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Dieperink KB, Møller JJK, Mikkelsen TB, Nissen NK, La Cour K, Rottmann N. The Danish landscape of providing support for caregivers of people with potentially life-threatening disease: A cross-sectional study among representatives of health services in Danish municipalities and hospitals. Scand J Public Health 2024; 52:494-501. [PMID: 37026179 DOI: 10.1177/14034948231159464] [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] [Indexed: 04/08/2023]
Abstract
AIMS (a) To investigate support for caregivers of people diagnosed with stroke, cancer, chronic obstructive pulmonary disease (COPD), dementia, or heart disease provided across healthcare settings in Denmark; (b) to assess differences in caregiver support across diagnoses and settings. METHODS A cross-sectional nationwide survey among professionals representing healthcare settings at municipalities (n = 479) and hospital wards and outpatient clinics (n = 425). The survey assessed identification of caregivers and support initiatives. RESULTS The response rate was 81% for municipalities and 49% for hospitals. Identification of caregivers was frequent in dementia care (81% and 100%) and less frequent in COPD care (58% and 64%) in municipalities and hospitals, respectively. Caregiver support differed significantly across diagnoses within municipalities (p = 0.009) and hospitals (p < 0.001). Systematic identification of vulnerable caregivers was <25% for all diagnoses except dementia. The most common support initiatives involving caregivers were primarily aimed at the ill person and included guidance about the disease and consequences for everyday life and lifestyle changes. Caregivers were least involved in support initiatives addressing physical training, work retention, sexuality, or cohabitation. CONCLUSIONS Disparities and significant differences across diagnoses exist in the identification of caregivers and the provision of support initiatives. Support initiatives involving caregivers primarily targeted patients. Future studies should investigate how caregivers' needs can be met across different diagnoses and healthcare settings and investigate potential changes in caregivers' needs during disease trajectories. In clinical practice, identification of vulnerable caregivers should be a major focus, and disease-specific clinical guidelines may be required to ensure sufficient support for caregivers.
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Affiliation(s)
- Karin B Dieperink
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Oncology, Odense University Hospital, Denmark
- Family focused healthcare Research (FaCe), University of Southern Denmark, Nyborg, Denmark
| | - Jens-Jakob K Møller
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Nyborg, Denmark
| | - Tina B Mikkelsen
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Nyborg, Denmark
| | - Nina Konstantin Nissen
- DEFACTUM - Social & Health Services and Labour Market, Central Denmark Region, Odense, Denmark
| | - Karen La Cour
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Nyborg, Denmark
- Department of Public Health, Research Unit for User involvement and Community-Based Interventions, University of Southern Denmark, Odense, Denmark
| | - Nina Rottmann
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Nyborg, Denmark
- Department of Psychology, University of Southern Denmark, Denmark
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Winter N, McKenzie K, Spence D, Lane K, Ugalde A. The experience of bereaved cancer carers in rural and regional areas: The impact of the COVID-19 pandemic and the potential of peer support. PLoS One 2023; 18:e0293724. [PMID: 37934771 PMCID: PMC10629652 DOI: 10.1371/journal.pone.0293724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 10/18/2023] [Indexed: 11/09/2023] Open
Abstract
BACKGROUND Caring for someone with cancer during end of life care can be a challenging and complex experience. Those living in rural and regional areas are less likely to have local healthcare services and may be physically isolated. Even where support services such as respite do exist, they may be less likely to be accessed due to the time burden in travelling to services. This was compounded by the COVID-19 pandemic. AIM To understand the potential benefits of peer support for bereaved carers of people with cancer from rural and regional locations during the COVID-19 period. METHODS Phone interviews were conducted with bereaved cancer carers living in rural and regional areas in Victoria. Semi-structured interviews were used, and participants were asked about their experience as a carer, bereavement and the potential for peer support. Interviews were audio recorded and transcribed verbatim; transcripts were coded and a thematic analysis was conducted. FINDINGS 12 interviews were conducted. Carers were mostly female (85%) and were on average 58 years of age (range 42-71). Interviews lasted an average of 58 minutes (range 53-91 minutes). Three themes were derived from the data; 1) Supportive care needs while caring and the impact of COVID-19; 2) Isolation during bereavement compounded by the COVID-19 pandemic; and 3) Peer support requires flexibility to meet diverse needs. CONCLUSION Peer support has potential to assist bereaved carers of people with cancer. A co-design approach may be beneficial for developing a flexible model for supporting and linking carers together.
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Affiliation(s)
- Natalie Winter
- School of Nursing & Midwifery and Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Kerry McKenzie
- Strategy and Support Division, Cancer Council Victoria, Melbourne, Australia
| | - Danielle Spence
- Strategy and Support Division, Cancer Council Victoria, Melbourne, Australia
| | - Katherine Lane
- Strategy and Support Division, Cancer Council Victoria, Melbourne, Australia
| | - Anna Ugalde
- School of Nursing & Midwifery and Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
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Wasserman S, Ould Brahim L, Attiya A, Belzile E, Lambert SD. An Evaluation of Interactive mHealth Applications for Adults Living with Cancer. Curr Oncol 2023; 30:7151-7166. [PMID: 37622999 PMCID: PMC10453401 DOI: 10.3390/curroncol30080518] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 07/18/2023] [Accepted: 07/21/2023] [Indexed: 08/26/2023] Open
Abstract
This study evaluated the quality and usefulness of interactive mobile health (mHealth) applications (apps) for adults with cancer. The PRISMA guidelines were followed to add rigor to the search, as well as to the data collection and analysis. The apps available in the most used app stores (Google Play and Apple) with interactive tailored features were identified. To supplement this, a Google web search was also conducted. The apps were evaluated for their quality using the validated Mobile App Rating Scale (MARS) and for their usefulness using a checklist of end users' desired features derived from the literature. The searches returned 3046 apps and 17 were retained for evaluation. The average quality score of the apps across the sample was 3.62/5 (SD 0.26, range: 3.14-4.06), with Outcomes4me scoring the highest. On average, the apps scored 50% (SD 2.5, range: 31-88%) on the usefulness checklist, with Cancer.net scoring the highest. The lowest-scoring categories were communications features on the usefulness checklist and "information" on the MARS, indicating areas for future work. The findings identified the apps of an acceptable quality and usefulness that could be recommended to those with cancer.
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Affiliation(s)
- Sydney Wasserman
- St. Mary’s Research Centre, Montreal, QC H3T 1M5, Canada; (S.W.); (L.O.B.); (E.B.)
- Ingram School of Nursing, Faculty of Medicine and Health Science, McGill University, Montréal, QC H3A 0G4, Canada
| | - Lydia Ould Brahim
- St. Mary’s Research Centre, Montreal, QC H3T 1M5, Canada; (S.W.); (L.O.B.); (E.B.)
