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Sun H, Wacharasin C, Hengudomsub P. Change in resilience among spousal caregivers of patients with newly-diagnosed advanced cancer over the first six months posttreatment in China. J Psychosom Res 2024; 183:111538. [PMID: 38823371 DOI: 10.1016/j.jpsychores.2023.111538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 10/13/2023] [Accepted: 10/23/2023] [Indexed: 06/03/2024]
Abstract
OBJECTIVE A longitudinal observational study was conducted and aimed to examine the change in resilience among spousal caregivers of newly-diagnosed advanced cancer patients over the first six months after initial treatment. METHODS In total, 312 Chinese spousal caregivers who were taking care of their patients with newly-diagnosed advanced cancer were recruited. The level of resilience was measured using the Connor-Davidson Resilience Scale at the first month post-initial treatment (T1), three-month post-initial treatment (T2), and six-month post-initial treatment (T3). Latent growth modeling analyses were performed to examine changes in resilience using Mplus 8.3. RESULTS The mean scores of resilience in spousal caregivers were 54.01 ± 7.68 at T1, 56.20 ± 6.38 at T2, and 57.97 ± 6.70 at T3, respectively. Results of latent growth modeling indicated that spousal caregivers showed a significant increase in their resilience scores over the first six months post-treatment (Mean slope = 1.98, p < 0.001). Furthermore, a significant individual variation in the rate of changes in resilience scores allowed spouses to be categorized into two groups: 42.9% participants with fast growth and 57.1% participants with slight growth. CONCLUSION Our findings highlight the importance that new knowledge about change patterns of resilience in the nursing field is beneficial to reveal different psychosomatic health. Acknowledging that resilience is a dynamic process that changes over time, it is crucial for healthcare providers to monitor the psychological adjustment and focus of vulnerable caregivers, particularly spouses.
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Affiliation(s)
- Haiyan Sun
- Faculty of Nursing, Burapha University, Chon Buri 20131, Thailand; School of Nursing, Jiangsu Vocational College of Medicine, Jiangsu 224005, PR China
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Wazqar DY. Challenges Experienced by Saudi Patients With Cancer and Their Family Caregivers in Using Digital Healthcare Technology Platforms in the COVID-19 Pandemic. Comput Inform Nurs 2024; 42:495-503. [PMID: 38376412 DOI: 10.1097/cin.0000000000001087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
COVID-19 has provided a unique boost to the use of digital healthcare technology, putting many vulnerable people at risk of digital exclusion. To promote digital healthcare equity, it is important to identify the challenges that may inhibit cancer patients and family caregivers from benefiting from such technology. This study explored the challenges that cancer patients and family caregivers experience in using digital healthcare technology platforms during the COVID-19 pandemic. A qualitative descriptive study using face-to-face semistructured individual interviews was carried out. A purposive sample of 21 participants was recruited from a public cancer hospital in Saudi Arabia. Qualitative content analysis with an inductive approach was utilized. The factors that challenged the ability of participants to benefit from digital healthcare technology were similar. Four themes related to the challenges the two groups experienced emerged: access to platforms, use of platforms for cancer health-related purposes, attitudes toward these platforms, and individual user preferences. This study identified numerous areas for improvement regarding digital healthcare technology platform implementation, which could increase future benefits and equal use. This study's findings also provide useful information to investigators who intend to create digital nursing interventions for both groups amid COVID-19 and other worldwide health crises.
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Affiliation(s)
- Dhuha Youssef Wazqar
- Author Affiliation: Department of Medical Surgical Nursing, Faculty of Nursing, King Abdulaziz University, Jeddah, Saudi Arabia
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Cui P, Cheng C, An H, Chen X, Chen C, Hu H. A chain mediation model reveals the association between family sense of coherence and quality of life in caregivers of advanced cancer patients. Sci Rep 2024; 14:10701. [PMID: 38730003 PMCID: PMC11087510 DOI: 10.1038/s41598-024-61344-4] [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: 02/21/2024] [Accepted: 05/05/2024] [Indexed: 05/12/2024] Open
Abstract
Caregivers of advanced cancer patients face challenges impacting their quality of life (QoL). While evidence suggests that family sense of coherence (FSOC) can enhance individual psychological well-being and reduce distress symptoms, the precise mechanism through which FSOC improves caregivers' QoL remains unclear. This study aimed to explore the relationships among FSOC, psychological resilience, psychological distress, and QoL in primary caregivers of advanced cancer patients. A cross-sectional observational study was undertaken from June 2020 to March 2021 across five tertiary hospitals in China. Instruments included a general characteristic questionnaire, the Family Sense of Coherence Scale, the Patient Health Questionnaire-4, the 10-item Connor-Davidson Resilience Scale, and the 8-item SF-8 health survey. Pearson's correlation and chain mediation analyses were performed using IBM SPSS (version 21) and PROCESS macro (version 3.4). Out of 290 valid questionnaires, results demonstrated that FSOC directly and positively influences caregivers' QoL. Psychological distress partially mediated the FSOC-QoL association, with paths "FSOC-psychological distress-QoL" and "FSOC-psychological resilience-psychological distress-QoL" contributing 43.08% and 6.72% of the total effect, respectively. Furthermore, this study distinguished physical and mental aspects of QoL, confirming both conform to the chain mediation model. FSOC impacts caregivers' QoL directly and indirectly through the mediation of psychological distress and the chain mediation effect of "psychological resilience-psychological distress". These insights enhance our understanding of the complex interplay between FSOC and QoL, underscoring the potential benefits of bolstering FSOC to strengthen caregiver resilience, alleviate distress, and ultimately elevate their QoL.
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Affiliation(s)
- Panpan Cui
- Department of Nursing, Henan Provincial Key Medicine Laboratory of Nursing, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, No. 7 Weiwu Road, Zhengzhou, China
- School of Nursing, Zhengzhou University, Zhengzhou, China
| | - Chunyan Cheng
- Hematology Department, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Huiying An
- Gastroenterology, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Xinyi Chen
- Medical Oncology, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Changying Chen
- The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe Dong Road, Zhengzhou, China.
- Institute for Hospital Management of Henan Province, Zhengzhou, China.
| | - Hengyu Hu
- Department of Nursing, Henan Provincial Key Medicine Laboratory of Nursing, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, No. 7 Weiwu Road, Zhengzhou, China.
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Yuen EYN, Hale M, Wilson C. The role of social support among caregivers of people with cancer from Chinese and Arabic communities: a qualitative study. Support Care Cancer 2024; 32:310. [PMID: 38668869 PMCID: PMC11052886 DOI: 10.1007/s00520-024-08502-6] [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: 09/06/2023] [Accepted: 04/13/2024] [Indexed: 04/29/2024]
Abstract
PURPOSE Cancer caregivers from culturally and linguistically diverse (CALD) communities have reported significant unmet emotional support needs. This study aimed explore the role of social support to manage emotional wellbeing among cancer caregivers from Arabic and Chinese communities in Australia. METHODS Semi-structured interviews were conducted with Chinese (n = 12) and Arabic (n = 12) speaking cancer caregivers. Participants' mean age was 40.6 years; majority were female (83%) and providing care to a parent (41.67%). RESULTS Using thematic analysis to analyse interview data, five overarching themes emerged describing caregivers' perspectives on social support. Themes were related to the following: (1) receiving emotional support from social networks, (2) barriers to accessing emotional support from social networks, (3) isolation and loss of connection following the cancer diagnosis, (4) faith as a source of support, and (5) utility of support groups and caregiver advocates. Several caregivers relied on social networks for emotional support; however, caregivers identified key cultural and generational barriers to seeking support from their social networks which prevented caregivers from disclosing their emotions and caregiving situation. Caregivers also reported being isolated from their support system. CONCLUSION Empirical testing of culturally appropriate strategies that improve social support seeking among caregivers from CALD communities is recommended.
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Affiliation(s)
- Eva Y N Yuen
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Melbourne, Australia.
- Centre for Quality and Patient Safety, Monash Health, Melbourne, Australia.
