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Alfaro-Diaz C, Esandi N, Clausen AM, Canga-Armayor N, Pueyo-Garrigues M, Dieperink KB. Instruments for Assessing Family Functioning in Adults Patients with Cancer: A Systematic Review of Measurement Properties. Semin Oncol Nurs 2024:151729. [PMID: 39277506 DOI: 10.1016/j.soncn.2024.151729] [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: 04/25/2024] [Revised: 08/09/2024] [Accepted: 08/16/2024] [Indexed: 09/17/2024]
Abstract
OBJECTIVES To identify instruments for assessing family functioning in adults patients with cancer and summarize their psychometric properties. METHODS Psychometric systematic literature review was conducted to June 2023 using four databases: PubMed, CINAHL, Psych INFO, and Web of Science. The psychometric properties of the instruments and the methodological quality of the studies were evaluated using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) was used to rate the best available evidence. RESULTS Forty-four studies reporting 13 instruments were included. The instruments measured varied attributes of family functioning and the dimensions were heterogeneous. The Cancer Communication Assessment Tool for Patients and Families (CCAT-PF) was rated the highest in terms of both methodological rigor and instrument quality. However, the Family Adaptability and Cohesion Evaluation Scale (FACES) and the Ice-Expressive Family Functioning Questionnaire (ICE-EFFQ) offer a more comprehensive measure of family functioning, since they assess multiple dimensions of family functioning and demonstrate high-quality measurement properties. CONCLUSIONS Instruments to assess family functioning were heterogeneous and exhibited limited reliability and validity. The FACES and the ICE-EFFQ seem to be the most suitable measures for adult cancer patients and their families. Future research should aim to refine the content of existing instruments and rigorously assess their psychometric properties. IMPLICATIONS FOR NURSING PRACTICE Given the profound impact of cancer on family functioning, the initial step in crafting effective interventions is providing valid and reliable instruments to measure the impact of these interventions. This paper could assist nursing professionals in making informed decisions regarding the most suitable instrument for assessing family functioning in adults patients living with life-threatening illness as is the case with cancer.
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Affiliation(s)
- Cristina Alfaro-Diaz
- Department of Nursing Care for Adult Patients, School of Nursing, Universidad de Navarra, Navarra, Spain; IdiSNa, Navarra Institute for Health Research, Universidad de Navarra, Navarra, Spain
| | - Nuria Esandi
- Department of Nursing Care for Adult Patients, School of Nursing, Universidad de Navarra, Navarra, Spain; IdiSNa, Navarra Institute for Health Research, Universidad de Navarra, Navarra, Spain.
| | - Anne Møller Clausen
- Department of Haematology, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Family focused healthcare research Center, University of Southern Denmark, Odense, Denmark
| | - Navidad Canga-Armayor
- IdiSNa, Navarra Institute for Health Research, Universidad de Navarra, Navarra, Spain; Department of Community, Maternity and Pediatric Nursing, School of Nursing, Universidad de Navarra, Navarra, Spain
| | - María Pueyo-Garrigues
- IdiSNa, Navarra Institute for Health Research, Universidad de Navarra, Navarra, Spain; Department of Community, Maternity and Pediatric Nursing, School of Nursing, Universidad de Navarra, Navarra, Spain
| | - Karin B Dieperink
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Family focused healthcare research Center, University of Southern Denmark, Odense, Denmark; Department of Oncology, Odense University Hospital, Odense, Denmark
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Gou M, Li L, Wang X, Yuan P, Li S, Wei Y, Zhou G. Risk Perception and Maternal Prenatal Depressive Symptoms in the Early Stage of COVID-19 Pandemic in China: Role of Negative Emotions and Family Sense of Coherence. Matern Child Health J 2024; 28:1631-1640. [PMID: 38856799 DOI: 10.1007/s10995-024-03964-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2024] [Indexed: 06/11/2024]
Abstract
BACKGROUND Prenatal depression is associated with adverse health outcomes for both mothers and their children. The worldwide COVID-19 pandemic has presented new risks and challenges for expectant mothers. The aims of the study were to investigate the underlying mechanism between COVID-19 risk perception of Chinese pregnant women and their prenatal depressive symptoms and potential protective factors such as family sense of coherence (FSOC). METHOD A total of 181 Chinese pregnant women (Mage = 31.40 years, SD = 3.67, ranged from 23 to 43) participated in an online survey from April 22 to May 16, 2020. Risk perception and negative emotions (fear and anxiety) related with COVID-19, FSOC, and prenatal depressive symptoms were assessed. RESULTS The experience of maternal COVID-19 related negative emotion fully mediated the positive relationship between COVID-19 risk perception and prenatal depressive symptoms of pregnant women (β = 0.12, 95% CI [0.06, 0.19]). When confronting COVID-19 related fear and anxiety, expectant mothers from higher coherent families experienced a significantly lower level of prenatal depressive symptoms. CONCLUSIONS Contextual negative emotional experience was demonstrated to explain how risk perception impacts depressive symptoms during severe public health crisis for pregnant women. FSOC may be a psychological resource protecting pregnant women from experiencing adverse psychological outcomes during COVID-19 pandemic.
