Systematic review on factors associated with self-perceived burden among cancer patients

Nutrition Security During Cancer: A Qualitative Investigation Among Patients With Cancer on Active Treatment From an Area of Persistent Poverty

OBJECTIVE

The objective of this paper was to qualitatively explore the eating habits and experience of nutrition security during cancer treatment among patients from an area of persistent poverty being treated in a safety net hospital oncology program.

METHODS

Eleven in-depth interviews were conducted with current individuals with cancer who were (1) undergoing active cancer treatment at LBJ Hospital, (2) over 18 years old, (3) English speaking, and (4) residing in an Acres Homes zip code. Reflexive thematic analysis was undertaken by four members of the study team, which brought together diverse expertise in health disparities, nutrition, food culture, and health communication.

RESULTS

Four main themes emerged from the data, including (1) food beliefs and eating behaviors in the context of cancer, (2) social and economic influences on food selection, procurement, and preparation, (3) lived experience of resiliency and coping with limited resources, and (4) the role of relationships (including social support, family, medical teams) in diet and food choice.

CONCLUSION

Findings from this study begin to fill a gap in knowledge regarding the complexities of managing nutritional needs among patients residing in an area of persistent poverty, which can inform the development of future health systems and community-based resources for those negotiating both cancer and chronically limited resources.

Association between psychological flexibility and self-perceived burden in patients with cervical cancer: A computer-simulated network analysis

PURPOSE

The study aimed to identify the profiles of psychological flexibility in patients with cervical cancer and how self-perceived burden networked to different psychological flexibility profiles.

METHODS

The Personalized Psychological Flexibility Index and the Self-Perceived Burden for Cancer Patients were used to measure psychological flexibility and self-perceived burden in patients from the "Be Resilient to Cancer" project. Latent profile analysis was used to identify profiles and computer-simulated network analysis was conducted to determine if self-perceived burden networked to any of the psychological flexibility profiles.

RESULTS

A total of 325 patients with cervical cancer were recruited in this study. Mean age was 42.26 years, the majority were married (71%) and 75.4% had early stage disease (I or II). Three profiles of psychological flexibility were identified: moderate avoidance-low acceptance/harnessing (34.8%), high avoidance-moderate acceptance/harnessing (36.9%), low avoidance and high acceptance/harnessing (28.3%). Furthermore, "worrying about damaging family relationships" and "feeling guilty about affecting family's life plans" were the most bridge symptoms as well as the targeted intervention symptoms for alleviating and aggravating the self-perceived burden respectively.

CONCLUSION

Three patterns of psychological flexibility were recognized with two symptoms might be targeted to improve the self-perceived burden in women with cervical cancer.

Relationship Between Perceived and Received Social Support in Family Caregivers: A Systematic Review with Meta-Analysis

Background: The care of dependent people is eminently family-oriented, and often, there is a high level of dedication to this family care. Constant and continuous care leads to a series of negative psychological consequences. Social support has been related to improved mental health in family caregivers. We found heterogeneous results regarding the relationship between the types of social support received and the perceived level of support. In addition, to our knowledge, no reviews analyse this relationship among family caregivers. Objectives: Therefore, we objective to systematically synthesise the relationships between perceived and received social support in informal caregivers. Methodology: We have carried out a quantitative systematic review with a meta-analysis, registered in PROSPERO (id: CRD42023470047); the systematic search was carried out in the following databases: PubMed, CINAHL, PsycINFO, and Scopus, until November 2023. After the selection and review of the results, twelve studies were obtained, two of which were eliminated due to a high risk of classification bias. Results: Regarding the results, a medium-size positive statistical association was found (r = 0.43). The results were consistent, accurate, and robust. The Trim and Fill test showed a variation of 7%. Subgroup analysis indicated no differences in the age group of the people cared for (adults or children), selection bias, and confounding bias. Conclusions: In conclusions, perceived social support is related to more social support received by family caregivers.

Existential distress and associated factors in advanced cancer patients: A cross-sectional study

BACKGROUND

Advanced cancer patients often experience existential distress (ED). However, the factors associated with ED remain unclear. This study investigated the current state of ED and identified the associated factors in Chinese patients with advanced cancer.

METHODS

A cross-sectional study was conducted among 352 advanced cancer patients from 3 tertiary hospitals in Fujian, China. Participants were invited to complete the Existential Distress Scale, Number Rating Scale, Self-Perceived Burden Scale, Quality of Life Concerns in the End-of-Life Questionnaire, and Hospital Anxiety and Depression Scale.

OBJECTIVES

This study aimed to investigate the level of existential distress among advanced cancer patients in China and identify the associated factors.

RESULTS

A total of 352 advanced cancer patients were recruited for this study. The average score for ED was 8.48 ± 7.12 among the advanced cancer patients. Multiple regression showed that the associated factors included depression (β = 0.32, p = 0.000), self-perceived burden (SPB) (β = 0.18, p = 0.001), the presence of a spouse (β = -0.10, p = 0.050), and reception of government subsidies (β = 0.17, p = 0.001). The factors accounted for 30.1% of the total variance in ED (F = 8.472, p < 0.001).