- Ingram School of Nursing, Faculty of Medicine and Health Science, McGill University, Montréal, QC H3A 0G4, Canada
| | - Ameer Attiya
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, QC H3C 3J7, Canada;
| | - Eric Belzile
- St. Mary’s Research Centre, Montreal, QC H3T 1M5, Canada; (S.W.); (L.O.B.); (E.B.)
| | - Sylvie D. Lambert
- St. Mary’s Research Centre, Montreal, QC H3T 1M5, Canada; (S.W.); (L.O.B.); (E.B.)
- Ingram School of Nursing, Faculty of Medicine and Health Science, McGill University, Montréal, QC H3A 0G4, Canada
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Gjerset GM, Kiserud CE, Wisløff T, McCarthy JB, Thorsen L. Perceived burden and need for support among caregivers of cancer patients. Acta Oncol 2023; 62:794-802. [PMID: 37540581 DOI: 10.1080/0284186x.2023.2240008] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 07/07/2023] [Indexed: 08/06/2023]
Abstract
BACKGROUND The aims of this study were to examine (1) the perceived burden among caregivers and identify those in risk of high burden and (2) the need for support among caregivers and identify associated factors. MATERIALS AND METHODS Cancer patients who participated in an educational program at the Montebello Center (MBC) in Norway between May 2021 and February 2022 were asked to invite a caregiver to answer a questionnaire. The caregiving burden was assessed with the Caregivers Reaction Assessment (CRA) that consists of 24 questions scored from 1 (strongly disagree) to 5 (strongly agree), covering five domains. A mean sum score was calculated for each domain. Higher subscale scores indicate higher levels of burden, except for caregiver esteem where a high score indicates a low burden. Need for support was assessed with 13 questions. RESULTS Of 464 invitations, 185 caregivers responded (response 40%), median age was 58.0 years and 58% were male. Caregiver burden mean scores were: 2.6 (SD 1.03) for Impact on schedule, 2.1 (SD 0.79) for Lack of family support, 2.1 (SD 0.76) for Impact on health, 2.0 (SD 0.86) for Impact on finances, and 4.2 (SD 0.47) for Caregiver esteem. Female caregivers, younger, higher education, having comorbidities, caring for patients having recurrence of cancer, and shorter time since diagnosis were associated with higher burden measured on individual subscales of the CRA. Most reported needs were information about: cancer, late effects and rehabilitation services and support from peers and professionals to cope with the new situation. Younger, caregiver comorbidity and recurrence of cancer of the patient were associated with more needs. CONCLUSIONS The results indicate that caregivers of cancer patients participating at the MBC report moderate caregiver burden, however, numerous caregivers reported need for support within several areas. Our findings need to be confirmed in a larger unselected group.
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Affiliation(s)
- Gunhild M Gjerset
- Department of Oncology, National Advisory Unit on Late Effects after Cancer Treatment, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
- Montebello Center, The Norwegian Resource Center for Coping with Cancer, Mesnali, Norway
- Department of Clinical Service, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
| | - Cecilie E Kiserud
- Department of Oncology, National Advisory Unit on Late Effects after Cancer Treatment, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
| | - Torbjørn Wisløff
- Health Service Research Unit, Akershus University Hospital, Lørenskog, Norway
| | - Jane B McCarthy
- Montebello Center, The Norwegian Resource Center for Coping with Cancer, Mesnali, Norway
| | - Lene Thorsen
- Department of Oncology, National Advisory Unit on Late Effects after Cancer Treatment, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
- Department of Clinical Service, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
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Kardosod A, Needham J, Coyne E. The experiences and needs of metastatic spinal cancer family caregivers at home: a systematic review. Support Care Cancer 2023; 31:310. [PMID: 37119292 PMCID: PMC10148781 DOI: 10.1007/s00520-023-07777-5] [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: 01/05/2023] [Accepted: 04/21/2023] [Indexed: 05/01/2023]
Abstract
PURPOSE Family caregivers have high responsibilities for caring for persons with metastatic spinal cancer; however, understanding the experiences and needs of family caregivers face to overall recent, what is nurse-led could support them to meet their needs appropriately? Thus, the study aimed to review the experiences and needs of metastatic spinal cancer caregivers at home in the past decades. METHODS A qualitative systematic review of 8 studies was undertaken. Analysed studies were conducted in different countries (Australia, Cyprus, Italy, Kenya, Pakistan, Thailand, and Turkey), covering a population of 92 caregivers. Thematic analysis was applied to identify family caregiver experiences and needs. RESULTS Thematic analysis identified four key themes from the included studies: (1) complexity of needs, (2) caregivers' role and physical needs, (3) complexity of psychosocial needs, and (4) understanding supportive care. CONCLUSIONS The results across 8 different countries indicate that family caregivers of metastatic spinal cancer commonly face diverse challenges in many diverse geographical contexts across cultures, requiring biomedical, practical, physical, and psychosocial support from healthcare systems within the matrix of broader challenges and resources available to improve supportive care for such service users.
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Affiliation(s)
- Apichat Kardosod
- School of Nursing and Midwifery, Griffith University, Logan Campus, University Dr, QLD, Meadowbrook, Australia
| | - Judith Needham
- School of Nursing and Midwifery, Griffith University, Logan Campus, University Dr, QLD, Meadowbrook, Australia
| | - Elisabeth Coyne
- School of Nursing and Midwifery, Griffith University, Logan Campus, University Dr, QLD, Meadowbrook, Australia
- Menzies Health Institute, Griffith University, Queensland, Australia
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Coyne E, Winter N, Carlini J, Robertson J, Dieperink K. Developing video resources to reduce the burden of caring for persons with brain cancer. Eur J Oncol Nurs 2022; 60:102187. [DOI: 10.1016/j.ejon.2022.102187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 07/21/2022] [Accepted: 07/27/2022] [Indexed: 11/04/2022]
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Stabile C, McCready T, Ancker JS, Pusic A, Temple LKF, Vickers A, Simon B, Ashby C, Carter J. A qualitative analysis of caregiver burden during the recovery process in ambulatory cancer surgery. Support Care Cancer 2022; 30:5713-5721. [PMID: 35318529 PMCID: PMC10107336 DOI: 10.1007/s00520-022-06991-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 03/15/2022] [Indexed: 01/25/2023]
Abstract
PURPOSE Cancer impacts caregivers as well as patients. Ambulatory oncology surgeries requiring a short hospital stay place additional responsibility on informal caregivers as they help patients navigate their post-operative recovery at home, and determine if symptoms are expected or emergent. Our objective was to explore the experience of informal caregivers during patients' ambulatory cancer surgery and then recovery at home with remote monitoring of symptoms via web-based patient-reported outcomes questionnaire ("Recovery Tracker"). METHODS Semi-structured interviews were conducted with caregivers from a larger sample participating in a randomized trial of the Recovery Tracker. Thematic analysis was applied to derive key themes and codes via NVivo qualitative analysis software (QSR International Inc.). Recruitment was conducted iteratively to ensure a heterogenous sample and thematic saturation. RESULTS Twenty-three semi-structured interviews were conducted. Four main themes emerged: (1) Predictability reduced stress among caregivers; (2) Unexpected events caused stress for caregivers; (3) The importance of a caregiver being present during the recovery process; and (4) Caregiver involvement in remote monitoring of symptoms was minimal. CONCLUSION Caregivers report not being overly burdened by the ambulatory surgery process, but they are very sensitive to any deviations from what they expected to happen. Further research and clinical practice on caregivers in the ambulatory setting should focus on how to set expectations and avoid unexpected events.
