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Sterba KR, Armeson K, Zapka J, Garrett-Mayer E, Scallion ML, Wall TK, Olsen J, Graboyes EM, Alberg AJ, Day TA. A pilot randomized controlled trial to evaluate a survivorship care planning intervention for head and neck cancer survivor-caregiver dyads. J Cancer Surviv 2024; 18:398-411. [PMID: 35761129 DOI: 10.1007/s11764-022-01227-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 06/14/2022] [Indexed: 11/12/2022]
Abstract
PURPOSE Head and neck cancer (HNC) survivors and caregivers face significant challenges after treatment. This study's objective was to evaluate the effects of a dyadic survivorship care planning (SCP) intervention on survivor and caregiver outcomes. METHODS This randomized controlled trial enrolled HNC survivors and caregivers within 18 months post-treatment, randomized dyads to SCP (one-session with written SCP and follow-up telephone call) or usual care and administered baseline and 6-month surveys. Multivariable linear regression examined intervention effects on depression and unmet needs in dyads and burden on caregiverss and a set of secondary outcomes. Rating scales and open-ended questions assessed acceptability. RESULTS We randomized 89 survivor-caregiver dyads (42 usual care, 47 SCP dyads). Fidelity to SCP was high for most survivorship domains except discussing care barriers (13%). The most commonly discussed referrals included nutrition (83%) and behavioral medicine (38%), but referral uptake was low. The SCP intervention did not improve depression or unmet needs among dyads or burden among caregivers at 6 months relative to usual care (p's > .05). Nurses and dyads rated SCP favorably with > 80% positive ratings for session length and care plan content. Qualitative findings highlighted that SCP helped consolidate complex clinical information and strengthened survivor-caregiver-clinician relationships. CONCLUSIONS An HNC SCP intervention was acceptable but ineffective in improving dyads' outcomes. IMPLICATIONS FOR CANCER SURVIVORS Post-treatment SCP in HNC dyads was ineffective in improving outcomes in survivors and caregivers as delivered in this study. More research is needed to understand how to capitalize on the acceptability of the SCP approach and enhance its effectiveness to support dyads.
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Affiliation(s)
- Katherine R Sterba
- Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, 68 President Street, MSC 955, Charleston, SC, 29425, USA.
| | - Kent Armeson
- Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, 68 President Street, MSC 955, Charleston, SC, 29425, USA
| | - Jane Zapka
- Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, 68 President Street, MSC 955, Charleston, SC, 29425, USA
| | - Elizabeth Garrett-Mayer
- Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, 68 President Street, MSC 955, Charleston, SC, 29425, USA
| | - Megan L Scallion
- Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, 68 President Street, MSC 955, Charleston, SC, 29425, USA
| | - Tiffany K Wall
- Department of Otolaryngology-Head and Neck Surgery and Hollings Cancer Center, Medical University of South Carolina, 87 Jonathan Lucas Street MSC 955, Charleston, SC, 29425, USA
| | - Jama Olsen
- Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, 68 President Street, MSC 955, Charleston, SC, 29425, USA
| | - Evan M Graboyes
- Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, 68 President Street, MSC 955, Charleston, SC, 29425, USA
- Department of Otolaryngology-Head and Neck Surgery and Hollings Cancer Center, Medical University of South Carolina, 87 Jonathan Lucas Street MSC 955, Charleston, SC, 29425, USA
| | - Anthony J Alberg
- Department of Epidemiology and Biostatistics, University of South Carolina, 915 Greene Street Room 465, Columbia, SC, 29208, USA
| | - Terry A Day
- Department of Otolaryngology-Head and Neck Surgery and Hollings Cancer Center, Medical University of South Carolina, 87 Jonathan Lucas Street MSC 955, Charleston, SC, 29425, USA
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Rimmer B, Balla M, Dutton L, Lewis J, Burns R, Gallagher P, Williams S, Araújo-Soares V, Finch T, Sharp L. 'A Constant Black Cloud': The Emotional Impact of Informal Caregiving for Someone With a Lower-Grade Glioma. QUALITATIVE HEALTH RESEARCH 2024; 34:227-238. [PMID: 37967320 PMCID: PMC10768339 DOI: 10.1177/10497323231204740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
Those closest to people with lower-grade gliomas (LGGs) often assume the role of informal caregiver (IC). The additional responsibilities mean ICs of people with cancer can experience adverse impacts on their own lives. We explored the emotional impact of informal caregiving for people with LGGs. This was a descriptive qualitative study within the multi-method Ways Ahead project. We conducted semi-structured interviews with individuals from the United Kingdom, who currently, or in the past 5 years, informally cared for someone with an LGG. Interviews encompassed experiences of emotional impact as a consequence of caregiving for someone with an LGG. Inductive thematic analysis was undertaken. We interviewed 19 ICs (mean age 54.6 years; 14 females, 5 males). Participants reported substantial emotional impact. Four themes and associated subthemes were generated: Emotional responses to the illness (e.g. feeling helpless), Emotional responses to the unknown (e.g. anxiety about future uncertainty), Emotional consequences of care recipient changes (e.g. challenges of changed relationship dynamics), and Emotional weight of the responsibility (e.g. feeling burnout). Emotional impact in one area often exacerbated impact in another (e.g. future uncertainty impacted feelings of helplessness). Participants detailed the factors that helped them manage the emotional impact (e.g. being resilient). ICs of people with LGGs can experience wide-ranging emotional responses to and impacts of the illness, uncertain prognosis, care recipient changes, and the toll of caregiving. Adjustment and resilience are key protective factors, though further consideration of ways to identify and fulfil the emotional support needs of ICs of people with LGGs is required.