- School of Psychology and Public Health, La Trobe University, Bundoora, VIC, Australia.
- Psycho-Oncology Research Unit, Olivia Newton John Centre, Austin Health, Heidelberg, VIC, Australia.
| | - Megan Hale
- School of Psychology and Public Health, La Trobe University, Bundoora, VIC, Australia
- Psycho-Oncology Research Unit, Olivia Newton John Centre, Austin Health, Heidelberg, VIC, Australia
| | - Carlene Wilson
- School of Psychology and Public Health, La Trobe University, Bundoora, VIC, Australia
- Psycho-Oncology Research Unit, Olivia Newton John Centre, Austin Health, Heidelberg, VIC, Australia
- Centre for Epidemiology and Biostatistics, University of Melbourne, Parkville, VIC, Australia
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Nielsen IH, Tolver A, Piil K, Kjeldsen L, Grønbæk K, Jarden M. Family caregiver quality of life and symptom burden in patients with hematological cancer: A Danish nationwide cross-sectional study. Eur J Oncol Nurs 2024; 69:102538. [PMID: 38457934 DOI: 10.1016/j.ejon.2024.102538] [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: 06/26/2023] [Revised: 02/05/2024] [Accepted: 02/16/2024] [Indexed: 03/10/2024]
Abstract
OBJECTIVE To investigate the quality of life (QoL) and the impact of caregiving in family caregivers of hematological cancer patients and its association with patient symptom burden. METHODS A cross-sectional study including Danish patients (n = 375) and caregivers (n = 140). Caregivers completed scales for anxiety and depression using the Hospital Anxiety and Depression Scale, sleep quality using the Pittsburgh Sleep Quality Index, health related QoL using the 12-item Short-Form Health Survey, and caregiver roles using the Caregiver Roles and Responsibilities Scale. Patients reported symptoms using the MD Anderson Symptom Inventory. Analysis of covariance was used to examine associations between patient symptom burden and caregivers' QoL outcomes. RESULTS The results show that caregivers experience sleep difficulties, moderate anxiety, and reduced QoL. Patient symptom burden was significantly associated with caregiver anxiety (p = 0.009), and mental well-being (p = 0.002), while patient treatment status was a significant factor associated with caregiver anxiety (p = 0.016), depression (p = 0.009), emotional well-being (p = 0.002), and sleep (p = 0.01). CONCLUSION Caregivers of patients with hematological cancers undergoing active treatment face a high symptom burden, which significantly impacts their QoL, including sleep, psychological well-being, and emotional health. Patients reported a high symptom burden, and patient symptom burden was significantly associated with caregiver QoL. Adequate patient and caregiver support is needed to promote their well-being and mitigate adverse health effects in caregivers, and this should be acknowledged in the context of caring for patients with hematological cancer.
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Affiliation(s)
- Iben Husted Nielsen
- Department of Haematology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.
| | - Anders Tolver
- Department of Mathematical Sciences, Data Science Laboratory, University of Copenhagen, Universitetsparken 5, 2200, Copenhagen, Denmark
| | - Karin Piil
- Department of Oncology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark; Department of Public Health, Aarhus University, Bartholins Allé 2, 8000, Aarhus C, Denmark
| | - Lars Kjeldsen
- Department of Haematology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Kirsten Grønbæk
- Department of Haematology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark; Biotech Research & Innovation Centre (BRIC), University of Copenhagen, Ole Maaløes Vej 5, 2200, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
| | - Mary Jarden
- Department of Haematology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
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Cloyes KG, Mansfield KJ, Wawrzynski SE, Vega M, Kent-Marvick J, Guo JW. Cancer Survivors' and Care Partners' Audio Diaries on Stress and Social Support Resources During the COVID-19 Pandemic. Semin Oncol Nurs 2024; 40:151623. [PMID: 38538507 PMCID: PMC11045306 DOI: 10.1016/j.soncn.2024.151623] [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: 10/02/2023] [Revised: 02/25/2024] [Accepted: 02/29/2024] [Indexed: 04/28/2024]
Abstract
OBJECTIVES To describe cancer survivors' and care partners' perceived stress and social support during the COVID-19 pandemic and assess the feasibility of audio diaries for assessing role-related needs and resources. METHODS Participants (N = 51; n = 28 survivors, n = 23 care partners) recorded three monthly audio diaries reporting stress and support experiences. Diaries were transcribed and content-analyzed using a hybrid approach. Stress-related content was inductively coded, and social support content was deductively coded by type (instrumental, information, emotional, companionship, appraisal; κ = 0.75) then inductively coded. Descriptive statistics summarized sociodemographic data and compared coding frequencies by role. We developed narrative summaries of stress and support categories and selected quotes for contextual detail. RESULTS Cancer-related stressors were most prevalent (28.8%), followed by work (26.8%), family (23.1%), social isolation (13.4%), and finances (8.0%). While no significant difference in reporting frequency was observed between roles, cancer-related stress was more prevalent for survivors while work-related stress was mentioned more by care partners. Emotional support was the most prevalent support type (32.1%), followed by companionship (25.3%), appraisal (17.9%), instrumental (16.67%), and informational support (8%). Survivors reported more appraisal support than care partners (χ2 = 6.48, df = 1, P = .011) and more support for self-care, while care partners expressed more other-oriented concerns and focused more on managing responsibilities and interactions outside the household. CONCLUSIONS The pandemic complicated and intensified role-based stressors already present in the survivorship context. Our findings highlight the importance of informal social support networks, particularly when access to formal services is limited, and suggest that audio diaries can be an effective tool for assessing support needs and resources. IMPLICATIONS FOR NURSING PRACTICE Nurses and healthcare providers should tailor social support assessments to address the distinct support needs and individual resources of cancer survivors and their care partners. This is especially critical in contexts that limit access to care and formal services.
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Affiliation(s)
- Kristin G Cloyes
- School of Nursing, Oregon Health & Science University, Portland, OR.
| | - Kelly J Mansfield
- College of Nursing, University of Utah College of Nursing, Salt Lake City, UT
| | - Sarah E Wawrzynski
- Center for Healthcare Delivery Science, Nemours Children's Health, Wilmington, DE
| | - Marilisa Vega
- College of Nursing, University of Utah College of Nursing, Salt Lake City, UT
| | | | - Jia-Wen Guo
- College of Nursing, University of Utah College of Nursing, Salt Lake City, UT
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7
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Ponti L, Cappelli F, Perfetto F, Maver P, Smorti M. Caregiver's psychological well-being and quality of relationship with cardiac amyloidosis patients. PSYCHOL HEALTH MED 2024; 29:66-78. [PMID: 38156665 DOI: 10.1080/13548506.2023.2280463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 10/31/2023] [Indexed: 01/03/2024]
Abstract
Caregivers' psychological well-being is linked to the quality of care provided for familiar with chronic illness. Despite caregivers of cardiac patients present an impaired psychological well-being, less investigated is the psychological well-being of caregivers of individuals with a rare disease such as the Transthyretin Cardiac Amyloidosis (ATTR-CA). Specifically, given that no study explored the well-being of the caregiver and the caregiver-patient relationship, this study aimed to analyze the prevalence of anxiety and depression in ATTR-CA caregivers and if these disorders were associated with patient's and caregiver's characteristics. Fifty-eight dyad caregiver-ATTR-CA patients completed the Hospital Anxiety and Depression Scale and the Network of Relationships Inventory. Moreover, ATTR-CA patients completed the Kansas City Cardiomyopathy Questionnaire, while caregivers completed the Multidimensional Scale of Social Support. Results showed that anxious caregivers (44%) reported higher conflict with patients. They had ATTR-CA relatives with a worse perception of cardiac symptoms and higher anxiety and depression. Depressed caregivers (39%) reported higher conflict with ATTR-CA relatives and lower perceived social support. Caregiver reported a high prevalence of anxiety and depression associated with worse personal relational well-being and to patient's psycho-physical condition. The care of ATTR-CA patient should consider the caregiver well-being.
