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Shen MJ, Prigerson HG, Maciejewski PK, Daly B, Adelman R, McConnell Trevino KM. A communication intervention to improve prognostic understanding and engagement in advance care planning among diverse advanced cancer patient-caregiver dyads: A pilot study. Palliat Support Care 2024; 22:10-18. [PMID: 37526150 PMCID: PMC10901460 DOI: 10.1017/s1478951523000901] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2023]
Abstract
OBJECTIVES Accurate prognostic understanding among patients with advanced cancer and their caregivers is associated with greater engagement in advance care planning (ACP) and receipt of goal-concordant care. Poor prognostic understanding is more prevalent among racial and ethnic minority patients. The purpose of this study was to examine the feasibility, acceptability, and impact of a patient-caregiver communication-based intervention to improve prognostic understanding, engagement in ACP, and completion of advance directives among a racially and ethnically diverse, urban sample of patients and their caregivers. METHODS Patients with advanced cancer and their caregivers (n = 22 dyads) completed assessments of prognostic understanding, engagement in ACP, and completion of advance directives at baseline and post-intervention, Talking About Cancer (TAC). TAC is a 7-session intervention delivered remotely by licensed social workers that includes distress management and communication skills, review of prognosis, and information on ACP. RESULTS TAC met a priori benchmarks for feasibility, acceptability, and fidelity. Prognostic understanding and engagement in ACP did not change over time. However, patients showed increases in completion of advance directives. SIGNIFICANCE OF RESULTS TAC was feasible, acceptable, and delivered with high fidelity. Involvement of caregivers in TAC may provide added layers of support to patients facing advanced cancer diagnoses, especially among racial and ethnic minorities. Trends indicated greater completion of advance directives but not in prognostic understanding or engagement in ACP. Future research is needed to optimize the intervention to improve acceptability, tailor to diverse patient populations, and examine the efficacy of TAC in a randomized controlled trial.
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Affiliation(s)
- Megan J Shen
- Division of Clinical Research, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Holly G Prigerson
- Department of Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Paul K Maciejewski
- Department of Radiology, Weill Cornell Medical College, New York, NY, USA
| | - Bobby Daly
- Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Ronald Adelman
- Department of Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Kelly M McConnell Trevino
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Burke H, Dunne S. "You nearly feel a little bit like you've less right to grieve": a qualitative study on the impact of cancer on adult siblings. J Cancer Surviv 2023; 17:1628-1638. [PMID: 36401074 PMCID: PMC9676809 DOI: 10.1007/s11764-022-01295-9] [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: 09/14/2022] [Accepted: 11/07/2022] [Indexed: 11/19/2022]
Abstract
PURPOSE Family members of cancer patients experience a range of challenges and are impacted in various ways by cancer. To our knowledge, the impact of cancer on adult siblings has yet to be explored. Sibling relationships are one of the longest relationships individuals have across the lifespan. Thus, the current study sought to investigate the perspectives of siblings of those who previously had cancer. METHODS Ten participants were recruited using purposive sampling. A qualitative, cross-sectional design was implemented with both virtual and in-person semi-structured interviews. Interviews were audio-recorded, transcribed and analysed using thematic analysis. RESULTS The researchers identified five themes relating to both the impact of cancer on siblings and the supports they received: changes in family relationships, sibling's grief is forgotten, benefits of social support networks, supporting their sibling and caregiving and self-support. CONCLUSIONS Cancer organizations and support services should focus on signposting services for siblings in order to ensure they can access support. Further research is needed with siblings to gain greater insight into what supports siblings feel are available for them to access, whether there are any for them to access or how supports can be improved. IMPLICATIONS FOR CANCER SURVIVORS The provision of appropriate psychological support for siblings of cancer patients will ensure they can provide optimal support and care to their siblings. This will in turn benefit cancer patients along their cancer trajectory as adequate support from their caregivers will enhance their quality of life.
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Affiliation(s)
- Hazel Burke
- School of Psychology, Dublin City University, Glasnevin, Dublin 9, Dublin, Ireland
| | - Simon Dunne
- School of Psychology, Dublin City University, Glasnevin, Dublin 9, Dublin, Ireland.
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3
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Tan JYA, Ong GYQ, Cheng LJ, Pikkarainen M, He HG. Effectiveness of mHealth-based psychosocial interventions for breast cancer patients and their caregivers: A systematic review and meta-analysis. J Telemed Telecare 2023:1357633X231187432. [PMID: 37650270 DOI: 10.1177/1357633x231187432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
BACKGROUND Breast cancer causes significant distress in patient-caregiver dyads. While psychosocial and/or mHealth-based interventions have shown efficacy in improving their psychosocial well-being, no reviews have synthesised the effectiveness of such interventions delivered specifically to the breast cancer patient-caregiver dyad. OBJECTIVE To synthesise available evidence examining the effectiveness of mHealth-based psychosocial interventions among breast cancer patient-caregiver dyads in improving their psychosocial well-being (primary outcomes: dyadic adjustment, depression and anxiety; secondary outcomes: stress, symptom distress, social well-being and relationship quality), compared to active or non-active controls. DESIGN A systematic review and meta-analysis. METHODS Randomised controlled trials and quasi-experimental studies were comprehensively searched from seven electronic databases (PubMed, CENTRAL, CINAHL, Embase, PsycINFO, Scopus, Web of Science), ongoing trial registries (ClinicalTrials.gov, WHO ICTRP) and grey literature (ProQuest Dissertations and Theses Global) from inception of databases till 23 December 2022. Studies involving breast cancer patient-caregiver dyads participating in mHealth-based psychosocial interventions, compared to active or non-active controls, were included. Exclusion criteria were terminally ill patients and/or participants with psychiatric disorders or cognitive impairment and interventions collecting symptomatic data, promoting breast cancer screening or involving only physical activities. Screening, data extraction and quality appraisal of studies were conducted independently by two reviewers. Cochrane Risk of Bias Tool version 1 and JBI Critical Appraisal Checklist were used to appraise the randomised controlled trials and quasi-experimental studies, respectively. Meta-analyses using Review Manager 5.4.1 synthesised the effects of outcomes of interest. Sensitivity and subgroup analyses were conducted. The GRADE approach appraised the overall evidence quality. RESULTS Twelve trials involving 1204 breast cancer patient-caregiver dyads were included. Meta-analyses found statistically significant increase in caregiver anxiety (standardised mean difference (SMD) = 0.43, 95% confidence interval (CI) [0.09, 0.77], Z = 2.47, p = 0.01), involving 479 caregivers in 5 studies, and stress (SMD = 0.25, 95% CI [0.05, 0.45], Z = 2.44, p = 0.01), involving 387 caregivers in 4 studies post-intervention, favouring control groups. The intervention effects on the remaining outcomes were statistically insignificant. Beneficial effects of such interventions remain uncertain. The overall quality of evidence was very low for all primary outcomes. CONCLUSIONS Results of the effectiveness of mHealth-based psychosocial interventions on the psychosocial well-being of breast cancer patient-caregiver dyads are inconclusive. The high heterogeneity shown in the meta-analyses and very-low overall quality of evidence imply the need for cautious interpretation of findings. Higher-quality studies are needed to assess the effects of psychosocial interventions on dyadic outcomes and determine optimal intervention regimes.
