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Pan X, Yang Y, Chen X, Huang W, Ye J, Huang Y, Li Y. Coping with family function changes: A qualitative study of couples facing advanced lung cancer. Asia Pac J Oncol Nurs 2024; 11:100504. [PMID: 39006320 PMCID: PMC11245901 DOI: 10.1016/j.apjon.2024.100504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 04/29/2024] [Indexed: 07/16/2024] Open
Abstract
Objective This study aimed to explore the experiences of couples with advanced lung cancer in coping with changes in their family functioning. Methods This study included patients with advanced lung disease and their spouses who were hospitalized in a tertiary hospital in Shanghai, China. Data were collected through interviews that focused on three key areas: (1) patient coping, (2) spousal coping, and (3) dyadic coping. Semi-structured qualitative interviews were conducted in Chinese and analyzed using Braun-Clarke thematic analysis. Results A total of 15 couples participated in the study (12 male and 3 female patients). The average age of the patients was 63.73 years, and that of their partners was 63.20 years. Marriage duration ranged from 25 to 53 years. Three distinct themes emerged from the data: individual patient coping was expressed in four areas: struggle, acceptance of reality, cherishing the present and regaining hope, and rebuilding family life; spousal coping was expressed in three areas: acceptance and understanding of the patient, providing active support, and adjusting roles and sharing of family responsibilities; and dyadic coping was expressed in three areas: cognitive consistency of changes in family functioning, stress communication, and family adjustment and adaptation based on shared cognition. A relationship diagram of patients with advanced lung cancer and their spouses in coping with post-cancer changes in family functioning was constructed. Conclusions Post-cancer coping with changes in family functioning in couples with advanced lung cancer is a continuous developmental and gradual evolutionary process, and there is a close relationship between the two that influences each other. Early assistance for couples to form consistent cognition and communicate effectively with the stress caused by the disease can help improve the family functioning of both partners and, in turn, improve the quality of life of patients. Therefore, it is recommended that clinicians conduct family- or couple-centered intervention studies aimed at improving the post-cancer quality of life of patients with advanced lung cancer.
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Affiliation(s)
- Xiaoting Pan
- School of Medicine, Tongji University, Shanghai, China
| | - Yingzi Yang
- School of Medicine, Tongji University, Shanghai, China
- Department of Nursing, Shanghai Health and Medical Center, Wuxi, China
| | - Xinxin Chen
- Department of Nursing, Shanghai Pulmonary Hospital, Shanghai, China
| | - Weichao Huang
- Department of Nursing, Shanghai Pulmonary Hospital, Shanghai, China
| | - Junyan Ye
- Department of Nursing, Shanghai Pulmonary Hospital, Shanghai, China
| | - Ying Huang
- Department of Nursing, Shanghai Pulmonary Hospital, Shanghai, China
| | - Yumei Li
- Department of Nursing, Shanghai Pulmonary Hospital, Shanghai, China
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Thomson MD, Wilson-Genderson M, Siminoff LA. Cancer patient and caregiver communication about economic concerns and the effect on patient and caregiver partners' perceptions of family functioning. J Cancer Surviv 2024; 18:941-949. [PMID: 36808388 PMCID: PMC10445289 DOI: 10.1007/s11764-023-01341-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 01/21/2023] [Indexed: 02/23/2023]
Abstract
PURPOSE Financial strain and stressful life events can constrain open communication within families. A cancer diagnosis can bring heightened emotional stress and financial strain for most cancer patients and their families. We evaluated how level of comfort and willingness to discuss important but sensitive economic topics affected longitudinal assessments of family relationships, exploring both within-person and between partner effects over 2 years after a cancer diagnosis. METHODS A case series of hematological cancer patient-caregiver dyads (n = 171) were recruited from oncology clinics in Virginia and Pennsylvania and followed for 2 years. Multi-level models were developed to examine the associations between comfort discussing economic aspects of cancer care and family functioning. RESULTS Broadly, caregivers and patients who were comfortable discussing economic topics reported higher family cohesion and lower family conflict. Dyads' assessments of family functioning were influenced both by their own and their partners level of communication comfort. Overtime, caregiver but not patients perceived a significant decrease in family cohesion. CONCLUSIONS Efforts to address financial toxicity in cancer care should include examination of how patients and families communicate as unaddressed difficulties can have detrimental effects on family functioning in the long term. Future studies should also examine whether the prominence of specific economic topics, such as employment status, varies depending on where the patient is in their cancer journey. IMPLICATIONS FOR CANCER SURVIVORS In this sample, cancer patients did not perceive the decline in family cohesion that was reported by their family caregiver. This is an important finding for future work that aims to identify the timing and nature to best intervene with caregiver supports to mitigate caregiver burden that may negatively impact long-term patient care and QoL.