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Affiliation(s)
- Mengke Gou
- School of Psychological and Cognitive Sciences, Beijing Key Laboratory of Behaviour and Mental Health, Peking University, Beijing, 100871, China
| | - Luyao Li
- Department of Obstetrics and Gynecology, Peking University Third Hospital, No. 49 Hua yuan north Road, Hai Dian district, Beijing, China
| | - Xi Wang
- School of Psychological and Cognitive Sciences, Beijing Key Laboratory of Behaviour and Mental Health, Peking University, Beijing, 100871, China
| | - Pengbo Yuan
- Department of Obstetrics and Gynecology, Peking University Third Hospital, No. 49 Hua yuan north Road, Hai Dian district, Beijing, China
| | - Shuang Li
- Department of Obstetrics and Gynecology, Peking University Third Hospital, No. 49 Hua yuan north Road, Hai Dian district, Beijing, China
| | - Yuan Wei
- Department of Obstetrics and Gynecology, Peking University Third Hospital, No. 49 Hua yuan north Road, Hai Dian district, Beijing, China.
| | - Guangyu Zhou
- School of Psychological and Cognitive Sciences, Beijing Key Laboratory of Behaviour and Mental Health, Peking University, Beijing, 100871, China.
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Koppner J, Lindelöf A, Iredahl F, Nilsson S, Thorsell A, Larsen HI, Faresjö Å. Sense of coherence, mental health, and hair cortisol concentrations among older people during the COVID -19 pandemic: a cross-sectional study. BMC Public Health 2024; 24:1502. [PMID: 38840150 PMCID: PMC11151583 DOI: 10.1186/s12889-024-19034-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 06/03/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND A person's sense of coherence (SoC) is likely to affect coping when exposed to a life changing event like the COVID -19 pandemic, which impacted the older population especially hard, an age group that already suffers from a lot of mental illness. Thus, the aim of this study was to investigate the associations between SoC and mental health in older adults using both screening scales and hair cortisol concentrations (HCC). METHOD A cross-sectional design studying a cohort of 70-80 years old, N = 260, set in Swedish primary care during the pandemic years 2021-2022. Instruments used are sense of coherence 13 (SoC-13), EQ-5D-3L, Geriatric depression scale 20 (GDS-20), Hospital anxiety and depression scale (HADS), and Perceived stress scale 10 (PSS-10). Sociodemography and factors concerning SoC, and mental health are explored. HCC are measured using radioimmunoassay. Outcome measures are factors independently associated with SoC. Linear regression models were performed with SoC as dependent variable, and priory path analyses explored whether associations with SoC were direct, or indirect via anxiety. RESULTS SoC was significantly associated with anxiety (p < 0.001), perceived economic status (p = 0.003), belief in the future (p = 0.001), and perceived negative mental effect from the COVID -19 pandemic (p = 0.002). The latter was 96% indirectly associated with SoC (p < 0.001), whereas perceived economic status together with belief in the future was 82% directly associated with SoC (p = 0.17). HCC and sex were not significantly associated with SoC, but, noticeably, high HCC was equally distributed between women and men. Women reported significantly lower quality of life (p = 0.03), and more symptoms of anxiety (p = 0.001) and depression (p < 0.001). CONCLUSION Anxiety, belief in the future, perceived negative effect on mental health due to the pandemic, and perceived economic status were significantly associated with SoC. Anxiety is suggested to be important in explaining the association between perceived negative mental effect from the COVID-19 pandemic and SoC. Women reported significantly poorer mental health and life quality than men.
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Affiliation(s)
- Jenny Koppner
- Department of Health, Medicine and Caring Sciences, Division of General practice, Linköping University, Linköping, Sweden.
| | - Ann Lindelöf
- Department of Health, Medicine and Caring Sciences, Division of General practice, Linköping University, Linköping, Sweden
| | - Fredrik Iredahl
- Department of Health, Medicine and Caring Sciences, Division of General practice, Linköping University, Linköping, Sweden
| | - Staffan Nilsson
- Department of Health, Medicine and Caring Sciences, Division of General practice, Linköping University, Linköping, Sweden
| | - Annika Thorsell
- Department of Biomedical and Clinical Sciences/Center for Social and Affective Neuroscience, Medicine, Linköping University, Linköping, Sweden
| | - Hanna Israelsson Larsen
- Department of Health, Medicine and Caring Sciences, Division of General practice, Linköping University, Linköping, Sweden
| | - Åshild Faresjö
- Department of Health, Medicine and Caring Sciences, Division of Society and Health/Public Health, Linköping University, Linköping, Sweden
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Sari Ozturk C, Kilicarslan E. A picture of hope: From the perspective of adolescents with cancer-A phenomenological-visual qualitative study. Nurs Health Sci 2024; 26:e13127. [PMID: 38797524 DOI: 10.1111/nhs.13127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 04/07/2024] [Accepted: 05/07/2024] [Indexed: 05/29/2024]
Abstract
This study aims to investigate the phenomenon of hope in adolescents diagnosed with cancer and examine adolescents' lived experiences of hope. The study was conducted between November 2022 and March 2023. The study used a phenomenological-visual qualitative research design with 20 adolescents in the pediatric oncology ward. The purposive sampling method was used in the study. Data were collected using "Descriptive Characteristic Form," "Semi-structured Interview Form," "Drawing Technique," and "Mutual Storytelling Technique". The adolescents were instructed, "Let us draw our hopes," and asked to draw pictures. Each adolescent was interviewed about the drawings and asked four semi-structured questions. Audio recordings of the interviews were made and transcribed. A hermeneutic phenomenological approach was used in the analysis of the data. Two main themes and four subthemes were identified in the study. Metaphorical and conceptual context was included in the theme of symbolizing and linking hope. Two subthemes, facilitators and barriers, were identified in the main theme of rooting hope. The study sheds light on hope experiences in adolescents receiving cancer treatment and guides healthcare professionals.
