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Martins H, Silva RS, Bragança J, Romeiro J, Caldeira S. Spiritual Distress, Hopelessness, and Depression in Palliative Care: Simultaneous Concept Analysis. Healthcare (Basel) 2024; 12:960. [PMID: 38786372 PMCID: PMC11121139 DOI: 10.3390/healthcare12100960] [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: 03/17/2024] [Revised: 04/23/2024] [Accepted: 05/03/2024] [Indexed: 05/25/2024] Open
Abstract
Spiritual distress, hopelessness, and depression are concepts that are often used in palliative care. A simultaneous concept analysis (SCA) of these concepts is needed to clarify the terminology used in palliative care. Therefore, the aim of this study is to conduct a SCA of spiritual distress, hopelessness, and depression in palliative care. A SCA was performed using the methodology of Haase's model. A literature search was conducted in March 2020 and updated in April 2022 and April 2024. The search was performed on the following online databases: CINAHL with Full-Text, MEDLINE with Full-Text, MedicLatina, LILACS, SciELO, and PubMed. The search was achieved without restrictions on the date of publication. A total of 84 articles were included in this study. The results highlight that the three concepts are different but also share some overlapping points. Spiritual distress is embedded in the rupture of their spiritual/religious belief systems, a lack of meaning in life, and existential issues. Hopelessness is a sense of giving up and an inability to control and fix the patient's situation. Finally, depression is a state of sadness with a multi-impaired situation. In conclusion, refining the three concepts in palliative care is essential since it promotes clarification and enhances knowledge development towards intervention.
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Affiliation(s)
- Helga Martins
- Postdoctoral Program in Integral Human Development, Católica Doctoral School, 1649-023 Lisbon, Portugal;
- Health School, Polytechnic Institute of Beja, 7800-000 Beja, Portugal
- Centre for Interdisciplinary Research in Health, Universidade Católica Portuguesa, 1649-023 Lisbon, Portugal;
| | - Rita S. Silva
- Faculty of Health Sciences and Nursing, Universidade Católica Portuguesa, 1649-023 Lisbon, Portugal; (R.S.S.); (J.B.)
| | - Joana Bragança
- Faculty of Health Sciences and Nursing, Universidade Católica Portuguesa, 1649-023 Lisbon, Portugal; (R.S.S.); (J.B.)
| | - Joana Romeiro
- Postdoctoral Program in Integral Human Development, Católica Doctoral School, 1649-023 Lisbon, Portugal;
- Centre for Interdisciplinary Research in Health, Universidade Católica Portuguesa, 1649-023 Lisbon, Portugal;
- Faculty of Health Sciences and Nursing, Universidade Católica Portuguesa, 1649-023 Lisbon, Portugal; (R.S.S.); (J.B.)
| | - Sílvia Caldeira
- Centre for Interdisciplinary Research in Health, Universidade Católica Portuguesa, 1649-023 Lisbon, Portugal;
- Faculty of Health Sciences and Nursing, Universidade Católica Portuguesa, 1649-023 Lisbon, Portugal; (R.S.S.); (J.B.)
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Prado RT, Leone DRR, Souza TDM, Werneck PV, Lacerda MR, de Castro EAB. Palliative care management by caregivers in home care: theoretical validation in a conversation circle. Rev Bras Enferm 2022; 75:e20210737. [PMID: 36102471 PMCID: PMC9728829 DOI: 10.1590/0034-7167-2021-0737] [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: 10/03/2021] [Accepted: 04/03/2022] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES to present the validation process of a Grounded Theory on the management of palliative care at home by a caregiver of a family member who experiences a death/dying process. METHODS a qualitative, explanatory research, which validated a theoretical matrix through a conversation circle containing 15 family caregivers and nine healthcare professionals, in December 2018. RESULTS forty-six propositions were validated regarding family caregivers' contextual, causal, intervening conditions, consequences and action strategies to deal with the dying and death process of a family member. Conversation circles encouraged dialogue and (re)signification of the senses and knowledge of those involved, proving to be a way of educating and promoting the exercise of citizenship by participants. FINAL CONSIDERATIONS the conversation circle made it possible for participants to interact and share information and experiences regarding home care for palliative patients and their families.
