Quality of life and associated factors among adults living with cancer and their family caregivers

The Influence of Sociodemographic Factors and Clinical Aspects on the Quality of Life of Surgically Treated Patients with Colorectal Cancer

Introduction

Due to the increasing number of cases and the levels of mortality, colorectal cancer is still a major health problem. Therefore, the growing interest in the quality of life of patients and the assessment of the quality of life of patients with colorectal cancer seems to be particularly important. The aim of the study was to investigate and determine factors that have a significant impact on the QoL of patients who were diagnosed with colorectal cancer that was surgically treated in the Surgical Department of the 4th Military Clinical Hospital in Wroclaw.

Methods

102 respondents were enrolled into the study. The QLQ-C30, QLQ-CR29 as well as an original questionnaire regarding the socioeconomic factors were used for the assessment. The information was supplemented with patients' clinical data.

Results

According to the QLQ-C30 questionnaire the average QoL of the respondents was 55%. Factors such as male gender, younger age, higher BMI, no significant weight loss, living with family, lower level of education and being professionally active have significant positive impact on QoL. In contrary, patients with more advanced and malignant cancer with tumor located in the right half of the colon had worse QoL. The particular domains of QoL influenced by these factors were also identified. Determining these factors will allow for more effective treatment, for the shortening of the hospitalization and finally for the reduction of the costs.

Conclusion

The better QoL of the patients with colorectal cancer treated surgically showed younger men, living with family and with the support from close people, professionally active, with primary level of education, and without significant weight loss, ie less than 5% of body weight in the last 6 months. Moreover, patients with cancer located in the left colon, at a lower stage, with a lower grading demonstrated a better QoL.

Cancer Patient Perspectives on the Meaning of Healing and the Clinician as a Healer

BACKGROUND

The experience of living with cancer is marked by suffering and loss, which creates a need for healing. Understanding what healing means to patients and how clinicians can play a role in the healing process is essential to holistic cancer care.

OBJECTIVE

The aim of this study was to explore the perspectives of cancer patients on the meaning and experiences of healing and the qualities of a clinician and the clinician-patient relationship that are healing.

METHODS

A qualitative study was conducted using semi-structured interviews with 14 cancer patients. Participants were asked about their illness experience, definition of healing, qualities of a healer, and relationships with clinicians that were healing. Interview transcripts were coded, and qualitative analysis was conducted to identify major themes.

RESULTS

Participants defined the nature of healing as comprising aspects of physical, mental, emotional, and spiritual well-being. Participants described healing as alleviating pain and symptoms; promoting mental strength, emotional comfort, and spiritual connection; restoring and adapting to losses; and improving quality of life. The qualities of a clinician that contributed to a healing relationship included listening, empathy and compassion, understanding patients' values and goals, and caring for the patient as a whole person.

CONCLUSION

Participants viewed healing as physical, psychosocial, and spiritual in nature and an important part of their cancer experience with an emphasis on quality of life. Clinicians played an important role beyond treating the cancer by helping in the healing process through their humanistic qualities and holistic approach to patient care.

Association between emotional competence and risk of unmet supportive care needs in caregivers of cancer patients at the beginning of care

PURPOSE

This cross-sectional study explored the associations between intrapersonal and interpersonal emotional competence (EC) and the unmet supportive care needs (SCN), anxiety, and depression of informal caregivers at the beginning of gastrointestinal or haematological cancer care, i.e. during chemotherapy and within 6 months after diagnosis.

METHODS

The participants completed a self-reported questionnaire, comprising the Short Profile of Emotional Competence (S-PEC), the SCN survey for partners and caregivers (SCNS-P&C), and the Hospital Anxiety and Depression Scale (HADS). Multivariate logistic regression models were performed to explore the influence of EC on unmet SCN and the presence of moderate/severe anxiety or depression.

