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K. NVSL, Rajkumar E, Gopi A, Hareesh PV, Romate J, Lakshmi R, Abraham J. Correlates of post-traumatic growth among persons bereaved from cancer: A systematic review and meta-analysis. PLoS One 2024; 19:e0300291. [PMID: 38489290 PMCID: PMC10942051 DOI: 10.1371/journal.pone.0300291] [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: 08/04/2023] [Accepted: 02/24/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Recent research identified that cancer bereavement can lead to post-traumatic growth (PTG). Although PTG and its correlates are well explored in cancer patients and survivors, persons bereaved from cancer have received scant attention. Therefore, the present review attempts to identify the correlates of PTG among persons bereaved from cancer. METHODS A systematic search in PubMed, Web of Science, APA PsycNet, Science Direct, Scopus, and Wiley was conducted to identify quantitative studies published in English, resulting in 12 eligible reports being included in the final analysis. JBI critical checklists were employed to appraise the risk of bias. RESULTS The review identified 17 correlates, which were classified into four categories: demographic factors (age, gender, religious status, level of education), loss-related factors (time since death, quality of death, prolonged grief symptoms), interpersonal factors (relationship to the deceased, social support, attachment style, bereavement behaviours) and intrapersonal factors (resilience, coping, rumination, benevolence, meaningfulness, self-worth). Random effects meta-analyses on six correlates revealed correlation coefficients of age = -0.02 (95% CI: -0.35-0.31), gender = 0.27 (95% CI: 0.08-0.45), time since death = 0.09 (95% CI: -0.02-0.20), quality of death = 0.29 (95% CI: -0.01-0.54), prolonged grief symptoms = 0.22 (95% CI: 0.08-0.35) and relationship to the deceased = 0.13 (95% CI: -0.03-0.29). Fixed effects meta-analysis was performed for social support (r = 0.13, 95% CI: 0.04-0.21). However, PTG was found to be significantly associated with gender, prolonged grief symptoms, and social support. CONCLUSIONS Very few studies examined PTG among persons bereaved from cancer, highlighting the need for increased attention, understanding, and conceptualisation of PTG in the population.
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Affiliation(s)
- N. V. Sri Lakshmi K.
- Department of Psychology, Central University of Karnataka, Kalaburagi, Karnataka, India
| | - Eslavath Rajkumar
- Department of Liberal Arts, Indian Institute of Technology Bhilai, Durg, Chhattisgarh, India
| | - Aswathy Gopi
- Department of Psychology, Central University of Karnataka, Kalaburagi, Karnataka, India
| | - P. V. Hareesh
- Department of Psychology, Central University of Karnataka, Kalaburagi, Karnataka, India
| | - John Romate
- Department of Psychology, Central University of Karnataka, Kalaburagi, Karnataka, India
| | - R. Lakshmi
- Department of Applied Psychology, Central University of Tamil Nadu, Thiruvarur, Tamil Nadu, India
| | - John Abraham
- St. John’s Medical College, St. John’s National Academy of Health Sciences, Bangalore, India
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Lee HJ, Lee DH, Lee DH, Kim JY. Posttraumatic Growth Inventory-Expanded: Factor Structure, Test-Retest Reliability, and Validity in Trauma-Exposed and Bereaved Adults. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231177847. [PMID: 37220767 DOI: 10.1177/00302228231177847] [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: 05/25/2023]
Abstract
Posttraumatic growth (PTG) is a positive psychological change experienced after trauma and it has gained global recognition in recent years. The present study aimed to validate a South Korean version of the Posttraumatic Growth Inventory-Expanded (K-PTGI-X) for use with trauma-exposed and bereaved samples. A national sample comprising South Korean adults was used for the analysis. As a result, the 4-factor bi-factor model was best supported in both the trauma and bereaved groups in terms of personal strength, new possibilities, spiritual-existential change, and being able to relate to others. Additionally, the K-PTGI-X showed satisfying reliability, concurrent validity, and discriminant validity. Lastly, regarding the group differences, women showed higher rates of PTG than men and the bereaved group exhibited higher spiritual and existential growth in the PTG than the trauma group. Given these results, implications for adaptation in various fields when assessing and encouraging PTG in practical settings are discussed.