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Affiliation(s)
- Ben Rimmer
- Population Health Sciences Institute, Newcastle University, Newcastle University Centre for Cancer, Newcastle upon Tyne, England
| | - Michelle Balla
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, England
| | - Lizzie Dutton
- Population Health Sciences Institute, Newcastle University, Newcastle University Centre for Cancer, Newcastle upon Tyne, England
| | - Joanne Lewis
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, England
| | - Richéal Burns
- Faculty of Science, Atlantic Technological University, Sligo, Ireland
- Health and Biomedical Strategic Research Centre, Atlantic Technological University, Sligo, Ireland
| | | | - Sophie Williams
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, England
| | - Vera Araújo-Soares
- Population Health Sciences Institute, Newcastle University, Newcastle University Centre for Cancer, Newcastle upon Tyne, England
- Centre for Preventive Medicine and Digital Health, Department for Prevention of Cardiovascular and Metabolic Disease, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Tracy Finch
- Department of Nursing, Midwifery and Health, Northumbria University, Newcastle upon Tyne, England
| | - Linda Sharp
- Population Health Sciences Institute, Newcastle University, Newcastle University Centre for Cancer, Newcastle upon Tyne, England
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Webb K, Sharpe L, Butow P, Dhillon H, Zachariae R, Tauber NM, O'Toole MS, Shaw J. Caregiver fear of cancer recurrence: A systematic review and meta-analysis of quantitative studies. Psychooncology 2023; 32:1173-1191. [PMID: 37303263 DOI: 10.1002/pon.6176] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 05/10/2023] [Accepted: 05/25/2023] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Fear of cancer recurrence (FCR) is reported by both cancer survivors and caregivers however less is known about caregiver FCR. This study aimed to (a) conduct a meta-analysis to compare survivor and caregiver FCR levels; (b) examine the relationship between caregiver FCR and depression, and anxiety; (c) evaluate psychometric properties of caregiver FCR measures. METHODS CINAHL, Embase, PsychINFO and PubMed were searched for quantitative research examining caregiver FCR. Eligibility criteria included caregivers caring for a survivor with any type of cancer, reporting on caregiver FCR and/or measurement, published in English-language, peer-review journals between 1997 and November 2022. The COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) taxonomy was used to evaluate content and psychometric properties. The review was pre-registered (PROSPERO ID: CRD42020201906). RESULTS Of 4297 records screened, 45 met criteria for inclusion. Meta-analysis revealed that caregivers reported FCR levels as high as FCR amongst survivors, with around 48% of caregivers reporting clinically significant FCR levels. There was a strong correlation between anxiety and depression and medium correlation with survivor FCR. Twelve different instruments were used to measure caregiver FCR. Assessments using the COSMIN taxonomy revealed few instruments had undergone appropriate development and psychometric testing. Only one instrument met 50% or more of the criteria, indicating substantial development or validation components were missing in most. CONCLUSIONS Results suggest FCR is as often a problem for caregivers as it is for survivors. As in survivors, caregiver FCR is associated with more severe depression and anxiety. Caregiver FCR measurement has predominately relied on survivor conceptualisations and unvalidated measures. More caregiver-specific research is urgently needed.
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Affiliation(s)
- Kyra Webb
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
- The Psycho-oncology Co-operative Group (PoCoG), School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
| | - Louise Sharpe
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
| | - Phyllis Butow
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
- The Psycho-oncology Co-operative Group (PoCoG), School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
| | - Haryana Dhillon
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
- The Psycho-oncology Co-operative Group (PoCoG), School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
- Centre for Medical Psychology & Evidence-Based Decision Making (CeMPED), School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
| | - Robert Zachariae
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
- Department of Oncology, Unit for Psychooncology and Health Psychology (EPoS), Aarhus University Hospital, Aarhus, Denmark
| | - Nina Møller Tauber
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Mia Skytte O'Toole
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Joanne Shaw
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
- The Psycho-oncology Co-operative Group (PoCoG), School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
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Sharp L, Mentor K, Deane J, Watson E, Roberts KJ, Silva M, Phillips M, Siriwardena AK, Hammond J, Bradshaw A, Exley C, Pandanaboyana S. Assessing impact, needs and quality-of-life among informal carers of people with pancreatic cancer, a prospective study: the PAN-CARER study protocol. BMJ Open 2023; 13:e068178. [PMID: 37188466 DOI: 10.1136/bmjopen-2022-068178] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/17/2023] Open
Abstract
INTRODUCTION Approximately 10 300 people are diagnosed with pancreatic cancer each year in the UK. The cancer and its treatment inflict a significant physical, functional and emotional burden on patients. Research suggests that patients have many ongoing needs for support and care, but that these needs are not met by existing services. Family members often step in to fill this gap and provide support and care during and after treatment. Research in other cancers shows that this informal caregiving can place a very heavy burden on carers. However, there are few studies in the international literature that have focused on informal carers in pancreatic cancer; none have been conducted in the UK. METHODS AND ANALYSIS Two complementary research methods will be utilised. First, a longitudinal quantitative study of 300 carers investigating, using validated questionnaires to assess the impact of caregiving (Caregiver Reaction Assessment), the unmet needs of carers (Supportive Care Needs Survey) and the quality-of-life (Short Form 12-item health survey), will be conducted. Second, qualitative interviews will be conducted with up to 30 carers to explore their experiences in more depth. Mixed-effects regression models will be applied to survey results to determine how impact, needs and quality-of-life vary over time, compare outcomes between carers of patients with operable and inoperable disease and identify social factors which affect outcomes. Interview data will undergo reflexive thematic analysis. ETHICS AND DISSEMINATION The protocol has been approved by the Health Research Authority of the UK (Ethical approval IRAS ID 309503). Findings will be published in peer-reviewed journals and presented at national and international conferences.
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Affiliation(s)
- Linda Sharp
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Keno Mentor
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
- HPB and Transplant Unit, Freeman Hospital, Newcastle upon Tyne, UK
| | - Jennifer Deane
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Eila Watson
- Clinical Health Care, Oxford Brookes University, Oxford, UK
| | - Keith J Roberts
- Liver Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Michael Silva
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | | | | | - John Hammond
- HPB and Transplant unit, Freeman Hospital, Newcastle upon Tyne, UK
| | - Alex Bradshaw
- Sunderland Royal Hospital, Sunderland, Tyne and Wear, UK
| | - Catherine Exley
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Sanjay Pandanaboyana
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
- HPB and Transplant unit, Freeman Hospital, Newcastle upon Tyne, UK
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van Hof KS, Hoesseini A, Dorr MC, Verdonck-de Leeuw IM, Jansen F, Leemans CR, Takes RP, Terhaard CHJ, de Jong RJB, Sewnaik A, Offerman MPJ. Unmet supportive care needs among informal caregivers of patients with head and neck cancer in the first 2 years after diagnosis and treatment: a prospective cohort study. Support Care Cancer 2023; 31:262. [PMID: 37052712 PMCID: PMC10101897 DOI: 10.1007/s00520-023-07670-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 03/05/2023] [Indexed: 04/14/2023]
Abstract
OBJECTIVE Informal caregivers of head and neck cancer (HNC) patients have a high caregiver burden and often face complex practical caregiving tasks. This may result in unmet supportive care needs, which can impact their quality of life (QoL) and cause psychological distress. In this study, we identify caregivers' unmet needs during long-term follow-up and identify caregivers prone to unmet supportive care needs. METHODS Data were used from the multicenter prospective cohort study NETherlands QUality of life and Biomedical cohort studies In Cancer (NET-QUBIC). The unmet supportive care needs, psychological distress, caregiver burden, and QoL were measured for 234 informal caregivers and their related patients at baseline, 3, 6, 12, and 24 months after. Mixed effect models for repeated measurements were used. RESULTS At baseline, most caregivers (70.3%) reported at least one unmet supportive care need, with most of the identified needs in the "healthcare & illness" domain. During the follow-up period, caregivers' unmet needs decreased significantly in all domains. Nevertheless, 2 years after treatment, 28.3% were still reporting at least one unmet need. Financial problems were increasingly associated with unmet needs over time. Furthermore, caring for a patient who themselves had many unmet needs, an advanced tumor stage, or severe comorbidity was associated with significantly more unmet needs in caregivers. CONCLUSIONS The current study shows the strong likelihood of caregivers of HNC patients facing unmet supportive care needs and the interaction between the needs of patients and caregivers. It is important to optimally support informal caregivers by involving them from the start when counseling patients, by providing them with relevant and understandable information, and by referring vulnerable caregivers for (psychosocial) support.