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Affiliation(s)
- Cara Stabile
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Taylor McCready
- Josie Robertson Surgery Center, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jessica S Ancker
- Department of Biomedical Informatics, Vanderbilt University, Nashville, TN, USA
| | - Andrea Pusic
- Department of Plastic and Reconstructive Surgery, Brigham and Women's Hospital, Harvard University, Boston, MA, USA
| | - Larissa K F Temple
- Colorectal Surgery Division, Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA
| | - Andrew Vickers
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Brett Simon
- Department of Anesthesia and Critical Care, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Department of Anesthesiology, Weill Medical College of Cornell University, New York, NY, USA
| | - Christina Ashby
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jeanne Carter
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA. .,Department of Psychiatry, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
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Luu KL, Witkamp FE, Nieboer D, Bakker EM, Kranenburg LW, van der Rijt CCD, Lorig K, van der Heide A, Rietjens JAC. Effectiveness of the "Living with Cancer" peer self-management support program for persons with advanced cancer and their relatives: study protocol of a non-randomized stepped wedge study. BMC Palliat Care 2022; 21:107. [PMID: 35692043 PMCID: PMC9188837 DOI: 10.1186/s12904-022-00994-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 05/30/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Persons with advanced cancer and their relatives experience physical, emotional, and psychosocial consequences of the illness. Most of the time, they must deal with these themselves. While peer self-management support programs may be helpful, there is little evidence on their value for this population. We present the research protocol of our SMART study that will evaluate the effectiveness of the "Living with Cancer" peer self-management support program, aimed at improving self-management behaviors, self-efficacy, and health-related quality of life of persons with advanced cancer and their relatives. METHODS We will conduct a non-randomized stepped wedge study in the Netherlands. We will include 130 persons with advanced cancer and 32 relatives. Participants can choose to either start the program within 4 weeks after inclusion or after eight to 10 weeks. The "Living with Cancer" is a peer self-management support program, based on the Chronic Disease Self-Management Program. It consists of six 1,5 hours video-conferencing group meetings with eight to 12 participants, preceded by two or three preparatory audio clips with supportive text per session. The program has the following core components: the learning of self-management skills (action-planning, problem-solving, effective communication, and decision-making), discussing relevant themes (e.g. dealing with pain and fatigue, living with uncertainty, and future planning), and sharing experiences, knowledge, and best practices. The primary outcome for both persons with advanced cancer and relatives is self-management behavior assessed by the subscale "constructive attitudes and approaches" of the Health Education Impact Questionnaire. Secondary outcomes are other self-management behaviors, self-efficacy, health-related quality of life, symptoms, depression and anxiety, and loneliness. Participants complete an online questionnaire at baseline, and after eight and 16 weeks. After each session, they complete a logbook about their experiences. Group meetings will be video recorded. DISCUSSION SMART aims to evaluate an innovative program building on an evidence-based self-management program. New features are its use for persons with advanced cancer, the inclusion of relatives, and the video-conferencing format for this population. The use of both quantitative and qualitative analyses will provide valuable insight into the effectiveness and value of this program. TRIAL REGISTRATION This study was registered in the Dutch Trial Register on October 2021, identifier NL9806 .
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Affiliation(s)
- K L Luu
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
| | - F E Witkamp
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Center of Expertise Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, the Netherlands
| | - D Nieboer
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - E M Bakker
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - L W Kranenburg
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - C C D van der Rijt
- Department of Medical Oncology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - K Lorig
- Stanford School of Medicine, CA, Stanford, USA
| | - A van der Heide
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - J A C Rietjens
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
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Heinsch M, Cootes H, Wells H, Tickner C, Wilson J, Sultani G, Kay-Lambkin F. Supporting friends and family of adults with a primary brain tumour: A systematic review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:869-887. [PMID: 34633723 DOI: 10.1111/hsc.13586] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 09/08/2021] [Accepted: 09/17/2021] [Indexed: 06/13/2023]
Abstract
Expanding on the limited work in supportive care for friends and family caregivers of adults with a primary brain tumour, this review sought to examine all available evidence since 2010 on the efficacy and feasibility of supportive interventions for this population including non-controlled studies. A systematic review of the literature was conducted on the feasibility and effectiveness/efficacy of supportive interventions for brain cancer caregivers in line with PRISMA guidelines. 13 studies met the eligibility criteria and were identified for inclusion. Most interventions employed tailored psychoeducation, and expert involvement via psychotherapy or care coordination. Only two interventions demonstrated clinically significant improvements. Findings indicate that dyadic yoga programs, and programs that enhance caregiver mastery to manage patient behavioural problems, may lead to improvements in some clinical outcomes. Results highlight the diverse nature of supportive interventions and indicate that support for primary brain tumour caregivers is currently suboptimal. Our findings illustrate an overall low certainty of evidence, with a need for more adequately powered randomised controlled trials. As the complexities of brain cancer care-giving are an obstacle to standardised interventions, this review underscores the need for future trials to incorporate complimentary qualitative research methodologies.