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Affiliation(s)
- Lucia Ponti
- Department of Humanities, University of Urbino, Urbino, Italy
- Cardiomyopathy Unit, Careggi University Hospital, Florence, Italy
| | - Francesco Cappelli
- Tuscan Regional Amyloidosis Centre, Careggi University Hospital, Florence, Italy
- Division of Interventional Structural Cardiology, Cardiothoracovascular Department, Careggi University Hospital, Florence, Italy
| | - Federico Perfetto
- Tuscan Regional Amyloidosis Centre, Careggi University Hospital, Florence, Italy
- IV Internal Medicine Division, Careggi University Hospital, Florence, Italy
| | - Perla Maver
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Martina Smorti
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
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8
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Mohammadian B, Mohammadi-Shahboulaghi F, Hosseini M, Arsalani N, Fallahi-Khoshknab M, Pirjani P. Factors influencing support provision to the family caregivers of elderly patients with cancer: A qualitative study. Eur J Oncol Nurs 2023; 67:102452. [PMID: 37883906 DOI: 10.1016/j.ejon.2023.102452] [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: 04/28/2023] [Revised: 10/11/2023] [Accepted: 10/15/2023] [Indexed: 10/28/2023]
Abstract
PURPOSE Family caregivers (FCs) play a significant role in providing care to elderly patients with cancer (PWC). Meanwhile, they face a wide range of challenges and are considered hidden patients who require special attention and support. Nonetheless, they do not receive adequate support. This study aimed at exploring the factors influencing support provision to the FCs of elderly PWC. METHOD This descriptive qualitative study was conducted in 2020-2022. Thirty-one FCs and family members of elderly PWC and healthcare providers were purposefully recruited from various healthcare centers in Tehran, Iran. Data were collected through semi-structured interviews and analyzed using Graneheim and Lundman's conventional content analysis approach. Trustworthiness was ensured through Lincoln and Guba's criteria. RESULTS Factors influencing support provision to the FCs of elderly PWC came into three main categories, namely the potential for supporting elderly PWC and FCs, complexity of family and social support, and support-related challenges of the healthcare system. CONCLUSIONS Identifying the factors influencing support provision to the FCs of elderly PWC can assist healthcare policymakers and authorities in developing more effective strategies to support these groups.
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Affiliation(s)
- Batol Mohammadian
- Nursing Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | - Farahnaz Mohammadi-Shahboulaghi
- Iranian Research Center on Aging, Nursing Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | - Mohammadali Hosseini
- Nursing Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | - Narges Arsalani
- Iranian Research Center on Aging, Nursing Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | | | - Pooneh Pirjani
- Iranian Cancer Control Center, Iran University of Medical Sciences, Tehran, Iran.
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9
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Kim YM, Lee JE. Dyadic Effects of Psychological Health on Quality of Life in Patients with Colorectal Cancer and Caregivers: A Systematic Review and Meta-Analysis. Semin Oncol Nurs 2023; 39:151477. [PMID: 37495448 DOI: 10.1016/j.soncn.2023.151477] [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: 02/13/2023] [Revised: 05/29/2023] [Accepted: 07/03/2023] [Indexed: 07/28/2023]
Abstract
OBJECTIVES This study aimed to review dyadic research on psychological health and health-related quality of life (HRQL) in patients with colorectal cancer (CRC) and caregivers and examine the pooled partner effects and actor effects based on the Actor-Partner Interdependence Model. DATA SOURCES A systematic review and meta-analysis were conducted. We registered our review protocol with PROSPERO (CRD42021258482). Six databases were searched until June 2021 using the following keywords: colorectal neoplasms, caregivers, depression, anxiety, stress, and quality of life. Two reviewers independently screened 1,597 studies that included both CRC patients and family caregivers. Meta-analyses were performed of the partner and actor effects of psychological health on HRQL in CRC. CONCLUSION Eighteen observational studies involving 2,757 patients with CRC and 2,601 caregivers were included. Regarding partner effects, the distress of patients with CRC affected their family caregivers' distress and burden. There were three types of actor effects among patients with CRC and family caregivers: 1) the social support of patients with CRC affects their level of distress; (2) the distress of patients with CRC affects their HRQL; and (3) caregivers' social support affects their level of distress. This study provides the first comprehensive overview of the dyadic relationships between psychological health and HRQL in patients with CRC and their caregivers. IMPLICATIONS FOR NURSING PRACTICE The development of dyadic interventions for improving psychological health is warranted to help both patients with CRC and their family caregivers live with improved HRQL and well-being.
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Affiliation(s)
- Young Man Kim
- Assistant Professor, College of Nursing, Jeonbuk National University, and Reseach Institute of Nursing Science, Jeonbuk National University, Jeonju-si, Republic of Korea
| | - Jung Eun Lee
- Assistant Professor, University of Rhode Island College of Nursing, Kingston, Rhode Island, USA.
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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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11
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Reblin M, Tay DL, Iacob E, Cloyes KG, Hebdon MCT, Ellington L. Hospice Caregivers' Perception of Family and Non-Family Social Support and Stress over Time: Associations with Reports of General Support. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5009. [PMID: 36981917 PMCID: PMC10049686 DOI: 10.3390/ijerph20065009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 03/09/2023] [Accepted: 03/10/2023] [Indexed: 06/18/2023]
Abstract
Social support has been identified as a key factor to protect wellbeing for home hospice cancer caregivers. However, few studies have assessed social support over time in this context, and measures of support are often limited to general assessments of perceived support. Our goal was to (1) describe change in cancer home hospice caregivers' social support over time during care and into bereavement and (2) explore the impact of perceived stress and support from family and non-family members on caregivers' perceived general social support. We conducted a secondary analysis of longitudinal prospective questionnaire data. Forty caregivers completed measures of general perceived support, family and non-family support and stress during hospice enrollment and 2 and 6 months post the patient's death. Linear mixed models were used to determine change in support over time and the contribution of specific support/stress ratings to general support assessments. Caregivers overall had moderate and stable levels of social support over time, though there was significant variation between and within individuals. Family and non-family support and stress from family predicted general perceptions of social support, while no effects were found for non-family stress. This work suggests a need for more specific measures of support and stress, and the need for research to focus on improving baseline levels of caregiver perceived support.
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Affiliation(s)
- Maija Reblin
- Department of Family Medicine, Larner College of Medicine, University of Vermont, Burlington, VT 05405, USA
| | - Djin L. Tay
- College of Nursing, University of Utah, Salt Lake City, UT 84112, USA
| | - Eli Iacob
- College of Nursing, University of Utah, Salt Lake City, UT 84112, USA
| | - Kristin G. Cloyes
- School of Nursing, Oregon Health & Sciences University, Portland, OR 97239, USA
| | | | - Lee Ellington
- College of Nursing, University of Utah, Salt Lake City, UT 84112, USA
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Yuen EY, Wilson C, Livingston PM, White VM, McLeod V, Hutchinson AM. Burden prediction in cancer caregivers: role of social support and connectedness. BMJ Support Palliat Care 2023:spcare-2022-004070. [PMID: 36746609 DOI: 10.1136/spcare-2022-004070] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 01/11/2023] [Indexed: 02/08/2023]
Abstract
OBJECTIVES Caregivers play a key role in providing support to people with cancer. However, caregiving can be stressful and demanding, resulting in perceived caregiver burden. Social connectedness is considered partially independent from social support, yet few studies have examined whether social connectedness impacts caregiver burden. The current study sought to examine: (a) associations among social support, social connectedness and burden in a sample of cancer caregivers and (b) the mediating effect of social connectedness on the relationship between social support and caregiver burden. METHODS A descriptive cross-sectional study was conducted. Data were collected as part of a larger project. The sample included 125 caregiver-cancer care recipient dyads. Caregivers completed the Social Connectedness Scale-Revised, the Medical Outcomes Study-Social Support Survey and the Zarit Burden Interview. Descriptive statistics, hierarchical multiple regression and mediation analyses were used to examine relationships between variables. RESULTS Correlation analyses showed higher perceived social support and social connectedness were significantly correlated with lower-reported caregiver burden (p<0.05). The hierarchical regression model showed that both social support and social connectedness were independent predictors of caregiver burden (p<0.001). Social connectedness partially mediated the relationship between social support and caregiver burden. CONCLUSIONS This study provides new evidence that social support buffers the negative effects of burden in caregivers, suggesting these are potentially modifiable factors of caregiver burden. Increased understanding of the factors that contribute to burden among cancer caregivers will inform targeted supportive care strategies to improve psychological health and well-being in this underserved group.
