cancer care in resource limited settings.
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Affiliation(s)
- Irene Betty Kizza
- Department of Adult Health and Critical Care, College of Nursing, Sultan Qaboos University, P. O. Box 66, Al Khod, Muscat, Oman.
| | - Joshua Kanaabi Muliira
- Department of Adult Health and Critical Care, College of Nursing, Sultan Qaboos University, P. O. Box 66, Al Khod, Muscat, Oman
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Determinants of quality of life among family caregivers of adult cancer patients in a resource-limited setting. Support Care Cancer 2019; 28:1295-1304. [PMID: 31240464 DOI: 10.1007/s00520-019-04947-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 06/18/2019] [Indexed: 12/15/2022]
Abstract
PURPOSE In resource-limited settings, family caregivers (FCGs) of adult cancer patients (ACPs) function in a context marred by high patient symptom burden, limited cancer care services and support and high caregiving burden. Despite this predicament, little is known about the quality of life (QoL) of FCGs in these settings. The study aimed to explore the determinants of QoL among FCGs of ACPs in Uganda. METHODS A cross-sectional design was used to collect data from 284 FCGs of ACPs. The study questionnaire was composed of the Katz Index, Family Pain Questionnaire, modified Chronic Pain Self-efficacy Scale and the Caregiver Quality of Life-Index-Cancer. RESULTS The mean age of FCGs was 36 ± 13.8 years. Most ACPs had stage 3 or 4 cancer (56%), severe pain (66.2%), reported moderate pain relief (51.1%) and were on chemotherapy (60.9%). The overall QoL of FCGs (70.2 ± 20.3) was moderate and 46.8% had low QoL. Most FCGs had high positive adaptation or financial concerns (55.3%) and low QoL in terms of burden (50.7%), disruptiveness (53.5%) and support (56.7%). The main determinants of overall QoL were FCGs' knowledge and self-eficacy for cancer pain management. The determinants of burden, disruptiveness, support and positive adaptations and financial concerns are reported. CONCLUSION The key determinants of the QoL of FCGs were knowledge and self-efficacy for cancer pain management. In Uganda and similar settings, interventions to build FCGs capacity in cancer-related pain and other symptom management may help to enhance the QoL of FCGs and the ACPs.
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Family caregivers for adult cancer patients: knowledge and self-efficacy for pain management in a resource-limited setting. Support Care Cancer 2018; 27:2265-2274. [PMID: 30327878 DOI: 10.1007/s00520-018-4504-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Accepted: 10/04/2018] [Indexed: 10/28/2022]
Abstract
Adult cancer patients (ACPs) in resource-limited settings disproportionately suffer from inadequate pain control despite advancements in pain management. Family caregivers (FCGs) can support optimal pain control for ACPs in these settings if they are knowledgeable and confident about the needed care. However, the status of FCGs' knowledge and self-efficacy (SE) for pain management in developing countries is not well established. PURPOSE To assess the FCGs' knowledge and SE levels for pain management among ACPs while at home in a resource-limited setting. METHODS Using a questionnaire that comprised a Family Pain Questionnaire and Chronic Pain Self-efficacy Scale, data were collected from 284 FCGs of ACPs receiving care from two cancer care centres. RESULTS The FCGs had moderate knowledge (mean = 41.70 ± 14.1) and SE (mean = 795.95 ± 301.3) levels for pain management at home for ACPs. Majority of the FCGs had low knowledge (52.1%), but expressed higher SE (52.5%). Poor self-rated health among FCGs was significantly associated with low knowledge levels (OR = 1.75; 95% CI 1.024-2.978, p = 0.041). SE was significantly associated with perceiving a low impact of caregiving on health (OR = 1.55; 95% CI 1.074-2.239, p = 0.019), hours of caregiving per week (OR = 0.52; 95% CI 0.315-0.854; p = 0.01) and receiving organisational support (OR = 0.388; 95% CI 0.222-0.679; p = 0.001). CONCLUSION The results show a need for deliberate interventions to enhance FCG knowledge and SE for pain management at home as one of the ways of improving cancer pain management in resource-limited settings.
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