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Christodoulou L, Parpottas P, Petkari E. Psychological interventions to enhance positive outcomes in adult cancer caregivers: A systematic review. J Health Psychol 2024; 29:747-769. [PMID: 38439520 DOI: 10.1177/13591053241236254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2024] Open
Abstract
This systematic review aims to examine the characteristics of psychological interventions that aim to enhance positive outcomes, such as wellbeing, post-traumatic growth, or hope in cancer caregivers. Studies published until December 2023 were searched on PubMed, Scopus, PsycINFO, WOS, PsycARTICLES and were included when examining interventions targeting positive outcomes with adult cancer caregivers. Of the 1424 articles retrieved through the databases, 16 studies were eligible for inclusion in this review, targeting 908 caregivers (70.2% female; Mage = 53.5). A narrative synthesis was used to describe the interventions, which were based on a variety of approaches such as psychoeducation, mindfulness, or Existential Behavioral Therapy, and reported positive gains for the positive outcomes. The results show few randomized controlled trials published to date, highlight the contrast between the focus shift towards these outcomes and the need for systematic testing of the interventions, to be able to inform evidence-based service delivery.
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Tsai TC, Mitchell HR, Zeitzer J, Ting A, Laurenceau JP, Spiegel D, Kim Y. Dyadic Investigation of Posttraumatic Stress Symptoms and Daily Sleep Health in Patients With Cancer and Their Caregivers. Psychosom Med 2024; 86:234-243. [PMID: 38345316 PMCID: PMC11081839 DOI: 10.1097/psy.0000000000001283] [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] [Indexed: 05/12/2024]
Abstract
OBJECTIVE Cancer can be a traumatic experience affecting multidimensional aspects of sleep among patients and caregivers. This study examined the differential associations of cancer-related posttraumatic stress symptoms (PTSS) with various sleep markers in this population. METHODS Patients newly diagnosed with colorectal cancer ( n = 138, mean age = 56.93 years, 31.88% female, 60.14% Hispanic, 6.53 months after diagnosis) and their sleep-partner caregivers ( n = 138, mean age = 55.32 years, 68.12% female, 57.97% Hispanic) completed questionnaires assessing the four PTSS clusters (intrusion, avoidance, alterations in arousal and reactivity, negative alterations in cognitions and mood). Participants also completed daily sleep diaries for 14 consecutive days, from which sleep onset latency (SOL), wake after sleep onset (WASO), and sleep duration were derived. RESULTS Actor-partner interdependence model revealed that caregivers' greater alterations in arousal and reactivity were associated with their own longer SOL ( b = 15.59, p < .001) and their patients' longer sleep duration ( b = 0.61, p = .014), whereas patients' arousal and reactivity were associated with their caregivers' shorter SOL ( b = -8.47, p = .050). Patients' and caregivers' greater negative alterations in cognitions and mood were associated with patients' longer SOL ( b = 9.15, p = .014) and shorter sleep duration ( b = -0.41, p = .050), respectively. Caregivers' greater intrusion was related to their own shorter SOL ( b = -10.14, p = .004). CONCLUSIONS The four PTSS clusters, particularly arousal and reactivity and negative cognitions and mood, have distinct associations with sleep markers individually and dyadically in patients and caregivers affected by cancer. Investigations of psychosocial and biobehavioral pathways underlying these relations are warranted. Tailored trauma treatments and sleep interventions may improve the well-being of this population.
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Affiliation(s)
- Thomas C. Tsai
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd., Coral Gables, FL, 33146, United States
| | | | - Jamie Zeitzer
- Department of Psychiatry and Behavioral Sciences, Stanford University
- Department of Psychiatry and Sleep Medicine, Palo Alto VA Medical Center
| | - Amanda Ting
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd., Coral Gables, FL, 33146, United States
| | | | - David Spiegel
- Department of Psychiatry and Behavioral Sciences, Stanford University
| | - Youngmee Kim
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd., Coral Gables, FL, 33146, United States
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Frank P, Olshan A, Iraca T, Anthony C, Wintrich S, Sasse E. Experiences and Support Needs of Caregivers of Patients with Higher-Risk Myelodysplastic Syndrome via Online Bulletin Board in the USA, Canada and UK. Oncol Ther 2024; 12:97-114. [PMID: 38062253 PMCID: PMC10881453 DOI: 10.1007/s40487-023-00253-4] [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: 09/19/2023] [Accepted: 11/08/2023] [Indexed: 02/23/2024] Open
Abstract
INTRODUCTION Patients with higher-risk myelodysplastic syndromes (MDS) face considerable challenges in disease management and often require caregiver support. Reports on the burden of caring for patients with advanced cancer suggest that caregivers receive insufficient support. Our research aimed to identify key challenges for caregivers of patients with higher-risk MDS. METHODS Online bulletin board is a qualitative research methodology which enables data collection via a web-based platform. A mix of moderator-led discussion guide and interparticipant discussion provides the caregiver insights as online dialogue, which then undergo content analysis to extract key findings. RESULTS Sixteen caregivers participated from the USA (n = 5), UK (n = 6) and Canada (n = 5). Content analysis identified the caregiver experience in higher-risk MDS as multifactorial, with seven key categories of caregiver burden: caregiver role and burden, mental health, family dynamics, disease experience, treatment experience, healthcare professional (HCP) interactions and information and education. CONCLUSION There is significant impact and burden on caregivers of patients with higher-risk MDS, which varies depending on disease stage, choice (or lack of choice) of treatments, and the personal situation of the caregiver. Emotional stress occurs mostly at diagnosis/prognosis stage and when told to 'watch and wait', which is amplified when HCPs are perceived to lack knowledge/expertise about MDS. There is a need for better education about MDS for HCPs, patients, caregivers and the general community; a need for improved communication between patients/caregivers and HCPs; and a high unmet need for better mental health and emotional support for both patient and caregiver.
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Affiliation(s)
- Pauline Frank
- Novartis Pharma AG, Fabrikstrasse 2, 4056, Basel, Switzerland.
| | - Anne Olshan
- Olshan Patient Relations Inc, Stamford, CT, USA
| | - Tracey Iraca
- Myelodysplastic Syndromes Foundation US, Yardville, NJ, USA
| | - Cindy Anthony
- Aplastic Anemia and Myelodysplasia Association Canada, King City, ON, Canada
| | | | - Emma Sasse
- Novartis Pharma AG, Fabrikstrasse 2, 4056, Basel, Switzerland
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Dusel J, Meng K, Arnold H, Rabe A, Jentschke E. Effectiveness of structured psycho-oncological counseling for relatives of lung cancer patients based on the CALM approach-study protocol of a randomized controlled trial. Trials 2024; 25:115. [PMID: 38336739 PMCID: PMC10858519 DOI: 10.1186/s13063-024-07954-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 01/25/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND The high incidence combined with the high lethality and bad prognosis of lung cancer highlight the need for psycho-oncological care for both patients and their relatives. While psychological interventions for relatives might be helpful, further research on the impact of specific interventions is necessary. Therefore, this trial aims to evaluate structured psycho-oncological counseling for relatives of lung cancer patients based on the Managing Cancer And Living Meaningfully (CALM) approach compared to usual care. In addition, we explore the impact of psycho-oncological support of relatives on the patients' mental health outcomes. METHODS The study is a single-center, prospective, randomized controlled trial with two measurement time points. Relatives of lung cancer patients and, thus, the patients themselves (i.e., dyads) are randomly allocated to the intervention group (IG) or the control group (CG) regardless of their disease or treatment stage. Relatives in the IG receive structured counseling based on the CALM approach (three to six sessions with psycho-oncologists). The CG receives usual psycho-oncological care. In addition, cancer patients in both study arms can request psycho-oncological support (usual care) as needed, but they will not get a specific intervention. Relatives and patients complete assessments at baseline (T0) and after the intervention/6 weeks (T1). The primary outcome for relatives is anxiety. Relatives' secondary outcomes include depressive symptoms, distress, supportive care needs, and quality of life. Patients' outcomes include anxiety, depression, and distress. All outcomes are assessed using self-report validated questionnaires. Intervention effects will be evaluated using analysis of covariance (ANCOVA) adjusting for baseline values. Power calculations reveal the need to enroll 200 subjects to detect an effect of d = 0.4. DISCUSSION The study will provide evidence for the effectiveness of the CALM intervention in relatives of lung cancer patients. Furthermore, study results will contribute to a better understanding of the effectiveness of a psycho-oncological intervention for highly impaired cancer patients and their relatives. If the CALM intervention positively affects the relatives' psychosocial outcome, it may be implemented in routine care. TRIAL REGISTRATION German Clinical Trials Register DRKS00030077. Retrospectively registered on 26 October 2022.
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Affiliation(s)
- Julia Dusel
- University Hospital Würzburg, Comprehensive Cancer Center Mainfranken, Josef-Schneider Str. 6, Würzburg, D-97080, Germany
| | - Karin Meng
- University Hospital Würzburg, Comprehensive Cancer Center Mainfranken, Josef-Schneider Str. 6, Würzburg, D-97080, Germany
| | - Hanna Arnold
- University Hospital Würzburg, Comprehensive Cancer Center Mainfranken, Josef-Schneider Str. 6, Würzburg, D-97080, Germany
| | - Antonia Rabe
- University Hospital Würzburg, Comprehensive Cancer Center Mainfranken, Josef-Schneider Str. 6, Würzburg, D-97080, Germany
| | - Elisabeth Jentschke
- University Hospital Würzburg, Comprehensive Cancer Center Mainfranken, Josef-Schneider Str. 6, Würzburg, D-97080, Germany.
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Gül İ, Toygar İ, Usta Yeşilbalkan Ö. Support needs of carers of cancer patients and the effects of the patient's age and cancer type on their needs. Eur J Oncol Nurs 2024; 68:102468. [PMID: 37988773 DOI: 10.1016/j.ejon.2023.102468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 10/18/2023] [Accepted: 11/09/2023] [Indexed: 11/23/2023]
Abstract
PURPOSE This study aimed to investigate support needs of carers of cancer patients and the effects of the patient's age and cancer type on their needs. METHODS In this descriptive and comparative study, the data were collected from the carers (n = 120) of the patient admitted to inpatient and outpatient clinics of a university hospital between June 2021 and October 2022. Patient identification form, carer identification form, and Carer Support Needs Assessment Tool (CSNAT) were used for data collection. The comparisons of the support needs were done for the carers according to the patient's age (<65 versus ≥65 years) and cancer type (hematological malignancies versus solid tumors). RESULTS Caring duration (19.78 ± 29.64 vs 10.33 ± 18.77 months) and caring hours per week (47.58 ± 26.90 vs 32.75 ± 25.75 h) were high in those caring for older adults. Carers of older adults need more support in providing personal care for their relatives (eg dressing, washing, toileting) (X2 = 8.000, p = 0.005). Carers of patients with hematological malignancies need more support in understanding their relative's illness (X2 = 6.136, p = 0.013), having time themselves in the day (X2 = 4.089, p = 0.043), managing their relative's symptoms, including giving medicines? (X2 = 5.263, p = 0.022), and their beliefs or spiritual concerns (X2 = 4.728, p = 0.030) compared to the carers of the patients with solid tumors. CONCLUSION The support needs of the carers vary depending on the patient's age and cancer type. Carers of older adults and patients with hematological malignancies need more support.
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Affiliation(s)
- İrem Gül
- Ege University Faculty of Nursing, Medical Nursin Department, İzmir, Turkey.
| | - İsmail Toygar
- Muğla Sıtkı Koçman University, Fethiye Faculty of Health Sciences, Muğla, Turkey.
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Roseleur J, Edney LC, Jung J, Karnon J. Prevalence of unmet supportive care needs reported by individuals ever diagnosed with cancer in Australia: a systematic review to support service prioritisation. Support Care Cancer 2023; 31:676. [PMID: 37934313 PMCID: PMC10630245 DOI: 10.1007/s00520-023-08146-y] [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: 07/08/2023] [Accepted: 10/26/2023] [Indexed: 11/08/2023]
Abstract
PURPOSE Improved health outcomes for individuals ever diagnosed with cancer require comprehensive, coordinated care that addresses their supportive care needs. Implementing interventions to address these is confounded by a lack of evidence on population needs and a large pool of potential interventions. This systematic review estimates the point prevalence of different supportive care needs stratified by the tool used to measure needs and cancer type in Australia. METHODS We searched MEDLINE, Embase, and Scopus from 2010 to April 2023 to identify relevant studies published on the prevalence of supportive care needs in Australia. RESULTS We identified 35 studies that met the inclusion criteria. The highest prevalent unmet need across all cancers was 'fear of cancer spreading' (20.7%) from the Supportive Care Needs Survey Short-Form 34 (SCNS-SF34), ranging from 9.4% for individuals ever diagnosed with haematological cancer to 36.3% for individuals ever diagnosed with gynaecological cancer, and 'concerns about cancer coming back' (17.9%) from the Cancer Survivors' Unmet Needs (CaSUN), ranging from 9.7% for individuals ever diagnosed with prostate cancer to 37.8% for individuals ever diagnosed with breast cancer. Two studies assessed needs in Aboriginal and Torres Strait Islander populations, reporting the highest needs for financial worries (21.1%). CONCLUSIONS Point prevalence estimates presented here, combined with estimates of the costs and effects of potential interventions, can be used within economic evaluations to inform evidence-based local service provision to address the supportive care needs of individuals ever diagnosed with cancer. IMPLICATIONS FOR CANCER SURVIVORS Local health services can use local evidence to prioritise the implementation of interventions targeted at unmet needs.
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Affiliation(s)
- Jackie Roseleur
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia.
| | - Laura Catherine Edney
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Jayda Jung
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Jonathan Karnon
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
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Winter N, McKenzie K, Spence D, Lane K, Ugalde A. The experience of bereaved cancer carers in rural and regional areas: The impact of the COVID-19 pandemic and the potential of peer support. PLoS One 2023; 18:e0293724. [PMID: 37934771 PMCID: PMC10629652 DOI: 10.1371/journal.pone.0293724] [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: 11/09/2022] [Accepted: 10/18/2023] [Indexed: 11/09/2023] Open
Abstract
BACKGROUND Caring for someone with cancer during end of life care can be a challenging and complex experience. Those living in rural and regional areas are less likely to have local healthcare services and may be physically isolated. Even where support services such as respite do exist, they may be less likely to be accessed due to the time burden in travelling to services. This was compounded by the COVID-19 pandemic. AIM To understand the potential benefits of peer support for bereaved carers of people with cancer from rural and regional locations during the COVID-19 period. METHODS Phone interviews were conducted with bereaved cancer carers living in rural and regional areas in Victoria. Semi-structured interviews were used, and participants were asked about their experience as a carer, bereavement and the potential for peer support. Interviews were audio recorded and transcribed verbatim; transcripts were coded and a thematic analysis was conducted. FINDINGS 12 interviews were conducted. Carers were mostly female (85%) and were on average 58 years of age (range 42-71). Interviews lasted an average of 58 minutes (range 53-91 minutes). Three themes were derived from the data; 1) Supportive care needs while caring and the impact of COVID-19; 2) Isolation during bereavement compounded by the COVID-19 pandemic; and 3) Peer support requires flexibility to meet diverse needs. CONCLUSION Peer support has potential to assist bereaved carers of people with cancer. A co-design approach may be beneficial for developing a flexible model for supporting and linking carers together.
