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Shen B, Sun J, Yu Z, Xu G, Zhou Y. Are couple-based psychological interventions beneficial for the mental health of prostate cancer patients and their spouses? A systematic review and meta-analysis. Clin Psychol Psychother 2023. [PMID: 37905476 DOI: 10.1002/cpp.2925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 09/28/2023] [Accepted: 10/13/2023] [Indexed: 11/02/2023]
Abstract
As the survival rates for prostate cancer (PCa) have improved, there has been an increasing focus on the mental health of couples affected by this condition. There have been several couple-based psychological interventions, and yet the impact of this treatment modality on the mental health of PCa patients and their spouses is unclear. Consequently, a systematic search was conducted in PubMed, Embase, Cochrane, LILACS, and Web of Science up to March 2023 for randomized controlled trials (RCTs) addressing the impacts of couple-based psychological interventions on both PCa patients and their spouses. Besides, the Cochrane Risk of Bias Assessment Tool was employed to evaluate the methodological quality and potential bias of the included studies. Moreover, statistical analysis and meta-analysis were performed utilizing Revman 5.4, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was employed to assess the certainty of evidence. A total of nine RCTs were included, utilizing anxiety, depression, distress, communication, and self-efficacy as outcome indicators to assess mental health. Results demonstrated that couple-based psychological interventions increased spouses' self-efficacy (WMD, 0.21; 95% CI: -0.00 ~ 0.42; P = 0.05) and communication (SMD, 0.34; 95% CI: 0.09 ~ 0.59; P = 0.009), while reducing their distress (SMD, -0.21; 95% CI: -0.40 ~ -0.02; P = 0.03). Nonetheless, there is a need for additional research on the effect of couple-based psychological interventions on the mental health of PCa-affected couples given the limited evidence supporting this conclusion.
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Affiliation(s)
- Bin Shen
- Shaoxing People's Hospital, Shaoxing, Zhejiang, China
- Department of Urology, First Affiliated Hospital of Shaoxing University, Shaoxing, Zhejiang, China
| | - Jianhong Sun
- Shaoxing People's Hospital, Shaoxing, Zhejiang, China
- Department of Urology, First Affiliated Hospital of Shaoxing University, Shaoxing, Zhejiang, China
| | - Zhenliang Yu
- Shaoxing People's Hospital, Shaoxing, Zhejiang, China
- Department of Urology, First Affiliated Hospital of Shaoxing University, Shaoxing, Zhejiang, China
| | - Gang Xu
- Shaoxing People's Hospital, Shaoxing, Zhejiang, China
- Department of Urology, First Affiliated Hospital of Shaoxing University, Shaoxing, Zhejiang, China
| | - Yaoying Zhou
- Shaoxing People's Hospital, Shaoxing, Zhejiang, China
- Department of Nursing, Shaoxing People's Hospital, Shaoxing, Zhejiang, China
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Podina IR, Bucur AM, Todea D, Fodor L, Luca A, Dinu LP, Boian RF. Mental health at different stages of cancer survival: a natural language processing study of Reddit posts. Front Psychol 2023; 14:1150227. [PMID: 37425170 PMCID: PMC10326387 DOI: 10.3389/fpsyg.2023.1150227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 06/07/2023] [Indexed: 07/11/2023] Open
Abstract
Introduction The purpose of this study was to use text-based social media content analysis from cancer-specific subreddits to evaluate depression and anxiety-loaded content. Natural language processing, automatic, and lexicon-based methods were employed to perform sentiment analysis and identify depression and anxiety-loaded content. Methods Data was collected from 187 Reddit users who had received a cancer diagnosis, were currently undergoing treatment, or had completed treatment. Participants were split according to survivorship status into short-term, transition, and long-term cancer survivors. A total of 72524 posts were analyzed across the three cancer survivor groups. Results The results showed that short-term cancer survivors had significantly more depression-loaded posts and more anxiety-loaded words than long-term survivors, with no significant differences relative to the transition period. The topic analysis showed that long-term survivors, more than other stages of survivorship, have resources to share their experiences with suicidal ideation and mental health issues while providing support to their survivor community. Discussion The results indicate that Reddit texts seem to be an indicator of when the stressor is active and mental health issues are triggered. This sets the stage for Reddit to become a platform for screening and first-hand intervention delivery. Special attention should be dedicated to short-term survivors.
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Affiliation(s)
- Ioana R. Podina
- Laboratory of Cognitive Clinical Sciences, University of Bucharest, Bucharest, Romania
- Department of Applied Psychology, University of Bucharest, Bucharest, Romania
| | - Ana-Maria Bucur
- Interdisciplinary School of Doctoral Studies, University of Bucharest, Bucharest, Romania
| | - Diana Todea
- Interdisciplinary School of Doctoral Studies, University of Bucharest, Bucharest, Romania
| | - Liviu Fodor
- International Institute for The Advanced Studies of Psychotherapy and Applied Mental Health, Babeș-Bolyai University, Cluj-Napoca, Romania
- Evidence Based Psychological Assessment and Interventions Doctoral School, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Andreea Luca
- Interdisciplinary School of Doctoral Studies, University of Bucharest, Bucharest, Romania
| | - Liviu P. Dinu
- Human Language Technology Research Center, University of Bucharest, Bucharest, Romania
- Faculty of Mathematics and Computer Science, University of Bucharest, Bucharest, Romania
| | - Rareș F. Boian
- Department of Computer Science, Babeş-Bolyai University, Cluj-Napoca, Romania
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Teo I, Ng S, Bundoc FG, Malhotra C, Ozdemir S, Steel JL, Finkelstein EA. A prospective study of psychological distress among patients with advanced cancer and their caregivers. Cancer Med 2023; 12:9956-9965. [PMID: 36934452 PMCID: PMC10166955 DOI: 10.1002/cam4.5713] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 02/07/2023] [Accepted: 02/08/2023] [Indexed: 03/20/2023] Open
Abstract
BACKGROUND Cancer can impact the psychological well-being of both patients and their informal caregivers. We investigated the joint trajectories of psychological distress among Singaporean advanced cancer patients-caregiver dyads. We also examined predictors of trajectory group membership. METHODS This study utilised data from 299 patients with advanced solid cancer and their caregivers over 33 months (12 times points). Group-based trajectory modelling was used to examine the joint trajectories of patient anxiety, patient depression, caregiver anxiety and caregiver depression scores using the Hospital Anxiety and Depression Scale. RESULTS Four joint trajectory groups were found: (1) Patient-caregiver low distress (27%), (2) patient-caregiver increasing distress (28.5%), (3) patient low- caregiver borderline distress (25%), (4) patient-caregiver high distress (19.5%). Dyads where the patient is below 50 years of age were more likely to be in Group 4. Dyads where caregiver-patient emotional closeness was low were more likely to be in Groups 2 or 4 where dyads reported increasing/high distress. Dyads that reported financial inadequacy were more likely to be in Groups 2, 3 and 4, while dyads with caregivers who were employed were more likely to be in group 3. CONCLUSIONS A substantial proportion of patients and caregivers reported anxiety and/or depression that lasted or increased throughout the study duration. We found significant heterogeneity in how dyads experienced psychological distress, suggesting that efforts should consider dyadic differences when providing psychological support. Particular focus should be placed on identifying dyads that are at risk and who require additional support.