RESULTS

Most of the 203 caregivers were women (n = 141, 69.80%) and the partners of patients (n = 148, 73.27%) suffering from gastrointestinal (n = 112, 55.17%) and haematological (n = 91, 44.83%) cancer. Only intrapersonal EC showed a significant influence out of all the dimensions of unmet SCN related to healthcare services and information (odds ratio (OR) = 0.35 [95%CI 0.19; 0.65]), emotional and psychological needs (OR = 0.43 [95%CI 0.25; 0.74]), work and social security (OR = 0.57 [95%CI 0.37; 0.88]), and communication and family support (OR = 0.61 [95%CI 0.39; 0.95]). A one-unit increase in the intrapersonal EC score significantly reduced the probability of anxiety (OR = 0.42, [95%CI 0.26; 0.68]) and depression (OR = 0.34, [95%CI 0.21; 0.55]).

CONCLUSION

Intrapersonal EC of caregivers is crucial to reduce the risk of unmet SCN, anxiety, and depression from the beginning of care. Identifying caregivers with lower intrapersonal EC may be necessary to increase vigilance from healthcare professionals and psychologists.

Exploring the spiritual needs of patients with advanced cancer in China: a qualitative study

This qualitative study aimed to gain a deep understanding of the spiritual needs of patients with advanced cancer. A qualitative study using semi-structured interviews was conducted. The interviews were audio-recorded, transcribed verbatim, and subjected to thematic analysis. Two researchers coded the interviews independently in NVivo 12 plus and developed major themes and subthemes by inductive and constant comparison. This study was conducted in the inpatient ward of a tertiary cancer hospital in Hunan Province, Chinese Mainland. Eligible participants with advanced cancer were recruited using the purposive sampling method. The sample size was determined by data saturation. All interviews were conducted face-to-face individually from May 2021 to July 2021. A total of 13 patients with advanced cancer patients were interviewed. Six themes were identified, namely being treated as normal and independent individuals, receiving and giving love, seeking inner peace, connecting with spiritual sources, finding meaning and purpose, and preparing for death. Different categories of spiritual needs of patients with advanced cancer were identified in this study. Healthcare professionals need to develop interventions that aim to meet patients' spiritual needs.

Health literacy, eHealth literacy and their association with burden, distress, and self-efficacy among cancer caregivers

Purpose

Health literacy skills are vital for cancer caregivers in helping cancer survivors to navigate their diagnosis, treatment, and recovery but little is known. This study explored health literacy and eHealth literacy among cancer caregivers and the relationship between health literacy/eHealth literacy and potential associated factors.

Methods

Informal caregivers who had cared for an individual with cancer completed a survey which collected demographic data and measured caregiver health literacy, eHealth literacy, self-efficacy, burden, and distress.

Results

Seven percent of caregivers had inadequate health literacy. Caregivers scored lowest on health literacy domains related to caregiver social support, information seeking and understanding care recipient preferences. eHealth literacy was associated with self-efficacy and burden while, different health literacy domains were associated with burden ('Understanding care recipient needs and preferences'), self-efficacy ('Cancer-related communication with the care recipient' and 'Understanding care recipients needs and preferences') and distress ('Proactivity and determination to seek information', 'Understanding care recipient needs and preferences', 'Understanding the healthcare system').

Conclusion

Findings highlight key areas of need regarding cancer caregiver health literacy which future research can target. Given the observed relationship between aspects of health literacy and burden, distress and self-efficacy future work could be carried out on how to alleviate high levels of burden and distress and how to enhance self-efficacy among cancer caregivers by addressing health literacy skills.

Implications for cancer survivors

Findings from this study will inform the development of health literacy interventions to support caregivers to build their health literacy skills and enable this group to better support cancer survivors as a result.

Factors related to the quality of life of family cancer caregivers

Background

Cancer caregivers directly affect patient health outcomes. To maintain the function and health of caregivers so that patients can receive efficient care, we must pay more attention to caregivers' quality of life in the process of caring for patients. However, the factors influencing caregivers' quality of life are complex.

Aim

To assess caregivers' quality of life in the process of caring for cancer patients and to explore the factors associated with it.