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Affiliation(s)
- Natalie Winter
- School of Nursing & Midwifery and Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Kerry McKenzie
- Strategy and Support Division, Cancer Council Victoria, Melbourne, Australia
| | - Danielle Spence
- Strategy and Support Division, Cancer Council Victoria, Melbourne, Australia
| | - Katherine Lane
- Strategy and Support Division, Cancer Council Victoria, Melbourne, Australia
| | - Anna Ugalde
- School of Nursing & Midwifery and Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
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Samuelsson M, Wennick A, Bengtsson M, Lydrup ML, Jakobsson J. Translation, cultural adaptation, and psychometric testing of the Supportive care needs survey for partners and caregivers for Swedish family members of persons diagnosed with colorectal cancer. J Patient Rep Outcomes 2023; 7:100. [PMID: 37819416 PMCID: PMC10567617 DOI: 10.1186/s41687-023-00636-1] [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: 05/03/2023] [Accepted: 09/15/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Colorectal cancer is the third most common cancer diagnosis globally and is increasing in both incidence and prevalence. Despite evidence showing that family members of persons diagnosed with cancer have supportive care needs, no validated questionnaire measuring the needs of family members of persons diagnosed with CRC exists in Swedish. Thus, the objective of the present study was to translate, culturally adapt, and evaluate the psychometric properties the Supportive Care Needs Survey - Partners and Caregivers 45. METHODS The translation and cultural adaptation followed a systematic yet iterative process. Firstly, the questionnaire was translated using a forward-backward approach. Secondly, face and content validity and comprehensibility were evaluated by two expert panels of colorectal cancer specialist nurses and family members, respectively. Lastly, the psychometric properties, validity, and reliability of the translated questionnaire were evaluated among 45 Swedish family members of persons diagnosed with colorectal cancer. RESULTS The face, content, and construct validity of the translated questionnaire were evaluated as satisfying. Moreover, psychometric evaluations showed high data quality and satisfactory internal consistency. However, the results also revealed unsolved issues regarding relevance, targeting, and internal consistency, as well as a probable scaling failure. CONCLUSION The translated and adapted questionnaire can be used to identify family members unmet needs of support throughout the colorectal cancer trajectory. The questionnaire showed promising validity and reliability in the target population. However, it needs to be further evaluated in a larger sample, preferably involving factor analysis and stability over time.
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Affiliation(s)
- Maria Samuelsson
- Faculty of Health and Society, Department of Care Science, Malmö University, Jan Waldenströms gata 25, 205 06, Malmö, Sweden.
- Department of Pediatrics, Skåne University Hospital, Malmö, Sweden.
| | - Anne Wennick
- Faculty of Health and Society, Department of Care Science, Malmö University, Jan Waldenströms gata 25, 205 06, Malmö, Sweden
| | - Mariette Bengtsson
- Faculty of Health and Society, Department of Care Science, Malmö University, Jan Waldenströms gata 25, 205 06, Malmö, Sweden
| | - Marie-Louise Lydrup
- Department of Surgery and Gastroenterology, Skåne University Hospital, Malmö, Sweden
| | - Jenny Jakobsson
- Faculty of Health and Society, Department of Care Science, Malmö University, Jan Waldenströms gata 25, 205 06, Malmö, Sweden
- Department of Surgery and Gastroenterology, Skåne University Hospital, Malmö, Sweden
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van Helmondt SJ, Lodder P, van Woezik R, de Vries J, van der Lee ML. CBT-based Online Self-help Training to Reduce Fear and Distress After Cancer (CAREST Randomized Trial): 24 Months Follow-up Using Latent Growth Models and Latent Class Analysis. Ann Behav Med 2023; 57:787-799. [PMID: 37078920 PMCID: PMC10441870 DOI: 10.1093/abm/kaac078] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2023] Open
Abstract
BACKGROUND Psychological distress (PD) and fear of cancer recurrence (FCR) are common consequences of surviving cancer. Online self-help training could help many cancer survivors deal with PD and FCR at low costs. PURPOSE To evaluate the long-term effectiveness of the CAncer REcurrence Self-help Training (CAREST trial) to reduce PD and FCR. Moreover, to evaluate the relation between FCR and PD across time and identify subgroups representing different change trajectories in FCR over time and their predictors. METHODS This multicenter randomized controlled trial included 262 female breast cancer survivors, assigned to online self-help training or care as usual. Participants completed questionnaires at baseline and four times during the 24-month follow-up. The primary outcomes were PD and FCR (Fear of Cancer Recurrence Inventory). Latent growth curve modeling (LGCM) and repeated measures latent class analysis (RMLCA) were performed, both according to the intention-to-treat principle. RESULTS LGCM showed no differences between the average latent slope in both groups for both PD and FCR. The correlation between FCR and PD at baseline was moderate for the intervention group and strong for the CAU group and did not significantly decrease over time in both groups. RMLCA revealed five latent classes and several predictors of class membership. CONCLUSIONS We did not find a long-term effect of the CBT-based online self-help training in reducing PD or FCR, nor in their relation. Therefore, we recommend adding professional support to online interventions for FCR. Information about FCR classes and predictors may contribute to improvement of FCR interventions.
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Affiliation(s)
- Sanne Jasperine van Helmondt
- Department of Medical and Clinical Psychology, Tilburg University, PO Box 90153, 5000 LE Tilburg, The Netherlands
- Scientific Research Department, Helen Dowling Institute, Professor Bronkhorstlaan 20, 3723 MB Bilthoven, The Netherlands
| | - Paul Lodder
- Department of Medical and Clinical Psychology, Tilburg University, PO Box 90153, 5000 LE Tilburg, The Netherlands
- Department of Methodology and Statistics, Tilburg University, PO Box 90153, 5000 LE Tilburg, The Netherlands
| | - Rosalie van Woezik
- Scientific Research Department, Helen Dowling Institute, Professor Bronkhorstlaan 20, 3723 MB Bilthoven, The Netherlands
| | - Jolanda de Vries
- Department of Medical and Clinical Psychology, Tilburg University, PO Box 90153, 5000 LE Tilburg, The Netherlands
- Admiraal de Ruyter Hospital (Adrz), PO Box 15, 4460 AA Goes, The Netherlands
| | - Marije Liesbeth van der Lee
- Department of Medical and Clinical Psychology, Tilburg University, PO Box 90153, 5000 LE Tilburg, The Netherlands
- Scientific Research Department, Helen Dowling Institute, Professor Bronkhorstlaan 20, 3723 MB Bilthoven, The Netherlands
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Kirk DL, Kabdebo I, Whitehead L. Prevalence of distress and its associated factors among caregivers of people diagnosed with cancer: A cross-sectional study. J Clin Nurs 2022; 31:3402-3413. [PMID: 34894019 PMCID: PMC9787485 DOI: 10.1111/jocn.16167] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 11/17/2021] [Accepted: 12/01/2021] [Indexed: 12/30/2022]
Abstract
AIMS AND OBJECTIVES To (i) determine prevalence of distress among caregivers of people living with cancer, (ii) describe caregivers' most commonly reported problems and (iii) investigate which factors were associated with caregivers' distress. BACKGROUND The psychological distress associated with a cancer diagnosis jointly impacts those living with cancer and their caregivers(s). As the provision of clinical support moves towards a dyadic model, understanding the factors associated with caregivers' distress is increasingly important. DESIGN Cross-sectional study. METHODS Distress screening data were analysed for 956 caregivers (family and friends) of cancer patients accessing the Cancer Council Western Australia information and support line between 1 January 2016 and 31 December 2018. These data included caregivers' demographics and reported problems and their level of distress. Information related to their care recipient's cancer diagnosis was also captured. Caregivers' reported problems and levels of distress were measured using the distress thermometer and accompanying problem list (PL) developed by the National Comprehensive Cancer Network. A partial-proportional logistic regression model was used to investigate which demographic factors and PL items were associated with increasing levels of caregiver distress. Pearlin's model of caregiving and stress process was used as a framework for discussion. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist was followed. RESULTS Nearly all caregivers (96.24%) recorded a clinically significant level of distress (≥4/10) and two thirds (66.74%) as severely distressed (≥7/10). Being female, self-reporting sadness, a loss of interest in usual activities, sleep problems or problems with a partner or children were all significantly associated with increased levels of distress. CONCLUSIONS Caregivers of people with cancer reporting emotional or familial problems may be at greater risk of moderate and severe distress. RELEVANCE TO CLINICAL PRACTICE Awareness and recognition of caregiver distress are vital, and referral pathways for caregivers are the important area of development.
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Affiliation(s)
- Deborah L. Kirk
- School of Nursing and MidwiferyEdith Cowan UniversityJoondalupWestern AustraliaAustralia
| | - Istvan Kabdebo
- School of Nursing and MidwiferyEdith Cowan UniversityJoondalupWestern AustraliaAustralia
| | - Lisa Whitehead
- School of Nursing and MidwiferyEdith Cowan UniversityJoondalupWestern AustraliaAustralia
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Ahmad T, Ornos EDB, Ahmad S, Al-Wassia RK, Mushtaque I, Shah SM, Al-Omari B, Baig M, Tang K. Global Research Mapping of Psycho-Oncology Between 1980 and 2021: A Bibliometric Analysis. Front Psychol 2022; 13:947669. [PMID: 35910981 PMCID: PMC9326365 DOI: 10.3389/fpsyg.2022.947669] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 06/07/2022] [Indexed: 01/15/2023] Open
Abstract
Background and Aim Psycho-oncology is a cross-disciplinary and collaborative sub-specialty of oncology that focuses on the psychological, behavioral, ethical, and social aspects of cancer in clinical settings. The aim of this bibliometric study was to analyze and characterize the research productivity and trends in psycho-oncology between 1980 and 2021. Methodology In May 2022, the Scopus® database was searched for psycho-oncology-related publications using predetermined search keywords with specific restrictions. Lotka’s law was applied to check the authors’ productivity, while Bradford’s law was used to assess the core journals in this field. The data was analyzed for different bibliometric indicators in the Biblioshiny package, an RStudio tool for bibliometric analysis. Results The initial search resulted in a total of 2,906 publications. Of which, 1,832 publications were included in the final analysis, published between 1980 and 2021. The analyzed publications were written by 7,363 authors from 74 countries and published in 490 journals. There has been a significant increase in psycho-oncology-related publications after 2010. The most productive year was 2021 (n = 365). The annual scientific growth rate was found to be 13.9%. The most relevant leading author in terms of publications was Luigi Grassi from the University of Ferrara, Italy (n = 42). Lotka’s law found that the number of authors declined as the number of papers written increased. The core journals were Psycho-Oncology, Supportive Care in Cancer, and Journal of Psychosocial Oncology. The most frequently used author’s keywords other than searching keywords were cancer, oncology, quality of life, depression, and anxiety. Recent psycho-oncology-related topics included mental health, COVID-19 infection in humans, people, pandemic, and tumor. The University of Sydney was the top-ranked institution. The leading country in terms of publications, citations, corresponding author country, and international collaboration was the United States of America (United States). The United States had the strongest collaboration with Australia and Canada. Conclusion The research hotspots include mental health conditions and interventions in cancer patients. We identified international collaboration and research expenditure to be strongly associated with psycho-oncology research productivity. Researchers’ collaboration, which is visible among developed countries, should be extended to low-income countries in order to expand psycho-oncology-related research and understanding.
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Affiliation(s)
- Tauseef Ahmad
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
- *Correspondence: Tauseef Ahmad, ; ; orcid.org/0000-0001-8793-273X
| | - Eric David B. Ornos
- College of Medicine, University of the Philippines Manila, Manila, Philippines
| | - Shabir Ahmad
- Department of Agriculture, Bacha Khan University Charsadda, Charsadda, Pakistan
| | - Rolina Kamal Al-Wassia
- Department of Radiology, Radiation Oncology Unit, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Iqra Mushtaque
- Department of Psychology, Bahauddin Zakariya University, Multan, Pakistan
| | - S. Mudasser Shah
- Department of Psychosomatics and Psychiatry, School of Medicine, Zhongda Hospital, Southeast University, Nanjing, China
| | - Basem Al-Omari
- Department of Epidemiology and Population Health, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
- KU Research and Data Intelligence Support Center (RDISC), Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
- Basem Al-Omari,
| | - Mukhtiar Baig
- Department of Clinical Biochemistry, Faculty of Medicine, Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Kun Tang
- Vanke School of Public Health, Tsinghua University, Beijing, China
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12
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Yamaki C, Takayama T, Hayakawa M, Wakao F. Users' evaluation of Japan's cancer information services: process, outcomes, satisfaction and independence. BMJ Open Qual 2021; 10:bmjoq-2021-001635. [PMID: 34949579 PMCID: PMC8705375 DOI: 10.1136/bmjoq-2021-001635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 12/01/2021] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Cancer information service (CIS) programmes are becoming increasingly important because patients need to obtain appropriate information and take an active role in their treatment decisions. Programme evaluation is required to determine the level of satisfaction and quality of experiences of users. The purpose of this study is (1) to identify users' evaluation of CIS programmes by both satisfaction and outcomes that reflect the quality of experience and impact of using the CIS, (2) to examine the related factors of these evaluation outcomes and (3) to analyse the differences of those relations between patients and families. METHOD The self-reported questionnaire was answered by 447 patients and 216 families of patients who used Cancer Information Support Centres (CISCs) at 16 designated cancer hospitals from January 2016 to April 2016. We developed 12 evaluation items, including satisfaction, experience and the impact of using CISC. RESULTS Respondents evaluated the CISC highly, especially in terms of overall satisfaction, followed by the counselling process. Immediate access to CISC was the strongest factor affecting outcomes. Patients who wanted to consult about 'disease or symptoms' or 'had no specific problem' tended to provide high scores for some outcomes, but those who wanted to consult about a 'financial problem' or 'discharge or care at home' provided negative scores. These trends were also observed in families but to a more limited extent. CONCLUSION Users' evaluation of CISCs was sufficiently high in terms of overall satisfaction, showing reasonable scores in outcome levels. Immediate access was the strongest factor affecting outcomes and topics of consultation more directly affected evaluation by patients than by families. The distribution of the scores of the measures and related factors was reasonable. The 12-item measurement tool employed in this study seems to be useful for quality monitoring of the CIS.