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Affiliation(s)
- Irene Teo
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore.,Signature Programme in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore.,National Cancer Centre Singapore, Singapore, Singapore
| | - Sean Ng
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore
| | | | - Chetna Malhotra
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore.,Signature Programme in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Semra Ozdemir
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore.,Signature Programme in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Jennifer L Steel
- Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Eric A Finkelstein
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore.,Signature Programme in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.,Duke Global Health Institute, Duke University, Durham, North Carolina, USA
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Perspectives on Emotional Care: A Qualitative Study with Cancer Patients, Carers, and Health Professionals. Healthcare (Basel) 2023; 11:healthcare11040452. [PMID: 36832985 PMCID: PMC9956222 DOI: 10.3390/healthcare11040452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/29/2023] [Accepted: 02/02/2023] [Indexed: 02/08/2023] Open
Abstract
The emotional consequences of a cancer diagnosis are well documented and range from emotional distress, defined as suffering associated with feelings such as shock, fear, and uncertainty, through to psychological distress that may manifest as depression, anxiety, feelings of hopelessness, or heightened risk of suicide. This study set out to explore the assumption that the provision of emotional care should be the platform upon which all other aspects of cancer care are delivered and, that without attention to emotional care, no other aspects of cancer care can be fully realized. Utilizing qualitative focus groups and in-depth interviews with 47 patients, carers, and health professionals, emotional care was shown to be (1) fundamental to the provision of comprehensive cancer care, (2) essential to easing the burden of a cancer diagnosis and demands of treatment, (3) everyone's business, and (4) a component of cancer care at any time and every time. Future studies are needed to test interventions to enhance provision of intentional, purposeful, and individualized emotional care to help patents achieve the best health outcomes possible.
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Zhu S, Yang C, Chen S, Kang L, Li T, Li J, Li L. Effectiveness of a perioperative support programme to reduce psychological distress for family caregivers of patients with early-stage lung cancer: study protocol for a randomised controlled trial. BMJ Open 2022; 12:e064416. [PMID: 35998958 PMCID: PMC9403120 DOI: 10.1136/bmjopen-2022-064416] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022] Open
Abstract
INTRODUCTION Family caregivers play a key role in providing ongoing long-term care and assistance to their loved ones during cancer treatment. However, family caregivers of patients with lung cancer are frequently unprepared for their roles and they may undergo psychological distress, thus reducing their own quality of life while affecting patients' health outcomes. Interventions that specifically target this population are lacking. This study aims to evaluate the effectiveness of a perioperative support programme on family caregivers of patients with early-stage lung cancer. METHODS AND ANALYSIS This study is guided by the Stress-Coping Model. Family caregivers of patients diagnosed with early-stage lung cancer and those who are scheduled for lung resection treatment will be invited to participate. Participants will be randomised to groups that either receive the perioperative support programme or usual care. The intervention consists of four face-to-face intervention sessions during the hospital stay and two weekly telephone follow-up sessions after discharge. Primary and secondary outcomes will be assessed at baseline and at 4 and 12 weeks after the intervention. Primary outcomes will include psychological distress and secondary outcomes will include caregiving burden, quality of life, coping style and social support. Generalised estimation equation model will be used to analyse the intervention effects. ETHICS AND DISSEMINATION The study was approved by the Ethics Committee of the Second Xiangya Hospital of Central South University (LYG2022003). The authors will disseminate the study's findings by publishing them in international scientific journals. TRIAL REGISTRATION NUMBER ChiCTR2200058280.
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Affiliation(s)
- Song Zhu
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, China
- Department of Thoracic Surgery, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Chen Yang
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Shihao Chen
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Lu Kang
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, China
- Department of Thoracic Surgery, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Tong Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, China
- Department of Thoracic Surgery, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jina Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, China
- Department of Thoracic Surgery, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Lezhi Li
- Xiangya Nursing School, Central South University, Changsha, Hunan, China
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Ebob-Anya BA, Bassah N. Psychosocial distress and the quality of life of cancer patients in two health facilities in Cameroon. Palliat Care 2022; 21:96. [PMID: 35650571 PMCID: PMC9158288 DOI: 10.1186/s12904-022-00981-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 04/14/2022] [Indexed: 11/30/2022] Open
Abstract
Background Psychosocial distress interferes with the ability to cope effectively with cancer, its physical symptoms and treatment. This in turn leads to poor outcomes in patients. Objective The aim of this study was to assess the level of psychosocial distress, emotional distress and the quality of life of cancer patients in two health facilities in Cameroon. Methods This study used a cross-sectional hospital-based design. The study was carried out over a period of three months from July–September 2020. The sample size was 120 cancer patients. A consecutive sampling technique was used to select participants. Three validated questionnaires were used: DT, HADS and EORTC QLQ-C30 to assess, psychosocial distress, emotional distress and quality of life respectively. Results were presented using descriptive (frequency, percentage, mean) and inferential statistics (Chi square, Pearson’s correlation, ANOVA). Data were analysed with SPSS version 21. All statistics were considered significant at an alpha value set at 0.05 level. Results The majority of patients 83 (69.2%) presented with clinically significant distress, with financial difficulties 87 (72.5%), fatigue 83 (69.2%), transportation 73 (60.8%) and difficulties with work/school 69(57.5%) being the most reported problems. Fifty nine (50.0%) and 56(47.5%) had moderate to severe anxiety and depression symptoms respectively. Overall on HADS, 67 patients (56.8%) presented with emotional distress. The quality of life was fair, with a mean of 52.4 ± 21.3.There was a statistically significant negative relationship (P < 0.0001), between psychosocial distress and quality of life of patients. Conclusion Cancer patients suffer from psychosocial distress, which has a negative relationship on their quality of life. It is important that healthcare professionals working in these settings, assess psychosocial distress early in patients with cancer to improve the quality of care and enhance quality of life. Supplementary Information The online version contains supplementary material available at 10.1186/s12904-022-00981-w.