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Affiliation(s)
- Maria D Thomson
- Department of Health Behavior and Policy, School of Medicine, Virginia Commonwealth University/Massey Cancer Center, Richmond, VA, USA.
| | - Maureen Wilson-Genderson
- College of Public Health, Social and Behavioral Sciences, Temple University, Suite 370, 1101 W. Montgomery Ave. Philadelphia, Bell Building, PA, 19122, USA
| | - Laura A Siminoff
- College of Public Health, Social and Behavioral Sciences, Temple University, Suite 370, 1101 W. Montgomery Ave. Philadelphia, Bell Building, PA, 19122, USA
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Shao M, Wang X, Zhang M, Ding Y, Ma B, Yang Y, Yu L, Chen C, Wang T. Caregiver burden, mutuality, and family resilience in colorectal cancer caring: A mediating model analysis. Eur J Oncol Nurs 2024; 68:102480. [PMID: 38101244 DOI: 10.1016/j.ejon.2023.102480] [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: 10/14/2023] [Revised: 11/15/2023] [Accepted: 11/18/2023] [Indexed: 12/17/2023]
Abstract
PURPOSE This study investigates the interaction between caregiver burden, mutuality, and family resilience in colorectal cancer management, and determines whether mutuality affects the effect of caregiver burden on family resilience. METHOD In this cross-sectional study, 295 family caregivers of colorectal cancer patients from two major public hospitals (Henan Province, China) were analyzed. Caregiver burden, mutuality, and family resilience were assessed through Chinese versions of the Zarit Burden Interview (ZBI-C), the mutuality Scale (MS-C), and the Family Resilience Questionnaire (FaREQ-C). The structural equation model and multiple mediating effect test were applied to explore the interaction between caregiver burden, mutuality, and family resilience. RESULTS Total and subscale scores of caregiver burden were negatively correlated with both mutuality (r = -0.54 to -0.32, P < 0.01) and family resilience (r = -0.60 to -0.26, P < 0.01). Family resilience and its four dimensions were positively correlated with mutuality (r = 0.17 to 0.51, P < 0.01). Mutuality served as a partial mediator between caregiver burden and family resilience. Caregiver burden had an indirect effect on family resilience through mutuality (β = -0.157, 95%CI: -0.316, -0.046, P = 0.009). CONCLUSIONS This study examined the interaction between caregiver burden, mutuality, and family resilience for colorectal cancer caring and confirmed the mediating role of mutuality in caregiver burden and family resilience. Therefore, we suggested that clinicians should develop strategies to improve the relationship between patients and caregivers so that both parties can actively manage stress and trauma experiences for improved colorectal cancer management.
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Affiliation(s)
- Mengwei Shao
- The College of Nursing and Health of Zhengzhou University, Zhengzhou, 450001, China.
| | - Xin Wang
- The College of Nursing and Health of Zhengzhou University, Zhengzhou, 450001, China.
| | - Menghan Zhang
- The College of Nursing and Health of Zhengzhou University, Zhengzhou, 450001, China
| | - Yangqing Ding
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Bin Ma
- School of Medical, Molecular and Forensic Sciences, Murdoch University, 6149, Australia
| | - Yi Yang
- The College of Nursing and Health of Zhengzhou University, Zhengzhou, 450001, China
| | - Lulu Yu
- The College of Nursing and Health of Zhengzhou University, Zhengzhou, 450001, China
| | - Changying Chen
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.
| | - Tao Wang
- The College of Nursing and Health of Zhengzhou University, Zhengzhou, 450001, China; Telethon Kids Institute, Perth, WA, 6872, Australia; Medical School, University of Western Australia, Perth, WA, 6872, Australia; People' s Hospital of Hebi, Hebi, 458010, China.