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Affiliation(s)
- Milena Heinsch
- Centre for Brain and Mental Health Research, University of Newcastle, Callaghan, New South Wales, Australia
| | - Hannah Cootes
- Centre for Brain and Mental Health Research, University of Newcastle, Callaghan, New South Wales, Australia
| | - Hannah Wells
- Centre for Brain and Mental Health Research, University of Newcastle, Callaghan, New South Wales, Australia
| | - Campbell Tickner
- Centre for Brain and Mental Health Research, University of Newcastle, Callaghan, New South Wales, Australia
| | - Jessica Wilson
- Centre for Brain and Mental Health Research, University of Newcastle, Callaghan, New South Wales, Australia
| | - Grace Sultani
- Social Work, School of Humanities and Social Science, University of Newcastle, Callaghan, NSW, Australia
| | - Frances Kay-Lambkin
- Centre for Brain and Mental Health Research, University of Newcastle, Callaghan, New South Wales, Australia
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Levoy K, Wool J, Ashare RL, Rosa WE, Barg FK, Meghani SH. "It's Rougher on Me Than It Is on Him": Family Caregiver-Generated and Prioritized Illness Concerns While Patients Undergo Cancer Treatments. JCO Oncol Pract 2022; 18:e525-e536. [PMID: 34735272 PMCID: PMC9014424 DOI: 10.1200/op.21.00164] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 07/25/2021] [Accepted: 09/30/2021] [Indexed: 01/07/2023] Open
Abstract
PURPOSE Research eliciting patients' illness concerns has typically focused later in the cancer continuum, rather than during cancer treatments. Family caregiver concerns are overlooked during this time. Less is known about how patients and caregivers prioritize concerns during cancer treatments, which holds potential for improving supportive oncology care (ie, primary palliative care). The purpose of this study was to elicit and compare which domains of supportive oncology are of highest importance to patients and caregivers during cancer treatments. METHODS Freelisting, a cognitive anthropology method, was used to elicit concerns in order of importance. Freelist data were analyzed using Smith's salience index. Qualitative interviews were conducted with a caregiver subsample to add explanatory insights. RESULTS In descending order, pain, death, fear, family, and awful were salient Freelist items for patients (n = 65), whereas sadness, time-consuming, support, anger, tired, death, and frustration were salient for caregivers (n = 24). When integrated with supportive oncology domains, patients' concerns reflected a prioritization of the physical (pain) and emotional (death, fear, and awful) domains, with less emphasis on social (family) aspects. Caregivers' prioritized the emotional (sadness, anger, death, and frustration) and social (time-consuming and support) domains, with less emphasis on the physical (tired) aspects. CONCLUSION Our findings suggest that enhancing primary palliative care delivery by oncology teams requires systems thinking to support both the patient and caregiver as the primary unit of care. Primary palliative care may be improved by prioritizing interventions that address physical concerns among patients as well as key social concerns among caregivers to support the complex caregiving role while patients undergo cancer treatments.
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Affiliation(s)
- Kristin Levoy
- Department of Community and Health Systems, Indiana University School of Nursing, Indianapolis, IN
- Center for Aging Research, Regenstrief Institute, Indianapolis, IN
| | - Jesse Wool
- Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, PA
- NewCourtland Center for Transitions and Health, University of Pennsylvania School of Nursing, Philadelphia, PA
- Nursing Operations Department, Children's Hospital of Philadelphia, Philadelphia, PA
| | | | - William E. Rosa
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Frances K. Barg
- Department of Family and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Salimah H. Meghani
- Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, PA
- NewCourtland Center for Transitions and Health, University of Pennsylvania School of Nursing, Philadelphia, PA
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA
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11
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Parmar JK, L’Heureux T, Anderson S, Duggleby W, Pollard C, Poole L, Charles L, Sonnenberg LK, Leslie M, McGhan G, Huhn A, Sereda S, Marion C, Tarnowski G, Mah J, Melenberg D, Weir C, Pooler C, MacLachlan N, Bremault-Phillips S, Tian PGJ, Sacrey LAR. Optimizing the integration of family caregivers in the delivery of person-centered care: evaluation of an educational program for the healthcare workforce. BMC Health Serv Res 2022; 22:364. [PMID: 35303870 PMCID: PMC8932680 DOI: 10.1186/s12913-022-07689-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 02/23/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND While family caregivers provide 70-90% of care for people living in the community and assist with 10-30% of the care in congregate living, most healthcare providers do not meaningfully involve family caregivers as partners in care. Recent research recommends that the healthcare workforce receive competency-based education to identify, assess, support, and partner with family caregivers across the care trajectory. OBJECTIVE This paper reports a mixed-methods evaluation of a person-centered competency-based education program on Caregiver-Centered Care for the healthcare workforce. METHODS This foundational education was designed for all healthcare providers and trainees who work with family caregivers and is offered free online (caregivercare.ca). Healthcare providers from five healthcare settings (primary, acute, home, supportive living, long-term care) and trainees in medicine, nursing, and allied health were recruited via email and social media. We used the Kirkpatrick-Barr health workforce training evaluation framework to evaluate the education program, measuring various healthcare providers' learner satisfaction with the content (Level 1), pre-post changes in knowledge and confidence when working with family caregivers (Level 2), and changes in behaviors in practice (Level 3). RESULTS Participants were primarily healthcare employees (68.9%) and trainees (21.7%) and represented 5 healthcare settings. Evaluation of the first 161 learners completing the program indicated that on a 5-point Likert scale, the majority were satisfied with the overall quality of the education (Mean(M) = 4.69; SD = .60). Paired T-tests indicated that out of a score of 50, post-education changes in knowledge and confidence to work with family caregivers was significantly higher than pre-education scores (pre M = 38.90, SD = 6.90; post M = 46.60, SD = 4.10; t(150) = - 16.75, p < .0001). Qualitative results derived from open responses echoed the quantitative findings in satisfaction with the education delivery as well as improvements in learners' knowledge and confidence. CONCLUSION Health workforce education to provide person-centered care to all family caregivers is an innovative approach to addressing the current inconsistent system of supports for family caregivers. The education program evaluated here was effective at increasing self-reported knowledge and confidence to work with family caregivers.