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Affiliation(s)
- Cigdem Sari Ozturk
- Nursing Faculty, Pediatric Nursing Department, Gazi University, Ankara, Turkey
| | - Ebru Kilicarslan
- Nursing Faculty, Pediatric Nursing Department, Gazi University, Ankara, Turkey
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Cui P, Cheng C, An H, Chen X, Chen C, Hu H. A chain mediation model reveals the association between family sense of coherence and quality of life in caregivers of advanced cancer patients. Sci Rep 2024; 14:10701. [PMID: 38730003 PMCID: PMC11087510 DOI: 10.1038/s41598-024-61344-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 05/05/2024] [Indexed: 05/12/2024] Open
Abstract
Caregivers of advanced cancer patients face challenges impacting their quality of life (QoL). While evidence suggests that family sense of coherence (FSOC) can enhance individual psychological well-being and reduce distress symptoms, the precise mechanism through which FSOC improves caregivers' QoL remains unclear. This study aimed to explore the relationships among FSOC, psychological resilience, psychological distress, and QoL in primary caregivers of advanced cancer patients. A cross-sectional observational study was undertaken from June 2020 to March 2021 across five tertiary hospitals in China. Instruments included a general characteristic questionnaire, the Family Sense of Coherence Scale, the Patient Health Questionnaire-4, the 10-item Connor-Davidson Resilience Scale, and the 8-item SF-8 health survey. Pearson's correlation and chain mediation analyses were performed using IBM SPSS (version 21) and PROCESS macro (version 3.4). Out of 290 valid questionnaires, results demonstrated that FSOC directly and positively influences caregivers' QoL. Psychological distress partially mediated the FSOC-QoL association, with paths "FSOC-psychological distress-QoL" and "FSOC-psychological resilience-psychological distress-QoL" contributing 43.08% and 6.72% of the total effect, respectively. Furthermore, this study distinguished physical and mental aspects of QoL, confirming both conform to the chain mediation model. FSOC impacts caregivers' QoL directly and indirectly through the mediation of psychological distress and the chain mediation effect of "psychological resilience-psychological distress". These insights enhance our understanding of the complex interplay between FSOC and QoL, underscoring the potential benefits of bolstering FSOC to strengthen caregiver resilience, alleviate distress, and ultimately elevate their QoL.
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Affiliation(s)
- Panpan Cui
- Department of Nursing, Henan Provincial Key Medicine Laboratory of Nursing, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, No. 7 Weiwu Road, Zhengzhou, China
- School of Nursing, Zhengzhou University, Zhengzhou, China
| | - Chunyan Cheng
- Hematology Department, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Huiying An
- Gastroenterology, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Xinyi Chen
- Medical Oncology, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Changying Chen
- The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe Dong Road, Zhengzhou, China.
- Institute for Hospital Management of Henan Province, Zhengzhou, China.
| | - Hengyu Hu
- Department of Nursing, Henan Provincial Key Medicine Laboratory of Nursing, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, No. 7 Weiwu Road, Zhengzhou, China.
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Shield T, Bayliss K, Hodkinson A, Panagioti M, Wearden A, Flynn J, Rowland C, Bee P, Farquhar M, Harris D, Grande G. What factors are associated with informal carers' psychological morbidity during end-of-life home care? A systematic review and thematic synthesis of observational quantitative studies. HEALTH AND SOCIAL CARE DELIVERY RESEARCH 2023:1-58. [PMID: 37991230 DOI: 10.3310/htjy8442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2023]
Abstract
Background Family carers are central in supporting patients nearing end of life. As a consequence, they often suffer detrimental impacts on their own mental health. Understanding what factors may affect carers' mental health is important in developing strategies to maintain their psychological well-being during caregiving. Aim To conduct a systematic review and thematic evidence synthesis of factors related to carers' mental health during end-of-life caregiving. Method Searches of MEDLINE, CINAHL, PsychINFO, Social Sciences Citation Index, EMBASE, Cochrane Central Register of Controlled Trials and Database of Abstracts of Reviews of Effects 1 January 2009-24 November 2019. We included observational quantitative studies focusing on adult informal/family carers for adult patients at end of life cared for at home considering any factor related to carer mental health (anxiety, depression, distress and quality of life) pre-bereavement. Newcastle-Ottawa Quality Assessment Scale was used. Thematic analysis with box score presentation, and meta-analysis were done where data permitted. Results Findings from 63 included studies underpinned seven emergent themes. Patient condition (31 studies): worse patient psychological symptoms and quality of life were generally associated with worse carer mental health. Patient depression was associated with higher depression in carers (standardised mean difference = 0.59, 95% confidence interval 0.32 to 0.87, I2 = 77%). Patients' other symptoms and functional impairment may relate to carer mental health, but findings were unclear. Impact of caring responsibilities (14 studies): impact on carers' lives, task difficulty and general burden had clear associations with worse carer mental health. Relationships (8 studies): family dynamics and the quality of the carer-patient relationship may be important for carer mental health and are worthy of further investigation. Finance (6 studies): insufficient resources may relate to carers' mental health and warrant further study. Carers' psychological processes (13 studies): self-efficacy and preparedness were related to better mental health. However, findings regarding coping strategies were mixed. Support (18 studies): informal support given by family and friends may relate to better carer mental health, but evidence on formal support is limited. Having unmet needs was related to worse mental health, while satisfaction with care was related to better mental health. Contextual factors (16 studies): older age was generally associated with better carer mental health and being female was associated with worse mental health. Limitations Studies were mainly cross-sectional (56) rather than longitudinal (7) which raises questions about the likely causal direction of relationships. One-third of studies had samples < 100, so many had limited statistical power to identify existing relationships. Conclusions and future work Future work must adopt a comprehensive approach to improving carers' mental health because factors relating to carer mental health cover a broad spectrum. The literature on this topic is diverse and difficult to summarise, and the field would benefit from a clearer direction of enquiry guided by explanatory models. Future research should (1) further investigate quality of relationships and finances; (2) better define factors under investigation; (3) establish, through quantitative causal analyses, why factors might relate to mental health; and (4) utilise longitudinal designs more to aid understanding of likely causal direction of associations. Study registration This study is registered as PROSPERO registration 2019 CRD42019130279 at https://www.crd.york.ac.uk/prospero/. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme HSDR 18/01/01 and is published in full in Health and Social Care Delivery Research. See the NIHR Funding and Awards website for further award information.
