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Wong LP, Xu X, Alias H, Ting CY, Tan HM, Lin Y. Patient- and caregiver-related factors affecting family caregiver burden of urologic cancer patients. Urol Oncol 2024; 42:245.e1-245.e8. [PMID: 38670816 DOI: 10.1016/j.urolonc.2024.04.004] [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: 12/02/2023] [Revised: 03/15/2024] [Accepted: 04/01/2024] [Indexed: 04/28/2024]
Abstract
OBJECTIVE This study aimed to investigate the level of family caregivers' (FC) burden and the extent to which patient- and caregiver-related factors influence the caregiving burden among FCs of urologic cancer (UC) patients. METHOD A cross-sectional survey was conducted on caregivers of UC patients who sought cancer care. The modified caregiver strain index (MCSI) was used to assess FC burden. RESULTS Just over half (54.3%) of FCs had moderate/high MCSI scores (score 9-26). By demographics, FCs who were unemployed (OR = 5.55, 95%CI 1.50-20.60) and perceived their current health condition as moderate/poor (OR = 6.05, 95%CI 1.95-18.78) reported higher odds of increased FC burden. Patient performance status played a pivotal role in exacerbating FC burden, whereby the odds of higher FC burden was 13 times higher in caregivers of UC patients having an Eastern Cooperative Oncology Group (ECOG) performance rating score of 3-4 (OR = 13.06, 95%CI 1.44-111.26) than those with a score of 0. Perceived lower levels of confidence in care provision were significantly associated with a higher level of strain (OR = 6.76, 985%CI 1.02-44.90). CONCLUSION Care recipient performance status was a strong patient-related factor associated with higher FC burden regardless of duration of caregiving and other caregiver-related factors after adjusting for caregiver demographics.
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Affiliation(s)
- Li Ping Wong
- Fujian Key Laboratory of Environmental Factors and Cancer, Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350102, Fujian, China; Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia.
| | - Xiaonan Xu
- Fujian Key Laboratory of Environmental Factors and Cancer, Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350102, Fujian, China
| | - Haridah Alias
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
| | - Chuo Yew Ting
- Pharmaceutical Services Division, Sarawak State Health Department, Ministry of Health Malaysia, Jalan Diplomatik, Off Jalan Bako, 93050, Kuching, Sarawak, Malaysia
| | - Hui Meng Tan
- Urology Clinic, Ramsay Sime Darby Medical Centre, Subang Jaya, Selangor, Malaysia; Department of Primary Care Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.
| | - Yulan Lin
- Fujian Key Laboratory of Environmental Factors and Cancer, Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350102, Fujian, China.
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Hosseini SJ, Ramezani M, Ashrafzadeh F, Jamali J. Motivation in caregiving among mothers of children with intellectual and developmental disabilities in Iran: A qualitative study. BMC Pediatr 2024; 24:472. [PMID: 39049077 PMCID: PMC11271013 DOI: 10.1186/s12887-024-04957-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 07/18/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND The motivation of caregivers plays a crucial role in the treatment, follow-up, and care of children with intellectual and developmental disabilities. Previous studies have focused on the older people and end-stage diseases, while giving less attention to the motivation of mothers caring for children with special needs. This study aimed to explore the motivations of mothers caring for children with intellectual and developmental disabilities in Iran. METHODS This study employed a qualitative approach, guided by the Self-Determination Theory. Purposeful sampling was initially used, followed by theoretical sampling until data saturation was achieved. Data were collected through semi-structured interviews with 26 mothers of children with intellectual and developmental disabilities. Mayring's seven-step directed content analysis approach was utilized for coding and categorization. The research adhered to ethical standards and ensured data trustworthiness through credibility, dependability, confirmability, and transferability measures. RESULTS The findings revealed that mothers' caregiving motivations could be classified into four main categories: (I) intrinsic, (II) identified-extrinsic, (III) introjected-extrinsic, and (IV) external-extrinsic. Additionally, twelve sub-categories were identified within these four main categories. CONCLUSION The findings revealed that mothers demonstrated varying levels of intrinsic and extrinsic motivations in caring for children with intellectual and developmental disabilities. By recognizing and enhancing the diverse sources of motivation, healthcare providers and policymakers can better support mothers in their caregiving roles, ultimately contributing to improved outcomes for both the mothers and their children.
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Affiliation(s)
- Seyed Javad Hosseini
- Department of Pediatrics, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Monir Ramezani
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Farah Ashrafzadeh
- Department of Pediatrics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Jamshid Jamali
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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3
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Sun H, Chen S, Chen X, Yang Q, Zhang H, Wacharasin C, Hengudomsub P. Predictors of changes in resilience among spousal caregivers of patients with advanced cancer within the first 6 months after initial treatment. J Clin Nurs 2024; 33:2619-2632. [PMID: 38108199 DOI: 10.1111/jocn.16972] [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: 07/31/2023] [Revised: 10/26/2023] [Accepted: 12/07/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND While previous research has established that resilience is affected by various factors, these studies have primarily focussed on individual variables associated with resilience, without providing insights into how to influence the rate of change in resilience. AIM To examine the trajectory of resilience and identify the factors associated with changes in resilience among spousal caregivers of patients with newly diagnosed advanced cancer receiving treatment during the first 6 months. DESIGN An observational longitudinal study. METHODS A total of 312 spousal caregivers of patients with newly diagnosed advanced cancer were recruited from January 2022 to December 2022 in Yancheng, China. Three data collection points were established, spanning from the first month to 6 months after initial cancer treatment. A latent growth model was employed to depict the resilience trajectory at various time points. A latent growth model with time-invariant covariates was adopted to determine the factors influencing resilience trajectory. The study adhered to the STROBE checklist for proper reporting. RESULTS Throughout the follow-up period, the participants experienced a significant increase in resilience. Gender, family income, the patient's health status, spirituality and belief in familism were significantly associated with the baseline resilience level. Moreover, family income, the patient's health status, spirituality, caregiver burden and belief in familism were significantly associated with the rate of resilience change over time. CONCLUSIONS Spousal caregivers demonstrated a linear increase in resilience during the first 6 months after initial treatment. Meanwhile, changes in resilience were influenced by multiple factors during the early phase of cancer treatment. Thus, more attention should be paid to early identification and implementation of targeted interventions. RELEVANCE TO CLINICAL PRACTICE Healthcare professionals should understand the change in resilience among spousal caregivers and conduct timely mental health interventions to enhance the resilience of families affected by cancer. PATIENT OR PUBLIC CONTRIBUTION The Guidance for Reporting Involvement of Patients and the Public-Short Form reporting checklists were used to improve patient and public involvement.
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Affiliation(s)
- Haiyan Sun
- School of Nursing, Jiangsu Vocational College of Medicine, Jiangsu, P. R. China
- Faculty of Nursing, Burapha University, Chon Buri, Thailand
| | - Shuqiao Chen
- Department of Nursing, Yancheng NO.1 People's Hospital, Jiangsu, P. R. China
| | - Xi Chen
- Department of Nursing, Yancheng NO.1 People's Hospital, Jiangsu, P. R. China
| | - Qin Yang
- School of Nursing, Jiangsu Vocational College of Medicine, Jiangsu, P. R. China
- Faculty of Nursing, Burapha University, Chon Buri, Thailand
| | - Hu Zhang
- Department of Basic Medicine, Jiangsu Vocational College of Medicine, Jiangsu, P. R. China
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Zeng Z, Holtmaat K, Koole SL. Psychological care for cancer survivors: a 2 × 2 model of interpersonal emotion regulation by caregivers. Front Psychol 2024; 15:1390692. [PMID: 38979076 PMCID: PMC11228138 DOI: 10.3389/fpsyg.2024.1390692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 06/05/2024] [Indexed: 07/10/2024] Open
Affiliation(s)
- Zihao Zeng
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam Public Health, Mental Health, Amsterdam, Netherlands
- School of Educational Science, Hunan Normal University, Changsha, China
| | - Karen Holtmaat
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam Public Health, Mental Health, Amsterdam, Netherlands
| | - Sander L Koole
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam Public Health, Mental Health, Amsterdam, Netherlands
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Mollaei F, Sharif Nia H, Pouralizadeh M, Karkhah S, Javadi-Pashaki N, Ghorbani Vajargah P. Resilience and related factors in caregivers of adult cancer patients: a systematic review. Ann Med Surg (Lond) 2024; 86:3451-3459. [PMID: 38846864 PMCID: PMC11152843 DOI: 10.1097/ms9.0000000000001469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 10/24/2023] [Indexed: 06/09/2024] Open
Abstract
Background This systematic review aimed to investigate resilience and its related factors in caregivers of adult patients with cancer. Materials and methods A systematic search of online electronic databases including Scopus, PubMed, Web of Science, Iranmedex, and Scientific Information Database (SID) was performed using keywords extracted from Medical Subject Headings such as "Psychological Resilience", "Caregiver", and "Cancer" from the earliest to 6 June 2023. The quality of the studies included in this review was evaluated using the appraisal tool for cross-sectional studies (AXIS tool). Results A total of 2735 caregivers of cancer patients participated in 15 studies. The majority of the studies found that caregivers of cancer patients had high levels of resilience. Factors related to the resilience of cancer patients' caregivers included caregivers' social support, caregivers' quality of life, patients' resilience, caregivers' family function, patients' performance, caregivers' age, caregivers' health status, caregivers' self-esteem, caregivers post-traumatic growth, caregivers religious, caregivers hope, caregivers positive affect, patients age, patients social support, patients resilience support, patients quality of life, caregivers' anxiety, caregivers' depression, caregivers' burden, caregivers level of education, caregivers financial problem, caregivers memory, caregivers negative affect, caregivers post-traumatic stress disorder, maternal distress, and patients post-traumatic stress disorder. Conclusion Therefore, healthcare administrators and policymakers can enhance the resilience of caregivers and the quality of care they provide by instituting ongoing training initiatives focused on evaluating mental well-being and implementing coping strategies for managing stress and depression.
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Affiliation(s)
- Fereshteh Mollaei
- Department of Nursing, Shahid Beheshti School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Hamid Sharif Nia
- Psychosomatic Research Center, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Nursing, Amol School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
| | - Moluk Pouralizadeh
- Department of Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Samad Karkhah
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
- Burn and Regenerative Medicine Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Nazila Javadi-Pashaki
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
- Social Determinants of Health Research Center (SDHRC), Guilan University of Medical Sciences, Rasht, Iran
| | - Pooyan Ghorbani Vajargah
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
- Burn and Regenerative Medicine Research Center, Guilan University of Medical Sciences, Rasht, Iran
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La IS, Johantgen M, Storr CL, Zhu S, Cagle JG, Ross A. Spirituality moderates the relationship between cancer caregiver burden and depression. Palliat Support Care 2024; 22:470-481. [PMID: 38131143 DOI: 10.1017/s1478951523001785] [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: 12/23/2023]
Abstract
OBJECTIVES Cancer has become a chronic disease that requires a considerable amount of informal caregiving, often quite burdensome to family caregivers. However, the influence of spirituality on the caregivers' burden and mental health outcomes has been understudied. This study was to examine how caregiver burden, spirituality, and depression change during cancer treatment and investigate the moderating role of spirituality in the relationship between caregiver burden and depression for a sample of caregivers of persons with cancer. METHODS This secondary analysis used a longitudinal design employing 3 waves of data collection (at baseline, 3 months, and 6 months). Family caregivers completed the Caregiver Reaction Assessment, Spiritual Perspective Scale, and the PROMIS® depression measure. Linear mixed model analyses were used, controlling for pertinent covariates. RESULTS Spirituality, total caregiver burden, and depression remained stable over 6 months. More than 30% of the caregivers had mild to severe depressive symptoms at 3 time points. There was evidence of overall burden influencing depression. Of note was a protective effect of caregivers' spirituality on the relationship between depression and caregiver burden over time (b = -1.35, p = .015). The lower the spirituality, the stronger the relationship between depression and burden, especially regarding subscales of schedule burden, financial burden, and lack of family support. SIGNIFICANCE OF RESULTS Spirituality was a significant resource for coping with caregiving challenges. This study suggests that comprehensive screening and spiritual care for cancer caregivers may improve their cancer caregiving experience and possibly influence the care recipients' health.