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Affiliation(s)
- Eva Yn Yuen
- School of Nursing and Midwifery, Deakin University, Burwood, Victoria, Australia
- Centre for Quality and Patient Safety, Institute for Health Transformation, Burwood, VIC, Australia
- Centre for Quality and Patient Safety - Monash Health Partnership, Monash Health, Clayton, VIC, Australia
| | - Carlene Wilson
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
- Psycho-Oncology Research Unit, Austin Health, Heidelberg, Victoria, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | | | - Victoria M White
- School of Psychology, Deakin University, Burwood, Victoria, Australia
| | - Vicki McLeod
- Oncology Unit, Monash Health, Melbourne, Victoria, Australia
| | - Alison M Hutchinson
- School of Nursing and Midwifery, Deakin University, Burwood, Victoria, Australia
- Centre for Quality and Patient Safety-Barwon Health Partnership, Barwon Health, Geelong, Victoria, Australia
- Centre for Quality and Patient Safety, Institute for Health Transformation, Deakin University, Burwood, VIC, Australia
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13
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Acquati C, Head KJ, Rand KL, Alwine JS, Short DN, Cohee AA, Champion VL, Draucker CB. Psychosocial Experiences, Challenges, and Recommendations for Care Delivery among Partners of Breast Cancer Survivors: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2786. [PMID: 36833489 PMCID: PMC9956235 DOI: 10.3390/ijerph20042786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 01/28/2023] [Accepted: 01/30/2023] [Indexed: 06/18/2023]
Abstract
For women diagnosed with breast cancer, partners are consistently identified as the primary support person. Despite growing consensus about the psychosocial experience and unmet needs of cancer caregivers, limited evidence exists about strategies to offer partner-centered care across the cancer continuum. This study describes challenges endured by partners of breast cancer survivors (BCS), strategies implemented to manage these experiences, and recommendations for healthcare providers to inform targeted psychosocial care. Using convenience sampling, 22 partners of female BCS were recruited and completed semi-structured interviews. Conventional content analysis was used to code and synthesize findings. Participants described undergoing five experiences in their role as romantic partners: (a) assuming the role of caregiver, (b) becoming healthcare advocates for BCS, (c) connecting emotionally with the partner, (d) managing their own painful emotions, and (e) connecting with others for support. Experience-specific coping strategies and recommendations were identified. Romantic partners face multiple transitions across the cancer care continuum, which warrant investigation to sustain their well-being and active participation in illness management. Psychosocial interventions for this group will benefit from flexible implementation and attention to care delivery, mental health, and supportive/social needs.
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Affiliation(s)
- Chiara Acquati
- Graduate College of Social Work, University of Houston, Houston, TX 77004, USA
- Tilman J. Fertitta Family College of Medicine, University of Houston, Houston, TX 77004, USA
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Katharine J. Head
- Department of Communication Studies, School of Liberal Arts, Indiana University-Purdue University Indianapolis, Indianapolis, IN 46202, USA
| | - Kevin L. Rand
- School of Science, Indiana University-Purdue University Indianapolis, Indianapolis, IN 46202, USA
| | | | | | - Andrea A. Cohee
- School of Nursing, Indiana University, Indianapolis, IN 46202, USA
- Melvin and Bren Simon Comprehensive Cancer Center, Indiana University, Indianapolis, IN 46202, USA
| | - Victoria L. Champion
- School of Nursing, Indiana University, Indianapolis, IN 46202, USA
- Melvin and Bren Simon Comprehensive Cancer Center, Indiana University, Indianapolis, IN 46202, USA
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14
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He Q, Xu P, Wang H, Wang S, Yang L, Ba Z, Huang H. The mediating role of resilience between perceived social support and sense of security in medical staff following the COVID-19 pandemic: A cross-sectional study. Front Psychiatry 2023; 14:1096082. [PMID: 36960462 PMCID: PMC10027772 DOI: 10.3389/fpsyt.2023.1096082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 02/09/2023] [Indexed: 03/09/2023] Open
Abstract
Background The COVID-19 pandemic not only posed a serious threat to public life and health but also had a serious impact on people's mental health, especially that of medical staff. Perceived social support is an important factor in one's sense of security. Objective Following the COVID-19 pandemic, the goal is to explore the potential mediating role of resilience in the relationship between perceived social support and the sense of security of Chinese medical personnel. Methods The multi-stage proportionally stratified convenience sampling method was adopted to select 4,076 medical professionals from 29 hospitals in Guangdong Province between September 2020 and October 2020. The Sense of Security Scale for Medical Staff, the Chinese version of the Connor-Davidson Resilience Scale, and the Perceived Social Support Scale were employed in this study. For statistical analysis and structural equation modeling (SEM), the SPSS 23.0 and Amos 24.0 software packages were used. Regression analysis was used to select the control variables to be included in the SEM. SEM analysis was conducted to verify the mediating effect of resilience on the relationship between perceived social support and a sense of security. Results Pearson's correlation analysis showed that perceived social support and resilience were positively associated with a sense of security (correlation coefficients range from 0.350 to 0.607, P < 0.01), and perceived social support (correlation coefficients range from 0.398 to 0.589, P < 0.01) was positively associated with resilience. Structural equation modeling revealed that resilience played a partial mediating role in the association between perceived social support and a sense of security (60.3% of the effect of perceived social support on security was direct, and 39.7% of the effect was mediated by resilience). Conclusions Hospital managers should make efforts to develop resilience. Interventions based on resilience should be developed to enhance the perception of social support and strengthen one's sense of security.
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Affiliation(s)
- Qingxia He
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Peng Xu
- Nursing Department, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Huajun Wang
- Nursing Department, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Shibin Wang
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Lulu Yang
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Zhiqiong Ba
- Nursing Department, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Huigen Huang
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
- *Correspondence: Huigen Huang
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15
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Jung M, Jeong Y, Park BJ. Adaptation of families of adult patients with brain tumor: Partial least squares structural equation modeling. PLoS One 2023; 18:e0285677. [PMID: 37167209 PMCID: PMC10174583 DOI: 10.1371/journal.pone.0285677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 04/23/2023] [Indexed: 05/13/2023] Open
Abstract
Brain tumor patients experience physical, psychological, social, and cognitive changes. These changes are challenging for both the patients and their families. These patients and their families need to adapt together on the cancer treatment path. This study aimed to identify the factors affecting adaptation in families of adult patients with brain tumors. A quantitative, cross-sectional study of 165 families of adult patients with primary brain tumors was conducted using a self-administered questionnaire. Partial least squares structural equation modeling was used to test a hypothetical model. The results showed that family stress, family functioning, and family resources influenced on family adaptation in families of adult patients with primary brain tumors. Among these factors, family resources were identified to be the strongest factor associated with family adaptation. The results of this study may be utilized as a theoretical basis in nursing to improve the family adaptation of patients with brain tumors. Regarding nursing practices, the results suggest that nurses should provide family-centered nursing interventions and promote family resources to help brain tumor patients and their families to adapt.
