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Gutiérrez-Sánchez B, Orgeta V, López-Martínez C, del-Pino-Casado R. Association between Social Support and Depressive Symptoms in Informal Caregivers of Adult and Older Dependents: A Systematic Review and Meta-Analysis. J Clin Med 2023; 12:6468. [PMID: 37892607 PMCID: PMC10607501 DOI: 10.3390/jcm12206468] [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: 09/18/2023] [Accepted: 10/08/2023] [Indexed: 10/29/2023] Open
Abstract
Social support is an important determinant of a carer's mental health. In recent decades, despite many studies reporting on the relationship between social support and depressive symptoms in informal caregivers of adult and older dependents, there are no systematic reviews synthesizing the available evidence. The purpose of the present study was to perform a systematic review and meta-analysis on the relationship between social support and depressive symptoms in informal caregivers of adults and older dependent people. We searched PubMed, CINAHL (EBSCO), PsycINFO (ProQuest), and Scopus, up to 15 January 2023 for studies. We applied no date or language limits to our search. A random-effects model was used to pool effect estimates. The included studies were also independently assessed for quality. Publication bias was evaluated by funnel plots, Egger's regression test, and the Trim and Fill method. Ninety-three studies were included in the review, reporting on a total of 15,431 informal caregivers. We found a moderate negative association between perceived social support and caregiver depressive symptoms (78 studies; r = -0.35, 95% CI = -0.39, -0.31; low heterogeneity and low risk of publications bias) and a small negative association between received social support and caregiver self-reported depressive symptoms (12 studies; r = -0.14, 95% CI = -0.20, -0.07; low heterogeneity and low risk of publications bias). Our results indicate that social support is a clinically relevant construct for carer well-being and an important protective factor for depressive symptoms in informal caregivers of adult and older dependents.
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Affiliation(s)
- Belén Gutiérrez-Sánchez
- Department of Nursing, Faculty of Health Sciences, University of Jaén, 23700 Jaén, Spain; (B.G.-S.); (R.d.-P.-C.)
| | - Vasiliki Orgeta
- Division of Psychiatry, University College London, London W1T 7BN, UK;
| | - Catalina López-Martínez
- Department of Nursing, Faculty of Health Sciences, University of Jaén, 23700 Jaén, Spain; (B.G.-S.); (R.d.-P.-C.)
| | - Rafael del-Pino-Casado
- Department of Nursing, Faculty of Health Sciences, University of Jaén, 23700 Jaén, Spain; (B.G.-S.); (R.d.-P.-C.)
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Muhamed AN, Chekole B, Tafesse FE, Dessie G, Bantie B, Habtu BF, Shemsu AM. Quality of Life among Ethiopian Cancer Patients: A Systematic Review of Literatures. SAGE Open Nurs 2023; 9:23779608231202691. [PMID: 37808099 PMCID: PMC10559689 DOI: 10.1177/23779608231202691] [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: 07/27/2022] [Accepted: 09/05/2023] [Indexed: 10/10/2023] Open
Abstract
Background Assessment of quality of life (QoL) in cancer patients can provide an overall picture of the patient's adaptation to the disease and maintain long-term health and well-being. Determining the QoL in cancer patients could help with better care and could be as prognostic as medical factors and the survival benefit that pharmacological treatment could provide. The main objective of this review was to determine the prevalence of QoL among Ethiopian adult cancer patients. Methods A systematic review was conducted using the "Preferred Reporting Results of Systematic Reviews and Meta-Analyses" guidelines. Databases such as PubMed/Medline, CINAHL, AMED, Embase, the Cochrane Library, ScienceDirect, World Health Organization's Hinari portal, and African Journals Online databases were searched from January 2022 to June 2022. Google, Google Scholar, and university repositories were used to access unpublished studies. Two reviewers independently screened the data using a standardized data extraction format and appraised their quality using the Newcastle-Ottawa Scale. Results In this review, 10 studies were included. The prevalence of poor QoL ranged from 52 to 89.6. The physical, role, social, and emotional functioning were the most affected domains of QoL and have been significantly associated with QoL. Financial difficulty was the most important predictor of QoL among Ethiopian cancer patients. Pain, dyspnea, nausea, vomiting, and poor appetite were also reported as predictors of QoL. Low income, lower educational status, unmarried status, underweight, anxiety, and depression, advanced stage of cancer, patients with ≤2 cycles of chemotherapy, and the presence of comorbid diseases were significantly correlated with QoL. Conclusions The QoL of an Ethiopian cancer patient was low. Quality of life assessments, appropriate symptom management, integration of psycho-oncology care, and providing economic support shall be considered to improve their QoL.