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Affiliation(s)
- In Seo La
- College of Nursing Science, Kyung Hee University, Seoul, South Korea
| | - Meg Johantgen
- University of Maryland School of Nursing, Baltimore, MD, USA
| | - Carla L Storr
- University of Maryland School of Nursing, Baltimore, MD, USA
| | - Shijun Zhu
- University of Maryland School of Nursing, Baltimore, MD, USA
| | - John G Cagle
- University of Maryland School of Social Work, Baltimore, MD, USA
| | - Alyson Ross
- Wisdom of the Whole Coaching Academy, Asheville, NC, USA
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Shoja M, Arsalani N, Fallahi-Khoshknab M, Mohammadi-Shahboulaghi F, Shirozhan S. The clarification of the concept of colostomy nursing care in ostomy care centers: A concept analysis through Walker and Avant's method. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2024; 13:132. [PMID: 38784265 PMCID: PMC11114522 DOI: 10.4103/jehp.jehp_482_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Accepted: 05/22/2023] [Indexed: 05/25/2024]
Abstract
BACKGROUND Specialist nurses need to have an accurate understanding of colostomy care-related concepts to provide care. Although patients with different types of ostomy have different types of needs, terms such as ostomy care, colostomy care, and ileostomy nursing are interchangeably used. Moreover, there are limited concept analysis studies into the concept of colostomy nursing care (CNC) in ostomy care centers (OCCs). The aim of this study was to analyze and clarify the concept of CNC in outpatient OCCs. METHODS AND MATERIAL This was a concept analysis study. This concept analysis was conducted using Walker and Avant's eight-step method. The online databases were searched until 2022 to retrieve documents on CNC. Finally, 35 articles and four books were included in the analysis, the defining attributes, antecedents, and consequences of the concepts were determined, and model and additional cases as well as empirical referents were presented. RESULTS The defining attributes of CNC in OCCs are the development of professional role, participatory practice and interdisciplinary care, selection of the best clinical procedures, care based on patient education, and patient rehabilitation. The antecedents of the concept are nurse-related antecedents, patient- and family-related antecedents, environmental antecedents, and professional rules and regulations. Its consequences are patients' and families' greater care-related knowledge, improvement of nurses' care quality, patient autonomy, and self-efficacy. CONCLUSION The concept of CNC in OCCs can be defined as "a continuous and coherent care based on knowledge, skill, expertise, experience, and colostomy type which uses interdisciplinary collaboration and the best available evidence in order to select and provide the best services according to patients' and families' culture and background, fulfill patients' physical, mental, sexual, social, and spiritual needs, and timely refer patients to specialists, with the ultimate goal of improving patient autonomy and facilitating their return to normal life."
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Affiliation(s)
- Maryam Shoja
- Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Narges Arsalani
- Department of Nursing, Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | | | - Farahnaz Mohammadi-Shahboulaghi
- Department of Nursing, Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Shima Shirozhan
- Health in Emergency and Disaster Research Center, Social Health Research Institute, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Bigdeli Shamloo MB, Ashrafizadeh H. Adaptation Process in Husbands of Iranian Women Undergoing Mastectomy From Diagnosis to Terminal Stages of the Disease: A Grounded Theory Study. OMEGA-JOURNAL OF DEATH AND DYING 2024:302228241245238. [PMID: 38679582 DOI: 10.1177/00302228241245238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
INTRODUCTION Breast cancer is the most common cancer in women and the second cause of cancer-related death. This research was performed to interpret the adaptation process among husbands of Iranian women undergoing mastectomy. MATERIALS AND METHODS In this grounded theory study, 23 participants were chosen purposefully and via convenient sampling. After interview with them about adaptation and ways of achieving it, note taking was done, which was analyzed via Strauss and Corbin approach. RESULTS Six themes were extracted: Confrontation with crisis, Challenges and opportunities, husband transformation, supportive systems, attempts for life management, accepting an uninvited guest, with each having subclasses. CONCLUSION According to the results of the present study the healthcare team and psychologists should identify this issue properly so that they could apply measures for facilitating the coping and acceptance of the issue in husbands of these patients.
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Affiliation(s)
| | - Hadis Ashrafizadeh
- Student Research Committee, Faculty of Nursing, Dezful University of Medical Sciences, Dezful, Iran
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Kırca K, Özveren H, Bağcı S. Evaluation of the Spiritual Care Needs of Patients with Cancer in a Chemotherapy Unit in Turkey. JOURNAL OF RELIGION AND HEALTH 2024; 63:1457-1474. [PMID: 37794297 DOI: 10.1007/s10943-023-01876-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/17/2023] [Indexed: 10/06/2023]
Abstract
This study was conducted to determine the spiritual care needs of cancer patients receiving chemotherapy. A cross-sectional descriptive design was used to analyze a total of 104 patients at a university hospital in Turkey. The data were collected using the Spiritual Care Needs Scale. The mean age of the patients participating in the study was 61.0 (10.2). It was determined that 31.7% of the patients stated that the concepts of spirituality and spiritual care are related to religion and worship. As a result, it was found that the patients receiving chemotherapy had high-spiritual care needs. The dimensions in which the spiritual needs of the patients were remarkably high were belief and spiritual practices, being in peace and security, the love and support of their relatives and being informed about health. The spiritual care need score of the patients increased significantly with marital status (p = 0.001), having children (p = 0.002), having a chronic disease (p = 0.04) and having an undergraduate/graduate level education (p = 0.01). Nurses should be aware of patient's spiritual needs, plan patient-specific spiritual care practices, conduct more studies on the effects of spiritual care on the patient and family and create guidelines for spiritual care practices in patients receiving chemotherapy in Turkey.
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Affiliation(s)
- Kamile Kırca
- Faculty of Health Sciences, Nursing Department, Kırıkkale University, Kırıkkale, Turkey
| | - Hüsna Özveren
- Faculty of Health Sciences, Nursing Department, Kırıkkale University, Kırıkkale, Turkey.
| | - Sema Bağcı
- Medical Oncology Clinic, Chemotherapy Unit, Kırıkkale University Faculty of Medicine Hospital, Kırıkkale, Turkey
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Zhang Y, Liu M, Han J, Tian X, Xin Y. Beyond the Burden: A Qualitative Inquiry into the Experiences of Chinese Informal Caregivers for People Living with HIV or AIDS. Patient Prefer Adherence 2024; 18:677-685. [PMID: 38505188 PMCID: PMC10949991 DOI: 10.2147/ppa.s454590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 03/11/2024] [Indexed: 03/21/2024] Open
Abstract
Purpose Informal caregivers are defined as families or close friends of patients, which take considerable responsibilities for providing care to people living with HIV/AIDS (PLWHA). Although there have been a number of studies in caregiver of PLWHA, research studies that sought to quantify the effects of informal caregiving for the caregivers failed to successfully provide empirical understanding of the nature of caregiving experience. Therefore, this study adopted a qualitative approach to explore the experiences and feelings of caregivers of PLWHA during the long-term care process. Methods The qualitative study was conducted in August 2023 in Beijing, China. Data were collected through individual in-depth semi-structured interviews with informal caregivers of PLWHA. Theme analysis was used to identify themes from the interview transcripts. Results A total of 21 participants were recruited into our study, 16 were family members of PLWAHA, and 5 were homosexual lover or close friend of PLWHA. Three major themes and ten sub themes were identified by thematic analysis: (1) care burden experience (including 5 sub-themes: negative emotional experience, psychological burden, economic burden, physical health loss and limitation of social interaction); (2) benefit findings from care (including 3 sub-theme: positive emotional experience, perceived social support, health promotion); (3) Demands for caregiving capacity (including 2 sub-theme: inadequate caregiving capacity and inadequate psychological comfort capacity). Conclusion This qualitative study provides a comprehensive exploration of the experiences faced by informal caregivers of PLWHA in China, uncovering the complex spectrum of psychological, physical, social, and economic challenges inherent in their caregiving roles, while predominantly challenging, caregivers also reported personal growth, increased social support, and emotional fulfillment. The research results could help in developing effective interventions to reduce the caregiver burden and improve their mental health.
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Affiliation(s)
- Ying Zhang
- School of Public Health, Capital Medical University, Beijing, 100069, People’s Republic of China
| | - Mingyuan Liu
- Department of Vascular Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People’s Republic of China
| | - Jing Han
- Department of Beijing Home of Red Ribbon, Beijing Ditan Hospital, Capital Medical University, Beijing, 100102, People’s Republic of China
| | - Xin Tian
- Administrative office of hospital, Beijing Ditan Hospital, Capital Medical University, Beijing, 100102, People’s Republic of China
| | - Youqing Xin
- Administrative Office of Hospital, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People’s Republic of China
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Shoja M, Arsalani N, Fallahi-Khoshknab M, Mohammadi-Shahboulaghi F. The barriers and facilitators to nursing care for patients with permanent colostomy in outpatient centers: A qualitative study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2024; 13:72. [PMID: 38559476 PMCID: PMC10979781 DOI: 10.4103/jehp.jehp_272_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 04/24/2023] [Indexed: 04/04/2024]
Abstract
BACKGROUND Ostomy care nurses are responsible for the management of patients with colostomy from the time of diagnosis. Currently, most ostomy care services are provided in outpatient ostomy care centers in order to reduce patients' hospital stay and reduce hospitalization-related costs. Many different factors can affect colostomy nursing care provision in these centers. Identification of these factors can facilitate quality care provision. MATERIALS AND METHODS This descriptive qualitative study was conducted in 2020-2021 to explore the barriers and facilitators to nursing care for patients with permanent colostomy in Tehran and Qom ostomy centers. Participants were twelve nurses with ostomy care licenses, two adult patients with permanent colostomy for at least two years, and one family caregiver of a patient with permanent colostomy purposefully selected from outpatient ostomy care centers in Iran. RESULT Data were collected via fifteen in-depth semi-structured interviews and were analyzed using Graneheim and Lundman's conventional content analysis. The barriers and facilitators to nursing care for patients with permanent colostomy in outpatient centers came into three main categories, namely specialized capabilities of colostomy care, care continuity, and caring status in the family. CONCLUSION These findings imply that not only nurses, but also patients, family caregivers, and referral systems can influence nursing care provision to permanent colostomy. Effective management of these factors can improve the quality of ostomy nursing care.
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Affiliation(s)
- Maryam Shoja
- Nursing Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Narges Arsalani
- Nursing Department, Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | | | - Farahnaz Mohammadi-Shahboulaghi
- Nursing Department, Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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12
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Moore C, Gallagher P, Dunne S. Health literacy, eHealth literacy and their association with burden, distress, and self-efficacy among cancer caregivers. Front Psychol 2024; 15:1283227. [PMID: 38434952 PMCID: PMC10904647 DOI: 10.3389/fpsyg.2024.1283227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 02/05/2024] [Indexed: 03/05/2024] Open
Abstract
Purpose Health literacy skills are vital for cancer caregivers in helping cancer survivors to navigate their diagnosis, treatment, and recovery but little is known. This study explored health literacy and eHealth literacy among cancer caregivers and the relationship between health literacy/eHealth literacy and potential associated factors. Methods Informal caregivers who had cared for an individual with cancer completed a survey which collected demographic data and measured caregiver health literacy, eHealth literacy, self-efficacy, burden, and distress. Results Seven percent of caregivers had inadequate health literacy. Caregivers scored lowest on health literacy domains related to caregiver social support, information seeking and understanding care recipient preferences. eHealth literacy was associated with self-efficacy and burden while, different health literacy domains were associated with burden ('Understanding care recipient needs and preferences'), self-efficacy ('Cancer-related communication with the care recipient' and 'Understanding care recipients needs and preferences') and distress ('Proactivity and determination to seek information', 'Understanding care recipient needs and preferences', 'Understanding the healthcare system'). Conclusion Findings highlight key areas of need regarding cancer caregiver health literacy which future research can target. Given the observed relationship between aspects of health literacy and burden, distress and self-efficacy future work could be carried out on how to alleviate high levels of burden and distress and how to enhance self-efficacy among cancer caregivers by addressing health literacy skills. Implications for cancer survivors Findings from this study will inform the development of health literacy interventions to support caregivers to build their health literacy skills and enable this group to better support cancer survivors as a result.