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Affiliation(s)
- Mijung Jung
- Department of Nursing, Kwangju Women's University, Gwangju, Korea
| | - Younhee Jeong
- College of Nursing Science, Kyung Hee University, Seoul, Korea
- East-West Nursing Research Institute, Kyung Hee University, Seoul, Korea
| | - Bong Jin Park
- College of Medicine, Kyung Hee University, Seoul, Korea
- Department of Neurosurgery, Kyung Hee Medical Center, Seoul, Korea
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16
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Yu T, Hu J, Zhang W, Zhang L, Zhao J. Psychological maltreatment and depression symptoms among Chinese adolescents: A multiple mediation model. CHILD ABUSE & NEGLECT 2022; 134:105940. [PMID: 36368166 DOI: 10.1016/j.chiabu.2022.105940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 10/15/2022] [Accepted: 10/19/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Adolescents are at risk of depression, and recent studies also found a high prevalence of depression among Chinese adolescents. Therefore, it is necessary to explore the risk and protective factors of depression among Chinese adolescents. OBJECTIVE This study examined the direct effect of psychological maltreatment on depression symptoms in adolescents and the mediating roles of emotion regulation and social support in their relationship. METHOD Data were collected from Chinese senior high school students (N = 687, 36.5 % males and 63.5 % females, Mage = 16.44 years, SD = 0.78) who completed the measures of psychological maltreatment, depression symptoms, perceived social support, and emotion regulation strategies, including cognitive reappraisal and expressive suppression. RESULTS The results indicated that: (a) psychological maltreatment was positively correlated with depression symptoms; (b) the two emotion regulation strategies and perceived social support partially mediated the link between psychological maltreatment and depression symptoms separately; (c) the two emotion regulation strategies and perceived social support partially mediated the link between psychological maltreatment and depression symptoms in a sequential pattern. CONCLUSION Psychological maltreatment was positively associated with depression symptoms in adolescents. Emotion regulation and perceived social support both significantly mediated the relationship between psychological maltreatment and depression symptoms.
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Affiliation(s)
- Tengxu Yu
- Department of Psychology, Liaoning Normal University, Dalian city 116029, Liaoning Province, China
| | - Jinsheng Hu
- Department of Psychology, Liaoning Normal University, Dalian city 116029, Liaoning Province, China.
| | - Wei Zhang
- Department of Psychology, Liaoning Normal University, Dalian city 116029, Liaoning Province, China
| | - Longfei Zhang
- Department of Psychology, Liaoning Normal University, Dalian city 116029, Liaoning Province, China
| | - Jiayin Zhao
- Department of Psychology, Liaoning Normal University, Dalian city 116029, Liaoning Province, China
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17
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Thomas S, Kanske P, Schäfer J, Hummel KV, Trautmann S. Examining bidirectional associations between perceived social support and psychological symptoms in the context of stressful event exposure: a prospective, longitudinal study. BMC Psychiatry 2022; 22:736. [PMID: 36443716 PMCID: PMC9703701 DOI: 10.1186/s12888-022-04386-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 11/11/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND After stressful event exposure, higher perceived social support is a well-established correlate of decreased risk for psychological symptoms, including depressive, anxiety and posttraumatic stress (PTS) symptoms. However, longitudinal data on the direction of this association and the stability of perceived social support are scarce and have yielded mixed results, with a particular lack of prospective studies. We aimed to investigate changes in perceived social support and bidirectional associations between perceived social support and psychological symptoms in a prospective, longitudinal study. METHODS A sample of German soldiers was assessed before and after deployment to Afghanistan. Group-based trajectory modelling was used to investigate the stability of perceived social support and to identify possible distinguishable trajectories of perceived social support. Bidirectional associations between perceived social support (general and workplace) and psychological symptoms (depressive, anxiety and PTS) were examined using gamma regressions. RESULTS Average levels of perceived general social support did not change, while perceived workplace social support increased slightly (t(344) = 5.51, p < .001). There were no distinguishable trajectories of perceived social support. Higher perceived general (Mean ratio (MR) = 0.84, 95% CI = [0.74, 0.95]) and workplace social support (MR = 0.82, 95% CI = [0.72, 0.92]) predicted lower depressive symptoms, but not anxiety or PTS symptoms. Only higher PTS (MR = 0.95, 95% CI = [0.91, 0.99]) and higher depressive symptoms (MR = 0.96, 95% CI = [0.93, 0.99]) predicted lower perceived general social support. CONCLUSIONS Perceived social support can remain relatively stable under exposure to environmental stressors such as military deployment. Higher perceived social support could protect against depressive symptoms via a stress-buffering mechanism, while support may need to be more tailored to individual needs for a protection against PTS symptoms. Individuals with elevated depressive and PTS symptoms might have impaired abilities or opportunities to access social support after stressful event exposure. Future studies could investigate distressing social emotions and associated maladaptive social cognitions as possible mechanisms in the association between symptoms and lower perceived social support. Especially with respect to PTS symptoms, future studies could focus on conditions that enable individuals to benefit from social support.
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Affiliation(s)
- Sarah Thomas
- grid.4488.00000 0001 2111 7257Institute of Clinical Psychology and Psychotherapy, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Philipp Kanske
- grid.4488.00000 0001 2111 7257Institute of Clinical Psychology and Psychotherapy, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany ,grid.419524.f0000 0001 0041 5028Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Judith Schäfer
- grid.4488.00000 0001 2111 7257Institute of Clinical Psychology and Psychotherapy, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Katrin Veronika Hummel
- grid.4488.00000 0001 2111 7257Institute of Clinical Psychology and Psychotherapy, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Sebastian Trautmann
- Institute of Clinical Psychology and Psychotherapy, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany. .,Department of Psychology, Faculty of Human Science, Medical School Hamburg, Am Kaiserkai 1, 20457, Hamburg, Germany. .,ICPP Institute of Clinical Psychology and Psychotherapy, Medical School Hamburg, Hamburg, Germany.
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18
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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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19
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Xi Y, Elkana O, Jiao WE, Li D, Tao ZZ. Associations between social support and anxiety during the COVID-19 lockdown in young and middle-aged Israelis: A cross-sectional study. World J Psychiatry 2022; 12:1194-1203. [PMID: 36186497 PMCID: PMC9521534 DOI: 10.5498/wjp.v12.i9.1194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/27/2022] [Accepted: 08/18/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND This study examined the associations between social support and anxiety during the coronavirus disease 2019 (COVID-19) in an Israeli sample.
AIM To examine the associations between social support and anxiety during the COVID-19 in an Israeli sample.
METHODS Data for this cross-sectional study were retrieved from an online survey. Linear regression, logistic regression and restricted cubic spline models were conducted to test for associations between social support and anxiety.
RESULTS A total of 655 individuals took part in the present study. In the univariate linear regression model, there is a negative correlation between the Generalized Anxiety Disorder-7 score (GAD-7) and the Multidimensional Perceived Social Support Scale (MSPSS) score. For MSPSS score, the multivariable adjusted regression coefficient and 95% confidence interval (CI) of GAD-7 score were -0.779 (-1.063 to -0.496). In the univariate logistic regression model, there was a negative correlation between anxiety (GAD-7 ≥ 9) and MSPSS score, and there was still a negative correlation in multivariate logical regression analysis. The odds ratios and 95%CI were 0.709 (0.563-0.894).
CONCLUSION Social support was inversely correlated with anxiety during COVID-19 in an Israeli sample.
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Affiliation(s)
- Yang Xi
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, China
| | - Odelia Elkana
- Behavioral Sciences, Academic College of Tel Aviv-Yafo, Jaffa 61083, Israel
| | - Wo-Er Jiao
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, China
| | - Di Li
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, China
| | - Ze-Zhang Tao
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, China
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Krishna R, Rajkumar E, Romate J, Allen JG, Monica D. Effect of Carnatic raga-Bilahari based music therapy on anxiety, sleep disturbances and somatic symptoms among caregivers of cancer patients. Heliyon 2022; 8:e10681. [PMID: 36164509 PMCID: PMC9508548 DOI: 10.1016/j.heliyon.2022.e10681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 07/12/2022] [Accepted: 09/13/2022] [Indexed: 12/24/2022] Open
Abstract
Carnatic raga-Bilahari based intervention is a music therapy technique that enhances relaxation and positivity by reducing anxiety. With extensive empirical evidence pointing out the detrimental challenges faced by the caregivers of cancer patients, the present study intends to find out the effectiveness of a Carnatic raga based music therapy on reducing anxiety, sleep disturbances, somatic symptoms and distress level among this population A single group pre-post research design was was used to conduct the study. General Health Questionnaire (GHQ-28) was used as a screening tool to select participants, and 30 participants were chosen using the purposive sampling. These individuals received instruction in listening to Carnatic music (raga-Bilahari), 5 days a week. The vocal and instrumental recordings were given on alternative days with each session lasting 15–30 min over a month of standard care. From the findings it is observed that there is significant decrease in the anxiety (p < 0.001), sleep disturbances (p < 0.001), somatic symptoms (p < 0.001) and distress level (p < 0.001) after the intervention.The study result thus indicates that Carnatic raga-Bilahari-based music intervention is effective among caregivers of cancer patients to reduce anxiety, sleep disturbances, somatic symptoms presentation, and their distress level.