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Affiliation(s)
- Ahmed Nuru Muhamed
- Department of Nursing, College of Medicine and Health Sciences, Wolkite University, Wolkite, SNNPR, Ethiopia
| | - Bogale Chekole
- Department of Nursing, College of Medicine and Health Sciences, Wolkite University, Wolkite, SNNPR, Ethiopia
| | | | - Getnet Dessie
- Department of Adult Health Nursing, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
- Australia National University, Center for Epidemiology and Population Health, Canberra, Australia
| | - Berihun Bantie
- Department of Adult Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, North West Ethiopia
| | - Bisrat Fikadu Habtu
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wolkite, SNNPR, Ethiopia
| | - Abdumejid Mustefa Shemsu
- Department of Public Health, College of Medicine and Health Sciences, Werabe University, Werabe, South West Ethiopia
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Muhamed AN, Bogale SK, Netere HB. Quality of Life and Associated Factors Among Adult Cancer Patients Undergoing Chemotherapy Treatment at Amhara National, Regional State, Ethiopia, 2021. SAGE Open Nurs 2023; 9:23779608231174866. [PMID: 37223221 PMCID: PMC10201175 DOI: 10.1177/23779608231174866] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 12/13/2022] [Accepted: 04/23/2023] [Indexed: 05/25/2023] Open
Abstract
Background In cancer, quality of life (QoL) is an important patient-reported metric; evaluating how patients feel physically and emotionally while fighting the disease could lead to better treatment. Despite its therapeutic effects, chemotherapy treatment causes a plethora of side effects that can affect QoL. Factors affecting the QoL of cancer patients undergoing chemotherapy treatment in Ethiopia have not been thoroughly investigated. As a result, this study assesses QoL and associated characteristics among adult cancer patients receiving chemotherapy at Amhara Region, Ethiopia in 2021. Martials and Methods From February 15 to May 15, 2021, an institutional based cross-sectional study was done in Amhara region. Three hundred fourteen patients were included in the study. The data was gathered using Amharic version of European organization for research and treatment of cancer quality of life questionnaire (EORTC QLQ C-30) through a face-to-face interview. Epi Data 4.6 was used to enter the data, which was then exported to SPSS version 23 for statistical analysis. Multivariable logistic regression analysis was used to determine the relationship between independent and dependent variables. The statistical significance was determined by a p-value of less than .05. Result Cancer patients in Amhara Region had a 44.32 average QoL. Emotional functioning AOR 1.01 (1.0-1.04), social functioning AOR 1.02 (1.01-1.03), nausea and vomiting AOR 0.95 (0.93-0.98), pain AOR 0.95 (0.93-0.98), financial difficulty 0.97 (0.95-0.99), education AOR 4.3 (1.49-12.32), underweight AOR 0.45 (0.24-0.84), > 5th cycle of chemotherapy AOR 4 (1.78-9.11), stage IV cancer AOR 0.21 (0.06-0.71), comorbidity AOR 0.28 (0.14-0.57), anxiety AOR 0.32 (0.12-0.84), and depression AOR 0.29 (0.13-0.63) were all significantly associated with QoL in multivariable logistic regression. Conclusion Adult cancer patients receiving chemotherapy in the Amhara region had a poor QoL. Emotional functioning, social functioning, nausea and vomiting, pain, financial difficulty, education, body mass index, cancer stage, chemotherapy cycle, comorbidity, anxiety, and depression all had association with QoL. To improve the QoL of cancer patients, QoL assessments, proper symptom management, nutritional support, and integration of psycho-oncology treatment should be considered.
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Affiliation(s)
- Ahmed Nuru Muhamed
- Department of Nursing, College of
Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Sitotaw Kerie Bogale
- Department of Nursing, College of
Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Henok Biresaw Netere
- Department of Nursing, College of
Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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Buertey AA. The professed effect of stigma on community psychiatric nurses in the Greater Accra region of Ghana. BMC Psychiatry 2022; 22:456. [PMID: 35799165 PMCID: PMC9264652 DOI: 10.1186/s12888-022-04089-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 06/17/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Stigma is a major factor that inhibits Mental Health Nurses work, especially Community Psychiatric Nurses, in terms of productivity. Even though mental health services have improved drastically, because of decentralization of mental health care, a lot more people still have reservations when it comes to mental health nurses particularly Community Psychiatric Nurses. The purpose of the study was to explore the professed effects of stigma on CPNs in the Southern part of Ghana. METHODS The study was carried out in three district hospitals (Ga South, Ga Central and Okaikoi) all in the Accra Metropolis. The aim of the study was to describe how stigma affects Community Psychiatric Nurses. A qualitative descriptive exploratory design was adopted for the study. The purposive sampling technique was used to recruit participants. Data was saturated with 12 participants, aged between 25 and 40 years. The audio-taped interviews were transcribed verbatim and afterwards analyzed using thematic and content analysis. RESULTS The findings gathered from participants revealed that Community Psychiatric Nurses experienced various effects of stigma, such as low productivity, depression, and anger. Most of the participants recounted how stigmatization had affected their work both in the hospital setting and in their communities. CONCLUSION The study showed that Community Psychiatric Nurses carried out their activities with much difficulty, because of their poor image. They stressed the need for recognition and support from employers, stakeholders and the general community so as to boost confidence and morale with the resultant effect of better healthcare delivery.
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Affiliation(s)
- Abigail Ansere Buertey
- Department of Mental Health, School of Nursing and Midwifery, University of Ghana, Legon, Accra, Ghana. .,School of Nursing, College of Health Sciences, University of Ghana, P.O. Box LG 43, Legon, Accra, Ghana.
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Çamlıca T, Koç Z. Loneliness, Social Support Level, Quality of Life and Symptom Management Among Turkish Oncology Patients. OMEGA-JOURNAL OF DEATH AND DYING 2022:302228221086057. [PMID: 35482974 DOI: 10.1177/00302228221086057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This cross-sectional and correlational study was performed in order to determine the relationships between the perceived loneliness and social support levels of Turkish oncology patients, as well as their quality of life and symptom management. A total of 370 oncology inpatients participated in this study. Data were collected using, the FACT-G Quality of Life Scale, the Multi-Dimensional Scale of Perceived Social Support (MSPSS), the UCLA-Loneliness Scale (UCLA-LS), and the Edmonton Symptom Assessment Scale. A negative advanced significant relationship was found between the MSPSS total scores (r = -0.754, p < 0.01) and the UCLA-LS total scores. As the social support levels of the patients increased, their loneliness levels were seen to decrease and their quality of life was seen to increase. The patients were found to experience the symptoms of fatigue, worry, and feeling unwell more often as their loneliness levels increased and social support levels decreased.