Design

This was a descriptive correlational study. A self-report questionnaire was used to anonymously collect data from one Chinese cancer hospital. The Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp-12), General Self-efficacy Scale (GSES), Positive and Negative Affect Schedule (PANAS), Connor-Davidson Resilience Scale 10 (CD-RISC-10), 24-item Caregiver Burden Inventory (CBI) and Caregiver Evaluation Questionnaire were used to measure caregivers' spiritual well-being, self-efficacy, affective well-being, resilience, caregiver burden and quality of life. One-way analysis of variance, the Kruskal-Wallis H test and multiple regression analysis were applied to measure the factors influencing caregivers' situations.

Setting and participants

A total of 315 caregivers of cancer patients were selected by convenience sampling. All participants were invited to complete the questionnaire through a one-on-one approach.

Results

The mean score for caregiver quality of life was 204.62 ± 36.61. After controlling for demographic factors, self-efficacy (β' = 0.265, p < 0.01), resilience (β' = 0.287, p < 0.01) and positive affect (β' = 0.103, p < 0.01) were protective factors for caregivers' quality of life. Negative affect (β' = -0.217, p < 0.01) and caregiver burden (β' = -0.219, p < 0.01) were negative factors. Notably, not all of these predictors can predict all dimensions of quality of life.

Conclusion

Caregivers' quality of life needs to be further improved. The results of this study may provide clues to help identify factors influencing caregivers' quality of life and implement targeted strategies to improve their quality of life.

Effects of Music on the Quality of Life of Family Caregivers of Terminal Cancer Patients: A Randomised Controlled Trial

The aim of this study was to investigate the effects of listening to self-chosen music on the quality of life of family caregivers of cancer patients receiving palliative home care. A total of 82 family caregivers were assigned either to the intervention group (n = 41) or to the control group (n = 41) in this double-blind, multicentre, randomised controlled clinical trial. The recruitment period was between July 2020 and September 2021. The intervention group received individualised pre-recorded music in daily 30 min sessions for 7 consecutive days. The control group was given a recorded repetition of the basic therapeutic training education also in 30 min sessions for 7 consecutive days. The primary endpoint assessed was the caregivers' quality of life (Quality of Life Family Version and European Quality of Life visual analogue scale) before and after the intervention. The secondary endpoint was their perceived satisfaction with the intervention (Client Satisfaction Questionnaire). The music intervention was successful, producing a tangible improvement in the caregivers' quality of life (p < 0.01) and satisfaction with the care provided (p = 0.002). The intervention was not only effective but produced no adverse effects. This study encourages the use of self-chosen music as a complementary intervention in nursing care for family caregivers of palliative cancer patients.

Experiences of Muslim women living with gynaecological cancer and family caregivers

BACKGROUND

Cancer has a large impact on the life of the diagnosed person and also their caregivers, who are typically family members. The impact of cancer on a Muslim woman and her caregivers has not been well researched because of cultural and social constraits.

AIMS

The aim of this study was to explorel the experiences of Muslim women with gynaecological cancers and their family caregivers.

METHODS

A descriptive phenomenological approach was adopted. A convenience sample was used in the research.

FINDINGS

The study findings were grouped into four major themes: the initial reaction to a cancer diagnosis from women and their caregivers, difficulties the patient and caregiver experienced (physiological, psychological, social and sexual), coping with cancer and expectations that caregivers and patients have of the institution and the health personnel. It was determined that during this disease and treatment, both the patients and caregivers faced difficulties, which can be categorised as physiological, psychological, social and sexual. Muslim women with gynaecological cancer frequently used coping behaviours, such as worshiping and believing that illness and healing come from God during the illness process.

CONCLUSIONS

Patients and their family caregivers lived through various difficulties. Healthcare professionals need to consider the expectations of patients with gynecological cancer, alongside those of their family caregivers. Nurses can help Muslim patients and their families cope with the problems they experience by being aware of the positive coping methods of Muslim cancer patients and their caregivers. Nurses should consider individuals' religious beliefs and cultural differences while giving care.

Emotional distress, supportive care needs and age in the prediction of quality of life of cancer patients' caregivers: A cross-sectional study

INTRODUCTION

The existing literature shows a significant impact of cancer on caregivers' quality of life (QoL) and divergent results according to associated factors. To better understand the experience of cancer patients' caregivers, the present study aimed at comparing caregivers' QoL according to cancer care pathway and type of cancer, and at identifying the factors associated with their QoL.

