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Yuen EYN, Hale M, Wilson C. The role of social support among caregivers of people with cancer from Chinese and Arabic communities: a qualitative study. Support Care Cancer 2024; 32:310. [PMID: 38668869 PMCID: PMC11052886 DOI: 10.1007/s00520-024-08502-6] [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: 09/06/2023] [Accepted: 04/13/2024] [Indexed: 04/29/2024]
Abstract
PURPOSE Cancer caregivers from culturally and linguistically diverse (CALD) communities have reported significant unmet emotional support needs. This study aimed explore the role of social support to manage emotional wellbeing among cancer caregivers from Arabic and Chinese communities in Australia. METHODS Semi-structured interviews were conducted with Chinese (n = 12) and Arabic (n = 12) speaking cancer caregivers. Participants' mean age was 40.6 years; majority were female (83%) and providing care to a parent (41.67%). RESULTS Using thematic analysis to analyse interview data, five overarching themes emerged describing caregivers' perspectives on social support. Themes were related to the following: (1) receiving emotional support from social networks, (2) barriers to accessing emotional support from social networks, (3) isolation and loss of connection following the cancer diagnosis, (4) faith as a source of support, and (5) utility of support groups and caregiver advocates. Several caregivers relied on social networks for emotional support; however, caregivers identified key cultural and generational barriers to seeking support from their social networks which prevented caregivers from disclosing their emotions and caregiving situation. Caregivers also reported being isolated from their support system. CONCLUSION Empirical testing of culturally appropriate strategies that improve social support seeking among caregivers from CALD communities is recommended.
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Affiliation(s)
- Eva Y N Yuen
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Melbourne, Australia.
- Centre for Quality and Patient Safety, Monash Health, Melbourne, Australia.
- School of Psychology and Public Health, La Trobe University, Bundoora, VIC, Australia.
- Psycho-Oncology Research Unit, Olivia Newton John Centre, Austin Health, Heidelberg, VIC, Australia.
| | - Megan Hale
- School of Psychology and Public Health, La Trobe University, Bundoora, VIC, Australia
- Psycho-Oncology Research Unit, Olivia Newton John Centre, Austin Health, Heidelberg, VIC, Australia
| | - Carlene Wilson
- School of Psychology and Public Health, La Trobe University, Bundoora, VIC, Australia
- Psycho-Oncology Research Unit, Olivia Newton John Centre, Austin Health, Heidelberg, VIC, Australia
- Centre for Epidemiology and Biostatistics, University of Melbourne, Parkville, VIC, Australia
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Kennedy DP, Friedman EM, Kirkegaard A, Edgington S, Shih R. Perceived loss of support to community caregivers during the COVID-19 pandemic in the United States. JOURNAL OF COMMUNITY PSYCHOLOGY 2024; 52:475-497. [PMID: 38329412 PMCID: PMC10977083 DOI: 10.1002/jcop.23107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 01/08/2024] [Indexed: 02/09/2024]
Abstract
Coronavirus disease (COVID-19) had a negative impact on the health and well-being of community caregivers. Few studies examine the pandemic's negative impact on the availability of social networks of caregivers. This article uses data collected during COVID-19 before vaccination to examine caregivers' reports of perceived lost and reduced network support. We assessed the personal networks of a nationally representative sample of 2214 community caregivers in the United States. We analyzed associations between caregiving factors and caregivers' perceptions of lost and reduced network support. Changes in care recipient living circumstances during COVID-19, longer-term caregiving, care recipient hearing/vision/mobility problems, caregiver travel/socializing restrictions, caregiver race/ethnicity, caregiver income, caregiver age, network connectivity, family relationships, and network members' age were associated with perceived lost/reduced support during the pandemic. Findings provide insights for the development of social network interventions to support caregivers and help them cultivate support networks resilient to public health crises.