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Affiliation(s)
- Hwa Jung Lee
- Traumatic Stress Center, Department of Education, Sungkyunkwan University, Seoul, South Korea
| | - Dong Hun Lee
- Traumatic Stress Center, Department of Education, Sungkyunkwan University, Seoul, South Korea
| | - Deok Hee Lee
- Traumatic Stress Center, Department of Education, Sungkyunkwan University, Seoul, South Korea
| | - Ji Yun Kim
- Department of Wesley Creative Convergence, Hyupsung University, Hwaseong, South Korea
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Kondo M, Kihira T, Sakaguchi Y, Shimada K, Shirai Y, Tamura K. Growth Experience Bereaved of a Spouse by Cancer: Relying on Merleau-Ponty's Reorganization of the Body Schemes. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231164859. [PMID: 36964705 DOI: 10.1177/00302228231164859] [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: 03/26/2023]
Abstract
The grief experienced by bereaved families can lead to positive changes, and its relevance to the emerging concept of posttraumatic growth has been explored. However, studies on survivors bereaved of a spouse by cancer are scarce; consequently, the nature of growth remains poorly understood. This study aimed to explore the growth experiences of survivors bereaved of a spouse by cancer. Based on Merleau-Ponty's theory of the body, we phenomenologically analyzed narratives/qualitative data collected through interviews of 21 survivors bereaved of a spouse by cancer. The assessment of the growth of survivors bereaved of a spouse by cancer began before the bereavement, with the questioning of habits with the living spouse because of illness and prognosis announcement and/or bereavement, reaffirming the connection with the spouse, realizing that it provides emotional support, and becoming accustomed to who they are now in the new environment.
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Affiliation(s)
- Megumi Kondo
- Department of Palliative Nursing, Graduate School of Medicine, Kyoto University, Japan
| | - Tomoki Kihira
- College of Nursing Art and Science, University of Hyogo, Japan
| | | | - Kazuki Shimada
- Department of Palliative Medicine, Kyoto University Hospital
| | - Yuki Shirai
- Department of Palliative Nursing, Graduate School of Medicine, Kyoto University, Japan
| | - Keiko Tamura
- Department of Palliative Nursing, Graduate School of Medicine, Kyoto University, Japan
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Garrouste-Orgeas M, Marché V, Pujol N, Michel D, Evin A, Fossez-Diaz V, Perruchio S, Vanbésien A, Verlaine C, Copel L, Kaczmarek W, Birkui de Francqueville L, Michonneau-Gandon V, de Larivière E, Poupardin C, Touzet L, Guastella V, Mathias C, Mhalla A, Bouquet G, Richard B, Gracia D, Bienfait F, Verliac V, Ranchou G, Kirsch S, Flahault C, Loiodice A, Bailly S, Ruckly S, Timsit JF. Incidence and risk factors of prolonged grief in relatives of patients with terminal cancer in French palliative care units: The Fami-Life multicenter cohort study. Palliat Support Care 2023:1-10. [PMID: 36878669 DOI: 10.1017/s1478951523000111] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
OBJECTIVES Psychological consequences of grief among relatives are insufficiently known. We reported incidence of prolonged grief among relatives of deceased patients with cancer. METHODS Prospective cohort study of 611 relatives of 531 patients with cancer hospitalized for more than 72 hours and who died in 26 palliative care units was conducted. The primary outcome was prolonged grief in relatives 6 months after patient death, measured with the Inventory Complicated Grief (ICG > 25, range 0-76, a higher score indicates more severe symptoms) score. Secondary outcomes in relatives 6 months after patient death were anxiety and depression symptoms based on Hospital Anxiety and Depression Scale (HADS) score (range 0 [best]-42 [worst]), higher scores indicate more severe symptoms, minimally important difference 2.5. Post-traumatic stress disorder symptoms were defined by an Impact Event Scale-Revised score >22 (range 0-88, a higher score indicates more severe symptoms). RESULTS Among 611 included relatives, 608 (99.5%) completed the trial. At 6 months, significant ICG scores were reported by 32.7% relatives (199/608, 95% CI, 29.0-36.4). The median (interquartile range ICG score) was 20.0 (11.5-29.0). The incidence of HADS symptoms was 87.5% (95% CI, 84.8-90.2%) at Days 3-5 and 68.7% (95% CI, 65.0-72.4) 6 months after patient's death, with a median (interquartile range) difference of -4 (-10 to 0) between these 2 time points. Improvement in HADS anxiety and depression scores were reported by 62.5% (362/579) relatives. SIGNIFICANCE OF RESULTS These findings support the importance of screening relatives having risk factors of developing prolonged grief in the palliative unit and 6 months after patient's death.