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Affiliation(s)
- Chikako Yamaki
- Institute for Cancer Control, National Cancer Center Japan, Chuo-ku, Tokyo, Japan
| | - Tomoko Takayama
- Institute for Cancer Control, National Cancer Center Japan, Chuo-ku, Tokyo, Japan
| | - Masayo Hayakawa
- Institute for Cancer Control, National Cancer Center Japan, Chuo-ku, Tokyo, Japan
| | - Fumihiko Wakao
- Institute for Cancer Control, National Cancer Center Japan, Chuo-ku, Tokyo, Japan
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13
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Seib C, Lazenby M, Dunn J, Chambers S. Considerations about risk of ongoing distress: what can we learn from repeat screening? Support Care Cancer 2021; 30:1011-1014. [PMID: 34697675 DOI: 10.1007/s00520-021-06621-y] [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: 06/19/2021] [Accepted: 10/08/2021] [Indexed: 10/20/2022]
Abstract
The importance of routine distress screening in cancer patients is widely acknowledged, though non-compliance with screening protocols is common. Cited reasons for non-adherence include lack of time and expertise and concerns about the resources associated with the identification and management of clinically relevant distress. This commentary examines changes in distress among people with cancer who participated in a tele-based psychosocial intervention, from the point of initial distress screening to 12 months after commencing the intervention. The goal is to contribute to the discussion about the potential infrastructure requirements of implementing screening programs among screening 'hesitant' cancer care services. Secondary analysis showed a general downward distress trajectory though the greatest reduction occurred between recruitment and baseline and before receiving a low-intensity psychosocial intervention (β = - 1.84, 95% CI - 2.12, - 1.56). While acknowledging transience of distress in some patients, our results support the possible therapeutic benefit of assessing and validating individuals' distress in the hope of preventing the development of more overt health problems associated with undiagnosed and untreated symptoms.
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Affiliation(s)
- Charrlotte Seib
- Menzies Health Institute Queensland, Griffith University, Clinical Sciences 2 Building, Parklands Drive, Southport, Queensland, 4215, Australia.
| | - Mark Lazenby
- School of Nursing, University of Connecticut, Mansfield, CT, USA
| | - Jeffrey Dunn
- Centre for Health Research, University of Southern Queensland, Darling Heights, Australia.,Prostate Cancer Foundation of Australia, Sydney, New South Wales, Australia.,Australian Catholic University, Brisbane, Australia
| | - Suzanne Chambers
- Menzies Health Institute Queensland, Griffith University, Clinical Sciences 2 Building, Parklands Drive, Southport, Queensland, 4215, Australia.,Centre for Health Research, University of Southern Queensland, Darling Heights, Australia.,Australian Catholic University, Brisbane, Australia.,Exercise Medicine Research Institute, Edith Cowan University, Perth, Australia
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14
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Psychological Distress and Its Association with Unmet Needs and Symptom Burden in Outpatient Cancer Patients: A Cross-Sectional Study. Semin Oncol Nurs 2021; 37:151214. [PMID: 34483014 DOI: 10.1016/j.soncn.2021.151214] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 08/03/2021] [Accepted: 08/03/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To evaluate the relationships of sociodemographic and clinical characteristics, symptom burden, and supportive care needs of patients with a prevalence of psychological distress in outpatients with cancer. DATA SOURCES The study was carried out with 298 outpatient cancer patients at an oncology center in Turkey, and a descriptive correlational design was used. The data were collected through Hospital Anxiety-Depression Scale (HADS), Nightingale Symptom Assessment Scale (N-SAS), and Supportive Care Needs Scale Short Form (SCNS-SF34). Descriptive statistics and hierarchical regression analyses were performed. CONCLUSION The study determined that the anxiety and depression scores of a significant portion of cancer patients receiving outpatient treatment were clinically significant. It was observed that the physical and psychological symptom burden of the patients and the increase in unmet care needs related to psychological, physical, and activities of daily life contributed to the development of anxiety and depression. Of the sociodemographic and disease-related characteristics of the patients, female sex was found to be an important factor for both anxiety and depression, and advanced age was found to be an important factor for depression. These results indicate that cancer patients receiving outpatient treatment need intensive supportive psychosocial care. IMPLICATIONS FOR NURSING PRACTICE It is recommended that patients' psychological distress levels and supportive care needs be included in the care process as a routine component of care, as in symptom assessment, and to develop a more sensitive and supportive care environment in meeting psychosocial care needs and accessing support.
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15
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Taylor J, Fradgley EA, Clinton-McHarg T, Hall A, Paul CL. Referral and uptake of services by distressed callers to the Cancer Council Information and Support telephone service. Asia Pac J Clin Oncol 2021; 18:303-310. [PMID: 34185960 DOI: 10.1111/ajco.13604] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 04/10/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Patient-centered cancer care includes emotional, informational, and practical support that is personalised to the needs of patients and inclusive of family and friends. However, when supportive care referrals are offered in hospital settings, distressed patients and carers do not consistently act on those referrals, which can prolong patient suffering. The degree to which sub-optimal referral uptake also occurs in Australian telephone support services is unknown. AIMS To report, among a sample of distressed patients and caregivers who called a cancer information and support service: 1) the types of services used; 2) proportion who received and actioned a referral (uptake); 3) associations between referral to a service and callers' characteristics); and, 4) associations between uptake of a referred service and callers' characteristics. METHODS This study used cross-sectional data collected at 3-month post-baseline from control participants (usual care group) enrolled in the Structured Triage and Referral by Telephone (START) trial. The START trial recruited distressed adult cancer patients and caregivers from the Cancer Council Information and Support Service (CIS). A research assistant conducted a 30-45 min telephone interview with participants, which included recall of referrals provided by CIS staff and reported uptake of referral(s) to the offered service types. RESULTS Most patients (98%) and caregivers (97%) reported receiving a referral to a service. For patients and caregivers respectively, information materials (71%, 77%), CIS call-back (51%, 43%), practical services (52%, 45%), and group peer support (49%, 51%) were the services most frequently offered. For callers receiving a referral, uptake was highest for information materials (91%) and CIS call-backs (89%) and lowest for specialist psychological services (30%). Significant association was found between older age and reduced uptake of services (p = 0.03). CONCLUSION The high uptake rate of CIS call-backs suggests it is a potentially more acceptable form of support compared to specialist psychological services. Efforts to reduce the barriers to telephone-based psychological services are required. Specifically, older age peoples' and caregivers' preferences for support and priorities who may benefit from a referral coordinator.
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Affiliation(s)
- Jo Taylor
- School of Medicine and Public health, University of Newcastle, Callaghan, New South Wales, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia.,Priority Research Centre for Cancer Research Innovation and Translation, University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton Heights, Newcastle, New South Wales, Australia
| | - Elizabeth A Fradgley
- School of Medicine and Public health, University of Newcastle, Callaghan, New South Wales, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia.,Priority Research Centre for Cancer Research Innovation and Translation, University of Newcastle, Callaghan, New South Wales, Australia.,Cancer Institute New South Wales, Cancer Institute New South Wales, Eveleigh, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton Heights, Newcastle, New South Wales, Australia
| | - Tara Clinton-McHarg
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia.,Priority Research Centre for Cancer Research Innovation and Translation, University of Newcastle, Callaghan, New South Wales, Australia.,School of Psychology, University of Newcastle, Callaghan, New South Wales, Australia
| | - Alix Hall
- School of Medicine and Public health, University of Newcastle, Callaghan, New South Wales, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia.,Hunter New England Population Health, Hunter New England Area Health Service, Newcastle, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton Heights, Newcastle, New South Wales, Australia
| | - Christine L Paul
- School of Medicine and Public health, University of Newcastle, Callaghan, New South Wales, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia.,Priority Research Centre for Cancer Research Innovation and Translation, University of Newcastle, Callaghan, New South Wales, Australia.,Hunter Medical Research Institute, New Lambton Heights, Newcastle, New South Wales, Australia
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16
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Distress experienced by lung cancer patients and their family caregivers in the first year of their cancer journey. Palliat Support Care 2021; 20:15-21. [PMID: 33899723 DOI: 10.1017/s1478951521000377] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Diagnosis of cancer is emotionally threatening not only for patients but also for their family caregivers (FC) who witness and share much of the illness experience. This study compares distress experienced by lung cancer patients and their FC during the year following the diagnosis. METHODS A prospective cohort study of 206 patients recently diagnosed with inoperable lung cancer (participation rate 79.5%) and 131 FC (participation rate 63.6%) was conducted in an ambulatory oncology clinic in Quebec City (Canada). They completed validated questionnaires regarding their personal and psychological characteristics (Hospital and Anxiety Depression Scale-HADS), in the first months after the diagnosis of lung cancer and after 6 and 12 months. Univariate, bivariate, and linear mixed models were conducted to compare patient and FC distress. RESULTS At baseline, 7.8% of patients reported distress (HADS total score >15) and their mean distress score was 7.0 ± 4.9 (range 0-42). In contrast, 33.6% of FC presented significant distress and their mean distress score was 12.0 ± 7.2 (P < 0.0001). Proportions of patients and FC with distress remained relatively stable at 6 and 12 months, and at every time point, FC reported higher levels of distress compared to their relative with cancer (P < 0.0001). Comparable trends were found when looking at the mean scores of distress, anxiety, and depression throughout the study. SIGNIFICANCE OF RESULTS Being diagnosed with lung cancer and going through its different phases seems to affect more FC than patients. The psychological impact of such diagnosis appears early after the diagnosis and does not significantly change over time. These findings reinforce the importance for oncology teams, to include FC in their systematic distress screening program, in order to help them cope with their own feelings and be able to play their role in patient support and care throughout the cancer journey.
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17
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Lee TY, Susanti HD, Hung KC, Yang SY, Fang HF, Tsai JR, Chiou JF, Chung MH. Health care needs of elderly patients with lung, liver, or colon cancer in Taiwan. BMC Palliat Care 2021; 20:21. [PMID: 33485348 PMCID: PMC7827987 DOI: 10.1186/s12904-021-00708-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 01/03/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Globally, different age groups in the elderly population have experienced major shifts over time. Human life expectancy doubled from the 19th to the twentieth century and has increased to 80 years in the twenty-first century. These conditions imply economic challenges and the increasing prevalence of certain health conditions. Old age is associated with increased care needs in various aspects of daily life. This study assessed the health care needs of elderly patients with lung, liver, and colorectal cancer in Taiwan and analyzed the factors underlying their needs. METHODS This cross-sectional descriptive survey assessed 234 elderly patients with diagnosis of lung, liver, and colorectal cancer in Taiwan. We investigated their health care needs and daily living functions by using the Supportive Care Needs Survey and Karnofsky Performance Status, respectively. RESULTS Patients required the most assistance in physical functioning and daily living. Patients aged ≥85 years required more care than those aged 65-74 years in terms of information access and sexuality needs. Patients with poor functional status required more care than those capable of undertaking normal activities. Patients diagnosed as having liver cancer required more care than those with lung or colorectal cancer. Patients with advanced cancer required more physical and daily care than those with early-stage cancer. CONCLUSIONS Patients' health care needs differed with age, primary cancer site, and functional status. Patients aged ≥85 years and those with poor function, primary liver cancer, and advanced cancer had higher care needs.
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Affiliation(s)
- Tzu-Yin Lee
- School of Nursing, College of Nursing, Taipei Medical University, No. 250, Wu-Xing Street, Taipei, Taiwan
| | - Henny Dwi Susanti
- School of Nursing, College of Nursing, Taipei Medical University, No. 250, Wu-Xing Street, Taipei, Taiwan.,Department of Nursing, Faculty of Health Science, University of Muhammadiyah Malang, Malang, East Java, Indonesia
| | - Kuo-Chen Hung
- Department of Computer Science and Information Management, Hungkuang University, Taichung City, Taiwan
| | - Su-Yueh Yang
- Department of Nursing, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Center for Nursing and Healthcare Research in Clinical Practice Application, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Hui-Fen Fang
- Department of Nursing, Taipei Cancer Center, Taipei Medical University, Taipei, Taiwan.,Cancer Center, Taipei Medical University Hospital, Taipei, Taiwan.,Nursing Services, Taipei Medical University Hospital, Taipei, Taiwan
| | - Jia-Ruey Tsai
- Division of Hematology and Oncology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan
| | - Jeng-Fong Chiou
- Taipei Cancer Center, Taipei Medical University, Taipei, Taiwan.,School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Min-Huey Chung
- School of Nursing, College of Nursing, Taipei Medical University, No. 250, Wu-Xing Street, Taipei, Taiwan. .,Department of Nursing, Shuang-Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
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18
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Denham AMJ, Wynne O, Baker AL, Spratt NJ, Turner A, Magin P, Palazzi K, Bonevski B. An online survey of informal caregivers' unmet needs and associated factors. PLoS One 2020; 15:e0243502. [PMID: 33301483 PMCID: PMC7728235 DOI: 10.1371/journal.pone.0243502] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 11/20/2020] [Indexed: 12/19/2022] Open
Abstract
PURPOSE/OBJECTIVE The purpose of this study was to assess the frequency of unmet needs of carers among a convenience sample of carers, and the participant factors associated with unmet needs, to inform the development of interventions that will support a range of caregivers. The aims of this study were to: (1) assess the most frequently reported moderate-high unmet needs of caregivers; and (2) examine the age, gender, condition of the care recipient, and country variables associated with types of unmet needs reported by informal caregivers. RESEARCH METHOD/DESIGN An online cross-sectional survey among informal caregivers in English-speaking countries was conducted. Self-reported unmet needs were assessed using an unmet needs measure with the following five unmet needs domains: (1) Health information and support for care recipient; (2) Health service management; (3) Communication and relationship; (4) Self-care; and (5) Support services accessibility. Informal caregivers were asked "In the last month, what was your level of need for help with…", and the ten highest ranked moderate-high unmet needs presented as ranked proportions. Logistic regression modelling examined the factors associated with types of unmet needs. RESULTS Overall, 457 caregivers were included in the final analysis. Seven of the ten highest ranked unmet needs experienced by caregivers in the last month were in the Self-care domain, including "Reducing stress in your life" (74.1%). Significant associations were found between younger caregiver age (18-45 years) and reporting moderate-high unmet needs in Health Information and support for care recipient, Health service management, and Support services accessibility (all p's = <0.05). CONCLUSIONS/IMPLICATIONS Caregivers are not experiencing significant differences in unmet needs between countries and caree/care recipient conditions, suggesting that general interventions could be developed to support a range of caregivers across countries. Increased awareness of informal caregivers' unmet needs, particularly for younger caregivers, among health care providers may improve support provision to caregivers.
