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Azimi F, Moghaddam-Tabrizi F, Sharafkhani R. The Effect of Group Counselling based on Constructive Couple Communication on Perceived Spousal Support in Uterine and Cervical Cancer Survivors: A Randomized Control Trial. INTERNATIONAL JOURNAL OF COMMUNITY BASED NURSING AND MIDWIFERY 2024; 12:162-174. [PMID: 39161859 PMCID: PMC11330556 DOI: 10.30476/ijcbnm.2024.101425.2420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 06/18/2024] [Accepted: 06/19/2024] [Indexed: 08/21/2024]
Abstract
Background Uterine and Cervical cancer survivors face challenges like the disruption of emotional and sexual relationships, struggle to maintain sexual life and intimacy, and the possibility of divorce. The study aimed to determine the effect of group counseling based on couples' constructive communication on perceived spousal support in uterine and cervical cancer survivors. Methods A randomized controlled trial on 40 women who survived uterine and cervical cancer were recruited using convenience sampling and then randomly allocated to a couple-based constructive communication intervention group and a routine cancer center care control group from June 2019 to March 2020 in Motahhari and Imam Khomeini hospitals in Urmia. The intervention group was involved in a group counseling session weekly for 5 weeks, regarding constructive couple communication skills. Perceived spouse support was assessed using the sources of social support scale which has 4 subscales informational, instrumental, emotional, and negative support before and one week after the end of the intervention in both groups. Data analysis was performed using SPSS version 24 through Independent and paired t-tests, Mann-Whitney U test, Wilcoxon, chi-square, and ANCOVA. P value<0.05 was considered statistically significant. Results The effect of the intervention was statistically significant in reducing negative support in the intervention group (2.70±0.80) in comparison with the control group (3.40±1.04) (P=0.03). It was also statistically significant in increasing informational support (3.45±0.71 vs. 2.15±0.80, P<0.001), instrumental support (3.15±0.58 vs. 2.85±0.74, P<0.001), and emotional support (19.40±1.60 vs. 16.10±2.10, P<0.001). Conclusion Group counseling based on couple constructive communication increased perceived spousal support in uterine and cervical cancer survivors. Trial Registration Number: IRCT20150125020778N22.
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Affiliation(s)
- Fatemeh Azimi
- Department of Consultation on Midwifery, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Fatemeh Moghaddam-Tabrizi
- Department of Consultation on Midwifery, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
- Maternal and Childhood Obesity Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Rahim Sharafkhani
- Department of Public Health, School of Health, Khoy University of Medical Sciences, Khoy, Iran
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Zhou J, Wang Z, Chen X, Lin C, Zhao J, Loke AY, Li Q. Mutual communication intervention for colorectal cancer patient-spousal caregiver dyads: A randomized controlled trial. Br J Health Psychol 2024. [PMID: 38849210 DOI: 10.1111/bjhp.12734] [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: 11/30/2023] [Revised: 05/24/2024] [Accepted: 05/27/2024] [Indexed: 06/09/2024]
Abstract
OBJECTIVE Gender could impact the psychosocial outcomes and coping strategies of cancer patients and their spousal caregivers (SCs). This study aims to develop a gender-concerned program for colorectal cancer (CRC) couple-based mutual communication intervention (MCI) and to assess its effectiveness on the intra-couple relationship and the individual functions of the partners. DESIGN A randomized clinical trial with two study groups was utilized. METHODS A total of 144 CRC patients and their SCs were randomly assigned to either MCI or usual care (UC) groups, and all of them were required to complete the measurements at baseline and post-intervention. The primary outcome was for mutual communication, and the secondary outcomes included dyadic coping, relationship satisfaction, anxiety, depression, benefit finding and quality of life. The data were analysed by multi-level modelling. RESULTS The MCI program was feasible and acceptable for Chinese CRC couples and was effective for the improvement of the intra-couple relationship and the individual functions of each partner. CRC patients showed more improvement in mutual communication and dyadic coping than their SCs in the MCI group. Also, this intervention effectiveness was found to be independent of gender. CONCLUSIONS The MCI program is beneficial for Chinese CRC couple's adaptation outcomes. This suggests that clinical medical staff should consider the gender tendency during the implementation of interventions. More researches are needed to extend the application of the MCI program to different participants (e.g. patients with the diagnosis of other types of cancer and their SCs).
