1
|
van Hof KS, Hoesseini A, Dorr MC, Verdonck-de Leeuw IM, Jansen F, Leemans CR, Takes RP, Terhaard CHJ, de Jong RJB, Sewnaik A, Offerman MPJ. Unmet supportive care needs among informal caregivers of patients with head and neck cancer in the first 2 years after diagnosis and treatment: a prospective cohort study. Support Care Cancer 2023; 31:262. [PMID: 37052712 PMCID: PMC10101897 DOI: 10.1007/s00520-023-07670-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 03/05/2023] [Indexed: 04/14/2023]
Abstract
OBJECTIVE Informal caregivers of head and neck cancer (HNC) patients have a high caregiver burden and often face complex practical caregiving tasks. This may result in unmet supportive care needs, which can impact their quality of life (QoL) and cause psychological distress. In this study, we identify caregivers' unmet needs during long-term follow-up and identify caregivers prone to unmet supportive care needs. METHODS Data were used from the multicenter prospective cohort study NETherlands QUality of life and Biomedical cohort studies In Cancer (NET-QUBIC). The unmet supportive care needs, psychological distress, caregiver burden, and QoL were measured for 234 informal caregivers and their related patients at baseline, 3, 6, 12, and 24 months after. Mixed effect models for repeated measurements were used. RESULTS At baseline, most caregivers (70.3%) reported at least one unmet supportive care need, with most of the identified needs in the "healthcare & illness" domain. During the follow-up period, caregivers' unmet needs decreased significantly in all domains. Nevertheless, 2 years after treatment, 28.3% were still reporting at least one unmet need. Financial problems were increasingly associated with unmet needs over time. Furthermore, caring for a patient who themselves had many unmet needs, an advanced tumor stage, or severe comorbidity was associated with significantly more unmet needs in caregivers. CONCLUSIONS The current study shows the strong likelihood of caregivers of HNC patients facing unmet supportive care needs and the interaction between the needs of patients and caregivers. It is important to optimally support informal caregivers by involving them from the start when counseling patients, by providing them with relevant and understandable information, and by referring vulnerable caregivers for (psychosocial) support.
Collapse
Affiliation(s)
- Kira S van Hof
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands.
| | - Arta Hoesseini
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Maarten C Dorr
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Irma M Verdonck-de Leeuw
- Department of Otolaryngology and Head and Neck Surgery, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Cancer Center Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Treatment and Quality of Life, Amsterdam, The Netherlands
- Department Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Van Der Boechorststraat 7-9, Amsterdam, The Netherlands
- Amsterdam Public Health, Mental Health, Amsterdam, The Netherlands
| | - Femke Jansen
- Department of Otolaryngology and Head and Neck Surgery, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Cancer Center Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Department Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Van Der Boechorststraat 7-9, Amsterdam, The Netherlands
| | - C Réne Leemans
- Department of Otolaryngology and Head and Neck Surgery, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Cancer Center Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Robert P Takes
- Department of Otolaryngology and Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Chris H J Terhaard
- Department of Radiation Oncology, University Medical Center, Utrecht, The Netherlands
| | - Robert J Baatenburg de Jong
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Aniel Sewnaik
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Marinella P J Offerman
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| |
Collapse
|
2
|
Reblin M, Tay DL, Iacob E, Cloyes KG, Hebdon MCT, Ellington L. Hospice Caregivers' Perception of Family and Non-Family Social Support and Stress over Time: Associations with Reports of General Support. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5009. [PMID: 36981917 PMCID: PMC10049686 DOI: 10.3390/ijerph20065009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 03/09/2023] [Accepted: 03/10/2023] [Indexed: 06/18/2023]
Abstract
Social support has been identified as a key factor to protect wellbeing for home hospice cancer caregivers. However, few studies have assessed social support over time in this context, and measures of support are often limited to general assessments of perceived support. Our goal was to (1) describe change in cancer home hospice caregivers' social support over time during care and into bereavement and (2) explore the impact of perceived stress and support from family and non-family members on caregivers' perceived general social support. We conducted a secondary analysis of longitudinal prospective questionnaire data. Forty caregivers completed measures of general perceived support, family and non-family support and stress during hospice enrollment and 2 and 6 months post the patient's death. Linear mixed models were used to determine change in support over time and the contribution of specific support/stress ratings to general support assessments. Caregivers overall had moderate and stable levels of social support over time, though there was significant variation between and within individuals. Family and non-family support and stress from family predicted general perceptions of social support, while no effects were found for non-family stress. This work suggests a need for more specific measures of support and stress, and the need for research to focus on improving baseline levels of caregiver perceived support.