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Affiliation(s)
- Tracey Shield
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester, Manchester, UK
| | - Kerin Bayliss
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester, Manchester, UK
| | - Alexander Hodkinson
- NIHR Greater Manchester Patient Safety Translational Research Centre, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, University of Manchester, Manchester, UK
| | - Maria Panagioti
- NIHR Greater Manchester Patient Safety Translational Research Centre, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, University of Manchester, Manchester, UK
| | - Alison Wearden
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, UK
| | - Jackie Flynn
- Public and Community Involvement and Engagement (PCIE) Panel, NIHR Applied Research Collaboration (ARC) Greater Manchester, Manchester, UK
| | - Christine Rowland
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, UK
| | - Penny Bee
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester, Manchester, UK
| | - Morag Farquhar
- School of Health Sciences, University of East Anglia, Norwich, UK
| | - Danielle Harris
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester, Manchester, UK
- NIHR Applied Research Collaboration (ARC) Greater Manchester, Manchester, UK
| | - Gunn Grande
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester, Manchester, UK
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Cui P, Shi J, Li S, Getu MA, Wang R, Chen C. Family resilience and its influencing factors among advanced cancer patients and their family caregivers: a multilevel modeling analysis. BMC Cancer 2023; 23:623. [PMID: 37403053 DOI: 10.1186/s12885-023-11101-z] [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: 10/18/2022] [Accepted: 06/22/2023] [Indexed: 07/06/2023] Open
Abstract
BACKGROUND Cancer is highly prevalent worldwide. Family resilience is a positive variable that helps families burdened by advanced cancer to cope effectively. This study aimed to describe the family resilience of advanced cancer patients and caregivers in dyads and identify its influencing factors at the individual and dyadic levels. METHODS This multisite cross-sectional study was conducted in oncology units in five tertiary hospitals in China. A total of 270 advanced cancer patient-caregiver dyads were recruited between June 2020 and March 2021. Patients' and caregivers' family resilience was measured by the Family Resilience Assessment Scale. Data on potential influencing factors, including demographic and disease-related characteristics as well as family sense of coherence, psychological resilience, perceived social support, symptom burden, and caregiver burden, were collected. Multilevel modeling analysis was adopted to control for the interdependence of the dyads. RESULTS A total of 241 dyads were included in the data analysis. The mean ages of patients and caregivers were 53.96 (SD 15.37) and 45.18 (SD 13.79) years, respectively. Most caregivers were spouses and adult children (45.6% and 39.0%, respectively). Patients reported a higher mean family resilience score than caregivers (152.56 vs. 149.87, respectively). Undergoing fewer than two types of treatment and a lower symptom burden of patients predicted higher patient (B = -9.702, -0.134, respectively) and caregiver (B = -5.462, -0.096, respectively) family resilience. Patients also reported higher family resilience under the following conditions: 1) were on a medical insurance plan other than the new rural cooperative medical system (B = 6.089), 2) had a better family sense of coherence (B = 0.415), 3) whose caregivers were unmarried (B = 8.618), perceived lower social support (B = -0.145) and higher psychological resilience (B = 0.313). Caregivers who were ≤ 44 years old (B = -3.221), had similar previous caregiving experience (B = 7.706), and had a stronger family sense of coherence (B = 0.391) reported higher family resilience. CONCLUSIONS Our findings highlight the importance of adopting a dyadic approach when caring for advanced cancer patients and their caregivers. Dyadic longitudinal research is suggested to discover more modifiable factors of family resilience and tailored interventions are needed to obtain optimal dyadic outcomes.
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Affiliation(s)
- Panpan Cui
- Nursing department, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China
- School of Nursing, Zhengzhou University, Zhengzhou, China
| | - Jiaoxia Shi
- Medical Oncology, Jiaozuo People's Hospital, Jiaozuo, China
| | - Shifeng Li
- Medical Oncology, Xinyang Central Hospital, Xinyang, China
| | - Mikiyas Amare Getu
- School of Nursing, Zhengzhou University, Zhengzhou, China
- School of Nursing, Woldia University, Weldiya, Ethiopia
| | - Ruibo Wang
- School of Nursing, Zhengzhou University, Zhengzhou, China
| | - Changying Chen
- The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe Dong Road, Zhengzhou, China.
- Institute for Hospital Management of Henan Province, Zhengzhou, China.