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Affiliation(s)
- Junrui Zhou
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Zhiming Wang
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Xuan Chen
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Chunyan Lin
- Affiliated Hospital, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Jie Zhao
- Affiliated Hospital, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Alice Yuen Loke
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon Hong Kong, China
| | - Qiuping Li
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
- Affiliated Hospital, Jiangnan University, Wuxi, Jiangsu Province, China
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Son H, Kim N. Therapeutic Parent-Child Communication and Health Outcomes in the Childhood Cancer Context: A Scoping Review. Cancers (Basel) 2024; 16:2152. [PMID: 38893270 PMCID: PMC11172360 DOI: 10.3390/cancers16112152] [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: 04/23/2024] [Revised: 05/17/2024] [Accepted: 05/28/2024] [Indexed: 06/21/2024] Open
Abstract
Family communication has been thought to be an important area to support children's adjustment to a cancer diagnosis. However, the characteristics of therapeutic parent-child communication that contribute to better patient outcomes and the specific patient health outcomes have been less explored. This current review explored the characteristics of therapeutic parent-child communication and its physical and psychological health outcomes. A total of 5034 articles were initially identified, and only 10 articles remained for inclusion in this review after application of the exclusion criteria. Most studies used a cross-sectional design and measured verbal communication characteristics and its psychological outcomes, but no physical outcomes. The characteristics of therapeutic verbal communication (openness, maternal validation, quality of information shared, etc.) and nonverbal communication (eye contact, close physical distance, and acknowledging behaviors) were identified. The psychological health outcomes included less distress, a lower level of PTSS, less internalizing and externalizing of symptoms, increased levels of social emotional competencies, better peer relationships, and more cooperation during the procedure at the individual level. Increased family cohesion and family adaptation were family-level outcomes. Longitudinal studies are needed to identify what qualities of communication predict better psychological outcomes so that interventions can be developed and tested. In addition, physical outcomes should be evaluated.
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Affiliation(s)
- Heeyeon Son
- College of Nursing, University of Tennessee, 1412 Circle Drive, Knoxville, TN 37996, USA
| | - Nani Kim
- School of Nursing, The University of Texas at Austin, 1710 Red River St., Austin, TX 78712, USA;
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4
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Zahedi H, Alizadeh-Dibazari Z, Mirghafourvand M, Sahebihagh MH, Hosseinzadeh M. The effectiveness of couple-based interventions on the marital outcomes of women with genital and breast cancer and their partners: a systematic review and meta-analysis. BMC Cancer 2024; 24:391. [PMID: 38539118 PMCID: PMC10976738 DOI: 10.1186/s12885-024-12088-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 03/05/2024] [Indexed: 07/23/2024] Open
Abstract
BACKGROUND Breast cancer and genital cancer are known as cancers that affect people's relationships with their partners. Women with such cancers are emotionally vulnerable and need more support from their partners. The present systematic review and meta-analysis evaluated the effectiveness of couple-based interventions on the marital outcomes of patients with these cancers and their intimate partners. METHODS To perform this systematic review, Google Scholar and databases such as PubMed, Web of Science, Cochrane, Scopus, SID (Scientific Information Database), and Magiran were searched systematically. The reviewed studies included randomized controlled trials and quasiexperimental studies in which the intervention group, couple-based interventions, and the control group received routine care, general education or no intervention for cancer treatment. In this study, the included participants were patients with breast cancer or genital cancer and their intimate partners. The primary outcomes considered in this study included patients' marital adjustment, patients' marital satisfaction, patients' marital intimacy, and patients' marital relationships. The secondary outcomes were partners' marital adjustment, partners' marital satisfaction, partners' marital intimacy, and partners' marital