Collapse
Affiliation(s)
- Maija Reblin
- Department of Family Medicine, Larner College of Medicine, University of Vermont, Burlington, VT 05405, USA
| | - Djin L. Tay
- College of Nursing, University of Utah, Salt Lake City, UT 84112, USA
| | - Eli Iacob
- College of Nursing, University of Utah, Salt Lake City, UT 84112, USA
| | - Kristin G. Cloyes
- School of Nursing, Oregon Health & Sciences University, Portland, OR 97239, USA
| | | | - Lee Ellington
- College of Nursing, University of Utah, Salt Lake City, UT 84112, USA
| |
Collapse
|
3
|
Bernstein RT, Garner-Purkis A, Gallagher JE, Newland-Pedley, Scambler S. A systematic review of social impacts of treatment and rehabilitation of head and neck cancer patients. ADVANCES IN ORAL AND MAXILLOFACIAL SURGERY 2023. [DOI: 10.1016/j.adoms.2023.100409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
|
4
|
A Prospective Study to Assess the Effectiveness of an Educational Package on Home-Based Post-operative Care of Oral Cancer Patients by Primary Caregivers. Indian J Surg 2021. [DOI: 10.1007/s12262-020-02357-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
5
|
Wang T, Mazanec SR, Voss JG. Needs of Informal Caregivers of Patients With Head and Neck Cancer: A Systematic Review. Oncol Nurs Forum 2021; 48:11-29. [PMID: 33337440 DOI: 10.1188/21.onf.11-29] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PROBLEM IDENTIFICATION Informal caregivers for patients with head and neck cancer perform complex caregiving tasks on a daily basis, but caregivers' needs are rarely acknowledged or addressed in current healthcare practice. LITERATURE SEARCH A thorough review of CINAHL®, MEDLINE®/PubMed®, and PsycINFO® was conducted by the authors. DATA EVALUATION 266 manuscripts were identified, with no time limit. The search was conducted in November 2019. In total, 19 articles were included in the review. SYNTHESIS Throughout the disease trajectory, caregivers' psychological and emotional support needs are consistently high, whereas information needs diminish over time. IMPLICATIONS FOR PRACTICE Informal caregivers are imperative in supplementing the continuing care demands of people living with head and neck cancer; however, they are at risk for experiencing caregiving burden. Skill training and psychological support interventions are needed for educating and supporting caregivers.
Collapse
|
6
|
Mitchell HR, Kim Y, Carver CS, Llabre MM, Ting A, Mendez AJ. Roles of age and sources of cancer caregiving stress in self-reported health and neuroendocrine biomarkers. Psychol Health 2020; 36:952-966. [PMID: 32744869 DOI: 10.1080/08870446.2020.1800009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To investigate the extent to which age and specific sources of caregiving stress are associated with cancer caregivers' health. Methods: New colorectal cancer caregivers (n = 88; age M = 49) reported caregiving stress (i.e., disrupted schedule, lacking family support, financial strain) and mental and physical health, and collected saliva samples assayed for neuroendocrine biomarkers (cortisol and α-amylase). Results: Disrupted daily schedule due to caregiving was associated with poorer self-reported mental health across all ages (B= -4.19, 95% CI: -6.59--1.80, p <.01), and associated with dysregulated cortisol patterns among older caregivers, but with more regulated cortisol patterns among younger caregivers, ps ≤ .01. Across all ages, lacking family support was associated with poorer self-reported physical health (B= -2.13, 95% CI: -4.33--0.07, p <.05), but more regulated α-amylase patterns (B = 2.51, 95% CI: 0.83-4.19, p <.01). Financial strain related to regulated cortisol levels only among older caregivers (B = 5.07, 95% CI: 0.58-9.57, p = .03) and more regulated α-amylase patterns across all ages (B= -25.81, 95% CI: -48.72--2.90, p <.05). Conclusion: Findings suggest that specific sources of caregiver stress manifest in health outcomes distinctly by age, and support the need for targeted psychosocial interventions for cancer caregivers.
