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Sun H, Wacharasin C, Hengudomsub P. Change in resilience among spousal caregivers of patients with newly-diagnosed advanced cancer over the first six months posttreatment in China. J Psychosom Res 2024; 183:111538. [PMID: 38823371 DOI: 10.1016/j.jpsychores.2023.111538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 10/13/2023] [Accepted: 10/23/2023] [Indexed: 06/03/2024]
Abstract
OBJECTIVE A longitudinal observational study was conducted and aimed to examine the change in resilience among spousal caregivers of newly-diagnosed advanced cancer patients over the first six months after initial treatment. METHODS In total, 312 Chinese spousal caregivers who were taking care of their patients with newly-diagnosed advanced cancer were recruited. The level of resilience was measured using the Connor-Davidson Resilience Scale at the first month post-initial treatment (T1), three-month post-initial treatment (T2), and six-month post-initial treatment (T3). Latent growth modeling analyses were performed to examine changes in resilience using Mplus 8.3. RESULTS The mean scores of resilience in spousal caregivers were 54.01 ± 7.68 at T1, 56.20 ± 6.38 at T2, and 57.97 ± 6.70 at T3, respectively. Results of latent growth modeling indicated that spousal caregivers showed a significant increase in their resilience scores over the first six months post-treatment (Mean slope = 1.98, p < 0.001). Furthermore, a significant individual variation in the rate of changes in resilience scores allowed spouses to be categorized into two groups: 42.9% participants with fast growth and 57.1% participants with slight growth. CONCLUSION Our findings highlight the importance that new knowledge about change patterns of resilience in the nursing field is beneficial to reveal different psychosomatic health. Acknowledging that resilience is a dynamic process that changes over time, it is crucial for healthcare providers to monitor the psychological adjustment and focus of vulnerable caregivers, particularly spouses.
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Affiliation(s)
- Haiyan Sun
- Faculty of Nursing, Burapha University, Chon Buri 20131, Thailand; School of Nursing, Jiangsu Vocational College of Medicine, Jiangsu 224005, PR China
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Riguzzi M, Thaqi Q, Peng-Keller S, Lorch A, Blum D, Naef R. Adoption of evidence-based end-of-life and bereavement support to families in cancer care: A contextual analysis study with health professionals. J Clin Nurs 2024; 33:3599-3614. [PMID: 38291546 DOI: 10.1111/jocn.17033] [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: 05/24/2023] [Revised: 12/19/2023] [Accepted: 01/07/2024] [Indexed: 02/01/2024]
Abstract
AIMS To investigate the level of adoption of evidence-based family engagement and support during end-of-life cancer care and subsequent bereavement and its contextual facilitators and barriers from health professionals' perspectives, and to explore differences between professional groups. DESIGN Contextual analysis using an online cross-sectional survey. METHODS This study was conducted in four Swiss hospitals and three home care oncology and palliative care services. Non-parametric testing was used to investigate the level of adoption and differences between nurses, physicians, occupational- and physiotherapists and psychosocial professionals (chaplains, onco-psychologists and social workers). The STROBE checklist for cross-sectional studies was followed. RESULTS The majority of the 111 participating health professionals were nurses. Adoption was statistically significantly higher during end-of-life care than bereavement, with nurses and physicians reporting higher levels than the other professional groups. Guidance on end-of-life family care was available in about half of the cases, in contrast to a quarter for bereavement care. Self-perceived knowledge, skills and attitudes were moderate to high, with nurses and physicians reporting higher levels than others, except for general skills in working with families. Organisational structures were experienced as rather supportive, with the psychosocial group appraising the organisational context as significantly less conducive to fully implementing end-of-life and bereavement care than others, particularly during the end-of-life phase. CONCLUSION Evidence-based family engagement and support were better adopted during end-of-life care than bereavement. Overall, nurses and physicians felt better enabled to care for families compared to other professional groups. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution. PROTOCOL REGISTRATION https://osf.io/j4kfh. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Implementation and quality improvement efforts should focus particularly on the bereavement phase and be tailored to professional groups. IMPACT The findings show that evidence-based family engagement and support practices during end-of-life were rather well adopted in contrast to subsequent bereavement care, with nurses and physicians better enabled than other professionals to provide care. A better understanding of health professionals' contributions and roles in family care is important to build interprofessional capacity for evidence-based end-of-life and bereavement support. REPORTING METHOD The STROBE checklist for reports of cross-sectional studies was followed (von Elm et al., 2007).
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Affiliation(s)
- Marco Riguzzi
- Institute for Implementation Science in Health Care, Faculty of Medicine, University of Zurich, Zurich, Switzerland
- Centre of Clinical Nursing Science, University Hospital Zurich, Zurich, Switzerland
| | - Qëndresa Thaqi
- Institute for Implementation Science in Health Care, Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Simon Peng-Keller
- Spiritual Care, Faculty of Theology, University of Zurich, Zurich, Switzerland
| | - Anja Lorch
- Medical Oncology and Hematology, University Hospital Zurich, Zurich, Switzerland
| | - David Blum
- Competence Centre for Palliative Care, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Centre for Palliative Care, City Hospital Zurich, Zurich, Switzerland
| | - Rahel Naef
- Institute for Implementation Science in Health Care, Faculty of Medicine, University of Zurich, Zurich, Switzerland
- Centre of Clinical Nursing Science, University Hospital Zurich, Zurich, Switzerland
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Rambod M, Nassabeh F, Salmanpour M, Pasyar N. The mediation role of hope in the relationship of resilience with depression, anxiety, and stress in caregivers of children and adolescents with cancer. Sci Rep 2024; 14:15817. [PMID: 38982133 PMCID: PMC11233650 DOI: 10.1038/s41598-024-65922-4] [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: 02/25/2024] [Accepted: 06/25/2024] [Indexed: 07/11/2024] Open
Abstract
This study aimed to determine the mediation role of hope in the relationship of resilience with depression, anxiety, and stress in caregivers of children and adolescents with cancer. This cross-sectional study was conducted on 200 caregivers of children and adolescents with cancer. Adult Hope Scale, Connor-Davidson Resilience Scale, and Depression, Anxiety and Stress (DAS) scales were used for data collection. The mediator and moderator model was tested using the SPSS macro PROCESS (Model 4, and 5). The mediator model (model 4) indicated that DAS significantly correlated with resilience (β = - 0.54, t-value = - 5.01, p < 0.001), and hope (β = - 0.84, t-value = - 3.45, p = 0.0007). Hope mediated the relationship between resilience and DAS among caregivers of children and adolescents with cancer (Effect = - 0.18, SE = 0.06, 95% CI - 0.33 to - 0.06). The mediator and moderator model (model 5) showed that female caregivers had a stronger correlation between resilience and DAS when compared to their male counterparts (β = - 0.56, t-value = - 3.90, p-value = 0.0001); also, hope mediated the relationship between resilience and DAS among caregivers of children and adolescents with cancer (Effect = - 0.20, SE = 0.08, 95% CI - 0.37 to - 0.04). In conclusion, hope was a mediator, and female caregivers were a moderator in the relationship of resilience with depression, anxiety, and stress, and its promotion might be effective among caregivers of children and adolescents with cancer. It seems that resilience, female caregivers, and hope may provide good protection against depression, anxiety, and stress in caregivers of cancer patients.
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Affiliation(s)
- Masoume Rambod
- Community Based Psychiatric Care Research Center, Nursing and Midwifery School, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Mahdi Salmanpour
- Department of Statistics, College of Mathematical Sciences, University of Kashan, Kashan, Iran
| | - Nilofar Pasyar
- Community Based Psychiatric Care Research Center, Nursing and Midwifery School, Shiraz University of Medical Sciences, Shiraz, Iran.