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Affiliation(s)
- Jasneet K. Parmar
- Department of Family Medicine, Faculty of Medicine and Dentistry, University of Alberta, 6-40 University Terrace, 8303 112 St NW, Edmonton, AB T6G 2T4 Canada
- Home Living and Transitions, Alberta Health Services – Edmonton Zone Continuing Care, Strathcona Health Centre, 2 Brower Drive, Baseline Road, Sherwood Park, AB T8H1V4 Canada
| | - Tanya L’Heureux
- Department of Family Medicine, Faculty of Medicine and Dentistry, University of Alberta, 6-40 University Terrace, 8303 112 St NW, Edmonton, AB T6G 2T4 Canada
| | - Sharon Anderson
- Department of Family Medicine, Faculty of Medicine and Dentistry, University of Alberta, 6-40 University Terrace, 8303 112 St NW, Edmonton, AB T6G 2T4 Canada
- Department of Human Ecology, University of Alberta, 335 Human Ecology Building, 8905 - 116 St NW, Edmonton, Alberta T6G 2N1 Canada
| | - Wendy Duggleby
- Faculty of Nursing, University of Alberta, 3-141 Edmonton Clinic Health Academy (ECHA), Edmonton, Alberta T6G 1C9 Canada
| | - Cheryl Pollard
- Faculty of Nursing, University of Regina, RI 508, 3737 Wascana Parkway, Regina, Saskatchewan S4S 0A2 Canada
| | - Lisa Poole
- Dementia Advocacy Canada, Calgary Dementia Network Strategic Council, Glencoe Club Dementia Advisory Group, Calgary, Canada
| | - Lesley Charles
- Department of Family Medicine, Faculty of Medicine and Dentistry, University of Alberta, 6-40 University Terrace, 8303 112 St NW, Edmonton, AB T6G 2T4 Canada
- Care of the Elderly, Glenrose Rehabilitation Hospital-East, 10230 111 Ave NW, Edmonton, AB T5G 0B7 Canada
| | - Lyn K. Sonnenberg
- Department of Family Medicine, Faculty of Medicine and Dentistry, University of Alberta, 6-40 University Terrace, 8303 112 St NW, Edmonton, AB T6G 2T4 Canada
- Faculty of Rehabilitation Medicine, University of Alberta, 3-14 Corbett Hall, Edmonton, AB T6G 2G4 Canada
| | - Myles Leslie
- School of Public Policy, University of Calgary, Calgary, 906 8th Avenue S.W. 5th Floor, Alberta T2P 1H9 Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, 3D10, 3280 Hospital Drive NW, Alberta T2N 4Z6 Canada
| | - Gwen McGhan
- Faculty of Nursing, University of Calgary, PF 3204, 2500 University Drive NW, Calgary, AB T2N 1N4 Canada
| | - Arlene Huhn
- Client Services & Programs, Alzheimer Society of Alberta and Northwest Territories, Suite 306, 10430-61 Avenue, Edmonton, AB T6H 2J3 Canada
| | - Sandy Sereda
- Caregivers Alberta, 12122 68 St NW, Edmonton, Alberta T5B 1R1 Canada
| | - Cecilia Marion
- Youville Home, Covenant Health, 9A St Vital Ave, St. Albert, Alberta T8N 1K1 Canada
| | - Glenda Tarnowski
- College of Licensed Practical Nurses of Alberta, St. Albert Trail Place, 13163-146 Street, Edmonton, AB T5L 4S8 Canada
| | - Jennifer Mah
- Faculty of Health and Community Studies, Norquest College, Edmonton, Canada
| | - Denise Melenberg
- Palliative Care Programs/Education and Practice Development/Community Programs, Alberta Health Services, Edmonton, Canada
| | - Carolyn Weir
- Palliative Care Programs/Education and Practice Development/Community Programs, Alberta Health Services, Edmonton, Canada
- Mother Rosalie Health Service Centre, 16930 87 Ave, Edmonton, AB T5R4H5 Canada
| | - Charlotte Pooler
- Faculty of Nursing, University of Alberta, 3-141 Edmonton Clinic Health Academy (ECHA), Edmonton, Alberta T6G 1C9 Canada
- Palliative Care Programs/Education and Practice Development/Community Programs, Alberta Health Services, Edmonton, Canada
| | - Nora MacLachlan
- Health and Community Studies, Bow Valley College, Calgary, North Campus, Seventh Floor, 345 - 6 Avenue SE., Alberta AB T2G 4S6 Canada
| | - Suzette Bremault-Phillips
- Faculty of Rehabilitation Medicine, University of Alberta, 3-14 Corbett Hall, Edmonton, AB T6G 2G4 Canada
| | - Peter George J. Tian
- Division of Care of the Elderly, Department of Family Medicine, University of Alberta, 6-40 University Terrace, 8303 112 St NW, Edmonton, AB T6G 2T4 Canada
| | - Lori-Ann R. Sacrey
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton Clinic Health Academy, 11405-87 Avenue, Edmonton, Alberta T6G 1C9 Canada
- Autism Research Centre (E209), Glenrose Rehabilitation Hospital, 10230 - 111 Avenue, Edmonton, AB T5G 0B7 Canada
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12
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Ikander T, Dieperink KB, Hansen O, Raunkiær M. Patient, Family Caregiver, and Nurse Involvement in End-of-Life Discussions During Palliative Chemotherapy: A Phenomenological Hermeneutic Study. JOURNAL OF FAMILY NURSING 2022; 28:31-42. [PMID: 34551643 DOI: 10.1177/10748407211046308] [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: 06/13/2023]
Abstract
The aim of this study was to investigate current nursing practice related to end-of-life discussions with incurable lung cancer patients and their family caregivers from the perspectives of patients, family caregivers, and nurses in an oncology outpatient clinic. This phenomenological hermeneutic study included nine patients, eight family caregivers, and 11 nurses. Data were collected using participant observation, informal and semi-structured individual or joint interviews with patients and family caregivers, and focus group interviews with nurses. A Ricoeur-inspired approach was used to analyze the data. Three themes were identified: (a) content of end-of-life discussions, (b) timing of end-of-life discussions, and (c) challenges in end-of-life discussions. End-of-life discussions were seldom initiated; when they were, it was often too late. Discussions addressed treatment, place of care, practical/economic concerns, and existential matters. The physical environment at the outpatient clinic, lack of continuity, and nurses' instrumental task workloads and time pressure posed challenges to initiating end-of-life discussions.
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Affiliation(s)
- Tine Ikander
- Department of Oncology, Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, Denmark
- REHPA, Danish Knowledge Centre of Rehabilitation and Palliative Care, Odense University Hospital, Denmark
- Family-focused healthcare research Centre (FaCe). Department of Clinical Research, University of Southern Denmark
- Department of Clinical Research, University of Southern Denmark
| | - Karin B Dieperink
- Department of Oncology, Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, Denmark
- Family-focused healthcare research Centre (FaCe). Department of Clinical Research, University of Southern Denmark
- Department of Clinical Research, University of Southern Denmark
| | - Olfred Hansen
- Department of Oncology, Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, Denmark
- Department of Clinical Research, University of Southern Denmark
| | - Mette Raunkiær
- REHPA, Danish Knowledge Centre of Rehabilitation and Palliative Care, Odense University Hospital, Denmark
- Department of Clinical Research, University of Southern Denmark
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13
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Nordentoft S, Dieperink KB, Johansson SD, Jarden M, Piil K. Evaluation of a multimodal rehabilitative palliative care programme for patients with high-grade glioma and their family caregivers. Scand J Caring Sci 2021; 36:815-829. [PMID: 34296773 DOI: 10.1111/scs.13019] [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: 02/10/2021] [Accepted: 07/11/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND Patients diagnosed with high-grade glioma and their family caregivers often experience intense disease and treatment trajectories. Fluctuations in patient's symptoms lead to enormous burdens for caregivers and the risk of developing symptoms of stress, anxiety, and depression. AIM The study aim is to explore patient and caregiver experiences and evaluate the relevance of and satisfaction with a multimodal rehabilitative palliative care programme for patients diagnosed with a high-grade glioma and their family caregivers. METHODS In a longitudinal multi-methods study, adult patients with high-grade glioma (n = 17) and their family caregivers (n = 16) completed a 4-day residential programme and a 2-day follow-up programme 3 months later. Participants completed questionnaires after each programme, scoring relevance and satisfaction on a 5-point Likert scale. Qualitative data were collected during four evaluation group interviews with patients and caregivers. RESULTS The mean overall satisfaction score was 4.80 (standard deviation [SD], 0.55) for the initial 4-day programme and 4.28 (SD, 0.83) for the follow-up programme. Three themes emerged in the evaluation group interviews: (1) meeting peers strengthens social well-being, (2) the value of information and focusing on individual needs, and (3) accepting life as an unpredictable passage. CONCLUSION Participants found completing the REHPA-HGG programme feasible and rated all sessions highly for relevance and satisfaction. Qualitative findings confirm the value of individualised information, acceptance, and peer interactions. IMPLICATION FOR PRACTICE A multimodal rehabilitative palliative care programme addressed unmet patient and caregiver needs. Peer-to-peer interventions for family caregivers may address individual support needs. Similar programmes may maximise benefit by avoiding planned behaviour changes and enhancing palliative approaches.