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Affiliation(s)
- Kira S van Hof
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands.
| | - Arta Hoesseini
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Maarten C Dorr
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Irma M Verdonck-de Leeuw
- Department of Otolaryngology and Head and Neck Surgery, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Cancer Center Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Treatment and Quality of Life, Amsterdam, The Netherlands
- Department Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Van Der Boechorststraat 7-9, Amsterdam, The Netherlands
- Amsterdam Public Health, Mental Health, Amsterdam, The Netherlands
| | - Femke Jansen
- Department of Otolaryngology and Head and Neck Surgery, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Cancer Center Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Department Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Van Der Boechorststraat 7-9, Amsterdam, The Netherlands
| | - C Réne Leemans
- Department of Otolaryngology and Head and Neck Surgery, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Cancer Center Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Robert P Takes
- Department of Otolaryngology and Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Chris H J Terhaard
- Department of Radiation Oncology, University Medical Center, Utrecht, The Netherlands
| | - Robert J Baatenburg de Jong
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Aniel Sewnaik
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Marinella P J Offerman
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
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Benyo S, Phan C, Goyal N. Health and Well-Being Needs Among Head and Neck Cancer Caregivers - A Systematic Review. Ann Otol Rhinol Laryngol 2023; 132:449-459. [PMID: 35549916 PMCID: PMC9989224 DOI: 10.1177/00034894221088180] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE This review provides a summary of the current understanding of the health and well-being of the head and neck cancer (HNC) caregiver. Our goal is to understand the healthcare needs required by the caregivers of our oncologic patients, which may ultimately influence quality of care and support that cancer patients require during treatment and recovery. METHODS Independent database searches were conducted to identify articles describing HNC caregiver health and healthcare utilization. Search terms included key synonyms for head and neck cancer, caregiver, psychological stress, anxiety, depression, mental health service, and delivery of healthcare in the title/abstract. RESULTS After following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Protocol, a total of 21 studies were included. Among the 21 studies in the review, a total of 1745 caregivers were included. The average age was 57 years, the majority were female (58%-100%), and spouses/partners of the patients (77%). The literature demonstrates significant anxiety, depression, post-traumatic stress disorder (PTSD), and physical health decline in addition to multifaceted unmet physical and mental health needs among HNC caregivers. CONCLUSION There is no standard for examining HNC caregiver healthcare needs, while there is evidence of increased healthcare utilization. The literature is limited regarding medical burdens faced by caregivers. Future research is needed to assess the physical health and comorbidities of HNC caregivers and their engagement with the healthcare system to guide further implementation of support models to address the needs of this population.
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Affiliation(s)
- Sarah Benyo
- The Pennsylvania State University, College of Medicine, Hershey, PA, USA
| | - Chandat Phan
- The Pennsylvania State University, College of Medicine, Hershey, PA, USA
| | - Neerav Goyal
- Department of Otolaryngology – Head and Neck Surgery, The Pennsylvania State University, College of Medicine, Hershey, PA, USA
- Neerav Goyal, MD, MPH, FACS, Department of Otolaryngology – Head and Neck Surgery, The Pennsylvania State University College of Medicine, 500 University Drive, H091, Hershey, PA 17033-0850, USA.
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Pérez-Jiménez D, Monroy-López A, Villarreal-Garza C, Gálvez-Hernández CL. [Unmet needs in caregivers of patients with breast cancer: dyadic perception]. Rev Salud Publica (Bogota) 2023; 22:288-293. [PMID: 36753153 DOI: 10.15446/rsap.v22n3.85012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 06/23/2020] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE To analyze the unmet needs of informal caregivers of women with breast cancer (CaMa) from a dyadic perspective. METHOD An exploratory, cross-sectional and qualitative study was carried out through in-depth interviews, completed in the Department of Breast Tumors of the National Cancer Institute of Mexico. Three dyads (informal primary caregivers and patients, respectively) were included. The analysis was performed using an inductive approach. Interpretive descriptive analysis was chosen as the most appropriate methodological design. RESULTS The main unmet needs of the informal primary caregivers, perceived by the dyads, were psychological (such as the negative feelings caused by the mood changes of the patients) and informative (for example, the caregivers asked for information related to side effects and how to care and that the writing information use colloquial terms). CONCLUSIONS The unmet needs are the result of taking care, the level of affective commitment they have with the patient and the lack of training for care. The study highlights the relevance of planning interventions from a dyadic perspective.
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Affiliation(s)
- Diana Pérez-Jiménez
- DP: Psicóloga. Instituto Nacional de Cancerología. Ciudad de México. México.
| | - Alejandra Monroy-López
- AM: Trabajadora Social. Ph.D. Antropología. Escuela Nacional de Trabajo Social-UNAM. Ciudad de México, México.
| | - Cynthia Villarreal-Garza
- CV: MD. Esp. Médica. Ph.D. Ciencias Médicas e Investigación. Centro de Cáncer de Mama del Hospital Zambrano Hellion, Tecnológico de Monterrey, San Pedro Garza García, Nuevo León. Monterrey, México.
| | - Carmen L Gálvez-Hernández
- CG: Psicóloga. Ph.D. Psicología y Salud. Instituto Nacional de Cancerología. Ciudad de México, México.