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Affiliation(s)
- Bachi-Ayukokang Ebob-Anya
- Department of Nursing, Faculty of Health Sciences, University of Buea, P.O Box 63, Buea, South-West Region, Cameroon. .,Buea Regional Hospital Annex, Buea, South-West Region, Cameroon.
| | - Nahyeni Bassah
- Department of Nursing, Faculty of Health Sciences, University of Buea, P.O Box 63, Buea, South-West Region, Cameroon
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7
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Thangarasa T, Hales S, Tong E, An E, Selby D, Isenberg-Grzeda E, Li M, Rodin G, Bean S, Bell JAH, Nissim R. A Race to the End: Family Caregivers' Experience of Medical Assistance in Dying (MAiD)-a Qualitative Study. J Gen Intern Med 2022; 37:809-815. [PMID: 34287775 PMCID: PMC8904693 DOI: 10.1007/s11606-021-07012-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 06/25/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND The June 2016 legalization of medical assistance in dying (MAiD) provided an added layer of choice to end-of-life care in Canada. Family caregivers play an important role in patient end-of-life decision-making. They may experience unique psychological burden or distress associated with their role. However, we know little about the caregiver experience associated with patient MAiD requests and the nature of psychosocial supports caregivers require before, during, and following MAiD intervention. OBJECTIVE The objective of this study is to better understand the caregiver experience of MAiD within the Canadian legal landscape following Bill C-14. DESIGN Caregiver experience was examined based on qualitative, semi-structured interviews. PARTICIPANTS A total of 22 caregivers of patients who had requested MAiD were interviewed. APPROACH Transcripts were recorded, transcribed, and analyzed based on grounded theory methodology. KEY RESULTS The caregiver experience of MAiD within the legal framework was found to be understood as a "race to the end," with the ultimate goal of creating an ideal dying experience for the patient while balancing a threat to capacity that would undermine their access to MAiD. Caregivers can be described within the overarching framework as either co-runners or onlookers. Sources of caregiver distress were linked to these roles. CONCLUSIONS The "race to the end" theoretical model contributes new knowledge and understanding that can inform the development of tailored support services for caregivers, the impact of legislative changes on this population, and future research examining decision-making near end of life and the caregiver experience.
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Affiliation(s)
- Tharshika Thangarasa
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
| | - Sarah Hales
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Eryn Tong
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Ekaterina An
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Debbie Selby
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Elie Isenberg-Grzeda
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Madeline Li
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Gary Rodin
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Sally Bean
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Jennifer A H Bell
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Rinat Nissim
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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Sutar R, Chaudhary P. Prognostic disclosure in cancer care: a systematic literature review. Palliat Care Soc Pract 2022; 16:26323524221101077. [PMID: 35693193 PMCID: PMC9178750 DOI: 10.1177/26323524221101077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 04/28/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Collusion in cancer care is the diplomatic concealment of information between a triad of the health care professional (HCP), patient, and caregiver. Free and expressive communication is determined by multiple factors, which establishes a healthy balance between ‘patient-centric’ and ‘family-centric’ decision making. The lack of a universal approach to prognostic disclosure techniques emphasizes the need for a systematic review of contemporary practice. Methods: A systematic review of the literature was conducted till June 2020 using themes based on cancer, communication, prognostic disclosure, and collusion by using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Fifty-three studies involving 10,569 subjects were studied for their utility on prognostic disclosure using different communication methods and interfaces. Twenty-three studies used a face-to-face interview with subjects while in-person telephonic interviews were conducted in two studies, 16 studies implicated semi-structured questionnaires, and 6 studies mentioned the development of a new technique/tool for disclosure. The duration of a session for prognosis-disclosure ranged from 22 min to 1 h. The involvement of palliative care specialists and mental health professionals was limited during the disclosure of the prognosis. Conclusion: The findings of the review indicate that patients in cancer care are aware of their diagnosis and to a certain extent of prognosis despite nondisclosure by their family members and treating teams. This review emphasizes the assessment of ‘disclosure wishes’ among patients and caregivers in separate interviews rather than simply relying on one specific method of interviewing. The nonconfrontational approach and training among HCPs are of utmost importance to build therapeutic resilience among the treating team involved in cancer care. Since many factors such as family wishes, cultural dissonance, medical model, and patient perception could become barriers to prognostic disclosure, there is a need to develop a universal approach to prognostic disclosure and handling associated collusion.
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Affiliation(s)
- Roshan Sutar
- Assistant Professor, Department of Psychiatry, All India Institute of Medical Sciences (AIIMS), Bhopal, Saket Nagar, Bhopal 462020, India
| | - Pooja Chaudhary
- Department of Psychiatry, All India Institute of Medical Sciences (AIIMS), Bhopal, Bhopal, India
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Pan YC, Lin YS. Systematic Review and Meta-Analysis of Prevalence of Depression Among Caregivers of Cancer Patients. Front Psychiatry 2022; 13:817936. [PMID: 35633789 PMCID: PMC9133351 DOI: 10.3389/fpsyt.2022.817936] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 03/03/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Caregivers of cancer patients commonly experience depressive symptoms due to the heavy burden of caregiving responsibility. OBJECTIVE This meta-analysis examined the prevalence of depression among caregivers of cancer patients. METHODS We included 85 studies covering 23,317 participants published between 2001 and 2021 (25 countries) that reported the prevalence of depression among caregivers of cancer patients. We examined the pooled prevalence of depression and hypothesized moderators, including year, age, sex, geographic regions, percentage of spousal caregivers, depression measures, and cancer stage. RESULTS All 85 effect sizes included 6,077 caregivers of patients with depression. The weighted average prevalence of depression was 25.14% (95% CI, 21.42-29.27%) among caregivers. The prevalence rates were moderated by geographic region, patients' cancer stage, and measures for depression. The prevalence rates also varied among the different measures assessing depression. The prevalence rate decreased with the mean age of the caregivers and the percentage of spousal caregivers. CONCLUSIONS This study revealed a high prevalence of depression among caregivers of cancer patients. The prevalence rates also varied with the study design, demographics of caregivers, and patients' medical information. These findings highlight that psychological support and intervention may be crucial for patients and their caregivers in clinical practice.