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Affiliation(s)
- Roberta Teixeira Prado
- Faculdade de Ciências Médicas e da Saúde de Juiz de Fora. Juiz de Fora, Minas Gerais, Brazil
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Bolela F, Lima RD, Souza ACD, Moreira MR, Lago AJDO, Simino GPR, Araújo JSD. Cancer patients in Palliative Care: occurrences related to venipuncture and hypodermoclysis. Rev Lat Am Enfermagem 2022; 30:e3623. [PMID: 35976356 DOI: 10.1590/1518-8345.5825.3623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 04/03/2022] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE to identify the occurrences related to peripheral venipuncture and hypodermoclysis among patients hospitalized in a general hospital and in an exclusive hospital institution for the care of patients in palliative cancer care. METHOD an observational, descriptive and multicenter study. The consecutive and non-probabilistic sample consisted of 160 cancer patients hospitalized in Palliative Care. The outcome variable corresponded to the occurrences and complications related to each type of puncture. A questionnaire containing the sociodemographic and clinical variables and a structured script for monitoring and daily evaluation of the puncture were used. Descriptive statistics were employed for data analysis. RESULTS the occurrences related to venipuncture at a general hospital were blood soiling at catheter insertion (17.4%) and expired use period (15.8%), while at a specific service for the care of patients under palliative care they were expired use period (32%) followed by infiltration (18.9%). As for hypodermoclysis, there were two subcutaneous punctures with phlogistic signs (1.0%) at the general hospital and a hematoma at the catheter insertion site (0.5%). At the specific service for the care of patients under palliative care there were three subcutaneous punctures with phlogistic signs (5.7%). CONCLUSION the number of occurrences related to peripheral venipuncture was higher than those related to hypodermoclysis.
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Affiliation(s)
- Fabiana Bolela
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em Enfermagem, Ribeirão Preto, SP, Brasil
| | - Roberta de Lima
- Instituto Nacional de Câncer José Alencar Gomes da Silva, Hospital do Câncer IV, Rio de Janeiro, RJ, Brasil
| | - Ana Carolina de Souza
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em Enfermagem, Ribeirão Preto, SP, Brasil
| | - Michele Rocha Moreira
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em Enfermagem, Ribeirão Preto, SP, Brasil
| | - Ana Julia de Oliveira Lago
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em Enfermagem, Ribeirão Preto, SP, Brasil
| | | | - Jakeline Silva de Araújo
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em Enfermagem, Ribeirão Preto, SP, Brasil
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Prado RT, Leone DRR, Souza TDM, Werneck PV, Lacerda MR, Castro EABD. Gestão de cuidados paliativos por cuidadores na atenção domiciliar: validação teórica em roda de conversa. Rev Bras Enferm 2022. [DOI: 10.1590/0034-7167-2021-0737pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
RESUMO Objetivos: apresentar o processo de validação de uma Teoria Fundamenta nos Dados sobre a gestão do cuidado paliativo domiciliar pelo cuidador de um familiar que vivencia processo de morte/morrer. Métodos: pesquisa do tipo explicativa, qualitativa, que validou uma matriz teórica por meio de uma roda de conversa contendo 15 cuidadores familiares e nove profissionais de saúde, em dezembro de 2018. Resultados: foram validadas 46 proposições relativas a condições contextuais, causais, intervenientes, consequências e estratégias de ação de cuidadores familiares para lidar com o processo de morrer e morte do familiar. A roda de conversa impulsionou o diálogo e a (re)significação dos sentidos e dos saberes dos envolvidos, demonstrando ser uma forma de educar e propiciar o exercício da cidadania dos participantes. Considerações Finais: a roda de conversa possibilitou a interação dos participantes e o compartilhamento de informações e experiências diante do cuidado domiciliar de pacientes paliativos e seus familiares.
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The Relationship between Cancer Caregiver Burden and Psychological Outcomes: The Moderating Role of Social Connectedness. Curr Oncol 2021; 29:14-26. [PMID: 35049676 PMCID: PMC8775135 DOI: 10.3390/curroncol29010002] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 12/03/2021] [Accepted: 12/14/2021] [Indexed: 11/18/2022] Open
Abstract
The present study: (a) examined the extent of caregiver burden and psychological wellbeing and (b) tested whether social connectedness moderated the association between caregiver burden and psychological symptoms in caregivers of people with cancer. The cross-sectional survey study included 189 cancer caregivers (mean age = 36.19 years, standard deviation = 11.78; 80.4% female). Data were collected on caregiver burden, social connectedness, and depression and anxiety. Moderation analysis was conducted to examine the effect of social connectedness on the relationship between caregiver burden and depression and anxiety. Caregiver burden was positively associated with depression and anxiety symptoms. Controlling for significant demographic and caregiver characteristics, the moderation model showed as perceived social connectedness increased, the relationship between caregiver burden and depression decreased (β = −0.007, se = 0.004, 95% CI: −0.014, 0.000, p = 0.05). By contrast, social connectedness did not moderate the association between caregiver burden and anxiety. Findings have implications for the management of depression in cancer caregivers. Social connectedness appears to provide a protective buffer from the negative impacts of caregiving, providing increased psychological resources to manage the burden associated with caregiving, resulting in lower depression. Research on strategies to improve caregiver wellbeing through enhancing engagement with social networks in ways that improve perceived sense of connectedness with others is warranted.