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Affiliation(s)
- Tuğçe Çamlıca
- 52994Süleyman Demirel University Health Research and Application Center, Isparta, Turkey
| | - Zeliha Koç
- Health Science Faculty, 37139Ondokuz Mayıs University, Samsun, Turkey
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Kutluk T, Ahmed F, Cemaloğlu M, Aydın B, Şengelen M, Kirazli M, Yurduşen S, Sullivan R, Harding R. Progress in palliative care for cancer in Turkey: a review of the literature. Ecancermedicalscience 2021; 15:1321. [PMID: 35047072 PMCID: PMC8723752 DOI: 10.3332/ecancer.2021.1321] [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: 10/09/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The demographic transition in Turkey is shifting the burden of diseases towards non-communicable diseases including cancer. Palliative care (PC) as a component of Universal Health Coverage assures patient and family-centred care provision throughout the spectrum of cancer. OBJECTIVES This study aimed to make a detailed evaluation of the progress achieved since the mid-90s and the current situation of cancer PC in Turkey. METHODS A literature review was conducted in PubMed, Scopus, Embase, ScienceDirect, Web of Science, Google Scholar, The Turkish Academic Network and Information Centre databases, Ministry of Health documents, Council of Higher Education's thesis 01/1995 to 07/2020. The information was categorised into the six domains: history of the cancer PC; law and regulations; education and research; opioid use; patient care and palliative centres; public awareness, psychosocial support and end of life ethics. RESULTS Of 27,489 studies, 331 met the inclusion criteria. The majority were published in the Turkish language and were journal articles. The findings showed that the development of PC in Turkey can be divided into three stages: early initiatives before 2000, the dissemination stage, 2000-2010 and the advanced stage after 2010. There is evidence of progress in terms of legal regulations, opioid use and number of PC services and research output. However, there is still a need for improvement in professional education, public awareness and end of life care. CONCLUSION There is evidence of progress, barriers and opportunities. However, bringing research into practice is needed for scale-up and integration of PC in cancer care in Turkey.
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Affiliation(s)
- Tezer Kutluk
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine and Cancer Institute, 06100 Ankara, Turkey
| | - Fahad Ahmed
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine and Cancer Institute, 06100 Ankara, Turkey
| | - Mustafa Cemaloğlu
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine and Cancer Institute, 06100 Ankara, Turkey
| | - Burça Aydın
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine and Cancer Institute, 06100 Ankara, Turkey
| | - Meltem Şengelen
- Department of Public Health, Hacettepe University Faculty of Medicine, 06100 Ankara, Turkey
| | - Meral Kirazli
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine and Cancer Institute, 06100 Ankara, Turkey
| | - Sema Yurduşen
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine and Cancer Institute, 06100 Ankara, Turkey
| | - Richard Sullivan
- King’s College London, Institute of Cancer Policy, Conflict & Health Research Group, London, UK
| | - Richard Harding
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Cicely Saunders Institute, King’s College London, London, UK
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7
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Zhang B, Lv X, Qiao M, Liu D. The Full Mediating Role of Loneliness on the Relationship Between Social Support and Depression Among Rural Family Caregivers of Persons With Severe Mental Illness. Front Public Health 2021; 9:729147. [PMID: 34778172 PMCID: PMC8580924 DOI: 10.3389/fpubh.2021.729147] [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: 06/22/2021] [Accepted: 09/30/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: Depression is a common and overwhelming psychiatric disorder among family caregivers of persons with severe mental illness (SMI). The interrelationships among social support, loneliness, and depression, especially among this relatively vulnerable group, are poorly understood. The aim of the present study was to test the hypothesis that the social support contributes to the alleviation of depression, through its effect on reducing loneliness. Methods: A survey of 256 rural family caregivers of persons with SMI was conducted between December 2017 and May 2018 in Chengdu City, Sichuan Province, China. Social support, loneliness and depression were measured. A series of multiple linear regression models and bootstrapping procedure were performed to examine the mediating effects of loneliness on the association between social support as well as its components and depression. Results: The proportion of family caregivers of persons with SMI who reported significant depressive symptoms was 53.5%. Loneliness fully mediated the negative association between social support and depression. As to three components of social support, subjective support and objective support only had indirect associations with depression mediated by loneliness, while support utilization had both direct and indirect relationships with depression. Conclusion: The current study highlighted that social support and its three components may acted as protective factors by decreasing the feelings of loneliness, which created a beneficial effect on depression among family caregivers of persons with SMI.
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Affiliation(s)
- Baiyang Zhang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xin Lv
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Mutian Qiao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Danping Liu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
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Abstract
OBJECTIVE Providing care to a loved one with cancer places demands on caregivers that result in changes to their daily routines and disruptions to their social relationships that then contribute to loneliness. Though caregivers' psychosocial challenges have been well studied, loneliness - a determinant of health - has not been well studied in this population. This narrative review sought to describe the current evidence on loneliness among caregivers of cancer patients. We aimed to (1) define loneliness, (2) describe its prevalence, (3) describe the association between loneliness and health outcomes, (4) describe risks and consequences of loneliness among cancer caregivers, (5) identify ways to assess loneliness, and (6) recommend strategies to mitigate loneliness in this unique population. METHOD We used evidence from articles listed in PubMed, PsycINFO, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases, book chapters, and reports. Articles were reviewed for the following inclusion criteria: (1) published in English, (2) caregivers of cancer patients, (3) loneliness as a study variable, and (4) peer-reviewed with no restriction on the timeframe of publication. Caregivers were defined as relatives, friends, or partners who provide most of the care and support for someone with cancer. RESULTS Eighteen studies met inclusion criteria and were included in the analysis. Caregivers' experiences of loneliness can contribute to negative effects on one's social, emotional, and physical well-being. Social support interventions may not be sufficient to address this problem. Existing recommendations to mitigate loneliness include cognitive and psychological reframing, one-on-one and group therapy, befriending, resilience training, and technology-based interventions. SIGNIFICANCE OF RESULTS Limited attention to loneliness in cancer caregivers poses a twofold problem that impacts patient and caregiver outcomes. Interventions are critically needed to address loneliness as a determinant of health in caregivers, given their pivotal role in providing care and impacting health outcomes for people with cancer.