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Affiliation(s)
- Jia Yu Amelia Tan
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Germaine Yi Qing Ong
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ling Jie Cheng
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- National University Health System, Singapore, Singapore
| | - Minna Pikkarainen
- Department of Occupational Therapy, Prosthetics and Orthoptics, Faculty of Health Sciences & Department of Product Design, Faculty of Technology, Art and Design, Oslo Metropolitan University, Oslo, Norway
- Martti Ahtisaari Institute, University of Oulu, Oulu, Finland
| | - Hong-Gu He
- National University Health System, Singapore, Singapore
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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4
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Horn AB, Zimmerli L, Maercker A, Holzer BM. The worse we feel, the more intensively we need to stick together: a qualitative study of couples' emotional co-regulation of the challenge of multimorbidity. Front Psychol 2023; 14:1213927. [PMID: 37637914 PMCID: PMC10450955 DOI: 10.3389/fpsyg.2023.1213927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 07/28/2023] [Indexed: 08/29/2023] Open
Abstract
Introduction Being faced with multimorbidity (i.e., being diagnosed with at least two chronic conditions), is not only demanding in terms of following complicated medical regimes and changing health behaviors. The changes and threats involved also provoke emotional responses in the patients but also in their romantic partners. This study aims at exploring the ways of emotional co-regulation that couples facing multimorbidity express when interviewed together. Method N = 15 opposite sex couples with one multimorbid patient after an acute health crisis that led to hospitalization were asked in a semi-structured interview about how they found ways to deal with the health situation, what they would recommend to other couples in a similar situation, and how they regulated their emotional responses. Interviews were analyzed qualitatively following open, axial, and selective coding, as in the grounded theory framework. Results Emerging categories from the romantic partners' and the patients' utterances revealed three main categories: First, overlapping cognitive appraisals about the situation (from fighting spirit to fatalism) and we-ness (construing the couple self as a unit) emerged as higher order factor from the utterances. Second, relationship-related strategies including strategies aimed at maintaining high relationship quality in spite of the asymmetric situation like strengthening the common ground and balancing autonomy and equity in the couple were often mentioned. Third, some couples mentioned how they benefit from individual strategies that involve fostering individual resources of the partners outside the couple relationship (such as cultivating relationships with grandchildren or going outdoors to nature). Discussion Results underline the importance of a dyadic perspective not only on coping with disease but also on regulating the emotional responses to this shared challenging situation. The utterances of the couples were in line with earlier conceptualizations of interpersonal emotion regulation and dyadic perspectives on we-disease. They broaden the view by integrating the interplay between individual and interpersonal regulation strategies and underline the importance of balancing individual and relational resources when supporting couples faced with chronic diseases.
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Affiliation(s)
- Andrea B. Horn
- CoupleSense: Health and Interpersonal Emotion Regulation Lab, University Research Priority Program “Dynamics of Healthy Aging,” University of Zurich, Zurich, Switzerland
- Center of Gerontology, Healthy Longevity Center, University of Zurich, Zurich, Switzerland
- Gerontopsychology and Gerontology, Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Lukas Zimmerli
- Department of Internal Medicine, Cantonal Hospital Olten (KSO), Olten, Switzerland
| | - Andreas Maercker
- Psychopathology and Clinical Intervention, Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Barbara M. Holzer
- Department of Internal Medicine, University Hospital Zurich, Zurich, Switzerland
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5
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Weitkamp K, Bodenmann G. Couples Coping Together: A Scoping Review of the Quantitative and Qualitative Evidence and Conceptual Work Across Three Decades. Front Psychol 2022; 13:876455. [PMID: 35756297 PMCID: PMC9226419 DOI: 10.3389/fpsyg.2022.876455] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 05/11/2022] [Indexed: 11/25/2022] Open
Abstract
Dyadic coping (DC), how couples cope together to deal with a stressor like chronic illness, has received increased attention over the last three decades. The aim of the current study was to summarize the current state of research on DC in couples. We conducted a scoping review of qualitative, quantitative, and mixed-methods studies published between 1990 and 2020, assessing DC in couples during three decades. 5,705 studies were identified in three electronic databases and hand searches. We included 643 sources in this review (with a total of N = 112,923 study participants). Most studies were based in the global North, particularly in the US and Europe. Publication numbers increased constantly over time. A third of study designs were cross-sectional studies followed by qualitative and longitudinal studies. The most prolific DC research areas were related to DC and minor stressors and DC and major physical health stressors. Overall, DC has been established internationally as a highly relevant construct in many disciplines (clinical, social, developmental, personality psychology, social work, nursing etc.). To conclude, the review reveals that future studies should focus on predictors, trajectories, and the importance of very specific DC behaviors for personal and dyadic functioning.
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Affiliation(s)
- Katharina Weitkamp
- Clinical Psychology for Children/Adolescents and Couples/Families, University of Zurich, Zurich, Switzerland
| | - Guy Bodenmann
- Clinical Psychology for Children/Adolescents and Couples/Families, University of Zurich, Zurich, Switzerland
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Lamson AL, Hodgson JL, Pratt KJ, Mendenhall TJ, Wong AG, Sesemann EM, Brown BJ, Taylor ES, Williams-Reade JM, Blocker DJ, Harsh Caspari J, Zubatsky M, Martin MP. Couple and family interventions for high mortality health conditions: A strategic review (2010-2019). JOURNAL OF MARITAL AND FAMILY THERAPY 2022; 48:307-345. [PMID: 34741539 DOI: 10.1111/jmft.12564] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 10/12/2021] [Indexed: 06/13/2023]
Abstract
The earliest publications in the field of marriage and family therapy introduced interventions conducted with families experiencing complex health conditions. This strategic review captures an evaluation of efficacy for 87 couple and family interventions published between 2010 and 2019 with a focus on the leading causes of mortality in the United States. These health conditions include chromosomal anomalies and accidents with infants aged 0-4 years; accidents and cancer among children aged 5-14; accidents among adolescents aged 15-24; and heart disease, cancer, accidents, chronic lower respiratory diseases, stroke, Alzheimer's disease, diabetes, influenza/pneumonia, and nephritis/nephrosis among adults 25 and older. Results support the need for greater inclusion of couples and families in assessments and interventions. The greatest chasm in efficacy research was with minoritized couples and families. Implications include ways to initiate couple and family interventions in the context of health conditions with attention given to accessibility, recruitment, retention, and evaluation.
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Affiliation(s)
- Angela L Lamson
- Department of Human Development & Family Science, College of Health and Human Performance, Greenville, North Carolina, USA
| | - Jennifer L Hodgson
- Department of Human Development & Family Science, College of Health and Human Performance, Greenville, North Carolina, USA
| | - Keeley J Pratt
- Department of Human Services, Human Development and Family Science Program, Couple and Family Therapy Specialization, College of Education & Human Ecology, Columbus, Ohio, USA
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
- Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Tai J Mendenhall
- Department of Family Social Science, University of Minnesota, Saint Paul, Minnesota, USA
| | - Alison G Wong
- Department of Marriage and Family Therapy, Fuller School of Psychology and Marriage and Family Therapy, Pasadena, California, USA
| | | | - Braden J Brown
- Department of Family Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Athletics Department, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA
| | - Erika S Taylor
- Department of Family Medicine, Behavioral Medicine Section, Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA
| | | | - Daniel J Blocker
- Pomona Valley Family Medicine Residency, Pomona Valley Hospital Medical Center, Pomona, California, USA
| | - Jennifer Harsh Caspari
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Max Zubatsky
- Department of Family and Community Medicine, Saint Louis University, St. Louis, Missouri, USA
| | - Matthew P Martin
- Doctor of Behavioral Health Program, College of Health Solutions, Arizona State University, Phoenix, Arizona, USA
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7
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Weitkamp K, Feger F, Landolt SA, Roth M, Bodenmann G. Dyadic Coping in Couples Facing Chronic Physical Illness: A Systematic Review. Front Psychol 2021; 12:722740. [PMID: 34759866 PMCID: PMC8573212 DOI: 10.3389/fpsyg.2021.722740] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 09/27/2021] [Indexed: 01/09/2023] Open
Abstract
Objective: Chronic physical illness affects not only patients but also their partners. Dyadic coping (DC)-the ways couples cope in dealing with a stressor such as chronic illness-has received increased attention over the last three decades. The aim of the current study was to summarize the state of research on DC in couples with chronic physical illnesses. Methods: We conducted a systematic review of qualitative, quantitative, and mixed-methods studies published between 1990 and 2020, assessing DC in couples affected by severe physical illnesses. We used DC and related search terms for the literature search in Psycinfo, Psyndex, and Medline. Five thousand three hundred thirty studies were identified in three electronic databases and 49 of these were included in the review (5,440 individuals reported on 2,820 dyads). We excluded studies on cancer, cardiovascular disease, and multiple sclerosis because of existing reviews in the respective fields. Half of the studies included were on diabetes. Other studies were on arthritis, chronic obstructive pulmonary disease (COPD), cystic fibrosis, human immunodeficiency virus (HIV), Huntington's disease, lupus erythematosus, Parkinson's disease, renal diseases, stroke, and endometriosis. Two raters extracted data using a predefined protocol, including study quality. Results were collated in a narrative synthesis organized by illness and DC operationalization. Results: Overall, DC was associated with beneficial outcomes in physical health, well-being, and relationship satisfaction. Differential effects became apparent for certain chronic conditions potentially depending on certain disease characteristics, such as early-onset, sudden-onset, or life-threatening conditions. Conclusion: Facing challenges together as a couple seemed indispensable for adapting to a diverse range of demands related to chronic illnesses with some specific demands of particular chronic diseases. There is a need for the development of truly dyadic interventions with an eye on the specific challenges of the various chronic conditions.