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Affiliation(s)
- Sara Nordentoft
- Research Unit, Center for Cancer and Organ Disease, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Department of Neurosurgery, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Center for Cancer and Organ Diseases, Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Karin B Dieperink
- Department of Oncology, Odense University Hospital, Odense, Denmark.,Danish Center for Rehabilitation and Palliative Care, REHPA, Nyborg, Denmark.,Family Focused Healthcare Center (FaCe), Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Susan D Johansson
- Danish Center for Rehabilitation and Palliative Care, REHPA, Nyborg, Denmark
| | - Mary Jarden
- Department of Hematology, Center for Cancer and Organ Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Karin Piil
- Center for Cancer and Organ Diseases, Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Department of Public Health, Aarhus University, Aarhus, Denmark
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14
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Maaskant JM, Jongerden IP, Bik J, Joosten M, Musters S, Storm-Versloot MN, Wielenga J, Eskes AM. Strict isolation requires a different approach to the family of hospitalised patients with COVID-19: A rapid qualitative study. Int J Nurs Stud 2021; 117:103858. [PMID: 33621720 PMCID: PMC7834466 DOI: 10.1016/j.ijnurstu.2020.103858] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 12/12/2020] [Accepted: 12/16/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND The outbreak of the COVID-19 pandemic influenced family-centred care dramatically due to restricting visiting policies. In this new situation, nurses were challenged to develop new approaches to involve family members in patient care. A better understanding of these changes and the experiences of nurses is essential to make an adaptation of procedures, and to secure a family-centred approach in care as much as possible. OBJECTIVES The aim of this study was to investigate how family involvement had taken place, and to explore the experiences of nurses with family involvement during the COVID-19 outbreak. In addition, we aimed to formulate recommendations for the involvement of family. METHODS We conducted a qualitative study using patient record review and focus-group interviews between April and July 2020. We reviewed records of patients with confirmed COVID-19, who were admitted to the COVID-19 wards at two affiliated university hospitals in the Netherlands. All records were searched for notations referring to family involvement. In two focus-groups, nurses who worked at the COVID-19 wards were invited to share their experiences. The Rigorous and Accelerated Data Reduction (RADaR) method was used to collect, reduce and analyse the data. RESULTS In total, 189 patient records were reviewed and nine nurses participated in the focus-group meetings. Patient records revealed infrequent and often unstructured communication with focus on physical condition. Nurses confirmed that communication with family was far less than before and that the physical condition of the patient was predominant. The involvement of family in care was limited to practicalities, although more involvement was described in end-of-life situations. Nurses experienced moral distress due to the visiting restrictions, though some acknowledged that they had experienced the direct patient care so intense and burdensome, that family contact simply felt too much. CONCLUSION The communication with and involvement of family in hospital care changed enormously during the COVID-19 outbreak. Based on the identified themes, we formulated recommendations that may be helpful for family-centered care in hospitals during periods of restricted visiting policy.
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Affiliation(s)
- J M Maaskant
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
| | - I P Jongerden
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, VU University, Amsterdam, the Netherlands
| | - J Bik
- Department of Internal Medicine, Amsterdam UMC, VU University, Amsterdam, the Netherlands
| | - M Joosten
- Department of Internal Medicine, Amsterdam UMC, VU University, Amsterdam, the Netherlands
| | - S Musters
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - M N Storm-Versloot
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - J Wielenga
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - A M Eskes
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Menzies Health Institute Queensland and School of Nursing and Midwifery, Griffith University, Gold Coast, Australia
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15
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Dieperink KB, Ikander T, Appiah S, Tolstrup LK. The cost of living with cancer during the second wave of COVID-19: A mixed methods study of Danish cancer patients' perspectives. Eur J Oncol Nurs 2021; 52:101958. [PMID: 33878634 DOI: 10.1016/j.ejon.2021.101958] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 04/01/2021] [Accepted: 04/05/2021] [Indexed: 12/14/2022]
Abstract
PURPOSE This study investigated experiences and levels of distress and resilience of Danish cancer patients during the second wave of the COVID-19 pandemic. METHODS The mixed methods design included a subset of cancer patients who responded to a cross-sectional survey in May 2020. Data were collected through telephone interviews. The National Comprehensive Cancer Network Distress Thermometer (NCCN DT), and Connor-Davidson-Resilience Scale (CD-RISC2) were used to measure distress and resilience. Data were analysed by thematic analysis and descriptive statistics. RESULTS Forty patients with lung, breast, colorectal and skin (melanoma) cancer were included; 65% were women. Mean age was 62.2 years (standard deviation [SD], 13.2). Most patients had curable disease (65%); 50% were in treatment and 50% in post-treatment follow up. The interviews revealed four themes: 1) the cost of living with cancer during COVID-19, 2) changes in cancer care delivery, 3) particularly vulnerable, and 4) importance of family support. Mean NCCN DT score was 2.3 (SD, 2.6) while the mean CD-RISC2 score was 7.25 (SD, 1.1). CONCLUSION Despite drastic changes in daily life imposed by COVID-19 restrictions, Danish cancer patients had remarkably low levels of distress and high levels of resilience. Patients in active treatment, with comorbidities or elderly felt vulnerable. Family support was invaluable in critical times.