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Indicadores e fatores associados à sobrecarga em cuidadores informais de pacientes em radioterapia. ACTA PAUL ENFERM 2021. [DOI: 10.37689/acta-ape/2021ao02924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Siqueira FD, Girardon-Perlini NMO, Andolhe R, Zanini RR, Santos EBD, Dapper SN. Caring ability of urban and rural family caregivers: association with overburden, stress and coping. Rev Esc Enferm USP 2021; 55:e03672. [PMID: 33886903 DOI: 10.1590/s1980-220x2019019103672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 05/27/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To correlate caring ability with overburden, stress and coping of urban and rural family caregivers of patients undergoing cancer treatment. METHOD Cross-sectional study, carried out in a referral hospital for cancer treatment, with urban and rural caregivers who responded the following instruments: questionnaire of sociodemographic characterization of the caregiver and the care provided, Perceived Stress scale, Burden Interview scale and Brief COPE. Pearson's correlation test was used for statistical analysis, with a significance level ≤5%. RESULTS A total of 163 urban caregivers and 59 rural caregivers participated in the study. Between the caring ability and stress, a negative and moderate correlation was found in rural caregivers. In the relationship between the caring ability and the overburden, there was a statistically significant correlation in urban caregivers in the interpersonal relationship and perception of self-efficacy factor. Between coping and the caring ability, a positive and moderate correlation was identified in coping focused on the problem in the knowledge dimension in urban caregivers. CONCLUSION Urban caregivers had greater intensity of overburden and coping focused on the problem in relation to the caring ability.
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Affiliation(s)
- Fernanda Duarte Siqueira
- Universidade Federal de Santa Maria, Programa de Pós-Graduação em Enfermagem, Santa Maria, RS, Brazil
| | | | - Rafaela Andolhe
- Universidade Federal de Santa Maria, Programa de Pós-Graduação em Enfermagem, Santa Maria, RS, Brazil
| | - Roselaine Ruviaro Zanini
- Universidade Federal de Santa Maria, Programa de Pós-Graduação em Engenharia de Produção, Santa Maria, RS, Brazil
| | - Evelyn Boeck Dos Santos
- Universidade Federal de Santa Maria, Programa de Pós-Graduação em Enfermagem, Santa Maria, RS, Brazil
| | - Steffani Nikoli Dapper
- Universidade Federal de Santa Maria, Programa de Pós-Graduação em Administração, Santa Maria, RS, Brazil
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Silva YC, Silva KL, Velloso ISC. Practices used by a home care team: implications for caregivers. Rev Bras Enferm 2021; 74:e20190794. [PMID: 33886829 DOI: 10.1590/0034-7167-2019-0794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Accepted: 10/31/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES to analyze the practices of a home care team and their implications for caregivers' performance. METHODS qualitative study with data obtained from observation of 21 users, 30 caregivers and 6 professionals from the home health care service in a municipality in Minas Gerais, from February to June 2018. The material was analyzed from the perspective of discourse analysis according to Michel Foucault. RESULTS team interference upon caregivers is exercised by disciplinary practices and prescriptive, authoritative and surveilling behaviors. The team's knowledge-power relationship determines caregivers' acceptance through convincing or through difficulty of understanding assigned orientations. Educational practices would enable caregivers to be constituted as active, participative, empowered and reflective subjects. FINAL CONSIDERATIONS team practices interfere with caregivers' ways of acting and being and they have implications in objectification and subjectification processes.
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Affiliation(s)
- Yara Cardoso Silva
- Universidade Federal de Minas Gerais. Belo Horizonte, Minas Gerais, Brazil
| | - Kênia Lara Silva
- Universidade Federal de Minas Gerais. Belo Horizonte, Minas Gerais, Brazil
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Karakurt P, Tuncer SK, Çiltaş NY, Doğan M. Determination of Caregiver Burden and Social Support Levels among Caregivers Providing Care for Patients Hospitalized in Palliative Care Clinics. GALICIAN MEDICAL JOURNAL 2020. [DOI: 10.21802/gmj.2020.4.14] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Providing care to someone with a chronic disease requires being physically, emotionally, and mentally energetic. In particular, the presence of a patient with a disease that requires palliative care changes daily activities and routines, increases responsibilities of those who take the responsibility for patient’s care and changes the roles in the family.