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Hammer K, Højgaard HS, Á Steig B, Wang AG, Bergenholtz HM, Rosted EE. Hope pictured in drawings by patients newly diagnosed with advanced cancer. J Clin Nurs 2023; 32:1262-1275. [PMID: 35277902 DOI: 10.1111/jocn.16274] [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: 12/20/2021] [Revised: 02/15/2022] [Accepted: 02/22/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Hope is an integral part of a dying person's needs and an important phenomenon that has not been satisfactorily explored. The tension between hope for a cure and the reality of being terminally ill is a paradox, which in the context of palliative cancer care, nurses and health care professionals must take into consideration. OBJECTIVE The purpose of this study was to elucidate the phenomenon of hope and to investigate the lived experiences of hope among newly diagnosed patients with advanced cancer. METHOD The study used a phenomenological-visual method where drawings and post-drawing interviews were used. The participants were six patients who recently had been offered specialised palliative care treatment. They were five women and one man with different cancer diagnoses and between 30 and 82 years of age (median 65 years). The data consisted of six drawings and individual post-drawing interviews with the participants. The study was reported using the COREQ checklist. RESULTS The study revealed one main concern 'Being in hope' and hope appeared in four different dimensions; internal, external, relational and transcendental. Hopelessness was present at all times. CONCLUSION Hope pictured in drawings was expressed through colour, shape, lines, symbols and metaphors, and hope incorporated internal, external, relational and transcendental aspects. Hope was constantly fighting against hopelessness and hope integrated with past, present and future. RELEVANCE TO CLINICAL PRACTICE Drawings, as well as other visual representations, are suitable tools when trying to understand an ineffable phenomenon such as hope experienced by people newly diagnosed with cancer.
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Affiliation(s)
- Kristianna Hammer
- Department of Palliative Care, National Hospital of the Faroe Islands, Tórshavn, Faroe Islands
| | | | - Bjarni Á Steig
- Department of Hematology and Palliative Care, National Hospital of the Faroe Islands, Tórshavn, Faroe Islands
| | - August G Wang
- Faculty of Health, University of Faroe Islands, Tórshavn, Faroe Islands.,Centre of Psychiatry, Copenhagen University Hospital Amager, Copenhagen S, Denmark
| | - Heidi M Bergenholtz
- Department of Surgery, Holbaek Hospital, Holbaek, Denmark.,REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Nyborg, UK
| | - Elizabeth E Rosted
- Department of Oncology and Palliative Care, Zealand University Hospital, Roskilde, Denmark.,University of Southern Denmark, Odense, Denmark
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Alfaro-Díaz C, Esandi N, Canga-Armayor N, Idoia Pardavila-Belio M, Pueyo-Garrigues M, Canga-Armayor A. Personal and Contextual Factors to the Successful Implementation of a Family Nursing Approach in Oncology Care. JOURNAL OF FAMILY NURSING 2022; 28:277-291. [PMID: 35414277 DOI: 10.1177/10748407221083071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The aim of this study was to explore nurses' attitudes and beliefs about the importance of families in nursing care, as well as the barriers and facilitators within the clinical context that influence the implementation offamily nursing in an in-patient oncology service. A cross-sectional study design, incorporating quantitative and qualitative measurements, was used with a sample of nurses in Spain from an oncology service (N = 39). In general, oncology nurses reported positive attitudes and beliefs about the importance of family in nursing care. However, they did not effectively involve the family in their daily clinical practice. This was due to the nurses' lack of clinical skills and competence to work with families as well as contextual factors such as the lack of time and workload that acted as barriers to the implementation of family-oriented care. This study identified areas of improvement that are needed to promote the effective and sustainable implementation of family nursing knowledge in clinical practice settings.
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Affiliation(s)
- Cristina Alfaro-Díaz
- University of Navarra, Pamplona, Spain
- Navarra Institute for Health Research, Pamplona, Spain
| | - Nuria Esandi
- University of Navarra, Pamplona, Spain
- Navarra Institute for Health Research, Pamplona, Spain
| | - Navidad Canga-Armayor
- University of Navarra, Pamplona, Spain
- Navarra Institute for Health Research, Pamplona, Spain
| | | | - María Pueyo-Garrigues
- University of Navarra, Pamplona, Spain
- Navarra Institute for Health Research, Pamplona, Spain
| | - Ana Canga-Armayor
- University of Navarra, Pamplona, Spain
- Navarra Institute for Health Research, Pamplona, Spain
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10
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Alfaro-Díaz C, Svavarsdottir EK, Esandi N, Klinke ME, Canga-Armayor A. Effectiveness of Nursing Interventions for Patients With Cancer and their Family Members: A Systematic Review. JOURNAL OF FAMILY NURSING 2022; 28:95-114. [PMID: 35057657 DOI: 10.1177/10748407211068816] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Cancer diagnosis poses enormous physical and psychosocial challenges for both the affected person and their families. This systematic review identifies the characteristics and effectiveness of nursing interventions offered to adult patients with cancer and their families. Five databases were searched, and 19 studies published from 2009 to 2020 were included. Interventions were categorized as follows: (a) interventions with supporting and cognitive components (n = 3), (b) interventions that included skills training for the caregiver (n = 3), (c) interventions to enhance care through managing symptoms (n = 8), (d) interventions focusing on the dyad or family-patient relationship (n = 4), and (e) interventions targeted to the patient's condition (n = 1). The results of this review offer an overview from which to carry out new studies and are useful for providing future directions within family nursing practice, taking into account the impact that the family has on the disease and the consequences the condition may bring to the whole family.
