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Leng QL, Lyons KS, Winters-Stone KM, Medysky ME, Dieckmann NF, Denfeld QE, Sullivan DR. Preliminary effects of a yoga intervention for lung cancer dyads: benefits for care partners. Support Care Cancer 2024; 32:447. [PMID: 38902487 DOI: 10.1007/s00520-024-08638-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 06/07/2024] [Indexed: 06/22/2024]
Abstract
PURPOSE Lung cancer is a disease with high mortality and morbidity, impacting both the patient and their closest contact, referred to in this paper as their care partner. There is limited evidence on how to support mental health and quality of life (QOL) for patient-care partner dyads during cancer treatment. This pilot study examines yoga as an intervention to improve well-being for the dyad. METHODS A single-group, 12-week pilot trial of yoga for patients and their care partners recruited from two hospitals during cancer treatment (N = 23 patient-partner dyads or 46 individuals). Most care partners were spouses (70%), with the remainder being adult children (22%), a sibling (4%), or a friend (4%). Descriptive statistics, Cohen's d effect sizes, and paired t-tests for validated psychosocial measures were calculated at baseline and 12 weeks. RESULTS Sixty-five percent of dyads (N = 13) completed the study, with withdrawals mostly due to disease progression. Among care partners, there was a decrease in depression symptomology on the PHQ-8 (p = 0.015, Cohen's d = 0.96) and improvement in QOL on the Caregiver QOL-Cancer scale (p = 0.001, Cohen's d = 0.61). Fifty percent of dyads experienced concordant improvement in depressive symptoms and 77% in QOL. CONCLUSION Patient-partner yoga is a promising intervention for improving mental health and QOL for patient-partner dyads among lung cancer survivors. This study demonstrates yoga to be acceptable, feasible, and with high concordance within patient-partner dyads for improvements in QOL. Yoga shows promise for patients and care partners to alleviate the negative psychosocial impacts of lung cancer, though more research is needed to confirm effects. TRIAL REGISTRATION ClinicalTrials.gov, NCT03649737, 12/9/2020.
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Affiliation(s)
- Qian L Leng
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR, USA.
| | - Karen S Lyons
- School of Nursing, Oregon Health and Science University, Portland, OR, USA
| | - Kerri M Winters-Stone
- School of Nursing, Oregon Health and Science University, Portland, OR, USA
- Knight Cancer Institute, Oregon Health and Science University, Portland, OR, USA
| | - Mary E Medysky
- School of Nursing, Oregon Health and Science University, Portland, OR, USA
| | - Nathan F Dieckmann
- School of Nursing, Oregon Health and Science University, Portland, OR, USA
| | - Quin E Denfeld
- School of Nursing, Oregon Health and Science University, Portland, OR, USA
- Division of Cardiovascular Medicine, Oregon Health and Science University, Portland, OR, USA
| | - Donald R Sullivan
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR, USA
- Division of Pulmonary, Allergy and Critical Care Medicine, Oregon Health and Science University, Portland, OR, USA
- Knight Cancer Institute, Oregon Health and Science University, Portland, OR, USA
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2
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Kim H, Mahmood A, Kedia S, Ogunsanmi DO, Sharma S, Wyant DK. Impact of Residential Segregation on Healthcare Utilization and Perceived Quality of Care Among Informal Caregivers in the United States. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-02018-9. [PMID: 38758399 DOI: 10.1007/s40615-024-02018-9] [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: 02/01/2024] [Revised: 04/10/2024] [Accepted: 05/06/2024] [Indexed: 05/18/2024]
Abstract
This study aimed to investigate the impact of racial residential segregation on healthcare utilization and perceived quality of care among informal caregivers in the US. It further assessed potential variations in the estimated impact across caregivers' race and socioeconomic status. We used data from the Health Information National Trends Survey Data Linkage Project (fielded in 2020) for a sample of 583 self-identified informal caregivers in the US. Fitting a series of regression models with the maximum likelihood estimation, we computed the beta coefficients (β) of interest and their associated Wald 95% confidence limits (CI). Caregivers who resided in areas with higher segregation, compared to those living in lower segregated areas, were less likely to visit a healthcare professional [β = - 2.08; Wald 95%CI - 2.093, - 2.067] (moderate); [β = - 2.53; Wald 95%CI - 2.549, - 2.523] (high)]. Further, caregivers residing in moderate [β = - 0.766; Wald 95%CI - 0.770, - 0.761] and high [β = - 0.936; Wald 95%CI - 0.941, - 0.932] segregation regions were less likely to perceive a better quality of care compared to those located in low segregation areas. Moreover, as segregation level increased, Black caregivers were less likely to see a health professional, less frequently used healthcare services, and had poorer perceived healthcare quality when compared to Whites. Our findings indicate that higher residential segregation is associated with lower healthcare utilization, such as visiting a healthcare professional, and poorer perceived healthcare quality among informal caregivers. Given the essential role of informal caregivers in the current healthcare system, it is vital to investigate and address challenges associated with access to and quality of essential healthcare services to improve caregivers' health and well-being, specifically for caregivers of minority backgrounds.
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Affiliation(s)
- Hyunmin Kim
- College of Nursing and Health Professions, School of Health Professions, The University of Southern Mississippi, Hattiesburg, MS, USA
| | - Asos Mahmood
- Center for Health System Improvement, College of Medicine, University of Tennessee Health Science Center, 956 Court Ave Avenue, Ste D222A, Memphis, TN, 38103, USA.
- Department of Medicine-General Internal Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA.
| | - Satish Kedia
- Division of Social and Behavioral Sciences, School of Public Health, The University of Memphis, Memphis, TN, USA
| | - Deborah O Ogunsanmi
- Tennessee Population Health Consortium and Institute for Health Outcomes and Policy Research, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Sadikshya Sharma
- College of Nursing and Health Professions, School of Health Professions, The University of Southern Mississippi, Hattiesburg, MS, USA
| | - David K Wyant
- Jack C. Massey College of Business, Frist College of Medicine, Belmont University, Nashville, TN, USA
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Johnston EA, Collins KE, Vicario JN, Sibthorpe C, Ireland MJ, Goodwin BC. Changes in rural caregivers' health behaviors while supporting someone with cancer: A qualitative study. Cancer Med 2024; 13:e7157. [PMID: 38572938 PMCID: PMC10993705 DOI: 10.1002/cam4.7157] [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: 11/23/2023] [Revised: 03/11/2024] [Accepted: 03/22/2024] [Indexed: 04/05/2024] Open
Abstract
PURPOSE Caring for someone with cancer has a significant impact on usual routines, including caregivers' ability to maintain their own health and wellbeing. Caregivers living in rural areas face additional challenges in supporting someone with cancer, and little is known about the impact of caregiving on the health behaviors of rural caregivers. Therefore, this study explored how caring for someone with cancer affected rural caregivers' health behaviors. METHODS Through semi-structured interviews, 20 rural caregivers described changes in their health behaviors while caring for someone with cancer and the factors underlying these changes. Specific prompts were provided for diet, physical activity, alcohol, smoking, sleep, social connection and leisure, and accessing health care when needed. Interviews were audio-recorded and transcribed verbatim. Content analysis was used to identify changes in health behaviors and the factors underlying these changes. The factors identified were mapped to the socioecological framework, identifying areas for intervention across multiple levels (individual, interpersonal, organizational, community, and policy). RESULTS Rural caregivers reported both positive and negative changes to their diet, physical activity, alcohol, and smoking. Sleep, social connection and leisure, and accessing health care were negatively impacted since becoming a caregiver. CONCLUSIONS Designing interventions to address rural caregivers' coping strategies, reduce carer burden and fatigue, improve access to cooking and exercise facilities and social support while away from home, reduce the need to travel for treatment, and increase the financial support available could yield widespread benefits for supporting the health and wellbeing of rural caregivers.
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Affiliation(s)
- Elizabeth A. Johnston
- Cancer Council QueenslandFortitude ValleyQueenslandAustralia
- School of Exercise and Nutrition SciencesQueensland University of TechnologyKelvin GroveQueenslandAustralia
- Population Health ProgramQIMR Berghofer Medical Research InstituteHerstonQueenslandAustralia
| | - Katelyn E. Collins
- Cancer Council QueenslandFortitude ValleyQueenslandAustralia
- School of Psychology and WellbeingUniversity of Southern QueenslandSpringfieldQueenslandAustralia
| | | | - Chris Sibthorpe
- Cancer Council QueenslandFortitude ValleyQueenslandAustralia
| | - Michael J. Ireland
- School of Psychology and WellbeingUniversity of Southern QueenslandSpringfieldQueenslandAustralia
- Centre for Health ResearchUniversity of Southern QueenslandSpringfieldQueenslandAustralia
| | - Belinda C. Goodwin
- Cancer Council QueenslandFortitude ValleyQueenslandAustralia
- Centre for Health ResearchUniversity of Southern QueenslandSpringfieldQueenslandAustralia
- School of Population and Global HealthUniversity of MelbourneMelbourneVictoriaAustralia
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Johnston EA, Ayre SK, Au-Yeung YT, Goodwin BC. A Scoping Review of Group Nutrition Education and Cooking Programs for People Affected by Cancer. J Acad Nutr Diet 2024:S2212-2672(24)00090-X. [PMID: 38395356 DOI: 10.1016/j.jand.2024.02.011] [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: 08/29/2023] [Revised: 02/08/2024] [Accepted: 02/20/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND Group nutrition education and cooking programs for people affected by cancer have the potential to address commonly reported unmet needs for dietary information, as well as provide opportunities for practical and social support. OBJECTIVE To report the nutrition-related content, delivery methods, and outcomes measured in group nutrition education and cooking programs for people affected by cancer in the published literature, and describe how these programs were developed, implemented, and evaluated. METHODS A scoping review of academic literature is reported using the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews guidelines. Key terms such as cancer, nutrition education, and cooking were searched across 4 databases (PubMed, Embase, Cumulative Index of Nursing and Allied Health Literature, and Web of Science) on June 1, 2023, for records published over the past 10 years. Records were independently screened by 2 reviewers. Data extracted included program participants, components, nutrition-related content, delivery methods, outcomes measured, and information about how the program was developed, implemented, and evaluated. RESULTS Of 2,254 records identified, 41 articles met eligibility criteria, reporting on 37 programs. Most programs were designed for adult cancer survivors (89%) and conducted after primary treatment (81%). Four programs invited caregivers to attend. Almost all programs (97%) included a nutrition education component, and more than half (59%) included cooking activities, with a predominant focus on recommendations and practical skills for healthy eating. Most programs were delivered byregistered dietitians and/or nutritionists (54%) and included group discussions (57%) and active involvement in cooking activities (57%) in program delivery. The participant outcomes that were measured covered dietary, psychosocial, clinical, and anthropometric domains. Many programs were developed with cancer survivors, dietitians or nutritionists, and researchers. No studies reported on sustainability of program implementation or overall costs. Programs were evaluated using data from surveys, focus groups, interviews, and field notes, with articles typically reporting on participation rates, reasons for nonparticipation, program acceptability, aspects of the nutrition-related programs valued by participants, and suggestions for improvement. CONCLUSIONS Future research should prioritize assessing the effectiveness of these programs for participants. Future development, implementation, and evaluation of these programs should include family members and friends and assess the sustainability of program delivery, including cost-effectiveness.
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Affiliation(s)
- Elizabeth A Johnston
- Viertel Cancer Research Centre, Cancer Council Queensland, Fortitude Valley, Queensland, Australia; School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland, Australia; Population Health Program, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia.
| | - Susannah K Ayre
- Viertel Cancer Research Centre, Cancer Council Queensland, Fortitude Valley, Queensland, Australia; School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Yin To Au-Yeung
- Viertel Cancer Research Centre, Cancer Council Queensland, Fortitude Valley, Queensland, Australia
| | - Belinda C Goodwin
- Viertel Cancer Research Centre, Cancer Council Queensland, Fortitude Valley, Queensland, Australia; Centre for Health Research, University of Southern Queensland, Springfield, Queensland, Australia; School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
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Erbay Dalli Ö, Bulut H. Level of caregiving burden and affecting factors in family caregivers of patients with lung cancer: A cross-sectional study. Support Care Cancer 2023; 32:60. [PMID: 38145998 DOI: 10.1007/s00520-023-08259-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 12/15/2023] [Indexed: 12/27/2023]
Abstract
PURPOSE To determine the caregiving burden level and affecting factors of family members caring for patients with lung cancer (LC). METHODS This study used a cross-sectional design and a convenience sampling method. The study was conducted between April 2023 and August 2023 with the LC patients (n = 448) and their caregivers (n = 448) who met the inclusion criteria and were followed up in seven clinics of a specialized hospital for pulmonary diseases in Turkey. Data were collected by using (1) a demographic questionnaire (for patient and caregiver), (2) the Zarit Burden Interview (ZBI), (3) the Beck Depression Inventory (BDI), and (4) the Caregiver Quality of Life Index-Cancer (CQoLC). RESULTS The study included 448 caregivers, with a mean age of 45.09 ± 13.48 years, and 71.4% were female. The mean ZBI score of 31.45 ± 16.71 indicated mild to moderate burden. Pearson correlation analysis showed that caregivers' depression levels increased and quality of life decreased significantly as the care burden increased. Multiple regression analysis indicated a significant relationship between the caregiver burden and the patient's age (p < 0.05), caregiver's chronic disease (p < 0.05), type of treatment given to the patient (p < 0.05), patient's metastasis status (p < 0.05) and caregiver's quality of life (p < 0.01). CONCLUSION The fact that most of the risk factors identified in this study are non-modifiable highlights the necessity of identifying caregiver burden early by nurses and initiating the appropriate support processes.