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Affiliation(s)
- Yuan-Chien Pan
- Department of Psychology, National Taiwan University, Taipei, Taiwan
| | - Yaw-Sheng Lin
- Department of Psychology, National Taiwan University, Taipei, Taiwan
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Silke L, Kirresh O, Sturt J, Lempp H. Development of the Rheumatoid Arthritis Distress Scale (RADS): a new tool to identify disease-specific distress in patients with Rheumatoid Arthritis. BMC Rheumatol 2021; 5:51. [PMID: 34782021 PMCID: PMC8594165 DOI: 10.1186/s41927-021-00220-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 07/23/2021] [Indexed: 11/13/2022] Open
Abstract
Background Patients with Rheumatoid Arthritis (RA) may experience psychological distress (depression, anxiety) in addition to their physical symptoms. People with RA may also experience disease-specific distress (DSD), related to the specific burden of living with their life-long condition. DSD is a patient reported outcome in several long-term conditions, including type 1 and 2 diabetes. The aims of this study were to determine whether DSD is experienced by people with RA, and if so, develop a Patient Reported Outcome Measure (PROM) to assess for DSD in people with RA. Methods A five-phased qualitative study was conducted which consisted of a secondary data analysis of 61 interviews of people with rheumatological disease (Phase 1), validation of findings via a Patient and Public Involvement (PPI) group of people with RA (n = 4) (Phase 2), item generation for a PROM (Phase 3) and establishing face and content validity of the PROM via PPI group (n = 4) and individual cognitive interviews (n = 9) of people with RA respectively (Phase 4 and 5). The final PROM was presented at a Patient Education Evening for patients with long-term rheumatological conditions, including RA, and carers. Results Five themes of rheumatological disease distress emerged from Phase 1, which were validated in the Phase 2 PPI group. After Phases 3–5, the Rheumatoid Arthritis Distress Scale (RADS) was formed of 39 items and 3 supplementary questions. Overall participants reported the content of the RADS to be clear and relevant, and that DSD is a valid concept in RA, distinct from other entities like clinical depression or anxiety. Conclusions DSD appears to be an important concept in RA. The 39-item RADS demonstrates acceptable face and content validity in this patient group. Further psychometric testing is needed. The RADS may be a useful tool for healthcare professionals to identify RA distress.
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Affiliation(s)
- Linda Silke
- Outpatient Physiotherapy Department, Mile End Hospital, Bancroft Rd, London, E1 4DG, UK.
| | - Othman Kirresh
- Chelsea and Westminster Hospital, 369 Fulham Road, London, SW10 9NH, UK
| | - Jackie Sturt
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, James Clerk Maxwell Building, Waterloo, London, SE1 8WA, UK
| | - Heidi Lempp
- Department of Inflammation Biology, Faculty of Life Sciences and Medicine, Centre for Rheumatic Diseases, Weston Education Centre, King's College London, 10, Cutcombe Road, London, SE5 9RJ, UK
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Fehrenbach MK, Brock H, Mehnert-Theuerkauf A, Meixensberger J. Psychological Distress in Intracranial Neoplasia: A Comparison of Patients With Benign and Malignant Brain Tumours. Front Psychol 2021; 12:664235. [PMID: 34489787 PMCID: PMC8418139 DOI: 10.3389/fpsyg.2021.664235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 07/20/2021] [Indexed: 01/03/2023] Open
Abstract
Objective: We aimed to assess psychological distress in patients with intracranial neoplasia, a group of patients who suffer from severe functional, neurocognitive and neuropsychological side effects, resulting in high emotional distress. Methods: We conducted a cross-sectional study, including inpatients with brain tumours. Eligible patients completed validated self-report questionnaires measuring depression, anxiety, distress, symptoms of posttraumatic stress disorder (PTSD), fear of progression and health-related quality of life. The questionnaire set was completed after brain surgery and receiving diagnosis and before discharge from hospital. Results: A total of n = 31 patients participated in this survey. Fourteen of them suffered from malignant (n = 3 metastatic neoplasia) and 17 from benign brain tumours. Mean values of the total sample regarding depression (M = 9.28, SD = 6.08) and anxiety (M = 6.00, SD = 4.98) remained below the cut-off ≥ 10. Mean psychosocial distress (M = 16.30, SD = 11.23, cut-off ≥ 14) and posttraumatic stress (M = 35.10, SD = 13.29, cut-off ≥ 32) exceeded the clinically relevant cut-off value in all the patients with intracranial tumours. Significantly, more patients with malignant (79%) than benign (29%) brain tumours reported PTSD symptoms (p = 0.006). Conclusion: Distress and clinically relevant PTSD symptoms in patients with intracranial neoplasia should be routinely screened and treated in psycho-oncological interventions immediately after diagnosis. Especially, neuro-oncological patients with malignant brain tumours or metastases need targeted support to reduce their emotional burden.
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Affiliation(s)
| | - Hannah Brock
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Anja Mehnert-Theuerkauf
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
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Effect of instrumental support on distress among family caregivers: Findings from a nationally representative study. Palliat Support Care 2021; 18:519-527. [PMID: 32090725 DOI: 10.1017/s1478951520000036] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND OBJECTIVE A priority focus on palliative and supportive care is helping the 43.5 million caregivers who care for individuals with serious illness. Lacking support may lead to caregiver distress and poorer care delivery to patients with serious illness. We examined the potential of instrumental support (assistance with material and task performance) to mitigate distress among caregivers. METHOD We analyzed data from the nationally representative Health Information National Trends Survey (HINTS V2, 2018). Informal/family caregivers were identified in HINTS V2 if they indicated they were caring for or making healthcare decisions for another adult with a health problem. We used the PROMIS® instrumental support four-item short-form T-scores and the Patient Health Questionnaire (PHQ-4) for distress. We examined multivariable linear regression models for associations between distress and instrumental support, adjusted for sampling weights, socio-demographics, and caregiving variables (care recipient health condition(s), years caregiving (≥2), relationship to care recipient, and caregiver burden). We examined interactions between burden and instrumental support on caregiver distress level. RESULTS Our analyses included 311 caregivers (64.8% female, 64.9% non-Hispanic White). The unweighted mean instrumental support T-score was 50.4 (SD = 10.6, range = 29.3-63.3); weighted mean was 51.2 (SE = 1.00). Lower instrumental support (p < 0.01), younger caregiver age (p < 0.04), higher caregiving duration (p = 0.008), and caregiver unemployment (p = 0.006) were significantly associated with higher caregiver distress. Mean instrumental support scores by distress levels were 52.3 (within normal limits), 49.4 (mild), 48.9 (moderate), and 39.7 (severe). The association between instrumental support and distress did not differ by caregiver burden level. CONCLUSIONS Poor instrumental support is associated with high distress among caregivers, suggesting the need for palliative and supportive care interventions to help caregivers leverage instrumental support.