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Affiliation(s)
- Cristina Alfaro-Díaz
- Universidad de Navarra, Pamplona, Spain
- Navarra Institute for Health Research, Pamplona, Spain
| | | | - Nuria Esandi
- Universidad de Navarra, Pamplona, Spain
- Navarra Institute for Health Research, Pamplona, Spain
| | - Marianne E Klinke
- University of Iceland, Reykjavik, Iceland
- Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland
| | - Ana Canga-Armayor
- Universidad de Navarra, Pamplona, Spain
- Navarra Institute for Health Research, Pamplona, Spain
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11
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Heydari F, Nikfarid L, Oujian P, Nasiri M, Motefakker S. Predictors of Perceived Family Sense of Coherence in Parents of Children with Cancer. Indian J Palliat Care 2022; 28:28-36. [PMID: 35673383 PMCID: PMC9165460 DOI: 10.25259/ijpc_107_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 01/09/2022] [Indexed: 12/01/2022] Open
Abstract
Objectives: Despite improvement in childhood cancer survival in recent decades, it is still an extremely challenging health condition for parents. The impacts of childhood cancer on the family as a whole are recently interested by researchers. Family coherence is one of these concepts and health-care providers need to understand the perception of parents of family coherence. This study aimed to assess the correlation between perceived family sense of coherence (SOC) in parents of children with cancer; with socio-demographic, psycho-emotional and family-related variables. Materials and Methods: This cross-sectional correlational study recruited 125 parents of children with cancer attending hospitals in Tehran in 2020, selected by convenience sampling method. The correlation between family SOC and demographic variables, chronic sorrow, coping behaviours, family functioning and social support was investigated using regression analysis. Results: The mean score perceived sense of family coherence in parents of children with cancer was higher in fathers (Beta = 0.17, P = 0.02), urban residents (beta = –0.2, P = 0.01) and homeowners (beta = –0.27, P = 0.001). The sense of family coherence had positive correlations with income grade (beta = 0.27, P = 0.006), coping behaviours (beta = 1.28, P = 0.002), social support (beta = 0.67, P = 0.001), negative correlations with the disturbance in family problem-solving (beta = –0.28, P = 0.006) and chronic sorrow (beta=-0.39, P = 0.001). Conclusion: The present study expanded the concept of family SOC in nursing knowledge and attracted the attention of the providers of family-centred care to the parents of children with cancer and their concerns, which directly and indirectly affect the entire family’s health.
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Affiliation(s)
- Fatemeh Heydari
- Department of Pediatric Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran,
| | - Lida Nikfarid
- Department of Pediatric Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran,
| | - Parastoo Oujian
- Department of Psychiatric and Management Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran,
| | - Maliheh Nasiri
- Department of Pediatric Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran,
| | - Sanaz Motefakker
- Department of Psychiatric and Management Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran,
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12
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Ghorbani F, Razban F, Iranmanesh S, Dehghan M. Sense of Coherence in Parents of Children With Cancer and Its Relationship With Self-Construal in Southeastern Iran. Clin Nurs Res 2021; 31:1072-1079. [PMID: 34955037 DOI: 10.1177/10547738211062717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study aimed to determine sense of coherence and its relationship with self-construal in parents of children with cancer in southeastern Iran. In this descriptive correlational study, 127 parents of children with cancer were studied using sense of coherence scale (SOC) and self-construal scale (SCS) in Iran. The results of the study showed that total mean score of SOC was 51.4 ± 14.2 and the interdependent self-construal (INT) in parents was higher than independent self-construal (IND). Also, the relationship between SOC and SCS showed that IND had a positive and statistically significant relationship with SOC manageability subscale. The weak SOC in the studied parents can cause more stress and suffering in dealing with their child's disease. It is essential that health care providers provide a comprehensive program to enhance parents' SOC and it should be noted that people who have a more INT felt less able to manage challenging situations.
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13
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Leite ACAB, García-Vivar C, DeMontigny F, Nascimento LC. Waves of family hope: narratives of families in the context of pediatric chronic illness. Rev Lat Am Enfermagem 2021; 29:e3504. [PMID: 34816873 PMCID: PMC8616230 DOI: 10.1590/1518-8345.5515.3504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 09/06/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to analyze narratives about the experience of hope of families in the context of pediatric chronic illness. METHOD a narrative research using Family Systems Nursing as a conceptual framework. Three families of children and adolescents diagnosed with complex chronic illness participated in this study, totaling 10 participants. Data collection was developed using family photo-elicitation interviews. Family narratives were constructed and analyzed according to inductive thematic analysis with theoretical data triangulation. RESULTS the analytical theme - Waves of Family Hope in the Context of Pediatric Chronic Illness - is composed of four different types of hope: uncertain hope, caring hope, latent hope, and expectant hope. Movement through these hopes generates a driving energy and depends on a number of factors: support, information, searching for normality, and thoughts and comparisons. CONCLUSION the results highlight the interaction and reciprocities of the members of the family unit, and the dynamics of hope, and illustrate the different types of hope and the factors that influence them. This study highlights the experience of hope as a family resource rather than just an individual resource, and supports health professionals in the planning of family care considering hope as an essential and dynamic family resource.
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Affiliation(s)
- Ana Carolina Andrade Biaggi Leite
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto,
PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP,
Brazil
- Scholarship holder at the Coordenação de Aperfeiçoamento de Pessoal
de Nível Superior (CAPES), Brazil
| | - Cristina García-Vivar
- Universidad Pública de Navarra, Departamento de Ciencias de la
Salud, Pamplona, Navarra, Spain
| | - Francine DeMontigny
- Université du Québec en Outaouais, Department of Nursing, Gatineau,
Quebec, Canada
| | - Lucila Castanheira Nascimento
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto,
PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP,
Brazil
- Scholarship holder at the Conselho Nacional de Desenvolvimento
Científico e Tecnológico (CNPq), Brazil
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14
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Duggleby W, Lee H, Nekolaichuk C, Fitzpatrick-Lewis D. Systematic review of factors associated with hope in family carers of persons living with chronic illness. J Adv Nurs 2021; 77:3343-3360. [PMID: 33876845 DOI: 10.1111/jan.14858] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 03/03/2021] [Accepted: 03/30/2021] [Indexed: 11/30/2022]
Abstract
AIMS To identify factors associated with hope in family carers of persons living with chronic illness. DESIGN A systematic review of quantitative and mixed method studies on hope in carers of persons living with chronic illness. DATA SOURCES Five electronic databases (Medline, Cumulative Index to Nursing and Allied Health Literature, Web of Science, ProQuest Dissertations and PsycINFO) were searched from inception to 13 July 2020. REVIEW METHODS Inclusion criteria were the following: (a) study population of adult (18 years of age and older) carers of persons living with chronic illness, (b) hope was measured as a variable, (c) reported factors associated with hope, (d) employed either quantitative or mixed methods design, (e) written in English and (f) was published in peer reviewed journals. All included studies were evaluated for quality using the Mixed Method Appraisal Tool. RESULTS Twenty-six studies were included in the systematic review. Quality of life, physical and mental health, life satisfaction and the hope of care recipients were found to be positively associated with hope. Carer's coping increased (self-efficacy and caregiver preparedness) as hope increased with a decrease in maladaptive coping strategies. Anxiety, depression, distress, grief and guilt were negatively associated with carers' hope. Carers' hope did not appear to be associated with carer or care-recipient demographic variables. CONCLUSION Carers' hope appears to be associated with the carers' over all positive health. The factors associated with carers' hope provide potential areas to focus intervention development such as strategies that increase self-efficacy. More research is needed to clarify if factors such as stage of disease and resilience are associated with hope. Research on carers' hope assessment and intervention development should also focus on factors associated with hope. IMPACT The findings underscore the need to assess and work with carers of persons living with chronic illness to enhance their hope.