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Affiliation(s)
- Katharina Weitkamp
- Clinical Psychology Children/Adolescents and Couples/Families, University of Zurich, Zurich, Switzerland
| | - Fabienne Feger
- ZHAW Zurich University of Applied Science, Zurich, Switzerland
| | - Selina A Landolt
- Clinical Psychology Children/Adolescents and Couples/Families, University of Zurich, Zurich, Switzerland
| | - Michelle Roth
- Clinical Psychology Children/Adolescents and Couples/Families, University of Zurich, Zurich, Switzerland
| | - Guy Bodenmann
- Clinical Psychology Children/Adolescents and Couples/Families, University of Zurich, Zurich, Switzerland
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8
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Chen M, Gong J, Cao Q, Luo X, Li J, Li Q. A literature review of the relationship between dyadic coping and dyadic outcomes in cancer couples. Eur J Oncol Nurs 2021; 54:102035. [PMID: 34520996 DOI: 10.1016/j.ejon.2021.102035] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 09/02/2021] [Accepted: 09/04/2021] [Indexed: 11/19/2022]
Abstract
PURPOSE Couples are usually affected by cancer as patient-partner dyads, and they may react as a unit rather than as individuals, i.e., dyadic coping. This paper aims to comprehensively summarise the relationship between dyadic coping and dyadic outcomes (relationship satisfaction, quality of life, and psychological adjustment) in cancer couples, and provide valuable evidence to guide future research. METHOD A systematic search of five online databases, e.g., Cochrane Library, Embase, Medline, PubMed, and PsycINFO, was conducted to identify cancer couple-based studies published in English or Chinese from January 1990 to March 2021. A manual search was also performed on the article reference lists. RESULTS Twenty-eight studies met the inclusion criteria. We found that communication, supportive dyadic coping, delegated dyadic coping and common dyadic coping might strengthen marital bonds, alleviate couples' stress, and facilitate mental health, but on the other hand, they possibly increase patients' and/or partners' physical or psychological burden. Negative dyadic coping and protective buffering were related to lower relationship satisfaction, worse quality of life, and more depressive symptoms. Patients reported more self-emotional disclosure, common dyadic coping, and negative dyadic coping than partners, while partners showed more holding back, supportive dyadic coping, delegated dyadic coping, and protective buffering. Moreover, patients were more susceptible to dyadic coping strategies. CONCLUSIONS This review provides a comprehensive overview of the relationship between dyadic coping and dyadic outcomes. Based on the available evidence, the development of personalised interventions for improving dyadic coping is required to help couples live better with cancer.
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Affiliation(s)
- Meizhen Chen
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China.
| | - Jiali Gong
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China.
| | - Qian Cao
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China.
| | - Xingjuan Luo
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China.
| | - Jieyu Li
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China.
| | - Qiuping Li
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China.
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9
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Li J, Luo X, Li Q. An Implementation Process Evaluation Based on an Integrated Psychosocial Support Program of Colorectal Cancer Couples in China: A Pilot Study. Healthcare (Basel) 2021; 9:110. [PMID: 33494349 PMCID: PMC7912170 DOI: 10.3390/healthcare9020110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 01/12/2021] [Accepted: 01/19/2021] [Indexed: 01/10/2023] Open
Abstract
Studies have shown that the qualitative process assessment of cancer couple-based psychosocial interventions is often ignored. This article aims to evaluate the implementation process of an integrated psychosocial program developed for colorectal cancer couples. Semi-structured qualitative interviews were conducted with eight colorectal cancer couple participants and two intervention facilitators. Normalization Process Theory was used to guide the data collection and analysis. Data analysis was conducted using a directed content analysis approach within a framework approach. Participants had a good understanding of the program significance. For most participants, the intervention duration was appropriate, and was well integrated into daily life. A lack of understanding of psychological nursing, and a lack of confidence in the use of online platforms and other personal factors, inhibited participants' experience of participating in the intervention. The facilitator's challenge in the implementation process was being flexible in dealing with situations occurring outside of the framework plan. Face-to-face and online psychological interventions require more flexibility, and participant cognition of psychosocial care was the key to the successful implementation of the intervention. Future research should consider raising participants' awareness of psychological care to better integrate this type of intervention into participants' daily lives and routine care.
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Affiliation(s)
| | | | - Qiuping Li
- Wuxi School of Medicine, Jiangnan University, Wuxi 214000, China; (J.L.); (X.L.)
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10
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Almatkyzy G, Mojica CM, Stroup AM, Llanos AAM, O'Malley D, Xu B, Tsui J. Predictors of health-related quality of life among Hispanic and non-Hispanic White breast cancer survivors in New Jersey. J Psychosoc Oncol 2020; 39:595-612. [PMID: 33198603 DOI: 10.1080/07347332.2020.1844844] [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: 10/23/2022]
Abstract
PURPOSE To examine predictors of health-related quality of life (HRQoL) in Hispanic and non-Hispanic White (NHW) breast cancer (BC) survivors. DESIGN Cross-sectional study using survey data. PARTICIPANTS Women diagnosed with BC at ages 21-79 years, between 2012-2014, recruited from the New Jersey State Cancer Registry. METHODS HRQoL was assessed using the Functional Assessment Cancer Therapy (FACT-G) instrument. Descriptive statistics compared Hispanics and NHWs, and multivariate regression analyses identified predictors of HRQoL. RESULTS HRQoL was significantly higher scores among NHW (85.7 ± 18.5) than Hispanics (79.4 ± 20.1) (p < 0.05). In multivariate analyses, comorbidities (β: -13.3, 95%CI: -20.6, -5.92), late-stage diagnosis (β: -5.67, 95%CI: -10.7, -0.62), lower income (β: -13.9, 95%CI: -19.8, -7.97) and younger age at diagnosis were associated with lower HRQoL. CONCLUSION Socio-demographic and clinic characteristics were significant predictors of HRQoL among diverse BC survivors. IMPLICATIONS FOR PSYCHOSOCIAL ONCOLOGY Supportive psychosocial care interventions tailored to the needs of young, low-income BC survivors with comorbidities are needed.
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Affiliation(s)
- Gulaiim Almatkyzy
- School of Social and Behavioral Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, USA
| | - Cynthia M Mojica
- School of Social and Behavioral Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, USA
| | - Antoinette M Stroup
- Division of Cancer Epidemiology, Rutgers School of Public Health, Cancer Prevention and Cancer Control, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - Adana A M Llanos
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, New Jersey, USA
| | - Denalee O'Malley
- Department of Family Medicine and Community Health, Rutgers State University of New Jersey, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
| | - Baichen Xu
- Division of Population Science, Rutgers Cancer Institute of New, New Brunswick, New Jersey, USA
| | - Jennifer Tsui
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
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11
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Zimansky M, Stasielowicz L, Franke I, Remmers H, Friedel H, Atzpodien J. Effects of Implementing a Brief Family Nursing Intervention With Hospitalized Oncology Patients and Their Families in Germany: A Quasi-Experimental Study. JOURNAL OF FAMILY NURSING 2020; 26:346-357. [PMID: 33283613 PMCID: PMC7723861 DOI: 10.1177/1074840720967022] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Family nursing, based on the Calgary Family and Intervention Models, was implemented in a German oncological inpatient unit to promote effective family functioning in the context of cancer care. The objective of this study was to investigate the effects of implementing family nursing care on several psychological and physical outcomes of patients and their family members. A quasi-experimental study with 214 patients with a cancer diagnosis and 122 family members was conducted. Findings indicate that the superiority of family nursing, when compared to traditional care, could not be confirmed with respect to patients' outcomes (psychological burden, social support, satisfaction with care) and family members' outcomes (psychological burden, physical complaints, satisfaction with care). Various factors, such as country-specific structures and challenges in implementing family nursing care on an inpatient unit, may have contributed to these findings. Further replication attempts in similar settings in other countries are needed to shed light on the factors impairing or promoting the implementation of family nursing in practice settings.