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Affiliation(s)
| | - Eslavath Rajkumar
- Department of Psychology, Central University of Karnataka, Kalaburagi, India
| | - John Romate
- Department of Psychology, Central University of Karnataka, Kalaburagi, India
| | - Joshua George Allen
- Humanities and Applied Sciences, Indian Institute of Management, Pundag, Ranchi, Jharkhand, India
| | - Daniel Monica
- Department of Psychology, Central University of Karnataka, Kalaburagi, India
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Caregiving-related experiences associated with depression severity and its symptomatology among caregivers of individuals with a severe mental disorder: an online cross-sectional study. Eur Arch Psychiatry Clin Neurosci 2022:10.1007/s00406-022-01451-3. [PMID: 35771258 PMCID: PMC9245882 DOI: 10.1007/s00406-022-01451-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 06/12/2022] [Indexed: 11/03/2022]
Abstract
Caring for a relative with a severe mental disorder puts family caregivers to a great risk of depression. While overall caregiving burden is a strong predictor of depression, the contribution of the various dimensions of burden to caregivers' depression as well as their relationships with depressive symptoms has received little attention. 384 family caregivers completed a cross-sectional online survey including the Center for Epidemiological Studies Depression (CES-D) scale, the Zarit Burden Interview (ZBI), and the Brief Experience of Caregiving Inventory (BECI), measuring caregiving burden and experience. We estimated the structure of the relationships between caregiving experiences (i.e., ZBI and BECI subscales) and CES-D symptoms using a network approach. Negative Emotion/Consequences, (lack of) Positive Personal Experience, and Stigma/Effects on Family were the most connected caregiving dimensions to depression. To untangle the role of the Negative Emotion/Consequences component (by far the most central node in estimated networks), a secondary analysis incorporating its composing items was estimated. Losing control over life, feeling strained around the relative and impaired self-perceived health emerged as central nodes. Interestingly, these caregiving-related dimensions or experiences were differentially connected to depressive symptoms. We discuss how these findings might help future research and inform tailored psychoeducational interventions for family caregivers of people with a severe mental disorder.
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22
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Cloyes KG, Guo JW, Tennant KE, McCormick R, Mansfield KJ, Wawrzynski SE, Classen SC, Jones EC, Reblin M. Exploring Social Support Networks and Interactions of Young Adult and LGBTQIA+ Cancer Survivors and Care Partners. Front Oncol 2022; 12:852267. [PMID: 35463370 PMCID: PMC9033283 DOI: 10.3389/fonc.2022.852267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 03/14/2022] [Indexed: 11/22/2022] Open
Abstract
Purpose The purpose of this study was to describe the social support networks and daily support interactions of cancer-affected individuals, including young adult (YA) and LGBTQIA+ survivors and care partners. Methods Participants were recruited at two United States cancer centers and via social media for a pilot study testing a novel online method for collecting prospective, daily social support interaction data (N=28). All participants were aged 18+; survivors had a current or recent cancer diagnosis and were engaged in treatment and/or services; care partners were identified by the survivors. Enrollment also purposefully targeted YA and LGBTQIA+ survivors. Social network data (up to 10 members) were assessed at baseline. Daily online surveys assessed support interactions between participants and specific network members over 14 days. Descriptive statistics summarized data and explored between-group (YA/non-YA, LGBTQIA+/non-LGBTQIA+) differences in social network characteristics (size, heterogeneity, density, centralization, cohesion) and support interactions (support source and type). Results There were no significant differences between YA and non-YA participants on any measures. LGBTQIA+ participants’ support networks were less dense (Mdn=0.69 vs. 0.82, p=.02), less cohesive (Mdn=0.85 vs. 0.91,.02), more centered on the participant (Mdn=0.40 vs. 0.24, p=.047), and included more LGBTQIA+ members (Mdn=0.35 vs. 0.00, p<.001). LGBTQIA+ participants reported having more interactions with LGBTQIA+ network members (Mdn=14.0 vs. Mdn=0.00, p<.001) and received significantly more of all types of support from LGBTQIA+ vs. non-LGBTQIA+ members. LGBTQIA+ participants also reported receiving more appraisal support than non-LGBTQIA+ (Mdn 21.64 vs. 9.12, p=.008) including more appraisal support from relatives (Mdn=11.73 vs 6.0, p+.037). Conclusions Important information related to support access, engagement, and needs is embedded within the everyday contexts of the social networks of cancer-affected people. Individualized, accessible, and prospective assessment could help illuminate how their “real world” support systems are working and identify specific strengths and unmet needs. These insights would inform the development of more culturally competent and tailored interventions to help people understand and leverage their unique support systems. This is particularly critical for groups like YA and LGBTQIA+ survivors and care partners that are underserved by formal support services and underrepresented in cancer, caregiving, and social support research.
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Affiliation(s)
- Kristin G. Cloyes
- College of Nursing, University of Utah, Salt Lake City, UT, United States
- *Correspondence: Kristin G. Cloyes,
| | - Jia-Wen Guo
- College of Nursing, University of Utah, Salt Lake City, UT, United States
| | - Karrin E. Tennant
- College of Nursing, University of Utah, Salt Lake City, UT, United States
| | - Rachael McCormick
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, United States
| | - Kelly J. Mansfield
- College of Nursing, University of Utah, Salt Lake City, UT, United States
| | | | - Sarah C. Classen
- Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, University of Texas Health Science Center at Houston, El Paso, TX, United States
| | - Eric C. Jones
- Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, University of Texas Health Science Center at Houston, El Paso, TX, United States
| | - Maija Reblin
- Larner College of Medicine, University of Vermont, Burlington, VT, United States
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Starr LT, Bullock K, Washington K, Aryal S, Parker Oliver D, Demiris G. Anxiety, Depression, Quality of Life, Caregiver Burden, and Perceptions of Caregiver-Centered Communication among Black and White Hospice Family Caregivers. J Palliat Med 2022; 25:596-605. [PMID: 34793244 PMCID: PMC8982115 DOI: 10.1089/jpm.2021.0302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Anxiety, depression, and reduced quality of life (QOL) are common problems for hospice family caregivers, but it is unknown if disparities in these experiences exist among Black and White caregivers. Objectives: To compare anxiety, depression, QOL, caregiver burden, and perceptions of caregiver-centered hospice team communication between Black and White hospice family caregivers. Design: Secondary analysis of baseline data from two randomized clinical trials. Setting/Subjects: Seven hundred twenty-two Black and White hospice family caregivers ages 18+ from Midwestern and Northeastern United States. Measurements: Measures included the Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire (PHQ-9), Caregiver Quality-of-Life Index-Revised (CQLI-R), Zarit Burden Interview (ZBI-7), and Caregiver-Centered Communication Questionnaire (CCCQ). Results: Black and White caregivers differed across demographic and socioeconomic variables. Nearly one-third of hospice family caregivers reported moderate-to-severe anxiety (32.1%) and moderate-to-severe depressive symptoms (32.0%). White caregivers reported lower QOL than Black caregivers (p = 0.04), specifically in emotional (p = 0.02) and social (p = 0.0005) domains. In multiple regression analyses controlling for caregiver and patient factors, we found no racial differences in depression, anxiety, QOL, caregiver burden, or perceptions of caregiver-centered hospice communication. Conclusions: Despite demographic and socioeconomic differences, Black and White hospice family caregivers experience similarly high levels of anxiety, depression, burden, and perceptions of hospice communication. Interventions to support hospice family caregivers across racial groups and research that identifies factors that mediate social determinants of health in this population are needed. The development and validation of culture-concordant mental health screening tools in racially diverse populations is recommended. Trial registration: ClinicalTrials.gov NCT02929108 and ClinicalTrials.gov NCT01444027.
