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Xiang D, Zhang ZX, Ge S, Wang WN, Lin BL, Chen SY, Guo EF, Zhang PB, Liu ZW, Li H, Mei YX. Physio-psycho-social interaction mechanism in dyadic health of young and middle-aged stroke survivors and their spousal caregivers: a longitudinal observational study protocol. BMJ Open 2023; 13:e065767. [PMID: 37041051 PMCID: PMC10106025 DOI: 10.1136/bmjopen-2022-065767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/13/2023] Open
Abstract
INTRODUCTION In recent years, stroke has become more common among young people. Stroke not only has a profound impact on patients' health but also incurs stress and health threats to their caregivers, especially spousal caregivers. Moreover, the health of stroke survivors and their caregivers is interdependent. To our knowledge, no study has explored dyadic health of young and middle-aged stroke survivors and their spousal caregivers from physiological, psychological and social perspectives. Therefore, this proposed study aims to explore the mechanism of how physiological, psychological and social factors affect dyadic health of young and middle-aged stroke survivors and their spousal caregivers. The findings of this study will provide implications for developing interventions to improve dyadic health of this growing population. METHODS AND ANALYSES We will collect data from 57 dyads of young and middle-aged stroke survivors and their spousal caregivers during hospitalisation and at 1, 3, 6, 9 and 12 months after discharge. Questionnaires will be used to collect participants' demographic information, stress, depression, anxiety, benefit finding, social support, mutuality and quality of life. The following physiological reactions will be collected at baseline, including interleukin 6, tumour necrosis factor-alpha and salivary cortisol. ETHICS AND DISSEMINATION The study was approved by the ethics review committee of life sciences of Zhengzhou University (No. ZZUIRB2020-53). Prior to being enrolled in the study, participants will be given full and detailed information about the possible risks involved, the informed consent process, confidentiality, the study procedure and secure data storage. Participants will be guaranteed that they can withdraw from the study at any time without providing a reason or leading to any consequences. Both oral and written informed consent will be obtained from all participants. The findings of this proposed study will be disseminated through peer-reviewed journals and academic conferences.
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Affiliation(s)
- Dandan Xiang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Zhen-Xiang Zhang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Song Ge
- Department of Natural Science, University of Houston Downtown, Houston, Texas, USA
| | - Wen Na Wang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Bei-Lei Lin
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Su-Yan Chen
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Er-Feng Guo
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Peng-Bo Zhang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Zhi-Wei Liu
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Hui Li
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Yong-Xia Mei
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
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Hanks E, Stewart A, Au-Yeung CK, Johnson E, Smith CH. Consensus on level descriptors for a functional children's eating and drinking activity scale. Dev Med Child Neurol 2023. [PMID: 36798989 DOI: 10.1111/dmcn.15542] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 01/13/2023] [Accepted: 01/13/2023] [Indexed: 02/18/2023]
Abstract
AIM To agree wording of level descriptors for a measure of functional outcome of children's eating and drinking. METHOD An online, modified Delphi method was used to gather feedback on current level descriptor wording and generate rewording suggestions. Thirty speech and language therapists, working in a variety of settings and geographical locations, were invited to be part of the Delphi expert panel. Content analysis was used to evaluate participants' comments and develop consensus level descriptors. Consensus for acceptable wording was set at 80% agreement. Face validity was assessed using 5-point Likert scales. RESULTS Nineteen expert speech and language therapists (median experience 18 years) completed round one; 15 out of 19 completed round two. Level descriptor rating reached 80% agreement in two rounds. Additionally, 93% of participants agreed the scale would accurately capture change in their setting, with 87% likely to use the scale in practice. INTERPRETATION This study has produced agreed wording for a functional measure of eating and drinking activity suitable for use with paediatrics feeding disorders, regardless of disease aetiology, presentation, age, or setting. Potential for widespread use is supported. Further evaluation of the tool's reliability and validity is required.
