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Rezaei M, Keyvanloo Shahrestanaki S, Mohammadzadeh R, Aghili MS, Rajabi M, Abbasi M, Khachian A, Momen R, Khavassi M, Aghaei S. Caregiving consequences in cancer family caregivers: a narrative review of qualitative studies. Front Public Health 2024; 12:1334842. [PMID: 38584929 PMCID: PMC10997218 DOI: 10.3389/fpubh.2024.1334842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 03/11/2024] [Indexed: 04/09/2024] Open
Abstract
Background Cancer is a significant public health issue, causing various challenges for individuals affected by it. As cancer progresses, patients often become dependent on others for support. Family caregivers and members play a crucial role in the recovery and rehabilitation of these patients. However, caregivers themselves face numerous challenges throughout the course of their family member's illness. Exploring the experiences of family caregivers can inform long-term planning and supportive interventions to address their caregiving difficulties. This study reviews previous literature on caregiving outcomes. Method This study presents a narrative review of qualitative studies, analyzing a total of 23 articles. The results were extracted and organized into subcategories. After revision by the research team, main categories were identified. These categories encompass both positive and negative outcomes of caregiving. Results The findings of this review demonstrate that caring for a family member with cancer has significant implications for caregivers. These implications include: (A) Positive outcomes of caregiving (such as achieving self-management and balance, promoting kinship intimacy, finding meaning and purpose, and experiencing spiritual growth) and (B) Negative outcomes of caregiving (including care-related physical exhaustion, disruption of personal life plans, psycho-emotional consequences, and socio-economic burden). Conclusion The results of this study highlight the challenges faced by family caregivers and emphasize the importance of addressing their needs within the healthcare system. By providing support and attention to their well-being, caregivers can enhance their resilience and adaptability in managing caregiving difficulties.
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Affiliation(s)
- Masoud Rezaei
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
- Cardiovascular Nursing Research Center, Rajaie Cardiovascular Medical and Research Center, Tehran, Iran
| | - Sahar Keyvanloo Shahrestanaki
- Department of Community Health Nursing and Geriatric Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mohammad Sadegh Aghili
- Department of Gerontological Nursing, School of Nursing, Abadan University of Medical Sciences, Abadan, Iran
| | - MohammadReza Rajabi
- Department of Cardiology, School of Medicine, Shahed University, Tehran, Iran
| | - Mohammad Abbasi
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Alice Khachian
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Momen
- Department of Critical Care Nursing, School of Nursing, Aja University of Medical Sciences, Tehran, Iran
| | - Mohammad Khavassi
- School of Nursing and Midwifery, Dezful University of Medical Sciences, Dezful, Iran
| | - Simin Aghaei
- Department of Pediatrics, Yasuj University of Medical Sciences, Yasuj, Iran
- Department of Nursing, School of Nursing, Yasuj University of Medical Sciences, Yasuj, Iran
- Student Research Committee, Yasuj University of Medical Sciences, Yasuj, Iran
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Nikbakht Nasrabadi A, Pahlevan Sharif S, Allen KA, Naghavi N, Sharif Nia H, Salisu WJ, Yaghoobzadeh A. The role of socioeconomic status in the relationship between social support and burden among cancer caregivers. Eur J Cancer Prev 2022; 31:198-203. [PMID: 33899748 DOI: 10.1097/cej.0000000000000683] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
While much research has focused on the direct impact of socioeconomic status on cancer patients, what is not clear is the impact of socioeconomic status on social support and the burden of care for caregivers. In this study, a cross-sectional method, using a convenience sampling approach, was adopted to collect the data of 191 caregivers of cancer patients who were referred to the oncology clinic and cancer institute of hospitals affiliated with Tehran University of Medical Sciences, Iran. The participants completed a questionnaire on basic demographics, the short version of the Burden Scale for Family Caregivers, and Zimet Multidimensional Perceived Social Support. A maximum likelihood exploratory factor analysis with oblique rotation to assess the factor structure of the constructs and the measurement model was conducted. The two-factor model consisting of 22 items explained 65.116% of the variance. There was a significant negative relationship between social support and burden (b = -0.771, P < 0.001) and also between economic status and burden (b = -0.308, P < 0.01). Moreover, there was a significant positive association between the interaction of social support and economic status and burden (b = 0.138, P < 0.05). More specifically, the negative relationship between social support and burden was statistically stronger for participants with weak economic status (b = -0.663, P < 0.001) than those with good economic status (b = -0.356, P < 0.01). Social support and an individual's economic status are essential determinants of caregiver burden. Further studies are recommended to better inform the precise support needed by caregivers to enhance their quality of life, and ultimately, that of the patients under their care.