The objective of this study was to determine the care burden and social support levels among the caregivers providing care for patients hospitalized in palliative care clinics.
Materials and Methods: The population of this descriptive and correlational study consisted of caregivers taking care of patients treated at the Palliative Care Clinic of Training and Research Hospital between May and October 2018; the sample consisted of 73 caregivers who volunteered to join the study and were open to communication. Data were collected by questioning patients and their caregivers about their sociodemographic characteristics, using the Caregiver Burden Scale and the Multidimensional Scale of Perceived Social Support. Data analysis included percentages, the Kruskal-Wallis test, the Mann-Whitney U test, and the Spearman’s Correlation Coefficient.
Results: The average caregivers’ age was 45.44±13.76 years; 75.3% of caregivers were females, 30.1% of caregivers were literate or had primary school degrees. Caregiver’s gender and educational levels were found not to affect caregiving and social support levels; however, the economic status affected caregiving and social support levels. There was a reverse correlation between the caregiver burden and their social support levels.
Conclusions: With increased caregiver burden, their social support level decreased. Nurses caring for patients in palliative care clinics will benefit from educating and supporting caregivers about clinic and home care; it will result in a positive level of social support for both caregivers and patients receiving care.
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THE EFFECTS OF CARE-GIVING UPON FAMILY MEMBERS OF INDIVIDUALS WHO ARE TREATED IN THE PALLIATIVE CARE UNIT: A PHENOMENOLOGICAL APPROACH. INTERNATIONAL JOURNAL OF HEALTH SERVICES RESEARCH AND POLICY 2020. [DOI: 10.33457/ijhsrp.737447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Delalibera M, Coelho A, Frade P, Barbosa A, Leal I. Caregiving and bereavement in palliative care: A cross-cultural study between Brazil and Portugal. Transcult Psychiatry 2020; 57:445-454. [PMID: 32216543 DOI: 10.1177/1363461520909596] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Caregiving and bereavement outcomes are strongly influenced by socio-cultural context. Past research has found higher levels of caregiver burden and psychological morbidity in Portuguese compared to Brazilian caregivers. This study compared Brazilian and Portuguese family caregivers in palliative care to identify differences in psychological morbidity and caregiver burden and their relationship with psychosocial factors such as sociodemographic variables, circumstances of end-of-life care and dying, social support, family functioning, and perception of quality of care. Prospective data were collected from convenience samples of family caregivers in Brazil (T0 n = 60; T1 n = 35) and Portugal (T0 n = 75; T1 n = 29) at two separate time points-during caregiving (T0), and during the first two months of bereavement (T1). The study samples consisted mostly of women, offspring, and spouses. In both countries, family caregivers devoted most of their day to taking care of their sick relatives and reported a lack of practical support. Portuguese caregivers had higher levels of burden than Brazilian caregivers, and in both populations a greater burden was associated with more psychopathological symptoms. Higher caregiver burden among Portuguese caregivers was associated with the circumstances of death and the perceived lack of emotional support. Among Portuguese caregivers, symptomatology persisted during bereavement, reaching significantly higher levels of anxiety, somatization, and peritraumatic symptoms compared to the Brazilian sample. These results show differences between family caregiver samples in Portugal and Brazil during the bereavement process. Understanding the underlying cultural patterns and mechanisms requires future research.
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Gomes NP, Pedreira LC, Gomes NP, Fonseca EDOS, Reis LAD, Santos ADA. Health-related consequences of caring for dependent relatives in older adult caregivers. Rev Esc Enferm USP 2019; 53:e03446. [DOI: 10.1590/s1980-220x2018002303446] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 09/20/2019] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: To know the health-related consequences of caring for dependent relatives in older adult caregivers. Method: Qualitative research carried out with older adult women who cared for family members enrolled in a federal public home care program. The identification of the older adult caregivers was done by consulting the patient’s charts, and the interview took place from March to June 2017. The data were systematized based on Content Analysis. Results: Six older adult caregivers of people with impaired functional capacity participated in the study. Three categories emerged: care-related musculoskeletal pain; health problems related to the somatization of the lived feeling; and self-care deficit by virtue of caring for another. Conclusion: The study revealed the consequences of caring for dependent family members on the health of older adult caregivers. Careful management is essential to prevent and/or reduce health problems, especially regarding the musculoskeletal system.
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