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Affiliation(s)
| | | | - Inga Franke
- Paracelsus-Wittekindklinik Bad Essen, Germany
| | | | - Heiko Friedel
- Gesellschaft für Gesundheitsmanagement mbH, Essen, Germany
| | - Jens Atzpodien
- Franziskus-Hospital Harderberg, Georgsmarienhütte, Germany
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12
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Li M, Chan CWH, Chow KM, Xiao J, Choi KC. A systematic review and meta-analysis of couple-based intervention on sexuality and the quality of life of cancer patients and their partners. Support Care Cancer 2019; 28:1607-1630. [PMID: 31872299 DOI: 10.1007/s00520-019-05215-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 11/26/2019] [Indexed: 12/21/2022]
Abstract
PURPOSE To synthesize the characteristics and effects of couple-based intervention on sexuality and the quality of life (QOL) of cancer patients and their intimate partners and its implications for future research and practice. METHODS A systematic review and meta-analysis of randomized and non-randomized controlled studies of interventions was conducted in nine English databases and two Chinese databases, with identification of related studies published in English and Chinese. The quality of the studies was assessed using the tools of the Effective Public Health Practice Project. RESULTS A total of 33 articles were identified for systematic review and 23 articles were identified for meta-analysis. For patients, the effect size was 0.42 (Hedges's g, 95% CI = 0.05-0.78, p = 0.03) for physical health. For partners, the effect size was 0.52 (Hedges's g, 95% CI = 0.06-0.98, p = 0.03) for sexual relationships. However, moderate to high heterogeneity was reported. Effects on sexual function, sexual self-concept, and mental health for couples were not significant. CONCLUSION Couple-based interventions had small to medium-sized effects on physical health for cancer patients. Partners could derive medium effects for improvement in sexual relationships from couple-based intervention. Future research should pay more attention to sexual self-concept in cancer patients and target types of cancer that are more likely to compromise sexuality and QOL. PROSPERO REGISTRATION The systematic review and meta-analysis has been registered in PROSPERO with registration number: CRD42019119047.
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Affiliation(s)
- Minjie Li
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Carmen W H Chan
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong.
| | - Ka Ming Chow
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Jinnan Xiao
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Kai Chow Choi
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong
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13
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Hendriksen E, Rivera A, Williams E, Lee E, Sporn N, Cases MG, Palesh O. Manifestations of anxiety and coping strategies in patients with metastatic lung cancer and their family caregivers: a qualitative study. Psychol Health 2019; 34:886-899. [PMID: 31155947 DOI: 10.1080/08870446.2019.1579909] [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] [Indexed: 10/26/2022]
Abstract
Objective: Advanced non-small cell lung cancer (NSCLC) is common, deadly, and associated with impairing anxiety for patients and caregivers who often co-experience similar symptoms that can vary together over time. We aimed to discover themes as to how NSCLC patients and caregivers express and cope with anxiety. Design: Semi-structured interviews of patient-caregiver dyads (N = 21), coded using NVivo Software. Main Outcome Measures: Open-ended questions on anxiety mutuality, giving or receiving care, communication, and the most difficult aspects of having or caring for someone with Stage IV NSCLC. Results: Analyses revealed that patients and caregivers were linked psychologically, co-experiencing symptoms of distress or coping, rising and falling together. Shared patient and caregiver themes emerged of cognitive, behavioural and physiological manifestations of anxiety and coping mechanisms. Conclusions: Patient and caregiver expressions of anxiety and coping methods mapped onto the cognitive-behavioural model, implying potential use of cognitive behavioural therapy (CBT) to address these issues. This expands understanding of symptoms and coping strategies in NSCLC, explores patient-caregiver interaction, and confirms the need for future clinical intervention. Future research should focus on development and dissemination of CBT-based dyadic interventions addressing anxiety in NSCLC patients and caregivers.
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Affiliation(s)
- Ellen Hendriksen
- a Department of Psychiatry and Behavioral Sciences , Stanford University School of Medicine , Stanford , California , USA
| | - Alexandra Rivera
- b PGSP-Stanford Psy.D. Consortium , Palo Alto , California , USA
| | - Emma Williams
- b PGSP-Stanford Psy.D. Consortium , Palo Alto , California , USA
| | - Eric Lee
- b PGSP-Stanford Psy.D. Consortium , Palo Alto , California , USA
| | - Nora Sporn
- c Department of Psychology , University of Kansas , Lawrence , Kansas , USA
| | - Mallory G Cases
- a Department of Psychiatry and Behavioral Sciences , Stanford University School of Medicine , Stanford , California , USA
| | - Oxana Palesh
- a Department of Psychiatry and Behavioral Sciences , Stanford University School of Medicine , Stanford , California , USA
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Acquati C, Kayser K. Dyadic Coping Across the Lifespan: A Comparison Between Younger and Middle-Aged Couples With Breast Cancer. Front Psychol 2019; 10:404. [PMID: 30941068 PMCID: PMC6433932 DOI: 10.3389/fpsyg.2019.00404] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 02/11/2019] [Indexed: 11/28/2022] Open
Abstract
The association between dyadic coping and adjustment to cancer has been well-established. However, a significant gap in the literature is the understanding of how the life stage of couples may influence their dyadic coping and the accompanying quality of life. Although younger couples have been identified at higher risk for poor coping because of less collaborative behaviors and higher vulnerability to stress, only a limited number of studies have addressed younger women's coping with breast cancer in the context of close relationships. The present study addressed the differential impact of the illness on the quality of life and dyadic coping behaviors of younger and middle-aged dyads and the influence of relational mutuality on couples' coping in the two groups. A sample of 86 couples participated in a cross-sectional study; 35 younger couples were compared to 51 middle-aged dyads. Patients and partners completed measures of quality of life, dyadic coping, and mutuality. Independent-samples t-tests were used to examine differences in the two groups, while the Actor-Partner Interdependence Model (APIM) identified actor and partner effects of relational mutuality on dyadic coping. Younger women and their partners reported statistically significant worse quality of life and dyadic coping scores than the middle-age group. For younger couples, positive and negative coping styles were the result of both actor and partner effects of mutuality. The study highlighted the more negative impact of breast cancer on the quality of life of younger patients and partners. It also revealed a stronger influence of each partner's relational mutuality compared to the middle-age group in predicting both adaptive and maladaptive coping behavior. Future studies should continue to examine the developmental trajectory of dyadic coping across the lifespan in order to develop psychosocial interventions to promote younger dyads' coping efforts.
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Affiliation(s)
- Chiara Acquati
- Graduate College of Social Work, University of Houston, Houston, TX, United States
| | - Karen Kayser
- Renato LaRocca Chair of Oncology Social Work, Kent School of Social Work, University of Louisville, Louisville, KY, United States
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Understanding the roles of patient symptoms and subjective appraisals in well-being among breast cancer patients. Support Care Cancer 2019; 27:4245-4252. [PMID: 30847702 DOI: 10.1007/s00520-019-04707-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 02/18/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE To examine the roles of both patient symptoms, and subjective appraisals of stress (self-efficacy, symptom barriers, symptom distress), in understanding well-being (anxiety, depression, cancer-specific quality of life, mental health quality of life, and physical health quality of life) in breast cancer patients. METHODS We examined data from 104 female breast cancer patients. Using a stress process model, we hypothesized that while high levels of patient symptoms would be associated with poorer patient well-being, these effects would be mediated by subjective appraisals, including patient self-efficacy, perceived symptom barriers, and symptom distress. RESULTS As expected, higher levels of patient symptoms were associated with poorer well-being on all five indicators. Subjective appraisals of stress added significantly to predictors of well-being, and were mediators of this relationship across all five outcomes. CONCLUSIONS While patient symptoms are important predictors of patient well-being, subjective appraisals of the stressfulness of symptoms, and of patients' self-efficacy in managing symptoms, are also key factors. The findings suggest the utility of a stress process model in understanding well-being in breast cancer patients, and point to the potential value of targeting patient appraisals as well as symptoms to improve psychological well-being and quality of life.
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Iwasaki M, Di Bianca MS, Nicholas DR. A forbidden topic at the end of life: “What about you after I'm gone?”. Psychooncology 2018; 27:2665-2667. [DOI: 10.1002/pon.4772] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 05/08/2018] [Accepted: 05/14/2018] [Indexed: 11/09/2022]
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Azlan HA, Overton PG, Simpson J, Powell PA. Effect of Partners' Disgust Responses on Psychological Wellbeing in Cancer Patients. J Clin Psychol Med Settings 2017; 24:355-364. [PMID: 29164511 DOI: 10.1007/s10880-017-9521-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The aim of this study was to explore quantitatively the relationship between disgust responses in cancer patients and their partners, and in turn their relationship to patients' psychological well-being. We recruited 50 participants with heterogeneous cancer diagnoses and their partners from cancer-related groups (e.g., charities). Patients completed questionnaires to determine levels of disgust propensity, disgust sensitivity, self-disgust, and symptoms of anxiety and depression. Disgust propensity and sensitivity were also assessed in their partners. Partners' disgust sensitivity was significantly positively correlated with cancer patients' self-disgust, disgust propensity, and depression. Path analyses suggested that patients' self-disgust plays a role in mediating the effect of partners' disgust sensitivity on patients' psychological well-being. This study provides the first quantitative evidence that psychological well-being in cancer patients is contingent on their partners' sensitivity to disgust, and that patients' self-disgust plays a mediating role. Focusing therapeutically on disgust responses could well be beneficial to people with cancer.