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Affiliation(s)
| | - Saeed Pahlevan Sharif
- Faculty of Business & Law, Taylor's University
- Centre for Industrial Revolution and Innovation (CIR4I), Taylor's University, Selangor, Malaysia
| | - Kelly A Allen
- Faculty of Education, Monash University and Centre for Positive Psychology, University of Melbourne, Melbourne, Australia
| | - Navaz Naghavi
- Faculty of Business & Law, Taylor's University
- Centre for Industrial Revolution and Innovation (CIR4I), Taylor's University, Selangor, Malaysia
| | - Hamid Sharif Nia
- School of Nursing and Midwifery Amol, Mazandaran University of Medical Sciences, Sari
| | - Waliu Jawula Salisu
- School of Nursing and Midwifery, Department of Medical-Surgical Nursing, Tehran University of Medical Sciences, Tehran
| | - Ameneh Yaghoobzadeh
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
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"You begin to give more value in life, in minutes, in seconds": spiritual and existential experiences of family caregivers of patients with advanced cancer receiving end-of-life care in Brazil. Support Care Cancer 2021; 30:2631-2638. [PMID: 34817692 PMCID: PMC8611251 DOI: 10.1007/s00520-021-06712-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 11/18/2021] [Indexed: 11/18/2022]
Abstract
Purpose Facing the end of life may trigger significant distress in family caregivers of patients with advanced cancer. However, few studies have addressed the spiritual and existential concerns of these family caregivers in their end-of-life care journey. This study aimed to understand the spiritual and existential experience of family caregivers of patients with advanced cancer facing the end of life in Brazil. Methods A purposive sample of 16 family caregivers of hospitalized terminally ill cancer patients in Brazil participated in in-depth interviews. Data collection and analysis were based on interpretative phenomenological analysis. Results Three superordinate themes in their spiritual and existential experience were identified: (i) connectedness through caregiving, personal relationships, and spiritual beliefs; (ii) shifting hope: from death as a possibility to preparation for impending death; (iii) reframing suffering and meaning. For these caregivers, the relationship with the patient and with others, their spiritual beliefs, and hope were significant sources of meaning. Hope was sustained by death avoidance, oscillating with death acceptance and hope that it would occur with comfort. Family caregivers also experienced existential and spiritual suffering in the form of guilt, suppressed emotions, and loneliness. Conclusion Health care providers should address and support caregivers’ spiritual needs and their relationships with the patient and others during end-of-life care and facilitate reflection regarding existential concerns, meaning, and preparation for impending death.
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Informal caregivers of older Muslims diagnosed with cancer: A portrait of depression, social support, and faith. Palliat Support Care 2021; 19:598-604. [PMID: 34676809 DOI: 10.1017/s147895152100081x] [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: 12/15/2022]
Abstract
OBJECTIVE Islamic population constitute more than 20% of the world population and is growing rapidly. Nevertheless, data concerning informal caregiving to older Muslim patients diagnosed with cancer are scarce. Improving the well-being of caregivers is a vital step to optimal care for the patients themselves throughout the Muslim community and the world. This study focuses on a sample of Palestinian caregivers of older Muslim patients diagnosed with cancer living in East Jerusalem, the West Bank, and Gaza. The study aims to describe the socio-demographic characteristics of the caregivers and to understand their social support, and identify predictors of caregivers' depression. METHODS A cross-sectional study of a convenience sample of 99 dyads of Palestinian patients (age ≥65) and their informal caregivers. Depression and social support were measured using the five items of the Geriatric Depression Scale and the Cancer Perceived Agents of Social Support questionnaire. RESULTS Caregivers were most frequently adult children (52%) or spouses (32%), with male patients cared for by spouses (47.5%) or sons (32%), and female patients by daughters (50%). Clinical levels of depression were reported by 76% of the caregivers and 85% of patients. The significant predictors of caregiver depression were female gender, lower education, lower perceived social support from spouse and family, and higher perceived support from faith. SIGNIFICANCE OF RESULTS Healthcare providers serving the study population should determine the position and role of the caregiver within the social and family structure surrounding the patients' families. This understanding may facilitate overcoming barriers to effective and meaningful social support.
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Feelings of Shame and Guilt in Patients with Cancer and Their Family Caregivers. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2021. [DOI: 10.5812/ijcm.117159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Benites AC, Rodin G, Leite ACAB, Nascimento LC, Dos Santos MA. 'The experience of spirituality in family caregivers of adult and elderly cancer patients receiving palliative care: A meta-synthesis'. Eur J Cancer Care (Engl) 2021; 30:e13424. [PMID: 33547680 DOI: 10.1111/ecc.13424] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 11/27/2020] [Accepted: 01/11/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Spirituality is a multidimensional aspect of human experience. In the context of palliative care, it is an individual resource that can be used to cope with illness and to assign new meanings to suffering. Qualitative studies that aim to investigate the experience of spirituality and the needs of family caregivers in this context are rare. OBJECTIVE This meta-synthesis aimed to synthesise qualitative studies on the experience of spirituality in family caregivers of adult and elderly cancer patients receiving palliative care. METHODS A systematic review was performed in six databases, and 14 studies were included in this meta-synthesis. RESULTS The results are presented as a thematic synthesis divided into two analytical themes: (1) The interweaving of spirituality with end-of-life care and (2) The dimensions of suffering and spirituality in the dying process of the loved one. Each analytical theme is explained by two descriptive themes. The results showed that family caregivers express their spirituality in a multidimensional way, giving meaning to the care provided and reassessing the meanings of their lives and their suffering. CONCLUSION Investigating the suffering and spiritual needs of family members in this context may be of value to inform comprehensive and multi-professional psychosocial care.