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Haun MW, Simon L, Sklenarova H, Zimmermann‐Schlegel V, Friederich H, Hartmann M. Predicting anxiety in cancer survivors presenting to primary care - A machine learning approach accounting for physical comorbidity. Cancer Med 2021; 10:5001-5016. [PMID: 34076372 PMCID: PMC8290227 DOI: 10.1002/cam4.4048] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 05/10/2021] [Accepted: 05/11/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The purpose of this study was to explore predictors for anxiety as the most common form of psychological distress in cancer survivors while accounting for physical comorbidity. METHODS We conducted a secondary data analysis of a large study within the German National Cancer Plan which enrolled primary care cancer survivors diagnosed with colon, prostatic, or breast cancer. We selected candidate predictors based on a systematic MEDLINE search. Using supervised machine learning, we developed a prediction model for anxiety by splitting the data into a 70% training set and a 30% test set and further split the training set into 10-folds for cross-validating the hyperparameter tuning step during model selection. We fit six different regression models, selected the model that maximized the root mean square error (RMSE) and fit the selected model to the entire training set. Finally, we evaluated the model performance on the holdout test set. RESULTS In total, data from 496 cancer survivors were analyzed. The LASSO model (α = 1.0) with weakly penalized model complexity (λ = 0.015) slightly outperformed all other models (RMSE = 0.370). Physical symptoms, namely, fatigue/weakness (β = 0.18), insomnia (β = 0.12), and pain (β = 0.04), were the most important predictors, while the degree of physical comorbidity was negligible. CONCLUSIONS Prediction of clinically significant anxiety in cancer survivors using readily available predictors is feasible. The findings highlight the need for considering cancer survivors' physical functioning regardless of the degree of comorbidity when assessing their psychological well-being. The generalizability of the model to other populations should be investigated in future external validations.
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Affiliation(s)
- Markus W. Haun
- Department of General Internal Medicine and PsychosomaticsHeidelberg UniversityHeidelbergGermany
| | - Laura Simon
- Clinical Psychology and PsychotherapyUlm UniversityUlmBaden‐WürttembergGermany
| | | | | | | | - Mechthild Hartmann
- Department of General Internal Medicine and PsychosomaticsHeidelberg UniversityHeidelbergGermany
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14
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An H, Chen C, Du R, Cheng C, Wang P, Dong S. Self-efficacy, psychological distress, and marital quality in young and middle-aged couples facing lymphoma: The mediating effect of dyadic coping. Psychooncology 2021; 30:1492-1501. [PMID: 33908116 DOI: 10.1002/pon.5711] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 04/19/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVE This study explored the mediating role of dyadic coping between self-efficacy, psychological distress and marital quality among young and middle-aged couples facing lymphoma. METHODS A total of 243 couples in which the patients were lymphoma were recruited to complete Dyadic Coping Inventory, Locke-Wallace Marital Adjustment Scale for both. And Strategies Used by People to Promote Health, Fear of Progression Questionnaire-Short Form for patients; General Self-Efficacy Scale and Hospital Anxiety and Depression Scale for spouses. We used the statistical programs SPSS 20.0 and SPSS Amos 20.0 for data analysis. RESULTS There were significant correlations between patient-spouse's dyadic coping and marriage quality scores. The patients' dyadic coping scores were significantly associated with their self-efficacy, fear of cancer recurrence scores, marriage quality, their spouse's self-efficacy, and marriage quality. The spouses' dyadic coping scores were significantly associated with their self-efficacy, anxiety, and marriage quality. The actor-partner interdependence mediation model analysis mediator effect of dyadic coping in the relationship between self-efficacy, psychological distress, and marriage quality had a good fit, with χ2 /df = 17.106, p = 0.194; root mean square error of approximation = 0.036; GFI = 0.992; CN = 243. CONCLUSIONS For both patient and spouses, dyadic coping mediated impact of self-efficacy on marriage quality of themselves and their spouses, and individuals' dyadic coping mediated impact their psychological distress on marriage quality of themselves and spouses. The study highlighted the need for couple-based interventions and including strategies combined with individual and dyadic therapy for both partners.
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Affiliation(s)
- Huiying An
- Henan Provincial People' s Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Changying Chen
- Department of Quality Control, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ruofei Du
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Chunyan Cheng
- Henan Provincial People' s Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Panpan Wang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Shiqi Dong
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
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Manne SL, Kashy D, Myers-Virtue S, Zaider T, Kissane DW, Heckman CJ, Kim I, Penedo F, Lee D. Relationship communication and the course of psychological outcomes among couples coping with localised prostate cancer. Eur J Cancer Care (Engl) 2021; 30:e13401. [PMID: 33586282 DOI: 10.1111/ecc.13401] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 07/28/2020] [Accepted: 11/27/2020] [Indexed: 01/17/2023]
Abstract
OBJECTIVE How couples communicate about cancer is an important predictor of psychological outcomes for men diagnosed with localised prostate cancer and their spouses. We examined the predictive role of disclosure, responsiveness, mutual avoidance, and holding back on depressive symptoms, psychological adjustment, cancer-specific distress, and cancer concerns. METHODS Eighty-one prostate cancer patients and their spouses completed measures of communication at baseline and measures of four psychological outcomes at baseline, five, 12, and 26 weeks after baseline. Dyadic growth models tested the effects of time and role on each outcome over time. RESULTS Higher disclosure and responsiveness predicted better psychological outcomes. Less mutual avoidance and holding back predicted poorer psychological outcomes. Across communication variables, individuals who engaged in poorer communication initially had poorer psychological outcomes that improved over time, whereas individuals who engaged in better communication initially maintained their more positive standing without change or changed in the positive direction. For all outcomes, those with better communication still had better psychological outcomes at six months. CONCLUSION Couples' cancer-specific relationship communication predicts their psychological outcomes. More research is needed to identify effective interventions, including a longer therapy course, individual communication training, or greater focus on addressing barriers to sharing and responsiveness.
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Affiliation(s)
- Sharon L Manne
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | | | | | - Talia Zaider
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - David W Kissane
- Department of Medicine, University of Notre Dame Australia, and Cabrini Health and Monash Health Psycho-Oncology, Monash University, Melbourne, Vic., Australia
| | | | - Isaac Kim
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Frank Penedo
- Sylvester Cancer Center, University of Miami, Miami, FL, USA
| | - David Lee
- Division of Urology, Perelman Center for Advanced Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
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Overcash J, Fugett S, Tan A, Ginther J, Williams N. Strain Among Caregivers of Older Adults Diagnosed With Breast Cancer. Oncol Nurs Forum 2019; 46:E185-E201. [PMID: 31626615 DOI: 10.1188/19.onf.e185-e201] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To illustrate the predictors of strain among caregivers of older adults diagnosed with breast cancer. SAMPLE & SETTING This study involved 39 women diagnosed with breast cancer who were aged 69 years or older, receiving any type of treatment, and seeking an initial assessment in a geriatric oncology program at a large cancer center in the midwestern United States and their caregivers. METHODS & VARIABLES This cross-sectional study evaluated relationships among the variables of caregiver strain, age, employment status, patient characteristics, and patient scores on the comprehensive geriatric assessment. Bivariate statistics and logistic regression models were used. RESULTS Increasing age of the caregiver was associated with less caregiver strain. Caregivers employed part-time experienced greater strain than those employed full-time. IMPLICATIONS FOR NURSING Nurses must assess for strain in caregivers of individuals diagnosed with cancer, particularly if they are younger and employed part-time. Caregivers of depressed patients should be assessed for strain and offered support.