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Affiliation(s)
- David P. Kennedy
- RAND Corporation, 1776 Main St., M5S., Santa Monica, CA 90047-2138
| | - Esther M. Friedman
- Institute for Social Research, University of Michigan at Ann Arbor, 426 Thompson St, Ann Arbor, MI 48104
| | | | - Sarah Edgington
- RAND Corporation, 1776 Main St., M5S., Santa Monica, CA 90047-2138
| | - Regina Shih
- RAND Corporation, 1776 Main St., M5S., Santa Monica, CA 90047-2138
- Emory University, 1518 Clifton Rd., Atlanta, GA
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Cloyes KG, Mansfield KJ, Wawrzynski SE, Vega M, Kent-Marvick J, Guo JW. Cancer Survivors' and Care Partners' Audio Diaries on Stress and Social Support Resources During the COVID-19 Pandemic. Semin Oncol Nurs 2024; 40:151623. [PMID: 38538507 PMCID: PMC11045306 DOI: 10.1016/j.soncn.2024.151623] [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: 10/02/2023] [Revised: 02/25/2024] [Accepted: 02/29/2024] [Indexed: 04/28/2024]
Abstract
OBJECTIVES To describe cancer survivors' and care partners' perceived stress and social support during the COVID-19 pandemic and assess the feasibility of audio diaries for assessing role-related needs and resources. METHODS Participants (N = 51; n = 28 survivors, n = 23 care partners) recorded three monthly audio diaries reporting stress and support experiences. Diaries were transcribed and content-analyzed using a hybrid approach. Stress-related content was inductively coded, and social support content was deductively coded by type (instrumental, information, emotional, companionship, appraisal; κ = 0.75) then inductively coded. Descriptive statistics summarized sociodemographic data and compared coding frequencies by role. We developed narrative summaries of stress and support categories and selected quotes for contextual detail. RESULTS Cancer-related stressors were most prevalent (28.8%), followed by work (26.8%), family (23.1%), social isolation (13.4%), and finances (8.0%). While no significant difference in reporting frequency was observed between roles, cancer-related stress was more prevalent for survivors while work-related stress was mentioned more by care partners. Emotional support was the most prevalent support type (32.1%), followed by companionship (25.3%), appraisal (17.9%), instrumental (16.67%), and informational support (8%). Survivors reported more appraisal support than care partners (χ2 = 6.48, df = 1, P = .011) and more support for self-care, while care partners expressed more other-oriented concerns and focused more on managing responsibilities and interactions outside the household. CONCLUSIONS The pandemic complicated and intensified role-based stressors already present in the survivorship context. Our findings highlight the importance of informal social support networks, particularly when access to formal services is limited, and suggest that audio diaries can be an effective tool for assessing support needs and resources. IMPLICATIONS FOR NURSING PRACTICE Nurses and healthcare providers should tailor social support assessments to address the distinct support needs and individual resources of cancer survivors and their care partners. This is especially critical in contexts that limit access to care and formal services.
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Affiliation(s)
- Kristin G Cloyes
- School of Nursing, Oregon Health & Science University, Portland, OR.
| | - Kelly J Mansfield
- College of Nursing, University of Utah College of Nursing, Salt Lake City, UT
| | - Sarah E Wawrzynski
- Center for Healthcare Delivery Science, Nemours Children's Health, Wilmington, DE
| | - Marilisa Vega
- College of Nursing, University of Utah College of Nursing, Salt Lake City, UT
| | | | - Jia-Wen Guo
- College of Nursing, University of Utah College of Nursing, Salt Lake City, UT
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Broadbridge E, Venetis MK, Devine KA, Lee LE, Banerjee SC, Greene K. Supporting the support person: Oncologists' roles in reducing support people's uncertainty and facilitating psychological adjustment. Psychooncology 2024; 33:e6313. [PMID: 38446532 PMCID: PMC11046424 DOI: 10.1002/pon.6313] [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: 10/23/2023] [Revised: 01/29/2024] [Accepted: 02/16/2024] [Indexed: 03/07/2024]
Abstract
OBJECTIVE Support people of cancer patients are at significant risk for psychological distress. Additionally, cancer patients' well-being is reciprocally associated with support peoples' psychological well-being. Informed by Uncertainty in Illness Theory, this study tests whether support person psychological well-being is influenced by provider communication and uncertainty reduction. METHODS We tested a multiple mediation model to investigate how empathic communication facilitates psychological adjustment in support people of cancer patients and how this process is mediated by support peoples' illness uncertainty and caregiver burden. Support people of cancer patients (N = 121; including spouses, adult children, etc.) completed an online questionnaire about their perceptions of oncologists' empathy, uncertainty about the cancer patients' illness, perceived caregiving burden, and their psychological adjustment to diagnoses. RESULTS Path analysis revealed that (1) more perceived oncologist empathy was associated with less illness uncertainty, (2) more illness uncertainty was associated with worse psychological adjustment and more perceived caregiver burden, and (3) more burden was associated with worse adjustment (χ2 (2) = 1.19, p = 0.55; RMSEA < 0.01; CFI = 1.00; SRMR = 0.02). CONCLUSIONS Given the reciprocal nature of well-being between cancer patients and their support people, it is critical to understand and bolster support people's psychological well-being. Results demonstrated how empathic provider communication can support psychological well-being for support people of cancer patients. Additionally, this study offers theoretical contributions to understandings of illness uncertainty in caregiver populations.