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Affiliation(s)
- Haffiezhah A Azlan
- Department of Psychology, University of Sheffield, Western Bank, Sheffield, UK
| | - Paul G Overton
- Department of Psychology, University of Sheffield, Western Bank, Sheffield, UK.
| | - Jane Simpson
- Division of Health Research, Lancaster University, Lancaster, UK
| | - Philip A Powell
- Department of Economics, University of Sheffield, Sheffield, UK
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Berry E, Davies M, Dempster M. Exploring the effectiveness of couples interventions for adults living with a chronic physical illness: A systematic review. PATIENT EDUCATION AND COUNSELING 2017; 100:1287-1303. [PMID: 28228340 DOI: 10.1016/j.pec.2017.02.015] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 02/09/2017] [Accepted: 02/11/2017] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Partners have a significant role in a person's ability to adjust to a chronic physical illness, which warrants their inclusion in couples interventions. However to deliver more specific, tailored support it is necessary to explore which types of couples interventions are most effective across certain chronic illness populations and outcomes. METHODS Five databases were searched using selected terms. Thirty-five articles met the eligibility criteria for inclusion. RESULTS The majority of studies were from the US, and most interventions targeted cancer populations. Couples interventions fell into two categories according to therapeutic approach; Cognitive Behavioural Skills Training (CBST) and Relationship Counselling (RC). When compared with a patient-only intervention or controls, CBST interventions effectively targeted behavioural, physical/somatic and cognitive outcomes, while RC more effectively targeted interpersonal outcomes. CONCLUSION Couples interventions can be more effective than patient-only interventions or controls across various patient and partner outcomes. Couples interventions tend to favour a skills-based or a relationship-based approach, which strongly influences the types outcomes effectively targeted. PRACTICE IMPLICATIONS Our findings suggest it could be therapeutically useful to integrate these two approaches to more holistically support couples living with chronic illness. We also identify the need to target understudied illness groups and ethnicities.
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Affiliation(s)
- Emma Berry
- Queen's University Belfast, School of Psychology, Northern Ireland.
| | - Mark Davies
- Department of Clinical Psychology, Belfast Health & Social Care Trust, Northern Ireland.
| | - Martin Dempster
- Queen's University Belfast, School of Psychology, Northern Ireland.
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19
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Sexual Consequences of Cancer and Its Treatment in Adolescents and Young Adults. CANCER IN ADOLESCENTS AND YOUNG ADULTS 2017. [DOI: 10.1007/978-3-319-33679-4_24] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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20
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Lambert SD, Girgis A. Unmet Supportive Care Needs Among Informal Caregivers of Patients with Cancer: Opportunities and Challenges in Informing the Development of Interventions. Asia Pac J Oncol Nurs 2017; 4:136-139. [PMID: 28503646 PMCID: PMC5412151 DOI: 10.4103/2347-5625.204485] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Sylvie D Lambert
- Ingram School of Nursing, McGill University, Montreal, Canada.,St. Mary's Research Centre, Montreal, Canada.,Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, The University of New South Wales, Liverpool, Australia
| | - Afaf Girgis
- Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, The University of New South Wales, Liverpool, Australia
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Abstract
BACKGROUND Although sexual health is a common concern for oncology patients, no practical guidelines to sexual intervention exist, perhaps because of a lack of systematic reviews or meta-analyses. OBJECTIVES The objectives of this study were to determine the effect size for psychoeducational intervention focused on sexuality and to compare effect sizes according to intervention outcomes and characteristic. METHODS We explored quantitative evidence for the effects of sexual intervention for cancer patients or partners by using the electronic databases. Among them, we considered 15 eligible articles. RESULTS The meta-analysis provided 133 effect sizes from 15 primary studies. The analysis revealed significant improvements after intervention, with a random-effects standardized mean difference of 0.75. Psychoeducational interventions focused on sexuality after cancer diagnosis were effective for compliance (2.40), cognitive aspect (1.29), and psychological aspect (0.83). Individual-based interventions (0.85) were more effective in improving outcomes than group approach and group combined with individual intervention. With regard to intervention providers, registered nurse only (2.22) and team approach including the registered nurse (2.38) had the highest effect size. Face-to-face intervention combined with telephone or the Internet (1.04) demonstrated a higher effect size than face-to-face (0.62) and telephone (0.58) independently. CONCLUSION We conducted an analysis of data from various subgroups of preexisting studies, obtained an overall estimate of the effectiveness of the intervention, and compared its effectiveness across variables that affect intervention outcomes. IMPLICATIONS FOR PRACTICE These results provide empirical data for evidence-based practice and inform the development of useful intervention programs through a comprehensive review and meta-analysis of the results.
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22
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Saita E, Acquati C, Molgora S. Promoting Patient and Caregiver Engagement to Care in Cancer. Front Psychol 2016; 7:1660. [PMID: 27826279 PMCID: PMC5079095 DOI: 10.3389/fpsyg.2016.01660] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 10/11/2016] [Indexed: 11/13/2022] Open
Abstract
The positive outcomes associated with Patient Engagement (PE) have been strongly supported by the recent literature. However, this concept has been marginally addressed in the context of cancer. Limited attention has also received the role of informal caregivers in promoting physical and psychological well-being of patients, as well as the interdependence of dyads. The Cancer Dyads Group Intervention (CDGI) is a couple-based psychosocial intervention developed to promote engagement in management behaviors, positive health outcomes, and the quality of the relationship between cancer patients and their informal caregivers. The article examines the ability of the CDGI to promote adaptive coping behaviors and the perceived level of closeness by comparing cancer patients participating in the intervention and patients receiving psychosocial care at usual. Results indicate that individuals diagnosed with cancer attending the CDGI present significant increases in Fighting Spirit and Avoidance, while reporting also reduced levels of Fatalism and Anxious Preoccupation. Initial indications suggest that the intervention may contribute to strengthening the relationship with the primary support person.
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Affiliation(s)
- Emanuela Saita
- Department of Psychology, Università Cattolica del Sacro Cuore Milan, Italy
| | - Chiara Acquati
- Graduate College of Social Work, University of Houston Houston, TX, USA
| | - Sara Molgora
- Department of Psychology, Università Cattolica del Sacro Cuore Milan, Italy
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Yu NX, Chan CLW, Zhang J. Dyadic Effects of Stigma and Discrimination on Distress in Chinese HIV Discordant Couples. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2016; 28:277-286. [PMID: 27427923 DOI: 10.1521/aeap.2016.28.4.277] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The present study investigated the dyadic effects of stigma and discrimination on distress in Chinese couples affected by HIV. Chinese people living with HIV (PLHIV) and their seronegative spouses (N = 119 couples) participated in this study. The PLHIV completed measures on stigma beliefs about being better off dead and dignity-related distress. The spouses completed measures on perceived discrimination and exclusion and caregiver distress. The results showed that there was no significant correlation between the PLHIV's stigma beliefs and the spouses' perceived discrimination and exclusion. The couples showed significant associations in their dignity-related distress and caregiver distress. Analyses using the actor-partner interdependence model showed that PLHIV's stigma beliefs and the spouses' perceived discrimination and exclusion both had significant actor and partner effects on distress within the dyad. Psychosocial interventions aiming for distress reduction in the context of HIV should tackle stigma and discrimination and target the couples rather than solely the patient or spouse.