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Affiliation(s)
| | - Susan Fugett
- Ohio State University Comprehensive Cancer Center and the Arthur G. James Cancer Hospital and Richard J. Solove Research Institute
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Mosher CE, Secinti E, Hirsh AT, Hanna N, Einhorn LH, Jalal SI, Durm G, Champion VL, Johns SA. Acceptance and Commitment Therapy for Symptom Interference in Advanced Lung Cancer and Caregiver Distress: A Pilot Randomized Trial. J Pain Symptom Manage 2019; 58:632-644. [PMID: 31255586 PMCID: PMC6754796 DOI: 10.1016/j.jpainsymman.2019.06.021] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 06/20/2019] [Accepted: 06/21/2019] [Indexed: 11/24/2022]
Abstract
CONTEXT Advanced lung cancer patients typically have a poor prognosis and many symptoms that interfere with functioning, contributing to high rates of emotional distress in both patients and family caregivers. There remains a need for evidence-based interventions to improve functional outcomes and distress in this population. OBJECTIVES This pilot trial examined the feasibility and preliminary efficacy of telephone-based Acceptance and Commitment Therapy (ACT) for symptomatic, advanced lung cancer patients and their distressed family caregivers. Primary outcomes were patient symptom interference with functioning and patient and caregiver distress. METHODS Symptomatic, advanced lung cancer patients and distressed caregivers (n = 50 dyads) were randomly assigned to six sessions of ACT or an education/support condition. Patients completed measures of symptom interference and measures assessing the severity of fatigue, pain, sleep disturbance, and breathlessness. Patients and caregivers completed measures of distress and illness acceptance and struggle. RESULTS The eligibility screening rate (51%) and retention rate (76% at six weeks postintervention) demonstrated feasibility. No group differences were found with respect to patient and caregiver outcomes. Both groups showed a small, significant decrease in struggle with the illness over the study period, but did not show meaningful change in other outcomes. CONCLUSION Findings suggest that telephone-based ACT is feasible for many advanced lung cancer patients and caregivers, but may not substantially reduce symptom interference and distress. Low baseline levels of certain symptoms may have contributed to null findings. Next steps include applying ACT to specific, clinically meaningful symptom interference and varying intervention dose and modality.
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Affiliation(s)
- Catherine E Mosher
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA.
| | - Ekin Secinti
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA
| | - Adam T Hirsh
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA
| | - Nasser Hanna
- Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Lawrence H Einhorn
- Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Shadia I Jalal
- Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA; Richard L. Roudebush VAMC, Indianapolis, Indiana, USA
| | - Gregory Durm
- Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | | | - Shelley A Johns
- Indiana University School of Medicine, Center for Health Services Research, Regenstrief Institute, Indianapolis, Indiana, USA
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Manne SL, Kashy DA, Zaider T, Kissane D, Lee D, Kim IY, Heckman CJ, Penedo FJ, Murphy E, Virtue SM. Couple-focused interventions for men with localized prostate cancer and their spouses: A randomized clinical trial. Br J Health Psychol 2019; 24:396-418. [PMID: 30852854 DOI: 10.1111/bjhp.12359] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 02/11/2019] [Indexed: 01/21/2023]
Abstract
OBJECTIVES Few couple-focused interventions have improved psychological and relationship functioning among men diagnosed with localized prostate cancer and their spouses. This study compared the impact of intimacy-enhancing therapy (IET), a general health and wellness intervention (GHW), and usual care (UC) on the psychological and relationship functioning of localized prostate cancer patients and their partners. Relationship length, relationship satisfaction, and patient masculinity were evaluated as moderators. DESIGN This study was a randomized clinical trial with three study arms and four assessment time points. METHODS A total of 237 patients and partners were randomly assigned to receive IET, GHW, or UC. Participants completed measures of psychological functioning and relationship satisfaction at baseline, 5 weeks, 3 months, and 6 months post-baseline. Primary outcomes were psychological adjustment, depression, cancer-specific distress, cancer concerns, and relationship satisfaction. RESULTS Spouses in IET showed greater increases in relationship satisfaction than spouses in GHW and UC between the baseline and 5-week follow-up. Among patients in longer relationships, significant increases in psychological adjustment were found in both treatments compared to UC. Among spouses in longer relationships, psychological adjustment increased in both IET and UC but declined in GHW. CONCLUSIONS Intimacy-enhancing therapy did not show an impact on general or cancer-specific distress, but did show an early impact on relationship satisfaction among spouses. IET was superior to UC for patients in longer relationships. It will be important for researchers to understand which couple-focused interventions benefits both patients and spouses and to identify characteristics of patients, partners, and couples who may not benefit from psychological treatments. Statement of contribution What is already known on this subject? Men diagnosed with localized prostate cancer report lower health-related quality of life and both patients and spouses report elevated distress. Relationship communication plays a role in couples' psychological adaptation to prostate cancer. Couple-focused interventions have illustrated an impact on relationship communication. There are no studies comparing different couple-focused interventions. What does this study add? Intimacy-enhancing therapy was not superior to no treatment or a comparison treatment for the broad range of psychological and relationship outcomes. Intimacy-enhancing therapy was superior to no treatment for patients in longer-term relationship. The general health and wellness intervention was not beneficial for men in shorter relationships and for men who did not endorse traditional masculine norms.
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Affiliation(s)
- Sharon L Manne
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | | | - Talia Zaider
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, USA
| | - David Kissane
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, USA.,Department of Psychiatry, Monash Medical Center, Monash University, Clayton, Victoria, Australia
| | - David Lee
- Penn Urology, Penn Presbyterian Medical Center, Philadelphia, Pennsylvania, USA
| | - Isaac Y Kim
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - Carolyn J Heckman
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA.,Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA
| | - Frank J Penedo
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, Illinois, USA
| | - Evangelynn Murphy
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
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19
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Secinti E, Rand KL, Johns SA, O'Neil BH, Helft PR, Shahda S, Jalal SI, Mosher CE. Social correlates of mental health in gastrointestinal cancer patients and their family caregivers: Exploring the role of loneliness. Support Care Cancer 2018; 27:2077-2086. [PMID: 30225573 DOI: 10.1007/s00520-018-4467-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 09/10/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE The present study examined the degree to which loneliness mediated the influence of negative (social constraints) and positive (emotional support) relationship qualities on the global mental health of advanced gastrointestinal (GI) cancer patients and their family caregivers. METHODS Fifty patient-caregiver dyads completed measures assessing social constraints (e.g., avoidance, criticism) from the other dyad members, emotional support from others, loneliness, and global mental health. Structural equation modeling was used to examine individual models, and Actor-Partner Interdependence Mediation Modeling was used to examine dyadic associations. RESULTS Individual path analyses for patients and caregivers demonstrated that emotional support had a significant indirect effect on mental health through loneliness (Bs = 0.32 and 0.30, respectively), but no associations were found between social constraints and mental health. In dyadic analyses, participants' loneliness and mental health were not significantly related to their partner's emotional support, loneliness, or mental health (Bs = - 0.18 to 0.18). CONCLUSIONS Findings suggest that for advanced GI cancer patients and caregivers, emotional support from others alleviates feelings of loneliness, which may lead to better mental health. However, the benefits of emotional support appear to be primarily intrapersonal rather than interpersonal in nature. Additionally, participants endorsed low levels of social constraints, which might explain their lack of relation to loneliness and mental health. Continued examination of interdependence in social processes between cancer patients and caregivers will inform intervention development.
