The relationship between positive aspects of caring, anxiety and depression in the caregivers of cancer patients: The mediational role of burden

Loneliness, psychological distress, and the moderating effect of positive aspects of caregiving among cancer caregivers

PURPOSE

Family caregivers of patients with cancer often experience both loneliness and symptoms of psychological distress, such as anxiety and depression. The purpose of this study was to evaluate the associations between loneliness and anxiety and loneliness and depression among family caregivers of patients with cancer and to investigate whether positive aspects of caregiving can have a moderating effect on these relationships.

METHODS

We conducted a cross-sectional exploratory study using baseline data from an ongoing multisite clinical trial. Multiple linear regression models were used to analyze the relationships between loneliness and psychological distress symptoms and the moderating effect of positive aspects of caregiving. Psychological distress outcomes were measured using PROMIS Short Forms (8a) for Anxiety and Depression.

RESULTS

We identified a significant association between loneliness and symptoms of both anxiety and depression. Positive aspects of caregiving did not significantly moderate the relationship between loneliness and depression or loneliness and anxiety.

CONCLUSION

The results of this study shed new light on the relationship between loneliness and symptoms of psychological distress experienced by family caregivers of cancer patients, providing a better understanding of the impact that recognition of positive aspects of caregiving has on the association between loneliness and psychological distress symptoms. Our findings emphasize the importance of targeting family caregiver loneliness in order to reduce psychological distress among family caregivers of cancer patients.

Unexpected changes and associated factors of care burden among caregivers of cancer patients one year after COVID-19 outbreak

Purpose

The study aimed to evaluate the changes in the care burden and quality of life of caregivers of cancer patients and correlates of care burden during the COVID-19 pandemic.

Methods

This cross-sectional study used the census sampling technique with 260 cancer patients and their caregivers during January to March 2020 in northeast Iran. Data collection tools included the Novak and Guest Care Burden Scale, the SF-36 Quality of Life Questionnaire, and the Stress, Anxiety, and Depression Scale (DASS-21). Data were analyzed using descriptive and inferential statistics (independent t-test and multiple linear regression analysis).

Results

Baseline scores of care burden and quality of life in caregivers suggested mild to moderate care burden and a reasonable quality of life and moderate levels of stress, anxiety, and depression in patients. The post-outbreak mean scores of care burden and quality of life significantly decreased and increased, respectively (p < .001). Regression analysis showed that 39.3% of the changes in the care burden score during the pandemic could be predicted by studied variables. In exchange for increasing the quality-of-life score and daily care hours, the care burden score decreases and increases. The burden of care in caregivers was also related to the type of cancer. Care burden in the caregivers of patients with breast and neurological malignancies was lower than the caregivers of patients with gastrointestinal cancer (p < .05).

Conclusion

Despite the results obtained, supportive and educational interventions are needed to reduce the caregiver burden and improve the quality of life of caregivers and measure its impact on levels of psychological distress in their patients clinically.

Effects of psychological capital and social support availability on anxiety and depression among Chinese emergency physicians: Testing moderated mediation model

Introduction

Anxiety often precedes depression, and the pathway from anxiety to depression may be affected by multiple exposures. Our research aims to explore the mediating effect of the social support availability (SSA) between anxiety and depression and how it is moderated by psychological capital.

Methods

A cross-sectional study was conducted among Chinese emergency physicians at the top-level general hospitals in eastern China. Data were collected via the questionnaire including anxiety and depression subscales of Symptom Checklist-90, Psychological Capital Questionnaire as well as Social Support Rating Scale. The PROCESS v3.4 macro was employed to assess the mediating role of SSA and a moderating role of psychological capital.

Results

A total of 536 valid samples were filtered. Anxiety, depression, SSA, and psychological capital were significant correlated. Anxiety was positively associated with depression (β = 0.82, p < 0.001), and the SSA mediated the relationship between anxiety and depression (indirect effect = 0.013, 95%BootCI [0.005, 0.023]). Psychological capital (specifically, self-efficacy, hope and resilience) further played a moderating role in the relationship between SSA and depression (β = 0.06, p < 0.01).

Conclusion

The mental health of emergency physicians should be concerned. In order to decrease anxiety and depression, SSA and psychological capital should be increased as the interventions for emergency physicians.