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Affiliation(s)
- Öznur Erbay Dalli
- Bursa Uludag University Faculty of Health Sciences, Department of Internal Medicine Nursing, Nilüfer, BURSA, Turkey, 16059.
| | - Hülya Bulut
- Health Sciences University Izmir Dr Suat Seren Chest Diseases and Surgery Training and Research Hospital, Konak, İZMİR, Turkey, 35170
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McDonnell KK, Owens OL, Umari F. Mindfulness-Based Interventions for Survivors of Lung Cancer and Their Partners: A Systematic Review. Int J Behav Med 2023; 30:616-627. [PMID: 36224314 PMCID: PMC10522728 DOI: 10.1007/s12529-022-10132-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Survivors of lung cancer and their partners often have complex unresolved physical, psychosocial, and behavioral needs that can negatively affect the survivors' and partners' well-being. This systematic review aimed to (1) examine the content and delivery of mindfulness-based interventions (MBIs) and (2) summarize and synthesize the current evidence for effectiveness of MBIs targeting survivors of lung cancer and/or one selected partner (dyads). METHOD Six databases were searched for interventional studies published in English between 1980 and June 2020 using three terms (lung neoplasms, mindfulness, caregivers). For outcome measures, the interventions focused on behavioral change (meditation, yoga, stretching, breathing), symptom management (dyspnea, fatigue, sleep disruption, anxiety, depression, stress reduction), and knowledge. Two reviewers independently assessed article eligibility. One reviewer performed and another independently verified data extraction. The Cochrane risk-of-bias tool for randomized trials was used to critically appraise RCTs. RESULTS Searching yielded 307 records, of which 64 were assessed for eligibility. Six studies investigated the impact of an MBI on survivors and partners. Four studies were single-arm feasibility studies; two were RCTs. Two feasibility studies and one RCT recruited romantic couples whereas the others recruited asymmetrical dyads. The single-arm studies reported strong feasibility and acceptability. RCTs reported significant outcomes for reduced cancer-related distress and depression, and improved QOL, self-compassion, mindfulness skills, and rumination. CONCLUSION Dyadic intervention research is a growing field. Few interventions target individuals with lung cancer and their partners. No interventions target partners alone. Future research should evaluate rigorous methodologies that enhance the understanding of independent and interdependent health-related effects within dyads and across relationships and settings.
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Affiliation(s)
- Karen Kane McDonnell
- Cancer Survivorship Research Center, College of Nursing, University of South Carolina, 1601 Greene Street, Columbia, SC 29208-4001 USA
| | - Otis L. Owens
- Healthy Aging Research and Technology (HART) Lab, College of Social Work; Core Faculty, Statewide Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC USA
| | - Fattona Umari
- College of Nursing, University of South Carolina, Columbia, SC USA
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Chen X, Qiao C, Arber A, Shen Y, Rui Y, Zhang R, Pei Z, Tang Y, Sha Z, Bao J, Zhang J, Li J, Wang D, Wang X. Enhancing resilient coping strategies for quality of life in Chinese adult children caregiving for parents with advanced cancer: a cross-sectional study. Support Care Cancer 2023; 31:591. [PMID: 37749433 PMCID: PMC10520155 DOI: 10.1007/s00520-023-08057-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 09/19/2023] [Indexed: 09/27/2023]
Abstract
PURPOSE This study investigated the mediating role of individual resilience in the relationship between caregiver burden and quality of life (QoL) among Chinese adult children providing care to their parents with advanced cancer, with the aim to inform effective coping strategies and positive caregiving outcomes. METHODS In a cross-sectional design, 614 caregivers from multiple centers, whose parents were undergoing chemotherapy and/or radiotherapy, completed questionnaires encompassing demographics, caregiver burden, symptoms of anxiety and depression, resilience, and QoL. RESULTS Findings revealed a moderate level of caregiver burden among participants, significantly influenced by factors including education level, family income, single-child status, and participation in social media patient support groups. Caregivers who were only children or involved in patient support groups reported higher burden. Importantly, path analysis showed a significant impact of caregiver burden, anxiety, and depression on QoL, with these relationships being mediated by individual resilience. CONCLUSIONS Chinese adult child caregivers face a considerable burden, negatively influencing their QoL. Individual resilience, a modifiable factor, was identified as a critical mediator in this relationship, mitigating the negative implications of caregiver burden, anxiety, and depression. These findings underscore the need for caregiver interventions that consider not only demographics but also the socio-psychological dynamics of caregiving to enhance caregiver QoL.
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Affiliation(s)
- Xian Chen
- Gynaecology Department, Women's Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), Nanjing, People's Republic of China
| | - Chengping Qiao
- Gynaecology Department, Women's Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), Nanjing, People's Republic of China
| | - Anne Arber
- School of Health Sciences, Faculty of Health and Medical Sciences, The University of Surrey, Guildford, UK
| | - Yan Shen
- Interventional Radiology Department, The First Affiliated Hospital With Nanjing Medical University, Nanjing, People's Republic of China
| | - Yehao Rui
- Oncology Department, Zhongda Hospital Southeast University, Nanjing, People's Republic of China
| | - Rui Zhang
- Oncology Department, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, People's Republic of China
| | - Zhongling Pei
- Interventional Radiology Department, The First Affiliated Hospital With Nanjing Medical University, Nanjing, People's Republic of China
| | - Yuanyuan Tang
- Radiotherapy Department, The First Affiliated Hospital With Nanjing Medical University, Nanjing, People's Republic of China
| | - Ziyu Sha
- Oncology Department, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, People's Republic of China
| | - Jianying Bao
- Interventional Radiology Department, The First Affiliated Hospital With Nanjing Medical University, Nanjing, People's Republic of China
| | - Jia Zhang
- Oncology Department, The First Affiliated Hospital With Nanjing Medical University, Nanjing, People's Republic of China
| | - Jinhua Li
- Geriatric Oncology Department, The First Affiliated Hospital With Nanjing Medical University, Nanjing, People's Republic of China
| | - Dan Wang
- Oncology Department, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, People's Republic of China.
| | - Xuemei Wang
- Interventional Radiology Department, The First Affiliated Hospital With Nanjing Medical University, Nanjing, People's Republic of China.
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Toledano-Toledano F, Jiménez S, Moral de la Rubia J, Merino-Soto C, Rivera-Rivera L. Positive Mental Health Scale (PMHS) in Parents of Children with Cancer: A Psychometric Evaluation Using Item Response Theory. Cancers (Basel) 2023; 15:2744. [PMID: 37345081 DOI: 10.3390/cancers15102744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 05/03/2023] [Accepted: 05/11/2023] [Indexed: 06/23/2023] Open
Abstract
Mental health is currently a public health issue worldwide. However, evidence is lacking regarding the validity of the instruments used to measure and assess positive mental health in specific populations. The objective of this study was to evaluate the psychometric properties of the PMHS using IRT. A cross-sectional retrospective study with non-probabilistic convenience sampling was conducted with 623 parents of children undergoing cancer treatment at the National Institute of Health in Mexico City. The participants responded to a battery of tests, including a sociodemographic questionnaire, the PMHS, Measurement Scale of Resilience, Beck Depression Inventory, Inventory of Quality of Life, Beck Anxiety Inventory, an interview regarding caregiver burden, and the World Health Organization Well-Being Index. PMHS responses were analyzed using Samejima's graded response model. The PMHS findings indicated that the IRT-based graded response model validated the single latent trait model. The scale scores were independent of depression, anxiety, well-being, caregiver burden, quality of life, and resilience. The PMHS scores were associated with low subjective well-being. The PMHS findings reveal that from an IRT-based perspective, this scale is unidimensional and is a valid, reliable, and culturally relevant instrument for assessing positive mental health in parents of children with chronic diseases.
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Affiliation(s)
- Filiberto Toledano-Toledano
- Unidad de Investigación en Medicina Basada en Evidencias, Hospital Infantil de México Federico Gómez, National Institute of Health, Dr. Márquez 162, Doctores, Cuauhtémoc, Mexico City 06720, Mexico
- Unidad de Investigación Multidisciplinaria en Salud, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Calzada México-Xochimilco 289, Arenal de Guadalupe, Tlalpan, Mexico City 14389, Mexico
- Dirección de Investigación y Diseminación del Conocimiento, Instituto Nacional de Ciencias e Innovación para la Formación de Comunidad Científica, INDEHUS, Periférico Sur 4860, Arenal de Guadalupe, Tlalpan, Mexico City 14389, Mexico
| | - Said Jiménez
- Unidad de Investigación en Medicina Basada en Evidencias, Hospital Infantil de México Federico Gómez, National Institute of Health, Dr. Márquez 162, Doctores, Cuauhtémoc, Mexico City 06720, Mexico
| | - José Moral de la Rubia
- Facultad de Psicología, Universidad Autónoma de Nuevo León, Dr. Carlos Canseco, 110, Esq. Dr. Aguirre Pequeño, Col. Mitras Centro, Monterrey 64460, Mexico
| | - Cesar Merino-Soto
- Instituto de Investigación de Psicología, Universidad de San Martín de Porres, 34, Lima 15011, Peru
| | - Leonor Rivera-Rivera
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Av. Universidad No. 655 Col. Santa María Ahuacatitlán, Cuernavaca 62100, Mexico
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Rosario-Ramos L, Peña-Vargas C, Torres-Blasco N. Acceptance of Caregiver-Patient Support to Latinx Coping with Advanced Cancer (CASA) Intervention: A Caregiver Case Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4996. [PMID: 36981903 PMCID: PMC10049334 DOI: 10.3390/ijerph20064996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/09/2023] [Accepted: 03/10/2023] [Indexed: 06/18/2023]
Abstract
Latinos frequently assume caregiver roles when the need arises in their social nucleus. Because of their active role, caregivers are heavily involved in their family member's cancer trajectory. Therefore, there is a need for culturally adapted interventions that integrate the caregiver and cancer patient. The objective is to present a case study of a former caregiver's experience and acceptance of the cultural adaptation of Caregiver-Patient Support to Latinx Coping with Advanced Cancer (CASA) intervention. We conducted a case study with a male caregiver between the ages of 20 and 30. A male caregiver expressed his experience and acceptance of a psychosocial intervention. He conveyed moderate to high acceptance of intervention components through anecdotes and opinions based on his experiences as a caregiver for multiple family members. Finally, he reported distress, but he presented little to no symptoms of caregiver burden, depression, anxiety, and hopelessness. It is crucial to culturally adapt interventions that integrate caregivers when they play a big part in their loved one's cancer journey. Integrating their perspective when adapting an intervention may assist in providing essential information that will benefit the patient and caregiver.
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Affiliation(s)
- Lianel Rosario-Ramos
- School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce 00716, Puerto Rico
| | - Cristina Peña-Vargas
- Ponce’s Research Institute, Ponce Health Sciences University, Ponce 00716, Puerto Rico
| | - Normarie Torres-Blasco
- School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce 00716, Puerto Rico
- Ponce’s Research Institute, Ponce Health Sciences University, Ponce 00716, Puerto Rico
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McDonnell KK, Andrews JO, Yang CH, Newsome BR, Weinkle E, Davis JE, Dunsiger S. Study Protocol for the Breathe Easier Trial: A Pilot RCT of a Dyad-Based, Multiple-Behavior Intervention for Improving Physical and Emotional Health in Survivors Facing Lung Cancer. Integr Cancer Ther 2023; 22:15347354231212876. [PMID: 38009546 PMCID: PMC10683396 DOI: 10.1177/15347354231212876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 09/14/2023] [Accepted: 10/23/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Research targeting survivors of lung cancer has yet to adequately address the management of physical deconditioning and unresolved symptoms (dyspnea, fatigue). The objective of the Breathe Easier trial is to test the feasibility and preliminary effects of a theory-based, multiple-behavior intervention (physical activity, smoking reduction for current smokers, stress management) targeting survivors of localized non-small-cell lung cancer (NSCLC, stages I-III) and their supportive partners. METHODS This pilot RCT will enroll 30 dyads (60 participants). Each dyad will consist of one survivor and one partner (defined as a family member or friend) Dyads will be randomized to the Intervention Group (IG) or the Attention Control Group (AC). IG members will receive the 12-week, home-based intervention based on the individual and family self-management theory, which targets improvements in self-efficacy, social support, and self-regulation. Improvement in lifestyle behaviors is a proximal outcome. Improvements in physical and emotional health are distal outcomes. Breathe Easier (IG) includes educational content written in plain language as well as breathing exercises and meditations; SMART goal setting; daily text messaging; and weekly telephone calls with trained staff. The AC program includes relevant National Institutes of Health publications plus weekly telephone chats. Members who currently smoke will also receive an evidence-based smoking cessation resource. DISCUSSION Breathe Easier focuses on changes in multiple behaviors in dyads coping with a diagnosis of NSCLC (stages I-III) with the overall purpose of improving physical and emotional health. Findings will provide additional evidence of the feasibility and preliminary effects of this intervention. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05956782; This trial was registered retrospectively.