Collapse
Affiliation(s)
| | - Youngmee Kim
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Charles S Carver
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Maria M Llabre
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Amanda Ting
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Armando J Mendez
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| |
Collapse
|
7
|
Nouzari R, Najafi SS, Momennasab M. Post-Traumatic Growth among Family Caregivers of Cancer Patients and Its Association with Social Support and Hope. INTERNATIONAL JOURNAL OF COMMUNITY BASED NURSING AND MIDWIFERY 2019; 7:319-328. [PMID: 31641681 PMCID: PMC6779924 DOI: 10.30476/ijcbnm.2019.73959.0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background: Cancer not only is a traumatic experience for the patients, but also can affect the family caregivers. Post-traumatic growth (PTG) refers to positive psychological changes experienced by people as a result of a struggle in dealing with traumatic events in life. Both the patients and their caregivers may experience PTG. The present study aimed to assess the extent of PTG in caregivers of patients with gastrointestinal cancer and to examine the relationship between the PTG dimensions and both the social support (SS) and hope.
Methods: The present descriptive correlational study was conducted during May-August 2018 in Shiraz, Iran. The target population included 112 caregivers who visited hospitals affiliated to Shiraz University of Medical Sciences, Shiraz, Iran. Data collection instruments included a demographic information form, post-traumatic growth inventory, social support appraisals scale, and Miller hope scale. The data were analyzed using the SPSS software (version 23.0). P<0.05 was considered statistically significant.
Results: The mean score for PTG, hope, and SS was 75.41±16.49, 190.95±24.20, and 89.10±12.84, respectively. A significant positive correlation was found between PTG and both SS (P<0.001, r=0.59) and hope (P<0.001, r=0.70). The results of the multiple regression analysis showed a significant relationship between PTG, SS, and hope (P<0.001). Hope had a higher effect on PTG (ẞ=0.62) compared to SS (ẞ=0.27).
Conclusion: The results showed a good level of PTG among the caregivers and the experience of stressful situations positively affected their psychological condition. The positive change was associated with the perceived SS and hope.
Collapse
Affiliation(s)
- Razieh Nouzari
- Student Research Committee, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Saeed Najafi
- Community Based Psychiatric Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Marzieh Momennasab
- Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
8
|
Heynsbergh N, Heckel L, Botti M, O SC, Livingston PM. Development of a Smartphone App for Informal Carers of People With Cancer: Processes and Learnings. JMIR Form Res 2019; 3:e10990. [PMID: 30973346 PMCID: PMC6482398 DOI: 10.2196/10990] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 10/19/2018] [Accepted: 12/30/2018] [Indexed: 12/14/2022] Open
Abstract
Background There are few support systems available to informal carers who provide care to cancer patients. Smartphone apps have the capacity to reach large audiences and can provide information and support at a time convenient to carers. Objective The aim of this study was to design a smartphone app prototype for carers of adults with cancer. Methods A multiple-method design was used to develop a smartphone app. Current and past carers of people with any type of cancer were recruited from a public hospital, a private hospital, and a carer organization, who participated in either a focus group or phone interview. Carers answered questions about items to include in an app to address supportive care needs identified. Using carers’ feedback, a smartphone app was designed and tested. Beta testing was conducted using a convenience sample of participants who completed scenarios to inform the app’s design, functionality, and usability. Scenarios were timed and marked as complete or incomplete. Participants completed a questionnaire about the usability of the app. Beta testing occurred in 2 stages—a paper-based version of the app and an app-based test using the participants’ preferred device. Alpha testing was completed internally to ensure the functionality of the app. Data were collected between May 2016 and August 2017. Results A total of 33 carers participated in phone interviews and 12 in focus groups; their average age was 55 (SD 14) years, and 60% (27/45) were female. The majority of carers (76%, 25/33) had a positive attitude toward using smartphone apps. Carers noted that smartphone technology might improve their ability to seek information and support in managing their own health as well as the care needs of the person with cancer. Carers requested a variety of information and resources to be included in the app. Paper-based testing included the following: participants (N=10) were aged above 30 years (30%, 3/10), 30 to 49 years (30%, 3/10), and 50 years or above (40%, 4/10), and 60% (6/10) were male. Participants found the app user-friendly and pleasing in appearance. App-based testing included the following: participants (N=10) were aged above 30 years (20%, 2/10), 30 to 49 years (30%, 3/10), and 50 years or above (50%, 5/10), and 50% (5/10) were male. Participants reported the app to be user-friendly and easy to navigate. The majority (60%, 6/10) of participants were unable to create a shortcut icon to add the app to the home screen of their phone. Conclusions Carers highlighted the needed information and support to assist them during the caring period; they also reported having a positive attitude toward smartphone apps. The Carer Guide App is currently undergoing a pilot study to further test usability among carers of people with 1 cancer type.