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Affiliation(s)
- Maité Garrouste-Orgeas
- IAME, INSERM, Université de Paris, Paris, France
- Palliative Care Unit, Reuilly Diaconesses Fondation, Rueil Malmaison, France
- Medical Unit, French British Hospital, Levallois-Perret, France
| | | | - Nicolas Pujol
- Research Department Palliative Care Unit, Jeanne Garnier Institution, Paris, France
| | - Dominique Michel
- Palliative Care Unit, Reuilly Diaconesses Fondation, Rueil Malmaison, France
| | - Adrien Evin
- Palliative Care Unit, University Teaching Hospital, Nantes, France
| | | | | | | | | | - Laure Copel
- Palliative Care Unit, Diaconesses Croix Saint Simon Hospital, Paris, France
| | | | | | | | | | | | - Licia Touzet
- Palliative Care Unit, University Teaching Hospital, Lille, France
| | - Virginie Guastella
- Palliative Care Unit, University Teaching Hospital, Clermont Ferrand, France
| | - Carmen Mathias
- Palliative Care Unit, Mulhouse Sud Alsace Hospital Network, Mulhouse, France
| | - Alaa Mhalla
- Palliative Care Unit, Albert Chenevier Hospital, Créteil, France
| | | | - Bruno Richard
- Palliative Care Unit, University Teaching Hospital, Montpellier, France
| | - Dominique Gracia
- Palliative Care Unit, General Hospital, Salon-de-Provence, France
| | - Florent Bienfait
- Palliative Care Unit, University Teaching Hospital, Angers, France
| | - Virginie Verliac
- Palliative Care Unit, Saintonge General Hospital, Saintes, France
| | - Gaelle Ranchou
- Palliative Care Unit, General Hospital, Périgueux, France
| | - Sylvie Kirsch
- Palliative Care Unit, Bligny Hospital, Briis-Sous-Forges, France
| | - Cécile Flahault
- Laboratory of Psychopathology and Health Process, Paris University Paris, Boulogne-Billancourt, France
| | | | | | | | - Jean-François Timsit
- IAME, INSERM, Université de Paris, Paris, France
- Medical and infectious diseases ICU (MI2), APHP Bichat Hospital, Paris, France
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Porro B, Broc G, Baguet‐Marin F, Cousson‐Gélie F. A questionable version of the
Post‐Traumatic
growth inventory—Short form in women diagnosed with breast cancer. Br J Health Psychol 2022; 27:1314-1329. [DOI: 10.1111/bjhp.12604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 05/04/2022] [Indexed: 12/24/2022]
Affiliation(s)
- Bertrand Porro
- Université d'Angers, Univ Rennes, Inserm, EHESP, Irset (Research Institute for Environmental and Occupational Health), UMR_S 1085, SFR ICAT, SIRIC ILIAD Angers France
- Psychology Laboratory EPSYLON EA Univ. Paul Valéry Montpellier 3 Montpellier France
| | - Guillaume Broc
- Psychology Laboratory EPSYLON EA Univ. Paul Valéry Montpellier 3 Montpellier France
| | - Fanny Baguet‐Marin
- Psychology Laboratory EPSYLON EA Univ. Paul Valéry Montpellier 3 Montpellier France
- Epidaure, Prevention Department of the Montpellier Cancer Institute SIRIC Montpellier Cancer Montpellier Cedex 5 France
| | - Florence Cousson‐Gélie
- Psychology Laboratory EPSYLON EA Univ. Paul Valéry Montpellier 3 Montpellier France
- Epidaure, Prevention Department of the Montpellier Cancer Institute SIRIC Montpellier Cancer Montpellier Cedex 5 France
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Dyadic effects of rumination and self-disclosure on posttraumatic growth in newly diagnosed gynecological cancer couples: an actor-partner interdependence modeling approach. Support Care Cancer 2022; 30:5167-5174. [PMID: 35246728 DOI: 10.1007/s00520-022-06869-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 01/24/2022] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To examine the dyadic effects of rumination and self-disclosure on posttraumatic growth among newly diagnosed gynecological cancer couples. METHODS This cross-sectional study recruited 400 newly diagnosed gynecological cancer couples from a tertiary general hospital from July to December 2020. Questionnaires were administered to collect information on demographic and cancer-related characteristics, rumination, self-disclosure, and posttraumatic growth. The actor-partner interdependence model was used to explore the dyadic effects of rumination and self-disclosure on posttraumatic growth. RESULTS Gynecological cancer survivors reported more posttraumatic growth than their spouses. The patients' deliberate rumination and self-disclosure and spouses' self-disclosure had actor and partner effects on their own and their spouses' posttraumatic growth. Besides, the patients' intrusive rumination and spouses' deliberate rumination had actor effects on their own posttraumatic growth. CONCLUSIONS Spouses' posttraumatic growth was influenced by their own and their wives' deliberate rumination and self-disclosure, while survivors' posttraumatic growth was affected by their own deliberate rumination, intrusive rumination, self-disclosure, and their spouses' self-disclosure. Promoting deliberate rumination and self-disclosure could facilitate the couples' posttraumatic growth. Besides, reducing intrusive rumination may be useful for the survivors and indirectly contribute to spouses' posttraumatic growth. This study indicates that couple-centered interventions may be crucial and more effective in facilitating posttraumatic growth among newly diagnosed gynecological cancer couples.