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Affiliation(s)
- Alexandra M. J. Denham
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle & Hunter Medical Research Institute, Callaghan, NSW, Australia
- Priority Research Centre for Stroke and Brain Injury, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- * E-mail:
| | - Olivia Wynne
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle & Hunter Medical Research Institute, Callaghan, NSW, Australia
| | - Amanda L. Baker
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle & Hunter Medical Research Institute, Callaghan, NSW, Australia
| | - Neil J. Spratt
- Priority Research Centre for Stroke and Brain Injury, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW, Australia
- Department of Neurology, Hunter New England Local Health District, John Hunter Hospital, New Lambton Heights, NSW, Australia
| | - Alyna Turner
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle & Hunter Medical Research Institute, Callaghan, NSW, Australia
- Deakin University, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Geelong, Victoria, Australia
| | - Parker Magin
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle & Hunter Medical Research Institute, Callaghan, NSW, Australia
| | - Kerrin Palazzi
- HMRI Clinical Research Design and Statistics (CReDITSS), Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Billie Bonevski
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle & Hunter Medical Research Institute, Callaghan, NSW, Australia
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19
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Bamgboje-Ayodele A, Levesque JV, Gerges M, Girgis A. The male perspective: A mixed methods study of the impact, unmet needs and challenges of caring for women with breast cancer. J Psychosoc Oncol 2020; 39:235-251. [PMID: 33238814 DOI: 10.1080/07347332.2020.1850600] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES As a formative investigation toward the development of a supportive care intervention for male caregivers, this study explored the emotional impact, unmet needs and challenges experienced by men when caring for a woman with breast cancer. DESIGN A cross-sectional mixed methods study, with an online survey and interviews. SAMPLE A total of 89 participants completed the survey, of whom 13 completed interviews. The majority (93%) of participants were husbands of care recipients; of the care recipients, 75% had early stage breast cancer and 45% were diagnosed over 5 years ago. METHOD Participants completed questionnaires assessing their emotional wellbeing, unmet needs and biopsychosocial challenges, with a sub-sample participating in subsequent interviews to elaborate on survey responses. FINDINGS Emotional difficulty was reported by <25% of the sample, and 83% reported experiencing at least one unmet need (M = 81.5, SD = 33.2). Of the 39 biopsychosocial challenges presented, 100%, 86% and 73% reported "ever experiencing," "currently experiencing," and "ever needing help," respectively. Interviewed participants echoed the most reported needs and challenges as changes to sex life, fear of recurrence and lack of practical information. CONCLUSIONS Male cancer caregivers experience diverse challenges and require psychological support and practical information using both online and offline approaches to support their caregiving responsibilities. IMPLICATIONS FOR PSYCHOSOCIAL PROVIDERS Healthcare professionals can support male caregivers by: being aware of their information and psycho-social needs; directing caregivers to online interventions for additional information; and facilitating the provision of online psycho-sexual and FCR support.
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Affiliation(s)
- Adeola Bamgboje-Ayodele
- Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Sydney, Australia
| | - Janelle V Levesque
- Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Sydney, Australia.,School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Martha Gerges
- Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Sydney, Australia
| | - Afaf Girgis
- Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Sydney, Australia
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20
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Taylor J, Fradgley E, Clinton-McHarg T, Byrnes E, Paul C. What are the sources of distress in a range of cancer caregivers? A qualitative study. Support Care Cancer 2020; 29:2443-2453. [PMID: 32929537 DOI: 10.1007/s00520-020-05742-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 09/04/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Caring for a person diagnosed with cancer is associated with elevated distress that may impact on caregiver health and patient outcomes. However, caregivers' distress is relatively under-researched. This Australian study explored a range of caregivers' reported sources of distress. METHODS The grounded theory approach informed semi-structured interviews that were conducted with a purposive and broad range sample of distressed caregivers identified through the 'Structured Triage And Referral by Telephone' (START) trial. A grounded theory framework was used to generate themes with data analysed by two independent coders using the NVivo software. RESULTS Caregivers (n = 14) were aged from 25 to 80 years, including two bereaved caregivers. The relationships of the caregivers to the patients were as follows: partner (n = 8), parent (n = 1), child (n = 3), sibling (n = 1), and friend (n = 1). Six major themes emerged in relation to sources of distress: (1) a lack of sufficient and timely information; (2) uncertainty; (3) the role and duties of caregiving; (4) lack of family-centred services; (5) practical challenges; and (6) impact of distress. CONCLUSION Caregivers face a number of specific challenges beyond those experienced by patients. It is essential to ensure that caregivers are actively well-informed and well-supported alongside the person who is diagnosed with cancer.
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Affiliation(s)
- Jo Taylor
- School of Medicine and Public Health, University of Newcastle, Level 4 West, HMRI Building, Callaghan, NSW, 2308, Australia. .,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia. .,Priority Research Centre for Cancer Research Innovation and Translation, University of Newcastle, Callaghan, Australia.
| | - Elizabeth Fradgley
- School of Medicine and Public Health, University of Newcastle, Level 4 West, HMRI Building, Callaghan, NSW, 2308, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia.,Priority Research Centre for Cancer Research Innovation and Translation, University of Newcastle, Callaghan, Australia.,Cancer Institute New South Wales, Eveleigh, Australia
| | - Tara Clinton-McHarg
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia.,Priority Research Centre for Cancer Research Innovation and Translation, University of Newcastle, Callaghan, Australia.,School of Psychology, University of Newcastle, Callaghan, Australia
| | - Emma Byrnes
- School of Medicine and Public Health, University of Newcastle, Level 4 West, HMRI Building, Callaghan, NSW, 2308, Australia.,Priority Research Centre for Generational Health and Aging, University of Newcastle, Callaghan, Australia
| | - Christine Paul
- School of Medicine and Public Health, University of Newcastle, Level 4 West, HMRI Building, Callaghan, NSW, 2308, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia.,Priority Research Centre for Cancer Research Innovation and Translation, University of Newcastle, Callaghan, Australia.,Hunter Research Cancer Alliance, HMRI Building, New Lambton Heights, Australia
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21
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Empowering caregivers in the radiotherapy process: the results of a randomized controlled trial. Support Care Cancer 2020; 29:2395-2404. [PMID: 32918607 DOI: 10.1007/s00520-020-05743-z] [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: 06/26/2020] [Accepted: 09/04/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE The present study aims to evaluate the effectiveness of a mobile-assisted empowerment program developed specifically for caregivers of cancer patients undergoing radiotherapy. METHODS In this study, seventy-four individuals who gave care for cancer patients that received radiotherapy between September 2019 and May 2020 were randomized to receive a mobile-assisted empowerment program or standard care. The mobile-assisted empowerment program comprised of education and information related to the radiotherapy process, videos, activities, and question-and-answer modules to support caregivers during the radiotherapy process. Outcome measures were collected at baseline (day 1 of radiotherapy) and on day 21 and included caregiver demographics, distress, quality of life, and coping style using validated questionnaires. RESULTS Compared with baseline, individuals' mean scores of distress were lower in the empowerment group than the control group (p < 0.001). General quality of life and sub-dimension mean scores were higher in the empowerment group than the control group (p ≤ 0.05). There was no difference in the coping style average scores (p ≥ 0.05) between the two groups. CONCLUSIONS This study supports the findings that a mobile-supported empowerment program reduced the level of caregiver distress and increased quality of life during their loved one's treatment with radiotherapy.
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22
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Bickel KE, Levy C, MacPhee ER, Brenner K, Temel JS, Arch JJ, Greer JA. An Integrative Framework of Appraisal and Adaptation in Serious Medical Illness. J Pain Symptom Manage 2020; 60:657-677.e6. [PMID: 32446974 PMCID: PMC7483912 DOI: 10.1016/j.jpainsymman.2020.05.018] [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: 12/23/2019] [Revised: 05/10/2020] [Accepted: 05/11/2020] [Indexed: 10/24/2022]
Abstract
Multiple randomized clinical trials have demonstrated that palliative care improves the quality of life of individuals with serious medical illness. Research also suggests that in patients with advanced cancer, palliative care's focus on symptom management, coping with illness, goals of care, and treatment decisions may be associated with improved patient quality of life in part by increasing patients' use of active (vs. passive) and approach-oriented (vs. avoidant) coping strategies. However, without a framework outlining the process that individuals with serious medical illness and their loved ones undergo, it is challenging to discern exactly where, how, and why palliative care may affect the serious medical illness experience. To address this gap, we propose a clinically applicable framework, derived from existing theory and research in the social and behavioral sciences. This framework, called the Integrative Framework of Appraisal and Adaptation in Serious Medical Illness, describes how patients and their loved ones cognitively and emotionally process the various events that may occur as they navigate serious medical illness and the end of life. The framework also describes how individuals and their loved ones use that event processing to determine next steps, while considering the impact of their surrounding external environment, their individual social roles, and their connections on this decision making. The framework presented in this article is intended to improve our ability to understand and care for individuals with serious medical illness and their loved ones, while stimulating further discussion and research to test and refine these ideas.
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Affiliation(s)
- Kathleen E Bickel
- VA Eastern Colorado Healthcare System, University of Colorado School of Medicine, Aurora, Colorado, USA.
| | - Cari Levy
- Palliative Medicine Section Chief, VA Eastern Colorado Healthcare System, Denver-Seattle Center of Innovation for Veteran-Centered and Value-Driven Research, Division of Health Care Policy and Research, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Edward R MacPhee
- Psychiatry Section Chief, VA Eastern Colorado Healthcare System, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Keri Brenner
- Medicine-Section of Palliative Care, Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, California, USA
| | - Jennifer S Temel
- Medicine, Harvard Medical School, Cancer Outcomes Research & Education Program, Massachusetts General Hospital Cancer Center, Thoracic Oncology, Boston, Massachusetts, USA
| | - Joanna J Arch
- Psychology and Neuroscience, University of Colorado Boulder, Boulder, Colorado, USA
| | - Joseph A Greer
- Psychology, Harvard Medical School, Center for Psychiatric Oncology & Behavioral Science, Cancer Outcomes Research & Education Program, Massachusetts General Hospital Cancer Center, Boston, Massachusetts, USA
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23
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Petricone-Westwood D, Hales S, Galica J, Stragapede E, Lebel S. What do partners of patients with ovarian cancer need from the healthcare system? An examination of caregiving experiences in the healthcare setting and reported distress. Support Care Cancer 2020; 29:1213-1223. [PMID: 32613371 DOI: 10.1007/s00520-020-05599-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 06/25/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE Ovarian cancer is typically characterized by late-stage diagnoses, frequent recurrences, and treatment changes. Ovarian cancer caregivers (OCC) are thus heavily involved with cancer care and often are highly distressed. METHODS We explored the relationship with OCC distress and caregiving experiences within the healthcare system and with the healthcare providers (HCP), using a cross-sectional questionnaire study. OCC provided sociodemographic and patient medical information, and completed measures of consequences of caregiving and needs from HCP, and of depression and anxiety. We recruited participants through advertisements and two cancer centers. RESULTS N = 82 OCC provided complete questionnaires. Participants on average were 57.2 years old, English-speaking white men, and were partnered for 28.5 years. On average, patients were diagnosed at stage III, and treated with surgery and chemotherapy. Eight percent met clinical cut-offs for depression (23.2% in sub-clinical range), and 23.2% met clinical cut-offs for anxiety (20.7% in sub-clinical range). Depression and anxiety were significantly correlated with lacking time for social relationships, higher workload, lacking information, and needing more help from HCP. Only depression was correlated with problematic quality of information from HCP. CONCLUSIONS OCC distress is related to their caregiving roles within the cancer care system, and how HCP support them in their responsibilities, which may contribute to a lack of time to access their supports. Perceived involvement by the HCP has an important influence on OCC distress. Higher demands of caregiving and insufficient support from the cancer care system may relate to increased distress. Our study supports the need for better integration of caregiver supports from within the healthcare system.
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Affiliation(s)
- Danielle Petricone-Westwood
- School of Psychology, University of Ottawa, 136 Jean Jacques Lussier, Vanier Hall 4016, Ottawa, ON, K1N 6N5, Canada.
| | - Sarah Hales
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, 610 University Ave, Room 16747, Toronto, ON, M5G 2M9, Canada
| | - Jacqueline Galica
- School of Nursing, Faculty of Health Sciences, Queen's University, Cataraqui Building, 92 Barrie Street, Kingston, ON, K7L 3N6, Canada
| | - Elisa Stragapede
- School of Psychology, University of Ottawa, 136 Jean Jacques Lussier, Vanier Hall 4016, Ottawa, ON, K1N 6N5, Canada
| | - Sophie Lebel
- School of Psychology, University of Ottawa, 136 Jean Jacques Lussier, Vanier Hall 4016, Ottawa, ON, K1N 6N5, Canada
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24
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Moving closer to death: understanding psychosocial distress among older veterans with advanced cancers. Support Care Cancer 2020; 28:5919-5931. [PMID: 32281033 DOI: 10.1007/s00520-020-05452-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 04/01/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Early identification of psychosocial distress is important to address the needs of vulnerable populations and influence symptom management. Older veterans diagnosed with life-limiting cancers are particularly vulnerable because they often have unmet needs, experiencing psychological or emotional problems and gaps in healthcare communication, which extends suffering. Lack of emotional support, ongoing physical pain, and unresolved symptom control can further increase distress among older veterans, contributing to complexity of decision-making for end of life (EOL) care. OBJECTIVE We explored older veterans' experiences and identification of psychosocial distress in cancer care to better understand how they describe distress while facing the end of life. METHODS Guiding this study is a conceptual framework from psychosocial oncology with the multifactorial experience of distress indicated by NCCN guidelines for distress screening. We use a phenomenological approach to explore the experience of psychosocial distress among older veterans diagnosed with advanced cancers at risk for dying within a year. INCLUSION CRITERIA Provider response of "no" to, "Would you be surprised if your patient died within a year?" and "yes", to the question, "Have you talked with your patient about the severity of their illness as being life-limiting, terminal?" RESULTS Five themes emerged: (1) the meaning of distress: "It's hard to explain"; (2) severity of advanced cancer: "There's no stage five"; (3) distressing thoughts about the possibility of dying: "Either way, it's life limiting"; (4) coping: "Deal with it and hope for a better day"; and (5) personal factors: "I don't want to be anything but a man who can handle adversity." Findings suggest older veterans may have unique cancer experiences different from other populations. CONCLUSION Older veterans in this study exhibited distressing symptoms which demonstrate they are at risk for declining health and in need of support for their distress. Healthcare providers are urged to understand the complexity of distress to provide the best possible treatment for older veterans.