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Affiliation(s)
- Chloe Moore
- School of Psychology, Dublin City University, Dublin, Ireland
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Zhang Q, Chen J, Fang K, Liu Q, Zhang P, Bai J, Zhang C. Psychological experiences of family caregivers of patients with breast cancer: Protocol for a meta-synthesis. Nurs Open 2024; 11:e2064. [PMID: 38268260 PMCID: PMC10701291 DOI: 10.1002/nop2.2064] [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: 03/08/2023] [Revised: 10/26/2023] [Accepted: 11/19/2023] [Indexed: 01/26/2024] Open
Abstract
AIM The number of breast cancer patients is increasing, but there are insufficient sources of information for their family caregivers. The purpose of this systematic review was to elaborate the psychologically realistic experiences and corresponding needs of family members of patients with breast cancer in the course of their experience in the disease which may provide them with effective, targeted intervention strategies to improve their quality of life. DESIGN Protocol for a meta-synthesis. METHODS We will search the Chinese databases (i.e., China National Knowledge Infrastructure, VIP Database and Wanfang Database) and the English databases (i.e., PubMed, Embase, Web of Science, the Cochrane Library, CINAHL and PsycINFO). Qualitative studies from the above databases, studying the psychological experiences of family members of patients with breast cancer, will be searched comprehensively. The quality of the study will be evaluated by two reviewers independently using the Joanna Briggs Institute (JBI) critical appraisal tools for qualitative study, and any disagreements will be discussed and judged by the third reviewer. Data will be extracted using JBI standardized data extraction tool. Then, the literature will be compared and analysed, and the raw results summarized using the JBI meta-aggregation tool. The reliability and credibility of the overall quality of the included studies will be assessed by using the JBI ConQual approach. RESULTS N/A. No Patient or Public Contribution. PROSPERO REGISTRATION NUMBER REDACTED.
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Affiliation(s)
| | - Jianfei Chen
- School of NursingWuhan UniversityWuhanHubei ProvinceChina
| | - Kui Fang
- Department of NeurosurgeryThe First Hospital of China Medical UniversityShenyangLiaoningChina
| | - Qianqian Liu
- Thyroid and Breast SurgeryZhongnan Hospital of Wuhan UniversityWuhanHubeiChina
| | - Pan Zhang
- Department of GastroenterologyZhongnan Hospital of Wuhan UniversityWuhanHubeiChina
| | - Jinbing Bai
- Nell Hodgson Woodruff School of NursingEmory UniversityAtlantaGeorgiaUSA
| | - Chunhua Zhang
- Nursing DepartmentZhongnan Hospital of Wuhan UniversityWuhanHubeiChina
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14
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Mohamed Hussin NA, Mohd Sabri NS. A qualitative exploration of the dynamics of guilt experience in family cancer caregivers. Support Care Cancer 2023; 31:659. [PMID: 37889352 PMCID: PMC10611882 DOI: 10.1007/s00520-023-08060-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 09/21/2023] [Indexed: 10/28/2023]
Abstract
Caregiving for cancer patients can cause stress among family caregivers. Caregiving stress is also associated with guilt as they cannot provide adequate care for cancer patients. However, guilt among family caregivers of cancer patients is poorly understood. This qualitative study aimed to explore the dynamics of guilt feelings in families that care for cancer patients. This study involved 45 family caregivers of cancer patients. Thematic data analysis was conducted. There were six themes emerging. Caregiving can be challenging, guilt and blame, guilt due to lack of self-capacity, guilt for neglecting others, no guilt at all, and discussion of guilt and blame as a caregiver. This study offers insight into social workers regarding the challenges and experiences faced by family caregivers of cancer patients. Appropriate health interventions and support should be provided to family caregivers of cancer patients to improve their well-being.
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15
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Najjuka SM, Iradukunda A, Kaggwa MM, Sebbowa AN, Mirembe J, Ndyamuhaki K, Nakibuule C, Atuhaire JP, Nabirye E, Namukwaya E, Kiguli S. The caring experiences of family caregivers for patients with advanced cancer in Uganda: A qualitative study. PLoS One 2023; 18:e0293109. [PMID: 37878610 PMCID: PMC10599584 DOI: 10.1371/journal.pone.0293109] [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: 08/25/2022] [Accepted: 10/05/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND Cancer morbidity and mortality is rising in sub-Saharan Africa. Given this rise, family caregivers play an integral role in provision of quality cancer care services. This study explored the family caregivers (FCGs)/relatives' experiences of caring for patients with advanced cancer (stage 3 or stage 4) in Uganda. METHODS This was a descriptive qualitative study exploring the lived experiences of FCGs of patients with advanced cancer attending care at the Uganda cancer institute. We purposively recruited twelve FCGs and conducted face-to-face in-depth interviews using an interviewer-guided semi-structured questionnaire. Data were analyzed by thematic analysis. RESULTS The age range of participants was 19 to 49 years. Most participants were children of the patients (n = 7), had attained tertiary education (n = 7), and had taken care of their loved ones for at least one year (n = 10). Six themes emerged from data analysis; (i) caring roles, (ii) caring burdens, (iii) role conflict, (iv) health system tensions, (v) support and motivation, (vi) caring benefits, lessons and recommendations. CONCLUSION Study findings highlight the fundamental role of FCGs in the care of their loved ones, and illuminate the neglected physical, psychological and social challenges of family caregivers amidst health system tensions and conflicting roles. The needs of family caregivers should be embedded within cancer care, prevention and control programs particularly in low resource settings.
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Affiliation(s)
| | | | - Mark Mohan Kaggwa
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
- Forensic Psychiatry Program, St Joseph’s Healthcare Hamilton, Hamilton, Ontario, Canada
| | | | - Joy Mirembe
- College of Health Sciences, Makerere University, Kampala, Uganda
| | | | | | | | - Elizabeth Nabirye
- Department of Palliative Care Medicine, College of Health Sciences Makerere University, Kampala, Uganda
| | - Elizabeth Namukwaya
- Department of Palliative Care Medicine, College of Health Sciences Makerere University, Kampala, Uganda
| | - Sarah Kiguli
- Department of Pediatrics and Child Health, College of Health Sciences Makerere University, Kampala, Uganda
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16
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Thanigachalam S, Sarkar S, Sethuramachandran A, Karunanithi G. Effect of Community-Based Health Education on Misconceptions Related to Caregiving for Cancer among Elderly in a Rural Area of Puducherry: A Pre-Post-Intervention Study. Indian J Community Med 2023; 48:755-761. [PMID: 37970171 PMCID: PMC10637609 DOI: 10.4103/ijcm.ijcm_336_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 07/31/2023] [Indexed: 11/17/2023] Open
Abstract
Background and Aim Families are crucial in providing comprehensive support to cancer patients, including physical, psychological, spiritual, and financial assistance. Unfortunately, cancer-related myths and stigma can have detrimental effects on those affected and their caregivers. This study aims to remove the misconceptions prevailing in a rural population of Puducherry regarding caregiving for cancer among elderly through a health education campaign. Materials and Methods A pre- and post-intervention study was conducted among 217 adults above 18 years of age in a rural area of Puducherry. The intervention was delivered through pamphlet distribution, health talks, and discussion. Attitude, beliefs, and knowledge regarding the misconceptions about cancer were assessed in a five-point Likert scale and then the difference in the proportion of subjects with misconceptions about cancer before and after the intervention was tested using the McNemar test. Results Among the respondents, 77% were females, 15% were illiterate, and 9.6% had a history of cancer in the family. About 23% felt cancer lends a bad name to the family and 24% considered palliative care as not necessary since end-stage cancer patients would die. Post-intervention, the perception that herbal items or diets may treat cancer declined from 45% to 18%, and that a cancer patient in the family lends bad name to the family declined from 23% to 3% (P < 0.001). Conclusions Community-based intervention can effectively reduce misconceptions related to caregiving for cancer among elderly in rural areas. These interventions can also improve the quality of care and support provided to cancer patients.
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Affiliation(s)
| | - Sonali Sarkar
- Department of Preventive and Social Medicine, Regional Cancer Centre, JIPMER, Puducherry, India
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17
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Kalyani CV, Rohilla KK, Gupta P, Gupta A, Gupta S. Effect of Psychosocial Interventions on Cancer's Caregiver Quality of Life: Meta-analysis. Clin Pract Epidemiol Ment Health 2023; 19:e174501792308240. [PMID: 38655551 PMCID: PMC11037513 DOI: 10.2174/17450179-v19-e230927-2022-ht14-4336-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 07/18/2023] [Accepted: 07/26/2023] [Indexed: 04/26/2024]
Abstract
Background People living with cancer benefit greatly from informal caregivers. No previous meta-analysis was done to check the effect of psychological intervention on cancer caregiver's quality of life. Objectives The goal of this meta-analysis was to check the effect of psychosocial interventions on Cancer's Caregiver quality of life and check the impact of various psychological intervention programs. Methods A comprehensive literature search was conducted from January 2006 to April 2021 using PubMed, PubMed Central, Clinical Key, CINAHL Database, EBSCO, Google Scholar and Cochrane database. Results The effect of psychological intervention programs on caregiver's quality of life was evaluated using a mean difference between experimental and control groups. A random-effects model was used to measure the mean difference (MD) for calculating the cancer caregiver's quality of life. The final report comprised eight trials with a total of 1142 participants. The caregiver intervention programme was found to improve cancer caregivers' quality of life, but not statistically significantly (mean difference=0.10; p<0.00001). Conclusion According to this meta-analysis, The psychological intervention program positively affected cancer caregiver's quality of life. Further randomised controlled trials are required to prove that psychological interventional programs are successful strategies for improving cancer caregiver's quality of life.
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Affiliation(s)
- C Vasantha Kalyani
- College of Nursing, All India Institute of Medical Sciences, Deoghar, India
| | - Kusum K. Rohilla
- College of Nursing, All India Institute of Medical Sciences, Deoghar, India
| | - Pratima Gupta
- Department of Microbiology, All India Institute of Medical Sciences, Deoghar, India
| | - Amit Gupta
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, India
| | - Sweety Gupta
- Department of Radiation Oncology, All India Institute of Medical Sciences, Rishikesh, India
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18
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Egeler MD, Boomstra E, Rohaan MW, Van den Heuvel NMJ, Fraterman I, Delfos M, van de Poll-Franse LV, Borch TH, Svane IM, Haanen JBAG, Retèl VP, Boekhout AH. "One more chance to survive": the experiences of patients with advanced melanoma and their partners with tumor-infiltrating lymphocyte therapy-a qualitative study and recommendations for future care. J Cancer Surviv 2023:10.1007/s11764-023-01452-8. [PMID: 37606816 DOI: 10.1007/s11764-023-01452-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 08/16/2023] [Indexed: 08/23/2023]
Abstract
PURPOSE Patients with advanced melanoma refractory to first-line treatment have a need for effective second-line treatment options. A recent phase 3 trial showed promising results for adoptive cell therapy with tumor-infiltrating lymphocytes (TILs) as second-line therapy in patients with advanced melanoma. However, it remains unknown how patients and their partners experience TIL therapy, which is key to evaluate and improve the quality of care. METHODS Semi-structured interviews about the experience of TIL therapy were conducted with patients with advanced melanoma and their partners 2-4 weeks post-treatment (short term) and >6 months after treatment (long term). RESULTS In total, 25 interviews were conducted with advanced melanoma patients treated with TIL (n=13) and their partners (n=12), with the majority being short-term interviews (n=17). Overall, patients and partners experienced TIL therapy as intense (uncertainty of successful TIL culture, multiple treatment-related toxicities, and extensive hospitalization). Patients and partners with young children or other caregiving responsibilities encountered the most challenges during TIL therapy. All patients, however, reported a recovery of all treatment-related toxicities within 2-4 weeks (except fatigue). CONCLUSION Clinical data justify the role of TIL therapy in the treatment of advanced melanoma. With the distinct nature of TIL therapy compared to the current standard of care, we have provided patient-centered recommendations that will further enhance the quality of TIL therapy. IMPLICATIONS FOR CANCER SURVIVORS As more patients with advanced melanoma are expected to receive TIL therapy in the future, our findings could be incorporated into survivorship care plans for this novel group of advanced melanoma survivors treated with TIL.