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Affiliation(s)
| | | | | | - Brandi R. Newsome
- University of South Carolina, Columbia, SC, USA
- Prisma Health, Columbia, SC, USA
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11
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Alnajar M, Mosleh S, Almalik M, Darawad M. Psychological predictors of quality of life among Jordanian cancer patients' caregivers. Psychooncology 2022; 31:1886-1894. [PMID: 36250593 DOI: 10.1002/pon.6054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 09/08/2022] [Accepted: 09/14/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The caregivers who provide care for patients with cancer often experience emotional and psychological stressors and burdens that could be influenced by several factors, including the cultural context. This study examines the level of emotional distress and burden and their effect on the quality of life (QOL) of Jordanian cancer patients' caregivers. METHODS A cross-sectional survey was conducted among 257 family caregivers of patients at various stages of cancer. RESULTS The average age of caregivers was 37.5 years (SD = 12.2). Most caregivers (145; 59.2%) were female and married (168; 68.6%). About a quarter were partners (32.2%) and lived with their patients (137; 55.9%). Caregivers with a reduced overall Caregiver Quality of Life Index-Cancer (CQOLC) score were more likely to be older, the parents of the patients, and living with patients in the same house. A significant negative relationship was found between caregivers' CQOLC and Zarit Burden Interview (r = -0.7, p = 0.001), anxiety (r = -0.69, p = 0.001), and depression (r = -0.42, p = 0.03) scores. Multiple linear regression analysis revealed that burden, anxiety, and depression scores were independent predictors and explained 63% of the variance in the total CQOLC score of caregivers. CONCLUSION Cancer caregivers are at elevated risk of poor QOL. Despite participants' low perception of the burden level, this study provides preliminary results for policymakers and medical practitioners to foster a comprehensive platform supporting cancer caregivers. Moreover, identifying the caregivers' readiness to provide the needed care and the availability of supportive resources, as a clinical routine, is strongly recommended.
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Affiliation(s)
- Malek Alnajar
- College of Nursing, The University of Utah, Salt Lake, Utah, USA
| | - Sultan Mosleh
- Faculty of Nursing, Mutah University, Mu'tah, Jordan.,Higher Collages of Technology, Faculty of Health Science, Fujairah, United Arab Emirates
| | - Mona Almalik
- Faculty of Nursing, Mutah University, Mu'tah, Jordan
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Zhu S, Yang C, Chen S, Kang L, Li T, Li J, Li L. Effectiveness of a perioperative support programme to reduce psychological distress for family caregivers of patients with early-stage lung cancer: study protocol for a randomised controlled trial. BMJ Open 2022; 12:e064416. [PMID: 35998958 PMCID: PMC9403120 DOI: 10.1136/bmjopen-2022-064416] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022] Open
Abstract
INTRODUCTION Family caregivers play a key role in providing ongoing long-term care and assistance to their loved ones during cancer treatment. However, family caregivers of patients with lung cancer are frequently unprepared for their roles and they may undergo psychological distress, thus reducing their own quality of life while affecting patients' health outcomes. Interventions that specifically target this population are lacking. This study aims to evaluate the effectiveness of a perioperative support programme on family caregivers of patients with early-stage lung cancer. METHODS AND ANALYSIS This study is guided by the Stress-Coping Model. Family caregivers of patients diagnosed with early-stage lung cancer and those who are scheduled for lung resection treatment will be invited to participate. Participants will be randomised to groups that either receive the perioperative support programme or usual care. The intervention consists of four face-to-face intervention sessions during the hospital stay and two weekly telephone follow-up sessions after discharge. Primary and secondary outcomes will be assessed at baseline and at 4 and 12 weeks after the intervention. Primary outcomes will include psychological distress and secondary outcomes will include caregiving burden, quality of life, coping style and social support. Generalised estimation equation model will be used to analyse the intervention effects. ETHICS AND DISSEMINATION The study was approved by the Ethics Committee of the Second Xiangya Hospital of Central South University (LYG2022003). The authors will disseminate the study's findings by publishing them in international scientific journals. TRIAL REGISTRATION NUMBER ChiCTR2200058280.
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Affiliation(s)
- Song Zhu
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, China
- Department of Thoracic Surgery, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Chen Yang
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Shihao Chen
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Lu Kang
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, China
- Department of Thoracic Surgery, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Tong Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, China
- Department of Thoracic Surgery, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jina Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, China
- Department of Thoracic Surgery, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Lezhi Li
- Xiangya Nursing School, Central South University, Changsha, Hunan, China
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Lee HJ, Park SK. Factors Related to the Caregiving Burden on Families of Korean Patients With Lung Cancer. Clin Nurs Res 2022; 31:1124-1135. [PMID: 35575283 DOI: 10.1177/10547738221098150] [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
The purposes of this study were to describe caregiver burden on families of patients with lung cancer and to examine its associated factors, including patient symptoms and symptom clusters. In this cross-sectional study, 120 patient-caregiver dyads were recruited from an outpatient clinic in a tertiary care hospital. Patient symptoms and caregiver burden were measured with structured questionnaire. Descriptive and inferential statistics were used to analyze data. Three patient symptom clusters were identified. Hierarchical regression showed that a patient's smoking history; caregiver age, education, health status, depression, social support, monthly family income, relationship with patient, and time spent on nursing each day; and presence of another caregiver explained 41.4% of the total variance in caregiver burden. When patient symptom clusters were added to regression model, change in total variance in caregiver burden was significant. To reduce their burden, caregivers should be taught how cancer progresses and its major symptoms after chemotherapy.
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Gender differences in the association between unmet support service needs and mental health among American cancer caregivers. Support Care Cancer 2022; 30:5469-5480. [PMID: 35304632 DOI: 10.1007/s00520-022-06966-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 03/07/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE Cancer caregiving can be distressing, and many caregivers have support service needs. Given the role gender has played in shaping norms around caring, gender may influence caregiving experiences. Using Behavioral Risk Factor Surveillance System data, 2015-2018, we aimed to examine gender as an effect modifier of the unmet support service needs and mental health association among cancer caregivers. METHODS Our n = 5814 sample represented approximately 4.8 million caregivers. Mental health was operationalized as number of mentally unhealthy days over the past 30 (MUDs) and Frequent Mental Distress (FMD, MUDs ± 14 days). Unmet supportive care needs included endorsement of needing but not receiving caregiving classes, help accessing services, support groups, counseling, and respite care. We conducted zero-inflated negative binomial (ZINB) and logistic regression analyses to examine the associations between unmet needs with MUDs and FMD and then tested gender as an effect modifier. RESULTS Cancer caregivers reported an average of 6 MUDs. Approximately 20% of caregivers reported FMD, and 17% reported having any unmet needs. Gender moderated the unmet needs and FMD association. Among female caregivers, those with unmet needs were more likely to report FMD (aOR: 2.167; 95%CI: 1.447, 3.243); among male caregivers, no association was found (aOR: 0.970; 95%CI: 0.471, 2.001). In the ZINB model of MUDs, no significant moderation effect of gender was found. CONCLUSION Though distress does not appear to vary by gender, having unmet support needs may negatively affect mental health in female cancer caregivers. Studies on gendered experiences can inform strategies to meet caregiver needs.
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Cremona RV, Cassar M, Sharples C. 3Cs: the experiences of informal caregivers of patients undergoing thoracic surgery. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2022; 31:S6-S15. [PMID: 35271364 DOI: 10.12968/bjon.2022.31.5.s6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The informal caregiver is pivotal to the postoperative experience of patients. The purpose of this study was to explore the informal caregivers' experience while accompanying patients through thoracotomy surgery. Specifically, and exclusively, the informal carers' personal reactions, needs and views regarding their experience in the patients' surgery trajectory were explored. A convenience sample of eight informal caregivers of patients who had undergone thoracotomy were interviewed approximately 2 weeks following discharge from a general hospital in Malta. The findings revealed knowledge regarding participants' experiences of demands and fears associated with the 3Cs: cancer, challenges and coping. The impact of timely information-sharing and support on the informal caregiver's experience was highlighted. These findings suggest that careful consideration of both a patient's and informal caregiver's needs promotes an enhanced hospitalisation experience, and creates opportunity for a better transition back home. Implications for research and practice are discussed.
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Affiliation(s)
| | - Maria Cassar
- Senior Lecturer, Department of Nursing, Faculty of Health Sciences, University of Malta
| | - Catherine Sharples
- Lecturer, Department of Nursing, Faculty of Health Sciences, University of Malta
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Abstract
OBJECTIVES To provide an overview on the role of family caregivers (FCGs) in the care of older adults with cancer and review quality of life needs for FCGs. DATA SOURCES Journal articles, research reports, state of the science papers, position papers, and clinical guidelines from professional organizations were used. CONCLUSION The high prevalence of multiple comorbidities and the associated burden of geriatric events in older adults have a substantial impact on the quality of life of their FCGs. Practical and efficient models of comprehensive assessment, interventions, and caregiving preparedness support are needed to improve outcomes for both older adults with cancer and their FCGs. IMPLICATIONS FOR NURSING PRACTICE Oncology nurses practicing in clinical and research settings have a responsibility to prepare themselves with evidence-based knowledge and resources to include the needs of FCGs in the care provided to older adults with cancer.
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McDonnell KK, Gallerani DG, Newsome BR, Owens OL, Beer J, Myren-Bennett AR, Regan E, Hardin JW, Webb LA. A Prospective Pilot Study Evaluating Feasibility and Preliminary Effects of Breathe Easier: A Mindfulness-based Intervention for Survivors of Lung Cancer and Their Family Members (Dyads). Integr Cancer Ther 2021; 19:1534735420969829. [PMID: 33118443 PMCID: PMC7604980 DOI: 10.1177/1534735420969829] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Objective: Symptom burden remains a distressing problem for survivors with non-small-cell lung cancer (stages I-IIIa). This pilot study evaluated feasibility and preliminary effects of a tailored mindfulness-based intervention, Breathe Easier, which encompasses meditation, 2 levels of mindful hatha yoga, breathing exercises, and participant interaction. METHODS Participants were recruited from 2 cancer programs in the US Southeast. A family member was required for participation. Sixty-two participants enrolled (20% recruitment) and 49 completed the intervention (79% retention). Participants chose level 1 yoga (basic) or level 2 (more advanced). Of the completers, survivors were 39% male and 65% Black. A community-based participatory research framework helped identify the specific needs and interests of potential participants and foreseeable barriers to implementation. A 2-month prospective, 1-group, pre-post design evaluated feasibility. Intervention dosage was measured using written protocols. Attendance and completion of daily home assignments measured adherence. Acceptability was assessed using a 10-item questionnaire, completed at three time points. Preliminary outcome data collected pre- and post-intervention tested the hypothesis that participants who received the 8-week intervention Breathe Easier would, post-intervention, demonstrate (a) less dyspnea, (b) less fatigue, (c) less stress, (d) improved sleep, (e) improved anxiety and depression, and (f) improved functional exercise capacity. Exit interviews were conducted, transcribed verbatim, and analyzed for content using descriptive statistics. RESULTS Quantitative and qualitative measures indicated strong feasibility. Over time, level 1 participants had statistically less dyspnea, fatigue and improved exercise capacity, as well as improved sleep, and stress scores. Level 2 participants experienced slightly increased dyspnea and fatigue but improved sleep, stress, and exercise capacity. All participants experienced anxiety and depression within normal limits pre- and post-intervention. Five major themes emerged out of exit interviews: Learning to Breathe Easier; Interacting with Others as a Personal Benefit; Stretching, Releasing Tension, and Feeling Energized; Enhancing Closeness with Committed Partners; Refocusing on Living; and Sustaining New Skills as a Decision. CONCLUSIONS The study offers insight into the feasibility of an 8-week in-person mindfulness-based intervention with a unique subset of understudied survivors of lung cancer and family members. Outcome data interpretation is limited by the 1-group design and sample size.