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Laidsaar-Powell R, Giunta S, Butow P, Turner S, Costa D, Saunders C, Koczwara B, Kay J, Jefford M, Schofield P, Boyle F, Yates P, White K, Sundaresan P, Varadarajan S, Juraskova I. An online intervention to improve oncology health professional self-efficacy in communicating with carers: Hybrid effectiveness-implementation evaluation of the eTRIO program. PATIENT EDUCATION AND COUNSELING 2024; 124:108251. [PMID: 38626502 DOI: 10.1016/j.pec.2024.108251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 03/11/2024] [Accepted: 03/13/2024] [Indexed: 04/18/2024]
Abstract
OBJECTIVES Many oncology health professionals (HPs) report communicating with carers as complex; and receive limited carer-relevant training. We developed an online HP education program for supporting and managing carer involvement (eTRIO). We aimed to assess whether HPs' self-efficacy in carer communication, knowledge, and decision-making preferences improve following eTRIO. Satisfaction and implementation potential were assessed. METHODS This type 1 hybrid effectiveness-implementation study used a pre-post single arm intervention design. HPs completed baseline measures, the eTRIO online module, and measures at 1- and 12-weeks post-intervention. Measures included: self-efficacy in carer communication (13-items), applied knowledge (7-items), preference for carer involvement in decisions (1-item). Fifteen of participants completed feedback interviews which underwent thematic analysis. User analytics were collected and analysed. RESULTS Fifty-six HPs completed baseline measures, 42 completed post- and follow-up measures. At baseline mean self-efficacy score was 88. HPs showed a statistically significant increase in self-efficacy post-intervention (mean = 105.8, CI [12.99, 20.47]), maintained at 12-weeks (mean = 101.1, CI [8.00, 15.72]). There were no changes in knowledge or decision-making preferences. Program engagement and satisfaction were high, 86.7% participants rated eTRIO as very/extremely helpful. CONCLUSIONS AND PRACTICE IMPLICATIONS eTRIO provided HPs with confidence to effectively engage with carers and manage complex situations such as family dominance. These gains are noteworthy, as conflict with families/carers contributes to HP burnout.
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Affiliation(s)
- Rebekah Laidsaar-Powell
- Centre for Medical Psychology & Evidence-based Decision-making, University of Sydney, Australia; Psycho-Oncology Co-operative Research Group, University of Sydney, Australia; School of Psychology, University of Sydney, Australia.
| | - Sarah Giunta
- Centre for Medical Psychology & Evidence-based Decision-making, University of Sydney, Australia; Psycho-Oncology Co-operative Research Group, University of Sydney, Australia; School of Psychology, University of Sydney, Australia
| | - Phyllis Butow
- Centre for Medical Psychology & Evidence-based Decision-making, University of Sydney, Australia; Psycho-Oncology Co-operative Research Group, University of Sydney, Australia
| | - Sandra Turner
- Department of Radiation Oncology, Westmead Hospital, Westmead, New South Wales, Australia; Faculty of Medicine and Health, The University of Sydney, Australia
| | - Daniel Costa
- School of Psychology, University of Sydney, Australia
| | - Christobel Saunders
- Department of Surgery, Royal Melbourne Hospital, University of Melbourne, Australia
| | - Bogda Koczwara
- Flinders Medical Centre, Adelaide, Australia; Flinders University, Adelaide, Australia
| | - Judy Kay
- School of Computer Science, The University of Sydney, Sydney, Australia
| | - Michael Jefford
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Australia
| | - Penelope Schofield
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Australia; Department of Psychology, and Iverson Health Innovation Research Institute Swinburne University, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Australia
| | - Frances Boyle
- Faculty of Medicine and Health, The University of Sydney, Australia; Patricia Ritchie Centre for Cancer Care & Research, Mater Hospital, Sydney, Australia
| | - Patsy Yates
- Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Kate White
- Susan Wakil School of Nursing, The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Australia
| | - Puma Sundaresan
- Trans Tasman Radiation Oncology Group, New South Wales, Australia; Sydney West Radiation Oncology Network, WSLHD, Sydney, Australia; Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Suganthy Varadarajan
- Department of Radiation Oncology, Westmead Hospital, Westmead, New South Wales, Australia; Blacktown Cancer and Haematology Centre, Blacktown Hospital, Blacktown, Australia
| | - Ilona Juraskova
- Centre for Medical Psychology & Evidence-based Decision-making, University of Sydney, Australia; Psycho-Oncology Co-operative Research Group, University of Sydney, Australia; School of Psychology, University of Sydney, Australia
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Sun H, Chen S, Chen X, Yang Q, Zhang H, Wacharasin C, Hengudomsub P. Predictors of changes in resilience among spousal caregivers of patients with advanced cancer within the first 6 months after initial treatment. J Clin Nurs 2024; 33:2619-2632. [PMID: 38108199 DOI: 10.1111/jocn.16972] [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: 07/31/2023] [Revised: 10/26/2023] [Accepted: 12/07/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND While previous research has established that resilience is affected by various factors, these studies have primarily focussed on individual variables associated with resilience, without providing insights into how to influence the rate of change in resilience. AIM To examine the trajectory of resilience and identify the factors associated with changes in resilience among spousal caregivers of patients with newly diagnosed advanced cancer receiving treatment during the first 6 months. DESIGN An observational longitudinal study. METHODS A total of 312 spousal caregivers of patients with newly diagnosed advanced cancer were recruited from January 2022 to December 2022 in Yancheng, China. Three data collection points were established, spanning from the first month to 6 months after initial cancer treatment. A latent growth model was employed to depict the resilience trajectory at various time points. A latent growth model with time-invariant covariates was adopted to determine the factors influencing resilience trajectory. The study adhered to the STROBE checklist for proper reporting. RESULTS Throughout the follow-up period, the participants experienced a significant increase in resilience. Gender, family income, the patient's health status, spirituality and belief in familism were significantly associated with the baseline resilience level. Moreover, family income, the patient's health status, spirituality, caregiver burden and belief in familism were significantly associated with the rate of resilience change over time. CONCLUSIONS Spousal caregivers demonstrated a linear increase in resilience during the first 6 months after initial treatment. Meanwhile, changes in resilience were influenced by multiple factors during the early phase of cancer treatment. Thus, more attention should be paid to early identification and implementation of targeted interventions. RELEVANCE TO CLINICAL PRACTICE Healthcare professionals should understand the change in resilience among spousal caregivers and conduct timely mental health interventions to enhance the resilience of families affected by cancer. PATIENT OR PUBLIC CONTRIBUTION The Guidance for Reporting Involvement of Patients and the Public-Short Form reporting checklists were used to improve patient and public involvement.
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Affiliation(s)
- Haiyan Sun
- School of Nursing, Jiangsu Vocational College of Medicine, Jiangsu, P. R. China
- Faculty of Nursing, Burapha University, Chon Buri, Thailand
| | - Shuqiao Chen
- Department of Nursing, Yancheng NO.1 People's Hospital, Jiangsu, P. R. China
| | - Xi Chen
- Department of Nursing, Yancheng NO.1 People's Hospital, Jiangsu, P. R. China
| | - Qin Yang
- School of Nursing, Jiangsu Vocational College of Medicine, Jiangsu, P. R. China
- Faculty of Nursing, Burapha University, Chon Buri, Thailand
| | - Hu Zhang
- Department of Basic Medicine, Jiangsu Vocational College of Medicine, Jiangsu, P. R. China
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Sherborne V, Ejegi-Memeh S, Tod AM, Taylor B, Hargreaves S, Gardiner C. Living with mesothelioma: a systematic review of mental health and well-being impacts and interventions for patients and their informal carers. BMJ Open 2024; 14:e075071. [PMID: 38951010 PMCID: PMC11218022 DOI: 10.1136/bmjopen-2023-075071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 06/12/2024] [Indexed: 07/03/2024] Open
Abstract
OBJECTIVES Mesothelioma is an aggressive cancer predominantly affecting the lung and abdominal linings. It can have a unique impact on mental health and well-being (MHWB) due to its incurability, poor prognosis and asbestos-exposure causation. This review's aims were to identify/synthesise international evidence on mesothelioma's MHWB impacts; explore MHWB interventions used by patients and carers; and identify evidence of their effectiveness. DESIGN Systematic review. DATA SOURCES Databases, searched March 2022 and March 2024, were MEDLINE; CINAHL; PsycINFO; Cochrane Library; ASSIA. ELIGIBILITY CRITERIA We included study designs focusing on psychological impacts of living with mesothelioma and MHWB interventions used by patients and informal carers, published in English since January 2002. DATA EXTRACTION AND SYNTHESIS A team of reviewers screened included studies using standardised methods. Quality was assessed using validated tools: Mixed-Methods Appraisal tool for primary research and Joanna Briggs Institute Critical Appraisal Checklist for Systematic Reviews. RESULTS Forty-eight studies met the inclusion criteria: 20 qualitative, 16 quantitative, nine reviews, two mixed-methods, one combined systematic review/qualitative study. UK studies predominated. Many MHWB impacts were reported, including traumatic stress, depression, anxiety and guilt. These were influenced by mesothelioma's causation, communication issues and carer-patient relational interactions. Participants used wide-ranging MHWB interventions, including religious/spiritual practice; talking to mental-health professionals; meaning-making. Some strategies were presented as unhelpful, for example, denial. Participants reported lack of access to support. CONCLUSIONS Most qualitative studies were rated high quality. The quality of the quantitative studies and reviews varied. The sparse literature regarding MHWB in mesothelioma means more research is needed into impacts on patients and carers, including trauma. To enable access to evidence-based support, research is recommended concerning MHWB interventions' effectiveness in mesothelioma. PROSPERO REGISTRATION NUMBER CRD42022302187.