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Affiliation(s)
- Nancy Xiaonan Yu
- Department of Applied Social Sciences, City University of Hong Kong, Hong Kong, China
| | - Cecilia L W Chan
- Department of Social Work and Social Administration and Center on Behavioral Health, The University of Hong Kong, Hong Kong, China
| | - Jianxin Zhang
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China
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24
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White I. Sexual Difficulties after Pelvic Radiotherapy: Improving Clinical Management. Clin Oncol (R Coll Radiol) 2015; 27:647-55. [DOI: 10.1016/j.clon.2015.06.018] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 06/16/2015] [Accepted: 06/18/2015] [Indexed: 10/23/2022]
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Zimmermann T. Intimate Relationships Affected by Breast Cancer: Interventions for Couples. Breast Care (Basel) 2015. [PMID: 26195938 DOI: 10.1159/000381966] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
A cancer diagnosis imposes significant emotional distress on a substantial proportion of patients and their partners, posing many challenges for both members of a couple. Facing a breast cancer diagnosis, couples may experience psychosocial distress, which might also affect their individual and dyadic functioning. Coping with cancer from a couple-based perspective as a dyadic stressor can profoundly influence psychosocial adjustment as well as individual and dyadic functioning of patients and spouses. Dyadic coping allows a better matching of needs, sharing of worries, and mutual support, resulting in higher relationship satisfaction. The aim of this article is to provide an overview of the issues faced by women diagnosed with breast cancer and their spouses, with particular emphasis on interventions for couples coping with cancer. The effectiveness of couple-based interventions is summarized with a critical discussion. For further research, a better understanding of the challenges couples coping with cancer may face and more insights on how to improve interventions for couples might facilitate improvements in the quality of cancer care.
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Affiliation(s)
- Tanja Zimmermann
- Clinic for Psychosomatics and Psychotherapy, Hanover Medical School, Hanover, Germany
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Carolan CM, Smith A, Forbat L. Conceptualising psychological distress in families in palliative care: Findings from a systematic review. Palliat Med 2015; 29:605-32. [PMID: 25802323 DOI: 10.1177/0269216315575680] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Adult palliative care patients and their family members experience significant psychological distress and morbidity. Psychosocial interventions adopting a systemic approach may provide a cogent model to improve the psychosocial care of families in palliative care. To facilitate design of these interventions, the construct of psychological distress in families in palliative care should be empirically derived. AIM To ascertain how psychological distress is conceptualised in families receiving palliative care. DESIGN A systematic review of the literature; this was followed by a thematic analysis and narrative synthesis. DATA SOURCES Using pre-defined search terms, four electronic databases (MEDLINE, CINAHL, PsycINFO and Behavioural Sciences collections) were searched with no date restrictions imposed. Pre-determined inclusion and exclusion criteria were then applied. RESULTS A total of 32 papers were included in the review. Two findings emerged from data synthesis. First, distress is conceptualised as a multi-dimensional construct but little consensus exists as to how to capture and measure distress. Second, distress in the families within these studies can be conceptualised using a tiered approach, moving from individual non-interactive depictions of distress through gradations of interaction to convey a systemic account of distress within the family system. Thus, distress shifts from a unitary to a systemic construct. CONCLUSION Currently, there is a paucity of research examining distress informed by family systems theories. This review proposes that distress in families in palliative care can be conceptualised and illustrated within a tiered model of distress. Further research is merited to advance current explanatory frameworks and theoretical models of distress.
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Affiliation(s)
- Clare M Carolan
- School of Health Sciences, University of Stirling (Western Isles Campus), Stornoway, UK
| | - Annetta Smith
- School of Health Sciences, University of Stirling (Western Isles Campus), Stornoway, UK
| | - Liz Forbat
- School of Health Sciences, University of Stirling (Stirling Campus), Stirling, UK
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A preliminary study to develop an intervention to facilitate communication between couples in advanced cancer. Palliat Support Care 2015; 13:1381-90. [DOI: 10.1017/s1478951514001333] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjective:Psychosocial interventions directed to couples where one has advanced cancer can reduce distress, enhance communication, and provide an opportunity for relational growth. The present study aimed to develop an intervention to facilitate communication about living with advanced cancer using the Patient Dignity Inventory (PDI) as the focus of a clinical interview with couples toward the end of life.Method:Couples were recruited from oncology and palliative care services at a Sydney hospital. After the PDI was developed and manualized as an intervention for couples, the PDI–Couple Interview (PDI–CI) was delivered by a clinical psychologist and comprised the following: (1) the patient completed the PDI; (2) the patient's identified partner completed the PDI about how they thought the patient was feeling; and (3) the clinician reviewed the results with the couple, summarizing areas of concurrence and discordance and facilitating discussion.Results:Some 34 couples were referred, of which 12 consented, 9 of whom completed the clinical interview. Reported benefits included enabling couples to express their concerns together, identifying differences in understanding, and giving “permission to speak” with each other. The focus of the interview around the PDI provided a structure that was particularly acceptable for men. Most couples confirmed that they were “on the same page,” and where differences were identified, it provided a forum for discussion and a mutual understanding of the challenges in managing advanced cancer within a supportive context.Significance of Results:Participant couples' experiences of the PDI–CI provide valuable insight into the benefits of this intervention. This preliminary study indicates that the intervention is a relatively simple means of enhancing closer communication and connection between couples where one has advanced cancer and may be an important adjunct in helping prepare couples for the challenges inherent toward the end of life. Further investigation of feasibility with a larger sample is recommended.
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Hopkinson JB, Richardson A. A mixed-methods qualitative research study to develop a complex intervention for weight loss and anorexia in advanced cancer: the Family Approach to Weight and Eating. Palliat Med 2015; 29:164-76. [PMID: 25501313 DOI: 10.1177/0269216314556924] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Worldwide, most people with incurable cancer experience weight loss and anorexia. These symptoms can distress patients and their family caregivers. Interventions that take account of the relationship between patient and family caregiver may improve outcomes for both members of this dyad. AIM To report an example of process for the development of a complex intervention, the Family Approach to Weight and Eating. DESIGN A mixed-methods process informed by the Medical Research Council's guidelines for developing a complex intervention was used to develop a psychosocial intervention for patients with incurable cancer and weight loss or poor appetite and their family caregivers and then to test for its feasibility, acceptability and perceived benefit. SETTING South of England in 2010/2011. PARTICIPANTS A purposive sample of patient-family caregiver dyads under the care of a specialist community palliative care team. Patient participants had incurable cancer and were cachectic or at risk of cachexia. RESULTS The patient-family caregiver dyads comprised seven female and nine male patients (age range 41-84 years) and their carers. The emergent form of the Family Approach to Weight and Eating was found to aid family talk about food, feelings and reciprocity, without adverse consequences. Of the dyads, 15 reported benefits of the Family Approach to Weight and Eating. Three patient participants spoke of the approach evoking sadness and three carers of guilt. CONCLUSION The Family Approach to Weight and Eating should now be tested in a pilot trial and the effect on emotional health outcomes in patients and their family caregivers evaluated.
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Affiliation(s)
- Jane B Hopkinson
- School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Alison Richardson
- University Hospital Southampton NHS Foundation Trust, Southampton, UK Faculty of Health Sciences, University of Southampton, Southampton, UK
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29
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Bitz C, Clark K, Vito C, Kruper L, Ituarte PHG, Loscalzo M. Partners' clinic: an innovative gender strengths-based intervention for breast cancer patients and their partners immediately prior to initiating care with their treating physician. Psychooncology 2014; 24:355-8. [DOI: 10.1002/pon.3604] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 05/16/2014] [Accepted: 05/23/2014] [Indexed: 11/11/2022]
Affiliation(s)
- Courtney Bitz
- Department of Supportive Care Medicine; City of Hope; Duarte CA USA
| | - Karen Clark
- Department of Supportive Care Medicine; City of Hope; Duarte CA USA
| | - Courtney Vito
- Division of Surgical Oncology; City of Hope; Duarte CA USA
| | - Laura Kruper
- Division of Surgical Oncology; City of Hope; Duarte CA USA
| | - Philip H. G. Ituarte
- Department of Surgery, Division of Surgical Oncology; City of Hope; Duarte CA USA
| | - Matthew Loscalzo
- Department of Supportive Care Medicine; City of Hope; Duarte CA USA
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30
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Li Q, Loke AY. A systematic review of spousal couple-based intervention studies for couples coping with cancer: direction for the development of interventions. Psychooncology 2014; 23:731-9. [DOI: 10.1002/pon.3535] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2013] [Revised: 03/01/2014] [Accepted: 03/05/2014] [Indexed: 12/11/2022]
Affiliation(s)
- Qiuping Li
- Wuxi Medical School; Jiangnan University; Wuxi Jiangsu Province China
| | - Alice Yuen Loke
- School of Nursing; The Hong Kong Polytechnic University; Hung Hom Kowloon Hong Kong China
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Romito F, Goldzweig G, Cormio C, Hagedoorn M, Andersen BL. Informal caregiving for cancer patients. Cancer 2013; 119 Suppl 11:2160-9. [PMID: 23695928 DOI: 10.1002/cncr.28057] [Citation(s) in RCA: 150] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Revised: 11/29/2012] [Accepted: 11/30/2012] [Indexed: 01/08/2023]
Abstract
According to the recent worldwide estimation by the GLOBOCAN project, in total, 12.7 million new cancer cases and 7.6 million cancer deaths occurred in 2008. The worldwide number of cancer survivors within 5 years of diagnosis has been estimated at be almost 28.8 million. Informal caregivers, such as family members and close friends, provide essential support to cancer patients. The authors of this report provide an overview of issues in the study of informal caregivers for cancer patients and long-term survivors in the United States and Europe, characterizing the caregivers commonly studied; the resources currently available to them; and their unmet needs, their psychosocial outcomes, and the psychosocial interventions tailored to their special circumstances. A broad overview of the state of research and knowledge, both in Europe and the United States, and observations on the directions for future research are provided.