Collapse
Affiliation(s)
| | - Leila Heckel
- School of Nursing and Midwifery, Faculty of Health, Geelong, Australia
| | - Mari Botti
- School of Nursing and Midwifery, Faculty of Health, Geelong, Australia.,Epworth HealthCare, Melbourne, Australia
| | - Seung Chul O
- School of Psychology, Faculty of Health, Deakin University, Geelong, Australia
| | | |
Collapse
|
9
|
Francescutti VA, Maciver AH, Stewart E, Clark N, Marrara B, Saad-Harfouche FG, Rodriguez EM. Characterizing the Patient Experience of CS/HIPEC Through In-Depth Interviews with Patients: Identification of Key Concepts in the Development of a Patient-Centered Program. Ann Surg Oncol 2019; 26:1063-1070. [PMID: 30603814 DOI: 10.1245/s10434-018-07120-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Indexed: 12/31/2022]
Abstract
INTRODUCTION The cytoreduction and hyperthermic intraperitoneal chemotherapy (CS/HIPEC) procedure is complex, involving lengthy preparation and recovery in a heterogeneous patient group. Understanding the patient experience is essential to improving interactions with health professionals that is critical to recovery. OBJECTIVE This study sought to characterize the early recovery and return to quality of life (at 3 and 6-12 months post-surgery, respectively) in patients having undergone CS/HIPEC, through structured interviews. METHODS Two sets of interviews were conducted among 20 CS/HIPEC patients. Interviews were uploaded into QSR NVivo 10 qualitative software (QSR International, Australia) and coded by two study personnel. Interview 1 focused on initial treatment decision making and postoperative hospitalization, while interview 2 focused on recovery, supports, and return to quality of life. RESULTS Among the participants, 60% were female and the mean age was 57 years (range 31-71). Diagnoses included disseminated peritoneal adenomucinosis (n = 6), appendiceal adenocarcinoma (n = 4), colorectal adenocarcinoma (n = 6), goblet cell (n = 2), and mesothelioma (n = 2). The first interview identified common themes of perioperative psychosocial isolation, lack of direction, and the importance of an established support system. Patients requested printed and audiovisual materials focused on addressing expectations. The main findings from the second interview captured patient experiences with longer-term complications, as well as surveillance. CONCLUSION Focused interviews with patients recently having undergone CS/HIPEC identified key issues that may be addressed in programs to improve the patient experience. These issues were distinctly different in relation to phase of recovery, and patient-centered programs designed with these factors in mind have the potential to enhance the recovery process.
Collapse
Affiliation(s)
- Valerie A Francescutti
- Department of Surgery, Hamilton Health Sciences and McMaster University, Hamilton, ON, Canada.
| | - Allison H Maciver
- Department of Surgery, London Regional Cancer Program, Western University, London, ON, Canada
| | - Erika Stewart
- Department of Surgical Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Nikia Clark
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Bianca Marrara
- School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, NY, USA
| | - Frances G Saad-Harfouche
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Elisa M Rodriguez
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| |
Collapse
|
10
|
Caring for the person with cancer and the role of digital technology in supporting carers. Support Care Cancer 2018; 27:2203-2209. [DOI: 10.1007/s00520-018-4503-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 10/04/2018] [Indexed: 01/21/2023]
|
11
|
Schwartz AJ, Riedel RF, LeBlanc TW, Desai D, Jenkins C, Mahoney E, Humphreys J, Hendrix CC. The experiences of older caregivers of cancer patients following hospital discharge. Support Care Cancer 2018; 27:609-616. [PMID: 30027328 DOI: 10.1007/s00520-018-4355-2] [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: 02/14/2018] [Accepted: 07/11/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE This study addressed the experiences of older caregivers of cancer patients in the 2 weeks following a hospital discharge. It sought to understand the challenges they face in providing supportive care to patients at home. METHODS Qualitative descriptive interviews with a narrative approach were conducted with each caregiver at 1 and 2 weeks following the patient's discharge from the hospital. A thematic analysis approach was used to identify the themes that emerged from the caregiver interviews. RESULTS Caregivers were primarily Caucasian (77%), were mostly 68 years of age or older (62%), and were primarily caring for a spouse (69%). Three key themes emerged from the qualitative analysis: caregiver and patient wellness are connected, caregivers' struggle with control issues, and challenges in communication with health professionals. CONCLUSIONS These findings highlight psychosocial changes that caregivers experience over the 2-week time period following hospital discharge. Implications include the need to identify interventions to better prepare caregivers for the post-discharge period.