SIGNIFICANCE OF RESULTS

Among the advanced cancer patients queried, ED was found to be positively influenced by depression, SPB, and reception of government subsidies and negatively influenced by the presence of a spouse. Depression was the most important risk factor, and thus future ED interventions should target depression.

The Relationship Between Facilitation of Patient Involvement and Self-Perceived Burden in Postoperative Lung Cancer Patients: The Mediating Role of Social Support

Aim

Patients with lung cancer often experience a high level of self-perceived burden, which significantly affects their quality of life and psychological health. Social support is closely related to the self-perceived burden, yet there is scant research on the relationship between social support, facilitation of patient involvement, and self-perceived burden. This study aims to understand the current situation of self-perceived burden in postoperative lung cancer patients and to explore the mediating role of social support between facilitation of patient involvement and self-perceived burden.

Methods

A cross-sectional design was used in this study. Using a convenience sampling method, a total of 331 lung cancer patients who were hospitalized for surgical treatment at a tertiary cancer hospital in Beijing, China, from August 2022 to May 2023, were selected to participate in this survey. The survey included a self-designed sociodemographic questionnaire, the Facilitation of Patient Involvement Scale (FPIS), the Perceived Social Support Scale (PSSS), and the Self-Perceived Burden Scale (SPBS). Data were analyzed using SPSS 24.0 for statistical description and Pearson correlation analysis, while AMOS 24.0 was utilized to construct a structural equation model to examine the mediation effect.

Results

The score of self-perceived burden in lung cancer patients was 26.42 ±8.23 points. Bot facilitation of patient involvement and social support was negatively correlated with self-perceived burden (r = -0.313, r = -0.332, P < 0.001). Social support plays a partially mediated role in the relationship between facilitation of patient involvement and self-perceived burden, accounting for 44.3% of the total effect.

Conclusion

The self-perceived burden of patients after lung cancer surgery was at a moderate level, and social support partially mediates the relationship between facilitation of patient involvement and self-perceived burden. Medical staff should encourage patient participation in their own treatment decisions and alleviate the burden associated with lung cancer and surgical treatment by enhancing their social support.

Nature and Determinants of Fear of Cancer Recurrence After Endoscopic Submucosal Dissection for Early Gastric Cancer: A Cross-Sectional Study

Gastric cancer is one of the most prevalent tumors in China and other countries, with high morbidity and mortality. Fear of cancer recurrence is common among cancer survivors. Fear of cancer recurrence experiences and psychological interventions have been investigated in breast and other cancers. However, this phenomenon and associated factors have not been evaluated in early gastric cancer survivors in China. The objective of this study was to investigate the nature of fear of cancer recurrence and influencing factors in Chinese patients with early gastric cancer treated with endoscopic submucosal dissection. This cross-sectional study in two centers included 312 early gastric cancer patients who answered self-report questionnaires and were treated with endoscopic submucosal dissection between June 2022 and May 2023 to assess fear of cancer recurrence. Gender, family history of gastrointestinal tumor, tumor recurrence, Helicobacter pylori infection, disease perception, and self-perceived burden were significant factors influencing fear of cancer recurrence (p < .05). More than half of early gastric cancer patients have fear of cancer recurrence, and how to deal with it has become a key issue in the postoperative care of patients. Medical professionals should address these factors to reduce fear of cancer recurrence in at-risk patients.

Self-Efficacy's Mediating Role in the Relationship Between Self-Perceived Burden and Health-Related Quality of Life Among Older-Adult Inpatients in China: A Cross-Sectional Study

Purpose

This study investigated the current state of self-efficacy and the association between self-perceived burden (SPB) and health-related quality of life (HRQoL) among Chinese older-adult inpatients.

Methods

A cross-sectional study was conducted using convenience sampling to survey Chinese older-adult inpatients. Data regarding demographic characteristics, self-efficacy, SPB, and HRQoL were collected. Pearson's correlation analysis was used to examine the correlations among the research variables. SPSS® Statistics V26.0, and SPSS® PROCESS Macro Model 4 were used to analyze the available data. The bootstrap method was used to analyze the mediating role of self-efficacy.

Results

Survey participants included 514 older-adult inpatients, with a mean age of 72.28±5.58 years. Self-efficacy (r=0.471, p<0.01) was positively correlated with HRQoL, whereas self-efficacy (r=-0.891, p<0.01) and HRQoL (r=-0.516, p<0.01) were negatively correlated with SPB. The mediating effect analysis revealed that self-efficacy either completely or partially mediated the effect of SPB on HRQoL, with the indirect effect accounting for 30.2% of the total.

Conclusion

This study provides a mediating model suggesting that SPB exerts both direct and indirect effects on the HRQoL of older-adult inpatients through self-efficacy.