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Affiliation(s)
| | - Maria K. Venetis
- Department of Communication, Rutgers University, New Brunswick, New Jersey, USA
| | - Katie A. Devine
- Division of Pediatric Hematology/Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - Lauren E. Lee
- Department of Communication, Rutgers University, New Brunswick, New Jersey, USA
| | - Smita C. Banerjee
- Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Kathryn Greene
- Department of Communication, Rutgers University, New Brunswick, New Jersey, USA
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Zwar L, König HH, Hajek A. Changes in Network Size, Quality, and Composition among Informal Caregivers in Different Welfare Clusters: Longitudinal Analyses Based on a Pan-European Survey (SHARE). Gerontology 2023; 69:1461-1470. [PMID: 37812929 DOI: 10.1159/000534187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 09/07/2023] [Indexed: 10/11/2023] Open
Abstract
INTRODUCTION This study analyzed the association between transitions into informal caregiving, inside and outside their own household, and changes in network size, quality, and composition among older adults (≥50 years) in four different welfare systems in Europe. METHODS Data from waves 4, 6, and 8 of the Survey of Health, Ageing and Retirement in Europe was used and included up to 110,823 participants (aged ≥50 years) from 12 countries. Participants were asked about informal caregiving inside and outside the household and their network size, quality (emotional closeness, contact frequency), and composition (family, friends, men, women). Adjusted linear and Poisson fixed effects regression analyses were conducted. RESULTS Participants transitioning into any caregiving (inside or outside the household) had a larger network. More women and family members were found among all those transitioning into caregiving, but only outside caregiving was associated with more men and friends in the network. Transitioning into caregiving outside was associated with reduced network closeness and contact. Changes among caregivers outside were similar in all welfare states but were more pronounced among caregivers inside the household of Eastern Europe. CONCLUSION Different patterns of changes in network size, quality, and composition were found among adults transitioning into caregiving inside and outside the household. All parameters changed among caregivers outside the household. However, the welfare system played a key role in the network changes among inside household caregivers. Thus, the micro as well as the macro context of caregiving is important for the support network of informal caregivers.
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Affiliation(s)
- Larissa Zwar
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Reblin M, Tay DL, Iacob E, Cloyes KG, Hebdon MCT, Ellington L. Hospice Caregivers' Perception of Family and Non-Family Social Support and Stress over Time: Associations with Reports of General Support. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5009. [PMID: 36981917 PMCID: PMC10049686 DOI: 10.3390/ijerph20065009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 03/09/2023] [Accepted: 03/10/2023] [Indexed: 06/18/2023]
Abstract
Social support has been identified as a key factor to protect wellbeing for home hospice cancer caregivers. However, few studies have assessed social support over time in this context, and measures of support are often limited to general assessments of perceived support. Our goal was to (1) describe change in cancer home hospice caregivers' social support over time during care and into bereavement and (2) explore the impact of perceived stress and support from family and non-family members on caregivers' perceived general social support. We conducted a secondary analysis of longitudinal prospective questionnaire data. Forty caregivers completed measures of general perceived support, family and non-family support and stress during hospice enrollment and 2 and 6 months post the patient's death. Linear mixed models were used to determine change in support over time and the contribution of specific support/stress ratings to general support assessments. Caregivers overall had moderate and stable levels of social support over time, though there was significant variation between and within individuals. Family and non-family support and stress from family predicted general perceptions of social support, while no effects were found for non-family stress. This work suggests a need for more specific measures of support and stress, and the need for research to focus on improving baseline levels of caregiver perceived support.
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Affiliation(s)
- Maija Reblin
- Department of Family Medicine, Larner College of Medicine, University of Vermont, Burlington, VT 05405, USA
| | - Djin L. Tay
- College of Nursing, University of Utah, Salt Lake City, UT 84112, USA
| | - Eli Iacob
- College of Nursing, University of Utah, Salt Lake City, UT 84112, USA
| | - Kristin G. Cloyes
- School of Nursing, Oregon Health & Sciences University, Portland, OR 97239, USA
| | | | - Lee Ellington
- College of Nursing, University of Utah, Salt Lake City, UT 84112, USA
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