Collapse
Affiliation(s)
- Abby J Schwartz
- East Carolina University School of Social Work, Mail Stop 505, 1000 E. Fifth St, Greenville, NC, 27858, USA.
| | - Richard F Riedel
- Division of Medical Oncology, Department of Medicine, Duke University School of Medicine, Durham, NC, USA.,Duke Cancer Institute, Durham, NC, USA
| | - Thomas W LeBlanc
- Duke Cancer Institute, Durham, NC, USA.,Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Devi Desai
- Duke University Hospital, Durham, NC, USA
| | - Carol Jenkins
- East Carolina University School of Social Work, Mail Stop 505, 1000 E. Fifth St, Greenville, NC, 27858, USA
| | - Ellen Mahoney
- Boston College School of Nursing, Chestnut Hill, MA, USA
| | | | | |
Collapse
|
12
|
Heynsbergh N, Heckel L, Botti M, Livingston PM. Feasibility, useability and acceptability of technology-based interventions for informal cancer carers: a systematic review. BMC Cancer 2018; 18:244. [PMID: 29499663 PMCID: PMC5834845 DOI: 10.1186/s12885-018-4160-9] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Accepted: 02/21/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Carers looking after someone with cancer often experience negative impacts on their own health. M-health interventions have been designed to provide information and support to patients and their carers. However, the effectiveness of technology-based interventions for carers is less well understood. The objectives were to assess the feasibility, useability and acceptability of technology-based interventions among carers of people living with cancer. METHODS A systematic search of the CINAHL, MEDLINE and PSYCINFO databases was performed using terms related to web-based interventions and smartphone applications, carers and cancer. Studies were included if a randomised controlled trial or pilot study was conducted, focused on adult carers looking after another adult with cancer and were published between January 2007-June 2017. Articles were excluded if they reported qualitative results only or were evaluating existing websites and applications. Feasibility was measured by attrition, recruitment rates and frequency of intervention use; useability was measured by the ease of intervention use and the role of features to minimise errors in use. Acceptability was measured by carers' perception of the appropriateness of the content and their ability to incorporate the intervention into their daily routines. RESULTS Of the 729 articles, six articles met the inclusion criteria. Attrition ranged from 14% - 77%, recruitment rates from 20% - 66% and intervention useability varied across studies. Half of the studies implemented measures to improve useability. Overall, carers rated the content of the interventions as appropriate and reported improved knowledge and communication. Acceptability was further demonstrated as carers preferred the flexibility available with web-based interventions. CONCLUSIONS Technology-based interventions are suitable for use among carers of people with cancer. Further research is required to fully assess the impact of technology as an information and support mechanism for carers.
Collapse
Affiliation(s)
- Natalie Heynsbergh
- Geelong, Faculty of Health, School of Nursing and Midwifery, Deakin University, Geelong, Victoria, 3220, Australia.