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McKeague B, Maguire R. "The effects of cancer on a family are way beyond the person who's had it": The experience and effect of a familial cancer diagnosis on the health behaviours of family members. Eur J Oncol Nurs 2021; 51:101905. [PMID: 33601195 DOI: 10.1016/j.ejon.2021.101905] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 01/27/2021] [Accepted: 01/28/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE People who are first-degree relatives of cancer patients are at an increased risk of developing cancer themselves. Despite this, relatives of cancer patients do not always make beneficial changes to their health behaviours. This study aimed to answer the following questions: (1) do the health behaviours of people who are first-degree relatives of cancer survivors change following cancer diagnosis, and if so, how, and why, (2) what motivations/barriers exist for first-degree relatives when seeking to engage with health promoting behaviours, and (3) what do first-degree relatives believe healthcare organisations can do to improve uptake of healthy lifestyle changes. METHOD Nine biological first-degree relatives of cancer survivors living in Ireland (6 children, 2 siblings, 1 parent) participated in semi-structured interviews which were later thematically analysed. RESULTS Findings revealed four superordinate themes: Being Conscious/Aware, Limited Lifestyle Changes, Psychosocial Consequences of Experience, and Unmet Needs, with each of these themes having two to three subordinate themes. Patient and public involvement emphasised Unmet Needs, including needs for information and family support, as the theme that was most reflective of participants' lived experience. CONCLUSIONS Results suggest that while family members tend not to change their lifestyle behaviours following cancer diagnosis, they do seem to make changes to their medical behaviours. Additionally, they can be negatively impacted by the experience in several other ways. Identifying means of support will allow relatives to cope better post diagnosis.
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Affiliation(s)
- Beth McKeague
- Department of Psychology, Maynooth University, Maynooth, County Kildare, Ireland.
| | - Rebecca Maguire
- Department of Psychology, Maynooth University, Maynooth, County Kildare, Ireland.
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Unsar S, Erol O, Ozdemir O. Caregiving burden, depression, and anxiety in family caregivers of patients with cancer. Eur J Oncol Nurs 2021; 50:101882. [PMID: 33421929 DOI: 10.1016/j.ejon.2020.101882] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 11/13/2020] [Accepted: 11/20/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE The purpose of this cross-sectional study was to determine the caregiving burden, depression and anxiety of family caregivers of Turkish patients with cancer and the affecting factors. METHODS This cross-sectional study was conducted between January-May 2018 with one hundred and fifty-eight caregivers and one hundred and fifty-eight patients with cancer who were treated at a university hospital in Edirne, Turkey. Data were collected with a questionnaire form, Zarit Burden Interview (ZBI) Scale and the Hospital Anxiety Depression Scale (HADS). RESULTS This study found that 51.3% of the patients with cancer were male, 70.3% of the caregivers were female and more than half of them (57.0%) were the spouses of the patients. The mean ZBI score of the caregivers was 24.62 ± 14.19. There was a positive relationship between the ZBI scores and HADS scores of family caregivers (p < 0.05). As the caregiving burden of caregivers increased, their anxiety and depression levels were increased too. It was found that as the caregiving duration of family caregivers increased, the caregiving burden increased, and caregivers' anxiety depression scores got worse (p < 0.05). In the multivariate analysis, the duration of caregiving per day/hours, ECOG score and the age of the caregiver independently affected the caregiving burden (p < 0.05). As the functional status of the patient with cancer got worse, caregiving burden increased. Caregiving burden was found to be higher in those who were younger, female and giving care for longer times per day (p < 0.05). CONCLUSION This study found that as the caregiving burden and caregivers' daily patient care duration increased, the level of anxiety and depression increased too. Caregivers of patients with cancer should take appropriate psychological intervention to decrease their distress. In addition, we thought that healthcare professionals must consider the factors affecting the caregiving burden which affect the patient care directly.
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Affiliation(s)
- Serap Unsar
- Trakya University, Faculty of Health Sciences, Department of Internal Medicine Nursing, Balkan Campus, Edirne, Turkey.
| | - Ozgul Erol
- Trakya University, Faculty of Health Sciences, Department of Internal Medicine Nursing, Balkan Campus, Edirne, Turkey.
| | - Ozlem Ozdemir
- Kırklareli University, School of Health, Health Management Department, Kırklareli, Turkey.
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Feder S, Schulman-Green D, Akgün KM. Palliative Care During a Pandemic. Respir Med 2021. [DOI: 10.1007/978-3-030-81788-6_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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21
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Silva GVD, Moraes DEBD, Konstantyner T, Leite HP. [Social support and quality of life of families with children with congenital heart disease]. CIENCIA & SAUDE COLETIVA 2020; 25:3153-3162. [PMID: 32785550 DOI: 10.1590/1413-81232020258.18402018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Accepted: 11/15/2018] [Indexed: 11/22/2022] Open
Abstract
The scope of this article is to evaluate to what extent social support for families with children with congenital disease impacts their quality of life. It involved a cross-sectional study with 254 parents of children with congenital heart disease. A semi-structured interview was conducted with the parents, using the Ecomap and the quality of life (World Health Organization Quality of Life Bref) and social support (Medical Outcomes Study) scales. Receiving social support was positively correlated with quality of life (r=0.535; p<0.001). A 10-point increase in the social support scale led to a 3-point increase in the total score of the quality of life scale (β=0.30; CI95%: 0.23; 0.37). Socioeconomic conditions were associated with quality of life (β=0.27; CI95%: 0.11; 0.43) and caregivers who reported not having leisure activity (β=-3.27; CI95% -5.55; -1.12) and who were undergoing health treatment (β=-2.86; CI95%: -5.55; -0.17) had a lower perception of quality of life. Negative consequences to the quality of life of caregivers taking care of a child with congenital heart disease can be intensified by a lack of leisure activity and having health problems. Adequate social support and socioeconomic resources positively influence the quality of life of these caregivers.
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Affiliation(s)
- Gisele Vilella da Silva
- Departamento de Pediatria, Universidade Federal de São Paulo. R. Botucatu 598, Vila Clementino. 04023-062 São Paulo SP Brasil.
| | - Denise Ely Bellotto de Moraes
- Departamento de Pediatria, Universidade Federal de São Paulo. R. Botucatu 598, Vila Clementino. 04023-062 São Paulo SP Brasil.
| | - Tulio Konstantyner
- Departamento de Pediatria, Universidade Federal de São Paulo. R. Botucatu 598, Vila Clementino. 04023-062 São Paulo SP Brasil.
| | - Heitor Pons Leite
- Departamento de Pediatria, Universidade Federal de São Paulo. R. Botucatu 598, Vila Clementino. 04023-062 São Paulo SP Brasil.
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Mitchell HR, Kim Y, Carver CS, Llabre MM, Ting A, Mendez AJ. Roles of age and sources of cancer caregiving stress in self-reported health and neuroendocrine biomarkers. Psychol Health 2020; 36:952-966. [PMID: 32744869 DOI: 10.1080/08870446.2020.1800009] [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: 10/23/2022]
Abstract
OBJECTIVE To investigate the extent to which age and specific sources of caregiving stress are associated with cancer caregivers' health. Methods: New colorectal cancer caregivers (n = 88; age M = 49) reported caregiving stress (i.e., disrupted schedule, lacking family support, financial strain) and mental and physical health, and collected saliva samples assayed for neuroendocrine biomarkers (cortisol and α-amylase). Results: Disrupted daily schedule due to caregiving was associated with poorer self-reported mental health across all ages (B= -4.19, 95% CI: -6.59--1.80, p <.01), and associated with dysregulated cortisol patterns among older caregivers, but with more regulated cortisol patterns among younger caregivers, ps ≤ .01. Across all ages, lacking family support was associated with poorer self-reported physical health (B= -2.13, 95% CI: -4.33--0.07, p <.05), but more regulated α-amylase patterns (B = 2.51, 95% CI: 0.83-4.19, p <.01). Financial strain related to regulated cortisol levels only among older caregivers (B = 5.07, 95% CI: 0.58-9.57, p = .03) and more regulated α-amylase patterns across all ages (B= -25.81, 95% CI: -48.72--2.90, p <.05). Conclusion: Findings suggest that specific sources of caregiver stress manifest in health outcomes distinctly by age, and support the need for targeted psychosocial interventions for cancer caregivers.
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Affiliation(s)
| | - Youngmee Kim
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Charles S Carver
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Maria M Llabre
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Amanda Ting
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Armando J Mendez
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
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Lifestyle behaviors and intervention preferences of early-stage lung cancer survivors and their family caregivers. Support Care Cancer 2020; 29:1465-1475. [PMID: 32691229 DOI: 10.1007/s00520-020-05632-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 07/13/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Lung cancer (LC) is a highly prevalent disease with more survivors diagnosed and treated at earlier stages. There is a need to understand psychological and lifestyle behavior needs to design interventions for this population. Furthermore, understanding the needs and role of family caregivers, especially given the risks associated with second-hand smoke, is needed. METHODS Thirty-one early-stage (stages I or IIA) LC survivors of (52% men) and 22 (50% women) caregivers (N = 53 total) completed surveys after surgery (baseline) and at 3- and 6-month follow-ups. Participants reported on psychological functioning, smoking, and physical activity (PA) as well as intervention preferences. RESULTS Survivors reported low levels of psychological distress and 3% were current smokers during the study. Approximately 79% were sedentary and not meeting national PA guidelines. Caregivers also reported minimal psychological distress and were sedentary (62% not meeting guidelines), but a larger proportion continued to smoke following the survivor's cancer diagnosis (14%). Both survivors and caregivers expressed interest in home-based PA interventions but differed regarding preferred format for delivery. Most (64%) caregivers preferred a dyadic format, where survivors and caregivers participate in the intervention together. However, most survivors preferred an individual or group format (57%) for intervention delivery. CONCLUSION Both LC survivors and family caregivers could benefit from PA interventions, and flexible, dyadic interventions could additionally support smoking cessation for family caregivers.
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Perceived Control Prevents Perception of Negative Changes in Life as a Result of Caring for a Patient With Heart Failure. J Cardiovasc Nurs 2020; 36:206-211. [PMID: 32541246 DOI: 10.1097/jcn.0000000000000717] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Family caregivers of patients with heart failure (HF) commonly experience emotional distress and caregiving burden. Despite their caregiving distress, caregivers may experience positive or negative changes in their life compared with before caregiving. Greater perceived control is associated with better health outcomes, but little is known about whether perceived control is related to caregivers' perceptions of positive or negative changes in life, independent of their distress and burden in providing care for patients with HF. The specific aims were to compare emotional distress and caregiving burden between caregivers who perceived positive versus negative changes in life due to caregiving and to examine whether perceived control predicts the perception of positive or negative changes in life while controlling for emotional distress and caregiving burden. METHODS Primary caregivers of patients with HF (N = 140, 75% women) completed questionnaires about perceived positive or negative changes in life as a result of caregiving, perceived control, depressive symptoms, anxiety, and caregiving burden. Independent t test, χ2, and logistic regressions were used to accomplish specific aims. RESULTS Compared with caregivers who reported positive changes in life (42%), caregivers who perceived negative changes in life (58%) had higher levels of depressive symptoms, anxiety, and caregiving burden. Lower level of perceived control was an independent predictor of perceived negative changes in life, controlling for age, gender, depressive symptoms, anxiety, and caregiving burden (odds ratio, 0.89; 95% confidence interval, 0.79-0.99; P = .0038). CONCLUSION Greater perceived control played a protective role for caregivers independent of caregiver burden. Interventions designed to enhance perceived control may improve caregivers' perceptions of changes in their life.
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Beer JM, Smith KN, Kennedy T, Mois G, Acena D, Gallerani DG, McDonnell KK, Owens OL. A Focus Group Evaluation of Breathe Easier: A Mindfulness-Based mHealth App for Survivors of Lung Cancer and Their Family Members. Am J Health Promot 2020; 34:770-778. [PMID: 32406241 DOI: 10.1177/0890117120924176] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To explore attitudes and acceptance (i.e., intent for future adoption) of survivors of lung cancer and their family members toward a dyad-focused mHealth mindfulness-based intervention (MBI). APPROACH Focus groups. SETTING Community hospital setting in South Carolina. PARTICIPANTS Survivors n = 11 (M = 64.6 years; 73% female; 64% African American) of non-small cell lung cancer (stage I-IIIa) and their family members, n = 8 (M = 58.6 years; 38% female; 75% African American). INTERVENTION A fully functional prototype mHealth app to deliver a tailored MBI for survivors of lung cancer and their family members. METHOD Semi-structured focus groups were conducted and assessed using thematic data analysis to identify the benefits, concerns, needs, and expectations of the app. RESULTS Convenience and health were the top benefits of using the app, while cost and difficulty of use were the top concerns. Survivors mentioned benefits more than their family members did. Participants felt positively about adding a community network to the app. Finally, participants expected to hear about Breathe Easier from their care provider. CONCLUSION Participants perceived a benefit to having credible health information delivered through an mHealth app. Guidance and credible health information regarding lung cancer survivorship should be accessible and convenient for everyone impacted by the disease. Thus, future research should explore platforms for a virtual support system and understanding dissemination of mHealth apps through health care providers.