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Affiliation(s)
- Virginia Sherborne
- Mesothelioma UK Research Centre, Division of Nursing and Midwifery, The University of Sheffield, Sheffield, UK
| | - Stephanie Ejegi-Memeh
- Mesothelioma UK Research Centre, Division of Nursing and Midwifery, The University of Sheffield, Sheffield, UK
| | - Angela Mary Tod
- Mesothelioma UK Research Centre, Division of Nursing and Midwifery, The University of Sheffield, Sheffield, UK
| | - Bethany Taylor
- Mesothelioma UK Research Centre, Division of Nursing and Midwifery, The University of Sheffield, Sheffield, UK
| | - Sarah Hargreaves
- Mesothelioma UK Research Centre, Division of Nursing and Midwifery, The University of Sheffield, Sheffield, UK
| | - Clare Gardiner
- Mesothelioma UK Research Centre, Division of Nursing and Midwifery, The University of Sheffield, Sheffield, UK
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Gray TF, Do KM, Amonoo HL, Sullivan L, Kelkar AH, Pirl WF, Hammer MJ, Tulsky JA, El-Jawahri A, Cutler CS, Partridge AH. Family Caregiver Experiences in the Inpatient and Outpatient Reduced-Intensity Conditioning Allogeneic Hematopoietic Cell Transplantation Settings: A Qualitative Study. Transplant Cell Ther 2024; 30:610.e1-610.e16. [PMID: 37783339 DOI: 10.1016/j.jtct.2023.09.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 09/21/2023] [Accepted: 09/24/2023] [Indexed: 10/04/2023]
Abstract
Caregivers (ie, family and friends) are essential in providing care and support for patients undergoing hematopoietic cell transplantation (HCT) and throughout their recovery. Traditionally delivered in the hospital, HCT is being increasingly provided in the outpatient setting, potentially heightening the burden on caregivers. Extensive work has examined the inpatient HCT caregiving experience, yet little is known about how caregiver experiences may differ based on whether the HCT was delivered on an inpatient or outpatient basis, particularly during the acute recovery period post-HCT. This study explored the similarities and differences in caregiver experiences in the inpatient and outpatient settings during the early recovery from reduced-intensity conditioning (RIC) allogeneic HCT. We conducted semistructured interviews (n = 15) with caregivers of adults undergoing RIC allogeneic HCT as either an inpatient (n = 7) or an outpatient (n = 8). We recruited caregivers using purposeful criterion sampling, based on the HCT setting, until thematic saturation occurred. Interview recordings were transcribed and coded through thematic analysis using Dedoose v.9.0. The study analysis was guided by the transactional model of stress and coping and the model of adaptation of family caregivers during the acute phase of BMT. Three themes emerged to describe similar experiences for HCT caregivers regardless of setting: (1) caregivers reported feeling like they were a necessary yet invisible part of the care team; (2) caregivers described learning to adapt to changing situations and varying patient needs; and (3) caregivers recounted how the uncertainty following HCT felt like existing between life and death while also maintaining a sense of gratitude and hope for the future. Caregivers also reported distinct experiences based on the transplantation setting and 4 themes emerged: (1) disrupted routines: inpatient caregivers reported disrupted routines when caring for the HCT recipient while simultaneously trying to manage non-caregiving responsibilities at home and work, and outpatient caregivers reported having to establish new routines that included frequent clinic visits with the patient while altering or pausing home and work responsibilities; (2) timing of caregiver involvement: inpatient caregivers felt more involved in care after the patient was discharged from the HCT hospitalization, whereas outpatient caregivers were already providing the majority of care earlier in the post-transplantation period; (3) fear of missing vital information: inpatient caregivers worried about missing vital information about the patient's care and progress if not physically present in the hospital, whereas outpatient caregivers feared overlooking vital information that may warrant contacting the care team as they monitored the patient at home; and (4) perceived adequacy of resources to meet psychosocial and practical needs: inpatient caregivers reported having adequate access to resources (ie, hospital-based services), whereas outpatient caregivers felt they had more limited access and needed to be resourceful in seeking out assistance. Inpatient and outpatient HCT caregivers described both similar and distinct experiences during the acute recovery period post-HCT. Specific interventions should address caregiver psychosocial needs (ie, distress, illness uncertainty, communication, and coping) and practical needs (ie, community resource referral, preparedness for home-based caregiving, and transplantation education) of HCT caregivers based on setting.
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Affiliation(s)
- Tamryn F Gray
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts; Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts; Division of Stem Cell Transplantation and Cellular Therapies, Dana-Farber Cancer Institute, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer, Boston, Massachusetts; Division of Palliative Medicine, Brigham and Women's Hospital, Boston, Massachusetts; Cancer Outcomes Research and Education Program, Massachusetts General Hospital Cancer Center, Boston, Massachusetts.
| | - Khuyen M Do
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Hermioni L Amonoo
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Cancer Outcomes Research and Education Program, Massachusetts General Hospital Cancer Center, Boston, Massachusetts; Department of Psychiatry, Brigham and Women's Hospital, Boston, Massachusetts
| | - Lauren Sullivan
- Division of Stem Cell Transplantation and Cellular Therapies, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Amar H Kelkar
- Division of Stem Cell Transplantation and Cellular Therapies, Dana-Farber Cancer Institute, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - William F Pirl
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Department of Psychiatry, Brigham and Women's Hospital, Boston, Massachusetts
| | - Marilyn J Hammer
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer, Boston, Massachusetts
| | - James A Tulsky
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Division of Palliative Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Areej El-Jawahri
- Harvard Medical School, Boston, Massachusetts; Cancer Outcomes Research and Education Program, Massachusetts General Hospital Cancer Center, Boston, Massachusetts; Divison of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Corey S Cutler
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts; Division of Stem Cell Transplantation and Cellular Therapies, Dana-Farber Cancer Institute, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Division of Hematologic Malignancies, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Ann H Partridge
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
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Opsomer S, De Clercq L, De Lepeleire J, Joossens S, Luyten P, Pype P, Lauwerier E. Do all roads lead to Rome? An ideal-type study on trajectories of resilience in advanced cancer caregiving. PLoS One 2024; 19:e0303966. [PMID: 38820251 PMCID: PMC11142429 DOI: 10.1371/journal.pone.0303966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 05/03/2024] [Indexed: 06/02/2024] Open
Abstract
OBJECTIVE Studies on resilience in advanced cancer caregiving typically focus on the interplay between resilience-promoting resources and coping strategies that may be associated with resilience. However, no studies have investigated the emergence of trajectories of resilience and distress in individuals confronted with a cancer diagnosis of a loved one. METHODS Ideal-type analysis, a method for constructing typologies from qualitative data, was used to identify trajectories involving resilience or the lack thereof based on fifty-four interviews conducted with seventeen partners of patients recently diagnosed with advanced cancer over a period of three years. FINDINGS Six trajectories could be distinguished, three of which involved resilience (rapidly adapting resilience, gradually adapting resilience, and slowly adapting resilience), while the other three trajectories (continuing distress, delayed distress, and frozen disconnection) reflected a less optimal adjustment. These different trajectories seemed to be rooted in the individual characteristics of partners, the behavior of a support network, and interactions between the two. CONCLUSION The differentiation between these trajectories in partners of patients diagnosed with cancer not only furthers research on resilience in the face of adversity, but also promises to assist healthcare professionals in optimizing support for this often-neglected group of partners of patients diagnosed with cancer.
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Affiliation(s)
- Sophie Opsomer
- Academic Centre for General Practice, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Luca De Clercq
- Clinical Psychology, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Jan De Lepeleire
- Academic Centre for General Practice, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Sofie Joossens
- Program of Health, University Colleges Leuven ‐ Limburg, Leuven, Belgium
| | - Patrick Luyten
- Clinical Psychology, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
| | - Peter Pype
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
- End-of-Life Care Research Group, Ghent University campus, Ghent, Belgium
| | - Emelien Lauwerier
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
- Department of Health Psychology, Faculty of Psychology, Open University, Heerlen, Netherlands
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9
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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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10
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Riguzzi M, Thaqi Q, Lorch A, Blum D, Peng-Keller S, Naef R. Contextual determinants of guideline-based family support during end-of-life cancer care and subsequent bereavement care: A cross-sectional survey of registered nurses. Eur J Oncol Nurs 2024; 70:102555. [PMID: 38626610 DOI: 10.1016/j.ejon.2024.102555] [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: 11/23/2023] [Accepted: 03/09/2024] [Indexed: 04/18/2024]
Abstract
PURPOSE In end-of-life cancer care, 10-20% of bereaved family members experience adverse mental health effects, including prolonged grief disorder. Despite great efforts, evidence-based recommendations to support their grieving process and well-being are often not successfully adopted into routine clinical care. This study identified facilitators and barriers using implementation science methodology. METHODS 81 registered nurses working in cancer care from four hospitals and three home care services in Switzerland assessed their current family support practices in end-of-life care and bereavement care. They then assessed organisational attributes of their institution and their own individual characteristics and skills regarding literature-based factors of potential relevance. Facilitators and barriers to guideline-based family support were determined using fractional logistic regression. RESULTS Service specialisation in palliative care, a culture that supports change, the availability of family support guidelines, billing/reimbursement of bereavement support services, and individual knowledge of family support and skill were systematically associated with higher adoption of guideline-based family support practices. Lack of privacy with families and insufficient training acted as significant barriers. CONCLUSIONS While several potentially relevant factors have emerged in the literature, certain organisational and individual determinants actually empirically predict guideline-based family support according to nurses in end-of-life cancer care, with some determinants having much stronger implications than others. This provides crucial guidance for focussing quality improvement and implementation efforts through tailored strategies, especially with scarce resources. Furthermore, adoption is lower in bereavement care than in end-of-life care, suggesting a particular need for supportive organisational cultures including specific training and billing/reimbursement options.