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Gallagher S, Bennett KM, Roper L. Loneliness and depression in patients with cancer during COVID-19. J Psychosoc Oncol 2020; 39:445-451. [PMID: 33274697 DOI: 10.1080/07347332.2020.1853653] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE Feelings of loneliness are likely to exacerbate risk of depression in people living with cancer during COVID-19. DESIGN AND METHODS Five hundred and eighteen people with cancer with data extracted from two waves (2017-19 and April 2020) of the Understanding Society UK dataset participated. FINDINGS An increased risk of depression was observed for cancer of the breast, prostate, blood, but not other cancers (e.g., lung, melanoma). After controlling for prior depression and other factors, it was loneliness during COVID-19, and not previous loneliness, that was predictive. Those currently lonely had a 4.5-fold increased risk of depression. These findings demonstrate that people living with cancer are at increased risk of developing depression during COVID-19, and that feelings of isolation help explain this risk. IMPLICATIONS These particular findings have implications for health promotion and intervention work and how best to support people who may feel lonely in this vulnerable group.
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Affiliation(s)
- Stephen Gallagher
- Department of Psychology, Centre for Social Issues Research, Study of Anxiety, Stress and Health Laboratory, University of Limerick, Limerick, Ireland.,Health Research Institute, University of Limerick, Castletroy, Limerick, Ireland
| | | | - Louise Roper
- Department of Psychology, University of Liverpool, Liverpool, UK
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10
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Dahill A, Al-Nakishbandi H, Cunningham K, Humphris G, Lowe D, Rogers S. Loneliness and quality of life after head and neck cancer. Br J Oral Maxillofac Surg 2020; 58:959-965. [DOI: 10.1016/j.bjoms.2020.04.041] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Accepted: 04/28/2020] [Indexed: 02/09/2023]
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Ross A, Perez A, Wehrlen L, Lee LJ, Yang L, Cox R, Bevans M, Ding A, Wiener L, Wallen GR. Factors influencing loneliness in cancer caregivers: A longitudinal study. Psychooncology 2020; 29:1794-1801. [PMID: 32672866 DOI: 10.1002/pon.5477] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 06/29/2020] [Accepted: 07/07/2020] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To describe levels of loneliness in cancer caregivers over a 6 month time period, and to examine factors that influence changes in loneliness in caregivers over time. METHODS Prospective, repeated measures design was utilized to examine levels of loneliness and factors that influence loneliness in 129 family caregivers of individuals undergoing cancer treatment at three time points over a 6 month period. Measures included: PROMIS global health and sleep disturbance; NIH Toolbox loneliness, self-efficacy and perceived stress; Family Care Inventory mutuality scale; and Caregiver Reaction Assessment. RESULTS Approximately one third (30.2%, n = 39) of the caregivers had high levels of loneliness, and levels of loneliness did not change over the three time points (P = .985). For any given time point, caregivers who were not married (P = .008), not working (P = .027), with worse mental health (P = .015), more perceived-stress (P < .0001), and more caregiver burden (P = .003) reported higher levels of loneliness. CONCLUSION This study provides guidance for clinicians attempting to identify at-risk caregivers by confirming the findings of previous research that caregivers with higher burden, stress and in poor mental health are at increased risk for loneliness. This study provides preliminary evidence that continuing to work during the caregiving trajectory may be beneficial to caregivers by reducing levels of loneliness. Future research is needed to confirm these findings and to examine novel interventions to reduce loneliness in cancer caregivers.
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Affiliation(s)
- Alyson Ross
- National Institutes of Health (NIH) Clinical Center, Bethesda, Maryland, USA
| | - Avery Perez
- Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania, USA
| | - Leslie Wehrlen
- National Institutes of Health (NIH) Clinical Center, Bethesda, Maryland, USA
| | - Lena J Lee
- National Institutes of Health (NIH) Clinical Center, Bethesda, Maryland, USA
| | - Li Yang
- National Institutes of Health (NIH) Clinical Center, Bethesda, Maryland, USA
| | - Robert Cox
- National Institutes of Health (NIH) Clinical Center, Bethesda, Maryland, USA
| | - Margaret Bevans
- National Institutes of Health (NIH) Clinical Center, Bethesda, Maryland, USA
| | - Alice Ding
- National Institutes of Health (NIH) Clinical Center, Bethesda, Maryland, USA
| | - Lori Wiener
- National Cancer Institute Center for Cancer Research Pediatric Oncology Branch, Bethesda, Maryland, USA
| | - Gwenyth R Wallen
- National Institutes of Health (NIH) Clinical Center, Bethesda, Maryland, USA
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Cao Q, Liu L. Loneliness and depression among Chinese drug users: Mediating effect of resilience and moderating effect of gender. JOURNAL OF COMMUNITY PSYCHOLOGY 2020; 48:414-425. [PMID: 31638727 DOI: 10.1002/jcop.22262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Accepted: 09/30/2019] [Indexed: 06/10/2023]
Abstract
This study aims to explore potential correlations between gender, loneliness, resilience, and depression simultaneously among Chinese drug users; and especially to investigate the mediating effect of resilience and the moderating effect of gender on the correlation between loneliness and depression. Participants of this study included 513 drug users (399 men and 114 women) who were under treatment in two compulsory drug treatment institutions in one Eastern Chinese city. All participants completed the UCLA (University of California, Los Angeles) loneliness scale, the Zung self-rating depression scale, and the Connor-Davidson resilience scale. A correlation matrix was constructed to analyze correlations between these three characteristics. Path analyses were performed in the PROCESS for SPSS in order to test the mediating effect of resilience on the association between loneliness and depression; while a series of hierarchical multiple regressions were conducted in SPSS 22.0 to test the moderating effect of gender on the association between loneliness and depression. Compared to male drug users, female ones reported higher average scores on loneliness and depression, which indicated that female drug users suffered severer loneliness and depression. Resilience partially mediates the link between loneliness and depression and gender acts as a moderator for the relationship between loneliness and depression.