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Takedomi Y, Tabuchi Y, Kumagai Y, Sakamoto M, Kosugi T, Kanegae S, Maezato K, Yakabe S. Post-traumatic growth of family members of deceased cancer patients and related factors in Japan: A cross-sectional study. Eur J Oncol Nurs 2021; 55:102058. [PMID: 34757272 DOI: 10.1016/j.ejon.2021.102058] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 09/15/2021] [Accepted: 10/15/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE This study examines the post-traumatic growth (PTG) of bereaved families who care for cancer patients and related factors in Japan. METHODS Participants included 1298 members of bereaved families of cancer patients (aged 20 or older). An anonymous self-administered questionnaire on PTG, coping, and social support was mailed to 496 bereaved families who provided written informed consent. RESULTS Responses were obtained from 476 bereaved families; however, since 28 families had missing data, 448 were included for the analyses. The mean age of participants was 61.4 years: 69% women and 45% spouses. The average age of the deceased was 72.8 years old for men (59%). The PTG score of the bereaved families was higher for women than for men (p < 0.0001). Moreover, the Post-Traumatic Growth Inventory Score for those above 65 years of age was higher than of those below 65 years of age (p < 0.0001). A regression analysis confirmed that emotion-focused coping, problem-focused coping, relationship with the deceased, advanced age of bereaved families, and emotional support impacted PTG. CONCLUSION The significance of the deceased for the bereaved, bereaved family members being older in age, emotion-focused coping, problem-focused coping, and emotional support suggest that these aspects are associated with psychological growth in terms of accepting the death of a loved one and moving forward. It is necessary to evaluate the relationship between the bereaved family and the deceased, the age and gender of the bereaved, coping behaviors, and support status and establish a higher quality bereaved family care system.
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Affiliation(s)
- Yumiko Takedomi
- Saga University, Institute of Nursing, Faculty of Medicine, 5-1-1 Nabeshima Saga-City, Saga, 849-8501, Japan.
| | - Yasuko Tabuchi
- Saga University, Institute of Nursing, Faculty of Medicine, 5-1-1 Nabeshima Saga-City, Saga, 849-8501, Japan
| | - Yuki Kumagai
- Saga University, Institute of Nursing, Faculty of Medicine, 5-1-1 Nabeshima Saga-City, Saga, 849-8501, Japan
| | - Maiko Sakamoto
- Saga University, Research and Education Center for Comprehensive Community Medicine, Faculty of Medicine, Saga, Japan
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ALKAN A, KÖKSOY EB, KARCI E, ALKAN A, BRUERA E, ÇAY ŞENLER F. Posttraumatic growth and death anxiety in caregivers of cancer patients: PHOENIX study. Turk J Med Sci 2020; 50:1364-1370. [PMID: 32490635 PMCID: PMC7491265 DOI: 10.3906/sag-2001-228] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 05/19/2020] [Indexed: 11/21/2022] Open
Abstract
Background/aim Posttraumatic growth (PTG) is defined as positive psychological changes following a challenging or traumatic life event. The purpose of this study is to define the predictors of PTG and death anxiety (DAN) in caregivers of cancer patients and evaluate the impact of DAN on PTG. Materials and methods The caregivers of cancer patients were evaluated using structured questionnaires, including a validated PTG scale and Templer death anxiety scale. Results In 3 different cancer centers, 426 participants were evaluated. In multivariate analysis of factors associated with PTG, a high DAN score was the only parameter associated with high PTG scores [OR: 1.6, CI (95%) 1.02–2.5, P = 0.03]. In multivariate analysis of factors associated with DAN, female sex was the only risk factor for high DAN scores [OR: 1.6, CI (95%) 1.1–2.8, P = 0.049]. There was a positive correlation between PTG and DAN scores (r = 0.15, P = 0.001). Higher DAN scores were associated with positive impacts on self-perception (37.0 versus 35.0, P = 0.02), philosophy of life (16.0 versus 13.0, P = 0.035), and changes in relationship (16.0 versus 14.0, P = 0.01) Conclusions This is the first report regarding the association between DAN and PTG. We found a positive impact of death anxiety on psychological changes in caregivers of cancer patients.