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Affiliation(s)
- Francesca Romito
- Experimental Unit of Psycho-Oncology, Department of Critical Area and Surgery, National Cancer Research Center Istituto Tumori Giovanni Paolo II, Bari, Italy.
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Brandão T, Schulz MS, Matos PM. Psychological intervention with couples coping with breast cancer: A systematic review. Psychol Health 2013; 29:491-516. [DOI: 10.1080/08870446.2013.859257] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Reid J, Scott D, Santin O, Cardwell CR, Donnelly M, Kernohan WG, O'Halloran PD, Regan J, Porter S. Evaluation of a Psychoeducational intervention for patients with Advanced Cancer who have Cachexia and their lay Carers (EPACaCC): study protocol. J Adv Nurs 2013; 70:1174-83. [DOI: 10.1111/jan.12268] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Joanne Reid
- School of Nursing and Midwifery; Queen's University Belfast; UK
| | - David Scott
- School of Nursing and Midwifery; Queen's University Belfast; UK
| | - Olinda Santin
- School of Nursing and Midwifery; Queen's University Belfast; UK
| | - Chris R. Cardwell
- School of Medicine, Dentistry and Biomedical Sciences; Queen's University Belfast; UK
| | - Michael Donnelly
- School of Medicine, Dentistry and Biomedical Sciences; Queen's University Belfast; UK
| | - W. George Kernohan
- Institute of Nursing and Health Research; University of Ulster; Newtownabbey UK
| | | | - Joan Regan
- Marie Curie Hospice Belfast/Belfast Health and Social care Trust; UK
| | - Sam Porter
- School of Nursing and Midwifery; Queen's University Belfast; UK
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Regan T, Lambert SD, Kelly B. Uptake and attrition in couple-based interventions for cancer: perspectives from the literature. Psychooncology 2013; 22:2639-47. [DOI: 10.1002/pon.3342] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Revised: 05/26/2013] [Accepted: 05/27/2013] [Indexed: 11/08/2022]
Affiliation(s)
- Tim Regan
- Centre for Translational Neuroscience and Mental Health, Faculty of Health, School of Medicine and Public Health; University of Newcastle; Newcastle Australia
| | - Sylvie D. Lambert
- Ingram School of Nursing, Faculty of Medicine; McGill University; Montreal Canada
- Priority Research Centre for Translational Neuroscience and Mental Health; The University of Newcastle; Waratah Australia
| | - Brian Kelly
- Centre for Translational Neuroscience and Mental Health, Faculty of Health, School of Medicine and Public Health; University of Newcastle; Newcastle Australia
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Lambert SD, Girgis A, McElduff P, Turner J, Levesque JV, Kayser K, Mihalopoulos C, Shih STF, Barker D. A parallel-group, randomised controlled trial of a multimedia, self-directed, coping skills training intervention for patients with cancer and their partners: design and rationale. BMJ Open 2013; 3:bmjopen-2013-003337. [PMID: 23883890 PMCID: PMC3731770 DOI: 10.1136/bmjopen-2013-003337] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION Coping skills training interventions have been found to be efficacious in helping both patients and their partners manage the physical and emotional challenges they face following a cancer diagnosis. However, many of these interventions are costly and not sustainable. To overcome these issues, a self-directed format is increasingly used. The efficacy of self-directed interventions for patients has been supported; however, no study has reported on the outcomes for their partners. This study will test the efficacy of Coping-Together-a multimedia, self-directed, coping skills training intervention for patients with cancer and their partners. METHODS AND ANALYSIS The proposed three-group, parallel, randomised controlled trial will recruit patients diagnosed in the past 4 months with breast, prostate, colorectal cancer or melanoma through their treating clinician. Patients and their partners will be randomised to (1) a minimal ethical care (MEC) condition-selected Cancer Council New South Wales booklets and a brochure for the Cancer Council Helpline, (2) Coping-Together generic-MEC materials, the six Coping-Together booklets and DVD, the Cancer Council Queensland relaxation audio CD and login to the Coping-Together website or (3) Coping-Together tailored-MEC materials, the Coping-Together DVD, the login to the website and only those Coping-Together booklet sections that pertain to their direct concerns. Anxiety (primary outcome), distress, depression, dyadic adjustment, quality of life, illness or caregiving appraisal, self-efficacy and dyadic and individual coping will be assessed before receiving the study material (ie, baseline) and again at 3, 6 and 12 months postbaseline. Intention-to-treat and per protocol analysis will be conducted. ETHICS AND DISSEMINATION This study has been approved by the relevant local area health and University ethics committees. Study findings will be disseminated not only through peer-reviewed publications and conference presentations but also through educational outreach visits, publication of lay research summaries in consumer newsletters and publications targeting clinicians. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12613000491763 (03/05/2013).
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Badr H, Krebs P. A systematic review and meta-analysis of psychosocial interventions for couples coping with cancer. Psychooncology 2012; 22:1688-704. [PMID: 23045191 DOI: 10.1002/pon.3200] [Citation(s) in RCA: 229] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2012] [Revised: 08/30/2012] [Accepted: 09/07/2012] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Quality of life (QOL) is a multidimensional construct that includes physical, psychological, and relationship well-being. METHODS We conducted a systematic review and meta-analysis of randomized controlled studies published between 1980 and 2012 of interventions conducted with both cancer patients and their partners that were aimed at improving QOL. Using bibliographic software and manual review, two independent raters reviewed 752 articles with a systematic process for reconciling disagreement, yielding 23 articles for systematic review and 20 for meta-analysis. RESULTS Most studies were conducted in breast and prostate cancer populations. Study participants (N = 2645) were primarily middle aged (mean = 55 years old) and white (84%). For patients, the weighted average effect size (g) across studies was 0.25 (95% CI = 0.12-0.32) for psychological outcomes (17 studies), 0.31 (95% CI = 0.11-0.50) for physical outcomes (12 studies), and 0.28 (95% CI = 0.14-0.43) for relationship outcomes (10 studies). For partners, the weighted average effect size was 0.21 (95% CI = 0.08-0.34) for psychological outcomes (12 studies) and 0.24 (95% CI = 0.6-0.43) for relationship outcomes (7 studies). CONCLUSION Therefore, couple-based interventions had small but beneficial effects in terms of improving multiple aspects of QOL for both patients and their partners. Questions remain regarding when such interventions should be delivered and for how long. Identifying theoretically based mediators and key features that distinguish couple-based from patient-only interventions may help strengthen their effects on patient and partner QOL.
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Affiliation(s)
- Hoda Badr
- Oncological Sciences, Mount Sinai School of Medicine, New York, NY 10029, USA.