Association of explicit and implicit social support with psychological adjustment in Chinese women with breast cancer: An interpersonal explanation

This study aimed to examine the linear and non-linear relationship between explicit and implicit social support and psychological adjustment as well as the underlying interpersonal mechanisms in a sample of Chinese women with breast cancer (n = 202). The results showed that explicit social support was associated with poorer psychological adjustment, while implicit social support exhibited the opposite trend. Moreover, the association between implicit social support and psychological adjustment was stronger at lower levels of implicit social support, but it weakened or disappeared at moderate or higher levels. Furthermore, we found that all the associations between social support and psychological adjustment could be explained by relationship concerns and perceived burdensomeness. These findings emphasize the importance of providing social support and supportive care to patients who have unmet supportive care needs, in line with cultural norms and expectations.

Exploring the determinants influencing suicidal ideation and depression in gastrointestinal cancer patients

Studies have shown a heightened prevalence of depression and suicidal ideation among patients with Gastrointestinal Cancer (GIC). GIC patients are at a 1.5- to threefold increased risk of suicide and depression compared to other cancer patients. This study investigates the interplay of internet use, family burden, and emotional support on mental health (depression) and suicidal ideation among patients with GIC. The study involves 202 respondents of which 78 were undergoing GIC treatment during this study. Using structural equation modeling, our findings indicate a substantial negative correlation between mental health and suicidal ideation. Overall, suicidal ideation (median score) was noticeably lower in patient who completed their treatment with noticeable individuals with exceptionally high SI even after completing the treatment. Notably, participants who had completed their treatment demonstrated a significantly stronger correlation between emotional support and mental health compared to those who were still undergoing treatment. Age was found to moderate the mental health-suicidal ideation link significantly. Internet usage for health-related information was also inversely correlated with mental health (directly) and suicidal ideation (indirectly). We noted that the influence of emotional support on mental health was significantly higher among individuals who completed their treatment compared to those who were undergoing their GIC treatment. Family burden emerged as significant negative influences on mental health, while emotional support positively impacted mental health. The findings of this study contribute towards a deeper understanding of suicide risk factors in GIC patients, potentially shaping more effective preventive strategies.

The Mediating Role of Self-Perceived Burden Between Social Support and Fear of Progression in Renal Transplant Recipients: A Multicenter Cross-Sectional Study

Purpose

To explore the mechanism of social support and fear of progression (FoP) in renal transplant recipients (RTRs) and the self-perceived burden that acts as a mediator between social support and FoP.

Patients and Methods

Sociodemographic and clinical characteristics, the Social Support Rating Scale (SSRS), the Self-Perceived Burden Scale (SPBS), and the Fear of Progression-Questionnaire-Short Form (FoP-Q-SF) were used. Structural equation modeling (SEM) was used to examine the mediating role of self-perceived burden.

Results

Our results showed that social support was negatively related to the self-perceived burden (r = -0.28, p < 0.001) and FoP (r = -0.37, p < 0.001). Moreover, we determined that self-perceived burden was positively related to FoP (r = 0.58, p < 0.001) and that the indirect effect of social support on FoP via self-perceived burden was significant (β = -0.172, 95% CI: -0.253, -0.097), and with a mediating effect value of 36.9%.

Conclusion

The FoP in RTRs is a concern. Higher social support and lower self-perceived burden can reduce the risk of FoP. Healthcare professionals (HCPs) should assist RTRs in correctly evaluating an individual's social support system, helping them optimize social support to reduce the self-perceived burden and the development of FoP.

Revision of the Advanced Cancer Patients' Distress Scale (ACPDS): a mixed-methods study among palliative patients and healthcare professionals in Germany

OBJECTIVES

To revise the 37-item Advanced Cancer Patients' Distress Scale (ACPDS) regarding its content, comprehensibility, applicability, and relevance by healthcare professionals (HCPs) and patients in order to enhance an existing instrument that is appropriate for the needs of patients with advanced cancer admitted to palliative care.

DESIGN

A preliminary revision of items regarding psychometric indices and relevance to initially shorten the scale, complemented by cognitive interviews with patients combining think-aloud and verbal-probe techniques and an HCP focus group on the detected remaining items. Interviews and the focus group were audio-recorded, transcribed verbatim and analysed using MAXQDA.

SETTING

The study took place at a German palliative care unit.

PARTICIPANTS

10 patients were interviewed (50% female) and 6 HCPs (3 physicians, 2 nurses and 1 psychologist) participated in the focus group.

OUTCOME MEASURES

Comprehensibility, applicability, and relevance of the ACPDS were evaluated.

RESULTS

Based on the psychometric revision, a reduced number of 17 items was discussed by the HCP focus group and within cognitive interviews with patients. For the rest of the analysis of the HCP focus group and the patient interview data, the introduction of the ACPDS was simplified and adapted to everyday language. As recommended by HCPs and patients, the example question was replaced. Nine items were reworded to boost clarity, openness, redundancy and mitigation. Three items were eliminated, and another three items were added.

CONCLUSION

With this revised 17-item version of the ACPDS, we constructed an instrument that seems to be appropriate for the needs of patients with advanced cancer in a palliative care setting. In the next step, the shortened scale will be tested on psychometric data and validated by a large sample of inpatients on palliative care suffering from advanced cancer.

TRIAL REGISTRATION NUMBER

DRKS ID: DRKS00022425.