relationships. A meta-analysis was performed with Review Manager v. 5.3 software (The Nordic Cochrane Centre, Cochrane Collaboration, 2014; Copenhagen, Denmark). The intervention impacts on continuous outcomes were measured using standardized mean differences (SMDs) with 95% confidence interval because of the use of various scales to evaluate the outcomes. The quality of evidence presented in the included studies was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. In the subgroup analysis, the studied outcomes were divided into two parts (theory-based and non-theory-based) in terms of the theoretical context of couple-based interventions. RESULTS From a total of 138 retrieved studies, 14 trials were eligible for inclusion in the study. The results of the meta-analysis showed that the patient's marital satisfaction increased significantly with couple-based interventions (SMD 0.46, 95% confidence interval 0.07 to 0.85; 7 trials, 341 patients, very low certainty) compared to the control group, but the evidence was uncertain. However, there were no significant differences between the groups in the partner's marital satisfaction, the patient's and partner's marital adjustment, and the patient's and partner's marital intimacy. Additionally, the results of the subgroup analysis showed that the couple-based interventions significantly increased the patient's marital adjustment (SMD 1.96, 95% CI 0.87 to 3.06; 4 trials, 355 patients, very low certainty), the partner's marital adjustment (SMD 0.53, 95% CI 0.20 to 0.86; 4 trials, 347 partners, very low certainty), the patient's marital satisfaction (SMD 0.89, 95% CI 0.35 to 1.43; 2 trials, 123 patients, very low certainty), and the partner's marital satisfaction (SMD 0.57, 95% CI 0.20 to 0.94; 2 trials, 123 partners, very low certainty) compared to the control group in theory-based studies. In. However, in non-theory-based studies, the results of the meta-analysis revealed no significant differences between the intervention and control groups. CONCLUSIONS The results of this study demonstrated the impact of couple-based interventions on the marital outcomes of patients with breast and genital cancers. Because of the very low confidence in the evidence, high-quality randomized trials with a sufficient sample size should be conducted considering the proper theoretical context.
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Affiliation(s)
- Hamideh Zahedi
- Department of Community Health Nursing, Nursing & Midwifery Faculty, Student Research Committee, Tabriz University of Medical sciences, Tabriz, Iran
| | - Zohreh Alizadeh-Dibazari
- Midwifery Department, Faculty of Nursing and Midwifery, Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- Social determinants of Health Research Center, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Hasan Sahebihagh
- Department of Community Health Nursing, Nursing & Midwifery Faculty, Tabriz University of Medical sciences, Tabriz, Iran
| | - Mina Hosseinzadeh
- Department of Community Health Nursing, Nursing & Midwifery Faculty, Tabriz University of Medical sciences, Tabriz, Iran.
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Zhou J, Chen X, Wang Z, Li Q. Coping together: Couple-based communication interventions in cancer care. Asia Pac J Oncol Nurs 2024; 11:100379. [PMID: 38433770 PMCID: PMC10904909 DOI: 10.1016/j.apjon.2024.100379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 01/04/2024] [Indexed: 03/05/2024] Open
Affiliation(s)
- Junrui Zhou
- Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Xuan Chen
- Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Zhiming Wang
- Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Qiuping Li
- Wuxi School of Medicine, Jiangnan University, Wuxi, China
- Affiliated Hospital, Jiangnan University, Wuxi, China
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Sun Q, Wang K, Chen Y, Peng X, Jiang X, Peng J. Effectiveness of dyadic interventions among cancer dyads: An overview of systematic reviews and meta-analyses. J Clin Nurs 2024; 33:497-530. [PMID: 37876319 DOI: 10.1111/jocn.16890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 08/09/2023] [Accepted: 09/13/2023] [Indexed: 10/26/2023]
Abstract
