Patient and caregiver needs in oncology. An Italian survey

Identifying the prevalence of unmet supportive care needs among family caregivers of cancer patients: an Italian investigation on home palliative care setting

PURPOSE

Family caregivers (FCs) are crucial resources in caring for cancer patients at home. The aim of this investigation was (1) to measure the prevalence of unmet needs reported by FCs of cancer patients in home palliative care, and (2) to investigate whether their needs change as their socio-demographic characteristics and the patients' functional abilities change.

METHODS

FCs completed a battery of self-report questionnaires, including the Cancer Caregiving Tasks, Consequences, and Needs (CaTCoN).

RESULTS

Data were collected from 251 FCs (74 men and 177 women, mean age 58.5 ± 14.2 years). Most of the participants experienced a substantial caregiving workload related to practical help (89.8%), provided some or a lot of personal care (73.1%), and psychological support (67.7%) to patients. More than half of the FCs reported that the patient's disease caused them negative physical effects (62.7%). Emotional, psychosocial, and psychological needs were referred. Some FCs reported that the patient's disease caused them a lot of stress (57.3%) and that they did not have enough time for friends/acquaintances (69.5%) and family (55.7%). The need to see a psychologist also emerged (44.0%). Age, caregiving duration, and patients' functional status correlated with FCs' unmet needs. Women reported more negative social, physical, and psychological consequences and a more frequent need to talk to a psychologist.

CONCLUSION

The analysis demonstrated that cancer caregiving is burdensome. The results can guide the development and implementation of tailored programs or support policies so that FCs can provide appropriate care to patients while preserving their own well-being.

Unmet needs and quality of life of caregivers of Korean breast cancer survivors: a cross-sectional study

Purpose

As the survival rates of cancer patients have been increasing due to early diagnosis and technological advances in treatment, their caregiver burden has also emerged as an important issue. In view of this situation, this study aims to investigate the unmet needs and quality of life of caregivers of Korean breast cancer survivors.

Methods

A multicenter cross-sectional interview survey was performed among 160 caregivers of Korean breast cancer survivors. Caregivers who gave written informed consent to participate completed the Comprehensive Needs Assessment Tool for Cancer Caregivers and EuroQol-5 Dimensions.

Results

The mean age of the caregivers was 46.4 years, 44.4% (71 of 160) were spouses of patients, and 52.5% (84 of 160) were personally taking care of cancer survivors. Unmet needs were highest in the ‘healthcare staff’ domain and the item with the highest level of unmet needs was ‘needed information about the current status of the patient's illness and its future courses.’ Poorer quality of life was closely related to higher levels of unmet needs. In multiple regression analysis, older age, employment, the presence of religion, and higher levels of stress and despair in daily life were associated with higher levels of unmet needs.

Conclusion

The most prevalent unmet need in Korean breast cancer caregivers was found in the ‘healthcare staff’ domain, and their quality of life was closely related to unmet needs. Therefore, healthcare staff is required to make efforts to accurately identify breast cancer caregivers vulnerable in terms of unmet needs and address their unmet needs.

A qualitative examination of patient priorities and preferences during treatment decision-making for recurrent head and neck cancer

PURPOSE

Patients with recurrent head and neck cancer (HNC) may feel overwhelmed at the prospect of having to consider treatment options particularly if they recently completed treatment for their primary disease or when they have no options that may lead to long-term survival. The purpose of this study was to examine patient priorities and preferences during treatment decision-making for recurrent HNC.

METHODS

Individuals with newly diagnosed recurrent HNC were recruited at a National Cancer Institute-Designated Cancer Center. Participants were interviewed using a structured interview guide. Descriptive statistics were used to describe participants, and qualitative template analysis was used to analyze interview data.

RESULTS

Participants (n = 38) considered information from healthcare providers, likelihood of treatment success, and other patient-specific factors in making their treatment decisions.

CONCLUSIONS

Although patients with recurrent HNC endorse a myriad of decision-making factors, the recommendation of their healthcare provider and the likelihood of treatment success are of paramount importance. Future research should focus on methods to rapidly identify patient priorities at the time of diagnosed recurrence while respecting patient coping and communication styles.

Assessments for Caregivers of Hospitalized Older Adults

A systematic review was conducted to characterize assessments for caregivers of hospitalized older adults. Electronic literature searches of Medline, PsycINFO, and CINAHL of articles on caregiver assessments published in English between 2006 and present were completed. Thirty-three articles underwent full-text review; four included assessments designed to capture caregiver needs in hospital settings. Original articles on the development of these assessments were reviewed for quality appraisal. Four findings emerged from our review. Existing assessments (a) focus on caregivers of specific conditions of older adults, (b) contain a singular caregiving domain, (c) measure caregiver outcomes or simply describe caregiving experiences, and (d) neglect psychometric properties. Health care providers are limited in their selection of assessments with caregivers of hospitalized older adults. This barrier is problematic if we are to equip caregivers to be successful at providing care to older adults. Future research should develop a hospital assessment for caregivers.

Occupational Class Groups as a Risk Factor for Gastrointestinal Cancer: A Case-Control Study

BACKGROUND

Cancer has a high mortality rate in both developing and developed countries. 11%-15% of cancers are attributable to occupational risk factors.

OBJECTIVE

To determine if specific occupational classes, based on the International Standard for Classification of Occupations 2008 (ISCO-08), are risk factors for gastrointestinal (GI) cancer.

METHODS

In this case-control study, 834 cancer patients were interviewed by a single physician. Cases included patients with GI cancer. Age-matched controls were selected from non-GI cancer patients. Each year of working, up until 5 years before the diagnosis, was questioned and categorized by the ISCO classification.

RESULTS

243 GI cancer cases and 243 non-GI cancer patients (486 in total) were studied. Working in ISCO class 8 (plant and machine operators, and assemblers) was significantly associated with higher risk of GI cancer (OR 1.63, 95% CI 1.05 to 2.52). Working in ISCO class 6 (skilled agricultural, forestry and fishery workers) and 9 (elementary occupations) were also associated with higher incidence of GI cancers.

CONCLUSION

Working in ISCO classes of 8, 6, and 9, which are usually associated with low socio-economic status, can be considered a risk factor for GI cancers.

[Are cancer outpatients ready for e-medicine?]

INTRODUCTION

E-health offers new opportunities for improving cancer outpatients' monitoring. The aim of this study was to assess the level and the use of electronic communication tools owned by cancer outpatients currently undergoing antitumoral treatment.

METHODS

This observational study consecutively recruited patients undergoing treatment at two day hospital oncology units from 1st to 31 October 2015. Each patient completed one standardised, anonymous questionnaire.

RESULTS

Overall, 386 questionnaires were analysed, of which 244 and 142 patients were from each hospital. Of these patients, 73% had access to the Internet either directly or through a third party. More than 90% of the patients owned a mobile phone, and half of them had a smartphone with Internet access. An increasing age and the socioeconomic class level were significantly associated with the use of the Internet and of a smartphone. Half of the patients had accessed websites dedicated to health topics and a quarter had used mobile applications on health topics. One-third of those patients found these electronic tools helpful. After adjustment, an increasing age was significantly associated with a decreased use of such tools. The majority (87%) of the patients enjoyed receiving text message reminders from their hospital about their consultation schedule.

CONCLUSION

Three in four cancer outpatients under treatment have access to the Internet and half use websites dedicated to health topics, with an impact of the age and the socioeconomic class level. Developing e-communication tools between caregivers and patients might be considered to improve their home monitoring.