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Christophe V, Anota A, Vanlemmens L, Cortot A, Ceban T, Piessen G, Charton E, Baudry AS. Unmet supportive care needs of caregivers according to medical settings of cancer patients: a cross-sectional study. Support Care Cancer 2022; 30:9411-9419. [PMID: 36205779 DOI: 10.1007/s00520-022-07379-7] [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: 03/21/2022] [Accepted: 09/26/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE The objectives of this study were to compare the unmet supportive care needs (SCN) of caregivers and describe the 10 most frequent of them according to various cancer settings: phase of cancer care pathway (i.e., treatment vs. follow-up), cancer site (i.e., breast, digestive, or lung cancer), and cancer status (i.e., metastatic vs. non-metastatic). METHODS Participants completed a self-reported questionnaire to assess their unmet SCN (SCNS-P&C). According to their cancer settings, non-parametric ANOVA or Mann-Whitney tests were performed to compare the SCNS-P&C scores. The prevalence of caregivers with unmet SCN was described using percentages. RESULTS Among 583 participants, 516 caregivers (88.5%) completed the SCNS-P&C questionnaire. Most patients had digestive (47.3%), non-metastatic cancer (67.6%) and were recruited during the follow-up phase (56.2%). The results revealed no significant difference in SCNS-P&C scores according to cancer settings except for caregivers of patients with metastatic cancer, who reported more unmet SCN related to health care service and information needs. The more qualitative item per item analysis seems to indicate the existence of five frequently unsatisfied SCN across situations, especially concerns about the recurrence and reduction of stress in patients, with variable ranking among the most unmet SCN. CONCLUSION Although there was no significant difference in unmet SCN scores between medical settings, examining the prevalence of unmet SCN helps identify the issues to focus on when supporting caregivers and developing dedicated consultations or interventions for them.
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Affiliation(s)
- Véronique Christophe
- CNRS, UMR 9193, SCALab, Sciences Cognitives et Sciences Affectives, Université de Lille, Rue du Barreau, BP 60149, 59653, Lille, Villeneuve d'Ascq cedex, France.
- Human and Social Sciences Department, Centre Léon Bérard, Lyon, France.
- Université Claude Bernard Lyon 1 , Centre de Recherche en Cancérologie de Lyon - UMR Inserm 1052 - CNRS 5286 - UCBL - CLB, Lyon, France.
| | - Amelie Anota
- Human and Social Sciences Department, Centre Léon Bérard, Lyon, France
- Department of Clinical Research and Innovation, Centre Léon Bérard, Lyon, France
- French National Platform Quality of Life and Cancer, Besançon, France
| | | | - Alexis Cortot
- Department of Thoracic Oncology, Albert Calmette University Hospital, Univ. Lille, Lille, France
| | - Tatiana Ceban
- Service d'Oncologie, Centre Hospitalier de Dunkerque, Dunkerque, France
| | - Guillaume Piessen
- CNRS, Inserm, CHU Lille, UMR9020-U1277, CANTHER, Cancer Heterogeneity, Plasticity and Resistance to Therapies, University Lille, F-59000, Lille, France
- Department of Digestive and Oncological Surgery, Claude Huriez University Hospital, University Lille, 59000, Lille, France
| | - Emilie Charton
- Human and Social Sciences Department, Centre Léon Bérard, Lyon, France
| | - Anne-Sophie Baudry
- CNRS, UMR 9193, SCALab, Sciences Cognitives et Sciences Affectives, Université de Lille, Rue du Barreau, BP 60149, 59653, Lille, Villeneuve d'Ascq cedex, France.
- Human and Social Sciences Department, Centre Léon Bérard, Lyon, France.
- Pôle Cancérologie et Spécialités Médicales, Centre Hospitalier de Valenciennes, Valenciennes, France.
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9
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François C, Maud V, Frederique B, Alison J, Solem Laviec H, Audrey R. Impact of Early Supportive Care Assessment on treatment decision in head and neck cancer before concomitant chemoradiotherapy. Support Care Cancer 2022; 30:6545-6553. [PMID: 35477810 DOI: 10.1007/s00520-022-07078-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 04/18/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To assess the impact of a global pretherapeutic comprehensive supportive care assessment performed in an outpatient supportive care clinic (OSCC) and early supportive care interventions on oncological treatment choice in patients with chemoradiation (CRT) indication for head and neck cancer (HNC). METHODS In this monocentric prospective observational study, we included all patients considered for CRT (exclusive or post-operative) for HNC from February 2019 to March 2020. The following frailty indicators were assessed: comorbidities (Charlson index), nutritional status, altered functional ability (ADL and IADL), social precarity (EPICES score), cognitive impairment (MoCA score), addictive habits and pain. RESULTS OSCC led to a change in treatment for 13.7% of patients, mainly de-escalations. Ninety-three percent of patients had at least one altered domain, including 50% with three or more altered domains. Cognitive function was the most frequently altered domain (66.7%). Altered functional ability was significantly associated with treatment de-escalation after OSCC. Treatment interruptions were significantly associated with treatment de-escalation and social precarity. De-escalation was also associated with a significantly poorer PFS (median of 23.2 mos. vs 8.8 mos., HR = 2.18 95%IC[1.02-4.63] p = 0.037)) and a non-significant trend towards worse OS (median 23.3mos. vs not reached (HR = 2.16 95%CI[0.88-5.31] p = 0.0836). CONCLUSION We strongly encourage the creation of OSCC for patients treated with chemoradiation for HNC. This practice, through an exhaustive assessment, favours therapeutic adaptation, personalized follow-up and optimization of supportive care.