AIMS AND OBJECTIVE To summarize evidence from systematic reviews (SRs)/meta-analyses (MAs) regarding the impact of dyadic interventions delivered to both members of a cancer dyad, including a cancer patient and caregiver (e.g. family caregiver, intimate partner). DESIGN This overview of SRs was conducted in accordance with the preferred reporting items for overviews of reviews statement. METHODS A comprehensive search of multiple databases, including PubMed, Cochrane Library, Embase, CINAHL, Web of Science, China National Knowledge Infrastructure and Wan Fang. The methodological and reporting quality of SRs and MAs was assessed using the Assessing the Methodological Quality of Systematic Reviews 2. The quality of the included SRs/MAs was evaluated using the Grades of Recommendations, Assessment, Development and Evaluation approach. RESULTS Eighteen SRs/MAs undertook quantitative synthesis to assess the impact of dyadic interventions on cancer dyads. Both the credibility of the SRs/MAs and the evidence quality of the outcome measures were below satisfactory standards. Prior SRs/MAs revealed several limitations such as lack of pre-published protocols or research objectives, failure to report excluded studies and insufficient details on funding sources for individual studies. CONCLUSIONS Dyadic interventions may prove advantageous for the physical health and dyadic adjustment of cancer dyads. Nevertheless, the reported results of dyadic interventions on the psychological health of patient-caregiver dyads affected by cancer are inconsistent. Thus, rigorous and comprehensive studies are requisite to establish reliable evidence for conclusive determinations. RELEVANCE TO CLINICAL PRACTICE The findings of this overview can guide healthcare practitioners when considering the use of dyadic interventions for cancer dyads. Moreover, these findings have the potential to enhance the integration of these approaches into clinical practice. PATIENT OR PUBLIC CONTRIBUTION Our paper presents an overview of systematic reviews, and therefore, such specific details may not be relevant to our study.
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Affiliation(s)
- Qian Sun
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Kunyuan Wang
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Yingliang Chen
- Gastrointestinal Surgery Unit, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiuhua Peng
- Medical Oncology, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiaohan Jiang
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Junsheng Peng
- School of Nursing, Sun Yat-sen University, Guangzhou, China
- Gastrointestinal Surgery Unit, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, Supported by National Key Clinical Discipline, Guangdong Institute of Gastroenterology, Guangzhou, China
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Xu J, Hoover RL, Woodard N, Leeman J, Hirschey R. A Systematic Review of Dietary Interventions for Cancer Survivors and Their Families or Caregivers. Nutrients 2023; 16:56. [PMID: 38201886 PMCID: PMC10780967 DOI: 10.3390/nu16010056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 12/19/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024] Open
Abstract
Family or caregiver engagement has the potential to support healthy dietary changes among cancer survivors. However, little is known about these family- or caregiver-involved dietary interventions and their effects. This systematic review aimed to identify the behavior change techniques (BCTs) used in dietary interventions for cancer survivors and their families or caregivers and to synthesize intervention effects on dietary and health outcomes. Following the PRISMA guidelines, we conducted systematic searches in three databases and identified 12 trials (16 peer-reviewed manuscripts) for inclusion in this review. Data were extracted from these manuscripts and the BCT taxonomy was used to identify the BCTs. A total of 38 BCTs were identified from 12 trials, 13 of which were used in at least half of the 12 trials. Ten studies reported significant intervention effects on health outcomes (e.g., adiposity) and six suggested significant improvements in dietary behaviors (e.g., fruit and vegetable intake). Overall, this review found that family- or caregiver-involved interventions for cancer survivors significantly improved dietary and health outcomes. Future research should identify BCTs particularly for dietary changes and develop effective dyadic strategies to facilitate diet-related interactions between survivors and their families or caregivers to enhance their engagement in healthy diets.
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Affiliation(s)
- Jingle Xu
- School of Nursing, University of North Carolina at Chapel Hill, Carrington Hall, 120 N. Medical Dr., Chapel Hill, NC 27599, USA; (R.L.H.); (J.L.); (R.H.)
| | - Rebecca L. Hoover
- School of Nursing, University of North Carolina at Chapel Hill, Carrington Hall, 120 N. Medical Dr., Chapel Hill, NC 27599, USA; (R.L.H.); (J.L.); (R.H.)
| | - Nathaniel Woodard
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 450 West Dr., Chapel Hill, NC 27599, USA;
| | - Jennifer Leeman
- School of Nursing, University of North Carolina at Chapel Hill, Carrington Hall, 120 N. Medical Dr., Chapel Hill, NC 27599, USA; (R.L.H.); (J.L.); (R.H.)