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Affiliation(s)
- Ekin Secinti
- Department of Psychology, Indiana University-Purdue University Indianapolis, 402 North Blackford Street, LD 124, Indianapolis, IN, 46202, USA.
| | - Kevin L Rand
- Department of Psychology, Indiana University-Purdue University Indianapolis, 402 North Blackford Street, LD 124, Indianapolis, IN, 46202, USA
| | - Shelley A Johns
- Indiana University School of Medicine, Center for Health Services Research, Regenstrief Institute, 1101 W. 10th Street, RF-226, Indianapolis, IN, 46202, USA
| | - Bert H O'Neil
- Indiana University School of Medicine, Indiana University Melvin and Bren Simon Cancer Center, 535 Barnhill Drive, Indianapolis, IN, 46202, USA
| | - Paul R Helft
- Indiana University School of Medicine, Indiana University Melvin and Bren Simon Cancer Center, 535 Barnhill Drive, Indianapolis, IN, 46202, USA
| | - Safi Shahda
- Indiana University School of Medicine, Indiana University Melvin and Bren Simon Cancer Center, 535 Barnhill Drive, Indianapolis, IN, 46202, USA
| | - Shadia I Jalal
- Indiana University School of Medicine, Indiana University Melvin and Bren Simon Cancer Center, 535 Barnhill Drive, Indianapolis, IN, 46202, USA
| | - Catherine E Mosher
- Department of Psychology, Indiana University-Purdue University Indianapolis, 402 North Blackford Street, LD 124, Indianapolis, IN, 46202, USA
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Lau BHP, Chow AYM, Wong DFK, Chan JSM, Chan CHY, Ho RTH, So TH, Lam TC, Lee VHF, Lee AWM, Chow SF, Chan CLW. Study protocol of a randomized controlled trial comparing integrative body-mind-spirit intervention and cognitive behavioral therapy in fostering quality of life of patients with lung cancer and their family caregivers. ACTA ACUST UNITED AC 2018; 15:258-276. [PMID: 29400621 DOI: 10.1080/23761407.2018.1435325] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Compared to cancers at other sites, lung cancer often results in greater psychosocial distress to both the patients and their caregivers, due to the poor prognosis and survival rate, as well as the heavy symptom burden. In recent years, making protocols of proposed or on-going studies publicly available via clinical trial registries and/or peer-reviewed journals has benefited health sciences with timely communication of the latest research trends and improved transparency in reporting. However, such practice is yet to be a common sight in evidence-informed social work. Hence, this paper discusses the value of publishing protocols in social work research and presents the protocol of a randomized controlled trial that compares the effectiveness of integrative body-mind-spirit intervention with cognitive behavioral therapy for enhancing quality of life of patients with lung cancer and their family caregivers. The data collection process was still on-going at the time of manuscript submission.
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Affiliation(s)
- Bobo Hi-Po Lau
- a Department of Social Work & Social Administration , University of Hong Kong , Pokfulam , Hong Kong
| | - Amy Y M Chow
- a Department of Social Work & Social Administration , University of Hong Kong , Pokfulam , Hong Kong
| | - Daniel F K Wong
- a Department of Social Work & Social Administration , University of Hong Kong , Pokfulam , Hong Kong
| | - Jessie S M Chan
- a Department of Social Work & Social Administration , University of Hong Kong , Pokfulam , Hong Kong
| | - Celia H Y Chan
- a Department of Social Work & Social Administration , University of Hong Kong , Pokfulam , Hong Kong
| | - Rainbow T H Ho
- a Department of Social Work & Social Administration , University of Hong Kong , Pokfulam , Hong Kong
| | - Tsz-Him So
- b Department of Clinical Oncology , University of Hong Kong , Pokfulam , Hong Kong
| | - Tai-Chung Lam
- b Department of Clinical Oncology , University of Hong Kong , Pokfulam , Hong Kong
| | - Victor Ho-Fun Lee
- b Department of Clinical Oncology , University of Hong Kong , Pokfulam , Hong Kong
| | - Anne W M Lee
- b Department of Clinical Oncology , University of Hong Kong , Pokfulam , Hong Kong
| | | | - Cecilia L W Chan
- a Department of Social Work & Social Administration , University of Hong Kong , Pokfulam , Hong Kong
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21
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Stinesen Kollberg K, Thorsteinsdottir T, Wilderäng U, Hugosson J, Wiklund P, Bjartell A, Carlsson S, Stranne J, Haglind E, Steineck G. Social constraints and psychological well-being after prostate cancer: A follow-up at 12 and 24 months after surgery. Psychooncology 2017; 27:668-675. [PMID: 29024232 DOI: 10.1002/pon.4561] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 09/05/2017] [Accepted: 09/28/2017] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Studies indicate that social constraints (barriers to emotional expression) may be a risk factor for psychological morbidity. We aimed to investigate the association between prostate cancer-related social constraints and psychological well-being following prostate cancer surgery. METHODS In a group of 3478 partnered patients, participating in the Laparoscopic Prostatectomy Robot Open trial, a prospective multicenter comparative study of robot-assisted laparoscopic and retropubic radical prostatectomy for prostate cancer, we used log-binomial regression analysis to investigate the links between prostate cancer-related social constraints at 3 months after surgery and psychological well-being at 12 and 24 months. RESULTS A total of 1086 and 1093 men reported low well-being at 12 and 24 months, respectively. Prostate cancer-related social constraints by partner predicted low psychological well-being at 12 months (adjusted RR: 1.4; 95% CI, 1.1-1.9) and by others (adjusted RR: 1.9; 95% CI, 1.1-3.5). Intrusive thoughts mediated the association. CONCLUSIONS Negative responses from the social environment, especially from partner to talking about the prostate cancer experience affected patients' psychological well-being 2 years after radical prostatectomy. Results emphasize the importance of helping patients mobilize psychosocial resources within their social network, especially among those with a lack of quality psychosocial support.