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Affiliation(s)
- Lauren T. Starr
- Department of Biobehavioral and Health Sciences, NewCourtland Center for Transitions and Health, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Karen Bullock
- Department of Social Work, College of Humanities and Social Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | - Karla Washington
- Division of Palliative Medicine, School of Medicine, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Subhash Aryal
- BECCA (Biostatistics * Evaluation * Collaboration * Consultation * Analysis) Lab, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Debra Parker Oliver
- Division of Palliative Medicine, School of Medicine, Washington University in St. Louis, St. Louis, Missouri, USA
- Barnes Jewish College, Goldfarb School of Nursing, St. Louis, Missouri, USA
| | - George Demiris
- Department of Biobehavioral and Health Sciences, NewCourtland Center for Transitions and Health, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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24
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The prevalence of physical activity among informal carers: a systematic review of international literature. SPORT SCIENCES FOR HEALTH 2022. [DOI: 10.1007/s11332-021-00893-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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25
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Del-Pino-Casado R, López-Martínez C, Osuna AF, Orgeta V. The relationship between perceived social support and psychological distress in carers of older relatives: A longitudinal cross-lagged analysis. J Affect Disord 2022; 297:401-406. [PMID: 34715173 DOI: 10.1016/j.jad.2021.10.075] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 09/30/2021] [Accepted: 10/23/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND OBJECTIVES Although a large body of research has examined the relationship between social support and psychological health of family carers of frail older people, the exact nature and direction of this relationship is not well understood with most research to date being cross-sectional. This longitudinal study explored the relationship between perceived social support and psychological distress in carers of older relatives. METHODS We used data from two longitudinal cohorts which included a total of 332 family carers of frail older people. We used cross-lagged panel analysis to investigate the longitudinal association between perceived social support and carer psychological distress controlling for a number of covariates over time. RESULTS Fully-adjusted Generalised Estimating Equations (GEE) and cross-lagged models indicated that higher social support was significantly associated with lower carer psychological distress over time (regression coefficient [B] = -0.178, standard error [SE] = 0.028), with levels of perceived social support exerting an effect on psychological distress rather than vice versa (β = 0.03, p = 0.32). LIMITATIONS All observations were based on self-report data, and there may be other variables that may explain the results that we did not account for. DISCUSSION AND IMPLICATIONS Our study finds that the directionality of the relationship appears to be from perceived social support to carer psychological distress suggesting that social support directly affects carer psychological health but not vice versa. This finding has important implications for the provision of social support interventions for carers of frail older people at risk of experiencing psychological distress.
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Affiliation(s)
- Rafael Del-Pino-Casado
- Department of Nursing, Faculty of Health Sciences, University of Jaén, Campus Las Lagunillas s/n, Jaén 23071, Spain.
| | - Catalina López-Martínez
- Department of Nursing, Faculty of Health Sciences, University of Jaén, Campus Las Lagunillas s/n, Jaén 23071, Spain
| | - Antonio Frías Osuna
- Department of Nursing, Faculty of Health Sciences, University of Jaén, Campus Las Lagunillas s/n, Jaén 23071, Spain
| | - Vasiliki Orgeta
- Division of Psychiatry, University College London, London, United Kingdom
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26
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The Relationship between Cancer Caregiver Burden and Psychological Outcomes: The Moderating Role of Social Connectedness. Curr Oncol 2021; 29:14-26. [PMID: 35049676 PMCID: PMC8775135 DOI: 10.3390/curroncol29010002] [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: 10/11/2021] [Revised: 12/03/2021] [Accepted: 12/14/2021] [Indexed: 11/18/2022] Open
Abstract
The present study: (a) examined the extent of caregiver burden and psychological wellbeing and (b) tested whether social connectedness moderated the association between caregiver burden and psychological symptoms in caregivers of people with cancer. The cross-sectional survey study included 189 cancer caregivers (mean age = 36.19 years, standard deviation = 11.78; 80.4% female). Data were collected on caregiver burden, social connectedness, and depression and anxiety. Moderation analysis was conducted to examine the effect of social connectedness on the relationship between caregiver burden and depression and anxiety. Caregiver burden was positively associated with depression and anxiety symptoms. Controlling for significant demographic and caregiver characteristics, the moderation model showed as perceived social connectedness increased, the relationship between caregiver burden and depression decreased (β = −0.007, se = 0.004, 95% CI: −0.014, 0.000, p = 0.05). By contrast, social connectedness did not moderate the association between caregiver burden and anxiety. Findings have implications for the management of depression in cancer caregivers. Social connectedness appears to provide a protective buffer from the negative impacts of caregiving, providing increased psychological resources to manage the burden associated with caregiving, resulting in lower depression. Research on strategies to improve caregiver wellbeing through enhancing engagement with social networks in ways that improve perceived sense of connectedness with others is warranted.
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27
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Du X, Kim YK. Direct and Indirect Associations between Family Residential Mobility, Parent Functioning, and Adolescent Behavioral Health. JOURNAL OF CHILD AND FAMILY STUDIES 2021; 30:3055-3069. [PMID: 34664006 PMCID: PMC8515153 DOI: 10.1007/s10826-021-02129-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/27/2021] [Indexed: 06/13/2023]
Abstract
Residential mobility and caregiver social support are two key factors influencing adolescents' and their caregivers' health status. However, few studies have examined whether these factors vary across developmental periods. The present study therefore adopted a life course perspective to investigate the longitudinal effects of residential mobility and caregiver social support on a range of individual health outcomes (i.e., caregiver depression, adolescent internalizing problems, and adolescent externalizing problems) among families exposed to disadvantaged social and economic conditions. Data were obtained from the Longitudinal Studies in Child Abuse and Neglect, and 425 children and their caregivers who completed the age 12, 14, 16, and 18 interviews were included in this study. Structural equation modeling was conducted to test the measurement and structural models. The results showed that greater residential mobility was significantly associated with higher levels of caregiver depression, which in turn led to more adolescent internalizing and externalizing problems. Alternatively, higher levels of caregiver social support mitigated the levels of caregiver depression, which in turn resulted in fewer adolescent internalizing and externalizing problems. Highly mobile children and their caregivers were found to be vulnerable to several negative health outcomes and in high need of mental and behavioral health support and services. These findings inform important policy and practice implications on social support for mobile caregivers to address their children's behavioral problems.
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Affiliation(s)
- Xi Du
- School of Social Work, Louisiana State University, Baton Rouge, LA 70803 USA
| | - Youn Kyoung Kim
- School of Social Work, Louisiana State University, Baton Rouge, LA 70803 USA
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28
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Predictive model of psychological distress in family caregivers of patients with cancer: a cross-sectional study. Support Care Cancer 2021; 29:5091-5101. [PMID: 33598735 DOI: 10.1007/s00520-021-06022-1] [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] [Received: 09/03/2020] [Accepted: 01/21/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE To examine a predictive theoretical model of psychological distress based on the following variables reflected on family caregivers of patients with cancer: the unmet supportive care needs, subjective caregiving burden, social support, and the positive aspects of caregiving. METHODS A cross-sectional descriptive study was conducted on a sample of 484 dyads of patients and their family caregivers. The caregivers completed structured questionnaires designed to measure psychological distress, unmet supportive care needs, subjective caregiving burden, positive aspects of caregiving, and social support. Patients' demographic variables and medical data were collected from a medical record review. We used a structural equation modeling to test the predictive theoretical model. RESULTS Path analysis results partially supported the proposed model with satisfactory fit indices. Specifically, family caregivers with an increasing number of unmet needs or a heavier caregiving burden were more likely to have more severe psychological distress. Bootstrapping results supported that the caregiving burden and social support were significant mediators. Greater unmet supportive care needs predicted higher psychological distress through increasing caregiving burden. Stronger social support predicted lower psychological distress through decreasing caregiving burden. Positive aspects of caregiving predicted lower caregiving burden through the increasing perceived social support, which in turn eliminated psychological distress. CONCLUSIONS Unmet supportive care needs could cause psychological distress through increasing caregiving burden. The positive aspects of caregiving reduced caregiving burden through increasing social support, which subsequently alleviated psychological distress. Interventions that aim to satisfy supportive care needs, to reduce caregiving burden, and to strengthen social support ties may boost the mental health of family caregivers.