| | - Leila Heckel
- Geelong, Faculty of Health, School of Nursing and Midwifery, Deakin University, Geelong, Victoria, 3220, Australia
| | - Mari Botti
- Geelong, Faculty of Health, School of Nursing and Midwifery and Epworth HealthCare, Deakin University, Geelong, Victoria, 3220, Australia
| | | |
Collapse
|
13
|
Balfe M, O'Brien K, Timmons A, Butow P, O' Sullivan E, Gooberman-Hill R, Sharp L. The unmet supportive care needs of long-term head and neck cancer caregivers in the extended survivorship period. J Clin Nurs 2016; 25:1576-86. [DOI: 10.1111/jocn.13140] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Myles Balfe
- National Cancer Registry of Ireland; Cork Airport Business Park; Cork Ireland
| | - Katie O'Brien
- National Cancer Registry of Ireland; Cork Airport Business Park; Cork Ireland
| | - Aileen Timmons
- National Cancer Registry of Ireland; Cork Airport Business Park; Cork Ireland
| | - Phyllis Butow
- Centre for Medical Psychology; University of Sydney; Sydney NSW Australia
| | | | | | - Linda Sharp
- Newcastle University; Professor of Cancer Epidemiology; Cork Ireland
| |
Collapse
|
14
|
The unmet supportive care needs-what advanced lung cancer patients' caregivers need and related factors. Support Care Cancer 2016; 24:2999-3009. [PMID: 26872793 DOI: 10.1007/s00520-016-3096-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 01/24/2016] [Indexed: 10/22/2022]
Abstract
PURPOSE To identify the unmet supportive care needs and related factors in caregivers of patients with advanced lung cancer. METHODS A cross-sectional study of 166 lung cancer patient-caregivers dyads was recruited at a medical center. The supportive care needs, fatigue, and sleep disturbance of caregivers were collected. Patients were assessed for symptom severity, anxiety, and depression. Logistic regression was used to reveal the related factors of unmet supportive care needs. RESULTS Of the 166 dyads surveyed, the top unmet needs were information needs, health care professional/health care service needs, and daily living needs. Patients' anxiety was positively correlated to overall caregiving needs, health care professional/health care service needs, interpersonal communication needs, and psychological/emotional needs of caregivers. The information needs and health care professional/health care service needs were related to the caregivers' fatigue. The sleep disturbance of caregivers was associated with their overall caregiving needs, daily living needs, and psychological/emotional needs. CONCLUSIONS Future interventions to meet the needs of caregivers should include specific needs assessment and continuing education in caregiving.
Collapse
|
15
|
Litzelman K, Kent EE, Rowland JH. Social factors in informal cancer caregivers: The interrelationships among social stressors, relationship quality, and family functioning in the CanCORS data set. Cancer 2015; 122:278-86. [PMID: 26479767 DOI: 10.1002/cncr.29741] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 08/27/2015] [Accepted: 09/18/2015] [Indexed: 11/11/2022]
Abstract
BACKGROUND Social and family factors can influence the health outcomes and quality of life of informal caregivers. Little is known about the distribution and correlates of such factors for caregivers of cancer patients. This study sought to fill this gap with data from the Cancer Care Outcomes Research and Surveillance consortium. METHODS Lung and colorectal cancer patients nominated an informal caregiver to participate in a caregiving survey. Caregivers reported their sociodemographic and caregiving characteristics, social stress, relationship quality with the patient, and family functioning. Descriptive statistics and Pearson correlations were used to assess the distribution of caregivers' social factors. Multivariable linear regressions assessed the independent correlates of each social factor. RESULTS Most caregivers reported low to moderate levels of social stress and good relationship quality and family functioning. In multivariable analyses, older age was associated with less social stress and better family functioning but worse relationship quality, with effect sizes (Cohen's d) up to 0.40 (P < .05). Caring for a female patient was associated with less social stress and better relationship quality but worse family functioning (effect sizes ≤ 0.16, P < .05). Few caregiving characteristics were associated with social stress, whereas several were significant independent correlates of relationship quality. Finally, social factors were important independent correlates of one another. CONCLUSIONS The results indicate the importance of personal and caregiving-related characteristics and the broader family context to social factors. Future work is needed to better understand these pathways and assess whether interventions targeting social factors can improve health or quality-of-life outcomes for informal cancer caregivers. Cancer 2016;122:278-286. © 2015 American Cancer Society.