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25
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Watanabe K, Katayama K, Yoshioka T, Narimatsu H. Impact of individual background on the unmet needs of cancer survivors and caregivers - a mixed-methods analysis. BMC Cancer 2020; 20:263. [PMID: 32228490 PMCID: PMC7106842 DOI: 10.1186/s12885-020-06732-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 03/10/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Cancer survivors and their caregivers may have various unmet needs that are medically difficult to solve. Previous studies have suggested the relations between individuals' backgrounds and their unmet needs. We conducted a large-scale analysis to clarify the influence of individuals' backgrounds, primarily cancer type, on specific types of unmet needs. METHODS Using a mixed-methods approach, we analyzed records of first-time callers to a cancer-focused telephone consultation service that was provided by the Kanagawa Cancer Clinical Research Information Organization from October 2006 to May 2014. The qualitative approach concerned extracting unmet needs mentioned in each consultation and classifying them into themes of specific needs, while the quantitative approach comprised multi-variated analysis of the relationships between the frequency by which the needs in each theme arose and the associated callers' backgrounds. RESULTS A total of 1938 consultation cases were analyzed. In the qualitative analysis, the needs were classified into 16 themes. The mean number of unmet needs for each caller was 1.58 (standard deviation = 0.86). In the multi-variated analysis, caregivers for colorectal cancer survivors had a lower frequency of "emotional/mental health" needs (OR: 0.31, 95%CI: 0.11-0.88, p = 0.028) than did caregivers for breast-cancer survivors. Nevertheless, this was the only significant difference in needs frequency among callers (including survivors and their caregivers) with specific cancer types. Meanwhile, there significant difference in the frequency of occurrence of each unmet need theme was found among items concerning other background elements. Among survivors, sex was related to the frequency of needs among "physical" and "resources" themes, and "emotions/mental health"; their age group with "employment"; treatment course with "physical" and "resources" themes and "cure"; residence with "physical" themes; presence of symptom with "physical," "education/information," "resources," "emotions/mental health," and "cure" themes. CONCLUSIONS This large-scale study suggests that cancer type is not a significant factor for specific unmet needs and that individuals' backgrounds and presence of symptoms play a more important role. Through this study, it was found that instruments to predict people's needs and a system to provide individualized cancer care across cancer types should be developed in the future.
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Affiliation(s)
- Kaname Watanabe
- Department of Clinical Oncology, Yamagata University, Faculty of Medicine, Yamagata, Japan.,Cancer Prevention and Cancer Control Division, Kanagawa Cancer Center, Research Institute, 2-3-2 Nakao, Asahi-ku, Yokohama, Kanagawa, 241-8515, Japan
| | - Kayoko Katayama
- Cancer Prevention and Cancer Control Division, Kanagawa Cancer Center, Research Institute, 2-3-2 Nakao, Asahi-ku, Yokohama, Kanagawa, 241-8515, Japan
| | - Takashi Yoshioka
- Department of Clinical Oncology, Yamagata University, Faculty of Medicine, Yamagata, Japan
| | - Hiroto Narimatsu
- Cancer Prevention and Cancer Control Division, Kanagawa Cancer Center, Research Institute, 2-3-2 Nakao, Asahi-ku, Yokohama, Kanagawa, 241-8515, Japan. .,Graduate School of Health of Innovation, Kanagawa University of Human Services, Kawasaki, Kanagawa, Japan.
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Arnaboldi P, Oliveri S, Vergani L, Marton G, Guiddi P, Busacchio D, Didier F, Pravettoni G. The clinical-care focused psychological interview (CLiC): a structured tool for the assessment of cancer patients' needs. Ecancermedicalscience 2020; 14:1000. [PMID: 32153655 PMCID: PMC7032941 DOI: 10.3332/ecancer.2020.1000] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Indexed: 12/12/2022] Open
Abstract
Integrating the psychosocial perspective in oncology is warranted. Here, we introduce a structured psychological intervention, the clinical-care focused psychological interview (CLiC), to address patients' needs in the relationship with health professionals, clinical pathway and decision-making process. The perceived utility and feasibility of the CLiC were evaluated in a preliminary sample of 30 patients who were candidates to undergo a radical cystectomy at the European Institute of Oncology, Milan, Italy. Patients reported a very high satisfaction with the interview, because it prepared them for their upcoming surgery by gathering more information about their clinical pathway and allowed them to discover the information they still needed. 30% stated that CLiC helped them to reorganise their thoughts and 36.7% understood the role of psychological intervention in the clinical pathway. Only 20% considered the CLiC useful in helping to build their relationship with the clinical staff. Before an invasive surgery such as radical cystectomy, patients' need for information regarding the upcoming surgery seems to prevail. Knowing the future consequences and adjusting toward the disease could be paramount for patients in facing uncertainty and they might feel that creating a relationship with physicians could be a secondary issue. However, our data show that a structured psychological intervention such as the CLiC interview can collect important information for patients and healthcare professionals to develop real patient-centred care.
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Affiliation(s)
- Paola Arnaboldi
- Psychiatry and Medical Psychology Service (SPPM), Cantonal Socio-Psychiatric Organisation (OSC), Via Tesserete 67, 6942 Savosa, Switzerland.,Ticino League against Cancer, Piazza Nosetto, 3, 6500 Bellinzona, Switzerland
| | - Serena Oliveri
- Department of Oncology and Hemato-Oncology, University of Milan, Via Festa del Perdono, 7, 20122 Milan, Italy.,Applied Research Division for Cognitive Psychological Science, European Institute of Oncology IRCCS (IEO), via Ripamonti 435, 20141 Milan, Italy
| | - Laura Vergani
- Department of Oncology and Hemato-Oncology, University of Milan, Via Festa del Perdono, 7, 20122 Milan, Italy.,Applied Research Division for Cognitive Psychological Science, European Institute of Oncology IRCCS (IEO), via Ripamonti 435, 20141 Milan, Italy
| | - Giulia Marton
- Department of Oncology and Hemato-Oncology, University of Milan, Via Festa del Perdono, 7, 20122 Milan, Italy.,Applied Research Division for Cognitive Psychological Science, European Institute of Oncology IRCCS (IEO), via Ripamonti 435, 20141 Milan, Italy
| | - Paolo Guiddi
- Applied Research Division for Cognitive Psychological Science, European Institute of Oncology IRCCS (IEO), via Ripamonti 435, 20141 Milan, Italy
| | - Derna Busacchio
- Applied Research Division for Cognitive Psychological Science, European Institute of Oncology IRCCS (IEO), via Ripamonti 435, 20141 Milan, Italy
| | - Florence Didier
- Applied Research Division for Cognitive Psychological Science, European Institute of Oncology IRCCS (IEO), via Ripamonti 435, 20141 Milan, Italy
| | - Gabriella Pravettoni
- Department of Oncology and Hemato-Oncology, University of Milan, Via Festa del Perdono, 7, 20122 Milan, Italy.,Applied Research Division for Cognitive Psychological Science, European Institute of Oncology IRCCS (IEO), via Ripamonti 435, 20141 Milan, Italy
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Taylor J, Fradgley EA, Clinton-McHarg T, Roach D, Paul CL. Distress screening and supportive care referrals used by telephone-based health services: a systematic review. Support Care Cancer 2019; 28:2059-2069. [PMID: 31872298 DOI: 10.1007/s00520-019-05252-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 12/16/2019] [Indexed: 12/28/2022]
Abstract
PURPOSE People affected by chronic diseases such as cancer report high levels of distress and a need for psychosocial support. It is unclear whether telephone-based services for people affected by chronic disease are a practical setting for implementing distress screening, referral protocols and rescreening to direct supportive care where it is needed. This systematic review aimed to describe the published literature regarding distress screening and supportive care referral practices in telephone-based services for people affected by chronic diseases such as cancer. METHODS A systematic literature search of MEDLINE, Embase, PsycInfo, CINAHL, Cochrane and Scopus was conducted in February 2018. Included quantitative studies involved: patients or caregivers affected by chronic diseases including cancer and describe a health service assessing psychosocial needs or distress via telephone. Extracted data included the type of cancer or other chronic disease, sample size, screening tool, referral or rescreening protocols, and type of health service. RESULTS The search identified 3989 potential articles with additional searches returning 30 studies (n = 4019); fourteen were eligible for full-text review. Of the 14 studies, 13 included cancer patients. Studies were across multiple settings and identified nine distress screening tools in use. CONCLUSION The reviewed studies indicate that validated distress-screening tools are being used via telephone to identify distress, particularly in relation to cancer. Screening-driven supportive care referrals are also taking place in telephone-based services. However, not all services use an established referral protocol. Ongoing rescreening of callers' distress is also limited despite it being an important recommendation from psycho-oncology guidelines.
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Affiliation(s)
- Jo Taylor
- School of Medicine and Public Health, University of Newcastle, Level 4 West, HMRI Building, Callaghan, NSW, 2308, Australia. .,Priority Research Centre for Health Behaviour, Level 4 West, HMRI Building, Callaghan, NSW, 2308, Australia. .,Priority Research Centre for Cancer Research Innovation and Translation, Level 4 West, HMRI Building, Callaghan, NSW, 2308, Australia.
| | - Elizabeth A Fradgley
- School of Medicine and Public Health, University of Newcastle, Level 4 West, HMRI Building, Callaghan, NSW, 2308, Australia.,Priority Research Centre for Health Behaviour, Level 4 West, HMRI Building, Callaghan, NSW, 2308, Australia.,Priority Research Centre for Cancer Research Innovation and Translation, Level 4 West, HMRI Building, Callaghan, NSW, 2308, Australia.,Cancer Institute New South Wales, Level 9, 8 Central Ave, Australian Technology Park, Eveleigh, NSW, 2015, Australia
| | - Tara Clinton-McHarg
- Priority Research Centre for Health Behaviour, Level 4 West, HMRI Building, Callaghan, NSW, 2308, Australia.,Priority Research Centre for Cancer Research Innovation and Translation, Level 4 West, HMRI Building, Callaghan, NSW, 2308, Australia.,School of Psychology, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia
| | - Della Roach
- School of Medicine and Public Health, University of Newcastle, Level 4 West, HMRI Building, Callaghan, NSW, 2308, Australia.,Priority Research Centre for Health Behaviour, Level 4 West, HMRI Building, Callaghan, NSW, 2308, Australia
| | - Chris L Paul
- School of Medicine and Public Health, University of Newcastle, Level 4 West, HMRI Building, Callaghan, NSW, 2308, Australia.,Priority Research Centre for Health Behaviour, Level 4 West, HMRI Building, Callaghan, NSW, 2308, Australia.,Priority Research Centre for Cancer Research Innovation and Translation, Level 4 West, HMRI Building, Callaghan, NSW, 2308, Australia
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28
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Livingston PM, Heckel L, Orellana L, Ashley D, Ugalde A, Botti M, Pitson G, Woollett A, Chambers SK, Parente P, Chirgwin J, Mihalopoulos C, Lavelle B, Sutton J, Phipps-Nelson J, Krishnasamy M, Simons K, Heynsbergh N, Wickramasinghe N, White V. Outcomes of a randomized controlled trial assessing a smartphone Application to reduce unmet needs among people diagnosed with CancEr (ACE). Cancer Med 2019; 9:507-516. [PMID: 31769226 PMCID: PMC6970035 DOI: 10.1002/cam4.2718] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 10/22/2019] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Smartphone technology represents an opportunity to deliver practical solutions for people affected by cancer at a scale that was previously unimaginable, such as information, appointment monitoring, and improved access to cancer support services. This study aimed to determine whether a smartphone application (app) reduced the unmet needs among people newly diagnosed with cancer. METHODS A single blind, multisite randomized controlled trial to determine the impact of an app-based, 4-month intervention. Newly diagnosed cancer patients were approached at three health service treatment clinics. RESULTS Eighty-two people were randomized (intervention; n = 43 and control; n = 39), average age was 59.5 years (SD: 12.9); 71% female; 67% married or in a de facto relationship. At baseline, there were no differences in participants' characteristics between the groups. No significant effects, in reducing unmet needs, were demonstrated at the end of intervention (4-month) or 12-month follow-up. Overall, 94% used the app in weeks 1-4, which decreased to 41% in weeks 13-16. Mean app use time per participant: Cancer Information, 6.9 (SD: 18.9) minutes; Appointment Schedule, 5.1 (SD: 9.6) minutes; Cancer Services 1.5 minutes (SD: 6.8); Hospital Navigation, 1.4 (SD: 2.8) minutes. CONCLUSIONS Despite consumer involvement in the design of this smartphone technology, the app did not reduce unmet needs. This may have been due to the study being underpowered. To contribute to a meaningful understanding and improved implementation of smartphone technology to support people affected by cancer, practical considerations, such as recruitment issues and access to, and confidence with, apps, need to be considered. Australian New Zealand Clinical Trials Registration (ACTRN) Trial Registration: 12616001251415; WEF 7/9/2016.