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Affiliation(s)
- Marco Riguzzi
- Institute for Implementation Science in Health Care, Faculty of Medicine, University of Zurich, Universitaetstrasse 84, 8006 Zurich, Switzerland; Centre of Clinical Nursing Science, University Hospital Zurich, Sonnentalstrasse 25, 8600 Dübendorf, Switzerland.
| | - Qëndresa Thaqi
- Institute for Implementation Science in Health Care, Faculty of Medicine, University of Zurich, Universitaetstrasse 84, 8006 Zurich, Switzerland; Centre of Clinical Nursing Science, University Hospital Zurich, Sonnentalstrasse 25, 8600 Dübendorf, Switzerland
| | - Anja Lorch
- Department of Medical Oncology and Haematology Clinic, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland
| | - David Blum
- Competence Centre for Palliative Care, University Hospital Zurich, University of Zurich, Raemistrasse 100, 8091 Zurich, Switzerland; Centre for Palliative Care, City Hospital Zurich, Tièchestrasse 99, 8037 Zurich, Switzerland
| | - Simon Peng-Keller
- Spiritual Care, Faculty of Theology, University of Zurich, Kirchgasse 9, 8001 Zurich, Switzerland
| | - Rahel Naef
- Institute for Implementation Science in Health Care, Faculty of Medicine, University of Zurich, Universitaetstrasse 84, 8006 Zurich, Switzerland; Centre of Clinical Nursing Science, University Hospital Zurich, Sonnentalstrasse 25, 8600 Dübendorf, Switzerland
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11
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Champagne ER. Caregiver Resilience and Dance/Movement Therapy: A Theoretical Review and Conceptual Model. J Appl Gerontol 2024; 43:319-327. [PMID: 37991282 PMCID: PMC10809734 DOI: 10.1177/07334648231210679] [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: 07/19/2023] [Revised: 08/28/2023] [Accepted: 09/25/2023] [Indexed: 11/23/2023] Open
Abstract
With the population aging, more people are living with neurodegenerative conditions, leading to an influx of informal family caregivers, who often experience negative health outcomes. Few caregiver interventions have successfully adopted a holistic, strengths-based approach to fostering resilience. This article examines existing literature on caregiver resilience factors, which include self-efficacy, flexibility, cultivating positive emotions, and drawing on spiritual and social supports. Despite how dance/movement therapy (DMT) has been shown to foster psychological and physiological benefits, it remains underexplored for caregivers. Therapeutic mechanisms of DMT are expounded for their innate correspondence to resilience factors, and a new comprehensive model of DMT for caregiver resilience is presented, with implications for future intervention design and measurement.
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Affiliation(s)
- Eden R. Champagne
- Department of Recreation and Leisure Studies, University of Waterloo, Waterloo, ON, USA
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12
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Thaqi Q, Riguzzi M, Blum D, Peng-Keller S, Lorch A, Naef R. End-of-life and bereavement support to families in cancer care: a cross-sectional survey with bereaved family members. BMC Health Serv Res 2024; 24:155. [PMID: 38303007 PMCID: PMC10832212 DOI: 10.1186/s12913-024-10575-2] [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: 05/24/2023] [Accepted: 01/08/2024] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Losing a close other to cancer is an incisive experience that occurs after a long course of illness and intense family caregiving. Despite an evident need for family engagement and support and guidance on this, patients and family members may not receive the attention and support they need when a family unit is experiencing a disruption by death. A clear understanding of the quality of care that is currently provided and its ability to address family needs is necessary to improve end-of-life and bereavement support to families affected by cancer. The purpose of this study is to investigate the quality of support of end-of-life and bereavement care to families, their (un)met needs, grief experiences, and self-perceived health outcomes. METHODS A multi-center, cross-sectional observational survey study with family members (n = 35) whose close other died of cancer in a health institution or their own home in German-speaking Switzerland. RESULTS Bereaved family members were mostly satisfied with end-of-life care. Information on the grief process and services, and acknowledgment of their grief was experienced as helpful. Most coped with their grief drawing on family resources and exhibited resilience, but they reported unmet needs in relation to family togetherness and caregiving. CONCLUSION This study with a small number of family members indicates that support provided to families across settings and illness trajectories is perceived as helpful, with specific needs related to family support. The findings suggest that improvements should focus on ensuring care that addresses the family as a unit and enables togetherness, mutual reflection, meaningful relationships, preparedness for death, resilience, and benefit-finding. PROTOCOL REGISTRATION https://osf.io/j4kfh .
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Affiliation(s)
- Qëndresa Thaqi
- Institute for Implementation Science in Health Care, Faculty of Medicine, University of Zurich, Universitaetstrasse 84, 8006, Zurich, Switzerland
- Centre of Clinical Nursing Science, University Hospital Zurich, Zurich, Switzerland
| | - Marco Riguzzi
- Institute for Implementation Science in Health Care, Faculty of Medicine, University of Zurich, Universitaetstrasse 84, 8006, Zurich, Switzerland
- Centre of Clinical Nursing Science, University Hospital Zurich, Zurich, Switzerland
| | - David Blum
- Competence Centre for Palliative Care, University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Centre for Palliative Care, City Hospital Zurich, Zurich, Switzerland
| | - Simon Peng-Keller
- Spiritual Care, Faculty of Theology, University of Zurich, Zurich, Switzerland
| | - Anja Lorch
- Medical Oncology and Hematology, University Hospital Zurich, Zurich, Switzerland
| | - Rahel Naef
- Institute for Implementation Science in Health Care, Faculty of Medicine, University of Zurich, Universitaetstrasse 84, 8006, Zurich, Switzerland.
- Centre of Clinical Nursing Science, University Hospital Zurich, Zurich, Switzerland.
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13
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Cheng CH, Hsu CH, Sie JR, Tsay SL, Tung HH. The Relationship Between Resilience and Health-Related Quality of Life Among Heart Failure Patients in New York Heart Association Functional Classes II and III. J Nurs Res 2024; 32:e312. [PMID: 38271064 DOI: 10.1097/jnr.0000000000000594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Heart failure is an intense, unpredictable, and stressful chronic disease caused by the decline in cardiac pumping function. The influence of heart failure affects patients not only in terms of physical capabilities but also in terms of their emotional and social dimensions, with patients in different functional classes experiencing different levels of effect. Although resilience and health-related quality of life have been studied in populations with heart failure, the scholarly understanding of different functional classes is limited. PURPOSE This study was designed to investigate the relationship between resilience and health-related quality of life among patients with heart failure in different physical functional classes in Taiwan. METHODS A cross-sectional design was applied to study patients with heart failure in northern Taiwan. Two structured questionnaires, including the Resilience Scale for Adults and the 12-item Short Form Health Survey, were used to assess resilience and health-related quality of life. New York Heart Association functional class was used to determine physical function status, and canonical correlation analysis was used to determine the weight of each resilience and quality-of-life domain for the different functional classes. RESULTS The 100 participants had an average age of 65.52 years. Slightly over half (56%) were classified as Functional Class II. A group difference in health-related quality of life was observed. Personal strength (rs = .759) and social competence (rs = -.576) were found to influence the resilience and emotional role dimension of quality of life (rs = -.996) in the Functional Class II group. In addition, family cohesion (rs = -.922), dominant resilience, physical function (rs = .467), and bodily pain (rs = .465) were found to influence quality of life in the Functional Class III group. CONCLUSIONS/IMPLICATIONS FOR PRACTICE The efficacy of measures taken to increase resilience to heart failure varied in patients in different functional classes. Functional Class II individuals were better able to manage the disease using their personal strength, whereas Functional Class III individuals relied more heavily on family support and assistance for this effort. Furthermore, participant feelings about quality of life also varied by functional class, with physical function and bodily pain taking on significantly more importance for Functional Class III individuals.