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Affiliation(s)
- Cherifi François
- Medical Oncology Department, Centre François Baclesse, Caen, France.
| | - Villemin Maud
- Medical Oncology Department, Centre François Baclesse, Caen, France.,Medical Oncology Department, Centre Hospitalier Memorial, Saint-Lô, France
| | - Bisiaux Frederique
- Supportive Care Department, Centre François Baclesse, Baclesse, Caen, France
| | - Johnson Alison
- Medical Oncology Department, Centre Hospitalier Memorial, Saint-Lô, France
| | - Heidi Solem Laviec
- Supportive Care Department, Centre François Baclesse, Baclesse, Caen, France
| | - Rambeau Audrey
- Medical Oncology Department, Centre Hospitalier Memorial, Saint-Lô, France.,Supportive Care Department, Centre François Baclesse, Baclesse, Caen, France
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10
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Pape E, Decoene E, Debrauwere M, Van Nieuwenhove Y, Pattyn P, Feryn T, Pattyn P, Verhaeghe S, Van Hecke A, Vandecandelaere P, Desnouck S, Dejonckheere D, Debleu C, Leupe T, Deseyne P, Geboes K, Van de Putte D, van Ramshorst GH, Vlerick I. Experiences and needs of partners as informal caregivers of patients with major low anterior resection syndrome: A qualitative study. Eur J Oncol Nurs 2022; 58:102143. [DOI: 10.1016/j.ejon.2022.102143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 03/23/2022] [Accepted: 04/12/2022] [Indexed: 11/04/2022]
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11
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A systematic mixed studies review of fear of cancer recurrence in families and caregivers of adults diagnosed with cancer. J Cancer Surviv 2021; 16:1184-1219. [PMID: 34762248 DOI: 10.1007/s11764-021-01109-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 09/06/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE Fear of cancer recurrence (FCR) may be equally prevalent, persistent and burdensome in cancer caregivers as in survivors. This systematic review evaluated FCR prevalence, severity, correlates, course, impact and interventions in cancer caregivers. METHODS Electronic databases were searched from 1997 to May 2021. Two reviewers identified eligible peer-reviewed qualitative or quantitative studies on FCR in adult caregivers or family members of adult cancer survivors. The risk of bias was assessed using the Cochrane Risk of Bias tools for randomised and non-randomised studies and the Mixed-Methods Appraisal Tool. A narrative synthesis and thematic synthesis occurred on quantitative and qualitative studies, respectively. RESULTS Of 2418 papers identified, 70 reports (59 peer-reviewed articles, 11 postgraduate theses) from 63 studies were included. Approximately 50% of caregivers experienced FCR. Younger caregivers and those caring for survivors with worse FCR or overall health reported higher FCR. Most studies found caregivers' FCR levels were equal to or greater than survivors'. Caregivers' FCR was persistently elevated but peaked approaching survivor follow-up appointments. Caregivers' FCR was associated with poorer quality of life in caregivers and survivors. Three studies found couple-based FCR interventions were acceptable, but had limited efficacy. CONCLUSIONS FCR in caregivers is prevalent, persistent and burdensome. Younger caregivers of survivors with worse overall health or FCR are at the greatest risk. Further research on identifying and treating caregivers' FCR is required. IMPLICATIONS FOR CANCER SURVIVORS Caregiver and survivor FCR are similarly impactful and appear interrelated. Addressing FCR may improve outcomes for both cancer caregivers and survivors.
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12
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Identifying the unmet supportive care needs of people affected by kidney cancer: a systematic review. J Cancer Surviv 2021; 16:1279-1295. [PMID: 34595697 DOI: 10.1007/s11764-021-01113-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 09/09/2021] [Indexed: 12/15/2022]
Abstract
PURPOSE To synthesize existing evidence on the unmet supportive care needs of people affected by kidney cancer, across the cancer care continuum. METHODS A systematic review was conducted according to the PRISMA Statement Guidelines. Electronic databases (CINAHL, MEDLINE, and PsychINFO) were searched using key search terms. Articles were assessed according to pre-specified eligibility criteria. Data extraction and quality appraisal were conducted. The findings were integrated in a narrative synthesis. RESULTS One thousand sixty-three publications were screened, and 18 publications met the inclusion criteria. The following domains of unmet needs in order of frequency included psychological/emotional needs (17/18: 94%), physical needs (10/18: 56%), social needs (4/18: 22%), interpersonal/intimacy needs (4/18: 22%), patient-clinician communication needs (3/18: 17%), family-related needs (3/18: 17%), health system/information needs (3/18: 17%), spiritual needs (3/18: 17%), daily living needs (2/18: 11%), practical needs (1/18: 6%), and cognitive needs (1/18: 6%). CONCLUSIONS There was a wide range of unmet supportive care needs experienced by people diagnosed with kidney cancer. A prominent focus was on psychological and physical needs. Further research is needed to understand how clinical (stage/treatment) and demographic (age/socio-economic/ethnicity) variables may moderate or mediate the relationship with unmet needs over time. With many unmet needs identified, this review provides a starting place to inform future work to address the complex unmet supportive care needs of people affected by kidney cancer. IMPLICATIONS FOR CANCER SURVIVORS Individuals living with kidney cancer have many unmet supportive care needs, and future research is needed to learn about what are the most pressing needs and how to best address these concerns to ensure holistic person-centered care is delivered.
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13
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O'Rourke L, Fisher PL, Campbell S, Wright A, Cherry MG. Factors Associated With Fear of Cancer Recurrence in Family Caregivers of Cancer Survivors: A Systematic Review. Front Psychol 2021; 12:625654. [PMID: 34335354 PMCID: PMC8323753 DOI: 10.3389/fpsyg.2021.625654] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 02/08/2021] [Indexed: 11/20/2022] Open
Abstract
Objective: Fear of cancer recurrence (FCR) is a significant concern for family caregivers of cancer survivors and is associated with many adverse outcomes, including increased emotional distress and poorer quality of life. Although several theoretical models have been proposed to account for FCR in cancer survivors, their applicability to caregivers is unknown. The aim of this review was to identify clinical, demographic and psychological factors that are associated with, and predict, FCR in caregivers of cancer survivors. Method: AMED, CINAHL, Medline, PsycINFO, and Scopus were systematically searched for relevant studies reporting quantitative data on factors associated with FCR or similar constructs (e.g., worry or anxiety about cancer recurrence) in family caregivers of adult cancer survivors. Included studies were assessed for methodological quality using a standardized checklist adapted from the Agency for Healthcare Research and Quality. Results: Sixteen studies, half of which were cross-sectional, were included and summarized narratively. Non-modifiable factors, including age (n = 6) and treatment modality (n = 4), were found to be associated with increased FCR. Significant positive associations were also reported between illness perceptions and FCR (n = 3). However, there was heterogeneity across included studies with regards to factors examined and most were conducted in the USA. There were also several methodological limitations to the included studies. Conclusions: Research examining FCR in caregivers of cancer survivors has predominantly focused on demographic and clinical factors. Given the paucity of research exploring the psychological mechanisms underpinning FCR, future research should investigate theoretical underpinnings of FCR in caregivers of cancer survivors to support the development of psychological interventions for this population. Systematic Review Registration: PROSPERO, identifier [CRD42019119729].