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Yang Y, Liu L, Chen J, Gan Y, Su C, Zhang H, Long E, Yan F, Chen Y. Does caring for patients with advanced non-small cell lung cancer affect health-related quality of life of caregivers? A multicenter, cross-sectional study. BMC Public Health 2024; 24:224. [PMID: 38238722 PMCID: PMC10797883 DOI: 10.1186/s12889-024-17669-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 01/04/2024] [Indexed: 01/22/2024] Open
Abstract
PURPOSE Patients with advanced non-small cell lung cancer (NSCLC) mostly receive essential routine care and support from informal caregivers, who usually experience poorer health-related quality of life (HRQoL). The study aimed to evaluate the HRQoL and its predictors among informal caregivers of patients with advanced NSCLC in China. METHODS We interviewed the adult caregiver population of patients with advanced NSCLC (stage IIIB~IV) in nine tertiary hospitals from multiple provinces in China between November 2020 and June 2021. The EQ-5D-5L instrument measured the HRQoL of caregivers, as analyzed by employing descriptive analysis, univariate analysis, Tobit regression, and multivariate logistic regression, and investigated the important influencing factors further. RESULTS A valid sample of 553 caregivers was analyzed. The mean EQ-5D-5L utility score of caregivers was 0.92 (SD = 0.14). Caregivers reported the greatest problems in mental health, with 45.39% reporting slight, moderate, severe, or extreme anxiety/depression. The potential influencing factors of HRQoL in caregivers included patients' age and cancer histology, relationship with the patients, and daily caregiving hours. Compared to other caregivers, patients' spouses had the lowest HRQoL. In addition, over six hours of caregiving per day was associated with lower HRQoL in caregivers of patients with advanced NSCLC. CONCLUSIONS The HRQoL of caregivers for patients with advanced NSCLC was investigated for the first time in China. The informal caregivers experience decreased HRQoL, with anxiety /depression problems being reported the most. The findings of this study would provide extensive information on the HRQoL of advanced NSCLC patients' caregivers for future health-promoting self-care.
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Affiliation(s)
- Yi Yang
- School of Public Health, Fudan University, Shanghai, China
- National Health Commission Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Liu Liu
- School of Public Health, Fudan University, Shanghai, China
- National Health Commission Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Jia Chen
- Department of Medical Oncology, The Affiliated Tumor Hospital of Nantong University &Nantong Tumor Hospital, Nantong, China
| | - Yuying Gan
- Department of Respiratory Medicine, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Chunxia Su
- Department of Medical Oncology, Shanghai Pulmonary Hospital & Thoracic Cancer Institute, Tongji University School of Medicine, Shanghai, China
| | - Haibo Zhang
- Department of Organization and Personnel, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Enwu Long
- Department of Pharmacy, Sichuan Academy of Medical Sciences/Sichuan Provincial People's Hospital, Sichuan, China
| | - Fei Yan
- Department of Oncology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Yingyao Chen
- School of Public Health, Fudan University, Shanghai, China.
- National Health Commission Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China.