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Affiliation(s)
- Karin Brochstedt Dieperink
- Research Unit of Oncology, The Academy of Geriatric Cancer Research (www.agecare.org), Odense University Hospital, Sdr. Boulevard 29, 5000, Odense C, Denmark; Family Focused Healthcare Research Center (FaCe), Denmark; Department of Clinical Research, University of Southern Denmark, J.B. Winsløws Vej 19.3, DK-5000 Odense C, Denmark.
| | - Tine Ikander
- Research Unit of Oncology, The Academy of Geriatric Cancer Research (www.agecare.org), Odense University Hospital, Sdr. Boulevard 29, 5000, Odense C, Denmark; Family Focused Healthcare Research Center (FaCe), Denmark; Department of Clinical Research, University of Southern Denmark, J.B. Winsløws Vej 19.3, DK-5000 Odense C, Denmark
| | - Sabina Appiah
- Research Unit of Oncology, The Academy of Geriatric Cancer Research (www.agecare.org), Odense University Hospital, Sdr. Boulevard 29, 5000, Odense C, Denmark
| | - Lærke Kjær Tolstrup
- Research Unit of Oncology, The Academy of Geriatric Cancer Research (www.agecare.org), Odense University Hospital, Sdr. Boulevard 29, 5000, Odense C, Denmark; Department of Clinical Research, University of Southern Denmark, J.B. Winsløws Vej 19.3, DK-5000 Odense C, Denmark
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16
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Ikander T, Jeppesen SS, Hansen O, Raunkiær M, Dieperink KB. Patients and family caregivers report high treatment expectations during palliative chemotherapy: a longitudinal prospective study. BMC Palliat Care 2021; 20:37. [PMID: 33637063 PMCID: PMC7912463 DOI: 10.1186/s12904-021-00731-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 02/19/2021] [Indexed: 11/10/2022] Open
Abstract
Background When discussing treatment options and future care, it is important to understand the expectations of patients and family caregivers related to palliative chemotherapy and to identify patterns in patients’ quality of life. The study aims were to evaluate differences in treatment expectations and quality of life between patients with thoracic cancer (non-small-cell lung cancer, small-cell lung cancer and mesothelioma) who were < 70 and ≥ 70 years of age and receiving palliative chemotherapy and to assess family caregivers’ treatment expectations. Methods A prospective longitudinal study included patients with thoracic cancer receiving outpatient palliative chemotherapy at a university hospital in Denmark and their family caregivers. Patients’ treatment expectations and quality of life were assessed three times during treatment with a survey of treatment expectations and the Functional Assessment of Cancer Therapy – General questionnaire. Family caregivers’ treatment expectations were assessed once. Results A total of 48 patients and 36 family caregivers participated between 2018 and 2019. No statistically significant age-related differences in treatment expectations and quality of life were identified. 28% of patients aged < 70 years and 7% of those aged ≥70 years expected a cure. Among family caregivers, 36% expected a cure. Across both age groups, mean total quality of life scores significantly decreased from 73.2 at first palliative chemotherapy cycle to 70.5 at third cycle (p = 0.02). No meaningful changes were found in quality of life within either age group. A subgroup analysis found no significant between-group differences in quality of life. Mean physical well-being score for all patients decreased from 20.3 at first cycle to 18.4 at third cycle (p = 0.03) and mean emotional well-being score decreased from 15.4 at first cycle to 14.6 at third cycle (p = 0.04). Conclusion This study emphasizes the importance of initiating conversations about treatment expectations and paying attention to expectations that may differ by the age of the patient and between patients and family caregivers. Addressing treatment expectations among patients and family caregivers and monitoring quality of life among patients is important in clinical practice. Supplementary Information The online version contains supplementary material available at 10.1186/s12904-021-00731-4.
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Affiliation(s)
- Tine Ikander
- Department of Oncology, Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, J.B. Winsløws Vej 4, 5000, Odense, Denmark. .,REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital and University of Southern Denmark, Nyborg, Denmark. .,Department of Clinical Research, University of Southern, Family Focused Healthcare Research Centre (FaCe), Odense, Denmark. .,Department of Clinical Research, University of Southern, Odense, Denmark. .,OPEN, Open Patient data Explorative Network, Odense University Hospital, Region of Southern, Odense, Denmark.
| | - Stefan Starup Jeppesen
- Department of Oncology, Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, J.B. Winsløws Vej 4, 5000, Odense, Denmark.,Department of Clinical Research, University of Southern, Odense, Denmark
| | - Olfred Hansen
- Department of Oncology, Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, J.B. Winsløws Vej 4, 5000, Odense, Denmark.,Department of Clinical Research, University of Southern, Odense, Denmark
| | - Mette Raunkiær
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital and University of Southern Denmark, Nyborg, Denmark.,Department of Clinical Research, University of Southern, Odense, Denmark
| | - Karin Brochstedt Dieperink
- Department of Oncology, Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, J.B. Winsløws Vej 4, 5000, Odense, Denmark.,Department of Clinical Research, University of Southern, Family Focused Healthcare Research Centre (FaCe), Odense, Denmark.,Department of Clinical Research, University of Southern, Odense, Denmark
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17
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Dieperink KB, Ellegaard E, Astrup AL, Hasse HT, Elnegaard CM, Jensen JD. Nurse-led group information for patients with breast cancer: Equal to individual information? A comparative study. Nurs Open 2021; 8:423-433. [PMID: 33318850 PMCID: PMC7729802 DOI: 10.1002/nop2.643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 08/18/2020] [Accepted: 09/08/2020] [Indexed: 11/08/2022] Open
Abstract
Aim To investigate outpatients with breast cancer perception of information before and after changed informational practice. Design The design was a comparative study. Method Information about breast cancer treatment and chemotherapy toxicity changed from individual to nurse-led group information. Women with early-stage breast cancer were eligible. To evaluate individual versus group information, the patients completed a questionnaire at their third cycle of chemotherapy, including Knowledge of treatment, Support from healthcare professionals or peers and general self-efficacy Ability to act in everyday life. The study is registered in OSF https://osf.io/bh7wg. Results In total, 90 participants in two groups were included: (a) individual information (N = 44) and (b) group information (N = 46). Groups were comparable in age and educational level. Both groups found the information satisfactory, with no significant differences regarding perceived knowledge or support. Five of ten questions in self-efficacy showed significantly better outcomes in patients receiving group information but with no difference in overall self-efficacy. Group information was non-inferior compared with individual information. Patients were satisfied in both groups.
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Affiliation(s)
- Karin Brochstedt Dieperink
- Department of OncologyResearch Unit of OncologyOdense University HospitalOdenseDenmark
- Department of Clinical ResearchUniversity of Southern DenmarkOdenseDenmark
| | - Elisabeth Ellegaard
- Department of OncologyResearch Unit of OncologyOdense University HospitalOdenseDenmark
| | - Anja Langkjær Astrup
- Department of OncologyResearch Unit of OncologyOdense University HospitalOdenseDenmark
| | - Henriette Tind Hasse
- Department of OncologyResearch Unit of OncologyOdense University HospitalOdenseDenmark
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18
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Acknowledging cancer as a family disease: A systematic review of family care in the cancer setting. Eur J Oncol Nurs 2020; 49:101841. [DOI: 10.1016/j.ejon.2020.101841] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 09/16/2020] [Accepted: 09/25/2020] [Indexed: 02/06/2023]
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19
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Caregiver Burden Domains and Their Relationship with Anxiety and Depression in the First Six Months of Cancer Diagnosis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17114101. [PMID: 32526823 PMCID: PMC7312950 DOI: 10.3390/ijerph17114101] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 06/05/2020] [Accepted: 06/06/2020] [Indexed: 12/16/2022]
Abstract
Cancer caregiving is associated with burden and a poor psychological state. However, there is no previous information about the predictive utility of specific burden domains on anxiety and depression in the first six months after a partner's cancer diagnosis. In a longitudinal study, 67 caregivers completed the Zarit Burden Interview (ZBI) and Hospital Anxiety and Depression Scale (HADS) at T1 (45-60 days after diagnosis) and T2 (180-200 days after diagnosis). Most of the caregivers were female (65.7%, mean age = 51.63, SD = 13.25), while patients were mostly male (56.7%). The TRIPOD checklist was applied. ZBI scores were moderate and HADS anxiety reached significant values. There were no differences in ZBI and HADS between T1 and T2. The relationship between burden, anxiety, and depression were more consistent at T2, while emotional burden at T1 were related and predicted anxiety and depression at T2. Some burden domains were related and predicted anxiety in caregivers in the first six months after partner cancer diagnosis. This information could be useful to prevent the onset of these symptoms in the first six months after diagnosis.