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Affiliation(s)
- Louise O'Rourke
- Department of Primary Care and Mental Health, University of Liverpool, Whelan Building, Quadrangle, Liverpool, United Kingdom
| | - Peter L Fisher
- Department of Primary Care and Mental Health, University of Liverpool, Whelan Building, Quadrangle, Liverpool, United Kingdom.,Clinical Health Psychology Service, Linda McCartney Centre, Liverpool University National Heath Service Foundation Trust, Liverpool, United Kingdom
| | - Sophie Campbell
- Clinical Health Psychology Service, Linda McCartney Centre, Liverpool University National Heath Service Foundation Trust, Liverpool, United Kingdom
| | - Amelia Wright
- Department of Primary Care and Mental Health, University of Liverpool, Whelan Building, Quadrangle, Liverpool, United Kingdom
| | - Mary Gemma Cherry
- Department of Primary Care and Mental Health, University of Liverpool, Whelan Building, Quadrangle, Liverpool, United Kingdom.,Clinical Health Psychology Service, Linda McCartney Centre, Liverpool University National Heath Service Foundation Trust, Liverpool, United Kingdom
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14
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Abstract
OBJECTIVE Providing care to a loved one with cancer places demands on caregivers that result in changes to their daily routines and disruptions to their social relationships that then contribute to loneliness. Though caregivers' psychosocial challenges have been well studied, loneliness - a determinant of health - has not been well studied in this population. This narrative review sought to describe the current evidence on loneliness among caregivers of cancer patients. We aimed to (1) define loneliness, (2) describe its prevalence, (3) describe the association between loneliness and health outcomes, (4) describe risks and consequences of loneliness among cancer caregivers, (5) identify ways to assess loneliness, and (6) recommend strategies to mitigate loneliness in this unique population. METHOD We used evidence from articles listed in PubMed, PsycINFO, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases, book chapters, and reports. Articles were reviewed for the following inclusion criteria: (1) published in English, (2) caregivers of cancer patients, (3) loneliness as a study variable, and (4) peer-reviewed with no restriction on the timeframe of publication. Caregivers were defined as relatives, friends, or partners who provide most of the care and support for someone with cancer. RESULTS Eighteen studies met inclusion criteria and were included in the analysis. Caregivers' experiences of loneliness can contribute to negative effects on one's social, emotional, and physical well-being. Social support interventions may not be sufficient to address this problem. Existing recommendations to mitigate loneliness include cognitive and psychological reframing, one-on-one and group therapy, befriending, resilience training, and technology-based interventions. SIGNIFICANCE OF RESULTS Limited attention to loneliness in cancer caregivers poses a twofold problem that impacts patient and caregiver outcomes. Interventions are critically needed to address loneliness as a determinant of health in caregivers, given their pivotal role in providing care and impacting health outcomes for people with cancer.
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15
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Niu A, Guo C, Zhong D, He G, Zhong W, Wang L, Chen Y, Shang L, Fu J. Identifying the Unmet Supportive Care Needs, with Concomitant Influencing Factors, in Family Caregivers of Cancer Patients in China. Asia Pac J Oncol Nurs 2021; 8:276-286. [PMID: 33850961 PMCID: PMC8030597 DOI: 10.4103/apjon.apjon_52_20] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 08/19/2020] [Indexed: 12/24/2022] Open
Abstract
Objective The objective of the study is to assess the unmet needs of cancer caregivers and to identify the possible predictors of their supportive care needs in China. Methods This multicenter, cross-sectional study enrolled 449 cancer patients' family caregivers' dyads. Patients provided general information and Karnofsky performance status (KPS); caregivers provided general information and completed a survey of Chinese version of the Supportive Care Needs Survey-Partners and Caregivers Scale. The independent samples t-test, one-way analysis of variance, and multiple stepwise regression were used to analyze the factors that influence the needs of caregivers. Results A proportion of caregivers who had no needs were 5.6%. A proportion of caregivers with ≥ 5 moderate or high unmet needs and with ≥ 10 moderate or high unmet needs were 77.7% and 63.2%, respectively. Healthcare services and information needs and communication and relationship needs were the most prominent areas of caregivers' unmet needs. The item "Finding out about financial support and government benefits for you and/or the person with cancer" was the highest level of unmet needs at 78.6%. The level of unmet needs was related to the patient's physical function (KPS score), caregiver's educational levels, financial burden of healthcare, as well as the level of burden related to caregiving (working status, caring for others, caregiving experience, and total caregiving time). Conclusions The level of unmet needs of family caregivers of cancer patients in China was higher. In clinical practice, more attention should be paid to family caregivers who take care of the patient with poor physical function, those who are highly educated, faced with higher financial burden of healthcare, and are currently working, as well as those who need to take care of others, spend more time caregiving, and have no caregiving experience.
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Affiliation(s)
- Aifang Niu
- Department of Internal Medicine, 947 Army Hospital, Kashgar, China
| | - Chunyong Guo
- Department of Internal Medicine, 947 Army Hospital, Kashgar, China
| | - Daozhu Zhong
- Department of Internal Medicine, 947 Army Hospital, Kashgar, China
| | - Guirong He
- Department of Internal Medicine, 947 Army Hospital, Kashgar, China
| | - Wenbo Zhong
- Department of Internal Medicine, Xinjiang Military District General Hospital, Urumqi, Xinjiang, China
| | - Lanmei Wang
- Department of Internal Medicine, 947 Army Hospital, Kashgar, China
| | - Yu Chen
- Department of Internal Medicine, 947 Army Hospital, Kashgar, China
| | - Lei Shang
- Department of Preventive Medicine, Air Force Medical University, Xi'an, Shaanxi, China
| | - Jufang Fu
- Nursing Department, Shenzhen University General Hospital, Shenzhen, Guangdong, China
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16
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Wang T, Mazanec SR, Voss JG. Needs of Informal Caregivers of Patients With Head and Neck Cancer: A Systematic Review. Oncol Nurs Forum 2021; 48:11-29. [PMID: 33337440 DOI: 10.1188/21.onf.11-29] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PROBLEM IDENTIFICATION Informal caregivers for patients with head and neck cancer perform complex caregiving tasks on a daily basis, but caregivers' needs are rarely acknowledged or addressed in current healthcare practice. LITERATURE SEARCH A thorough review of CINAHL®, MEDLINE®/PubMed®, and PsycINFO® was conducted by the authors. DATA EVALUATION 266 manuscripts were identified, with no time limit. The search was conducted in November 2019. In total, 19 articles were included in the review. SYNTHESIS Throughout the disease trajectory, caregivers' psychological and emotional support needs are consistently high, whereas information needs diminish over time. IMPLICATIONS FOR PRACTICE Informal caregivers are imperative in supplementing the continuing care demands of people living with head and neck cancer; however, they are at risk for experiencing caregiving burden. Skill training and psychological support interventions are needed for educating and supporting caregivers.