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Affiliation(s)
- M D Egeler
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
| | - E Boomstra
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - M W Rohaan
- Division of Medical Oncology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - N M J Van den Heuvel
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - I Fraterman
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - M Delfos
- Division of Medical Oncology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - L V van de Poll-Franse
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
- Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
- Department of Medical and Clinical Psychology, Center of Research on Psychology in Somatic Diseases (CoRPS), Tilburg University, Tilburg, The Netherlands
| | - T H Borch
- National Center for Cancer Immune Therapy, Department of Oncology, Copenhagen University Hospital, Herlev, Denmark
| | - I M Svane
- National Center for Cancer Immune Therapy, Department of Oncology, Copenhagen University Hospital, Herlev, Denmark
| | - J B A G Haanen
- Division of Medical Oncology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
- Division of Molecular Oncology and Immunology, Netherlands Cancer Institute, Amsterdam, The Netherlands
- Department of Clinical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - V P Retèl
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - A H Boekhout
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
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19
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Murphy KA, Corveleyn AE, Park ER, Irwin KE. Challenges, rewards, and lessons learned from family and community caregivers of individuals with serious mental illness and cancer. Support Care Cancer 2023; 31:492. [PMID: 37493815 PMCID: PMC11011208 DOI: 10.1007/s00520-023-07827-y] [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: 11/05/2022] [Accepted: 05/21/2023] [Indexed: 07/27/2023]
Abstract
PURPOSE The caregiving experience for individuals with serious mental illness (SMI) and cancer has not been explored in previous cancer caregiver research. This study assessed the challenges, rewards, and lessons learned from this unique population of caregivers. METHODS We conducted qualitative interviews with 13 caregivers (9 family caregivers, 4 community caregivers) of patients recently diagnosed with head and neck, breast, lung, or gastrointestinal cancer and SMI who participated in a single-arm pilot of person-centered collaborative care. Interviews were transcribed and analyzed using inductive and deductive approaches. Investigators developed a coding scheme based on the interview guide. Interviews were double-coded and themes were identified via an iterative consensus process consistent with a content analysis framework. Comparisons between community and family caregiver experiences were explored. RESULTS Caregiving challenges included the impact of mental health symptoms on timely diagnosis, treatment, and coordination of care and lack of resources specific to SMI and cancer caregiving. Family caregivers valued increased closeness and meaningfulness in their relationships. Family and community caregivers found it rewarding to be part of a person-centered care model that was effective for the patient. Lessons learned included tending to their own needs too, and the importance of advocacy and a team approach to decrease mental health stigma and coordinate care. CONCLUSIONS This study highlights the complex challenges and rewards experienced by family and community caregivers for individuals with cancer and SMI. Tailored approaches to support caregivers as individuals are needed. Additional research on community caregiver-patient dyads and non-spousal family caregiver-patient dyads are needed to inform intervention development.
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Affiliation(s)
- Kerri A Murphy
- Massachusetts General Hospital, Center for Psychiatric Oncology, 55 Fruit St., Yawkey 10B, Boston, MA, 02114, USA
| | - Amy E Corveleyn
- Massachusetts General Hospital, Center for Psychiatric Oncology, 55 Fruit St., Yawkey 10B, Boston, MA, 02114, USA
| | - Elyse R Park
- Department of Psychiatry, Massachusetts General Hospital, 100 Cambridge St., Suite 1600, Boston, MA, 02114, USA
- Health Promotion and Resiliency Intervention Research (HPRIR) Program, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Kelly E Irwin
- Massachusetts General Hospital, Center for Psychiatric Oncology, 55 Fruit St., Yawkey 10B, Boston, MA, 02114, USA.
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
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20
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Mbozi P, Mukwato PK, Kalusopa VM, Simoonga C. Experiences and coping strategies of women caring for their husbands with cancer at the Cancer Diseases Hospital in Lusaka, Zambia: a descriptive phenomenological approach. Ecancermedicalscience 2023; 17:1572. [PMID: 37533947 PMCID: PMC10393314 DOI: 10.3332/ecancer.2023.1572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Indexed: 08/04/2023] Open
Abstract
The Cancer Diseases Hospital (CDH) 2019 annual report revealed an upsurge in the number of new cancer patients accessing services from 35 patients in 2006 to 3,008 in 2019. This study explored the experiences and coping strategies of women caring for their husbands with cancer attending the CDH. A phenomenological research design was used with stratified purposeful sampling. Data were collected using an interview schedule and analysed using thematic analysis. The women's challenges included mobility difficulties and hospital admissions/problems; socio-economic problems, psychological and emotional distress; and caregiving liability and spiritual anguish. The benefits that female spouses experienced during caring for their loved ones included knowledge about cancer and infection prevention, a strong marital relationship, tolerance and perseverance, resilience and hope and good relationship with other caregivers. The women's needs included financial support, physical needs, psychosocial counselling, caregiver accommodation, time off from caregiving, information needs and sexual intimacy and contact. Their coping strategies included spiritual support from spiritual carers, prayer and meditation, music and storytelling, social support and a good marital relationship. The findings demonstrate that wives of patients with cancer experience many challenges in their caring journey. Nurses must anticipate and/or intervene as part of their nursing practice to reduce the negative impact on female caretakers in this situation. Hospital standard operating procedures must be developed to put both the patients and their caregivers at the centre of oncology nursing care, particularly in settings with limited allied professional support, e.g., psychologists. Caretaker coping strategies highlighted in this study must be made available for both the patients and their wives, e.g., linking wives to trained spiritual carers upon their husband's admission to the hospital, to aid a smooth caregiving experience.
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Affiliation(s)
- Patience Mbozi
- Department of Nursing, Faculty of Health Sciences, Chreso University, Lusaka 10101, Zambia
| | - Patricia Katowa Mukwato
- Department of Basic and Clinical Sciences, School of Nursing Sciences, University of Zambia, Lusaka 10101, Zambia
| | - Victoria Mwiinga Kalusopa
- Department of Basic and Clinical Sciences, School of Nursing Sciences, University of Zambia, Lusaka 10101, Zambia
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21
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Son EH, Wallen GR, Flynn S, Yang L, Lee LJ. Patterns of health-promoting behaviors and associated factors in family caregivers of people receiving cancer treatment: A latent class profile analysis. Psychooncology 2023; 32:1038-1047. [PMID: 37157152 PMCID: PMC10590684 DOI: 10.1002/pon.6145] [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: 10/13/2022] [Revised: 04/02/2023] [Accepted: 04/10/2023] [Indexed: 05/10/2023]
Abstract
OBJECTIVE Family caregivers tend to neglect their health while prioritizing the needs of their care recipients. Identifying subgroups of caregivers based on the patterns of health-promoting behaviors (HPBs) may help develop tailored interventions for them, yet little is known. The purpose of this study was: (1) to identify latent classes with distinct patterns of HPBs in family caregivers of people with cancer; and (2) to investigate factors associated with the latent class membership. METHODS We performed a cross-sectional data analysis using the baseline dataset from a longitudinal survey study that assessed HPBs of family caregivers of individuals who received cancer treatment at a national research hospital (N = 124). Latent class profile analysis was conducted to identify latent classes based on the subdomains of the Health-Promoting Lifestyle Profile II, followed by multinomial logistic regression analysis to investigate factors associated with the latent class membership. RESULTS Three latent classes were identified: a high level of HPB (Class 1, 25.8%); a moderate level of HPB (Class 2, 53.2%); and a low level of HPB (Class 3, 21.0%) of HPBs. Controlling for caregiver age and sex, caregiver burden due to lack of family support, perceived stress, self-efficacy and body mass index were factors associated with the latent class membership. CONCLUSIONS HPBs of our caregiver sample appeared in relatively stable patterns at different levels. Higher caregiver burden and perceived stress and lower self-efficacy were associated with the lower practice of HPBs overall. Our findings may serve as a reference for screening caregivers who need support and developing person-centered interventions.
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Affiliation(s)
- Elisa H. Son
- Translational Biobehavioral and Health Disparities Branch, National Institutes of Health (NIH) Clinical Center, Bethesda, Maryland, USA
| | - Gwenyth R. Wallen
- Translational Biobehavioral and Health Disparities Branch, National Institutes of Health (NIH) Clinical Center, Bethesda, Maryland, USA
| | - Sharon Flynn
- National Heart, Lung, and Blood Institute, NIH, Bethesda, Maryland, USA
| | - Li Yang
- Translational Biobehavioral and Health Disparities Branch, National Institutes of Health (NIH) Clinical Center, Bethesda, Maryland, USA
| | - Lena J. Lee
- Translational Biobehavioral and Health Disparities Branch, National Institutes of Health (NIH) Clinical Center, Bethesda, Maryland, USA
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McAndrew NS, Erickson J, Hetland B, Guttormson J, Patel J, Wallace L, Visotcky A, Banerjee A, Applebaum AJ. A Mixed-Methods Feasibility Study: Eliciting ICU Experiences and Measuring Outcomes of Family Caregivers of Patients Who Have Undergone Hematopoietic Stem Cell Transplantation. JOURNAL OF FAMILY NURSING 2023:10748407231166945. [PMID: 37191306 PMCID: PMC10330518 DOI: 10.1177/10748407231166945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
The impact of an intensive care unit (ICU) admission on family caregivers of patients who have undergone hematopoietic stem cell transplantation (HSCT) has not been well described. Aims of this study were to determine the feasibility of conducting research with family caregivers of HSCT patients during an ICU admission and generate preliminary data about their experiences and engagement in care. Using a mixed-methods, repeated measures design, we collected data from family caregivers after 48 hr in the ICU (T1) and at 48 hr after transferring out of ICU (T2). Enrolling HSCT caregivers in research while in the ICU was feasible (10/13 consented; 9/10 completed data collection at T1); however, data collection at T2 was not possible for most caregivers. Caregiver distress levels were high, and engagement in care was moderate. The three themes that emerged from interviews (n = 5) highlighted that although HSCT family caregivers faced many challenges and received limited support during their ICU experience, they were able to access their own personal resources and demonstrated resilience.
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Affiliation(s)
- Natalie S McAndrew
- University of Wisconsin-Milwaukee, USA
- Froedtert & the Medical College of Wisconsin, Milwaukee, USA
| | | | - Breanna Hetland
- University of Nebraska Medical Center, Omaha, USA
- Nebraska Medicine, Omaha, USA
| | | | | | | | | | | | - Allison J Applebaum
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medicine, New York, NY, USA
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23
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Parsekar SS, Meijering L, Bailey A, Nair S. Perceptions and Experiences of Informal Caregivers of Breast Cancer Patients in South India: A Qualitative Study. Asian Pac J Cancer Prev 2023; 24:1651-1658. [PMID: 37247285 PMCID: PMC10495876 DOI: 10.31557/apjcp.2023.24.5.1651] [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: 12/08/2022] [Accepted: 05/15/2023] [Indexed: 05/31/2023] Open
Abstract
BACKGROUND This study was conducted to explore the prevailing perceptions and experiences of caregiving burden among informal caregivers of women living with breast cancer in South India. METHODS In-depth interviews were conducted among breast cancer care-receivers (n=35) and their informal caregivers (n=39) and a thematic analysis was used to analyze the data. Informal caregiver in the context of this study was defined as one who takes up the responsibility of an informal caregiving role, and were either self-identified or acknowledged by the care-receivers. RESULTS Four main inductive themes in the domains of: emotional culpability, financial and workplace liability, psychosocial affliction, physical strain and health system demand were identified, that were associated with caregiver burden. CONCLUSION Informal caregivers form an integral part of the cancer care continuum in India. It is recommended to factor in the identified themes while developing a caregiver needs assessment model in the context of caring for breast cancer patients in the Indian setting.
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Affiliation(s)
- Shradha S. Parsekar
- Department of Community Medicine, Kasturba Medical College (KMC), Manipal Academy of Higher Education (MAHE), Manipal, India.
| | - Louise Meijering
- Department of Demography, Faculty of Spatial Sciences, University of Groningen, Netherlands.
| | - Ajay Bailey
- International Development Studies, Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, the Netherlands.
- Transdisciplinary Centre for Qualitative Methods, Prasanna School of Public Health, MAHE, Manipal, India.
| | - Suma Nair
- Department of Community Medicine, Kasturba Medical College (KMC), Manipal Academy of Higher Education (MAHE), Manipal, India.
- Centre for Community Oncology, KMC, MAHE, Manipal, India.
- DYPU School of Public Health, DY Patil Deemed to be University, Nerul, Navi Mumbai, India.