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Affiliation(s)
- Qilong Cao
- Department of Finance, Business School, Changzhou University, Changzhou, China
| | - Liu Liu
- Department of Social Work and Social Policy, School of Social and Behavioral Sciences, Nanjing University, Nanjing, China
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14
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Leung YW, Maslej MM, Ho C, Razavi S, Uy P, Hosseini MA, Avery J, Rodin G, Peterkin A. Cocreating Meaning Through Expressive Writing and Reading for Cancer Caregivers. J Palliat Care 2019:825859719871538. [PMID: 31476955 DOI: 10.1177/0825859719871538] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Caregivers of patients with cancer cope with socioemotional challenges, which can adversely affect their well-being. We developed an intervention, expressive writing and reading (EWR), to promote emotional processing and social connectedness among caregivers. In a single-arm pilot study, we assessed its feasibility and perceived usefulness. METHODS Caregivers participated in weekly 1.5-hour EWR workshops offered over 20 weeks. After 4 sessions, they completed semistructured interviews, which were analyzed using qualitative descriptive analysis. FINDINGS Of 65 caregivers approached, 25 were eligible, 18 consented, and 9 (50%) caregivers completed at least 4 workshops and the interview. Their responses revealed 3 themes: "inner processing," "interpersonal learning," and "enhanced processing and preparedness." Perceived benefits of EWR included emotional and cognitive processing (individual and collaborative), learning from the emotions and experiences of other caregivers, and preparing for upcoming challenges. CONCLUSIONS Expressive writing and reading can be a safe and cost-effective supportive intervention for caregivers of patients with cancer.
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Affiliation(s)
- Yvonne W Leung
- 1 Department of Psychiatry, University of Toronto, Ontario, Canada.,2 Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Marta M Maslej
- 3 Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Clara Ho
- 2 Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,4 Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Shima Razavi
- 2 Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Paul Uy
- 1 Department of Psychiatry, University of Toronto, Ontario, Canada
| | | | - Jonathan Avery
- 2 Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Gary Rodin
- 1 Department of Psychiatry, University of Toronto, Ontario, Canada.,2 Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Allan Peterkin
- 1 Department of Psychiatry, University of Toronto, Ontario, Canada.,5 Department of Psychiatry, Mount Sinai Hospital, Toronto, Ontario, Canada
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Secinti E, Rand KL, Johns SA, O'Neil BH, Helft PR, Shahda S, Jalal SI, Mosher CE. Social correlates of mental health in gastrointestinal cancer patients and their family caregivers: Exploring the role of loneliness. Support Care Cancer 2018; 27:2077-2086. [PMID: 30225573 DOI: 10.1007/s00520-018-4467-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 09/10/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE The present study examined the degree to which loneliness mediated the influence of negative (social constraints) and positive (emotional support) relationship qualities on the global mental health of advanced gastrointestinal (GI) cancer patients and their family caregivers. METHODS Fifty patient-caregiver dyads completed measures assessing social constraints (e.g., avoidance, criticism) from the other dyad members, emotional support from others, loneliness, and global mental health. Structural equation modeling was used to examine individual models, and Actor-Partner Interdependence Mediation Modeling was used to examine dyadic associations. RESULTS Individual path analyses for patients and caregivers demonstrated that emotional support had a significant indirect effect on mental health through loneliness (Bs = 0.32 and 0.30, respectively), but no associations were found between social constraints and mental health. In dyadic analyses, participants' loneliness and mental health were not significantly related to their partner's emotional support, loneliness, or mental health (Bs = - 0.18 to 0.18). CONCLUSIONS Findings suggest that for advanced GI cancer patients and caregivers, emotional support from others alleviates feelings of loneliness, which may lead to better mental health. However, the benefits of emotional support appear to be primarily intrapersonal rather than interpersonal in nature. Additionally, participants endorsed low levels of social constraints, which might explain their lack of relation to loneliness and mental health. Continued examination of interdependence in social processes between cancer patients and caregivers will inform intervention development.
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Affiliation(s)
- Ekin Secinti
- Department of Psychology, Indiana University-Purdue University Indianapolis, 402 North Blackford Street, LD 124, Indianapolis, IN, 46202, USA.