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17
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Bamgboje-Ayodele A, Levesque JV, Gerges M, Girgis A. The male perspective: A mixed methods study of the impact, unmet needs and challenges of caring for women with breast cancer. J Psychosoc Oncol 2020; 39:235-251. [PMID: 33238814 DOI: 10.1080/07347332.2020.1850600] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES As a formative investigation toward the development of a supportive care intervention for male caregivers, this study explored the emotional impact, unmet needs and challenges experienced by men when caring for a woman with breast cancer. DESIGN A cross-sectional mixed methods study, with an online survey and interviews. SAMPLE A total of 89 participants completed the survey, of whom 13 completed interviews. The majority (93%) of participants were husbands of care recipients; of the care recipients, 75% had early stage breast cancer and 45% were diagnosed over 5 years ago. METHOD Participants completed questionnaires assessing their emotional wellbeing, unmet needs and biopsychosocial challenges, with a sub-sample participating in subsequent interviews to elaborate on survey responses. FINDINGS Emotional difficulty was reported by <25% of the sample, and 83% reported experiencing at least one unmet need (M = 81.5, SD = 33.2). Of the 39 biopsychosocial challenges presented, 100%, 86% and 73% reported "ever experiencing," "currently experiencing," and "ever needing help," respectively. Interviewed participants echoed the most reported needs and challenges as changes to sex life, fear of recurrence and lack of practical information. CONCLUSIONS Male cancer caregivers experience diverse challenges and require psychological support and practical information using both online and offline approaches to support their caregiving responsibilities. IMPLICATIONS FOR PSYCHOSOCIAL PROVIDERS Healthcare professionals can support male caregivers by: being aware of their information and psycho-social needs; directing caregivers to online interventions for additional information; and facilitating the provision of online psycho-sexual and FCR support.
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Affiliation(s)
- Adeola Bamgboje-Ayodele
- Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Sydney, Australia
| | - Janelle V Levesque
- Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Sydney, Australia.,School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Martha Gerges
- Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Sydney, Australia
| | - Afaf Girgis
- Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Sydney, Australia
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Wu VS, Smith AB, Girgis A. The unmet supportive care needs of Chinese patients and caregivers affected by cancer: A systematic review. Eur J Cancer Care (Engl) 2020; 31:e13269. [PMID: 32495473 DOI: 10.1111/ecc.13269] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 12/04/2019] [Accepted: 04/16/2020] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Cancer patients and caregivers have myriad unmet needs which can have detrimental consequences on their psychosocial wellbeing. This systematic review aims to identify the unmet supportive care needs of immigrant and native Chinese cancer patients and caregivers. METHODS We systematically searched various electronic databases (e.g. Scopus, CINAHL, PsycInfo, etc.) from the earliest date available until January 2018. Additional studies were identified through reference lists and citation tracking. Eligibility criteria included: (a) qualitative, quantitative and/or mixed methods studies published in English; (b) immigrant and native Chinese cancer patients and/or caregivers (age ≥18 years); (c) unmet needs and/or their correlates. Studies were assessed for their risk of bias, and a narrative synthesis of findings was performed. RESULTS Forty-seven papers from 45 studies met eligibility criteria. The most prevalent area of unmet needs was health system and information. Patients most commonly desired one member of the hospital to talk to about all aspects of their care. Caregivers preferred information about the patient's prognosis and likely outcome. Anxiety was most commonly associated with higher levels of health system and information needs. CONCLUSION Chinese patients and caregivers experience a range of unmet health system and information needs, which differ depending on their stage along the cancer trajectory.
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Affiliation(s)
- Verena Shuwen Wu
- Psycho-Oncology Research Group, 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, NSW, Australia
| | - Allan Ben Smith
- Psycho-Oncology Research Group, 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, NSW, Australia
| | - Afaf Girgis
- Psycho-Oncology Research Group, 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, NSW, Australia
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19
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Cognetti DM, Villaflor VM, Fakhry C, Miller MC, Malloy KM. Survivorship support in head and neck cancer: American Head and Neck Society survey. Head Neck 2020; 42:939-944. [DOI: 10.1002/hed.26066] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 11/24/2019] [Accepted: 12/17/2019] [Indexed: 12/20/2022] Open
Affiliation(s)
- David M. Cognetti
- Department of Otolaryngology, Sydney Kimmel Medical College at Thomas Jefferson University Philadelphia Pennsylvania
| | - Victoria M. Villaflor
- Department of Medical Oncology, Robert H Lurie Comprehensive Cancer Center of Northwestern University Chicago Illinois
| | - Carole Fakhry
- Department of Otolaryngology, Johns Hopkins University School of Medicine Baltimore Maryland
| | - Matthew C. Miller
- Department of Otolaryngology, University of Rochester School of Medicine Rochester New York
| | - Kelly M. Malloy
- Department of Otolaryngology, University of Michigan Medical School Ann Arbor Michigan
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20
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Profiles of caregivers most at risk of having unmet supportive care needs: Recommendations for healthcare professionals in oncology. Eur J Oncol Nurs 2019; 43:101669. [DOI: 10.1016/j.ejon.2019.09.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 09/24/2019] [Accepted: 09/29/2019] [Indexed: 12/18/2022]
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21
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Ergen M, Arikan F. Psychometric validation of the Turkish version of the Supportive Care Needs Survey for Partners and Caregivers (SCNS-P&C-T) of cancer patients. Eur J Cancer Care (Engl) 2019; 29:e13177. [PMID: 31571324 DOI: 10.1111/ecc.13177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 09/03/2019] [Accepted: 09/09/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To evaluate the validity and reliability study of the Supportive Care Needs Survey for partners and caregivers of cancer patients in Turkish society (SCNS-P&C-T). METHODS This cross-sectional survey followed by a test-retest reliability and psychometric validation study was conducted with 270 participants. The research data were collected using a patient and caregiver demographic survey, the SCNS-P&C-T, the Caregiver Strain Index, and the Hospital Anxiety and Depression Scale. RESULTS Ten expert opinions were found to be consistent for content validity of the scale (I-CVI = 0.993, S-CVI = 0.956). The confirmatory factor analysis could not confirm the factor structure of the original scale. Therefore, an exploratory factor analysis was performed and the scale factor structure was determined. These factor structures are (a) psychological and emotional needs, (b) health care and information, (c) work and social needs, (d) communication and family needs. CONCLUSION The SCNS-P&C-T is a valid and reliable tool which can be used to identify unmet needs among caregivers in Turkish populations.