METHODS

Caregivers were included in the study either during chemotherapy or follow-up to assess their QoL (CARGOQoL), unmet supportive care needs (SCNS-P&C), and anxiety and depression levels (HADS). CARGOQoL scores were then compared using ANOVA or Mann-Whitney non-parametric tests (objective 1). Based on univariate analyses, a multivariate analysis of covariance or linear regression model was performed for each CARGOQoL dimension (objective 2).

RESULTS

Among 583 participants (57.29% included during the follow-up phase), 523 completed the questionnaires. There was no effect of treatment phase and little effect of cancer site or disease stage on caregivers' QoL. Although significant factors associated with caregivers' QoL varied according to the dimensions assessed, the main associated factors were psychological experience (p < 0.05), satisfaction with the patient's care and supportive care needs (p < 0.01), and age of the patient or caregiver (p < 0.005).

CONCLUSION

This study shows the necessity to support caregivers during both active treatment and follow-up. It highlights the crucial role of emotional distress, supportive care and age in caregivers' QoL, regardless of the patients' oncological status.

Proposing and evaluating a model of depression, stress, resilience and spirituality in relation to pain in women with breast cancer: Investigating the mediating role of mindfulness

BACKGROUND

Pain experience is one of the most common symptoms of women with breast cancer receiving chemotherapy. It may cause physical and psychological problems and interfere with the treatment process.

AIMS

This study aimed to examine the relationship between depression, stress, resilience and spirituality on the pain symptoms of breast cancer patients during chemotherapy and explore the potential mediating role of mindfulness in this association.

METHOD

Two hundred and forty women with breast cancer receiving chemotherapy from Shiraz University Hospital, were selected and evaluated by a purposive sampling method. The research instruments were Perceived Stress Scale, Beck Depression Questionnaire-2, Mindfulness, Resilience, Spirituality and Pain Questionnaires. The obtained data was analyzed by SPSS software and MPLUS using Spearman correlation coefficient and path analysis.

RESULTS

Based on the findings of direct path analysis, depression, stress, and spirituality showed a significant relationship with mindfulness, but resilience had no significant relationship with mindfulness (p < 0.01). Furthermore, depression, stress, resilience, and mindfulness showed a significant relationship with pain, while spirituality had no significant relationship with pain (p < 0.01). Finally, indirect path analysis revealed mindfulness is a significant mediator of stress and pain (p < 0.05).

CONCLUSIONS

The present study suggested a model can be useful in better understanding of the psychological components affecting pain in breast cancer patients, after and during their treatments. It also provided an effective framework to develop and investigate pain-focused and non-pharmacological interventions.

Psychosocial aspects of adult cancer patients: A scoping review of sub-Saharan Africa

OBJECTIVE

Psychosocial aspects of adult cancer patients in sub-Saharan Africa (SSA) have been described in silos of research articles. Integrative analysis of regional evidence is lacking. This review aimed to describe the scope of existing research on mental health problems, identify research gaps and make informed research, policy and practice recommendations.

METHODS

Search was conducted for original peer-reviewed research articles, irrespective of their quality, on psychosocial aspects of cancer in all SSA countries using PubMed, Google Scholar, Google search, African Index Medicus and direct searches of reference list of pertinent journal articles. Publications in English or translated to English were included. Case reports, dissertations, abstracts, publications without primary focus on psychosocial issues, psychosocial issues in children and studies conducted with SSA populations living outside the sub-region were excluded. The methodological framework described by Arksey and O'Malley was used to synthesize and present the results. Inductive approach was used to arrive at the thematic areas. Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guideline was used to describe the review.

RESULTS

Eighty-three studies conducted across 15 countries were identified. Six thematic areas emerged namely; psychosocial needs, psychiatric disorders, coping strategies, suicidality, psychometrics and psychosocial interventions. Fifteen of 46 countries had at least one study with the majority of articles emanating from Nigeria. Research articles on psychosocial needs, psychiatric morbidities and coping strategies appears adequate for systematic review in SSA region. Despite the overwhelming evidence of high unmet psychosocial needs, a huge gap exists regarding psychosocial interventions.