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Belapurkar P, Acharya S, Shukla S, Kumar S, Khurana K, Acharya N. Prevalence of Anxiety, Depression, and Perceived Stress Among Family Caregivers of Patients Diagnosed With Oral Cancer in a Tertiary Care Hospital in Central India: A Cross-Sectional Study. Cureus 2023; 15:e47100. [PMID: 38021994 PMCID: PMC10646617 DOI: 10.7759/cureus.47100] [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: 09/18/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Background and objectives Oral cancer is a significant health issue in India, with one of the highest incidence rates globally. Family caregivers play a crucial role in the care of oral cancer patients, but their mental health often faces challenges. This study aimed to assess the prevalence of anxiety, depression, and perceived stress among family caregivers of oral cancer patients in a tertiary care hospital in central India and explore the associated psychosocial factors. Population and method The study was carried out between March 2023 and August 2023 in a tertiary care hospital in Wardha, Maharashtra. Family caregivers (N=82, mean age = 36.1 (SD 10.5) years) of patients with clinically diagnosed oral cancer were subjected first to structured psychiatric clinical interviews to screen for psychiatric diagnoses and then were given self-reporting questionnaires for socio-demographic data, Beck Depression Inventory (BDI-II) for measuring the emotional, cognitive, and motivational symptoms of depression, Manifest Anxiety Scale (MAS) to assess the degree of anxiety and Perceived Stress Scale-10 (PSS-10) to assess stress level. Data was analysed using IBM SPSS Statistics for Windows, Version 26.0 (Released 2019; IBM Corp., Armonk, New York, United States). Chi-square test and logistic regression analyses were conducted wherever appropriate in order to explore predictive factors of depressive, anxious, or stress symptoms. Result In the studied population, the majority experienced symptoms of depression (65.1%), anxiety (69.5%), and perceived stress (74.7%). Caregivers of patients with advanced oral cancer were found to have a higher likelihood of experiencing depression (χ2 (1) = 16.76, p < .001) and anxiety related to unemployment (χ2 (1) = 10.12, p = .001) or insufficient earnings (χ2 (1) = 28.63, p < .001). Additionally, participants with no or little formal education (χ2 (1) = 4.63, p = 0.031) and lower income (χ2 (1) = 28.63, p < .0001) were significantly more likely to experience distress compared to those with higher levels of education. Conclusion This study highlights the need for comprehensive support systems for family caregivers of oral cancer patients. Educational programs, financial assistance, and mental health services should be tailored to caregivers' specific needs. Early identification and intervention strategies can help mitigate the psychological impact of caregiving. Further research is essential to develop targeted interventions that enhance the well-being of caregivers and improve the quality of life for both patients and caregivers.
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Affiliation(s)
- Parth Belapurkar
- Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND
| | - Sourya Acharya
- Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND
| | - Samarth Shukla
- Department of Pathology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND
| | - Sunil Kumar
- Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND
| | - Kashish Khurana
- Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND
| | - Neema Acharya
- Department of Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND
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Zhou T, Qu J, Sun H, Xue M, Liu Y. Relationship between mutuality and depression in patients with chronic heart failure and caregivers in China: An actor-partner interdependence model analysis. Front Psychol 2022; 13:928311. [PMID: 36160581 PMCID: PMC9493196 DOI: 10.3389/fpsyg.2022.928311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 08/12/2022] [Indexed: 11/13/2022] Open
Abstract
Background Patients with chronic heart failure and their family caregivers may experience adverse emotional problems, such as depression. Mutuality, which refers to the relationship between caregivers and those they care for, is an important factor affecting depression in the dyads. The purpose of this study was to investigate the relationship between mutuality and depression in patients with CHF and their caregivers in China. Methods In this cross-sectional study, we used the Mutuality Scale and the Self-Rating Depression Scale to measure mutuality and depression of patients and caregivers. We used SPSS version 26.0 and AMOS version 21.0 to analyze the data. An APIM was established to analyze the actor-partner effects of patient-caregiver mutuality and depression. Results A total of 250 dyads of patients and caregivers were included in the study. There were statistically significant differences in mutuality and depression between CHF patients and caregivers. The 4 dimensions of patients' mutuality all have the actor effect on depression. There were 3 partner effects of caregivers' "pleasurable activities", "shared values", and "reciprocity" on depression. Regarding caregiver depression, we only found an actor effect of caregivers' "shared values" on depression. Conclusion The relationship between patients and caregivers should be evaluated in the clinical setting, and it is very important to develop intervention measures to improve the adverse emotional problems affecting both patients and their caregivers.
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Affiliation(s)
| | | | | | | | - Yongbing Liu
- School of Nursing, Yangzhou University, Yangzhou, China
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