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Affiliation(s)
- Mevlüde Ergen
- Department of Medical Oncology, Memorial Hospital, Antalya, Turkey
| | - Fatma Arikan
- Faculty of Nursing, Akdeniz University, Antalya, Turkey
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22
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Dri E, Bressan V, Cadorin L, Stevanin S, Bulfone G, Rizzuto A, Luca G. Providing care to a family member affected by head and neck cancer: a phenomenological study. Support Care Cancer 2019; 28:2105-2112. [PMID: 31396744 DOI: 10.1007/s00520-019-05026-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 08/01/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Cancer is recognized as a family illness as many head and neck cancer (HNC) patients after treatment require assistance from a family caregiver throughout the rest of their life. The purpose of this study was to explore the lived experience of primary family caregivers of HNC patients dealing with laryngectomy regarding their complex supportive role. METHODS Phenomenological study based on individual interviews of twelve primary caregivers of HNC patients, recruited by purposeful sampling. Interview contents were analyzed in depth, in accordance with Colaizzi's descriptive analysis framework, to explore and identify significant themes and subthemes. RESULTS Analysis evidenced three main topics and subthemes embracing various aspects of the caregiver's lived experiences: (1) experiencing disease and the pathway of care, (2) handling changes to everyday life, and (3) support received by others. CONCLUSION Given the essential role the caregiver has in the patient's post-treatment recovery, future planning of HNC patient care must consider the caregivers' needs. In order to guarantee an appropriate and effective health professional care, it is important to consider caregivers' issues and needs as part of HNC patient care planning from the diagnosis to the follow-up.
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Affiliation(s)
- Elisa Dri
- School of Nursing, Department of Medical and Biological Sciences, Udine University, Viale Ungheria 20, 33100, Udine, Italy
| | - Valentina Bressan
- School of Nursing, Department of Medical and Biological Sciences, Udine University, Viale Ungheria 20, 33100, Udine, Italy.
| | - Lucia Cadorin
- Continuing Education Centre, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Via Franco Gallini 2, 33081, Aviano, Italy
| | - Simone Stevanin
- Agency for Health and Social Care, Veneto Region, Palazzo Molin, San Polo 2514, 30125, Venice, Italy
| | | | - Antonio Rizzuto
- Department of ENT, University Hospital of Udine, Piazzale Santa Maria della Misericordia, 15, 33100, Udine, Italy
| | - Ghirotto Luca
- Direzione Scientifica, Azienda USL - IRCCS di Reggio Emilia, Viale Umberto I°, 50, 42123, Reggio Emilia, Italy
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Abstract
OBJECTIVES To review the family caregivers' unmet needs in the long-term phase of survivorship to identify unique challenges faced by family caregivers. DATA SOURCES Research-based articles and published reports. CONCLUSION Family caregivers diverge into three distinct groups in the long-term survivorship phase: those remaining in care, those whose patients have survived and where care is no longer needed, and those whose patients have died. Their primary unmet needs vary by the different caregivership trajectories. IMPLICATIONS FOR NURSING PRACTICE Comprehensive understanding of family caregivers' unmet needs is required to develop family caregiver care plans in long-term survivorship.
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Jansen F, Eerenstein SEJ, Lissenberg‐Witte BI, Uden‐Kraan CF, Leemans CR, Verdonck‐de Leeuw IM. Unmet supportive care needs in patients treated with total laryngectomy and its associated factors. Head Neck 2018; 40:2633-2641. [DOI: 10.1002/hed.25358] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 02/16/2018] [Accepted: 05/16/2018] [Indexed: 11/11/2022] Open
Affiliation(s)
- Femke Jansen
- Department of Otolaryngology ‐ Head and Neck Surgery, Cancer Center Amsterdam (CCA)VU University Medical Center Amsterdam The Netherlands
| | - Simone Elisabeth Jacoba Eerenstein
- Department of Otolaryngology ‐ Head and Neck Surgery, Cancer Center Amsterdam (CCA)VU University Medical Center Amsterdam The Netherlands
| | | | - Cornelia Foekje Uden‐Kraan
- Department of Clinical Psychology, Faculty Behavioural and Movement Sciences, Amsterdam Public Health Research InstituteVrije Universiteit Amsterdam Amsterdam The Netherlands
| | - Charles René Leemans
- Department of Otolaryngology ‐ Head and Neck Surgery, Cancer Center Amsterdam (CCA)VU University Medical Center Amsterdam The Netherlands
| | - Irma Maria Verdonck‐de Leeuw
- Department of Otolaryngology ‐ Head and Neck Surgery, Cancer Center Amsterdam (CCA)VU University Medical Center Amsterdam The Netherlands
- Department of Clinical Psychology, Faculty Behavioural and Movement Sciences, Amsterdam Public Health Research InstituteVrije Universiteit Amsterdam Amsterdam The Netherlands
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25
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Nguyen NTA, Ringash J. Head and Neck Cancer Survivorship Care: A Review of the Current Guidelines and Remaining Unmet Needs. Curr Treat Options Oncol 2018; 19:44. [DOI: 10.1007/s11864-018-0554-9] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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26
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Ringash J, Bernstein LJ, Devins G, Dunphy C, Giuliani M, Martino R, McEwen S. Head and Neck Cancer Survivorship: Learning the Needs, Meeting the Needs. Semin Radiat Oncol 2018; 28:64-74. [DOI: 10.1016/j.semradonc.2017.08.008] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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27
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In a bad place: Carers of patients with head and neck cancer experiences of travelling for cancer treatment. Eur J Oncol Nurs 2017; 30:29-34. [DOI: 10.1016/j.ejon.2017.07.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 06/21/2017] [Accepted: 07/01/2017] [Indexed: 11/24/2022]
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