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24
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Weiss CR, Baker C, Gillespie A, Jones J. Ambiguous loss in family caregivers of loved ones with cancer, a synthesis of qualitative studies. J Cancer Surviv 2023; 17:484-498. [PMID: 36396909 DOI: 10.1007/s11764-022-01286-w] [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: 06/07/2022] [Accepted: 10/24/2022] [Indexed: 11/19/2022]
Abstract
PURPOSE The purpose of this synthesis of qualitative studies is to explore manifestations of ambiguous loss within the lived experiences of family caregivers (FCG) of loved ones with cancer. Grief and loss are familiar companions to the family caregivers of loved ones with cancer. Anticipatory loss, pre-loss grief, complicated grief, and bereavement loss have been studied in this caregiver population. It is unknown if family caregivers also experience ambiguous loss while caring for their loved ones along the uncertain landscape of the cancer illness and survivorship trajectory. METHODS We conducted a four-step qualitative meta-synthesis of primary qualitative literature published in three databases between 2008 and 2021. Fourteen manuscripts were analyzed using a qualitative appraisal tool and interpreted through thematic synthesis and reciprocal translation. RESULTS Five themes were derived, revealing FCGs appreciate change in their primary relationship with their loved ones with cancer, uncertainty reconciling losses, an existence that is static in time, living with paradox, and disenfranchised grief. The results of this synthesis of qualitative studies complement the descriptors of ambiguous loss presented in previous research. CONCLUSIONS The results of this synthesis of qualitative studies complement the descriptors of ambiguous loss presented in previous theoretical and clinical research. By understanding ambiguous loss as a complex and normal human experience of cancer FCGs, oncology and palliative care healthcare providers can introduce interventions and therapeutics to facilitate caring-healing and resiliency. IMPLICATIONS FOR CANCER SURVIVORS Untreated ambiguous loss can result in a decrease in wellbeing, loss of hope, and loss of meaning in life. It is imperative that cancer FCGs experiencing ambiguous loss are recognized and supported so that they may live well in the family disease of cancer.
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Affiliation(s)
- Charlotte R Weiss
- College of Nursing, University of Colorado, Denver-Anschutz Medical Campus, Denver, CO, USA.
- , Wilmington, USA.
| | - Christina Baker
- College of Nursing, University of Colorado, Denver-Anschutz Medical Campus, Denver, CO, USA
| | - Anne Gillespie
- College of Nursing, University of Colorado, Denver-Anschutz Medical Campus, Denver, CO, USA
| | - Jacqueline Jones
- College of Nursing, University of Colorado, Denver-Anschutz Medical Campus, Denver, CO, USA
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Psychological Processes Associated With Resilience in UK-Based Unpaid Caregivers During the COVID-19 Pandemic. CLINICAL PSYCHOLOGY IN EUROPE 2022; 4:e10313. [PMID: 36762350 PMCID: PMC9881121 DOI: 10.32872/cpe.10313] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 11/02/2022] [Indexed: 12/24/2022] Open
Abstract
Background Unpaid caregivers have faced and dealt with additional challenges during the COVID-19 pandemic. Understanding the psychological processes associated with their resilience is warranted. The objective of this study was to examine the associations between resilience with mental distress, emotion regulation strategies (i.e., reappraisal and suppression) and interpretation bias in adult caregivers. Method Participants were living in the UK, aged 18+, and consisted of 182 unpaid caregivers of an adult aged 18+ living with a long-term health condition, and 120 non-caregivers. Data were collected in an online study during the first national UK COVID-19 lockdown (May and September 2020). Hierarchical multiple regression analyses explored whether emotion regulation strategies and interpretation bias explained unique variance in levels of resilience in caregivers whilst controlling for anxiety and depression. Results Compared to non-caregivers, caregivers reported higher levels of anxiety, depression, negative interpretation bias and lower levels of resilience. Emotion regulation strategies did not differ between groups. Within caregivers, greater resilience was associated with lower mood disturbance, a positive interpretation bias, and greater use of cognitive reappraisal and lower use of suppression strategies to regulate emotions. Emotion regulation and interpretation bias together predicted an additional 15% of variance in current levels of resilience. Conclusion Our findings indicate that psychological mechanisms such as emotion regulation strategies, particularly reappraisal, and interpretation bias are associated with resilience in caregivers. Although preliminary, our findings speak to exciting clinical possibilities that could form the target of interventions to improve resilience and lower mental distress in unpaid caregivers.
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Mariyanti H, Jiar Yeo K, Hui Lee S, Nursalam N. Nursing students' perception of caring: a literature review. CENTRAL EUROPEAN JOURNAL OF NURSING AND MIDWIFERY 2022. [DOI: 10.15452/cejnm.2021.12.0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
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Ketlogetswe TS, Van Rensburg JJJ, Maree JE. The experiences of caregivers of patients living with cancer admitted to a hospice in South Africa. Int J Palliat Nurs 2022; 28:164-171. [PMID: 35465701 DOI: 10.12968/ijpn.2022.28.4.164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Caregivers share cancer experiences with patients, but little is known about their own experiences in the end-of-life phase, the most difficult phase in the caregiving journey. AIMS To describe the experiences of caregivers of cancer patients admitted to a hospice in South Africa. METHODS A qualitative design was used; 22 (n=22) participants were purposively selected and in-depth interviews were conducted. Analysis of the data was by qualitative content analysis. FINDINGS A total of three themes arose from the data: emotional responses towards the caregiver role, personal cost of caregiving and spiritual issues relating to caregiving. CONCLUSION Caring for cancer patients during the last phase of life was not easy. Responsibilities overwhelmed the participants and they were emotionally exhausted. They lacked knowledge of how to care and experienced a heavy financial burden. Despite the challenges that they faced, faith and religious practices served as a coping mechanism and kept some going.
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Affiliation(s)
- Tinalipi S Ketlogetswe
- MSc candidate, Department of Nursing Education, University of the Witwatersrand, South Africa
| | | | - Johanna Elizabeth Maree
- Associate Professor, Department of Nursing Education, University of the Witwatersrand, South Africa
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Aljuaid M, Ilyas N, Altuwaijri E, Albedawi H, Alanazi O, Shahid D, Alonazi W. Quality of Life among Caregivers of Patients Diagnosed with Major Chronic Disease during COVID-19 in Saudi Arabia. Healthcare (Basel) 2022; 10:healthcare10030523. [PMID: 35327001 PMCID: PMC8953432 DOI: 10.3390/healthcare10030523] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 03/03/2022] [Accepted: 03/08/2022] [Indexed: 12/19/2022] Open
Abstract
Quality of life (QoL) is considered one of the measures of health outcomes. Limited research studies have assessed family caregivers’ QoL, especially among patients diagnosed with chronic disease. This study measures the QoL of caregivers who guardian patients diagnosed with cardiovascular disease, diabetes, cancer, and/or other diseases during the COVID-19 pandemic. Participants were primary caregivers who were supporting, in the last six months, individuals diagnosed with one of the previously mentioned chronic diseases. This included caregivers of patients admitted to a tertiary hospital from January 2021 to July of the same year (n = 1081); all participants completed the World Health Organization Quality of Life Assessment tool (WHOQOL-BREF) questionnaire. Caregivers of patients with cancer reported the highest mean level of QoL, followed by diabetes, cardiovascular diseases, then other different diseases (M = 3.80; M = 3.38; M = 3.37; and M = 2.51, respectively). A chi-square test of independence was performed to examine the relationship between the QoL of the four groups and their behaviors (i.e., caregivers’ psychological onuses and physical actions/reactions). The relation between these variables was significant, X2 (3, n = 1081) = 8.9, p = 0.001. The Kruskal–Wallis test indicated significant differences among the four groups (p ≤ 0.001). While the overall results of the QoL level of participants were low, a major recommendation of this study was to incorporate a QoL assessment to caregivers of chronically ill patients. Regular psychological and physical health check-ups of caregivers should be mandated in the healthcare system. Research studies should consider investigating and identifying the factors affecting health outcomes and positive developments which have a great impact on the wellbeing of both caregivers and patients on personal, organizational, and national levels.
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Affiliation(s)
- Mohammed Aljuaid
- Department of Health Administration, College of Business Administration, King Saud University, Riyadh 11587, Saudi Arabia; (M.A.); (E.A.)
| | - Namrah Ilyas
- Centre for Clinical Psychology, University of the Punjab, Lahore 66000, Pakistan;
| | - Eman Altuwaijri
- Department of Health Administration, College of Business Administration, King Saud University, Riyadh 11587, Saudi Arabia; (M.A.); (E.A.)
- Department of Administrative and Social Sciences, College of Business Applied Studies and Community Service, King Saud University, Riyadh 11587, Saudi Arabia
| | - Haddel Albedawi
- Department of Community Health, College of Applied Medical Sciences, King Saud University, Riyadh 11587, Saudi Arabia;
| | - Ohoud Alanazi
- Department of Public Administration, College of Business Administration, King Saud University, Riyadh 11587, Saudi Arabia;
| | - Duaa Shahid
- Hult International Business School, Cambridge, MA 02141, USA;
| | - Wadi Alonazi
- Department of Health Administration, College of Business Administration, King Saud University, Riyadh 11587, Saudi Arabia; (M.A.); (E.A.)
- Correspondence: ; Tel.: +966-114-693-999
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Lagarde JBB, Cauyan JM, Laurino M, Tumulak MAJ, San Juan M, Ventura E. Qualitative inquiry on the experiences of Filipino women living with a sister with breast cancer: insights for psycho-oncology. ASIA PACIFIC JOURNAL OF COUNSELLING AND PSYCHOTHERAPY 2022. [DOI: 10.1080/21507686.2022.2036210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- John Benedict Biñas Lagarde
- Department of Pediatrics, College of Medicine and Philippine General Hospital, University of the Philippines, Manila
| | | | - Mercy Laurino
- Department of Pediatrics, College of Medicine and Philippine General Hospital, University of the Philippines, Manila
- Cancer Prevention Programs, Seattle Cancer Care Alliance, Seattle, Washington
| | - Ma-Am Joy Tumulak
- Department of Pediatrics, College of Medicine and Philippine General Hospital, University of the Philippines, Manila
- Institute of Human Genetics, National Institutes of Health, University of the Philippines, Manila
| | - Michael San Juan
- Section of Medical Oncology, Department of Medicine, College of Medicine and Philippine General Hospital, University of the Philippines, Manila
| | - Elizabeth Ventura
- College of Social Sciences and Philosophy, University of the Philippines, Diliman
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Caring experiences of family caregivers of patients with pancreatic cancer: an integrative literature review. Support Care Cancer 2022; 30:3691-3700. [PMID: 34993653 DOI: 10.1007/s00520-021-06793-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 12/30/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE This review summarizes and synthesizes the available empirical literature on the experiences concerned with the problems and challenges faced by caregivers of patients with pancreatic cancer. METHODS An integrative review method was used, and a literature search was conducted using five databases. We searched the terms "pancreatic cancer," "caregiver," and "experience," and used the Boolean operators OR and AND to combine them. The Joanna Briggs Institute critical appraisal tools were used to assess the quality of the included studies. RESULTS Four qualitative studies, one mixed method, and three quantitative studies met the selection criteria and were included in the review. Informal family caregivers of patients with pancreatic cancer experienced multifaceted roles, lack of information, difficulties in maintaining emotional well-being, and positive coping. The factors associated with their caring experience included the caregivers' demographics, patients' psychological status, and clinical characteristics. CONCLUSION Caregivers of patients with pancreatic cancer have various experiences while providing care. Health care providers should offer opportunities for caregivers to recognize their feelings, provide sufficient information and psychological support, and foster coping strategies to maintain the physical and psychosocial well-being of caregivers.