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Affiliation(s)
- Jenay M Beer
- Institute of Gerontology, University of Georgia, Athens, GA, USA.,College of Public Health, University of Georgia, Athens, GA, USA.,School of Social Work, University of Georgia, Athens, GA, USA
| | - Kasey N Smith
- College of Public Health, University of Georgia, Athens, GA, USA
| | - Taylor Kennedy
- College of Public Health, University of Georgia, Athens, GA, USA.,School of Social Work, University of Georgia, Athens, GA, USA
| | - George Mois
- School of Social Work, University of Georgia, Athens, GA, USA
| | - Dane Acena
- College of Engineering, Computing, and Applied Sciences, 2545Clemson University, Clemson, SC, USA
| | - David G Gallerani
- College of Nursing, 2629University of South Carolina, Columbia, SC, USA
| | | | - Otis L Owens
- College of Social Work, 2629University of South Carolina, Columbia,SC, USA
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Overcash J, Fugett S, Tan A, Ginther J, Williams N. Strain Among Caregivers of Older Adults Diagnosed With Breast Cancer. Oncol Nurs Forum 2019; 46:E185-E201. [PMID: 31626615 DOI: 10.1188/19.onf.e185-e201] [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
OBJECTIVES To illustrate the predictors of strain among caregivers of older adults diagnosed with breast cancer. SAMPLE & SETTING This study involved 39 women diagnosed with breast cancer who were aged 69 years or older, receiving any type of treatment, and seeking an initial assessment in a geriatric oncology program at a large cancer center in the midwestern United States and their caregivers. METHODS & VARIABLES This cross-sectional study evaluated relationships among the variables of caregiver strain, age, employment status, patient characteristics, and patient scores on the comprehensive geriatric assessment. Bivariate statistics and logistic regression models were used. RESULTS Increasing age of the caregiver was associated with less caregiver strain. Caregivers employed part-time experienced greater strain than those employed full-time. IMPLICATIONS FOR NURSING Nurses must assess for strain in caregivers of individuals diagnosed with cancer, particularly if they are younger and employed part-time. Caregivers of depressed patients should be assessed for strain and offered support.
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Affiliation(s)
| | - Susan Fugett
- Ohio State University Comprehensive Cancer Center and the Arthur G. James Cancer Hospital and Richard J. Solove Research Institute
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Divdar Z, Foroughameri G, Farokhzadian J. The psychosocial needs and quality of life of family caregivers of patients with organ transplant. J Res Nurs 2019; 24:344-355. [PMID: 34394546 DOI: 10.1177/1744987119845029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Families of patients with organ transplants experience many problems, both with the onset of illness and during the hospitalisation of their relative for an organ transplant. The healthcare providers try their best to give high-quality care to patients. However, they neglect quality of life and psychosocial needs of family caregivers. Aims This study aimed to assess the psychosocial needs and quality of life of the family caregivers of post-transplant patients and the relationship between these two variables. Methods This descriptive correlational study was conducted on liver, kidney and bone marrow transplant wards in the largest transplant centre affiliated with a university of medical science in south-eastern Iran. The sample included 230 family caregivers of post-transplant patients, who were selected using quota sampling. Data were collected using the 45-item questionnaire of psychosocial needs (the Critical Care Family Needs Inventory) with five dimensions (assurance, comfort, information, proximity and support), and the Short Form-36 Quality of Life questionnaire with eight scales (physical functioning, physical problems, emotional problems, social functioning, pain, vitality, mental health and perception of health). In the Critical Care Family Needs Inventory, 1 indicates not important and 4 very important. In the Short Form-36 Quality of Life questionaire, 0 indicates the worst health and 100 the best health. Results The participants rated the mean of their psychosocial needs as important (3.18 ± 0.27). Also, the mean of quality of life of participants was at an undesirable level (45.17 ± 92.66). The psychosocial needs of the caregivers showed a poor, inverse significant relationship with their quality of life (r = -0.16, p = 0.01). Conclusion The results showed that with increasing psychosocial needs of family caregivers of post-transplant patients, their quality of life declines. Healthcare providers should implement developed plans and appropriate strategies to fulfil psychosocial needs and improve the quality of life of family caregivers of these patients.
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Affiliation(s)
- Zahra Divdar
- Student Research Committee, Kerman University of Medical Sciences, Kerman, Iran
| | - Golnaz Foroughameri
- Instructor, Department of Community Health Nursing, School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Jamileh Farokhzadian
- Assistant Professor, Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran
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Lightfoot N, MacEwan L, Tufford L, Holness DL, Mayer C, Kramer DM. Who cares? The impact on caregivers of suspected mining-related lung cancer. ACTA ACUST UNITED AC 2019; 26:e494-e502. [PMID: 31548817 DOI: 10.3747/co.26.4635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Background In the present study, we investigated the emotional, physical, financial, occupational, practical, and quality-of-life impacts on caregivers of patients with mining-related lung cancer. Methods This concurrent, embedded, mixed-methods study used individual in-depth qualitative interviews and the 36-item Short Form Health Survey (version 2: RAND Corporation, Santa Monica, CA, U.S.A.) quality-of-life measure with 8 caregivers of patients with suspected mining-related lung cancer who had worked in Sudbury or Elliot Lake (or both), and sometimes elsewhere. Individuals who assist workers in filing compensation claims were also interviewed in Sudbury and Elliot Lake. Interviews (n = 11) were transcribed and analyzed thematically. Results Caregiver themes focused on the long time to, and the shock of, diagnosis and dealing with lung cancer; not much of a life for caregivers; strong views about potential cancer causes; concerns about financial impacts; compensation experiences and long time to compensation; and suggestions for additional support. Quality-of-life scores were below the norm for most measures. Individuals who assist workers in preparing claims were passionate about challenges in the compensation journey; the requirement for more and better family support; the need to focus on compensation compared with cost control; the need for better exposure monitoring, controls, resources, and research; and job challenges, barriers, and satisfaction. Conclusions Caregivers expressed a need for more education about the compensation process and for greater support. Worker representatives required persistence, additional workplace monitoring and controls, additional research, and a focus on compensation compared with cost control. They also emphasized the need for more family support.
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Affiliation(s)
- N Lightfoot
- School of Rural and Northern Health, Laurentian University, Sudbury, ON
| | - L MacEwan
- School of Social Work, Laurentian University, Sudbury, ON
| | - L Tufford
- School of Social Work, Laurentian University, Sudbury, ON
| | - D L Holness
- Dalla Lana School of Public Health and Department of Medicine, University of Toronto, and Division of Occupational Medicine and Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON
| | - C Mayer
- Supportive Care Oncology Research Unit, Health Sciences North, Sudbury, ON
| | - D M Kramer
- School of Occupational and Public Health, Ryerson University, Toronto, ON
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Nightingale CL, Steffen LE, Tooze JA, Petty W, Danhauer SC, Badr H, Weaver KE. Lung Cancer Patient and Caregiver Health Vulnerabilities and Interest in Health Promotion Interventions: An Exploratory Study. Glob Adv Health Med 2019; 8:2164956119865160. [PMID: 31360617 PMCID: PMC6637827 DOI: 10.1177/2164956119865160] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 06/14/2019] [Accepted: 06/28/2019] [Indexed: 12/20/2022] Open
Abstract
Introduction Lung cancer patients and their caregivers are at risk for negative health behaviors and poor psychosocial functioning, but few interventions exist that target this population. To inform intervention development, we explored potential targets and interest and concordance in health promotion interventions among lung cancer patients and their caregivers. Methods Lung cancer patients (n = 18) with a smoking history and their caregivers (n = 15) participated in a cross-sectional, observational survey study (an average of 1 month postdiagnosis) to assess health behaviors, psychosocial functioning, and interest in health promotion interventions. Fisher’s exact and Wilcoxon rank-sum tests examined factors associated with intervention interest. McNemar’s test examined concordance in interest. Results Many caregivers (40%) reported providing care at least 4 days per week, and over half (53.3%) reported a smoking history. Patients reported high cancer self-blame (mean = 3.1, standard deviation = 0.9, range = 1–4). Patients (55.6%) and caregivers (60%) reported clinically significant depressive symptoms. There was high interest and concordance in interest in cancer education (patients, 77.8%; caregivers, 86.7%) and diet and exercise (patients, 66.7%; caregivers, 80%) interventions. Significantly more caregivers were interested in stress reduction (patients, 53.3%; caregivers, 73.3%; P = .05) and yoga (patients, 16.7%; caregivers, 50%; P = .03) than patients. Caregivers interested in stress reduction interventions had higher levels of distress than those not interested. Discussion Health promotion interventions are needed and of interest to lung cancer patients and caregivers. Shared interests in interventions suggest dyadic interventions may be appropriate, yet interventions should also address distinct patient and caregiver needs.
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Affiliation(s)
- Chandylen L Nightingale
- Department of Social Sciences & Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Laurie E Steffen
- Department of Social Sciences & Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Janet A Tooze
- Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - William Petty
- Section on Hematology and Oncology, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Suzanne C Danhauer
- Department of Social Sciences & Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Hoda Badr
- Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Kathryn E Weaver
- Department of Social Sciences & Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina
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Hsieh CC, Yu CJ, Chen HJ, Chen YW, Chang NT, Hsiao FH. Dispositional mindfulness, self-compassion, and compassion from others as moderators between stress and depression in caregivers of patients with lung cancer. Psychooncology 2019; 28:1498-1505. [PMID: 31087458 DOI: 10.1002/pon.5106] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 04/19/2019] [Accepted: 05/07/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The present study aimed to identify the most important protective factors predicting caregivers' depressive symptoms among factors of caregivers' dispositional mindfulness, self-compassion, compassion from others, and patients' dispositional mindfulness and their moderator effects on the relationship between caregiving stress and depressive symptoms. METHODS A total of 72 lung cancer outpatients and their family caregivers participated in this study. Family caregivers completed the Kingston Caregiver Stress Scale, Beck Depression Inventory-II (BDI-II), Five Facet Mindfulness Questionnaire (FFMQ), Self-Compassion Scale, and Compassion from Others Scale. Patients completed the EORTC Quality of Life Questionnaire Core 30 (EORTC QLQ-C30), BDI-II, and FFMQ. RESULTS After controlling for patients' factors (treatment status, symptom distress, and depressive symptoms) and caregivers' health status, caregivers' stress and dispositional mindfulness, the domain of mindful awareness, and self-compassionate action were significantly associated with their depressive symptoms. Further analysis indicated that mindful awareness or self-compassionate action could buffer the effect of caregiving stress on depressive symptoms. When the two moderators, mindful awareness and self-compassionate action, were tested simultaneously, only self-compassionate action remained as a significant moderating effect. CONCLUSIONS Caregivers' mindful awareness and self-compassionate action were protective factors, which mitigate the impact of caregiving stress on their depressive symptoms. Therefore, the future supportive program aims at training the competencies of self-compassionate action with mindful awareness, which may enhance caregivers' coping resources.
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Affiliation(s)
- Chia-Chen Hsieh
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chong-Jen Yu
- National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Hsiu-Jung Chen
- Department of Educational Psychology and Counseling, National Taiwan Normal University, Taipei, Taiwan
| | - Yu-Wen Chen
- Department of Social Work, National Taiwan University, Taipei, Taiwan
| | - Nien-Tzu Chang
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Fei-Hsiu Hsiao
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan
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Kilic ST, Oz F. Family Caregivers' Involvement in Caring with Cancer and their Quality of Life. Asian Pac J Cancer Prev 2019; 20:1735-1741. [PMID: 31244294 PMCID: PMC7021632 DOI: 10.31557/apjcp.2019.20.6.1735] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Indexed: 01/28/2023] Open
Abstract
Background: Cancer is a chronic disease and a major health problem. It affects both patients and their family
caregivers multidimensionally. The family caregivers may be affected by not only the disease process but also hospital
policies, economic difficulties, accessibility and communication of health care service and can be in need of help.