| | - Kevin L Rand
- Department of Psychology, Indiana University-Purdue University Indianapolis, 402 North Blackford Street, LD 124, Indianapolis, IN, 46202, USA
| | - Shelley A Johns
- Indiana University School of Medicine, Center for Health Services Research, Regenstrief Institute, 1101 W. 10th Street, RF-226, Indianapolis, IN, 46202, USA
| | - Bert H O'Neil
- Indiana University School of Medicine, Indiana University Melvin and Bren Simon Cancer Center, 535 Barnhill Drive, Indianapolis, IN, 46202, USA
| | - Paul R Helft
- Indiana University School of Medicine, Indiana University Melvin and Bren Simon Cancer Center, 535 Barnhill Drive, Indianapolis, IN, 46202, USA
| | - Safi Shahda
- Indiana University School of Medicine, Indiana University Melvin and Bren Simon Cancer Center, 535 Barnhill Drive, Indianapolis, IN, 46202, USA
| | - Shadia I Jalal
- Indiana University School of Medicine, Indiana University Melvin and Bren Simon Cancer Center, 535 Barnhill Drive, Indianapolis, IN, 46202, USA
| | - Catherine E Mosher
- Department of Psychology, Indiana University-Purdue University Indianapolis, 402 North Blackford Street, LD 124, Indianapolis, IN, 46202, USA
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Abstract
BACKGROUND Negative emotions, which have a common, chronic and recurrent structure, play a vital role in the development and maintenance of psychopathology. In this study, loneliness as a negative emotion was considered to be a predisposing factor in depression. AIM The aim of this meta-analysis is to determine the effect of loneliness on depression. METHOD Initially, a literature scan was performed and all related literature was pooled together ( n = 531). Based on scales determined by the researchers, it was decided to include 88 studies in the analysis. This study obtained a sampling group of 40,068 individuals. RESULTS The results of using a random effects model for analysis showed that loneliness had a moderately significant effect on depression. None of the variables of study sampling group, type of publication and publication year were found to be moderator variables. CONCLUSION According to the results of the research, loneliness may be said to be a significant variable affecting depression. The findings obtained are discussed in light of the literature.
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Affiliation(s)
- Evren Erzen
- 1 Department of Primary Education, Faculty of Education, Artvin Coruh University, Artvin, Turkey
| | - Özkan Çikrikci
- 2 Department of Educational Sciences, Faculty of Education, Ordu University, Ordu, Turkey
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17
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Hopelessness, Death Anxiety, and Social Support of Hospitalized Patients With Gynecologic Cancer and Their Caregivers. Cancer Nurs 2018; 42:373-380. [DOI: 10.1097/ncc.0000000000000622] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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18
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Weller D. “Yes, I have cancer, but I'm also lonely”; tackling a common problem in cancer care. Eur J Cancer Care (Engl) 2018; 27:e12844. [DOI: 10.1111/ecc.12844] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- David Weller
- Centre for Population Health Sciences; University of Edinburgh; Edinburgh UK
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19
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Worry in Head and Neck Cancer Caregivers: The Role of Survivor Factors, Care-Related Stressors, and Loneliness in Predicting Fear of Recurrence. Nurs Res 2017; 66:295-303. [PMID: 28654567 DOI: 10.1097/nnr.0000000000000223] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Fear of recurrence (FOR) is a primary concern for both cancer survivors and their caregivers, yet little is known about what care-related factors exacerbate this worry. OBJECTIVES This study aimed to establish the role of care-related stressors-as distinct from survivor characteristics-in predicting FOR in head and neck cancer caregivers. METHODS HNC survivor-caregiver dyads took part in a mailed survey. Survivors provided information on health and quality of life (using the Functional Assessment of Cancer Therapy Questionnaire). Caregivers provided sociodemographic information, impact of caring on their time and finances, as well as their level of social support (Oslo Support Scale), loneliness (3-point loneliness scale), and completed the Worry of Cancer Scale (to measure FOR). RESULTS Data from 180 dyads were available for analysis. Multiple regression analysis was used to examine the role of caregiver stressors, social support, and loneliness while controlling for caregiver and survivor characteristics. The model explained 28% of the variance in Worry of Cancer scores (FOR). Caregivers who reported more loneliness, spent more time caring, and had greater financial stress from caring had higher scores on Worry of Cancer (FOR). Female caregivers, those caring for younger survivors, and those with survivors who had undergone less extensive forms of surgery also reported higher FOR. DISCUSSION A combination of factors place caregivers at greater risk of cancer-related worry, paving the way for designing interventions aimed at reducing FOR in caregivers of patients with head and neck cancers.
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Soylu C, Ozaslan E, Karaca H, Ozkan M. Psychological distress and loneliness in caregiver of advanced oncological inpatients. J Health Psychol 2016; 21:1896-906. [DOI: 10.1177/1359105314567770] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
The objective of this study is to compare and examine the relationships between levels of loneliness, anxiety, depression, and other variables on primary caregivers and cancer inpatients. The study involved 100 Turkish primary caregivers of inpatients with advanced or terminal stages of cancer. Loneliness and anxiety scores were significantly higher for the primary caregivers of inpatients with terminal stage of cancer than primary caregivers of inpatients with advanced stage of cancer. Excluding the cancer stage, loneliness and anxiety were primarily associated with the socio-demographic factors of primary caregivers rather than the characteristics of patients.
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Chukwuorji JC, Amazue LO, Ekeh OH. Loneliness and psychological health of orthopaedic patients’ caregivers: does gender make a difference? PSYCHOL HEALTH MED 2016; 22:501-506. [DOI: 10.1080/13548506.2016.1173711] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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22
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Loneliness of oncology patients at the end of life. Support Care Cancer 2016; 24:3525-31. [DOI: 10.1007/s00520-016-3159-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 03/07/2016] [Indexed: 10/22/2022]
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Kahriman F, Zaybak A. Caregiver Burden and Perceived Social Support among Caregivers of Patients with Cancer. Asian Pac J Cancer Prev 2016; 16:3313-7. [PMID: 25921137 DOI: 10.7314/apjcp.2015.16.8.3313] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
The purpose of this study is to describe the relationship between caregiver burden and perceived social support among caregivers of patients with cancer. The research was conducted in a university hospital in Izmir, Turkey. Eighty patient relatives who provided care service to patients with cancer who were admitted at hematology and oncology clinics participated in the study. The findings indicated that the care burden score was mild level. The mean of the perceived social support score was 58.4±21.0 supporting the conclusion that there is a weak and negative-direct relation between caregiver and perceived social support and that as the perceived social support increased, conversely, care burden decreased.