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Affiliation(s)
- Patricia M Livingston
- Faculty of Health, Deakin University, Geelong, Vic., Australia.,School of Nursing and Midwifery, Faculty of Health, Deakin University, Geelong, Vic., Australia
| | - Leila Heckel
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Geelong, Vic., Australia
| | - Liliana Orellana
- Biostatistics Unit, Faculty of Health, Deakin University, Geelong, Vic., Australia
| | - David Ashley
- Duke University School of Medicine, Durham, NC, USA
| | - Anna Ugalde
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Geelong, Vic., Australia
| | - Mari Botti
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Geelong, Vic., Australia.,Epworth HealthCare, Richmond, Vic., Australia
| | - Graham Pitson
- Andrew Love Cancer Centre, Barwon Health, University Hospital, Geelong, Vic., Australia
| | - Anne Woollett
- The University of Melbourne, Medicine, Dentistry and Health Sciences, Melbourne, Vic., Australia
| | - Suzanne K Chambers
- Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Phillip Parente
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Vic., Australia.,Eastern Health, Department of Oncology, Box Hill, Vic., Australia
| | | | - Cathrine Mihalopoulos
- Faculty of Health, School of Health and Social Development, Deakin University, Geelong, Vic., Australia
| | - Barbara Lavelle
- Faculty of Health, Deakin University, Geelong, Vic., Australia
| | | | | | - Mei Krishnasamy
- The University of Melbourne, Medicine, Dentistry and Health Sciences, Melbourne, Vic., Australia
| | - Katherine Simons
- North Eastern Melbourne Integrated Cancer Service, Heidelberg, Vic., Australia
| | - Natalie Heynsbergh
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Geelong, Vic., Australia
| | - Nilmini Wickramasinghe
- Iverson Health Innovation Research Institute, Swinburne University, Hawthorn, Vic., Australia
| | - Vicki White
- Faculty of Health, School of Psychology, Deakin University, Geelong, Vic., Australia
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The Effects of Holy Name Meditation on Spiritual Well-being, Depression, and Anxiety of Patients With Cancer. J Hosp Palliat Nurs 2019; 20:368-376. [PMID: 30063630 DOI: 10.1097/njh.0000000000000451] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This study was conducted to evaluate the effects of the Holy Name Meditation on cancer patients' spiritual well-being, anxiety, depression, and pain. Twenty-eight patients were enrolled in the control group, and 18 patients were selected for the experimental group. Only the patients in the experimental group completed 5 weeks of the Holy Name Meditation Program. All participants were surveyed to assess spiritual well-being (Spiritual Well-Being Scale), anxiety and depression (Symptom Checklist 90-R), and pain (numeric pain rating scale). There were no significant differences between the two groups' general characteristics, but the baseline survey revealed that anxiety and depression levels were higher in the experimental group. Analyzing the results after controlling the baseline scores of anxiety and depression showed that spiritual well-being was increased (F = 4.80, P = .034), whereas anxiety (F = 4.98, P = .031) and depression (F = 7.28, P = .010) were decreased after the intervention. No difference in pain was found between the two groups. The Holy Name Meditation Program was thus effective in enhancing cancer patients' spiritual well-being and decreasing their anxiety and depression. Therefore, it is recommended that Holy Name Meditation be provided in clinical settings to reduce the psychosocial and spiritual suffering of cancer patients.
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30
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Heckel L, Heynsbergh NL, Livingston PM. Are cancer helplines effective in supporting caregivers? A systematic review. Support Care Cancer 2019; 27:3219-3231. [PMID: 31098794 PMCID: PMC6660576 DOI: 10.1007/s00520-019-04807-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 04/07/2019] [Indexed: 11/09/2022]
Abstract
PURPOSE The aims of this systematic review were to summarize the profile of caregivers accessing cancer helplines, to evaluate caregiver satisfaction with the helpline service, and to review the evidence base of intervention studies testing the efficacy of community-based cancer helplines in improving caregiver health and well-being. METHODS Four electronic databases (Medline, CINAHL, PsychINFO, and EMBASE) were systematically searched to identify relevant literature, including all articles published in English until May 2018. Reference lists of accepted papers were reviewed for the inclusion of additional potentially relevant articles, gray literature was excluded. RESULTS Forty-five publications met the inclusion criteria for this review. Forty-one papers reported on the proportion of caregivers accessing cancer helplines. Twenty-six studies described demographic and clinical characteristics of caregivers and eight reported on call characteristics. Reasons for contacting the service were stated in 21 studies and caregiver satisfaction with the helpline service was assessed in 12 articles. Fourteen studies investigated specific topics of interest (e.g., prevalence of sleep problems, distress screening, or clinical trial participation). Two randomized controlled trials examined the efficacy of cancer helplines in improving caregiver outcomes, with findings showing interventions to be effective in reducing distress and unmet needs, and in increasing positive adjustment. CONCLUSIONS There is limited scientific evidence regarding the efficacy of cancer helplines to improve caregivers' health and well-being. More intervention studies are needed to examine the benefits of cancer helplines to this study population to ensure structured referral pathways can be established.
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Affiliation(s)
- Leila Heckel
- Faculty of Health, School of Nursing and Midwifery, Deakin University, Geelong, VIC, 3220, Australia
| | - Natalie L Heynsbergh
- Faculty of Health, School of Nursing and Midwifery, Deakin University, Geelong, VIC, 3220, Australia.
| | - Patricia M Livingston
- Faculty of Health, School of Nursing and Midwifery, Deakin University, Geelong, VIC, 3220, Australia
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31
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Haynes K, Ugalde A, Pittman L, Linde D, Shields M, Livingston P. The contribution of wellness centres to cancer care: Patient and carer perspectives. Collegian 2019. [DOI: 10.1016/j.colegn.2018.09.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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32
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Leydon GM, Halls A, Ekberg K, Latter S, Stuart B, Moynihan C, Salmon P, Danquah L, Brindle L, Howe S, Woods CJ, Little P. Specialist call handlers' perspectives on providing help on a cancer helpline: A qualitative interview study. Eur J Cancer Care (Engl) 2019; 28:e13081. [PMID: 31124213 DOI: 10.1111/ecc.13081] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 02/15/2019] [Accepted: 03/25/2019] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To identify call handlers' key experiences of providing telephone help on a cancer helpline. METHODS Semi-structured qualitative interviews with 30 call handlers from three UK-based cancer helplines. Transcribed interview data were analysed thematically. RESULTS Thematic analysis identified three themes: (a) call handlers' perceptions of their role on the helpline, (b) challenges of working on a helpline and (c) the need for training/keeping up with competencies. Call handlers reported satisfaction with their experience. However, there are tensions: whilst advice is formally not part of the remit of the helpline, in practice the boundary between giving advice and giving information can be blurred. No follow-up with callers could be difficult and experienced as a lost opportunity to help. Managing patient expectations could be challenging, and interviewees described particular difficulties with distressed callers. Training for the role was commonplace, but there was sometimes a desire for more opportunities. CONCLUSION There are challenges faced by helpline staff, and it can be difficult to manage callers' distress and expectations of what they might get from a call experience. Recognising the skill and complexity of the call handler role is important, as it is meeting call handlers' support and training needs. Support is important to minimise the risk to their own emotional well-being.
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Affiliation(s)
- Geraldine M Leydon
- Primary Care and Population Sciences, University of Southampton, Southampton, England
| | - Amy Halls
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, England
| | - Katie Ekberg
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Queensland, Australia
| | - Sue Latter
- School of Health Sciences, University of Southampton, Southampton, England
| | - Beth Stuart
- Primary Care and Population Sciences, University of Southampton, Southampton, England
| | - Clare Moynihan
- Institute of Cancer Research, Psychology Research Group, London, England
| | - Peter Salmon
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, England
| | - Lisa Danquah
- London School of Hygiene and Tropical Medicine, London, England
| | - Lucy Brindle
- School of Health Sciences, University of Southampton, Southampton, England
| | - Sonia Howe
- The Helplines Partnership, Peterborough, Cambridgeshire, England
| | - Catherine J Woods
- Primary Care and Population Sciences, University of Southampton, Southampton, England
| | - Paul Little
- Primary Care and Population Sciences, University of Southampton, Southampton, England
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Geerse OP, Brandenbarg D, Kerstjens HAM, Berendsen AJ, Duijts SFA, Burger H, Holtman GA, Hoekstra-Weebers JEHM, Hiltermann TJN. The distress thermometer as a prognostic tool for one-year survival among patients with lung cancer. Lung Cancer 2019; 130:101-107. [PMID: 30885329 PMCID: PMC7026622 DOI: 10.1016/j.lungcan.2019.02.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 02/04/2019] [Accepted: 02/08/2019] [Indexed: 12/25/2022]
Abstract
INTRODUCTION The use of patient-reported outcome measures is increasingly advocated to support high-quality cancer care. We therefore investigated the added value of the Distress Thermometer (DT) when combined with known predictors to assess one-year survival in patients with lung cancer. METHODS All patients had newly diagnosed or recurrent lung cancer, started systemic treatment, and participated in the intervention arm of a previously published randomised controlled trial. A Cox proportional hazards model was fitted based on five selected known predictors for survival. The DT-score was added to this model and contrasted to models including the EORTC-QLQ-C30 global QoL score (quality of life) or the HADS total score (symptoms of anxiety and depression). Model performance was evaluated through improvement in the -2 log likelihood, Harrell's C-statistic, and a risk classification. RESULTS In total, 110 patients were included in the analysis of whom 97 patients accurately completed the DT. Patients with a DT score ≥5 (N = 51) had a lower QoL, more symptoms of anxiety and depression, and a shorter median survival time (7.6 months vs 10.0 months; P = 0.02) than patients with a DT score <5 (N = 46). Addition of the DT resulted in a significant improvement in the accuracy of the model to predict one-year survival (P < 0.001) and the discriminatory value (C-statistic) marginally improved from 0.69 to 0.71. The proportion of patients correctly classified as high risk (≥85% risk of dying within one year) increased from 8% to 28%. Similar model performance was observed when combining the selected predictors with QoL and symptoms of anxiety or depression. CONCLUSIONS Use of the DT allows clinicians to better identify patients with lung cancer at risk for poor outcomes, to further explore sources of distress, and subsequently personalize care accordingly.
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Affiliation(s)
- O P Geerse
- University of Groningen, University Medical Center Groningen, Department of Pulmonary Diseases, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Department of General Practice and Elderly Care Medicine, Groningen, the Netherlands.
| | - D Brandenbarg
- University of Groningen, University Medical Center Groningen, Department of General Practice and Elderly Care Medicine, Groningen, the Netherlands
| | - H A M Kerstjens
- University of Groningen, University Medical Center Groningen, Department of Pulmonary Diseases, Groningen, the Netherlands
| | - A J Berendsen
- University of Groningen, University Medical Center Groningen, Department of General Practice and Elderly Care Medicine, Groningen, the Netherlands
| | - S F A Duijts
- University of Groningen, University Medical Center Groningen, Department of General Practice and Elderly Care Medicine, Groningen, the Netherlands
| | - H Burger
- University of Groningen, University Medical Center Groningen, Department of General Practice and Elderly Care Medicine, Groningen, the Netherlands; Amsterdam University Medical Center, Academic Medical Center, Department of Psychiatry, University of Amsterdam, Amsterdam, the Netherlands
| | - G A Holtman
- University of Groningen, University Medical Center Groningen, Department of General Practice and Elderly Care Medicine, Groningen, the Netherlands
| | - J E H M Hoekstra-Weebers
- University of Groningen, University Medical Center Groningen, Wenckebach Institute, Groningen, the Netherlands; Netherlands Comprehensive Cancer Organization (IKNL), The Netherlands
| | - T J N Hiltermann
- University of Groningen, University Medical Center Groningen, Department of Pulmonary Diseases, Groningen, the Netherlands
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Aziza YDA, Wang ST, Huang MC. Unmet supportive care needs and psychological distress among parents of children with cancer in Indonesia. Psychooncology 2018; 28:92-98. [PMID: 30315686 DOI: 10.1002/pon.4914] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Revised: 10/04/2018] [Accepted: 10/07/2018] [Indexed: 11/11/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the needs and associating factors, psychological distress of parents, when taking care of children with cancer in Indonesia. METHODS A cross-sectional study was conducted among 100 parents of children with cancer from the pediatric ward of two hospitals in Indonesia. The parents were assessed using the Indonesian version of the Supportive Care Needs Survey for Partner and Caregiver (unmet needs) and the Hospital Anxiety Depression Scale (psychological distress). The factors associated with unmet needs were analyzed using hierarchical linear regression. RESULTS Among the surveyed parents, 83% had over 10 unmet needs. Among these unmet needs, need for information was the highest one. In the self-report measure using a clinical cut-off, 49% of the parents reported signs of anxiety, and 25% had signs of depression. Parents reporting clinically relevant levels of anxiety had more unmet needs than parents without clinically relevant anxiety. Having fewer children was correlated with higher work and social needs, and higher levels of education were correlated with more psychological needs. However, the children's clinical variables were not associated with the overall needs in the regression model. CONCLUSIONS Most parents of children with cancer reported a need for more information and reported signs of anxiety and depression. Parents with fewer children and higher levels of education were identified as a vulnerable population due to having greater needs. The result of this study can be used to improve supportive care for parents of children with cancer in hospital settings.
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Affiliation(s)
| | - Shan-Tair Wang
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Mei-Chih Huang
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Hyde MK, Zajdlewicz L, Lazenby M, Dunn J, Laurie K, Lowe A, Chambers SK. The validity of the Distress Thermometer in female partners of men with prostate cancer. Eur J Cancer Care (Engl) 2018; 28:e12924. [PMID: 30252180 DOI: 10.1111/ecc.12924] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 04/04/2018] [Accepted: 08/22/2018] [Indexed: 01/01/2023]
Abstract
Female partners of prostate cancer (PCa) survivors experience heightened psychological distress that may be greater than that expressed by PCa patients. However, optimal approaches to detect distressed, or at risk of distress, partners are unclear. This study applied receiver operating characteristics analysis to evaluate diagnostic accuracy, sensitivity and specificity of the Distress Thermometer (DT) compared to widely used measures of general (Hospital Anxiety and Depression Scale) and cancer-specific (Impact of Events Scale-Revised) distress. Participants were partners of men with localised PCa (recruited around diagnosis) about to undergo or had received surgical treatment (N = 189), and partners of men diagnosed with PCa who were 2-4 years post-treatment (N = 460). In both studies, diagnostic utility of the DT overall was not optimal. Although area under the curve scores were acceptable (ranges: 0.71-0.92 and 0.83-0.94 for general and cancer-specific distress, respectively), sensitivity, specificity and optimal DT cut-offs for partner distress varied for general (range: ≥2 to ≥5) and cancer-specific (range: ≥3 to ≥5) distress both across time and between cohorts. Thus, it is difficult to draw firm conclusions about the diagnostic capabilities of the DT for partners or recommend its use in this population. More comprehensive screening measures may be needed to detect partners needing psychological intervention.