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Affiliation(s)
- Wendy Duggleby
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - HeunJung Lee
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Cheryl Nekolaichuk
- Division of Palliative Care Medicine, University of Alberta, Health Services Centre, Edmonton, AB, Canada
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15
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Association between Depression, Lifestyles, Sleep Quality and Sense of Coherence in a Population with Cardiovascular Risk. Nutrients 2021; 13:nu13020585. [PMID: 33578822 PMCID: PMC7916624 DOI: 10.3390/nu13020585] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 01/26/2021] [Accepted: 02/06/2021] [Indexed: 01/03/2023] Open
Abstract
People with cardiovascular risk have more depression than the general population. Depression and cardiovascular risk have been commonly linked to lower sense of coherence (SOC) values, unhealthy lifestyles, and poor sleep quality. The aim of this study was to analyze the association between depression, health-related lifestyles, sleep quality, and SOC in a population with cardiovascular risk. A cross-sectional study was conducted in 310 participants (aged 35–75 years) with cardiovascular risk. Sociodemographic and anthropometric characteristics, cardiovascular risk, SOC score, depression levels, sleep quality, and lifestyles (physical activity, diet quality (measured as the adherence to the Mediterranean diet), and tobacco and alcohol consumption) were determined. The regression analysis showed significant associations between depression levels and sex (odds ratio (OR): 2.29; 95% CI: 1.29, 4.07), diet (OR: 0.85; 95% CI: 0.73, 0.99), body mass index (BMI) (OR: 1.06; 95% CI: 1.01, 1.12), cardiovascular disease (CVD) (OR: 2.55; 95% CI: 1.18, 5.48), sleep quality (OR: 0.26; 95% CI: 0.15, 0.46), and SOC (OR: 0.96; 95% CI: 0.94, 0.98). Protective effects of male sex, a lower BMI, no CVD, a higher adherence to the Mediterranean diet, a high sleep quality, and a higher SOC were found. In conclusion, among lifestyles determined, only diet was associated with depression levels. SOC and sleep quality were also found as significant predictors for depression levels.
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16
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Rapelli G, Lopez G, Donato S, Pagani AF, Parise M, Bertoni A, Iafrate R. A Postcard From Italy: Challenges and Psychosocial Resources of Partners Living With and Without a Chronic Disease During COVID-19 Epidemic. Front Psychol 2020; 11:567522. [PMID: 33362633 PMCID: PMC7759477 DOI: 10.3389/fpsyg.2020.567522] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 11/23/2020] [Indexed: 01/08/2023] Open
Abstract
The new Coronavirus (COVID-19) has been declared a global pandemic by the World Health Organization (WHO). The sudden outbreak of this new virus and the measure of lockdown adopted to contain the epidemic have profoundly changed the lifestyles of the Italian population, with an impact on people's quality of life and on their social relationships. In particular, due to forced and prolonged cohabitation, couples may be subject to specific stressors during the epidemic. In addition, living with a chronic health condition may add specific challenges to the ones posed by the epidemic itself. The present cross-sectional study aimed to provide a picture of the challenges as well as the resources for both individual and relational well-being of Italian individuals in a couple relationship (N = 1921), with a specific attention to the comparison between individuals living with and without a chronic disease. Results showed that people with a chronic disease had lower psychological well-being and more fears and worries about the COVID-19. People with a chronic disease perceived fewer resources than healthy people. Moreover, the challenges are shown to be associated with less psychological well-being and high pessimism about the future. Instead individual, relational, and social resources play a protective role during the pandemic for both healthy and chronically ill people.