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Affiliation(s)
- Emily Hanks
- Department of Psychology and Language Sciences, University College London, London, UK
| | - Alexandra Stewart
- Department of Psychology and Language Sciences, University College London, London, UK.,Department of Speech and Language Therapy, Great Ormond Street Hospital, London, UK
| | - Claudia Kate Au-Yeung
- Department of Psychology and Language Sciences, University College London, London, UK
| | - Emily Johnson
- Department of Speech and Language Therapy, Great Ormond Street Hospital, London, UK
| | - Christina H Smith
- Department of Psychology and Language Sciences, University College London, London, UK
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Nightingale C, Sterba KR, Levine B, Tooze JA, Greven K, Frizzell B, Hughes RT, Snavely A, Lesser GJ, Norona S, Pleasant K, Weaver KE. Feasibility and Acceptability of a Multi-Modality Self-Management Intervention for Head and Neck Cancer Caregivers: A Pilot Randomized Trial. Integr Cancer Ther 2022; 21:15347354221098984. [PMID: 35575280 PMCID: PMC9121462 DOI: 10.1177/15347354221098984] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 03/29/2022] [Accepted: 04/20/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Head and neck cancer (HNC) patients undergoing radiation therapy (RT) experience significant side effects, presenting challenging care tasks for their informal (unpaid) caregivers. HNC caregivers report low caregiving self-efficacy, high distress, and interest in supportive care interventions. OBJECTIVE This randomized pilot trial assessed the feasibility and acceptability of a 6 to 7 week supported self-management intervention (Prepare to Care) offering psychoeducation and stress management skills building for caregivers of patients receiving RT for HNC. METHODS Caregivers were randomized to Prepare to Care or standard of care. Primary feasibility measures included participation and retention percentages. Assessments were completed before the intervention, at intervention completion, and 6-weeks later after intervention completion. RESULTS Caregivers (N = 38) were predominantly female (88.6%), an average age of 56 years old, and a spouse/partner to the patient (71.4%). Participation percent was 42.2%; retention at intervention conclusion was 80% and 77% at the 6-week follow-up. Quantitative and qualitative results support acceptability, with 64% to 88% reporting each intervention module was helpful (quite a bit or very). Intervention caregivers reported a significantly greater improvement in self-efficacy for progressive muscle relaxation (PMR). CONCLUSIONS Prepare to Care and the randomized pilot trial methods are feasible and acceptable for HNC caregivers of patients receiving RT. A significant treatment effect was observed for self-efficacy for PMR, and findings were in the expected direction regarding improved caregiving self-efficacy. Further research is necessary to determine the efficacy of this intervention with a focus on increased engagement strategies and longer-term outcomes. TRIAL REGISTRATION NCT03032250.
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Affiliation(s)
| | | | | | | | | | - Bart Frizzell
- Wake Forest School of Medicine,
Winston-Salem, NC, USA
| | | | - Anna Snavely
- Wake Forest School of Medicine,
Winston-Salem, NC, USA
| | | | - Sandra Norona
- Wake Forest School of Medicine,
Winston-Salem, NC, USA
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Park J, Ross A, Klagholz SD, Bevans MF. The Role of Biomarkers in Research on Caregivers for Cancer Patients: A Scoping Review. Biol Res Nurs 2017; 20:300-311. [PMID: 29130313 DOI: 10.1177/1099800417740970] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Biomarkers can be used as prognostic, predictive, or monitoring indicators of an associated outcome. The purpose of this review was to provide a comprehensive summary of the research examining the use of biomarkers as surrogate end points for clinical outcomes in family caregivers for cancer patients, identify gaps, and make recommendations for future research. METHODS A scoping review, a process of mapping the existing literature, was conducted. Studies comparing biomarkers across caregivers and controls and/or examining relationships between biomarkers and psychological health were reviewed. RESULTS The studies ( N = 18) of caregivers for cancer patients who were identified used biomarkers to predict outcomes ( n = 13) and to monitor the efficacy of interventions ( n = 6). Biomarkers were divided into two categories based on physiological systems involved: (1) neuroendocrine function (sympathetic-adrenal-medullary axis activity, hypothalamic-pituitary-adrenal axis activity) and (2) immune function. Predictive biomarkers were sensitive to differences between caregivers and controls. The biomarkers were used to evaluate outcomes frequently associated with stress, depression, and anxiety. Cortisol was the biomarker most commonly measured to monitor the efficacy of interventions. DISCUSSION Biomarkers are most commonly incorporated into caregiver studies to predict group membership and psychological health. Neuroendocrine biomarkers, specifically cortisol, are most frequently assessed. Future research should include biomarkers of other physiologic functions (e.g., cardiovascular function, cognitive dysfunction, and cell aging) and those that serve as multisystem indicators. Expanding the scientific study of biomarkers will contribute to our understanding of the mechanisms through which stress may influence caregiver health.
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Affiliation(s)
- Jumin Park
- 1 National Institutes of Health Clinical Center, Bethesda, MD, USA
| | - Alyson Ross
- 1 National Institutes of Health Clinical Center, Bethesda, MD, USA
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