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Affiliation(s)
- Ching-Hui Cheng
- MSN, RN, Deputy Chief of Cardiac Nursing Department, Heart Center, Cheng-Hsin General Hospital, Taiwan, ROC
| | - Ching-Hwa Hsu
- PhD, RN, NP, Assistant Professor, School of Nursing, College of Medicine, Chang Gung University, Taiwan, ROC
| | - Jia-Rong Sie
- MSN, RN, NP, Doctoral Student, Department of Nursing, National Yang Ming Chiao Tung University, and Nurse Practitioner, Department of Emergency Medicine, National Taiwan University Hospital, Taiwan, ROC
| | - Shiow-Luan Tsay
- PhD, RN, APN, Professor, College of Nursing & Health Sciences, Da-Yeh University, Taiwan, ROC
| | - Heng-Hsin Tung
- PhD, RN, FNP, DNP, Distinguished Professor, Department of Nursing, National Yang Ming Chiao Tung University, and Adjunct Nursing Consultant, Tungs' Taichung MetroHarbor Hospital, Taiwan, ROC
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14
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Haydon HM, Blackler A, Nowak AK, Langbecker D, Collier J, Halkett G. Exploratory multi-methods evaluation of an online intervention for carers of people with high-grade glioma. Neurooncol Pract 2023; 10:544-554. [PMID: 38026580 PMCID: PMC10666811 DOI: 10.1093/nop/npad032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023] Open
Abstract
Background Inadequate knowledge and skills and a lack of confidence to provide care have been identified as major unmet needs for carers of people with brain cancer. An online intervention was developed to address the unmet needs of carers of people with high-grade glioma. Methods Ten carers evaluated the intervention through multiple methods. Acceptability and usability were measured through online data analytics (unique page views, time on page), surveys, and interviews. Questionnaires measured potential impacts on distress (Distress Thermometer), depression, anxiety (Hospital Anxiety and Depression Scale), carer competence (Carer Competence Scale), carer preparedness (Caregiving Preparedness Scale), unmet needs (Supportive Care Needs Scale - Brain Tumor Specific for carers), usability and acceptability (USE). Results Results suggested the intervention had high levels of usability (usability scales' means range = 5.1 to 6.7 out of 7) and acceptability (M = 76.3/100). Correlations indicated the potential to impact depression. Qualitative findings highlighted benefits of the intervention as a comprehensive reliable resource that could validate and normalize carer experiences. Interview findings guided further improvements (eg, additional carer videos, content organization). Conclusions The study indicated high acceptability and usability of an online intervention for carers of people with high-grade glioma. This exploratory study also provided preliminary indications of a potential to decrease depression. However, a more robust, potentially longitudinal, investigation is needed with a larger and broader sample. Informed by this study, the intervention has been amended and a randomized controlled trial will further evaluate the enhanced intervention.
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Affiliation(s)
- Helen M Haydon
- Centre for Online Health, The University of Queensland, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
- Centre for Health Services Research, The University of Queensland, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Alethea Blackler
- School of Design, Queensland University of Technology, Brisbane City, Queensland, Australia
| | - Anna K Nowak
- School of Medicine, University of Western Australia, Perth, Western Australia, Australia
| | - Danette Langbecker
- Centre for Online Health, The University of Queensland, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
- Centre for Health Services Research, The University of Queensland, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Justin Collier
- Centre for Online Health, The University of Queensland, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
- Centre for Health Services Research, The University of Queensland, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Georgia Halkett
- School of Nursing, Curtin University, Bently Western Australia, Australia
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15
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Ng JHY, Luk BHK, Lee NPM. Gender differences in cancer spousal caregiving: A systematic review. Palliat Support Care 2023; 21:880-889. [PMID: 37334489 DOI: 10.1017/s1478951523000731] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
OBJECTIVES Cancer does affect not only the lives of the patients but also that of their spouses. The aims of this systematic review are to (i) explore the gender differences in the impact of caregiving for cancer on spousal caregivers, (ii) facilitate the conceptual understanding of gender differences in caregiving, and (iii) identify directions for future research and clinical practice targeting spousal caregivers. METHODS A comprehensive search was conducted of the electronic databases of MEDLINE, PsycINFO, EBSCO, and CINAHL Plus for papers published in English between 2000 and 2022. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to identify, select, appraise, and synthesize the studies. RESULTS A total of 20 studies from seven countries were reviewed. Findings of the studies were presented using the biopsychosocial model. Spousal caregivers of cancer patients suffered from physical, psychological, and socioeconomic morbidities, with female spousal caregivers reporting a higher level of distress. The gendered positioning of spousal caregivers in the societal context had further brought about over-responsibility and self-sacrifice among women. SIGNIFICANCE OF RESULTS The gendered positions of cancer spousal caregivers further illustrated the gender differences in the caregiving experiences and consequences. Health-care professionals in routine clinical practice should be proactive in identifying physical, mental, and social morbidities among cancer spousal caregivers, particularly female ones, and providing timely interventions. Health-care professionals should recognize the pressing need for empirical research, political engagement, and action plans to address the health status and health-related behaviors of patients' spouses along the cancer trajectory.
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Affiliation(s)
- Janet H Y Ng
- Department of Chinese and Bilingual Studies, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
| | - Bronya H K Luk
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Homantin, Kowloon, Hong Kong, China
| | - Natalie P M Lee
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Homantin, Kowloon, Hong Kong, China
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16
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Chen X, Qiao C, Arber A, Shen Y, Rui Y, Zhang R, Pei Z, Tang Y, Sha Z, Bao J, Zhang J, Li J, Wang D, Wang X. Enhancing resilient coping strategies for quality of life in Chinese adult children caregiving for parents with advanced cancer: a cross-sectional study. Support Care Cancer 2023; 31:591. [PMID: 37749433 PMCID: PMC10520155 DOI: 10.1007/s00520-023-08057-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 09/19/2023] [Indexed: 09/27/2023]
Abstract
PURPOSE This study investigated the mediating role of individual resilience in the relationship between caregiver burden and quality of life (QoL) among Chinese adult children providing care to their parents with advanced cancer, with the aim to inform effective coping strategies and positive caregiving outcomes. METHODS In a cross-sectional design, 614 caregivers from multiple centers, whose parents were undergoing chemotherapy and/or radiotherapy, completed questionnaires encompassing demographics, caregiver burden, symptoms of anxiety and depression, resilience, and QoL. RESULTS Findings revealed a moderate level of caregiver burden among participants, significantly influenced by factors including education level, family income, single-child status, and participation in social media patient support groups. Caregivers who were only children or involved in patient support groups reported higher burden. Importantly, path analysis showed a significant impact of caregiver burden, anxiety, and depression on QoL, with these relationships being mediated by individual resilience. CONCLUSIONS Chinese adult child caregivers face a considerable burden, negatively influencing their QoL. Individual resilience, a modifiable factor, was identified as a critical mediator in this relationship, mitigating the negative implications of caregiver burden, anxiety, and depression. These findings underscore the need for caregiver interventions that consider not only demographics but also the socio-psychological dynamics of caregiving to enhance caregiver QoL.
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Affiliation(s)
- Xian Chen
- Gynaecology Department, Women's Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), Nanjing, People's Republic of China
| | - Chengping Qiao
- Gynaecology Department, Women's Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), Nanjing, People's Republic of China
| | - Anne Arber
- School of Health Sciences, Faculty of Health and Medical Sciences, The University of Surrey, Guildford, UK
| | - Yan Shen
- Interventional Radiology Department, The First Affiliated Hospital With Nanjing Medical University, Nanjing, People's Republic of China
| | - Yehao Rui
- Oncology Department, Zhongda Hospital Southeast University, Nanjing, People's Republic of China
| | - Rui Zhang
- Oncology Department, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, People's Republic of China
| | - Zhongling Pei
- Interventional Radiology Department, The First Affiliated Hospital With Nanjing Medical University, Nanjing, People's Republic of China
| | - Yuanyuan Tang
- Radiotherapy Department, The First Affiliated Hospital With Nanjing Medical University, Nanjing, People's Republic of China
| | - Ziyu Sha
- Oncology Department, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, People's Republic of China
| | - Jianying Bao
- Interventional Radiology Department, The First Affiliated Hospital With Nanjing Medical University, Nanjing, People's Republic of China
| | - Jia Zhang
- Oncology Department, The First Affiliated Hospital With Nanjing Medical University, Nanjing, People's Republic of China
| | - Jinhua Li
- Geriatric Oncology Department, The First Affiliated Hospital With Nanjing Medical University, Nanjing, People's Republic of China
| | - Dan Wang
- Oncology Department, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, People's Republic of China.
| | - Xuemei Wang
- Interventional Radiology Department, The First Affiliated Hospital With Nanjing Medical University, Nanjing, People's Republic of China.