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Affiliation(s)
- Melissa K Hyde
- Cancer Council Queensland, Brisbane, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | | | - Mark Lazenby
- School of Nursing, Yale University, New Haven, Connecticut
| | - Jeff Dunn
- Cancer Council Queensland, Brisbane, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.,Institute for Resilient Regions, University of Southern Queensland, Toowoomba, Queensland, Australia.,School of Social Science, The University of Queensland, St Lucia, Queensland, Australia
| | - Kirstyn Laurie
- Cancer Council Queensland, Brisbane, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Anthony Lowe
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Suzanne K Chambers
- Cancer Council Queensland, Brisbane, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.,Institute for Resilient Regions, University of Southern Queensland, Toowoomba, Queensland, Australia.,Faculty of Health, University of Technology Sydney, New South Wales, Australia.,Exercise Medicine Research Institute, Edith Cowan University, Perth, Western Australia, Australia
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Bonacchi A, Fazzini E, Messina S, Muraca MG, Pacetti P, Di Miceli S, Miccinesi G. Sociodemographic, clinical, and psychological characteristics identify groups of Italian cancer patients with high rates of unmet needs. TUMORI JOURNAL 2018; 105:288-295. [PMID: 30185126 DOI: 10.1177/0300891618792458] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Although an optimal goal remains the routine assessment of unmet needs of all patients with cancer, particular attention should be paid to those groups of patients with characteristics known to be more frequently associated with unmet needs in general or with specific areas of need. This report aims to describe the sociodemographic, clinical, and psychological characteristics associated with higher unmet needs in Italian cancer patients. METHODS A total of 835 cancer patients from different care settings (ward, day hospital, follow-up ambulatory, rehabilitation unit, and palliative care) filled out the Needs Evaluation Questionnaire (NEQ), the Psychological Distress Inventory, and the Sense of Coherence Scale. Association of NEQ scores with the clinical and demographic variables were tested using analysis of variance. RESULTS Higher NEQ total score was associated with lower educational level, inpatient care setting, radiotherapy treatment, psychological distress, and lower resilience trait sense of coherence. Different predictors were identified for different areas of unmet needs. Care setting, psychological distress, and resilience trait were the strongest indicators of unmet needs in every area: information/communication, assistance/care, material needs, relational needs, and psychoemotional support. CONCLUSIONS Clinicians should consider that inpatients with a high distress and a low resilience trait sense of coherence represent a group of cancer patients to be investigated with particular attention regarding unmet needs.
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Affiliation(s)
- Andrea Bonacchi
- 1 Clinical and Descriptive Epidemiology Unit, Institute for Cancer Research and Prevention-ISPO, Florence, Italy.,2 Centro Studi e Ricerca Synthesis, Florence, Italy
| | | | | | - Maria Grazia Muraca
- 3 Centro Riabilitazione Oncologica, Institute for Cancer Research and Prevention-ISPO, Florence, Italy
| | - Paola Pacetti
- 4 Azienda USL Nordovest, Oncologia Ambito Territoriale di Massa Carrara, Carrara, Italy
| | - Stefania Di Miceli
- 5 Rete di Cure Palliative, Zona Nord Ovest, USL Centro Firenze, Florence, Italy
| | - Guido Miccinesi
- 1 Clinical and Descriptive Epidemiology Unit, Institute for Cancer Research and Prevention-ISPO, Florence, Italy
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Heckel L, Fennell KM, Orellana L, Boltong A, Byrnes M, Livingston PM. A telephone outcall program to support caregivers of people diagnosed with cancer: utility, changes in levels of distress, and unmet needs. Support Care Cancer 2018; 26:3789-3799. [PMID: 29766259 DOI: 10.1007/s00520-018-4246-6] [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: 01/31/2018] [Accepted: 05/06/2018] [Indexed: 12/17/2022]
Abstract
PURPOSE To evaluate the utility of a telephone outcall program for cancer caregivers and to examine longitudinal changes in their distress levels and supportive care needs. METHODS As part of the PROTECT trial, caregivers assigned to the intervention arm (N = 108) received three telephone outcalls from a Cancer Council 13 11 20 nurse at three time points (7-10 days post-randomization, 1 and 4 months later). During each call, caregivers were screened for distress using the Distress Thermometer (range: 0-10) then six supportive care issues were raised for discussion. Participants completed a utility survey 1 month post-intervention. RESULTS The outcall program was highly acceptable and perceived as beneficial by caregivers. Overall, 95% reported it was worth their time to take part in the outcall program and 82% stated that the program was very relevant to them. Level of distress and impact of distress decreased over time (p = 0.0031, p < 0.0001, respectively). Average call duration decreased over time (p < 0.0001) and was longer for female than male caregivers (p = 0.0009). The frequency of caregivers discussing issues related to psychological distress (p = 0.0003), health literacy (p < 0.0001), financial (p = 0.0014), and practical concerns (p = 0.0121) decreased over time. Psychological distress was more often discussed by female than male caregivers (p = 0.0153), and family issues more often by younger (< 55 years) than older caregivers (p = 0.0071). CONCLUSIONS Utility of this outcall program was high. Caregivers' level of distress and unmet needs decreased over time. Gender and age differences emerged, which warrants the need for tailored support. Further research is necessary to identify the best method of improving access to 13 11 20 services for caregivers.
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Affiliation(s)
- Leila Heckel
- Faculty of Health, School of Nursing and Midwifery, Deakin University, Geelong, VIC, 3220, Australia.
| | - Kate M Fennell
- Cancer Council SA, 202 Greenhill Road, Eastwood, South Australia, 5063, Australia.,Flinders Centre for Innovation in Cancer, School of Medicine, Flinders University, Sturt Road, Bedford Park, South Australia, 5042, Australia.,Sansom Institute for Health Research, University of South Australia, City East Campus, North Terrace, Adelaide, South Australia, 5000, Australia
| | - Liliana Orellana
- Faculty of Health, Biostatistics Unit, Deakin University, Geelong, VIC, 3220, Australia
| | - Anna Boltong
- Cancer Council Victoria, 615 St Kilda Road, Melbourne, VIC, 3004, Australia.,Melbourne School of Health Sciences, The University of Melbourne, Grattan Street, Parkville, VIC, 3010, Australia
| | - Monica Byrnes
- Cancer Council SA, 202 Greenhill Road, Eastwood, South Australia, 5063, Australia
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Ndetei D, Musyimi C, Tele A, Musau A, Gitonga I, Mutiso V. Psychological Well-Being and Social Functioning Across the Cancer Stages: Implications for Palliative Care. JOURNAL OF SOCIAL WORK IN END-OF-LIFE & PALLIATIVE CARE 2018; 14:194-208. [PMID: 31307350 DOI: 10.1080/15524256.2018.1472718] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 04/10/2018] [Accepted: 04/17/2018] [Indexed: 06/10/2023]
Abstract
Studies conducted regarding cancer care have mainly focused on the management of physical conditions, with few studies assessing psychological well-being throughout illness course. This cross-sectional study (n = 389) examined the psychological well-being and social functioning of patients with cancer across cancer stages, among adult patients attending a cancer clinic at a public referral hospital in Kenya. Social and occupational functioning entails the ability to interact optimally with one's environments including work, social activities, and relationships and fulfill the roles within such environments, as well as engage in meaningful activities of daily life. Psychological well-being, on the other hand, is a dynamic concept that includes subjective, social, and psychological dimensions and health-related behaviors. We used various measures to assess different facets of respondent's life and psychological well-being. Results showed that cancer status was negatively associated with social and occupational functioning and psychological well-being. Results also revealed that increasing severity of an individual's cancer disease placed them at a higher risk of disability and psychological impairment. To reduce this risk, routine psychological care across the disease continuum is recommended.
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Affiliation(s)
- David Ndetei
- a Africa Mental Health Foundation , Nairobi , Kenya
- b Department of Psychiatry , University of Nairobi , Nairobi , Kenya
| | | | - Albert Tele
- a Africa Mental Health Foundation , Nairobi , Kenya
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Zhang Y, Zhang Y, Liu W, Yan Y, Wei H. Comprehensive unmet needs and correlations with quality of life in Chinese cancer patients. Eur J Cancer Care (Engl) 2018; 27:e12813. [DOI: 10.1111/ecc.12813] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Y.P. Zhang
- Faculty of Nursing; Xi'an Jiaotong University Health Science Center; Xi'an China
| | - Y. Zhang
- Faculty of Nursing; Xi'an Jiaotong University Health Science Center; Xi'an China
| | - W.H. Liu
- Faculty of Nursing; Xi'an Jiaotong University Health Science Center; Xi'an China
| | - Y.T. Yan
- Faculty of Nursing; Xi'an Jiaotong University Health Science Center; Xi'an China
| | - H.H. Wei
- Faculty of Nursing; Xi'an Jiaotong University Health Science Center; Xi'an China
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Do Correlates of Pain-Related Stoicism and Cautiousness Differ in Younger and Older People With Advanced Cancer? THE JOURNAL OF PAIN 2017; 19:301-316. [PMID: 29155166 DOI: 10.1016/j.jpain.2017.11.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 10/31/2017] [Accepted: 11/06/2017] [Indexed: 11/20/2022]
Abstract
Age differences are not evident in pain-related stoicism and cautiousness in people with cancer pain. Little is known about the factors associated with these pain-related attitudes or age-related patterns in these associations. The present cross-sectional study investigated the biopsychosocial correlates of the attitudes in younger and older patients with advanced cancer. Pain-related stoicism (fortitude, concealment, superiority) and cautiousness (self-doubt, reluctance) were assessed using the Pain Attitudes Questionnaire-Revised (PAQ-R). Participants, 155 younger (younger than 60 years old) and 114 older (60 years old or older) patients with advanced cancer completed the PAQ-R and measures of sociodemographic and medical characteristics, pain intensity, cognitive-affective pain-related responses, physical functioning, psychological distress and well-being, and psychosocial functioning. Backwards regression analyses identified correlates for each PAQ-R factor separately for younger and older patients. Activity engagement was a frequent correlate, but its relationship with concealment was the only association common to both age groups. Younger and older patients exhibited different avoidance-related constructs suggesting relational challenges in the former group (avoidant attachment) and intrapersonal fear in the latter (cognitive avoidance). Medical correlates also showed age differences: younger patients showed symptom-focused correlates, whereas older patients showed aging-related correlates. Findings support a biopsychosocial framework of cancer-pain adaptation incorporating a lifespan-developmental perspective. PERSPECTIVE To our knowledge, this article is the first to identify biopsychosocial correlates of stoic and cautious attitudes toward cancer pain in younger and older patients with advanced cancer. Findings highlight possible age-related motivations for greater pain-related stoicism or cautiousness and can potentially inform interventions addressing challenges in cancer-pain adaptation in advanced cancer.
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Ettridge KA, Bowden JA, Chambers SK, Smith DP, Murphy M, Evans SM, Roder D, Miller CL. "Prostate cancer is far more hidden…": Perceptions of stigma, social isolation and help-seeking among men with prostate cancer. Eur J Cancer Care (Engl) 2017; 27:e12790. [PMID: 29112317 DOI: 10.1111/ecc.12790] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2017] [Indexed: 11/29/2022]
Abstract
The purpose of this study was to provide in-depth insight into men's experiences of prostate cancer, specifically: perceived stigma and self-blame, social isolation, unmet need and help-seeking. A qualitative descriptive approach was used. Semi-structured interviews were undertaken with 20 men diagnosed with prostate cancer, and thematic analysis was undertaken. Some participants perceived a stigma associated with prostate cancer and cancer in general, which sometimes acted as a barrier to disclosure. Self-blame and internalisation of cause was not a prominent issue. Participants' descriptions of emotional distress, social isolation and anxiety demonstrated the impact of prostate cancer. Social isolation was most commonly reported as a physical consequence of treatment and/or side effects. Participants felt both support and ongoing care were limited at post-treatment. Most did not seek or receive help for emotional or psychosocial problems from a formal source due to anticipated awkwardness, autonomous coping, not burdening others, unwanted sympathy and retaining privacy. Prostate cancer can cause considerable emotional and social burden for some men, and many are unlikely to seek or receive help. Men, and their support networks, require active encouragement throughout diagnosis, treatment and follow-up to overcome barriers and access additional support, particularly for sexual, emotional and psychosocial issues.
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Affiliation(s)
- K A Ettridge
- Population Health Research Group, South Australian Health and Medical Institute, Adelaide, SA, Australia.,School of Psychology, University of Adelaide, Adelaide, SA, Australia
| | - J A Bowden
- Population Health Research Group, South Australian Health and Medical Institute, Adelaide, SA, Australia.,School of Psychology, University of Adelaide, Adelaide, SA, Australia
| | - S K Chambers
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld, Australia.,Cancer Council Queensland, Fortitude Valley, Qld, Australia.,Prostate Cancer Foundation of Australia, Sydney, NSW, Australia.,Exercise Medicine Research Institute, Edith Cowan University, Perth, WA, Australia.,Institute for Resilient Regions, University of South Queensland, Toowoomba, Qld, Australia
| | - D P Smith
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld, Australia.,Cancer Council NSW, Woolloomooloo, NSW, Australia.,Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - M Murphy
- Michael Murphy Research, Melbourne, VIC, Australia
| | - S M Evans
- Monash University, Melbourne, VIC, Australia
| | - D Roder
- Population Health Research Group, South Australian Health and Medical Institute, Adelaide, SA, Australia.,Monash University, Melbourne, VIC, Australia.,School of Health Science, University of South Australia, Adelaide, SA, Australia.,School of Public Health, University of Adelaide and the South Australian Health and Medical Research Institute, Adelaide, SA, Australia
| | - C L Miller
- School of Public Health, University of Adelaide and the South Australian Health and Medical Research Institute, Adelaide, SA, Australia
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Abstract
BACKGROUND Cancer-related psychological distress, as a concept, has limited research literature substantiation. Several studies report that patients with cancer suffer from significant psychological distress; however, the description of the concept of cancer-related psychological distress has not been clearly described. Theoretical work based on the concept is also unclear. OBJECTIVES This article is a report on the concept of cancer-related psychological distress to clarify the concept as separate from non-cancer-related psychological distress and promote the use of the term in nursing practice and research across the cancer trajectory. METHODS This article used a content analysis to examine the literature. The literature review for this article used CINAHL®, PsycINFO®, and PubMed to search publications from 1999-2016. FINDINGS Content analysis of the literature revealed that the term psychological distress was used often with regard to distress in patients with cancer, but the concept of cancer-related psychological distress was not clearly defined. Four attributes encompass the concept of cancer-related psychological distress.