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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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Goula P, Iconomou G, Gourzis P, Kalofonos HP, Georgila E, Maria A, Assimakopoulos K. Prospective assessment of psychopathological symptoms and their relation to demographic factors in primary caregivers of cancer patients throughout chemotherapy. Support Care Cancer 2021; 30:2467-2475. [PMID: 34779919 DOI: 10.1007/s00520-021-06662-3] [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: 07/01/2021] [Accepted: 10/27/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE The present study aims to investigate the course of psychological symptoms through chemotherapy in a sample of primary caregivers of patients with cancer and to examine all possible correlations between psychological distress and demographic characteristics. METHODS In this prospective study, 112 primary family caregivers of cancer patients were evaluated. Symptom checklist 90 revised (SCL-90-R) was administered to assess their pathological symptoms, the Hospital Anxiety and Depression Scale (HADS) to assess depression and anxiety. There was an evaluation at the beginning of chemotherapy and a second at the end of the patients' intravenous chemotherapy treatment (EOT). RESULTS A total of 112 primary caregivers were initially enrolled in the study, and 99 (88.4%) completed it. Caregivers' psychopathology was low to moderate at both points of time (baseline and EOT). However, a considerable decrease in the Global Severity Index (GSI) emerged over time. CONCLUSIONS At EOT, participants reported statistically significant decreases in five aspects of SCL 90, namely Depression, phobic anxiety, obsessive-compulsive symptoms, somatization, and psychoticism. A notable finding was that female caregivers were significantly more distressed, especially when providing care to a male recipient.
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Affiliation(s)
- Panagiota Goula
- Psychiatric Clinic, School of Health Sciences, Department of Medicine, University of Patras, Rion, 265 04, Patras, Greece.
| | - Gregoris Iconomou
- Division of Oncology, School of Health Sciences, Department of Medicine, University of Patras Medical School, Rion, Patras, Greece
| | - Philippos Gourzis
- Psychiatric Clinic, School of Health Sciences, Department of Medicine, University of Patras, Rion, 265 04, Patras, Greece
| | - Haralabos P Kalofonos
- Division of Oncology, School of Health Sciences, Department of Medicine, University of Patras Medical School, Rion, Patras, Greece
| | - Eleni Georgila
- Division of Oncology, School of Health Sciences, Department of Medicine, University of Patras Medical School, Rion, Patras, Greece
| | - Adraskela Maria
- Psychiatric Clinic, School of Health Sciences, Department of Medicine, University of Patras, Rion, 265 04, Patras, Greece
| | - Konstantinos Assimakopoulos
- Psychiatric Clinic, School of Health Sciences, Department of Medicine, University of Patras, Rion, 265 04, Patras, Greece
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Abstract
OBJECTIVES To provide an overview on the role of family caregivers (FCGs) in the care of older adults with cancer and review quality of life needs for FCGs. DATA SOURCES Journal articles, research reports, state of the science papers, position papers, and clinical guidelines from professional organizations were used. CONCLUSION The high prevalence of multiple comorbidities and the associated burden of geriatric events in older adults have a substantial impact on the quality of life of their FCGs. Practical and efficient models of comprehensive assessment, interventions, and caregiving preparedness support are needed to improve outcomes for both older adults with cancer and their FCGs. IMPLICATIONS FOR NURSING PRACTICE Oncology nurses practicing in clinical and research settings have a responsibility to prepare themselves with evidence-based knowledge and resources to include the needs of FCGs in the care provided to older adults with cancer.
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Turan GB, Dayapoğlu N, Özer Z. Evaluation of care burden and caregiving preparedness in caregivers of patients with epilepsy: A sample in eastern Turkey. Epilepsy Behav 2021; 124:108370. [PMID: 34717246 DOI: 10.1016/j.yebeh.2021.108370] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 09/23/2021] [Accepted: 09/25/2021] [Indexed: 10/20/2022]
Abstract
AIM This study was conducted to evaluate the care burden and caregiving preparedness in caregivers of patients with epilepsy. METHODS This descriptive, cross-sectional study evaluated the caregivers of patients with epilepsy who were referred to the neurology outpatient clinic of a university hospital in Erzurum, eastern Turkey, between February 2020 and February 2021. The study was carried out with 147 volunteers among the patients with epilepsy who were referred to the neurology outpatient clinic between the specified dates. The data were collected with Caregiver Question Form, the Brief Disability Questionnaire (BDQ), the Burden Interview (BI), and the Preparedness for Caregiving Scale (PCS). RESULTS The mean BI score of the caregivers who participated in the study was 43.14 ± 18.08, their mean PCS score was 14.12 ± 7.76, and their mean BDQ score was 10.53 ± 4.65. In the regression analysis conducted, it was found that being married, having little knowledge of patient care, undertaking all of the roles in caregiving and having caregiving duration of 24 months and longer had a negative effect on PCS total score, while having an undergraduate degree and higher had a positive significant effect. It was found that having an undergraduate degree and higher had a negative effect on BI total score, while all of the roles undertaken in caregiving had a positive significant effect on BI total score. It was found that PCS had a negative significant effect on BI total score (p < 0.001). CONCLUSION Caregivers of patients with epilepsy had a moderate level of burden and caregiving preparedness, and the patients cared for had a moderate level of disability. Caregiver burden increased as disability of patients with epilepsy and the tasks undertaken in caregiving increased, whereas burden decreased as caregiver education and caregiving preparedness increased.
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Affiliation(s)
| | | | - Zülfünaz Özer
- Department of Nursing, Faculty of Health Sciences, Istanbul Sabahattin Zaim University, Istanbul, Turkey
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O'Rourke L, Fisher PL, Campbell S, Wright A, Cherry MG. Factors Associated With Fear of Cancer Recurrence in Family Caregivers of Cancer Survivors: A Systematic Review. Front Psychol 2021; 12:625654. [PMID: 34335354 PMCID: PMC8323753 DOI: 10.3389/fpsyg.2021.625654] [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: 11/04/2020] [Accepted: 02/08/2021] [Indexed: 11/20/2022] Open
Abstract
Objective: Fear of cancer recurrence (FCR) is a significant concern for family caregivers of cancer survivors and is associated with many adverse outcomes, including increased emotional distress and poorer quality of life. Although several theoretical models have been proposed to account for FCR in cancer survivors, their applicability to caregivers is unknown. The aim of this review was to identify clinical, demographic and psychological factors that are associated with, and predict, FCR in caregivers of cancer survivors. Method: AMED, CINAHL, Medline, PsycINFO, and Scopus were systematically searched for relevant studies reporting quantitative data on factors associated with FCR or similar constructs (e.g., worry or anxiety about cancer recurrence) in family caregivers of adult cancer survivors. Included studies were assessed for methodological quality using a standardized checklist adapted from the Agency for Healthcare Research and Quality. Results: Sixteen studies, half of which were cross-sectional, were included and summarized narratively. Non-modifiable factors, including age (n = 6) and treatment modality (n = 4), were found to be associated with increased FCR. Significant positive associations were also reported between illness perceptions and FCR (n = 3). However, there was heterogeneity across included studies with regards to factors examined and most were conducted in the USA. There were also several methodological limitations to the included studies. Conclusions: Research examining FCR in caregivers of cancer survivors has predominantly focused on demographic and clinical factors. Given the paucity of research exploring the psychological mechanisms underpinning FCR, future research should investigate theoretical underpinnings of FCR in caregivers of cancer survivors to support the development of psychological interventions for this population. Systematic Review Registration: PROSPERO, identifier [CRD42019119729].
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Affiliation(s)
- Louise O'Rourke
- Department of Primary Care and Mental Health, University of Liverpool, Whelan Building, Quadrangle, Liverpool, United Kingdom
| | - Peter L Fisher
- Department of Primary Care and Mental Health, University of Liverpool, Whelan Building, Quadrangle, Liverpool, United Kingdom.,Clinical Health Psychology Service, Linda McCartney Centre, Liverpool University National Heath Service Foundation Trust, Liverpool, United Kingdom
| | - Sophie Campbell
- Clinical Health Psychology Service, Linda McCartney Centre, Liverpool University National Heath Service Foundation Trust, Liverpool, United Kingdom
| | - Amelia Wright
- Department of Primary Care and Mental Health, University of Liverpool, Whelan Building, Quadrangle, Liverpool, United Kingdom
| | - Mary Gemma Cherry
- Department of Primary Care and Mental Health, University of Liverpool, Whelan Building, Quadrangle, Liverpool, United Kingdom.,Clinical Health Psychology Service, Linda McCartney Centre, Liverpool University National Heath Service Foundation Trust, Liverpool, United Kingdom
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The Interaction Between Hematological Cancer Patients and Family Caregivers and Their Life Changes: A Qualitative Dyadic Approach. Cancer Nurs 2021; 44:E201-E208. [PMID: 32195708 DOI: 10.1097/ncc.0000000000000800] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Diagnosis of hematological cancer affects patients and caregivers as a unit. Few studies have focused on the relationship between hematological cancer patients and their caregivers. OBJECTIVE To explore (a) the interaction between patients receiving treatment for hematological cancer in a hematology-oncology clinic and their family caregivers and (b) perceived changes in lives of patients receiving treatment for hematological cancer in a hematology-oncology clinic and their family caregivers. METHODS We used a qualitative descriptive design with a dyadic approach. The study sample included 11 patients with hematological cancer and 11 family caregivers selected through purposive sampling. In-depth interviews were conducted using a semistructured interview format. RESULTS As a result of a content analysis, 3 themes emerged: hidden emotions, companionship, and life changes. Both the patients and the family caregivers described coping by hiding their feelings, thoughts, and needs and reducing communication with each other. Dyad members described commitment to each other and an increase in confidence. In addition, the patients and the family caregivers experienced changes in their roles and perspectives during the diagnosis and treatment process. CONCLUSION Patients with hematological cancer and family caregivers need nurses' support. Nurses should be prepared to provide patient-caregiver-based interventions. IMPLICATION FOR PRACTICES It is important that nurses take action to strengthen the relationship between patients and their caregivers, particularly with a focus on carrying out interventions to improve communication between them. Nurses can also strengthen dyads' coping by drawing attention to positive developments in their perspectives and relationships.
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Effects of psychosocial interventions on psychological outcomes among caregivers of advanced cancer patients: a systematic review and meta-analysis. Support Care Cancer 2021; 29:7237-7248. [PMID: 34240256 DOI: 10.1007/s00520-021-06102-2] [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: 01/05/2021] [Accepted: 02/23/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE This systematic review aimed to synthesize the effectiveness of psychosocial interventions on caregivers of advanced cancer patients, in comparison with usual care, on caregivers' quality of life (QoL), anxiety, and depression symptoms. METHODS Comprehensive searches for published and unpublished studies were performed using nine electronic databases, two trial registers, and reference lists of included studies. Two reviewers independently screened, appraised, and extracted data. The Cochrane risk of bias tool was used to appraise the methodological quality of included studies, while the Cochrane data extraction tool was used to elicit relevant information. Meta-analysis, narrative analysis, and sensitivity analysis were conducted to synthesize data. Standardized mean differences (SMD) represented effects of psychosocial interventions. RESULTS Fifteen randomized controlled trials were included in this review. At post-intervention, findings revealed a significant small pooled effect size (SMD = 0.45) on QoL and significant moderate effect on depression (SMD = - 0.65). However, a small non-significant pooled effect size was observed on anxiety (SMD = - 0.24). At follow-up assessments, effect sizes of all outcomes were small and non-significant. Overall quality of evidence was rated very low for all outcomes and most studies had unclear or high risk of bias. Thus, results should be interpreted with caution. CONCLUSION Psychosocial interventions were effective in improving QoL and depression among caregivers of persons with advanced cancer. However, future randomized control trials with lower risk of bias, larger sample size, detailed participant characteristics, and informative interventions are desirable.
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Prevalence and factors associated with depressive symptoms among family caregivers of palliative care patients at Hospice Africa Uganda. Palliat Support Care 2021; 20:375-382. [PMID: 34154696 DOI: 10.1017/s1478951521000730] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Caregiving for cancer and HIV/AIDS patients is complex, and the burden may vary with the type of disease, stages of the illness, and the type of palliative care intervention. Cancer and HIV/AIDS diagnosis and treatment adversely affect not only the patients but also their families and caregivers. They are vulnerable to stress, distress, and depression. Studies in developed countries have shown high prevalence of depression among family caregivers, but the scale of the problem among family caregivers in Uganda is not known. OBJECTIVE This study aimed to establish the prevalence and factors associated with depressive symptoms among family caregivers of palliative care patients at Hospice Africa Uganda. METHOD We used a mixed method study to determine the prevalence and factors associated with depressive symptoms among family caregivers of palliative care patients at Hospice Africa Uganda. We assessed depressive symptoms using the Patient Health Questionnaire-9 (PHQ-9) and collected socio-demographic data using a tailored questionnaire. We used binary logistic regression to assess for the association between depressive symptomatology and caregiver socio-demographic and clinical characteristics. RESULTS We recruited 161 family caregivers, 64% of whom were female. The study revealed a high prevalence of depressive symptoms (46%) (n = 74) among the family caregivers. Education status and religious affiliation were significantly associated with depressive symptomatology. SIGNIFICANCE OF RESULTS Family caregivers of palliative care patients face a high burden of depressive symptoms. Efforts to care for family caregivers within palliative care should include assessment and management of depressive symptoms in this population.