CONCLUSION

Further research is needed into identified gaps in the region and quality of evidence of these studies need to be improved upon. Comprehensive policies and action plan development are sin qua non for addressing psychosocial problems of adults with cancer in SSA.

Positive Mental Health and Mental Health Literacy of Informal Caregivers: A Scoping Review

Positive mental health and mental health literacy are two main concepts to ensure an individual and social state of mental health and well-being. A scoping review of the scientific literature published in the field of health sciences was conducted to identify the relationship between mental health literacy and the positive mental health of family caregivers. A research expression was used to search for articles in health databases, respecting the main topics of the Participants/Concept/Context (PCC) framework. A total of eight articles were included from the 2830 initially identified using the PRISMA Extension for Scoping Reviews (PRISMA-ScR) process. It was noticeable that none of the studies related positive mental health and mental health literacy of caregivers. Nevertheless, it was possible to identify predictors of mental health and self-efficacy, such as burden and a lack of information about and support in the process of care. Caregivers' quality of life, self-esteem and confidence are also important positive mental health predictors that are closely related to health literacy. The knowledge of these factors can contribute to the reduction in negative determinants of mental health of caregivers and the resolution of strategies to meet caregivers' needs.

Improving the health-related quality of life of adult Nigerians living with cancer and their family caregivers: intervention development

Background

Evidence for the effectiveness of interventions aimed at improving the health-related quality of life of people living with cancer and/or family members is compelling. However, most interventional research has been conducted in high-income countries, and no intervention had been tested in low-income countries such as Nigeria. It is critical to design a culturally theory-based intervention in a resource-poor setting to address the needs and support coping strategies of cancer patients and their family caregivers.

Methods

Theory, evidence, and practical issues were considered. The Medical Research Council framework for developing and evaluating complex interventions and Behaviour Change Wheel provided the framework for intervention design. Findings generated by a needs assessment of adult Nigerians with cancer and their family caregivers and relevant theories (the Spirituality and the Supportive Care Framework for Cancer) informed content development.

Results

A theory-based, culturally tailored socio-spiritual intervention was developed to address the specific needs of adult Nigerians with cancer and their family caregivers. A 4-week intervention included strategies designed to improve social and spiritual support, information and health literacy, and health-related quality of life.

Conclusions

A systemic approach was used to conceptualise an evidence-based and theory-informed intervention tailored to address previously identified shortfalls in support available to adults living with cancer and their family caregivers, in Nigeria. If implemented and effective, such an intervention has the potential to improve the health-related quality of life of people living with cancer and their families in Nigeria.

Feasibility of a socio-spiritual intervention to improve quality of life of adult Nigerians with cancer and their family caregivers: Protocol for a randomised controlled trial

BACKGROUND

Despite high psychosocial needs that negatively affect the quality of life of adults living with cancer and their family caregivers, there is a lack of interventions that are culturally sensitive to low-income countries. This protocol tests the feasibility of a randomised controlled trial on the efficacy of a socio-spiritual intervention to improve the quality of life of adult Nigerians living with cancer and their family caregivers.

METHODS/DESIGN

This two-arm trial will recruit 152 adults with cancer and their family caregivers (76 dyads). Participants will be recruited from a clinical facility in Zaria, Kaduna State, Nigeria. Eligible participants will be randomly assigned to either the intervention or control group at a 1:1 ratio. The intervention consists of four weekly face-to-face sessions with a focus on spirituality, social support, and information needs. Control participants will receive usual care. Outcome measures include feasibility, spiritual need, social need, information, cancer health literacy, and quality of life collected at baseline and immediate post-intervention.

DISCUSSION

Nigeria has the highest rate of extreme poverty globally with high rates of cancer mortality. Testing the feasibility of social-spiritual interventions in resource poor settings is important to establish preliminary efficacy and sustainability. Family-centred interventions for adults living with cancer and their family caregivers can strengthen their coping capabilities. If this intervention is feasible and effective, it could be implemented both in clinical practice and communities in other low and middle income countries.