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Regan TW, Lambert SD, Girgis A, Kelly B, Kayser K, Turner J. Do couple-based interventions make a difference for couples affected by cancer? A systematic review. BMC Cancer 2012; 12:279. [PMID: 22769228 PMCID: PMC3464780 DOI: 10.1186/1471-2407-12-279] [Citation(s) in RCA: 118] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2011] [Accepted: 06/21/2012] [Indexed: 11/10/2022] Open
Abstract
Background With the growing recognition that patients and partners react to a cancer diagnosis as an interdependent system and increasing evidence that psychosocial interventions can be beneficial to both patients and partners, there has been a recent increase in the attention given to interventions that target couples. The aim of this systematic review was to identify existing couple-based interventions for patients with cancer and their partners and explore the efficacy of these interventions (including whether there is added value to target the couple versus individuals), the content and delivery of couple-based interventions, and to identify the key elements of couple-based interventions that promote improvement in adjustment to cancer diagnosis. Method A systematic review of the cancer literature was performed to identify experimental and quasi-experimental couple-based interventions published between 1990 and 2011. To be considered for this review, studies had to test the efficacy of a psychosocial intervention for couples affected by cancer. Studies were excluded if they were published in a language other than English or French, focused on pharmacological, exercise, or dietary components combined with psychosocial components, or did not assess the impact of the intervention on psychological distress (e.g., depression, anxiety) or quality of life. Data were extracted using a standardised data collection form, and were analysed independently by three reviewers. Results Of the 709 articles screened, 23 were included in this review. Couple-based interventions were most efficacious in improving couple communication, psychological distress, and relationship functioning. Interventions had a limited impact on physical distress and social adjustment. Most interventions focused on improving communication and increasing understanding of the cancer diagnosis within couples. Interventions were most often delivered by masters-level nurses or clinical psychologists. Although most were delivered in person, few were telephone-based. No difference in efficacy was noted based on mode of delivery. Factors associated with uptake and completion included symptom severity, available time and willingness to travel. Conclusion Given effect sizes of couple-based interventions are similar to those reported in recent meta-analyses of patient-only and caregiver-only interventions (~d=.35-.45), it appears couple-based interventions for patients with cancer and their partners may be at least as efficacious as patient-only and caregiver-only interventions. Despite evidence that couple-based interventions enhance psycho-social adjustment for both patients and partners, these interventions have not yet been widely adopted. Although more work is needed to facilitate translation to routine practice, evidence reviewed is promising in reducing distress and improving coping and adjustment to a cancer diagnosis or to cancer symptoms.
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Affiliation(s)
- Tim W Regan
- Centre for Translational Neuroscience and Mental Health, Faculty of Health, School of Medicine and Public Health, The University of Newcastle, Newcastle, Australia.
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Hollist CS, Falceto OG, Ferreira LM, Miller RB, Springer PR, Fernandes CLC, Nunes NA. Portuguese translation and validation of the Revised Dyadic Adjustment Scale. JOURNAL OF MARITAL AND FAMILY THERAPY 2012; 38 Suppl 1:348-358. [PMID: 22765345 DOI: 10.1111/j.1752-0606.2012.00296.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The absence of a translated and validated instrument for measuring marital satisfaction in Brazil, the largest country in South America and fifth most populous country in the world, is a significant barrier for research and mental health service delivery. The purpose of this study was to translate and validate a marital satisfaction scale into Portuguese that would have both empirical credibility and cultural relevance in Brazil. A six-step serial approach was used to simultaneously translate and culturally validate the Revised Dyadic Adjustment Scale (RDAS). The translated instrument (RDAS-P) demonstrated good psychometric properties during field testing.
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Affiliation(s)
- Cody S Hollist
- Department of Child, Youth and Family Studies, University of Nebraska-Lincoln, 130 Mable Lee Hall, Lincoln, Nebraska 68588, USA.
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Applebaum AJ, DuHamel KN, Winkel G, Rini C, Greene PB, Mosher CE, Redd WH. Therapeutic alliance in telephone-administered cognitive-behavioral therapy for hematopoietic stem cell transplant survivors. J Consult Clin Psychol 2012; 80:811-6. [PMID: 22468908 DOI: 10.1037/a0027956] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE A strong therapeutic alliance has been found to predict psychotherapeutic treatment success across a variety of therapeutic modalities and patient populations. However, only a few studies have examined therapeutic alliance as a predictor of psychotherapy outcome among cancer survivors, and none have examined this relation in telephone-administered cognitive-behavioral therapy (T-CBT). This study evaluated the extent to which therapeutic alliance affected psychotherapy outcomes in survivors of hematopoietic stem cell transplantation (HSCT), a treatment for some cancers. METHOD Forty-six patients enrolled in a randomized clinical trial of T-CBT for posttraumatic stress disorder (PTSD) completed a baseline assessment (including self-report measures of PTSD symptoms, depression, and general distress), 10 individual T-CBT sessions, and follow-up assessments at 6, 9, and 12 months post-baseline. Therapeutic alliance was assessed after the 3rd T-CBT session with the Working Alliance Inventory, which yields overall and subscale (task, bond, and goal) scores. RESULTS Analyses revealed that higher total therapeutic alliance scores prospectively predicted decreased depressive symptomatology; higher task scores predicted decreased overall distress, depressive symptomatology, symptoms of re-experiencing, and avoidance; and higher bond scores predicted decreased depressive symptomatology and symptoms of re-experiencing. CONCLUSIONS These results suggest that assessments of therapeutic alliance should be incorporated into routine clinical care, and therapeutic alliance should be specifically cultivated in interventions to maximize psychotherapeutic benefits involving vulnerable populations such as cancer survivors.
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Affiliation(s)
- Allison J Applebaum
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, 641 Lexington Ave., New York, NY 10022, USA.
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Pollack LA, Hawkins NA, Peaker BL, Buchanan N, Risendal BC. Dissemination and translation: a frontier for cancer survivorship research. Cancer Epidemiol Biomarkers Prev 2012; 20:2093-8. [PMID: 21980017 DOI: 10.1158/1055-9965.epi-11-0652] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
As the field of survivorship research grows, the need for translation is imperative to expand new knowledge into arenas that directly impact survivors. This commentary seeks to encourage research focused on dissemination and translation of survivorship interventions and programs, including practice-based research. We overview diffusion, dissemination and translation in the context of cancer survivorship and present the RE-AIM and Knowledge to Action frameworks as approaches that can be used to expand research into communities. Many academic, governmental, and community-based organizations focus on cancer survivor. Future survivorship research should contribute to harmonizing these assets to identify effective interventions, maximize their reach and adoption, and integrate promising practices into routine care.
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Affiliation(s)
- Lori A Pollack
- Epidemiology and Applied Research Branch, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
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Hopkinson JB, Brown JC, Okamoto I, Addington-Hall JM. The effectiveness of patient-family carer (couple) intervention for the management of symptoms and other health-related problems in people affected by cancer: a systematic literature search and narrative review. J Pain Symptom Manage 2012; 43:111-42. [PMID: 21719250 DOI: 10.1016/j.jpainsymman.2011.03.013] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2011] [Revised: 03/14/2011] [Accepted: 03/15/2011] [Indexed: 11/28/2022]
Abstract
CONTEXT Cancer is widely acknowledged to impact on the whole family. Yet, we do not know if there is benefit (or harm) from patient-family carer interventions in the context of cancer care. OBJECTIVES To report a systematic search for and narrative review of patient-family carer interventions tested in the context of cancer care for effect on symptoms and other health-related problems in patients and/or their family members. METHODS A systematic literature search was carried out using Cochrane principles. Searches were of MEDLINE, EMBASE, PsycINFO, and CINAHL databases for reported trials of patient-family carer focused interventions. Outcomes of interest were health indicators; measures of physical, psychological, social, and quality-of-life status of the patient and/or family member(s). Limits were English language; 1998 to March 2010; and adults. Relevant information was extracted, quality assessed using the Cochrane Collaboration's tool for assessing risk of bias, and presented as a narrative synthesis (meta-analysis was not appropriate). RESULTS The review found no empirically tested interventions for family groups (patient and two or more family members), but 22 interventions for patient-family carer partnerships (couple interventions) tested in 23 studies and reported in 27 publications. Recruitment and attrition were problematic in these studies, limiting the reliability and generalizability of their results. CONCLUSION In the trials of cancer couple interventions included in the review, a pattern emerged of improvement in the emotional health of cancer patients and their carers when the intervention included support for the patient-family carer relationship. Further investigation is warranted.
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Piercy FP. It is not enough to be busy…. JOURNAL OF MARITAL AND FAMILY THERAPY 2012; 38:1-2. [PMID: 22283378 DOI: 10.1111/j.1752-0606.2011.00284.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Care needs after primary breast cancer treatment. Survivors' associated sociodemographic and medical characteristics. Psychooncology 2011; 22:125-32. [DOI: 10.1002/pon.2069] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2011] [Revised: 08/17/2011] [Accepted: 08/17/2011] [Indexed: 12/24/2022]
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Joseph LT, Griffith JL, Magley MA, Monson MR. Excessive Bickering Between a Lymphoma Patient and Her Spouse. Psychiatr Ann 2011. [DOI: 10.3928/00485713-20110829-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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