This process may affect their quality of life. However, there have not been enough studies on quality of life of family
caregivers of patients with cancer in Turkish culture. Therefore, this study aimed to evaluate the quality of life of
family caregivers of patients with cancer in Turkey. Objectives: The purpose of study was to evaluate the quality of
life of family caregivers with cancer patients in Turkey. Methods: Participants consist of the family caregivers who
volunteered to take part in this descriptive study from 11 hospitals (n =378) which has a daily chemotherapy units
and located within the boundaries of Ankara, Turkey. ‘Sociodemographic Characteristic Form’ and ‘Quality of Life
Scale-Family Version were used as data collection tool. The Kruskal-Wallis and Mann-Whitney U, tests were used
for data analysis. Resultes:It is found that there are statistically significant difference among the factors of gender,
employment status, income level, and whether caregivers reside with their patients. Family caregivers’ quality of life is
negatively affected during the caregiving process (p < 0.05). Conclusion: The results indicate that family caregivers’
quality of life are negatively affected to care process. The results of this research are important as they highlight the
need to also consider family caregivers’ quality of life when caring for patients, and study highlight possible areas in
which support can be provided for family caregivers of cancer patients in Turkey.
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Affiliation(s)
- Sevcan Toptas Kilic
- Hacettepe University Faculty of Nursing, Psychiatric Nursing Department, Ankara, Turkey.
| | - Fatma Oz
- Near East University, Faculty of Nursing, Mersin, Turkey
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van Roij J, Brom L, Youssef-El Soud M, van de Poll-Franse L, Raijmakers NJH. Social consequences of advanced cancer in patients and their informal caregivers: a qualitative study. Support Care Cancer 2019; 27:1187-1195. [PMID: 30209602 PMCID: PMC6394690 DOI: 10.1007/s00520-018-4437-1] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 08/21/2018] [Indexed: 12/29/2022]
Abstract
PURPOSE Cancer threatens the social well-being of patients and their informal caregivers. Social life is even more profoundly affected in advanced diseases, but research on social consequences of advanced cancer is scarce. This study aims to explore social consequences of advanced cancer as experienced by patients and their informal caregivers. METHODS Seven focus groups and seven in-depth semi-structured interviews with patients (n = 18) suffering from advanced cancer and their informal caregivers (n = 15) were conducted. Audiotapes were transcribed verbatim and open coded using a thematic analysis approach. RESULTS Social consequences were categorized in three themes: "social engagement," "social identity," and "social network." Regarding social engagement, patients and informal caregivers said that they strive for normality by continuing their life as prior to the diagnosis, but experienced barriers in doing so. Regarding social identity, patients and informal caregivers reported feelings of social isolation. The social network became more transparent, and the value of social relations had increased since the diagnosis. Many experienced positive and negative shifts in the quantity and quality of their social relations. CONCLUSIONS Social consequences of advanced cancer are substantial. There appears to be a great risk of social isolation in which responses from social relations play an important role. Empowering patients and informal caregivers to discuss their experienced social consequences is beneficial. Creating awareness among healthcare professionals is essential as they provide social support and anticipate on social problems. Finally, educating social relations regarding the impact of advanced cancer and effective support methods may empower social support systems and reduce feelings of isolation.
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Affiliation(s)
- Janneke van Roij
- The Netherlands Comprehensive Cancer Organisation, PO box 19079, 3501 DB, Utrecht, The Netherlands.
- CoRPS - Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.
| | - Linda Brom
- The Netherlands Comprehensive Cancer Organisation, PO box 19079, 3501 DB, Utrecht, The Netherlands
| | | | - Lonneke van de Poll-Franse
- The Netherlands Comprehensive Cancer Organisation, PO box 19079, 3501 DB, Utrecht, The Netherlands
- CoRPS - Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Natasja J H Raijmakers
- The Netherlands Comprehensive Cancer Organisation, PO box 19079, 3501 DB, Utrecht, The Netherlands
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Health behavior changes in African American family members facing lung cancer: Tensions and compromises. Eur J Oncol Nurs 2019; 38:57-64. [PMID: 30717937 DOI: 10.1016/j.ejon.2018.12.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 12/05/2018] [Accepted: 12/06/2018] [Indexed: 11/22/2022]
Abstract
PURPOSE Behavioral interventions targeting cancer survivors often fail to address the clustering of unhealthy behaviors among family members and friends, and the impact of close relationships on behavior change. The study's aim was to identify factors associated with receptivity and preferences for lifestyle behavior change among family members of African-American survivors of lung cancer. METHODS Principles of social cognitive theory guided the design. A descriptive, qualitative study recruited 26 African-American family members of lung cancer survivors from two teaching hospitals in the southeastern United States. A 20-item Information Form collected demographic, health status, and health behavior information. Family members participated in one of three semi-structured focus group discussions. RESULTS Four major themes emerged: family members and survivors both resisted the caregiver role; dramatic changes evoked by the diagnosis of lung cancer were facilitators and barriers to lifestyle choices; leaning on faith was the primary source of support; and these families live with a constant threat of multiple cancers. Findings emphasize the importance of meaningful conversations among health-care providers, survivors, and family members during the time of diagnosis, treatment, and recovery, so that family members are better prepared to cope with anticipated changes. CONCLUSIONS This study highlights the stressors that affect family members and sheds light on their unique needs. The stressors limit their ability to change health behaviors. Family members need basic education, skills training, and support related to the lung cancer diagnosis and other cancers. Current methods to provide these services are limited in their accessibility, availability, and effectiveness.
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Tang W, Friedman DB, Kannaley K, Davis RE, Wilcox S, Levkoff SE, Hunter RH, Gibson A, Logsdon RG, Irmiter C, Belza B. Experiences of caregivers by care recipient's health condition: A study of caregivers for Alzheimer's disease and related dementias versus other chronic conditions. Geriatr Nurs 2018; 40:181-184. [PMID: 30366611 DOI: 10.1016/j.gerinurse.2018.09.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Revised: 09/18/2018] [Accepted: 09/23/2018] [Indexed: 12/16/2022]
Abstract
This study described experiences of caregivers of persons with Alzheimer's disease and other dementias (ADRD) and caregivers of persons with other chronic conditions on self-reported health, type of assistance they provide, perceptions of how caregiving interferes with their lives, and perceived level of support. A secondary analysis was conducted of the 2013 Porter Novelli SummerStyles survey data. Of the 4033 respondents, 650 adults self-identified as caregivers with 11.6% caring for people with ADRD. Over half of all caregivers reported that caregiving interfered with their lives to some extent. The greater the perceived support caregivers reported, the less they thought that caregiving interfered with their lives (p < .001). No significant differences were found between ADRD and non-ADRD caregivers regarding general health, types of assistance they provided, and perceived level of support. These findings have the potential to inform future research and practice in the development of supportive services for caregivers.
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Affiliation(s)
| | | | | | | | - Sara Wilcox
- University of South Carolina, Columbia, SC, USA
| | | | - Rebecca H Hunter
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | | | | | - Basia Belza
- University of Washington, Seattle, Washington, USA
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Sun V, Kim JY, Raz DJ, Chang W, Erhunmwunsee L, Uranga C, Ireland AM, Reckamp K, Tiep B, Hayter J, Lew M, Ferrell B, McCorkle R. Preparing Cancer Patients and Family Caregivers for Lung Surgery: Development of a Multimedia Self-Management Intervention. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2018; 33:557-563. [PMID: 27542378 PMCID: PMC5573658 DOI: 10.1007/s13187-016-1103-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
The surgical treatment of lung malignancies often results in persistent symptoms, psychosocial distress, and decrements in quality of life (QOL) for cancer patients and their family caregivers (FCGs). The potential benefits of providing patients and FCGs with preparatory education that begins in the preoperative setting have been explored in multiple medical conditions, with positive impact observed on postoperative recovery, psychological distress, and QOL. However, few studies have explored the benefits of preparatory educational interventions to promote self-management in cancer surgery, including lung surgery. This paper describes the systematic approach used in the development of a multimedia self-management intervention to prepare cancer patients and their FCGs for lung surgery. Intervention development was informed by (1) contemporary published evidence on the impact of lung surgery on patients and FCG, (2) our previous research that explored QOL, symptoms, and caregiver burden after lung surgery, (3) the use of the chronic care self-management model (CCM) to guide intervention design, and (4) written comments and feedback from patients and FCGs that informed intervention development and refinement. Pilot-testing of the intervention is in process, and a future randomized trial will determine the efficacy of the intervention to improve patient, FCG, and system outcomes.
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Affiliation(s)
- Virginia Sun
- Division of Nursing Research and Education, Department of Population Sciences, City of Hope, 1500 East Duarte Road, Duarte, CA, 91010, USA.
| | - Jae Y Kim
- Division of Thoracic Surgery, Department of Surgery, City of Hope, Duarte, CA, USA
| | - Dan J Raz
- Division of Thoracic Surgery, Department of Surgery, City of Hope, Duarte, CA, USA
| | - Walter Chang
- Department of Anesthesiology, City of Hope, Duarte, CA, USA
| | - Loretta Erhunmwunsee
- Division of Thoracic Surgery, Department of Surgery, City of Hope, Duarte, CA, USA
| | - Carolina Uranga
- Department of Nursing, Clinical Practice and Education, City of Hope, Duarte, CA, USA
| | - Anne Marie Ireland
- Department of Nursing, Solid Tumor Malignancies Program, City of Hope, Duarte, CA, USA
| | - Karen Reckamp
- Department of Medical Oncology and Therapeutics Research, City of Hope, Duarte, CA, USA
| | - Brian Tiep
- Department of Respiratory Diseases and Pulmonary Rehabilitation, City of Hope, Duarte, CA, USA
| | | | - Michael Lew
- Department of Anesthesiology, City of Hope, Duarte, CA, USA
| | - Betty Ferrell
- Division of Nursing Research and Education, Department of Population Sciences, City of Hope, 1500 East Duarte Road, Duarte, CA, 91010, USA
| | - Ruth McCorkle
- School of Nursing, Yale University, New Haven, CT, USA
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Winger JG, Rand KL, Hanna N, Jalal SI, Einhorn LH, Birdas TJ, Ceppa DP, Kesler KA, Champion VL, Mosher CE. Coping Skills Practice and Symptom Change: A Secondary Analysis of a Pilot Telephone Symptom Management Intervention for Lung Cancer Patients and Their Family Caregivers. J Pain Symptom Manage 2018; 55:1341-1349.e4. [PMID: 29366911 PMCID: PMC5899922 DOI: 10.1016/j.jpainsymman.2018.01.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 01/03/2018] [Accepted: 01/10/2018] [Indexed: 02/05/2023]
Abstract
CONTEXT Little research has explored coping skills practice in relation to symptom outcomes in psychosocial interventions for cancer patients and their family caregivers. OBJECTIVES To examine associations of coping skills practice to symptom change in a telephone symptom management (TSM) intervention delivered concurrently to lung cancer patients and their caregivers. METHODS This study was a secondary analysis of a randomized pilot trial. Data were examined from patient-caregiver dyads (n = 51 dyads) that were randomized to the TSM intervention. Guided by social cognitive theory, TSM involved four weekly sessions where dyads were taught coping skills including a mindfulness exercise, guided imagery, pursed lips breathing, cognitive restructuring, problem solving, emotion-focused coping, and assertive communication. Symptoms were assessed, including patients' and caregivers' psychological distress and patients' pain interference, fatigue interference, and distress related to breathlessness. Multiple regression analyses examined associations of coping skills practice during the intervention to symptoms at six weeks after the intervention. RESULTS For patients, greater practice of assertive communication was associated with less pain interference (β = -0.45, P = 0.02) and psychological distress (β = -0.36, P = 0.047); for caregivers, greater practice of guided imagery was associated with less psychological distress (β = -0.30, P = 0.01). Unexpectedly, for patients, greater practice of a mindfulness exercise was associated with higher pain (β = 0.47, P = 0.07) and fatigue interference (β = 0.49, P = 0.04); greater practice of problem solving was associated with higher distress related to breathlessness (β = 0.56, P = 0.01) and psychological distress (β = 0.36, P = 0.08). CONCLUSION Findings suggest that the effectiveness of TSM may have been reduced by competing effects of certain coping skills. Future interventions should consider focusing on assertive communication training for patients and guided imagery for caregivers.
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Affiliation(s)
- Joseph G Winger
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA.
| | - Kevin L Rand
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA
| | - Nasser Hanna
- Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Shadia I Jalal
- Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA; Richard L. Roudebush VAMC, Indianapolis, Indiana, USA
| | - Lawrence H Einhorn
- Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Thomas J Birdas
- Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - DuyKhanh P Ceppa
- Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Kenneth A Kesler
- Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | | | - Catherine E Mosher
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA
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“I Didn’t Expect to Learn as Much as I Did”: Rewards of Caregiving in Young Adulthood. JOURNAL OF ADULT DEVELOPMENT 2018. [DOI: 10.1007/s10804-018-9284-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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38
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Lau BHP, Chow AYM, Wong DFK, Chan JSM, Chan CHY, Ho RTH, So TH, Lam TC, Lee VHF, Lee AWM, Chow SF, Chan CLW. Study protocol of a randomized controlled trial comparing integrative body-mind-spirit intervention and cognitive behavioral therapy in fostering quality of life of patients with lung cancer and their family caregivers. ACTA ACUST UNITED AC 2018; 15:258-276. [PMID: 29400621 DOI: 10.1080/23761407.2018.1435325] [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] [Indexed: 01/22/2023]
Abstract
Compared to cancers at other sites, lung cancer often results in greater psychosocial distress to both the patients and their caregivers, due to the poor prognosis and survival rate, as well as the heavy symptom burden. In recent years, making protocols of proposed or on-going studies publicly available via clinical trial registries and/or peer-reviewed journals has benefited health sciences with timely communication of the latest research trends and improved transparency in reporting. However, such practice is yet to be a common sight in evidence-informed social work. Hence, this paper discusses the value of publishing protocols in social work research and presents the protocol of a randomized controlled trial that compares the effectiveness of integrative body-mind-spirit intervention with cognitive behavioral therapy for enhancing quality of life of patients with lung cancer and their family caregivers. The data collection process was still on-going at the time of manuscript submission.