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Affiliation(s)
- Andrea Carolina Benites
- Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Departamento de Psicologia, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil.,Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Global Institute of Psychosocial, Palliative and End-of-Life Care (GIPPEC), University of Toronto, Toronto, Ontario, Canada
| | - Gary Rodin
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Global Institute of Psychosocial, Palliative and End-of-Life Care (GIPPEC), University of Toronto, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Ana Carolina Andrade Biaggi Leite
- Escola de Enfermagem de Ribeirão Preto, WHO Collaborating Centre for Nursing Research Development, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Lucila Castanheira Nascimento
- Escola de Enfermagem de Ribeirão Preto, WHO Collaborating Centre for Nursing Research Development, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Manoel Antônio Dos Santos
- Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Departamento de Psicologia, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil
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Abdullah R, Guo P, Harding R. Preferences and Experiences of Muslim Patients and Their Families in Muslim-Majority Countries for End-of-Life Care: A Systematic Review and Thematic Analysis. J Pain Symptom Manage 2020; 60:1223-1238.e4. [PMID: 32659320 DOI: 10.1016/j.jpainsymman.2020.06.032] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 05/26/2020] [Accepted: 06/19/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Care for people with progressive illness should be person centered and account for their cultural values and spiritual beliefs. There are an estimated 1.7 billion Muslims worldwide, largely living in low-income and middle-income countries. AIMS This study aimed to identify, appraise, and integrate the evidence for the experiences and preferences of Muslim patients and/or families for end-of-life care in Muslim-majority countries. DESIGN Systematic review. DATA SOURCES PsychINFO, MEDLINE, Embase, Global Health, CINAHL, Cochrane Library and Registry of Clinical Trials, PubMed, Applied Social Sciences Index and Abstracts (ASSIA), Social Services Abstracts, Sociological Abstracts, Social Policy & Practice, and Scopus were searched until December 2018. Handsearching was performed, and gray literature was included. Qualitative studies analyzed using thematic analysis and quantitative component provided triangulation. RESULTS The initial search yielded n = 5098 articles, of which n = 30 met the inclusion criteria. A total of 5342 participants (4345 patients; 81.3%) were included; 97.6% had advanced cancer. Most (n = 22) studies were quantitative. Three themes and subthemes from qualitative studies were identified using thematic analysis: selflessness (burden to others and caregiver responsibilities), ambivalence (hope and hopelessness), and strong beliefs in Islam (beliefs in death and afterlife and closeness to Allah). Qualitative studies reported triangulation; demonstrating conflicts in diagnosis disclosure and total pain burden experienced by both patients and families. CONCLUSION Despite the scarce evidence of relatively low quality, the analysis revealed core themes. To achieve palliative care for all in line with the total pain model, beliefs must be identified and understood in relation to decision-making processes and practices.
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Affiliation(s)
- Rafidah Abdullah
- Hospital Sultan Haji Ahmad Shah, Ministry of Health, Temerloh, Malaysia.
| | - Ping Guo
- University of Birmingham, Cicely Saunders Institute, Kings College London, London United Kingdom
| | - Richard Harding
- Cicely Saunders Institute, Kings College London, London, United Kingdom
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Liu Z, Heffernan C, Tan J. Caregiver burden: A concept analysis. Int J Nurs Sci 2020; 7:438-445. [PMID: 33195757 PMCID: PMC7644552 DOI: 10.1016/j.ijnss.2020.07.012] [Citation(s) in RCA: 179] [Impact Index Per Article: 44.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 06/29/2020] [Accepted: 07/21/2020] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVE Caregiver burden is used frequently within the nursing literature. It has not yet been clearly defined as there are different opinions regarding this concept. The purpose of this paper is to provide clarity surrounding the concept caregiver burden. METHODS An electronic search of MEDLINE, CINAHL, Health Source Nursing/Academic Edition and Academic Search Complete (ASC) of EBSCO, China National Knowledge Infrastructure (CNKI) and Google Scholar were searched with a limit of 10 years and published in the English or Chinese language. The paper adopted the framework by Walker and Avant. The attributes, antecedents, consequences and uses of the concept were identified. RESULTS At total of 33 articles were included. The three attributes of caregiver burden were identified as self-perception, multifaceted strain, and over time. The antecedents included insufficient financial resources, multiple responsibility conflict, lack of social activities. The consequences of caregiver burden resulted in negative change which included decreased care provision, decrease in quality of life, physical and psychological health deterioration. CONCLUSION A definition of caregiver burden was developed. Tools to measure caregiver burden were identified. The findings from this analysis can be used in nursing practice, nursing education, research and administration.
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Affiliation(s)
- Zhu Liu
- Department of Hepatobiliary Surgery, The People’s Hospital of Deyang City, Deyang, Sichuan, China
| | - Catrina Heffernan
- Department of Nursing and Healthcare Sciences, Institute of Technology Tralee, Co. Kerry, Ireland
| | - Jie Tan
- Department of Hepatobiliary Surgery, The People’s Hospital of Deyang City, Deyang, Sichuan, China
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