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 450 West Dr., Chapel Hill, NC 27599, USA;
| | - Rachel Hirschey
- School of Nursing, University of North Carolina at Chapel Hill, Carrington Hall, 120 N. Medical Dr., Chapel Hill, NC 27599, USA; (R.L.H.); (J.L.); (R.H.)
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 450 West Dr., Chapel Hill, NC 27599, USA;
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Zhou J, Chen X, Wang Z, Lin C, Zhao J, Loke AY, Li Q. Mutual communication processes within Chinese colorectal cancer patient-spousal caregiver dyads: A qualitative study of taking gender into account. Eur J Oncol Nurs 2023; 67:102427. [PMID: 37879197 DOI: 10.1016/j.ejon.2023.102427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 09/23/2023] [Accepted: 09/29/2023] [Indexed: 10/27/2023]
Abstract
PURPOSE Mutual communication within cancer couples is a complex process. More research is needed to explore the complex process of mutual communication and its nuances presented by various factors in different culture contexts. Gender, a factor embedded in marital relationships, is an important consideration. We thus aim to explore the mutual communication process within Chinese colorectal cancer couples and take gender into account. METHODS A qualitative study was conducted by interviewing 20 colorectal cancer patients and 15 spousal caregivers. Inductive thematic analysis was used to analyze the transcripts. RESULTS Three themes (mutual communication and support interaction, communication quality, and foundation of mutual communication and collaboration) were developed. Gender was found to have specific impact on emotional disclosure and communication challenges. A preliminary framework of "smile" was constructed to demonstrate the relationship among the three themes and the relationships between the three themes and dyads' psychosocial adaptation to colorectal cancer. CONCLUSIONS Study findings demonstrate complex mutual communication processes within colorectal cancer couples and the impact of gender. The findings will contribute to developing more effective colorectal cancer couple-based mutual communication interventions. Health practitioners are suggested to improve mutual communication within colorectal cancer couples in three aspects: relational topics, emotional disclosure and communication skills. Guiding couples to deal with each theme and the relationship among the themes simultaneously is helpful for them to return and smile to their normal life.
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Affiliation(s)
- Junrui Zhou
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Xuan Chen
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Zhiming Wang
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Chunyan Lin
- Affiliated Hospital, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Jie Zhao
- Affiliated Hospital, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Alice Yuen Loke
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon Hong Kong, China
| | - Qiuping Li
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China; Affiliated Hospital, Jiangnan University, Wuxi, Jiangsu Province, China.
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Zhou J, Wang Z, Chen X, Li Q. Gender Differences in Psychosocial Outcomes and Coping Strategies of Patients with Colorectal Cancer: A Systematic Review. Healthcare (Basel) 2023; 11:2591. [PMID: 37761788 PMCID: PMC10530630 DOI: 10.3390/healthcare11182591] [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: 08/27/2023] [Revised: 09/14/2023] [Accepted: 09/19/2023] [Indexed: 09/29/2023] Open
Abstract
(1) Background: Gender is an important factor impacting cancer experience. This review mainly aimed to summarize colorectal cancer (CRC) patients' gender differences in psychosocial outcomes and coping strategies. (2) Methods: Relevant studies were searched for in four electronic databases from 2007 to July 2023. And manual searching was performed on the included studies' reference lists to identify additional eligible studies. (3) Results: A total of 37 eligible articles were included in this review. These studies were conducted in 19 countries, and they targeted CRC patients at various treatment stages. Significant results showed that female patients tended to have more psychological distress, complex social functioning, and less sexual distress and to choose more positive coping strategies than male patients. But there was no gender difference in psychosocial outcomes and/or coping strategies in some studies, which implied that gender similarity also existed. (4) Conclusions: The findings support the fact that there are both gender differences and similarities in CRC patients' psychosocial outcomes and coping strategies. A perspective beyond the simple masculine-feminine binary improved our in-depth understanding of gender tendency. Importantly, taking gender tendency into account is critical for medical staff to provide more personalized support and communication interventions.
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Affiliation(s)
| | | | | | - Qiuping Li
- Wuxi School of Medicine, Jiangnan University, Wuxi 214122, China; (J.Z.); (Z.W.); (X.C.)
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