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Mubin N, Bin Abdul Baten R, Jahan S, Zohora FT, Chowdhury NM, Faruque GM. Cancer related knowledge, attitude, and practice among community health care providers and health assistants in rural Bangladesh. BMC Health Serv Res 2021; 21:191. [PMID: 33653315 PMCID: PMC7927368 DOI: 10.1186/s12913-021-06202-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 02/08/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cancer remains one of the primary causes of death in Bangladesh. The success of cancer control in rural areas depends on the ability of the health care system and workforce to identify and manage cases properly at early stages. Community Health Workers (CHW) can play a vital role in this process. The present study aims to assess cancer related Knowledge, Attitude, and Practice (KAP) among 2 categories of CHWs - Community Health Care Providers (CHCP) and Health Assistants (HA) in rural Bangladesh. METHODS A descriptive cross-sectional study was conducted using a self-administered questionnaire from July 2019 to June 2020. Multi-stage sampling technique was used to determine the sample. One Upazilla Health Complex (UHC) from each of the eight administrative divisions of Bangladesh were randomly chosen as study sites, from which 325 CHCPs and HAs were in the final sample. Multivariate logistic regression models were developed to determine the association between KAP scores and demographic variables. RESULTS Our study shows that a modest number of respondents scored above average in the knowledge (54.15%), attitude (58.15%), and practice (65.54%) sections. Majority CHCPs (90.91%) and HAs (96.06%) did not receive govt. training on cancer. Only 20.71% HAs and 25.2% CHCPs knew about the availability of cancer treatment options in Bangladesh. Uncertainty about the availability of relevant treatments or vaccinations at public facilities was also high. Having cancer in the family, income, duration of employment and workplace locations were important predictors of cancer related KAP scores. CONCLUSION Healthcare workforce's knowledge gap and unfavorable attitude towards cancer may result in poor delivery of care at the rural level. For many people in rural areas, CHCPs and HAs are the first point of contact with the healthcare system and thus effective cancer control strategies must consider them as key stakeholders. Targeted training programs must be adopted to address the cancer related KAP gaps among CHCPs and HAs.
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Affiliation(s)
- Nazirum Mubin
- Department of Radiotherapy, Dhaka Medical College Hospital, Dhaka, Bangladesh
| | | | | | - Fatema Tuz Zohora
- Ministry of Health and Family Welfare, Government of Bangladesh, Dhaka, Bangladesh
| | - Naim Mahmud Chowdhury
- Department of Oral and Maxillofacial Surgery, Chhattogram International Dental College, Chittagong, Bangladesh
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Loh KP, Soto-Perez-de-Celis E, Duberstein PR, Culakova E, Epstein RM, Xu H, Kadambi S, Flannery M, Magnuson A, McHugh C, Trevino KM, Tuch G, Ramsdale E, Yousefi-Nooraie R, Sedenquist M, Liu JJ, Melnyk N, Geer J, Mohile SG. Patient and caregiver agreement on prognosis estimates for older adults with advanced cancer. Cancer 2021; 127:149-159. [PMID: 33036063 PMCID: PMC7736110 DOI: 10.1002/cncr.33259] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 07/06/2020] [Accepted: 08/07/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Disagreements between patients and caregivers about treatment benefits, care decisions, and patients' health are associated with increased patient depression as well as increased caregiver anxiety, distress, depression, and burden. Understanding the factors associated with disagreement may inform interventions to improve the aforementioned outcomes. METHODS For this analysis, baseline data were obtained from a cluster-randomized geriatric assessment trial that recruited patients aged ≥70 years who had incurable cancer from community oncology practices (University of Rochester Cancer Center 13070; Supriya G. Mohile, principal investigator). Patient and caregiver dyads were asked to estimate the patient's prognosis. Response options were 0 to 6 months, 7 to 12 months, 1 to 2 years, 2 to 5 years, and >5 years. The dependent variable was categorized as exact agreement (reference), patient-reported longer estimate, or caregiver-reported longer estimate. The authors used generalized estimating equations with multinomial distribution to examine the factors associated with patient-caregiver prognostic estimates. Independent variables were selected using the purposeful selection method. RESULTS Among 354 dyads (89% of screened patients were enrolled), 26% and 22% of patients and caregivers, respectively, reported a longer estimate. Compared with dyads that were in agreement, patients were more likely to report a longer estimate when they screened positive for polypharmacy (β = 0.81; P = .001), and caregivers reported greater distress (β = 0.12; P = .03). Compared with dyads that were in agreement, caregivers were more likely to report a longer estimate when patients screened positive for polypharmacy (β = 0.82; P = .005) and had lower perceived self-efficacy in interacting with physicians (β = -0.10; P = .008). CONCLUSIONS Several patient and caregiver factors were associated with patient-caregiver disagreement about prognostic estimates. Future studies should examine the effects of prognostic disagreement on patient and caregiver outcomes.
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Affiliation(s)
- Kah Poh Loh
- Division of Hematology/Oncology, Department of Medicine, James P Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York, USA
| | - Enrique Soto-Perez-de-Celis
- Department of Geriatrics, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico
| | - Paul R. Duberstein
- Department of Health Behavior, Society, and Policy, Rutgers School of Public Health, Piscataway, New Jersey, USA
| | - Eva Culakova
- Division of Hematology/Oncology, Department of Medicine, James P Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York, USA
| | - Ronald M. Epstein
- Division of Hematology/Oncology, Department of Medicine, James P Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York, USA
- Department of Family Medicine, University of Rochester Medical Center, Rochester, New York, USA
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA
- Department of Medicine|Palliative Care, University of Rochester Medical Center, Rochester, New York, USA
| | - Huiwen Xu
- Division of Hematology/Oncology, Department of Medicine, James P Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York, USA
- Department of Surgery|Cancer Control, University of Rochester Medical Center, Rochester, New York, USA
| | - Sindhuja Kadambi
- Division of Hematology/Oncology, Department of Medicine, James P Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York, USA
| | - Marie Flannery
- School of Nursing, University of Rochester Medical Center, Rochester, New York, USA
| | - Allison Magnuson
- Division of Hematology/Oncology, Department of Medicine, James P Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York, USA
| | - Colin McHugh
- Division of Hematology/Oncology, Department of Medicine, James P Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York, USA
| | - Kelly M. Trevino
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Gina Tuch
- Department of Aged Care, Alfred Health, Melbourne, Australia
| | - Erika Ramsdale
- Division of Hematology/Oncology, Department of Medicine, James P Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York, USA
| | - Reza Yousefi-Nooraie
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, New York, USA
| | - Margaret Sedenquist
- SCOREboard Advisory Group, University of Rochester Medical Center, Rochester, New York, USA
| | - Jane Jijun Liu
- Heartland National Cancer Institute (NCI) Community Oncology Research Program (NCORP), USA
| | | | - Jodi Geer
- Metro Minnesota Community Oncology Research Program, USA
| | - Supriya G. Mohile
- Division of Hematology/Oncology, Department of Medicine, James P Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York, USA
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Garg R, Rebić N, De Vera MA. Information Needs About Cancer Treatment, Fertility, and Pregnancy: Qualitative Descriptive Study of Reddit Threads. JMIR Cancer 2020; 6:e17771. [PMID: 33263547 PMCID: PMC7744261 DOI: 10.2196/17771] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 06/11/2020] [Accepted: 08/22/2020] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND A reproductive health implication of the increasing incidence of cancer among women is the impact of cancer treatment on fertility. OBJECTIVE As patients are increasingly using the internet, particularly online forums, to seek and share experiences, our objective was to understand information needs about cancer treatment, fertility, and pregnancy of women with cancer as well as their caregivers. METHODS We searched threads (original posts and responses) on four subreddit sites of Reddit ("r/Cancer," "r/TryingForABaby," "r/BabyBumps," and "r/Infertility") over a 5-year period between February 4th, 2014 and February 4th, 2019. Threads with original posts involving a lived experience or question regarding cancer treatment and female fertility and/or pregnancy or parenting/having children from the perspective of either patient or caregiver were included in our analysis. We analyzed threads using thematic analysis. RESULTS From 963 Reddit threads identified, 69 were analyzed, including 56 with original posts by women with cancer and 13 with original posts by caregivers. From threads made by patients, we identified themes on becoming a part of an online community, impacts of cancer treatment and fertility concerns on self and social relationships, making family planning decisions, and experiences with medical team. We also identified a theme on the impact of cancer treatment and fertility concerns on caregivers. CONCLUSIONS Reddit provided a rich pool of data for analyzing the information needs of women facing cancer. Our findings demonstrate the far-reaching impacts of cancer treatment and fertility on physical, mental, and psychosocial health for both patients and their caregivers.
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Affiliation(s)
- Ria Garg
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada.,Collaboration for Outcomes Research and Evaluation, University of British Columbia, Vancouver, BC, Canada
| | - Nevena Rebić
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada.,Collaboration for Outcomes Research and Evaluation, University of British Columbia, Vancouver, BC, Canada.,Arthritis Research Canada, Richmond, BC, Canada
| | - Mary A De Vera
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada.,Collaboration for Outcomes Research and Evaluation, University of British Columbia, Vancouver, BC, Canada.,Arthritis Research Canada, Richmond, BC, Canada
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42
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Üzar-Özçeti̇n YS, Dursun Sİ. Quality of life, caregiver burden, and resilience among the family caregivers of cancer survivors. Eur J Oncol Nurs 2020; 48:101832. [DOI: 10.1016/j.ejon.2020.101832] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 08/17/2020] [Accepted: 09/10/2020] [Indexed: 10/23/2022]
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43
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Pereira MG, Vilaça M, Pinheiro M, Ferreira G, Pereira M, Faria S, Monteiro S, Bacalhau R. Quality of life in caregivers of patients with multiple myeloma. Aging Ment Health 2020; 24:1402-1410. [PMID: 31129996 DOI: 10.1080/13607863.2019.1617240] [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: 10/26/2022]
Abstract
Objectives: This study aimed to assess the relationship between sociodemographic, clinical, and psychological variables with quality of life (QoL) and the moderating role of caregivers' age and caregiving duration in caregivers of patients with Multiple Myeloma.Method: The sample included 118 caregivers who completed questionnaires that assessed psychological morbidity, satisfaction with social support, coping, burden, unmet needs, and QoL.Results: High psychological morbidity, burden and information, financial and emotional unmet needs were associated with lower QoL, while higher satisfaction with social support and more effective use of coping strategies were associated with better QoL. Women caregivers reported more satisfaction with social support and those who did not choose to care reported greater financial unmet needs and more use of coping strategies. The relationship between caregivers' psychological morbidity/social support and QoL was mediated by emotional needs and double mediated by coping and burden. The caregivers' age moderated the relationship between psychological morbidity/social support and emotional needs.Conclusion: Interventions to support the caregiver's emotional needs to promote their QoL are needed. These should be particularly tailored for older caregivers reporting greater psychological morbidity and younger caregivers less satisfied with their social support, as they have a negative indirect impact on their QoL.