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Sun H, Qian Q, Qin Y, Guo L, Hengudomsub P. Dynamic changes in resilience among family caregivers in the face of healthcare challenges: A scoping review. Arch Psychiatr Nurs 2023; 45:113-123. [PMID: 37544685 DOI: 10.1016/j.apnu.2023.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 06/14/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND Resilience as a dynamic concept has already been described through various longitudinal studies. To better understand the changes in the resilience of caregivers over the course of care-providing, however, a scoping review can provide a clearer picture of their resilience process which, in turn, can be used to improve caregivers' well-being. OBJECTIVES To provide a comprehensive overview of dynamic change in the resilience of caregivers while caring for the family to enhance understanding and potential for future research. METHODS Following the methodological framework of Arksey and O'Malley, this scoping review was conducted using the Preferred Reporting Items for Systematic Reviews and the Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Checklist. Five electronic databases were searched for research published in English between January 2012 and May 2022, after which a manual search was performed. Key terms related to resilience and caregivers in longitudinal studies were included and screened for. Identified trajectories of patterns in resilience and factors associated with resilience process were categorized using content analysis. RESULTS In total, 24 longitudinal studies met the eligibility criteria. Conceptually, our findings demonstrate three modes of change following healthcare challenges, each of which varies substantially. Methodologically, the results reveal three subcategories of assessment tools that can be used to impact caregivers' resilience when confronted with significant healthcare challenges. Consequentially, personal traits and environmental resources interacting with the resilience process will then lead to various outcomes in their resilience, including stability, growth, or decline. CONCLUSION This review describes the change patterns of the resilience process, assessment instruments, and associated factors to offer a dynamic perspective for the investigation and intervention of psychological resilience. Major gaps nonetheless remain for future research regarding an operationalizing dynamic change in resilience.
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Affiliation(s)
- Haiyan Sun
- School of Nursing, Jiangsu Vocational College of Medicine, 224005, Jiangsu, P.R. China; Faculty of Nursing, Burapha University, 20131, Chon Buri, Thailand
| | - Qian Qian
- School of Nursing, Jiangsu Vocational College of Medicine, 224005, Jiangsu, P.R. China
| | - Yang Qin
- School of Nursing, Jiangsu Vocational College of Medicine, 224005, Jiangsu, P.R. China; Faculty of Nursing, Burapha University, 20131, Chon Buri, Thailand
| | - Lingling Guo
- School of Nursing, Jiangsu Vocational College of Medicine, 224005, Jiangsu, P.R. China
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18
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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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Qian Y, Asad S, Park EM, Mills JA, Kent EE. Rural resilience during COVID-19: the lived experience of North Carolinian rural-dwelling cancer caregivers. Support Care Cancer 2023; 31:396. [PMID: 37318622 PMCID: PMC11071545 DOI: 10.1007/s00520-023-07840-1] [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: 11/11/2022] [Accepted: 05/24/2023] [Indexed: 06/16/2023]
Abstract
PURPOSE To illuminate the lived experience of resilience in rural-dwelling North Carolinian cancer caregivers at the intersection of cancer and the COVID-19 pandemic. METHODS In spring, 2020, we recruited self-identified primary caregivers (CGs) for a relative/friend with cancer living in a rural area. We conducted cross-sectional semi-structured interviews and then thematically analyzed transcripts to identify and categorize instances of stressors and benefit-finding. RESULTS Of the 24 participants, 29% were < 50 years old, 42% identified as non-Hispanic Black, 75% were women, and 58% were spousal CGs. Most care recipients (CRs) had stage IV cancer (n = 20) and cancer types varied. Participants played a variety of roles in caregiving and experienced stressors related to caregiving demands (e.g., conflicts with other responsibilities), rurality (e.g., transportation), and the COVID-19 pandemic (e.g., new visitor policy at hospital). Despite stressful experiences, participants also identified many positive aspects of their caregiving. Five domains of benefit-finding were identified: appreciation (e.g., gratitude toward their ability to care for CRs), CG-CR dyad relationship dynamics (e.g., increased closeness), interpersonal relationship dynamics (e.g., perceived peer support), faith (e.g., ability to cope through praying), and personal growth (e.g., new skills learned from caregiving). CONCLUSION Rural-dwelling cancer caregivers from mixed sociodemographic backgrounds identified a diverse range of benefits from caregiving, despite experiencing multiple stressors, including emergent stressors from the COVID-19 pandemic. Healthcare delivery serving rural communities may consider expanding transportation assistance and boosting benefit-finding to ameliorate stress in cancer caregivers.
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Affiliation(s)
- Yiqing Qian
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sarah Asad
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 1102-B McGavran-Greenberg Hall, CB # 7411, Chapel Hill, NC, 27599-7411, USA
| | - Eliza M Park
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jiona A Mills
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Erin E Kent
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 1102-B McGavran-Greenberg Hall, CB # 7411, Chapel Hill, NC, 27599-7411, USA.
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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20
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Kurita GP, Eidemak I, Larsen S, Jeppesen PB, Antonsen LB, Molsted S, Liem YS, Pressler T, Sjøgren P. The impact of caring on caregivers of patients with life-threatening organ failure. Palliat Support Care 2023:1-7. [PMID: 37185060 DOI: 10.1017/s1478951523000469] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
OBJECTIVES This study aimed at characterizing 3 populations of family/friend caregivers of patients with different life-threatening organ failure regarding health-related quality of life, caregiver burden, and dyadic coping. METHODS Three cross-sectional (population) studies were conducted at a tertiary hospital in Denmark (2019-2020). Patients with renal failure (RF), cystic fibrosis (CF), and intestinal failure (IF) were asked to designate the closest person with ≥18 years old involved in the care (caregiver) to participate in this study. Number of caregivers included were RF = 78, CF = 104, and IF = 73. Electronic questionnaires were filled in by caregivers to assess health-related quality of life and caregiver burden and by caregivers and respective patients to assess dyadic coping. RESULTS The 3 caregiver groups had self-perception of poor health and energy; however, caregivers of CF patients perceived their physical role functioning better than those caregiving for RF and IF patients (p = 0.002). The level of caregiver burden was reported as not high, but caregivers used in average 13 hours/day for caring. Moreover, cleaning tasks (p = 0.005) and personal care (p = 0.009) were more demanding in RF and IF patients. Caregivers also did not differ regarding dyadic coping. When comparing patients and caregivers, stress communication by oneself and the partner differed (p < 0.001). SIGNIFICANCE OF RESULTS Caregivers spent many hours in the care role, they reported poor health, and dyadic coping may be improved. Interventions in caregivers of patients with life-threatening organ failure could help to improve care management at home, caregiver's health, and dyadic coping between caregiver and patient and consequently reduce caregiver burden.