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Zhu L, Yao J, Schroevers MJ, Zhang H, Xie J, Liu A, Fleer J, Ranchor AV, Song Z. Patterns of unmet supportive needs and relationship to quality of life in Chinese cancer patients. Psychooncology 2017; 27:600-606. [PMID: 28873264 DOI: 10.1002/pon.4554] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 08/25/2017] [Accepted: 08/27/2017] [Indexed: 11/12/2022]
Abstract
OBJECTIVE This study aimed to (1) identify distinct patterns of unmet needs in Chinese cancer patients; (2) examine whether sociodemographic and medical characteristics distinguished these patterns; and (3) examine whether people with distinct patterns reported differential quality of life (QoL). METHODS This cross-sectional study recruited 301 cancer patients from 2 hospitals in China. The 34-item Supportive Care Needs Survey Short-Form was used to measure unmet needs across 5 domains: physical and daily living, psychological, patient care and support, health systems and information, and sexuality. Latent class analysis was performed to identify patterns of unmet needs across these domains. RESULTS Four patterns of unmet needs were identified, differing in levels and nature of unmet needs. Participants in class 1 (47%) reported few unmet needs. Patients in class 2 (15%) had moderate levels of unmet needs, displaying similar levels across 5 domains. People in class 3 (25%) and class 4 (13%) reported similarly high levels on "psychological," "health care system and information," "physical and daily living," and "patient care," but differing in "sexuality," with class 3 reporting low levels while class 4 high on "sexuality." None of sociodemographic and medical characteristics distinguished these patterns significantly. Compared to other classes, people in class 1 reported highest levels of QoL. CONCLUSIONS This study demonstrates the existence of 4 patterns of unmet supportive needs in Chinese cancer patients. Patients with few unmet needs reported the best QoL.
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Affiliation(s)
- Lei Zhu
- Shaanxi Key Laboratory of Behavior and Cognitive Neuroscience, School of Psychology, Shaanxi Normal University, Xi'an, China
| | - Juntao Yao
- Shaanxi Provincial Tumor Hospital, Xi'an, China
| | - Maya J Schroevers
- Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Hongmei Zhang
- Department of Oncology, Xijing Hospital attached to the Medical University of the Air Force, Xi'an, China
| | - Juan Xie
- Shaanxi Provincial Tumor Hospital, Xi'an, China
| | - Ailan Liu
- Shaanxi Provincial Tumor Hospital, Xi'an, China
| | - Joke Fleer
- Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Adelita V Ranchor
- Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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An evaluation of social work services in a cancer accommodation facility for rural South Australians. Support Care Cancer 2017; 26:147-154. [PMID: 28762008 DOI: 10.1007/s00520-017-3828-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 07/10/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE The purpose of this investigation was to evaluate the social work service at an accommodation facility for people receiving cancer treatment away from home with a focus on distress, impact of support, and type of assistance received from the social work service. METHOD Guests who stayed at the Cancer Council Lodge during June 2015 were mailed a questionnaire collecting information about level of distress upon arrival and departure, impact of support in several areas, and what the service assisted them with specifically. RESULTS The sample comprised 149 guests. Social work contact (n = 19) was associated with greater reduction in distress between arrival and departure compared with no contact (n = 56). Contact with a social worker was associated with greater odds of agreeing or strongly agreeing that guests felt supported in 6 out of 10 areas assessed. These areas were managing the challenges related to cancer, approaching support services, asking questions of healthcare teams, accessing support services, coping with strong emotions, and understanding reactions of family and friends. The most common types of support received were emotional and informational support. CONCLUSIONS This study describes some of benefits of providing social work services to people receiving cancer treatment away from home and has implications for provision of social work service resources in similar settings. Further research could investigate the impact of this service in similar settings using randomised controlled trials to better account for potential biases. Research in this area has potential to inform program development and policy.
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45
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Aubin M, Vézina L, Verreault R, Simard S, Desbiens JF, Tremblay L, Dumont S, Fillion L, Dogba MJ, Gagnon P. Effectiveness of an intervention to improve supportive care for family caregivers of patients with lung cancer: study protocol for a randomized controlled trial. Trials 2017; 18:304. [PMID: 28676071 PMCID: PMC5496252 DOI: 10.1186/s13063-017-2044-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 06/05/2017] [Indexed: 11/25/2022] Open
Abstract
Background Family caregivers (FC) often experience higher distress levels than their relative with cancer. Many cancer centers have implemented distress screening programs, but most of them concentrate their efforts on patients, with little attention to their FC. To fill this gap, a pragmatic intervention has been designed to improve supportive care for FC of patients with lung cancer. This article describes the study protocol of a single-center randomized controlled trial to assess its effectiveness. Methods/design A total of 120 lung cancer patients and their FC are randomly assigned to the experimental group (exposed to intervention, N = 60) or to the control group (usual care, N = 60). The intervention includes: (1) systematic FC distress screening and problem assessment near their relative’s cancer diagnosis, and every 2 months, (2) privileged contact with an oncology nurse (ON) away from the patient to address FC problems and (3) liaison by the ON with the family physician of FC reporting high distress (thermometer score ≥5/10), or problems relying on FP expertise. In both groups, FC, patient and process-of-care outcomes are measured at baseline and every 3 months, up to 9 months. The primary endpoint is FC distress measured by the Hospital Anxiety and Depression Scale (HADS) and the Psychological Distress Index used in the Quebec Health Survey (PDQHS). Individual interviews with 10 FC and a focus group with the oncology team will be conducted at the study end to further document the effectiveness of the intervention and its impact on quality of life (for FC) and practice organization (for the oncology team). Discussion This trial will assess the effectiveness of an innovative intervention based on interprofessional collaboration between primary care and oncology care. It targets a population in great need, yet often neglected, and has the potential to clearly improve patient and caregiver experience of cancer care, and reduce the burden of disease. Trial registration ClinicalTrials.gov, ID: NCT02531464. Registered on 15 July 2015. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-2044-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Michèle Aubin
- Research Centre of the Institut Universitaire de Cardiologie et de Pneumologie de Quebec (IUCPQ), Quebec, QC, Canada. .,Research Centre of Primary Care and Services-Université Laval (CERSSPL-UL), Quebec, QC, Canada. .,Research Centre of the CHU de Quebec, Quebec, QC, Canada. .,Department of Family Medicine and Emergency Medicine, Université Laval, Quebec, QC, Canada. .,Maison Michel-Sarrazin Research Team in Palliative Care and Psychosocial Oncology (ERMOS), Quebec, QC, Canada. .,Laval Family Medicine Unit, Université Laval, Quebec, QC, Canada. .,CIUSSS Capitale-Nationale , 2690, Chemin des Quatre-Bourgeois, Quebec, QC, G1V 0B7, Canada.
| | - Lucie Vézina
- Research Centre of the Institut Universitaire de Cardiologie et de Pneumologie de Quebec (IUCPQ), Quebec, QC, Canada.,Laval Family Medicine Unit, Université Laval, Quebec, QC, Canada
| | - René Verreault
- Research Centre of Primary Care and Services-Université Laval (CERSSPL-UL), Quebec, QC, Canada.,Department of Social and Preventive Medicine, Université Laval, Quebec, QC, Canada
| | - Sébastien Simard
- Research Centre of the Institut Universitaire de Cardiologie et de Pneumologie de Quebec (IUCPQ), Quebec, QC, Canada.,Maison Michel-Sarrazin Research Team in Palliative Care and Psychosocial Oncology (ERMOS), Quebec, QC, Canada.,Pulmonary Oncology Centre, IUCPQ, Quebec, QC, Canada
| | - Jean-François Desbiens
- Research Centre of the CHU de Quebec, Quebec, QC, Canada.,Maison Michel-Sarrazin Research Team in Palliative Care and Psychosocial Oncology (ERMOS), Quebec, QC, Canada.,Faculty of Nursing, Université Laval, Quebec, QC, Canada
| | - Lise Tremblay
- Research Centre of the Institut Universitaire de Cardiologie et de Pneumologie de Quebec (IUCPQ), Quebec, QC, Canada.,Pulmonary Oncology Centre, IUCPQ, Quebec, QC, Canada.,Department of Medicine, Université Laval, Quebec, QC, Canada
| | - Serge Dumont
- Research Centre of Primary Care and Services-Université Laval (CERSSPL-UL), Quebec, QC, Canada.,Research Centre of the CHU de Quebec, Quebec, QC, Canada.,Maison Michel-Sarrazin Research Team in Palliative Care and Psychosocial Oncology (ERMOS), Quebec, QC, Canada.,Faculty of Social Sciences, Université Laval, Quebec, QC, Canada
| | - Lise Fillion
- Research Centre of the CHU de Quebec, Quebec, QC, Canada.,Maison Michel-Sarrazin Research Team in Palliative Care and Psychosocial Oncology (ERMOS), Quebec, QC, Canada.,Faculty of Nursing, Université Laval, Quebec, QC, Canada
| | - Maman Joyce Dogba
- Research Centre of Primary Care and Services-Université Laval (CERSSPL-UL), Quebec, QC, Canada.,Research Centre of the CHU de Quebec, Quebec, QC, Canada.,Department of Family Medicine and Emergency Medicine, Université Laval, Quebec, QC, Canada
| | - Pierre Gagnon
- Research Centre of Primary Care and Services-Université Laval (CERSSPL-UL), Quebec, QC, Canada.,Research Centre of the CHU de Quebec, Quebec, QC, Canada.,Maison Michel-Sarrazin Research Team in Palliative Care and Psychosocial Oncology (ERMOS), Quebec, QC, Canada.,Department of Psychiatry, Université Laval, Quebec, QC, Canada
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Partner's survivorship care needs: An analysis in head and neck cancer patients. Oral Oncol 2017; 71:113-121. [PMID: 28688678 DOI: 10.1016/j.oraloncology.2017.06.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 06/05/2017] [Accepted: 06/15/2017] [Indexed: 11/22/2022]
Abstract
PURPOSE To determine the number, type and predictors of unmet needs for head and neck cancer (HNC) survivors' partner's. METHODS Partners of HNC patients were invited to complete the Cancer Survivors' Partners Unmet Needs Survey (CaSPUN). Analysis determined number, proportion and factors associated with greater unmet needs using linear regression. Agreement between the unmet needs of patients and their partners was determined. RESULTS Among the 44 partners participated 29 reported ≥1 unmet need and 4 had a very high number of needs (31-35). The most common unmet needs were related to concerns about cancer returning, coping with supporting someone with cancer, and the changes cancer has caused. The highest reported needs were in the Relationships domain. Increasing patient unmet needs was significantly associated with increasing partner unmet needs (p<0.01). CONCLUSIONS A significant proportion of head and neck cancer partners experience unmet needs, which often differ from the patient's needs.
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48
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Alananzeh I, Levesque J, Kwok C, Everett B. Integrative Review of the Supportive Care Needs of Arab People Affected by Cancer. Asia Pac J Oncol Nurs 2016; 3:148-156. [PMID: 27981153 PMCID: PMC5123499 DOI: 10.4103/2347-5625.177396] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
This review aimed to identify the unmet supportive care needs to conduct an integrative review of the literature, to identify the unmet supportive care needs of Arab people affected by cancer (patients and caregivers), and the impact of these needs on quality of life and psychosocial well-being. In July 2015 databases, search engines and electronic list servers were searched, with no limit on the year of publication. Reference lists of included articles and published reviews were also hand searched. Six studies met the inclusion criteria. Most studies examined the supportive care/unmet needs of Arab cancer patients and their family caregivers. Language, communication, information, and the need to get relief from dependency were the most frequently reported unmet needs among Arab cancer patients. For immigrant Arab patients, physical unmet needs were higher than other migrant groups and native Anglo-Australians. Arab caregivers’ unmet needs included concerns about providing suitable care for their family member, sharing their experience with other caregivers, obtaining information, and, in the case of pediatric cancers, dealing with siblings’ emotional reactions. The existing literature exploring the unmet supportive care needs of Arab people affected by cancer is limited suggesting that comprehensive studies are needed to enhance our understanding of these needs and to inform service planning.
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Affiliation(s)
- Ibrahim Alananzeh
- Centre for Applied Nursing Research, School of Nursing and Midwifery, Ingham Institute for Applied Medical Research, Western Sydney University, Penrith, New South Wales, Australia
| | - Janelle Levesque
- Psycho-Oncology Research Group, Centre for Oncology Education and Research Translation, Ingham Institute for Applied Medical Research, UNSW Medicine, The University of New South Wales, Australia
| | - Cannas Kwok
- Centre for Applied Nursing Research, School of Nursing and Midwifery, Ingham Institute for Applied Medical Research, Western Sydney University, Penrith, New South Wales, Australia
| | - Bronwyn Everett
- Centre for Applied Nursing Research, School of Nursing and Midwifery, Ingham Institute for Applied Medical Research, Western Sydney University, Penrith, New South Wales, Australia
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Young J, Snowden A. A systematic review on the factors associated with positive experiences in carers of someone with cancer. Eur J Cancer Care (Engl) 2016; 26. [DOI: 10.1111/ecc.12544] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2016] [Indexed: 01/28/2023]
Affiliation(s)
- J. Young
- Edinburgh Napier University; Edinburgh UK
| | - A. Snowden
- Edinburgh Napier University; Edinburgh UK
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50
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Manne S, Hudson SV, Baredes S, Stroup A, Virtue SM, Paddock L, Kalyoussef E. Survivorship care experiences, information, and support needs of patients with oral and oropharyngeal cancer. Head Neck 2016; 38 Suppl 1:E1935-46. [PMID: 26788714 PMCID: PMC4844877 DOI: 10.1002/hed.24351] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 09/23/2015] [Accepted: 10/17/2015] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND There is little research documenting the posttreatment experiences and needs of oral/oropharyngeal cancer survivors. METHODS In this cross-sectional study, 92 patients with oral/oropharyngeal cancer diagnosed between 2 and 5 years prior completed a survey about oral cancer information and support needs. RESULTS About half retrospectively reported that they did not receive a written treatment summary. The desire for more oral cancer information was common; one-third or more desired more information about long-term effects, recommended follow-up, and symptoms that should prompt contacting a doctor. Support needs were less common; only a lack of energy was rated as a significant support need. Patients who had a recurrence, did not drink alcohol, and had a greater recurrence fear desired more information. Smokers and more distressed patients reported more support needs. CONCLUSION Survivors reported the desire for more oral cancer information. A desire for assistance was less common. © 2016 Wiley Periodicals, Inc. Head Neck 38: E1935-E1946, 2016.
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Affiliation(s)
- Sharon Manne
- Department of Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Shawna V Hudson
- Department of Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Soly Baredes
- Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Antoinette Stroup
- Department of Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
- Department of Nutritional Sciences, Rutgers School of Public Health, Piscataway, New Jersey
| | - Shannon Myers Virtue
- Department of Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Lisa Paddock
- Department of Nutritional Sciences, Rutgers School of Public Health, Piscataway, New Jersey
| | - Evelyne Kalyoussef
- Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey
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