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Affiliation(s)
- M Graça Pereira
- School of Psychology, University of Minho, Braga, Portugal.,Psychology Research Center (CIPsi), University of Minho, Braga, Portugal
| | - Margarida Vilaça
- School of Psychology, University of Minho, Braga, Portugal.,Psychology Research Center (CIPsi), University of Minho, Braga, Portugal
| | - Marisa Pinheiro
- School of Psychology, University of Minho, Braga, Portugal.,Psychology Research Center (CIPsi), University of Minho, Braga, Portugal
| | - Gabriela Ferreira
- School of Psychology, University of Minho, Braga, Portugal.,Psychology Research Center (CIPsi), University of Minho, Braga, Portugal
| | - Marta Pereira
- School of Psychology, University of Minho, Braga, Portugal.,Psychology Research Center (CIPsi), University of Minho, Braga, Portugal
| | - Sara Faria
- School of Psychology, University of Minho, Braga, Portugal.,Psychology Research Center (CIPsi), University of Minho, Braga, Portugal
| | - Sara Monteiro
- Department of Education and Psychology, University of Aveiro, Aveiro, Portugal.,Center for Health Technologies and Services Research (CINTESIS), University of Porto, Porto, Portugal
| | - Rosário Bacalhau
- School of Psychology, University of Minho, Braga, Portugal.,Portuguese Institute of Oncology Francisco Gentil, Lisboa, Portugal
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44
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Smith T, Fletcher J, Lister S. Lived experiences of informal caregivers of people with chronic musculoskeletal pain: a systematic review and meta-ethnography. Br J Pain 2020; 15:187-198. [PMID: 34055340 DOI: 10.1177/2049463720925110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background People with chronic pain often seek support from friends and family for everyday tasks. These individuals are termed informal caregivers. There remains uncertainty regarding the lived experiences of these people who care for individuals with chronic musculoskeletal pain. The aim of this article is to synthase the evidence on the lived experiences of informal caregivers providing care to people with chronic musculoskeletal pain. Methods A systematic literature review was undertaken of published and unpublished literature databases including EMBASE, MEDLINE, CINAHL, PubMed, the WHO International Clinical Trial Registry and ClinicalTrials.gov registry (to September 2019). Qualitative studies exploring the lived experiences of informal caregivers of people with chronic musculoskeletal pain were included. Data were synthesised using a meta-ethnography approach. Evidence was evaluated using the Critical Appraisal Skills Programme qualitative appraisal tool. Results From 534 citations, 10 studies were eligible (360 participants: 171 informal caregivers of 189 care recipients). The evidence was moderate quality. Seven themes arose: the relationship of caregivers to healthcare professionals; role reversal with care recipients; acting the confidant to the care recipient; a constant burden in caregiving; legitimising care recipient's condition; knowledge and skills to provide caregiving; and the perception of other family members and wider society to the caregiver/care recipient dyad. Conclusion The lived experiences of caregivers of people with chronic musculoskeletal pain is complex and dynamic. There is an inter-connected relationship between caregivers, care recipients and healthcare professionals. Exploring how these experiences can be modified to improve a caregiving dyad's lived experience is now warranted.
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Affiliation(s)
- Toby Smith
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.,Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
| | - Jessica Fletcher
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.,Physiotherapy Department, Connect Health, Milton Keynes, UK
| | - Sarah Lister
- Physiotherapy Department, Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, UK
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45
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Tranberg M, Andersson M, Nilbert M, Rasmussen BH. Co-afflicted but invisible: A qualitative study of perceptions among informal caregivers in cancer care. J Health Psychol 2019; 26:1850-1859. [PMID: 31778077 PMCID: PMC8392770 DOI: 10.1177/1359105319890407] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
This article explores the lived experience of informal caregivers in cancer care, focusing on the perceived burden and needs of individuals seeking support from an informal group for next of kin. A total of 28 individuals who were closely related to a patient with cancer participated in focus group interviews. Three themes were identified: setting aside one's own needs, assuming the role of project manager, and losing one's sense of identity. Together they form the framing theme: being co-afflicted. The characteristics of informal caregivers are shown to be similar to those of people with codependency, motivating development of targeted interventions from this perspective.
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Affiliation(s)
| | | | - Mef Nilbert
- Lund University, Sweden.,Region Skane, Sweden.,Hvidovre Hospital, Denmark.,Danish Cancer Society Research Center, Denmark
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46
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Karvinen KH, Brunet J, Carr LJ. Family history of cancer as a cue to action for physical activity behaviour and beliefs. Psychol Health 2019; 35:933-945. [DOI: 10.1080/08870446.2019.1693570] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Kristina H. Karvinen
- School of Physical and Health Education, Nipissing University, North Bay, ON, Canada
| | - Jennifer Brunet
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
- Institut du Savoir de L’Hôpital Montfort (IRHM), Ottawa, ON, Canada
- Centre for Cancer Therapeutics, Ottawa Hospital Research Institute (OHRI), Ottawa, ON, Canada
| | - Lucas J. Carr
- Department of Health and Human Physiology, University of Iowa, Iowa City, IA, USA
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47
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Saimaldaher ZH, Wazqar DY. Relationships between caregiving stress, mental health and physical health in family caregivers of adult patients with cancer: implications for nursing practice. Scand J Caring Sci 2019; 34:889-898. [DOI: 10.1111/scs.12795] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 09/15/2019] [Accepted: 10/29/2019] [Indexed: 02/06/2023]
Affiliation(s)
- Zahra'a H. Saimaldaher
- Department of Medical Surgical Nursing Faculty of Nursing King Abdulaziz University Jeddah Saudi Arabia
| | - Dhuha Y. Wazqar
- Department of Medical Surgical Nursing Faculty of Nursing King Abdulaziz University Jeddah Saudi Arabia
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48
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Younes Barani Z, Rahnama M, Naderifar M, Badakhsh M, Noorisanchooli H. Experiences of Spouses of Women with Breast Cancer: A Content Analysis. Asian Pac J Cancer Prev 2019; 20:3167-3172. [PMID: 31653169 PMCID: PMC6982647 DOI: 10.31557/apjcp.2019.20.10.3167] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Indexed: 11/25/2022] Open
Abstract
Introduction: In addition to the affected person, diagnosis and treatment of breast cancer also severely affects her husband. Therefore, it is worth paying attention to the needs of husbands of women with breast cancer. Therefore, the aim of the present study was to explain the experiences of spouses of women with breast cancer. Method: The present study was a qualitative study with conventional content analysis approach. Purposive sampling was carried out by selecting 6 spouses of women with breast cancer. Data were collected through semi-structured interview. The recorded interviews were transcribed verbatim. Content analysis was used to reduce and name the data, obtain analytical codes, and finally recognize the theme. Results: Data analysis resulted in the extraction of 4 categories of couples’ mental challenges, multifaceted romantic meditation, multifaceted traumas caused by the disease, dual energies (inductions) of relatives, and 12 subcategories. Conclusion: In spite of suffering from all the challenges and traumas, husbands of women with breast cancer have not left their wives alone and have done their best to improve their lives; so, we can raise ““Scarifying your life to save your wife’s life”” as an extract from the experience of spouses of women with breast cancer. Knowing and understanding this point by clinical staffs and policy makers can provide pave the way for planning to provide comprehensive support to these men.
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Affiliation(s)
- Zeinab Younes Barani
- Student Research Committee, Faculty of Nursing and Midwifery, Zabol University of Medical Sciences, Zabol, Iran
| | - Mozhgan Rahnama
- Faculty of Nursing and Midwifery, Zabol University of Medical Sciences, Zabol, Iran
| | - Mahin Naderifar
- Department of Nursing, Faculty of Nursing and Midwifery, Zabol University of Medical Sciences, Zabol, Iran
| | - Mahin Badakhsh
- Lecturer, Midwifery Department, Faculty of Nursing and Midwifery, Zabol University of Medical Sciences, Zabol, Iran
| | - Hajar Noorisanchooli
- Department of Nursing, Faculty of Nursing and Midwifery, Zabol University of Medical Sciences, Zabol, Iran
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49
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Gibbons SW, Ross A, Wehrlen L, Klagholz S, Bevans M. Enhancing the cancer caregiving experience: Building resilience through role adjustment and mutuality. Eur J Oncol Nurs 2019; 43:101663. [PMID: 31606005 DOI: 10.1016/j.ejon.2019.09.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 08/30/2019] [Accepted: 09/05/2019] [Indexed: 11/18/2022]
Abstract
PURPOSE The purpose of this study was to explore the dyadic experience of caring for a family member with cancer. Particular attention was given to examine the relationship between dyadic perceptions of role adjustment and mutuality as facilitators in resilience for posttreatment cancer patients and family caregivers. METHOD For this convergent parallel, mixed-methods study using grounded theory methodologies, 12 dyads were recruited from the National Institutes of Health Clinical Center in Bethesda, Maryland, USA. Qualitative data collection focused on social interactions between cancer patients and their family caregivers to better understand and describe how post-treatment patients and caregivers create mutuality in their relationships, how they describe the processes of role-adjustment, and how these processes facilitate dyadic resiliency. Quantitative data collected through electronic survey included the Family Caregiving Inventory (FCI) for Mutuality Scale, Neuro QoL Ability to Participate in Social Roles and Activities, and Satisfaction with Social Roles and Activities-Short Forms, and Mental Health Continuum-Short Form (MHC). RESULTS Eleven participants were spouses. Twenty-two self-reported as Caucasian. The sample ranged from 35 to 71 years of age (Caregiver M = 53.7, Patient M = 54.3). Most of the caregivers were female (n = 8; 66.7%) and most of the patients were male (n = 9; 75%). Qualitative interview data illuminated two primary psychosocial processes relating to resilience, role adjustment and mutuality, as key facilitators for transformation and growth within dyadic partnerships coping with the challenges of cancer treatment and cancer caregiving. The FCI-mutuality score for patients (M = 3.65 ± 0.47) and caregivers (M = 3.45 ± 0.42) reflected an average level of relationship quality. Relative to participation in, and satisfaction with social roles and activities, patients (M = 50.66 ± 7.70, M = 48.81 ± 6.64, respectively) and caregivers (M = 50.69 ± 8.6, M = 51.9 ± 8.75, respectively) reported scores that were similar to the US General Population (M = 50 ± 10). CONCLUSIONS New patterns of role adjustment and mutuality can assist with making meaning and finding benefit, and these patterns contribute to dyadic resilience when moving through a cancer experience. There are few interventions that target the function of the dyad, yet the emergent model identified in this paper provides a direction for future dyadic research. By developing interventions at a dyadic level, providers have the potential to encourage dyadic resilience and sustain partnerships from cancer treatment into survivorship.
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Affiliation(s)
- Susanne W Gibbons
- Uniformed Services University of the Health Sciences, Bethesda, MD, 20815, USA.
| | - Alyson Ross
- National Institutes of Health, Clinical Center, Bethesda, MD, 20815, USA.
| | - Leslie Wehrlen
- National Institutes of Health, Clinical Center, Bethesda, MD, 20815, USA.
| | - Stephen Klagholz
- National Institutes of Health, Clinical Center, Bethesda, MD, 20815, USA.
| | - Margaret Bevans
- National Institutes of Health, Clinical Center, Bethesda, MD, 20815, USA.
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50
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Areia NP, Mitchell A, Fonseca G, Major S, Relvas AP. A Visual-Analogue Screening Tool for Assessing Mood and Quality of Daily Life Complications in Family Members of People Living With Cancer: Portuguese Version of the Emotion Thermometers: Burden Version. Eval Health Prof 2019; 43:264-269. [PMID: 31203658 DOI: 10.1177/0163278719857456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Cancer is a disease that impacts not only the patient but also affects the entire family. Family members experience high levels of distress. Therefore, screening for cancer-specific distress among family members of people with cancer is important but relatively unexplored. This cross-sectional study aims to analyze the psychometric properties of a screening tool for family members of people with cancer. We examined the usefulness of the emotional thermometers burden version (ET-BV) in detecting caregiver emotional distress. The ET-BV is a simple multidomain visual analogue scale distributed in two major domains: "emotional upset" and "impact." A total of 364 cancer patients' family members completed the ET-BV and Brief Symptom Inventory. Analyses were aimed to examine the diagnostic accuracy (receiver operating characteristic) of the ET-BV. A fair to good diagnostic accuracy was achieved for ET-BV. For emotional upset thermometers, a cutoff of ≥5 was determined and for impact thermometers, a cutoff of ≥4 was established. ET-BV seems to be a useful, quick, and simple tool for distress screening in family members of people with cancer. A revision of a specific thermometer is discussed in order to increase ET screening performance and clinical utility.
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Affiliation(s)
- Neide P Areia
- Centre for Social Studies, University of Coimbra, Coimbra, Portugal
| | - Alex Mitchell
- Leicester Cancer Research Centre, University of Leicester, Leicester, United Kingdom
| | - Gabriela Fonseca
- Faculty of Psychology and Education Science, University of Coimbra, Coimbra, Portugal
| | - Sofia Major
- Faculty of Social Sciences and Humanities, University of Azores, Ponta Delgada, Portugal
| | - Ana P Relvas
- Faculty of Psychology and Education Science, University of Coimbra, Coimbra, Portugal
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