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Affiliation(s)
- Ali ALKAN
- Department of Medical Oncology, Faculty of Medicine, Muğla Sıtkı Koçman University, MuğlaTurkey
| | - Elif Berna KÖKSOY
- Department of Medical Oncology, Faculty of Medicine, Ankara University, AnkaraTurkey
| | - Ebru KARCI
- Department of Medical Oncology, Bağcılar Education and Research Hospital, İstanbulTurkey
| | - Aslı ALKAN
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Muğla Sıtkı Koçman University, MuğlaTurkey
| | - Eduardo BRUERA
- Department of Palliative, Rehabilitation, and Integrative Medicine; the University of Texas MD Anderson Cancer Center, Houston, TexasUSA
| | - Filiz ÇAY ŞENLER
- Department of Medical Oncology, Faculty of Medicine, Ankara University, AnkaraTurkey
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Perpiñá-Galvañ J, Orts-Beneito N, Fernández-Alcántara M, García-Sanjuán S, García-Caro MP, Cabañero-Martínez MJ. Level of Burden and Health-Related Quality of Life in Caregivers of Palliative Care Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E4806. [PMID: 31795461 PMCID: PMC6926780 DOI: 10.3390/ijerph16234806] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 11/19/2019] [Accepted: 11/24/2019] [Indexed: 12/19/2022]
Abstract
The complexity of palliative care means that the emotional distress and burden that primary family caregivers suffer under can be particularly high. The objective of this study was to determine the level of burden endured by these primary family caregivers and to identify the variables that predict it in the caregiving relatives of people who require home-based palliative care. A descriptive-correlational cross-sectional study was conducted. Socio-demographic and clinical data were collected from caregivers through a self-administered questionnaire that included questions from the 12-Item Short Form Health Survey (SF-12), Zarit Caregiver Burden Interview (ZBI), Hospital Anxiety and Depression Scale (HADS), Brief Resilient Coping Scale (BRCS), Post Traumatic Growth Inventory (PTGI), and Fatigue Assessment Scale (FAS). A total of 77 caregivers participated; 66.2% were women, and the mean age was 61.5 years. Most (62.3%) were providing care to cancer patients. From among these data, the presence of anxiety as a clinical problem (48.1%), a high average fatigue score (FAS) of 23.0 (SD = 8.5), and the prevalence of intense overload (41.6%) stood out. We found statistically significant correlations between the variables of burden, fatigue, post-traumatic growth, anxiety, and depression, with the latter two being the main predictive variables of burden. In addition, caregiver burden was associated with a worsening of health. Identifying the factors that influence the appearance of overburden will allow the specific needs of careers to be assessed in order to offer them emotional support within the healthcare environment.
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Affiliation(s)
- Juana Perpiñá-Galvañ
- Department of Nursing, University of Alicante, 03690 Alicante, Spain; (J.P.-G.); (S.G.-S.); (M.J.C.-M.)
- Institute of Health and Biomedical Research of Alicante (ISABIAL-FISABIO Foundation), 03010 Alicante, Spain;
| | - Núria Orts-Beneito
- Institute of Health and Biomedical Research of Alicante (ISABIAL-FISABIO Foundation), 03010 Alicante, Spain;
| | - Manuel Fernández-Alcántara
- Institute of Health and Biomedical Research of Alicante (ISABIAL-FISABIO Foundation), 03010 Alicante, Spain;
- Department of Health Psychology, University of Alicante, 03690 Alicante, Spain
| | - Sofía García-Sanjuán
- Department of Nursing, University of Alicante, 03690 Alicante, Spain; (J.P.-G.); (S.G.-S.); (M.J.C.-M.)
- Institute of Health and Biomedical Research of Alicante (ISABIAL-FISABIO Foundation), 03010 Alicante, Spain;
| | | | - María José Cabañero-Martínez
- Department of Nursing, University of Alicante, 03690 Alicante, Spain; (J.P.-G.); (S.G.-S.); (M.J.C.-M.)