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Affiliation(s)
- Geana Paula Kurita
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Palliative Research Group, Department of Oncology, Centre for Cancer and Organ Diseases, Rigshospitalet, Copenhagen, Denmark
- Multidisciplinary Pain Centre, Department of Anaesthesia, Pain and Respiratory Support, Neuroscience Centre, Rigshospitalet, Copenhagen, Denmark
| | - Inge Eidemak
- Section of Palliative Medicine, Department of Oncology, Centre for Cancer and Organ Diseases, Rigshospitalet, Copenhagen, Denmark
| | - Sille Larsen
- Section of Palliative Medicine, Department of Oncology, Centre for Cancer and Organ Diseases, Rigshospitalet, Copenhagen, Denmark
| | - Palle Bekker Jeppesen
- Department of Intestinal Failure and Liver Diseases, Centre for Cancer and Organ Diseases, Rigshospitalet, Copenhagen, Denmark
| | - Louise Bangsgaard Antonsen
- Department of Intestinal Failure and Liver Diseases, Centre for Cancer and Organ Diseases, Rigshospitalet, Copenhagen, Denmark
| | - Stig Molsted
- Department of Clinical Research, Nordsjællands Hospital, Hillerød, Denmark
| | - Ylian Serina Liem
- Department of Nephrology, Centre for Cancer and Organ Diseases, Rigshospitalet, Copenhagen, Denmark
| | - Tania Pressler
- Cystic Fibrosis Centre, Juliane Marie Centre, Rigshospitalet, Copenhagen, Denmark
| | - Per Sjøgren
- Palliative Research Group, Department of Oncology, Centre for Cancer and Organ Diseases, Rigshospitalet, Copenhagen, Denmark
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21
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Opsomer S, Joossens S, Lauwerier E, De Lepeleire J, Pype P. Resilience in advanced cancer caregiving promoted by an intimate partner's support network: insights through the lens of complexity science. A framework analysis. BMC Palliat Care 2023; 22:12. [PMID: 36803396 PMCID: PMC9936125 DOI: 10.1186/s12904-023-01134-3] [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: 10/01/2022] [Accepted: 02/06/2023] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND The tremendous physical and mental burden that comes with caregiving puts the intimate partners of patients diagnosed with advanced cancer at risk for mental disorders. However, most partners seem to be protected by resilience. Such a resilience process is promoted by certain individual characteristics (e.g., flexibility, positive attitude, internal strength, capacity to balance incoming and outgoing information, and ability to ask for and accept support and advice) and by the availability of a support network, consisting of family, friends, and healthcare professionals. Such a heterogeneous group striving towards the same goals can be considered a complex adaptive system (CAS), a concept stemming from complexity science. AIMS To study the behavior of the support network through the lens of complexity science and to provide insights to the means by which an available network may promote resilience. METHODS Nineteen interviews with members from the support networks of eight intimate partners were analyzed deductively using the CAS principles as a coding framework. Subsequently, the quotes under each principle were coded inductively to concretize patterns in the behavior of the support networks. Eventually, the codes were charted into a matrix to identify intra- and inter-CAS similarities, differences, and patterns. FINDINGS The network's behavior adapts dynamically to the changing circumstances as the patient's prognosis worsens. Furthermore, the behavior is based on internalized basic rules (such as reassuring availability and maintaining communication without being intrusive), attractors (e.g., feeling meaningful, appreciated, or connected), and the history of the support network. However, the interactions are non-linear and often unpredictable due to the context member's own concerns, needs, or emotions. CONCLUSIONS Applying the lens of complexity science to the behavior of an intimate partner's support network gives us insight into the network's behavioral patterns. Indeed, a support network is a dynamic system that behaves according to the principles of a CAS and adapts resiliently to the changing circumstances as the patient's prognosis worsens. Moreover, the behavior of the support network appears to promote the intimate partner's resilience process throughout the patient's care period.
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Affiliation(s)
- Sophie Opsomer
- Academic Centre for General Practice, Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 33, box 7001, 3000, Leuven, Belgium. .,Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
| | - Sofie Joossens
- grid.451396.cProgram of Health, University Colleges Leuven - Limburg, Leuven, Belgium
| | - Emelien Lauwerier
- grid.5342.00000 0001 2069 7798Department of Public Health and Primary Care, Ghent University, Ghent, Belgium ,grid.5342.00000 0001 2069 7798Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Jan De Lepeleire
- grid.5596.f0000 0001 0668 7884Academic Centre for General Practice, Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 33, box 7001, 3000 Leuven, Belgium
| | - Peter Pype
- grid.5342.00000 0001 2069 7798Department of Public Health and Primary Care, Ghent University, Ghent, Belgium ,grid.5342.00000 0001 2069 7798End-of-Life Care Research Group, Ghent University Campus, Ghent, Belgium
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22
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Musich S, Wang SS, Kraemer S, Yeh CS. The association of psychological protective factors with caregiver mental health outcomes. Geriatr Nurs 2023; 50:174-180. [PMID: 36791542 DOI: 10.1016/j.gerinurse.2023.01.020] [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: 01/04/2023] [Revised: 01/19/2023] [Accepted: 01/20/2023] [Indexed: 02/15/2023]
Abstract
The primary objectives were to investigate the association of resilience, purpose-in-life, and social connections in additive combinations with mental health outcomes of caregivers: 1) reduced levels of loneliness and/or depression; and 2) higher levels of positive perception of aging and quality of life. The study sample was identified from adults age ≥65, who had completed a survey during May-June 2018 or May-June 2019, and self-identified as caregivers (N=1,015; 15.4%). Resilience, purpose-in-life, and social connections were dichotomized as high/low; then counted with equal weighting 0 to 3. Among caregiver respondents, 24%, 29%, 32%, and 15% had 0, 1, 2, or 3 of these protective factors, respectively. As the number of protective factors increased, loneliness and depression decreased and positive perception of aging and quality of life increased. Caregiver interventions that include a focus on psychological protective factors may help to buffer caregiving-related stress thereby improving mental health and quality of life.
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Affiliation(s)
- Shirley Musich
- Research for Aging Populations, Optum Labs, 315 E. Eisenhower Parkway, Suite 305, Ann Arbor, MI 48108, 248-626-0082.
| | - Shaohung S Wang
- Research for Aging Populations, Optum Labs, 315 E. Eisenhower Parkway, Suite 305, Ann Arbor, MI 48108, 248-626-0082
| | - Sandra Kraemer
- Medicare & Retirement, UnitedHealthcare Alliances, PO Box 9472, Minneapolis, MN 55440, 952-931-5866
| | - Charlotte S Yeh
- AARP Services, Inc., 601 E. Street, N.W., Washington, D.C. 20049, 202-434-7531
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23
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Arefian M, Asgari-Mobarake K, Fazilatpour M, Zanguri V, Akrami M. Proposing and evaluating a model of depression, stress, resilience and spirituality in relation to pain in women with breast cancer: Investigating the mediating role of mindfulness. Eur J Oncol Nurs 2023; 62:102268. [PMID: 36716529 DOI: 10.1016/j.ejon.2023.102268] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 12/16/2022] [Accepted: 01/04/2023] [Indexed: 01/07/2023]
Abstract
BACKGROUND Pain experience is one of the most common symptoms of women with breast cancer receiving chemotherapy. It may cause physical and psychological problems and interfere with the treatment process. AIMS This study aimed to examine the relationship between depression, stress, resilience and spirituality on the pain symptoms of breast cancer patients during chemotherapy and explore the potential mediating role of mindfulness in this association. METHOD Two hundred and forty women with breast cancer receiving chemotherapy from Shiraz University Hospital, were selected and evaluated by a purposive sampling method. The research instruments were Perceived Stress Scale, Beck Depression Questionnaire-2, Mindfulness, Resilience, Spirituality and Pain Questionnaires. The obtained data was analyzed by SPSS software and MPLUS using Spearman correlation coefficient and path analysis. RESULTS Based on the findings of direct path analysis, depression, stress, and spirituality showed a significant relationship with mindfulness, but resilience had no significant relationship with mindfulness (p < 0.01). Furthermore, depression, stress, resilience, and mindfulness showed a significant relationship with pain, while spirituality had no significant relationship with pain (p < 0.01). Finally, indirect path analysis revealed mindfulness is a significant mediator of stress and pain (p < 0.05). CONCLUSIONS The present study suggested a model can be useful in better understanding of the psychological components affecting pain in breast cancer patients, after and during their treatments. It also provided an effective framework to develop and investigate pain-focused and non-pharmacological interventions.
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Affiliation(s)
- Mohsen Arefian
- Department of Psychology, Faculty of Education and Psychology, University of Isfahan, Isfahan, Iran
| | - Karim Asgari-Mobarake
- Department of Psychology, Faculty of Education and Psychology, University of Isfahan, Isfahan, Iran.
| | - Masoud Fazilatpour
- Department of Psychology, Faculty of Education and Psychology, Shiraz University, Shiraz, Iran
| | - Vahid Zanguri
- Breast Diseases Research Center, Department of Surgical Oncology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Majid Akrami
- Breast Diseases Research Center, Department of Surgical Oncology, Shiraz University of Medical Sciences, Shiraz, Iran
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24
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Wittenberg E, Goldsmith JV, Savage MW, Sullivan SS. Exploring Differences in Caregiver Communication in Serious Illness. J Palliat Med 2023. [PMID: 36603111 DOI: 10.1089/jpm.2022.0406] [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: 01/07/2023] Open
Abstract
Background: Demographic factors, such as disease context and family relationships, are communication mediators and moderators; however, little is known about how understanding these factors can improve caregiver communication with providers. Recognition of communication differences among caregivers may aid the development of approaches to improve serious illness communication. Objective: To explore whether caregiver communication differs by disease context (cancer vs. dementia) and caregiver communication type (Manager, Carrier, Partner, and Lone). Caregiver communication type is based on communication patterns between the care recipient and caregiver. Design and Measurements: Caregivers of persons with cancer and/or dementia were surveyed from a U.S. national research registry website. Measures of caregiver communication included information needs, communication confidence, perception of provider understanding of the caregiver, perceived frequency of caregiver assessment, and caregiver stress. Analysis of variance (ANOVA) determined significant differences between caregiver communication (p < 0.05) based on disease context and caregiver communication type. Results: Cancer caregivers reported higher unrecognized-demanded information states (i.e., not recognizing information was needed), more communication confidence, and more frequent caregiver assessment compared to dementia caregivers. Among caregiver communication types, Manager caregiver types were more confident communicating than other caregiver types and perceived greater understanding by providers than the Lone caregiver type. Manager caregivers reported significantly less stress than other caregiver communication types. Conclusions: Understanding disease context and caregiver communication type may help improve caregiver communication with health care providers.