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29
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Su Z, McDonnell D, Liang B, Kue J, Li X, Šegalo S, Advani S, Flores BE, Wang J. Technology-based health solutions for cancer caregivers to better shoulder the impact of COVID-19: a systematic review protocol. Syst Rev 2021; 10:43. [PMID: 33526095 PMCID: PMC7849615 DOI: 10.1186/s13643-021-01592-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 01/15/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Cancer patients are particularly vulnerable to COVID-19, partially owing to their compromised immune systems and curbed or cut cancer healthcare services caused by the pandemic. As a result, cancer caregivers may have to shoulder triple crises: the COVID-19 pandemic, pronounced healthcare needs from the patient, and elevated need for care from within. While technology-based health interventions have the potential to address unique challenges cancer caregivers face amid COVID-19, limited insights are available. Thus, to bridge this gap, we aim to identify technology-based interventions designed for cancer caregivers and report the characteristics and effects of these interventions concerning cancer caregivers' distinctive challenges amid COVID-19. METHODS A systematic search of the literature will be conducted in PubMed, PsycINFO, CINAHL, and Scopus from the database inception to the end of March 2021. Articles that center on technology-based interventions for cancer caregivers will be included in the review. The search strategy will be developed in consultation with an academic librarian who is experienced in systematic review studies. Titles, abstracts, and full-text articles will be screened against eligibility criteria developed a priori. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses procedures will be followed for the reporting process. CONCLUSIONS COVID-19 has upended cancer care as we know it. Findings of this study can shed light on evidence-based and practical solutions cancer caregivers can utilize to mitigate the unique challenges they face amid COVID-19. Furthermore, results of this study will also offer valuable insights for researchers who aim to develop interventions for cancer caregivers in the context of COVID-19. In addition, we also expect to be able to identify areas for improvement that need to be addressed in order for health experts to more adequately help cancer caregivers weather the storm of global health crises like COVID-19 and beyond. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42020196301.
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Affiliation(s)
- Zhaohui Su
- School of Nursing, Center on Smart and Connected Health Technologies, Mays Cancer Center, UT Health San Antonio, San Antonio, TX 78229 USA
| | - Dean McDonnell
- Department of Humanities, Institute of Technology Carlow, Carlow, R93 V960, Ireland
| | - Bin Liang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 10010 China
| | - Jennifer Kue
- School of Nursing, Ohio State University, Columbus, USA
| | - Xiaoshan Li
- Program of Public Relations and Advertising, Beijing Normal University-Hong Kong Baptist University United International College, Zhuhai, China
| | - Sabina Šegalo
- Department of Microbiology, Faculty of Medicine, University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina
| | - Shailesh Advani
- Terasaki Institute of Biomedical Innovation, Los Angeles, CA 21100 USA
| | - Bertha E. Flores
- School of Nursing, UT Health San Antonio, San Antonio, TX 78229 USA
| | - Jing Wang
- School of Nursing, Center on Smart and Connected Health Technologies, Mays Cancer Center, UT Health San Antonio, San Antonio, TX 78229 USA
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30
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Su Z, McDonnell D, Liang B, Kue J, Li X, Šegalo S, Advani S, Flores BE, Wang J. Technology-based Health Solutions for Cancer Caregivers to Better Shoulder the Impact of COVID-19: A Systematic Review Protocol. RESEARCH SQUARE 2021:rs.3.rs-66218. [PMID: 32908975 PMCID: PMC7480034 DOI: 10.21203/rs.3.rs-66218/v1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND Cancer patients are particularly vulnerable to COVID-19, partially owing to their compromised immune systems and curbed or cut cancer healthcare services caused by the pandemic. As a result, cancer caregivers may have to shoulder triple crises: the COVID-19 pandemic, pronounced healthcare needs from the patient, and elevated need for care from within. While technology-based health interventions have the potential to address unique challenges cancer caregivers face amid COVID-19, limited insights are available. Thus, to bridge this gap, we aim to identify technology-based interventions designed for cancer caregivers and report the characteristics and effects of these interventions concerning cancer caregivers' distinctive challenges amid COVID-19. METHODS A systematic search of the literature will be conducted in PubMed, PsycINFO, CINAHL, and Scopus from the database inception to the end of March, 2021. Articles that center on technology-based interventions for cancer caregivers will be included in the review. The search strategy will be developed in consultation with an academic librarian who is experienced in systematic review studies. Titles, abstracts, and full-text articles will be screened against eligibility criteria developed a priori. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses procedures will be followed for the reporting process. CONCLUSIONS COVID-19 has upended cancer care as we know it. Findings of this study can shed light on evidence-based and practical solutions cancer caregivers can utilize to mitigate the unique challenges they face amid COVID-19. Furthermore, results of this study will also offer valuable insights for researchers who aim to develop interventions for cancer caregivers in the context of COVID-19. In addition, we also expect to be able to identify areas for improvement that need to be addressed in order for health experts to more adequately help cancer caregivers weather the storm of global health crises like COVID-19 and beyond. STUDY PROTOCOL REGISTRATION PROSPERO CRD42020196301.
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Affiliation(s)
- Zhaohui Su
- University of Texas Health Science Center at San Antonio
| | | | - Bin Liang
- Chinese Academy of Medical Sciences and Peking Union Medical College
| | | | - Xiaoshan Li
- Beijing Normal University-Hong Kong Baptist University United International College
| | | | | | | | - Jing Wang
- University of Texas Health Science Center at San Antonio
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Caregiver Quality of Life Before and After Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy. J Am Coll Surg 2020; 230:679-687. [PMID: 32007532 DOI: 10.1016/j.jamcollsurg.2019.12.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 12/16/2019] [Indexed: 11/23/2022]
Abstract
BACKGROUND Cytoreductive surgery plus intraperitoneal hyperthermic chemotherapy (CRS+HIPEC) is a formidable procedure, often affecting the quality of life (QOL) of the caregiver as well as the patient. We explored the impact of quality of life and depressive symptom burdens of CRS+HIPEC caregivers prospectively. STUDY DESIGN Patient and caregiver dyads were both consented per IRB-approved protocol; CRS ± HIPEC was performed. The impact on QOL and depressive symptom burdens was assessed on patient-caregiver dyads via the Caregiver Quality of Life (CG QOL-C), CES-D (Center for Epidemiological Studies - Depression) instruments; pre-CS+HIPEC (T1), postoperative (T2), 6 (T3), and 12 (T4) months. RESULTS Seventy-seven dyads were approached, with 73 participating. Both caregiver and patient depressive symptom trajectories changed significantly. CES-D means for caregivers were (T1-4): 15.1 (SE [standard error] 1.7), 15.0 (1.4), 10.3 (1.4), 13.1 (2.1), p = 0.0008; for patients were: 10.3 (SE 1.1), 13.7 (1.4), 9.0 (1.2), and 10.3 (1.5), p = 0.0002. Preoperatively, caregivers scored 4.8 points (SD 13.4) (p = 0.026) higher than patients. Patients experienced an increase in depression scores at the postoperative visit. At T3, both groups dropped to less concerning levels; yet caregiver CES-D scores increased again at T4 4.7 points (SD 12.5) higher than the patients, and financial well-being became worse from T1 to T3. Possible, probable, and "cases" of depression were higher for caregivers were at all measured time points. CONCLUSIONS Significant numbers of caregivers endured high depressive symptom burdens and financial concerns. Different caregiver-patient trajectories reflect the need for differential timing of supportive interventions. Evaluation of quality of life and impact of CRS+HIPEC procedures must move beyond assessment of only the patient.
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