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20
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Petersson NB, Jørgensen AL, Danbjørg DB, Dieperink KB. Video-consulted rounds with caregivers: The experience of patients with cancer. Eur J Oncol Nurs 2020; 46:101763. [PMID: 32447267 DOI: 10.1016/j.ejon.2020.101763] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 03/23/2020] [Accepted: 04/13/2020] [Indexed: 12/15/2022]
Abstract
PURPOSE This study aim to explore how adult patients admitted to an oncology ward experience video-consulted rounds with caregivers as a mean for family involvement. METHODS The methodological framework for the study was Interpretative phenomenological analysis. Participant observations during video-consulted rounds and semi-structured interviews were conducted between November 2018 and March 2019 at the Department of Oncology, Odense University Hospital, Denmark. RESULTS 15 patients participated in the study. Overall, patients experienced video-consulted rounds as a satisfactory way of involving their families in rounds while also creating a sense of presence and comfort. Appropriate positioning of stakeholders could influence the experience of virtual rounds. Limitations included the lack of physical care from caregivers, specifically when patients discussed serious matters with health care professionals. Furthermore, patients experienced challenges in reading body language when communicating virtually with their families. CONCLUSION The study provides important knowledge regarding patients' experiences with video-consulted rounds with caregivers. In concordance with patients' experiences, video-consulted rounds can offer a family centered way to involve caregivers in patient rounds. However, there should be awareness in regard to how the technology is used and to which context it is applied.
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Affiliation(s)
- Nadja Buch Petersson
- Department of Oncology, Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, Sdr. Boulevard 29, 5000, Odense, Denmark.
| | - Ane Løvendahl Jørgensen
- Department of Plastic Surgery, Odense University Hospital, J.B. Winsløws vej 4, 5000, Odense, Denmark.
| | - Dorthe Boe Danbjørg
- Department of Hematology, Odense University Hospital, Kløvervænget 6, 5000, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Winsløvparken 19, 5000, Odense, Denmark; CIMT - Centre for Innovative Medical Technology, University of Southern Denmark, Kløvervænget 8C, 5000, Odense, Denmark.
| | - Karin Brochstedt Dieperink
- Department of Oncology, Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, Sdr. Boulevard 29, 5000, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Winsløvparken 19, 5000, Odense, Denmark; FaCe - Family Focused Healthcare Research Center, Department of Clinical Research, University of Southern, Denmark.
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21
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Østergaard B, Clausen AM, Agerskov H, Brødsgaard A, Dieperink KB, Funderskov KF, Nielsen D, Sorknaes AD, Voltelen B, Konradsen H. Nurses' attitudes regarding the importance of families in nursing care: A cross-sectional study. J Clin Nurs 2020; 29:1290-1301. [PMID: 31971287 DOI: 10.1111/jocn.15196] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 01/05/2020] [Accepted: 01/10/2020] [Indexed: 11/26/2022]
Abstract
AIMS AND OBJECTIVES To investigate attitudes towards family involvement in care among a broad sample of Danish nurses from all sectors and healthcare settings. BACKGROUND Evidence suggests that nurses hold both supportive and less supportive attitudes about involvement of family members in the care of patients, and the existing findings are limited to specific healthcare contexts. DESIGN A cross-sectional study adhering to the Strengthening the Reporting of Observational Studies in Epidemiology for reporting observational studies. METHODS Using snowball sampling, the Families' Importance in Nursing Care-Nurses' Attitudes questionnaire was initially administered to a broad, convenience sample of Danish registered nurses through social media: Facebook interest groups and the homepage of the Danish Family Nursing Association. These nurses were encouraged to send the invitation to participate in their network of nursing colleagues. Complete data sets from 1,720 nurses were available for analysis. RESULTS In general, the nurses considered the family as important in patient care. Nurses who held master's and doctorate degrees scored significantly higher than nurses with a basic nursing education. Nurses who had had experience with illness within their own families tended to score higher on the family as a conversational partner subscale than those without this experience. Nurses with the longest engagement within hospital settings scored significantly lower than those with the longest engagement within primary health care and/or psychiatry. CONCLUSIONS Families are considered important in nursing care. Younger nurses with a basic education, short-term engagement at a hospital and no experiences with illness within their own families were predictors of less supportive attitudes towards including the family in nursing care. RELEVANCE TO CLINICAL PRACTICE Clinical leaders and managers should promote education on the importance of active family involvement in patient care in clinical practice and undergraduate education. More focus on collaboration with families in the hospital setting is needed.
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Affiliation(s)
- Birte Østergaard
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Anne M Clausen
- Department of Hematology, Odense University Hospital, Odense, Denmark
| | - Hanne Agerskov
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Department of Nephrology, Odense University Hospital, Odense, Denmark
| | - Anne Brødsgaard
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital Amager Hvidovre, Hvidovre, Denmark.,Section for Nursing, Institute of Public Health, Aarhus University, Aarhus, Denmark
| | - Karin B Dieperink
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Department of Oncology, Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, Odense, Denmark
| | - Karen F Funderskov
- Department of Clinical Physiology, Danish Center for Sleep Medicine - Rigshospitalet, Copenhagen, Denmark
| | - Dorthe Nielsen
- Migrant Health Clinic, Department of Infectious diseases, Odense University Hospital, Odense, Denmark.,Department of Nursing/Health Sciences Research Center, University College Lillebaelt, Vejle, Denmark
| | - Anne D Sorknaes
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Medical Department, Svendborg Hospital, Odense University Hospital, Svendborg, Denmark
| | - Barbara Voltelen
- Department of Nursing/Health Sciences Research Center, University College Lillebaelt, Vejle, Denmark
| | - Hanne Konradsen
- Department of Gastroenterology, Herlev and Gentofte University Hospital, Hellerup, Denmark.,Department of Neurobiology, Care Sciences and Society, NVS, Karolinska Instituttet, Solna, Sweden.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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