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Affiliation(s)
- Elaine Wittenberg
- Department of Communication Studies, California State University, Los Angeles, Los Angeles, California, USA
| | - Joy V Goldsmith
- Department of Communication and Film, University of Memphis, Memphis, Tennessee, USA
| | - Matthew W Savage
- School of Communication, San Diego State University, San Diego, California, USA
| | - Suzanne S Sullivan
- School of Nursing, University at Buffalo, State University of New York, Buffalo, New York, USA
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25
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Mitchell HR, Applebaum AJ, Lynch KA, Reiner AS, Atkinson TM, Buthorn JJ, Sigler AS, Bossert D, Brewer K, Corkran J, Fournier D, Panageas KS, Diamond EL. Challenges and positive impact of rare cancer caregiving: A mixed-methods study of caregivers of patients with Erdheim-Chester disease and other histiocytic neoplasms. EClinicalMedicine 2022; 54:101670. [PMID: 36188434 PMCID: PMC9519468 DOI: 10.1016/j.eclinm.2022.101670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/05/2022] [Accepted: 09/07/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The importance of deriving benefit and meaning has been identified among cancer caregivers, but this has yet to be examined in the context of rare cancers. We sought to characterize unmet needs and experiences of caregivers of patients with Erdheim-Chester disease (ECD) and other histiocytic neoplasms (HN) and to identify factors associated with finding benefit and meaning-making in providing care for patients with rare cancers. METHODS Caregivers of patients with ECD and other HN completed quantitative surveys. Linear univariable regression modeling examined associations between unmet needs, social and family support, and intolerance of uncertainty with benefit finding and meaning-making. A subset participated in qualitative interviews assessing experiences of rare cancer caregiving that were analyzed with applied thematic analysis (NCT039900428). FINDINGS Of caregivers (N = 92, M = 54 years old, 68% female) of patients with ECD (75%) and other HN (25%), 78% reported moderately or severely unmet support needs, most frequently informational (58%) and psychological/emotional (66%) needs. Caregivers with unmet informational, psychological/emotional, and social support needs, difficulty tolerating uncertainty, a longer duration of the patient's illness, lower social support, more family conflict, and higher anxiety and depression symptoms demonstrated less benefit finding and meaning-making (ps <.05). Qualitative interviews (N = 19) underscored information and support needs and the capacity to derive meaning from caregiving. INTERPRETATION Rare cancer caregivers report numerous unmet information and support needs, needs that arise from disease rarity itself and which are associated with diminished capacity for deriving benefit and meaning from caregiving. Findings highlight targets for interventions to improve support for caregivers with HN and other rare cancers. FUNDING NIH P30 CA008748 (PI: Craig Thompson, MD), NIH T32 CA009461 (H.M.; PI: Jamie Ostroff, PhD), Frame Family Fund (E.L.D.), Applebaum Foundation (E.L.D.).
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Affiliation(s)
- Hannah-Rose Mitchell
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Allison J. Applebaum
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Kathleen A. Lynch
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Anne S. Reiner
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Thomas M. Atkinson
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Justin J. Buthorn
- Department of Neurology, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Allison S. Sigler
- Department of Neurology, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Dana Bossert
- Department of Neurology, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Kathleen Brewer
- Erdheim-Chester Disease Global Alliance, DeRidder, LA, United States
| | - Jessica Corkran
- Erdheim-Chester Disease Global Alliance, DeRidder, LA, United States
| | | | - Katherine S. Panageas
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Eli L. Diamond
- Department of Neurology, Memorial Sloan Kettering Cancer Center, New York, NY, United States
- Corresponding author at: Department of Neurology, Memorial Sloan Kettering Cancer Center 160 East 53rd St. Second Floor Neurology, New York, NY 10022 United States.
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26
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Opsomer S, Joossens S, De Lepeleire J, Pype P, Lauwerier E. Trapped in a double cage: How patients' partners experience the diagnosis of advanced cancer in times of the COVID-19 pandemic: An interpretative phenomenological analysis. Palliat Med 2022; 36:810-820. [PMID: 35272521 PMCID: PMC9087315 DOI: 10.1177/02692163221080660] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND When confronting a partner's diagnosis of advanced cancer, family caregivers are often protected against severe psychological illness by their mental resilience. However, the current COVID-19 pandemic endangers this resilience through the daily threat of contagion exposure, viral transmission, isolation, and fear of death. AIM To examine the experiences of partners caring for a person with advanced cancer during the COVID-19 pandemic. SETTING Twelve partners (all under the age of 65) of persons newly diagnosed with advanced cancer immediately before or during the pandemic were interviewed. An interpretative phenomenological approach was used in analyzing the data. FINDINGS Partners experience the COVID-19 pandemic as "living in a double cage." Due to pandemic mandates and restrictions, the pace of their lives slows. However, COVID-19 does not slow the progression of the cancer, nor does it allow for an escape from the cancer. The pandemic has a significant impact on several elements of resilience. Nevertheless, the participants succeed in adapting and coping in a balanced and creative way despite the new challenges imposed by the pandemic. CONCLUSION The COVID-19 pandemic challenges one's resilience, a process that, under normal circumstances, may evolve while caring for a partner diagnosed with advanced cancer. Although most partners seem to cope adaptively with both advanced cancer and COVID-19, healthcare professionals should be aware of the risk of exhaustion. Furthermore, it can be presupposed that threatened, contextual factors that may support resilience should be preserved to increase the chances for a resilient outcome.
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Affiliation(s)
- Sophie Opsomer
- Academic Center for General Practice, KU Leuven, Belgium.,Department of Public Health and Primary Care, Ghent University, Belgium
| | - Sofie Joossens
- Program of Health, University Colleges Leuven-Limburg, Belgium
| | | | - Peter Pype
- Department of Public Health and Primary Care, Ghent University, Belgium.,End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Brussels, Belgium
| | - Emelien Lauwerier
- Department of Public Health and Primary Care, Ghent University, Belgium.,Department of Experimental Clinical and Health Psychology, Ghent University, Belgium
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27
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Qureshi A, Hargest C, Swain N, Aldabe D, Hale L. Psychosocial interventions for building resilience of informal carers of people living with stroke: a systematic review. Disabil Rehabil 2022; 45:1419-1432. [PMID: 35468030 DOI: 10.1080/09638288.2022.2063419] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE To identify and synthesise the evidence of interventions purported to build resilience among informal carers of stroke survivors. METHODS A systematic review of randomised controlled trials of psychosocial interventions to build resilience for carers of people post-stroke was planned. A systematic search was conducted in seven online databases from inception to March 2021. Outcomes measured were resilience and its proxy constructs including copying, adaptation, adjustment, problem-solving, self-efficacy, locus of control, competence and strength. RESULTS Twelve studies were included in the review and were grouped into four intervention categories (i) Education and social support, (ii) problem-solving skills, (iii) problem-solving skills, and psychoeducation and (iv) information provision, problem-solving skills and psychoeducation. Level of evidence A exists for interventions that combine information provision, problem-solving skills and psychoeducation over the interventions that only use problem-solving skills intervention or problem-solving skills with psychoeducation strategies. All interventions apart from one reported significant within and/or between group changes in outcomes. CONCLUSION Interventions comprising of information provision, problem-solving skills and psychoeducation appear to be beneficial to improve resilience of carers. However, because of the heterogeneity of the interventions and outcome measures reported across the twelve studies no particular intervention could be definitively supported. CLINICAL TRIAL REGISTRATION Systematic review registration: CRD 42020172824 https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020172824 IMPLICATIONS FOR REHABILITATIONProviding care for stroke survivors is particularly demanding due to the lack of preparation for managing the unexpected and complex nature of stroke, resulting in negative physical, social, behavioral, emotional, and financial outcomes.The long-term nature of stroke and its many residual problems can negatively affect the physical and psychological well-being of the individual and their carers, which may subsequently affect the recovery of the stroke survivor.Evidence suggests that resilience is the protective shield for carers' stress and burnout.Integrating interventions focusing on carers' resilience as part of the stroke rehabilitation process is imperative to ensure the well-being of carers and the sustainability of the care provided to the stroke survivor.
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Affiliation(s)
- Ayesha Qureshi
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy - University of Otago, Dunedin, New Zealand
| | - Claire Hargest
- School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Nicola Swain
- School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Daniela Aldabe
- School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Leigh Hale
- School of Physiotherapy, University of Otago, Dunedin, New Zealand
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