- Institute of Health and Biomedical Research of Alicante (ISABIAL-FISABIO Foundation), 03010 Alicante, Spain;
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Ware OD, Cagle JG. Informal Caregiving Networks for Hospice Patients With Cancer and Their Impact on Outcomes: A Brief Report. Am J Hosp Palliat Care 2019; 36:235-240. [DOI: 10.1177/1049909118792011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This prospective study investigates informal care networks and their impact on hospice outcomes. Primary caregivers (N = 47) were the main source of data from 2 time points: within a week of enrollment in hospice and bereavement. Data were also collected from 42 secondary caregivers. Intraclass correlation coefficients (ICCs) determined correspondence between primary and secondary caregivers regarding informal care network size. Correlations were used to test associations between variables. Nonparametric paired sample tests were used to analyze change in anger and guilt. The ICC found poor correspondence (−0.13) between primary and secondary caregivers’ network descriptions. Correlational analyses found a strong/moderate negative association between quality of dying (QOD) and grief ( r = −0.605, P < .05). Study participants reported increased anger (0.4, P < .05, range 1-5) and guilt (0.4, P < .05, range 1-5), particularly among caregivers with high levels of support. Findings suggest that improving QOD may facilitate postdeath coping for caregivers.
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Affiliation(s)
- Orrin D. Ware
- University of Maryland School of Social Work, Baltimore, MD, USA
| | - John G. Cagle
- University of Maryland School of Social Work, Baltimore, MD, USA
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11
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Jordan G, Malla A, Iyer SN. "It's Brought Me a Lot Closer to Who I Am": A Mixed Methods Study of Posttraumatic Growth and Positive Change Following a First Episode of Psychosis. Front Psychiatry 2019; 10:480. [PMID: 31379615 PMCID: PMC6643164 DOI: 10.3389/fpsyt.2019.00480] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 06/19/2019] [Indexed: 11/13/2022] Open
Abstract
Background: A first episode of psychosis is often a traumatic experience that may also lead to positive change, a phenomenon that has received little attention. This knowledge gap may impede service providers' capacity to foster positive change among service users. Objective: To investigate aspects of positive change among persons receiving early intervention services for psychosis. Design: The study objective was addressed using a mixed methods convergent design, which entailed simultaneously employing qualitative and quantitative methods. Setting: This study was conducted at a specialized early intervention service for psychosis based in Montreal, Quebec, Canada. Participants: Participants included service users receiving services at an early intervention service for psychosis. Participants had to be fluent in English or French, be clinically stable enough to take part in the study, and have received at least 6 months of treatment. Participants were conveniently sampled in the quantitative component and purposefully sampled in the qualitative component. The quantitative component was carried out using a cross-sectional survey design. Ninety-four participants completed the Posttraumatic Growth Inventory, a widely used measure of positive change. Data on the extent and domains of posttraumatic growth were summarized using descriptive statistics. The qualitative component was carried out using a qualitative descriptive approach. Semistructured interviews were conducted with 12 participants. Data were analyzed using thematic analysis. Findings from both components were integrated using a weaving method in the discussion section. Results: Quantitative results indicated that most participants reported a moderate amounts of posttraumatic growth. A greater appreciation of life was the most commonly endorsed domain, whereas spiritual growth was the least commonly endorsed domain. The qualitative results revealed that in addition to suffering, participants experienced positive changes, such as improved health and personality, and a stronger sense of self; stronger, more balanced religiosity and spirituality; improved relationships with others; and improved lifestyles, goals, and expectations for the future. Conclusions: Positive change may be a common phenomenon in the aftermath of first episode psychosis. The study findings may provide hope to those who have experienced a first episode of psychosis and can inform efforts by early intervention services to provide recovery-oriented, growth-focused care.
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Affiliation(s)
- Gerald Jordan
- Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, Verdun, QC, Canada.,Department of Psychiatry, McGill University, Montreal, QC, Canada.,Program for Recovery and Community Health, Yale University, New Haven, CT, United States
| | - Ashok Malla
- Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, Verdun, QC, Canada.,Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Srividya N Iyer
- Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, Verdun, QC, Canada.,Department of Psychiatry, McGill University, Montreal, QC, Canada
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Hirooka K, Fukahori H, Taku K, Izawa S, Ogawa A. Posttraumatic growth in bereaved family members of patients with cancer: a qualitative analysis. Support Care Cancer 2018; 27:1417-1424. [DOI: 10.1007/s00520-018-4440-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 08/23/2018] [Indexed: 10/28/2022]
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