Effect of Carnatic raga-Bilahari based music therapy on anxiety, sleep disturbances and somatic symptoms among caregivers of cancer patients

Carnatic raga-Bilahari based intervention is a music therapy technique that enhances relaxation and positivity by reducing anxiety. With extensive empirical evidence pointing out the detrimental challenges faced by the caregivers of cancer patients, the present study intends to find out the effectiveness of a Carnatic raga based music therapy on reducing anxiety, sleep disturbances, somatic symptoms and distress level among this population A single group pre-post research design was was used to conduct the study. General Health Questionnaire (GHQ-28) was used as a screening tool to select participants, and 30 participants were chosen using the purposive sampling. These individuals received instruction in listening to Carnatic music (raga-Bilahari), 5 days a week. The vocal and instrumental recordings were given on alternative days with each session lasting 15–30 min over a month of standard care. From the findings it is observed that there is significant decrease in the anxiety (p < 0.001), sleep disturbances (p < 0.001), somatic symptoms (p < 0.001) and distress level (p < 0.001) after the intervention.The study result thus indicates that Carnatic raga-Bilahari-based music intervention is effective among caregivers of cancer patients to reduce anxiety, sleep disturbances, somatic symptoms presentation, and their distress level.

Caring experiences of family caregivers of patients with pancreatic cancer: an integrative literature review

PURPOSE

This review summarizes and synthesizes the available empirical literature on the experiences concerned with the problems and challenges faced by caregivers of patients with pancreatic cancer.

METHODS

An integrative review method was used, and a literature search was conducted using five databases. We searched the terms "pancreatic cancer," "caregiver," and "experience," and used the Boolean operators OR and AND to combine them. The Joanna Briggs Institute critical appraisal tools were used to assess the quality of the included studies.

RESULTS

Four qualitative studies, one mixed method, and three quantitative studies met the selection criteria and were included in the review. Informal family caregivers of patients with pancreatic cancer experienced multifaceted roles, lack of information, difficulties in maintaining emotional well-being, and positive coping. The factors associated with their caring experience included the caregivers' demographics, patients' psychological status, and clinical characteristics.

CONCLUSION

Caregivers of patients with pancreatic cancer have various experiences while providing care. Health care providers should offer opportunities for caregivers to recognize their feelings, provide sufficient information and psychological support, and foster coping strategies to maintain the physical and psychosocial well-being of caregivers.

Perceived social support and distress in carers of people with lung cancer: The serial mediation of resilience and positive aspects of caregiving

PURPOSE

To determine the mediating roles of resilience and positive aspects of caregiving (PAC) in the effect of perceived social support (PSS) on distress.

METHODS

This study, with a cross-sectional design, was conducted in a Chinese hospital. Instruments included the Multidimensional Scale of Perceived Social Support, Chinese version Connor-Davidson Resilience Scale, Positive Aspects of Caregiving, and the Depression, Anxiety, Stress Scales-21. Descriptive analysis and serial mediation analysis were conducted by SPSS 22.0.

RESULTS

Data from 300 Chinese carers of people with lung cancer was used. The correlation analysis showed that PSS, resilience, and PAC were protective factors of distress. The mediation analysis revealed that resilience and PAC separately and serially mediated the effect of PSS on distress.

CONCLUSION

Carers of people with lung cancer perceived positive and negative caregiving experiences simultaneously. PSS could alleviate distress by enhancing resilience and promoting PAC. Multicomponent interventions integrating PSS, resilience, and PAC should be designed to alleviate distress among Chinese carers of people with lung cancer.

Determination of Caregiver Burden and Social Support Levels among Caregivers Providing Care for Patients Hospitalized in Palliative Care Clinics

Providing care to someone with a chronic disease requires being physically, emotionally, and mentally energetic. In particular, the presence of a patient with a disease that requires palliative care changes daily activities and routines, increases responsibilities of those who take the responsibility for patient’s care and changes the roles in the family. The objective of this study was to determine the care burden and social support levels among the caregivers providing care for patients hospitalized in palliative care clinics. Materials and Methods: The population of this descriptive and correlational study consisted of caregivers taking care of patients treated at the Palliative Care Clinic of Training and Research Hospital between May and October 2018; the sample consisted of 73 caregivers who volunteered to join the study and were open to communication. Data were collected by questioning patients and their caregivers about their sociodemographic characteristics, using the Caregiver Burden Scale and the Multidimensional Scale of Perceived Social Support. Data analysis included percentages, the Kruskal-Wallis test, the Mann-Whitney U test, and the Spearman’s Correlation Coefficient. Results: The average caregivers’ age was 45.44±13.76 years; 75.3% of caregivers were females, 30.1% of caregivers were literate or had primary school degrees. Caregiver’s gender and educational levels were found not to affect caregiving and social support levels; however, the economic status affected caregiving and social support levels. There was a reverse correlation between the caregiver burden and their social support levels. Conclusions: With increased caregiver burden, their social support level decreased. Nurses caring for patients in palliative care clinics will benefit from educating and supporting caregivers about clinic and home care; it will result in a positive level of social support for both caregivers and patients receiving care.