Collapse
Affiliation(s)
| | - Erin E Kent
- National Cancer Institute, Rockville, Maryland
| | | |
Collapse
|
16
|
How relatives of patients with head and neck cancer experience pain, disease progression and treatment: a qualitative interview study. Eur J Oncol Nurs 2014; 18:405-10. [PMID: 24726013 DOI: 10.1016/j.ejon.2014.03.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Revised: 03/13/2014] [Accepted: 03/18/2014] [Indexed: 11/20/2022]
Abstract
PURPOSE This study of relatives to patients with head and neck cancer (HNC) treated with radiotherapy describes how the relatives experienced the patient's situation, especially with respect to pain, and how the relatives themselves experienced the situation. METHODS Semi-structured interviews of 21 relatives to HNC patients who suffered from pain were conducted, and a qualitative content analysis was performed. RESULTS The relatives experienced that the patients suffered from physical, psychological, and social pain. A dark picture consisting of lack of participation and knowledge, psychological distress, and lack of support were reported. Thus, a main category: relatives struggle with loved one's pains related to head and neck cancer treatment and with their own demanding situation - was based on the following four categories: inability to relieve and comprehend the physical suffering of the patients; overwhelming emotions were experienced that affect the patients and the relatives themselves; in need of support from the health care service; and altered daily activities and family roles due to illness and treatment. CONCLUSION In patients physical, psychological, and social pain were prominent and in relatives psychological distress, lack of knowledge and support were experienced. Thus, to reduce pain and anxiety in patients and relatives, the health care professionals should provide relevant knowledge about pain management. The health care professionals should also provide educational interventions that address the psychological and social factors that impact pain for HNC patients and their relatives. Well-thought supporting care and easily accessible information about practical concerns should be offered to HNC patients and their relatives.
Collapse
|
17
|
Chen SC, Lai YH, Liao CT, Huang BS, Lin CY, Fan KH, Chang JTC. Unmet supportive care needs and characteristics of family caregivers of patients with oral cancer after surgery. Psychooncology 2014; 23:569-77. [DOI: 10.1002/pon.3458] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Revised: 10/30/2013] [Accepted: 11/01/2013] [Indexed: 11/06/2022]
Affiliation(s)
- Shu-Ching Chen
- Department of Nursing; Chang Gung University of Science and Technology; Taoyuan Taiwan
- Head and Neck Oncology Group; Chang Gung Medical Foundation, Chang Gung Memorial Hospital at LinKou; Taoyuan Taiwan
| | - Yeur-Hur Lai
- School of Nursing, College of Medicine; National Taiwan University; Taipei Taiwan
| | - Chun-Ta Liao
- Department of Otorhinolaryngology, Head and Neck Surgery; Chang Gung Medical Foundation, Chang Gung Memorial Hospital at LinKou; Taoyuan Taiwan
- College of Medicine; Chang Gung University; Taoyuan Taiwan
- Head and Neck Oncology Group; Chang Gung Medical Foundation, Chang Gung Memorial Hospital at LinKou; Taoyuan Taiwan
| | - Bing-Shen Huang
- College of Medicine; Chang Gung University; Taoyuan Taiwan
- Department of Radiation Oncology; Chang Gung Medical Foundation, Chang Gung Memorial Hospital at LinKou; Taoyuan Taiwan
- Head and Neck Oncology Group; Chang Gung Medical Foundation, Chang Gung Memorial Hospital at LinKou; Taoyuan Taiwan
| | - Chien-Yu Lin
- College of Medicine; Chang Gung University; Taoyuan Taiwan
- Department of Radiation Oncology; Chang Gung Medical Foundation, Chang Gung Memorial Hospital at LinKou; Taoyuan Taiwan
- Head and Neck Oncology Group; Chang Gung Medical Foundation, Chang Gung Memorial Hospital at LinKou; Taoyuan Taiwan
| | - Kang-Hsing Fan
- College of Medicine; Chang Gung University; Taoyuan Taiwan
- Department of Radiation Oncology; Chang Gung Medical Foundation, Chang Gung Memorial Hospital at LinKou; Taoyuan Taiwan
- Head and Neck Oncology Group; Chang Gung Medical Foundation, Chang Gung Memorial Hospital at LinKou; Taoyuan Taiwan
| | - Joseph Tung-Chien Chang
- College of Medicine; Chang Gung University; Taoyuan Taiwan
- Department of Radiation Oncology; Chang Gung Medical Foundation, Chang Gung Memorial Hospital at LinKou; Taoyuan Taiwan
- Head and Neck Oncology Group; Chang Gung Medical Foundation, Chang Gung Memorial Hospital at LinKou; Taoyuan Taiwan
| |
Collapse
|