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Affiliation(s)
- Giada Rapelli
- Department of Psychology, Family Studies and Research University Centre, Universitá Cattolica del Sacro Cuore, Milan, Italy
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17
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Duke S, Campling N, May CR, Lund S, Lunt N, Richardson A. Co-construction of the family-focused support conversation: a participatory learning and action research study to implement support for family members whose relatives are being discharged for end-of-life care at home or in a nursing home. BMC Palliat Care 2020; 19:146. [PMID: 32957952 PMCID: PMC7507823 DOI: 10.1186/s12904-020-00647-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 09/04/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Many people move in and out of hospital in the last few weeks of life. These care transitions can be distressing for family members because they signify the deterioration and impending death of their ill relative and forthcoming family bereavement. Whilst there is evidence about psychosocial support for family members providing end-of-life care at home, there is limited evidence about how this can be provided in acute hospitals during care transitions. Consequently, family members report a lack of support from hospital-based healthcare professionals. METHODS The aim of the study was to implement research evidence for family support at the end-of-life in acute hospital care. Informed by Participatory Learning and Action Research and Normalization Process Theory (NPT) we co-designed a context-specific intervention, the Family-Focused Support Conversation, from a detailed review of research evidence. We undertook a pilot implementation in three acute hospital Trusts in England to assess the potential for the intervention to be used in clinical practice. Pilot implementation was undertaken during a three-month period by seven clinical co-researchers - nurses and occupational therapists in hospital specialist palliative care services. Implementation was evaluated through data comprised of reflective records of intervention delivery (n = 22), in-depth records of telephone implementation support meetings between research team members and co-researchers (n = 3), and in-depth evaluation meetings (n = 2). Data were qualitatively analysed using an NPT framework designed for intervention evaluation. RESULTS Clinical co-researchers readily incorporated the Family-Focused Support Conversation into their everyday work. The intervention changed family support from being solely patient-focused, providing information about patient needs, to family-focused, identifying family concerns about the significance and implications of discharge and facilitating family-focused care. Co-researchers reported an increase in family members' involvement in discharge decisions and end-of-life care planning. CONCLUSION The Family-Focused Support Conversation is a novel, evidenced-based and context specific intervention. Pilot implementation demonstrated the potential for the intervention to be used in acute hospitals to support family members during end-of-life care transitions. This subsequently informed a larger scale implementation study. TRIAL REGISTRATION n/a.
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Affiliation(s)
- Sue Duke
- School of Health Sciences, University of Southampton, Highfield, Southampton, SO17 1BJ, England.
| | - Natasha Campling
- School of Health Sciences, University of Southampton, Highfield, Southampton, SO17 1BJ, England
| | - Carl R May
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, England
| | - Susi Lund
- School of Health Sciences, University of Southampton, Highfield, Southampton, SO17 1BJ, England
| | - Neil Lunt
- Department of Social Policy and Social Work, University of York, Heslington, York, YO10 5DD, England
| | - Alison Richardson
- University Hospitals Southampton and School of Health Sciences, University of Southampton, Highfield, Southampton, SO17 1BJ, England
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18
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Krug K, Bossert J, Stooß L, Siegle A, Villalobos M, Hagelskamp L, Jung C, Thomas M, Wensing M. Consideration of sense of coherence in a structured communication approach with stage IV lung cancer patients and their informal caregivers: a qualitative interview study. Support Care Cancer 2020; 29:2153-2159. [PMID: 32880008 PMCID: PMC7892692 DOI: 10.1007/s00520-020-05724-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 08/26/2020] [Indexed: 02/01/2023]
Abstract
Objective Salutogenetic aspects are valuable for consideration in patient-centred care of advanced oncological diseases with a limited life expectancy. The Milestone Communication Approach (MCA), involving physician-nurse tandems, addresses specific challenges and needs over the disease trajectory of patients with stage IV lung cancer and their informal caregivers. This study aims to explore patients’ and informal caregivers’ salutogenetic experiences with the MCA concept. Methods This qualitative study used face-to-face semi-structured interviews with patients and informal caregivers. All generated data were audio-recorded, pseudonymised and transcribed verbatim. Data were structured using Qualitative Content Analysis. The material was coded deductively into themes related to the components of sense of coherence (Aaron Antonovsky) and emerging sub-themes. All data was managed and organised in MAXQDA. Results In 25 interviews, sense of coherence was referred to with all three components: “Comprehensibility” was supported by information conveyed suitably for the patients; “meaningfulness” was addressed as accepting the situation; and “manageability” led to advance care planning the patients were comfortable with. Patients and informal caregivers experienced the interprofessional tandem as an added value for patient care. Conclusions Participants appreciate the MCA in its support for coping with a life-limiting disease. Considering salutogenetic aspects facilitates prognostic awareness and advance care planning. Nevertheless, individual needs of patients and informal caregivers require an individualised application of the MCA.
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Affiliation(s)
- Katja Krug
- Department of General Practice and Health Services Research, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany.
| | - Jasmin Bossert
- Department of General Practice and Health Services Research, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany.,Thoraxklinik Heidelberg, Department of Thoracic Oncology, Heidelberg University Hospital, Röntgenstraße 1, 69126, Heidelberg, Germany
| | - Lydia Stooß
- Department of General Practice and Health Services Research, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
| | - Anja Siegle
- Thoraxklinik Heidelberg, Department of Thoracic Oncology, Heidelberg University Hospital, Röntgenstraße 1, 69126, Heidelberg, Germany
| | - Matthias Villalobos
- Thoraxklinik Heidelberg, Department of Thoracic Oncology, Heidelberg University Hospital, Röntgenstraße 1, 69126, Heidelberg, Germany
| | - Laura Hagelskamp
- Thoraxklinik Heidelberg, Department of Thoracic Oncology, Heidelberg University Hospital, Röntgenstraße 1, 69126, Heidelberg, Germany
| | - Corinna Jung
- Thoraxklinik Heidelberg, Department of Thoracic Oncology, Heidelberg University Hospital, Röntgenstraße 1, 69126, Heidelberg, Germany.,Medical School Berlin, Calandrellistr. 1-9, 12247, Berlin, Germany
| | - Michael Thomas
- Thoraxklinik Heidelberg, Department of Thoracic Oncology, Heidelberg University Hospital, Röntgenstraße 1, 69126, Heidelberg, Germany
| | - Michel Wensing
- Department of General Practice and Health Services Research, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
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