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Affiliation(s)
- Karin Stinesen Kollberg
- Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - Ulrica Wilderäng
- Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jonas Hugosson
- Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Peter Wiklund
- Department of Molecular Medicine and Surgery, Section of Urology, Karolinska Institute, Stockholm, Sweden
| | - Anders Bjartell
- Department of Urology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Stefan Carlsson
- Department of Molecular Medicine and Surgery, Section of Urology, Karolinska Institute, Stockholm, Sweden
| | - Johan Stranne
- Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Eva Haglind
- Department of Surgery, Institute of Clinical Sciences, SSORG-Scandinavian Surgical Outcomes Research Group, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden
| | - Gunnar Steineck
- Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Division of Clinical Cancer Epidemiology, Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden
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22
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Toussaint L, Barry M, Angus D, Bornfriend L, Markman M. Self-forgiveness is associated with reduced psychological distress in cancer patients and unmatched caregivers: Hope and self-blame as mediating mechanisms. J Psychosoc Oncol 2017; 35:544-560. [DOI: 10.1080/07347332.2017.1309615] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | - Michael Barry
- Department of Pastoral Care, Cancer Treatment Centers of America, Philadelphia, PA, USA
| | - Drew Angus
- Department of Spiritual Outreach, Cancer Treatment Centers of America, Philadelphia, PA, USA
| | - Lynn Bornfriend
- Department of Psychiatry, Cancer Treatment Centers of America, Philadelphia, PA, USA
| | - Maurie Markman
- Department of Medicine and Science, Cancer Treatment Centers of America, Philadelphia, PA, USA
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23
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Pankrath AL, Weißflog G, Mehnert A, Niederwieser D, Döhner H, Hönig K, Gündel H, Vogelhuber M, Friedrich M, Ernst J. The relation between dyadic coping and relationship satisfaction in couples dealing with haematological cancer. Eur J Cancer Care (Engl) 2016; 27. [DOI: 10.1111/ecc.12595] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2016] [Indexed: 11/29/2022]
Affiliation(s)
- A.-L. Pankrath
- Department of Medical Psychology and Medical Sociology; University of Leipzig; Leipzig Germany
| | - G. Weißflog
- Department of Medical Psychology and Medical Sociology; University of Leipzig; Leipzig Germany
| | - A. Mehnert
- Department of Medical Psychology and Medical Sociology; University of Leipzig; Leipzig Germany
| | - D. Niederwieser
- Department of Haematology and Medical Oncology; University Hospital Leipzig; Leipzig Germany
| | - H. Döhner
- Department of Internal Medicine III; University of Ulm; Ulm Germany
| | - K. Hönig
- Clinic of Psychosomatic Medicine and Psychotherapy; University of Ulm; Ulm Germany
| | - H. Gündel
- Clinic of Psychosomatic Medicine and Psychotherapy; University of Ulm; Ulm Germany
| | - M. Vogelhuber
- Department of Internal Medicine III; University Medical Centre Regensburg; Regensburg Germany
| | - M. Friedrich
- Department of Medical Psychology and Medical Sociology; University of Leipzig; Leipzig Germany
| | - J. Ernst
- Department of Medical Psychology and Medical Sociology; University of Leipzig; Leipzig Germany
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Mosher CE, Winger JG, Hanna N, Jalal SI, Einhorn LH, Birdas TJ, Ceppa DP, Kesler KA, Schmitt J, Kashy DA, Champion VL. Randomized Pilot Trial of a Telephone Symptom Management Intervention for Symptomatic Lung Cancer Patients and Their Family Caregivers. J Pain Symptom Manage 2016; 52:469-482. [PMID: 27401514 PMCID: PMC5075493 DOI: 10.1016/j.jpainsymman.2016.04.006] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 03/18/2016] [Accepted: 04/27/2016] [Indexed: 10/21/2022]
Abstract
CONTEXT Lung cancer is one of the most common cancers affecting both men and women and is associated with high symptom burden and psychological distress. Lung cancer patients' family caregivers also show high rates of distress. However, few interventions have been tested to alleviate significant problems of this population. OBJECTIVES This study examined the preliminary efficacy of telephone-based symptom management (TSM) for symptomatic lung cancer patients and their family caregivers. METHODS Symptomatic lung cancer patients and caregivers (n = 106 dyads) were randomly assigned to four sessions of TSM consisting of cognitive-behavioral and emotion-focused therapy or an education/support condition. Patients completed measures of physical and psychological symptoms, self-efficacy for managing symptoms, and perceived social constraints from the caregiver; caregivers completed measures of psychological symptoms, self-efficacy for helping the patient manage symptoms and managing their own emotions, perceived social constraints from the patient, and caregiving burden. RESULTS No significant group differences were found for all patient outcomes and caregiver self-efficacy for helping the patient manage symptoms and caregiving burden at two- and six-weeks post-intervention. Small effects in favor of TSM were found regarding caregiver self-efficacy for managing their own emotions and perceived social constraints from the patient. Study outcomes did not significantly change over time in either group. CONCLUSION Findings suggest that our brief telephone-based psychosocial intervention is not efficacious for symptomatic lung cancer patients and their family caregivers. Next steps include examining specific intervention components in relation to study outcomes, mechanisms of change, and differing intervention doses and modalities.
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Affiliation(s)
- Catherine E Mosher
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA.
| | - Joseph G Winger
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA
| | - Nasser Hanna
- Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Shadia I Jalal
- Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA; Richard L. Roudebush Veterans Affairs Medical Center, Indianapolis, Indiana, USA
| | - Lawrence H Einhorn
- Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Thomas J Birdas
- Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - DuyKhanh P Ceppa
- Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Kenneth A Kesler
- Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Jordan Schmitt
- Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA; Richard L. Roudebush Veterans Affairs Medical Center, Indianapolis, Indiana, USA
| | - Deborah A Kashy
- Department of Psychology, Michigan State University, East Lansing, Michigan, USA
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Abstract
BACKGROUND Relatives are the primary and existential resource of cancer patients, while at the same time experiencing substantial distress themselves. OBJECTIVES This article presents a description of tasks, roles and distress factors, the prevalence of psychosocial distress, description of risk factors in families contributing to dysfunctional coping, options and empirical evidence for the efficacy of psychosocial support. METHODS Evaluation of registry data, analysis of case reports, discussion of basic research findings, meta-analyses and expert judgments. RESULTS Psychosocial distress in relatives of cancer patients is comparable to the degree of distress experienced by the patients and is sometimes even higher. Distress in relatives is still underrecognized, underreported and undertreated. Hostile interaction patterns, low emotional expression and high conflict tendencies impair coping with cancer and its treatment. Psychosocial support for the family of cancer patients improves coping behavior and the quality of life both in relatives and patients. CONCLUSION Professional and lay caregivers need to adopt a social perspective on cancer whereby participation and inclusion of relatives in the treatment, acknowledgment of their engagement and recognition of their distress is beneficial for both patients and their relatives. Screening for psychosocial distress in relatives is recommended, attention should be drawn to psychosocial support services and utilization should be encouraged.
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