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Affiliation(s)
- Bobo Hi-Po Lau
- a Department of Social Work & Social Administration , University of Hong Kong , Pokfulam , Hong Kong
| | - Amy Y M Chow
- a Department of Social Work & Social Administration , University of Hong Kong , Pokfulam , Hong Kong
| | - Daniel F K Wong
- a Department of Social Work & Social Administration , University of Hong Kong , Pokfulam , Hong Kong
| | - Jessie S M Chan
- a Department of Social Work & Social Administration , University of Hong Kong , Pokfulam , Hong Kong
| | - Celia H Y Chan
- a Department of Social Work & Social Administration , University of Hong Kong , Pokfulam , Hong Kong
| | - Rainbow T H Ho
- a Department of Social Work & Social Administration , University of Hong Kong , Pokfulam , Hong Kong
| | - Tsz-Him So
- b Department of Clinical Oncology , University of Hong Kong , Pokfulam , Hong Kong
| | - Tai-Chung Lam
- b Department of Clinical Oncology , University of Hong Kong , Pokfulam , Hong Kong
| | - Victor Ho-Fun Lee
- b Department of Clinical Oncology , University of Hong Kong , Pokfulam , Hong Kong
| | - Anne W M Lee
- b Department of Clinical Oncology , University of Hong Kong , Pokfulam , Hong Kong
| | | | - Cecilia L W Chan
- a Department of Social Work & Social Administration , University of Hong Kong , Pokfulam , Hong Kong
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Finley J. Caregiver Café: Providing Education and Support to Family Caregivers of Patients With Cancer. Clin J Oncol Nurs 2018; 22:91-96. [DOI: 10.1188/18.cjon.91-96] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Mosher CE, Ott MA, Hanna N, Jalal SI, Champion VL. Development of a Symptom Management Intervention: Qualitative Feedback From Advanced Lung Cancer Patients and Their Family Caregivers. Cancer Nurs 2017; 40:66-75. [PMID: 26925990 PMCID: PMC5001932 DOI: 10.1097/ncc.0000000000000350] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Little is known about cancer patient and family caregiver preferences for the content and format of nonpharmacologic interventions. Revising interventions based on patient and caregiver feedback before implementation may improve intervention feasibility and acceptability, especially in the context of advanced-stage cancer. OBJECTIVES The aim of the study was to obtain feedback from patients with advanced-stage, symptomatic lung cancer and their family caregivers on the content and format of a nonpharmacologic symptom management intervention under development. The intervention blended evidence-based cognitive-behavioral and emotion-focused strategies to reduce physical and psychological symptoms. METHODS Semistructured qualitative interviews were conducted with 21 patients with advanced-stage, symptomatic lung cancer and caregivers. Participants reviewed handouts regarding intervention components and provided feedback. RESULTS Patients and caregivers desired intervention components that addressed the patient's high symptom burden such as education regarding treatment adverse effects and the provision of various coping tools. Offering interventions with a brief or flexible length and delivering them via telephone were other suggestions for enhancing intervention acceptability. Participants also preferred an equal focus on patient and caregiver concerns and a more positive intervention framework. CONCLUSIONS Intervention preferences of patients with advanced-stage lung cancer and caregivers underscore the severity of the disease and treatment process and the need to adapt interventions to patients with high symptom burden. These preferences may be incorporated into future intervention trials to improve participant recruitment and retention. IMPLICATIONS FOR PRACTICE Nurses can modify interventions to meet the needs of patients with advanced-stage, symptomatic lung cancer and caregivers. For example, flexibility regarding intervention content and length may accommodate those with significant symptoms.
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Affiliation(s)
- Catherine E Mosher
- Author Affiliations: Department of Psychology, Indiana University-Purdue University Indianapolis (Dr Mosher); and Departments of Pediatrics (Dr Ott) and Medicine (Drs Hanna and Jalal), School of Medicine, and School of Nursing (Dr Champion), Indiana University, Indianapolis
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Pilot Study of a Communication Coaching Telephone Intervention for Lung Cancer Caregivers. Cancer Nurs 2017; 41:506-512. [PMID: 28753194 DOI: 10.1097/ncc.0000000000000535] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Family caregivers are a key communication source for nurses, and there is a need to provide communication skill building for caregivers. OBJECTIVE A pilot study was conducted to determine feasibility and use of a communication coaching telephone intervention aimed at improving caregiver confidence in communication and reducing psychological distress. METHODS A printed communication guide for caregivers and a 1-time communication coaching call delivered by a research nurse were provided to caregivers. Recruitment and attrition, implementation and content of coaching calls, caregiver outcomes, and satisfaction with intervention were analyzed. RESULTS Twenty caregivers were recruited across 4 cohorts-diagnosis, treatment, survivorship, and end of life-with recruitment greater than 70%. Caregiver calls averaged 37 minutes, and most caregivers reported communication challenges with family members. Caregiver action plans revealed a need to develop communication skills to ask for help and share information. Caregivers reported satisfaction with the print guide, and 90% of caregivers followed through with their action plan, with 80% reporting that the action plan worked. Caregiver confidence in communication with healthcare providers was improved, except for caregivers of cancer survivors. CONCLUSIONS Recruitment and attrition rates demonstrate feasibility of the intervention. Caregivers reported that the communication coaching telephone intervention was considered valuable and they were able to implement a communication action plan with others. IMPLICATIONS FOR PRACTICE Lessons were learned about intervention content, namely, that nurses can help caregivers learn communication strategies for asking for help, sharing cancer information, and initiating self-care.
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Cuthbert CA, King-Shier K, Tapp D, Ruether D, Culos-Reed SN. Exploring Gender Differences in Self-Reported Physical Activity and Health Among Older Caregivers. Oncol Nurs Forum 2017. [PMID: 28632242 DOI: 10.1188/17.onf.435-445] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To document self-reported physical health and activity levels of older caregivers. Gender differences in physical health, physical activity levels, and predictors of physical activity were also examined.
. DESIGN A cross-sectional study.
. SETTING Tom Baker Cancer Centre in Calgary, Alberta, Canada.
. SAMPLE 130 caregivers aged 60 years or older caring for individuals with breast, prostate, or colorectal cancer.
. METHODS Self-report survey including validated questionnaires on physical and mental health and physical activity levels. Convenience sampling was used. Data were analyzed using descriptive statistics, correlations, and multiple regression.
. MAIN RESEARCH VARIABLES The physical component score of the SF-36v2® was the main research variable. Other variables included the mental component score of the SF-36v2, sleep quality, depression, social support, physical activity levels, and anxiety.
. FINDINGS The mean age of caregivers was 70 years. Physical health and physical activity levels were higher than population norms. A significant difference in physical health (p = 0.015) existed between men and women but not in physical activity levels (p = 0.079). Predictors of physical activity levels were age (β = -0.291), physical health (β = 0.307), and caregiving hours per week (β = -0.221).
. CONCLUSIONS The findings suggest that gender had a minimal effect on physical health and no effect on physical activity levels in older caregivers. Depression and poor sleep quality were high in some caregivers but did not predict physical activity levels.
. IMPLICATIONS FOR NURSING The negative effects of caregiving on physical health and physical activity levels in older caregivers are not universal. Nurses should be aware of the caregiving situation and promote health based on the individual.
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Lambert S, Girgis A, Descallar J, Levesque JV, Jones B. Trajectories of mental and physical functioning among spouse caregivers of cancer survivors over the first five years following the diagnosis. PATIENT EDUCATION AND COUNSELING 2017; 100:1213-1221. [PMID: 28089132 DOI: 10.1016/j.pec.2016.12.031] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 11/30/2016] [Accepted: 12/29/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Identify the trajectories of physical and mental functioning among spouse caregivers of patients with cancer over the first five years post-diagnosis and variables associated with low or deteriorating functioning. METHODS Caregivers completed a survey at 6 months and 1, 2, 3.5, and 5 years post-patient diagnosis, including the SF-12 for quality of life (QOL). SF-12 Mental Component Summary (MCS, n=299) and Physical Component Summary (PCS, n=300) scores were analyzed using SAS. RESULTS Five trajectories for PCS were identified, the top three were: (a) high PCS (53.0%); (b) steady decline in PCS (17.0%); and (c) steady increase, but remaining below population norm (16.7%). Five trajectories for MCS were also identified, the top two being: (a) high MCS (45.8%) and (b) MCS comparable to population norm (27.8%). Variables associated with low or deteriorating QOL included depression, social support, coping, burden, and/or unmet needs. CONCLUSIONS This is the first study to document spouse caregivers' QOL over the first five years post-patient diagnosis. Although many participants experienced high functioning, almost a third reported low or deteriorating mental or physical functioning. PRACTICE IMPLICATIONS Variables associated with low or deteriorating mental and physical functioning can be targeted in future interventions.
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Affiliation(s)
- Sylvie Lambert
- Ingram School of Nursing, McGill University, Montreal, Canada; St. Mary's Research Centre, Montreal, Canada; Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, UNSW Medicine, University of New South Wales, Australia.
| | - Afaf Girgis
- Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, UNSW Medicine, University of New South Wales, Australia
| | - Joseph Descallar
- Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, The University of New South Wales, Liverpool, Australia
| | - Janelle V Levesque
- Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, UNSW Medicine, University of New South Wales, Australia
| | - Bobby Jones
- Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, USA
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Kugimoto T, Katsuki R, Kosugi T, Ohta A, Sato H. Significance of Psychological Stress Response and Health-related Quality of Life in Spouses of Cancer Patients When Given Bad News. Asia Pac J Oncol Nurs 2017; 4:147-154. [PMID: 28503648 PMCID: PMC5412153 DOI: 10.4103/2347-5625.204494] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Objective: This study illuminates the degree of psychological stress response experienced by spouses of cancer patients when given bad news at three different times (notification of the name of the disease, notification of recurrence, and notification of terminality) as well as the factors that influence the response and the health status of the spouse as measured by health-related quality of life (QOL). Methods: A total of 203 individuals (57 men and 146 women) who had received the three types of news were surveyed using a self-report questionnaire on psychological stress response, marital satisfaction, and health-related QOL scales. Results: The degree of the psychological stress response was the highest for notification of terminality, followed by notification of the name of the disease, and notification of recurrence. The influencing factors varied depending on the notification period. Although no significant difference was observed for health-related QOL among the three notification types, significant differences were observed for certain items when compared with national standard values. Conclusions: When a notification of terminality, which produced the highest psychological stress response, is given, providing care that considers health-related QOL is necessary not only for patients but also for their spouses.