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Affiliation(s)
- Fatma Kahriman
- Ataturk Training and Research Hospital, Izmir Katip Celebi University, Izmir, Turkey E-mail :
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Abstract
PURPOSE/OBJECTIVES To present the findings from recent research on the experience of relocation for specialist treatment for patients in the hematology/oncology population. RESEARCH APPROACH Descriptive, qualitative study based on exploratory, in-depth interviews that were recorded, transcribed, coded, and thematically analyzed. SETTING Leukaemia Foundation of Queensland, Australia. PARTICIPANTS A purposive sample of 45 individuals with hematologic cancer who had to relocate for specialist treatment. METHODOLOGIC APPROACH A descriptive, qualitative methodology actioned through open-ended, in-depth interviews with 45 participants who relocated for specialist treatment. FINDINGS The findings indicate that relocation happens at a time when patients are particularly emotionally vulnerable from the shock of their diagnosis or relapse and the confrontation with a potentially life-threatening condition. During this time, when the need for the comfort and support of home and family is heightened, patients have to separate from their family and travel to metropolitan specialist centers. For patients from regional, rural, and remote locations, which are lengthy distances from metropolitan hospitals, the choice to return home during treatment is not a realistic option. Distance also can be a barrier that prevents family from visiting the hospital to provide support. CONCLUSIONS Individuals who have to relocate require psychosocial support. Because of the stresses associated with relocation for specialist care, many patients from regional, rural, and remote areas would prefer to be treated locally. INTERPRETATION Understanding and responding to family issues associated with relocation for specialist treatment is an important aspect of oncology nursing care for patients who have to relocate from regional, rural, and remote areas. Because centralization of specialist hematology treatment is a worldwide trend, the findings have relevance to an international nursing audience.
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Affiliation(s)
- Pam McGrath
- Centre for Community Science in Griffith Health Institute at Griffith University in Meadowbrook, Queensland, Australia
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25
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Deckx L, van den Akker M, van Driel M, Bulens P, van Abbema D, Tjan-Heijnen V, Kenis C, de Jonge ET, Houben B, Buntinx F. Loneliness in patients with cancer: the first year after cancer diagnosis. Psychooncology 2015; 24:1521-8. [PMID: 25914244 DOI: 10.1002/pon.3818] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 03/02/2015] [Accepted: 03/14/2015] [Indexed: 01/22/2023]
Abstract
OBJECTIVES We studied the frequency and evolution of social and emotional loneliness in older cancer patients in comparison with younger cancer patients and older people without cancer. We evaluated if changes in common cancer-related and ageing-related problems such as fatigue, cognitive functioning and functional status contributed to the occurrence of loneliness. METHODS This study was part of the KLIMOP study (Dutch acronym for project on older cancer patients in Belgium and the Netherlands) and included older (≥70 years) and younger cancer patients (50-69 years) and older people without cancer. Data were collected at baseline and 1-year follow-up. Loneliness was measured with the loneliness scale of De Jong-Gierveld. The relationship between loneliness after 1 year and changes in fatigue, cognitive functioning and functional status was tested in multivariate logistic regression analyses. RESULTS Data were available for 475 participants. At baseline, older cancer patients were less lonely compared with older people without cancer. After 1 year, the frequency of emotional loneliness had significantly increased for older cancer patients (26-42%, p < 0.001) and had reached levels of older people without cancer. Emotional loneliness also increased for younger cancer patients (25-34%, p = 0.02), but not for older people without cancer (40-38%, p = 0.69). Frequency of social loneliness did not change significantly. People who were persistently fatigued and people who became or were persistently impaired on cognitive functioning were at increased risk of becoming lonely. CONCLUSION Loneliness, in particular emotional loneliness, is a common problem in cancer patients, and its frequency changes considerably over time.
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Affiliation(s)
- Laura Deckx
- Department of General Practice, KU Leuven, Leuven, Belgium
| | - Marjan van den Akker
- Department of General Practice, KU Leuven, Leuven, Belgium.,Department of Family Medicine, School CAPHRI, Maastricht University, Maastricht, The Netherlands
| | - Mieke van Driel
- Discipline of General Practice, School of Medicine, The University of Queensland, Brisbane, Australia
| | - Paul Bulens
- Limburgs Oncologisch Centrum, Hasselt, Belgium
| | - Doris van Abbema
- Department of Medical Oncology, School GROW, Maastricht University, Maastricht, the Netherlands
| | - Vivianne Tjan-Heijnen
- Department of Medical Oncology, School GROW, Maastricht University, Maastricht, the Netherlands
| | - Cindy Kenis
- Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Eric T de Jonge
- Department of Gynaecology, Ziekenhuis Oost-Limburg, Genk, Belgium
| | - Bert Houben
- Department of Abdominal and Oncological Surgery, Jessa Hospital, Hasselt, Belgium
| | - Frank Buntinx
- Department of General Practice, KU Leuven, Leuven, Belgium.,Department of Family Medicine, School CAPHRI, Maastricht University, Maastricht, The Netherlands
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Theeke LA, Mallow J, Gianni C, Legg K, Glass C. The Experience of Older Women Living with Loneliness and Chronic Conditions in Appalachia. ACTA ACUST UNITED AC 2015; 39:61-72. [PMID: 26594267 DOI: 10.1037/rmh0000029] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This phenomenological qualitative study explored the experience of living with loneliness and multiple chronic conditions for rural older women in Appalachia. The study took place in 2012 in Northern West Virginia. Participants were 14 older women who were chronically ill, community dwelling, and lonely (Score of 40 or higher on the Revised 20-item UCLA Loneliness Scale). Thematic content analysis revealed four categories that contained thirteen themes: (a) negative emotions of loneliness, which included themes of sadness, disconnection, fear, anger, and worry; (b) positive emotions when not lonely, which included themes of joy with others and pride in self; (c) loss of independence and loneliness, which included themes of functional decline contributes to loneliness, burden, and gratitude for help; and (d) ways of managing loneliness, which included remembering holidays and happier moments, staying busy, and getting out. The study contributes new knowledge about the experience of anger, fear, and worry when lonely. These emotions have not extensively been identified as significant to loneliness. Future studies exploring the links between loneliness and anger, fear, worry, and negative physical health outcomes could enhance knowledge of mechanisms by which loneliness contributes to health decline. Additionally, knowing that positive emotions such as joy are described as being linked to less lonely times could inform future work that aims to diminish loneliness and enhance positive emotional states. Finally, understanding that functional impairment is described as contributing to loneliness in this population reinforces the need to assess for and address functional limitations.
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Risk factors for loneliness in patients with cancer: a systematic literature review and meta-analysis. Eur J Oncol Nurs 2014; 18:466-77. [PMID: 24993076 DOI: 10.1016/j.ejon.2014.05.002] [Citation(s) in RCA: 92] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2014] [Revised: 03/07/2014] [Accepted: 05/05/2014] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To systematically review the literature on the severity and risk factors for loneliness in adult cancer patients. METHODS We systematically reviewed quantitative studies addressing loneliness in cancer patients. Exclusion criteria were absence of a validated loneliness questionnaire, and studies that focused on loneliness determined by specific circumstances, and not cancer in general (e.g. appearance concerns, cultural and language barriers, requiring palliative care). We searched PsycINFO, CINAHL, Embase, Cochrane Library, and Pubmed in compliance with the predefined in- and exclusion criteria. The search, quality appraisal, and data extraction were performed by two independent reviewers. Weighted mean scores were calculated by using random effects adjusted inverse variance weighting. RESULTS We included 15 studies. In 13 studies the UCLA loneliness scale was used (range 20-80; higher scores indicate higher loneliness). The weighted mean loneliness score was 38.26 (95% CI: 35.51-41.00), which corresponds to moderate loneliness. Time since diagnosis was positively associated with degree of loneliness. Other cancer-related factors, such as cancer site, treatment type, or stage of disease were not associated with loneliness. The non-cancer related determinants of loneliness in cancer patients that emerged from our review were being unmarried (people who have never been married, are widowed or divorced), and lack of psychological or social support. CONCLUSION Our findings suggest that the level of loneliness rises with increasing time after cancer diagnosis. Furthermore, social functioning emerged as a consistent theme, for which it was shown that lack of social support was associated with increasing levels of loneliness.
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Mitchell AJ, Ferguson DW, Gill J, Paul J, Symonds P. Depression and anxiety in long-term cancer survivors compared with spouses and healthy controls: a systematic review and meta-analysis. Lancet Oncol 2013; 14:721-32. [PMID: 23759376 DOI: 10.1016/s1470-2045(13)70244-4] [Citation(s) in RCA: 459] [Impact Index Per Article: 41.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Cancer survival has improved in the past 20 years, affecting the long-term risk of mood disorders. We assessed whether depression and anxiety are more common in long-term survivors of cancer compared with their spouses and with healthy controls. METHODS We systematically searched Medline, PsycINFO, Embase, Science Direct, Ingenta Select, Ovid, and Wiley Interscience for reports about the prevalence of mood disorders in patients diagnosed with cancer at least 2 years previously. We also searched the records of the International Psycho-oncology Society and for reports that cited relevant references. Three investigators independently extracted primary data. We did a random-effects meta-analysis of the prevalences of depression and anxiety in cancer patients compared with spouses and healthy controls. FINDINGS Our search returned 144 results, 43 were included in the main analysis: for comparisons with healthy controls, 16 assessed depression and ten assessed anxiety; of the comparisons with spouses, 12 assessed depression and five assessed anxiety. The prevalence of depression was 11·6% (95% CI 7·7-16·2) in the pooled sample of 51 381 cancer survivors and 10·2% (8·0-12·6) in 217 630 healthy controls (pooled relative risk [RR] 1·11, 95% CI 0·96-1·27; p=0·17). The prevalence of anxiety was 17·9% (95% CI 12·8-23·6) in 48 964 cancer survivors and 13·9% (9·8-18·5) in 226 467 healthy controls (RR 1·27, 95% CI 1·08-1·50; p=0·0039). Neither the prevalence of depression (26·7% vs 26·3%; RR 1·01, 95% CI 0·86-1·20; p=0·88) nor the prevalence of anxiety (28·0% vs 40·1%; RR 0·71, 95% CI 0·44-1·14; p=0·16) differed significantly between cancer patients and their spouses. INTERPRETATION Our findings suggest that anxiety, rather than depression, is most likely to be a problem in long-term cancer survivors and spouses compared with healthy controls. Efforts should be made to improve recognition and treatment of anxiety in long-term cancer survivors and their spouses. FUNDING None.
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Affiliation(s)
- Alex J Mitchell
- Department of Psycho-oncology, Leicester Partnership Trust, Leicester, UK.
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29
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Kim JH. Influencing Factors on Depression in Stomach Cancer Patients Receiving Chemotherapy. ACTA ACUST UNITED AC 2012. [DOI: 10.7475/kjan.2012.24.6.588] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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