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Affiliation(s)
| | - Ryo Katsuki
- Deptartment of Anesthesiology, NHO Ureshino Medical Center, Ureshino, Japan
| | - Toshifumi Kosugi
- Deptartment of Palliative Care, Saga-ken Medical Center, Koseikan, Saga, japan
| | | | - Hidetoshi Sato
- Department of Comprehensive Community-based Palliative Care, Faculty of Medicine, Saga University Hospital, Saga University, Saga, Japan
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Schellekens M, van den Hurk D, Prins J, Donders A, Molema J, Dekhuijzen R, van der Drift M, Speckens A. Mindfulness-based stress reduction added to care as usual for lung cancer patients and/or their partners: A multicentre randomized controlled trial. Psychooncology 2017; 26:2118-2126. [DOI: 10.1002/pon.4430] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 03/16/2017] [Accepted: 03/20/2017] [Indexed: 11/10/2022]
Affiliation(s)
- M.P.J. Schellekens
- Department of Psychiatry; Radboud University Medical Centre; Nijmegen The Netherlands
| | - D.G.M. van den Hurk
- Department of Pulmonary Diseases; Radboud University Medical Centre; Nijmegen The Netherlands
| | - J.B. Prins
- Department of Medical Psychology; Radboud University Medical Centre; Nijmegen The Netherlands
| | - A.R.T. Donders
- Department of Health Evidence; Radboud University Medical Centre; Nijmegen The Netherlands
| | - J. Molema
- Department of Pulmonary Diseases; Radboud University Medical Centre; Nijmegen The Netherlands
| | - R. Dekhuijzen
- Department of Pulmonary Diseases; Radboud University Medical Centre; Nijmegen The Netherlands
| | - M.A. van der Drift
- Department of Pulmonary Diseases; Radboud University Medical Centre; Nijmegen The Netherlands
| | - A.E.M. Speckens
- Department of Psychiatry; Radboud University Medical Centre; Nijmegen The Netherlands
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Almutairi KM, Alodhayani AA, Alonazi WB, Vinluan JM. Assessment of Health-Related Quality of Life Among Caregivers of Patients with Cancer Diagnosis: A Cross-Sectional Study in Saudi Arabia. JOURNAL OF RELIGION AND HEALTH 2017; 56:226-237. [PMID: 27236467 DOI: 10.1007/s10943-016-0261-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
A descriptive cross-sectional survey was conducted over 5 months in two tertiary hospitals in Riyadh, Saudi Arabia. The 5-month period was from November 2014 to March 2015. The survey instrument used was a Short-Form Health Survey SF-36 (the RAND 36-item) questionnaire that measure QOL of the caregivers. Our study subjects included 289 randomly selected Saudi caregivers. Almost all the mean scores were increased (higher than 50) with the exception of levels of energy/fatigue. Role functioning/physical scored the highest (81.02 ± 35.33) followed by physical functioning (76.34 ± 29.83). Other domains of QOL scored (71.02 ± 35.33) for the role functioning/emotional; pain (71.15 ± 28.48), emotional well-being (60.58 ± 18.44); social functioning (58.39 ± 25.83), and general health (54.32 ± 17.08). In multivariate regression analysis, the model predicts that the contributions of age, gender, and the cancer type of patients were a statistically significant predictor with the QOL domains of caregivers. Cancer caregivers in Saudi Arabia caring for patients more than 1 year after diagnosis reported favorable QOL. Factors associated with QOL domains included age, gender of the caregivers, and the types of cancer patients. These findings are encouraging as a baseline for providing more information to future studies in QOL of caregivers.
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Affiliation(s)
- Khalid M Almutairi
- Department of Community Health Science, College of Applied Medical Science, King Saud University, Riyadh, Saudi Arabia.
| | - Abdulaziz A Alodhayani
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Wadi B Alonazi
- College of Business Administration, King Saud University, Riyadh, Saudi Arabia
| | - Jason M Vinluan
- Department of Community Health Science, College of Applied Medical Science, King Saud University, Riyadh, Saudi Arabia
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Tiwari A, Lao L, Wang AXM, Cheung DST, So MKP, Yu DSF, Lum TYS, Yuk Fung HYK, Yeung JWF, Zhang ZJ. Self-administered acupressure for symptom management among Chinese family caregivers with caregiver stress: a randomized, wait-list controlled trial. Altern Ther Health Med 2016; 16:424. [PMID: 27793197 PMCID: PMC5084390 DOI: 10.1186/s12906-016-1409-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 10/20/2016] [Indexed: 11/10/2022]
Abstract
Background Caregiving can be stressful, potentially creating physical and psychological strain. Substantial evidence has shown that family caregivers suffer from significant health problems arising from the demands of caregiving. Although there are programs supporting caregivers, there is little evidence regarding their effectiveness. Acupressure is an ancient Chinese healing method designed to restore the flow of Qi (vital energy) by applying external pressure to acupoints. A randomized, wait-list controlled trial was developed to evaluate the effectiveness of a self-administered acupressure intervention on caregiver stress (primary objective) and stress-related symptoms of fatigue, insomnia, depression, and health-related quality of life (secondary objectives) in Chinese caregivers of older family members. Methods Two hundred Chinese participants, aged ≥ 21 years, who are the primary caregivers of an older family member and screen positive for caregiver stress and symptoms of fatigue/insomnia/depression will be recruited from a community setting in Hong Kong. Subjects will be randomized to receive either an immediate treatment condition (self-administered acupressure intervention) or a wait-list control condition. The self-administered acupressure intervention will include (i) an individual learning and practice session twice a week for 2 weeks, (ii) a home follow-up visit once a week for 2 weeks, and (iii) 15-min self-practice twice a day for 6 weeks. The wait-list control group will receive the same acupressure training after the intervention group has completed the intervention. We hypothesize that Chinese family caregivers in the intervention group will have lower levels of caregiver stress, fatigue, insomnia, depression, and higher health-related quality of life after completion of the intervention than participants in the wait-list control group. Discussion This study will provide evidence for the effectiveness of self-administered acupressure in reducing stress and improving symptoms of fatigue, insomnia, depression, and health-related quality of life in Chinese family caregivers. The findings will inform the design of interventions to relieve negative health effects of caregiving. Furthermore, the results can raise community awareness and serve as a basis for policymaking, planning, and allocation of resources regarding empowerment of family caregivers for self-care. Trial registration Current Controlled Trials NCT02526446. Registered August 10, 2015.
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Schellekens MPJ, van den Hurk DGM, Prins JB, Molema J, van der Drift MA, Speckens AEM. The suitability of the Hospital Anxiety and Depression Scale, Distress Thermometer and other instruments to screen for psychiatric disorders in both lung cancer patients and their partners. J Affect Disord 2016; 203:176-183. [PMID: 27295374 DOI: 10.1016/j.jad.2016.05.044] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 04/13/2016] [Accepted: 05/22/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND Lung cancer patients and their partners report high rates of distress. Although distress is of importance, psychiatric disorders might be more important in terms of prognostic value and additional psychological treatment. This study examined the suitability of the Hospital Anxiety and Depression Scale (HADS), Distress Thermometer (DT), Beck Depression Inventory (BDI-II) and State subscale of State Trait Anxiety Inventory (STAI-S) to screen for psychiatric disorders in lung cancer patients and partners. METHODS A consecutive sample of lung cancer patients and partners completed the screening instruments. The Structured Clinical Interview DSM-IV (SCID-I) was used to diagnose psychiatric axis I disorders. RESULTS In 144 patients, overall ability of HADS total score (HADS-T) screening for patients with psychiatric disorders was good, whereas DT appeared less suitable. In 98 partners, the performance of HADS-T was good. Although no instrument was successful in identifying psychiatric disorders, HADS-T came closest with a fair performance in patients and partners. LIMITATIONS Several patients and partners declined participation because they perceived participation as too distressing. As decliners possibly have the highest rates of disorders, our findings might underestimate the prevalence of psychiatric disorders. A low prevalence negatively affects the positive predictive value and complicates efficient screening for psychiatric disorders. CONCLUSION The HADS-T appears to be a suitable screening instrument for ruling out those lung cancer patients and partners without a psychiatric disorder. Regarding identifying those with a psychiatric disorder, HADS-T should be used to refer both patients and partners for further diagnostics and treatment to a psychiatrist/psychologist.
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Affiliation(s)
- Melanie P J Schellekens
- Department of Psychiatry, Radboud University Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
| | - Desiree G M van den Hurk
- Department of Pulmonary Diseases, Radboud University Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Judith B Prins
- Department of Medical Psychology, Radboud University Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Johan Molema
- Department of Pulmonary Diseases, Radboud University Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Miep A van der Drift
- Department of Pulmonary Diseases, Radboud University Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Anne E M Speckens
- Department of Psychiatry, Radboud University Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
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Schellekens MPJ, Karremans JC, van der Drift MA, Molema J, van den Hurk DGM, Prins JB, Speckens AEM. Are Mindfulness and Self-Compassion Related to Psychological Distress and Communication in Couples Facing Lung Cancer? A Dyadic Approach. Mindfulness (N Y) 2016; 8:325-336. [PMID: 28360948 PMCID: PMC5355515 DOI: 10.1007/s12671-016-0602-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Lung cancer patients and their spouses report high rates of distress. Due to the increasing popularity of and evidence for mindfulness-based interventions in cancer, mindfulness and self-compassion have been identified as potentially helpful skills when coping with cancer. This dyadic study examined how mindfulness and self-compassion are related to psychological distress and communication about cancer in couples facing lung cancer. Using the actor-partner interdependence model, self-reported mindfulness, self-compassion, psychological distress and communication about cancer were analyzed in a cross-sectional sample of 88 couples facing lung cancer. Regarding psychological distress, no difference was found between patients and spouses. In both partners, own levels of mindfulness (B = −0.19, p = .002) and self-compassion (B = −0.45, p < .001) were negatively related to own distress levels. At a dyadic level, own self-compassion was less strongly associated with distress if the partner reported high self-compassion (B = 0.03, p = .049). Regarding communication about cancer, patients reported to communicate more openly with their partner than with spouses. However, after controlling for gender, this difference was no longer significant. In both partners, own self-compassion (B = 0.03, p = .010) was significantly associated with own communication while mindfulness was not. A trend showed that mindfulness of the partner was related to more open communication in the individual (B = 0.01, p = .080). These findings give a first indication that mindfulness and self-compassion skills may go beyond the individual and could impact couple functioning. Future research should examine whether couples facing (lung) cancer may benefit from programs in which mindfulness and self-compassion are cultivated.
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Affiliation(s)
- Melanie P J Schellekens
- Radboud Centre for Mindfulness, Department of Psychiatry, Radboud University Medical Centre, Reinier Postlaan 4, P.O. Box 9101, 6500HB Nijmegen, The Netherlands
| | - Johan C Karremans
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Miep A van der Drift
- Department of Lung Diseases, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Johan Molema
- Department of Lung Diseases, Radboud University Medical Centre, Nijmegen, The Netherlands
| | | | - Judith B Prins
- Department of Medical Psychology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Anne E M Speckens
- Radboud Centre for Mindfulness, Department of Psychiatry, Radboud University Medical Centre, Reinier Postlaan 4, P.O. Box 9101, 6500HB Nijmegen, The Netherlands
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Borman P, Gökçe-Kutsal Y, Terzioğlu F, Okumuş M, Ceceli E, Karahan S, Şenel K, Gökkaya KO, Doğan A, Eskiyurt N, Günaydin R, Eyigör S, Şahin N, Şahin M. A Multicenter Pilot Study of Burden Among Caregivers of Geriatric Rehabilitation Patients With Neuromusculoskeletal Diseases. Rehabil Nurs 2016; 42:199-209. [PMID: 27080048 DOI: 10.1002/rnj.272] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE In this study, we aimed to describe the sociodemographic characteristics of caregivers of patients in a geriatric unit and to clarify the relationship between caregiver burden and specific clinical variables in the patients and the characteristics of the caregivers. DESIGN Cross-sectional multicenter study. METHODS One hundred twenty-three patients and 123 caregiver dyads, with mean ages of 72.5 ± 7.7 years and 51 ± 14.7 years, respectively, were included. The functional, psychological, and cognitive statuses of the patients were determined, and the sociodemographic characteristics of the caregivers as well as the type and duration of caregiving were recorded. Caregivers completed the Caregiver Burden Inventory (CBI) to measure the perceived burden of care. Most patients were female and generally lived with their family. FINDINGS Most of the caregivers were family members (90%), female (73.2%), primary school graduates (52.8%), and first-degree relatives (73.1%). The average CBI score was 33, and the highest CBI subscores were for time, developmental, and physical burdens. Caregiver burden correlated with the patient's ambulatory, psychological, and cognitive status and with the caregiver's age, gender, income level, and duration of caregiving. CONCLUSIONS We have highlighted the relationship between caregiver and patient characteristics in a cohort of elderly Turkish patients with neurological and musculoskeletal disorders. In particular, we have highlighted the heavy caregiver burden in a developing country. CLINICAL RELEVANCE Our results may guide the nurses to understand the requirements of caregivers and to help them find suitable resources that would meet their needs to cope with their burden.
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Affiliation(s)
- Pinar Borman
- 1 Department of Physical Medicine and Rehabilitation, Medical Faculty, Hacettepe University, Ankara, Turkey2 Faculty of Nursing, Hacettepe University, Ankara, Turkey3 Department of Physical Medicine and Rehabilitation, Medical Faculty, Kirikkale University, Kirikkale, Turkey4 Department of Bio-Statistics, Medical Faculty, Hacettepe University, Ankara, Turkey5 Department of Physical Medicine and Rehabilitation, Medical Faculty, Erzurum University, Erzurum, Turkey6 Clinic of Physical Medicine and Rehabilitation, Ankara Rehabilitation Training and Research Hospital, Ankara, Turkey7 Department of Physical Medicine and Rehabilitation, Medical Faculty, Istanbul University, Istanbul, Turkey8 Department of Physical Medicine and Rehabilitation, Medical Faculty, Ordu University, Ordu, Turkey9 Department of Physical Medicine and Rehabilitation, Medical Faculty, Ege University, Izmir, Turkey10 Department of Physical Medicine and Rehabilitation, Medical Faculty, Balikesir University, Balikesir, Turkey
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