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Yang Y, He F, Li D, Zhao Y, Wang Y, Zhang H, Qiao C, Cui Y, Lin L, Guan H. Effect of family resilience on subjective well-being in patients with advanced cancer: the chain mediating role of perceived social support and psychological resilience. Front Psychol 2024; 14:1222792. [PMID: 38638678 PMCID: PMC11024269 DOI: 10.3389/fpsyg.2023.1222792] [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: 05/15/2023] [Accepted: 12/04/2023] [Indexed: 04/20/2024] Open
Abstract
Purposes Domestic and international research has found that patients with advanced cancer prioritize increasing their quality of life above extending their lives with simple or intensive treatments. The current study investigates the pathways to improve patients' sense of well-being from the family, social, and individual levels, that is to say, it investigates the mediating roles of comprehending social support as well as psychological resilience in the relationship between family resilience and subjective well-being, and it also provides references for future intervention. Method The Family Resilience Questionnaire (FRQ), General Well-being Schedule (GWB), Perceived Social Support Scale (PSSS), and the Chinese version of the Cornor-Davidson Resilience Scale 10-item (CD-RISC) were all completed by 338 patients with advanced cancer who took part in the study. Results The study's findings demonstrated a significant and positive correlation between family resilience, subjective well-being, perceived social support, and psychological resilience. Additionally, there was a significant direct effect of family resilience on subjective well-being as well as a mediating and chain mediating effect between perceived social support and psychological resilience. The findings of this study will be very helpful in the future when it comes to enhancing the quality of life for patients with advanced cancer through intervention. Conclusion Subjective well-being can be influenced directly by the family resilience of advanced cancer patients, or indirectly through the psychological resilience and perceived social support.
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Affiliation(s)
- Yating Yang
- School of Public Administration (School of Emergency Management), Northwest University, Xi’an, Shaanxi, China
| | - Fei He
- School of Public Administration (School of Emergency Management), Northwest University, Xi’an, Shaanxi, China
| | - Dongfang Li
- School of Public Administration (School of Emergency Management), Northwest University, Xi’an, Shaanxi, China
| | - Yuanyuan Zhao
- School of Public Administration (School of Emergency Management), Northwest University, Xi’an, Shaanxi, China
| | - Ya Wang
- School of Public Administration (School of Emergency Management), Northwest University, Xi’an, Shaanxi, China
| | - Haoran Zhang
- School of Public Administration (School of Emergency Management), Northwest University, Xi’an, Shaanxi, China
| | - Chan Qiao
- School of Public Administration (School of Emergency Management), Northwest University, Xi’an, Shaanxi, China
| | - Yingfang Cui
- School of Public Administration (School of Emergency Management), Northwest University, Xi’an, Shaanxi, China
| | - Leyun Lin
- Viterbi School of Engineering, University of Southern California, Los Angeles, CA, United States
| | - Hao Guan
- Department of Burns and Cutaneous Surgery, Xijing Hospital, Xi’an, China
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Im EO, Yi JS, Chee W. A Decision Tree Analysis on Symptom Experience of Asian American Breast Cancer Survivors. West J Nurs Res 2023; 45:1076-1084. [PMID: 37882470 DOI: 10.1177/01939459231204294] [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] [Indexed: 10/27/2023]
Abstract
BACKGROUND Mainly due to their cultural attitudes toward symptoms and breast cancer, Asian American breast cancer survivors tend to suffer from symptoms and often delay in getting treatments, information, and support. To improve their symptom management, it would be important to determine risk groups among them. Decision tree analyses reportedly help determine risk groups by identifying the characteristics that are directly associated with target health outcomes. OBJECTIVE Using a decision tree analysis, this study aimed at identifying the characteristics that were closely linked to the symptom experience of Asian American breast cancer survivors. METHODS This was a part of a parent randomized controlled trial among Asian American breast cancer survivors. Only the data from 135 women at the pre-test were included. Multiple instruments were used to collect the data: the Memorial Symptom Assessment Scale-Short Form, the Cancer Behavior Inventory, the PRQ-2000, the Perceived Isolation Scale, and the Supportive Care Needs Survey-Short Form 34. The data were analyzed using latent profile analysis and decision tree analyses. RESULTS Two most frequently found profiles included the low symptom experience profile (72.6%) and the high symptom experience profile (27.4%). The high symptom experience profile was predicted by 2 combined characteristics; (a) high psychological needs for help (over 60.00 points), and (b) low psychological needs for help (cut point = 60.00), high perceived barriers (cut point = 1.62), and high social isolation (social support) (cut point = 2.33). CONCLUSIONS These characteristics linked to Asian American breast cancer survivors with high symptom experience need to be considered in future intervention development.
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Affiliation(s)
| | - Jee-Seon Yi
- Emory University, Atlanta, GA, USA
- College of Nursing, Institute of Health Sciences, Gyeongsang National University, Jinju, Republic of Korea
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Wang H, Deng T, Cao C, Feng D. Distinct dyadic quality of life profiles among patient-caregiver dyads with advanced lung cancer: a latent profile analysis. Support Care Cancer 2023; 31:704. [PMID: 37975958 DOI: 10.1007/s00520-023-08182-8] [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: 08/29/2023] [Accepted: 11/10/2023] [Indexed: 11/19/2023]
Abstract
PURPOSE This study aimed to identify the heterogeneity of dyadic quality of life (QoL) profiles, determine whether these profiles differ in terms of demographic and medical factors, neuroticism, resilience, and family functioning, and explore the combined effect of patient and caregiver neuroticism, resilience, and family functioning on dyadic QoL profiles. METHODS A cross-sectional study was conducted with 304 advanced lung cancer patient-caregiver dyads. Self-report questionnaires were administered to patient-caregiver dyads to assess demographic and medical characteristics, neuroticism, resilience, family functioning, and QoL. RESULTS The latent profile analysis identified four subgroups of dyadic QoL: patient-low-caregiver-high profile (38.82%), patient-high-caregiver-high profile (22.37%), patient-high-caregiver-low profile (19.74%), and patient-low-caregiver-low profile (19.08%). Additionally, when both patients and their caregivers had a high level of neuroticism or low level of resilience and low family functioning, compared with only member having them, there was a higher risk of poorer dyadic QoL. CONCLUSIONS Our study identified the four heterogeneities of dyadic QoL profiles among advanced lung cancer patient-caregiver dyads. Future dyadic interventions should consider the heterogeneity of dyadic QoL in this population and prioritize patient-caregiver dyads at risk of poor dyadic QoL. Furthermore, when high neuroticism, low resilience, or family functioning coexist between patients and their caregivers, both parties exhibit much lower dyadic QoL.
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Affiliation(s)
- Hui Wang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Wenhuaxi Road 44, Jinan, 250012, Shandong, China
| | - Tiantian Deng
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Wenhuaxi Road 44, Jinan, 250012, Shandong, China
| | - Cong Cao
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Wenhuaxi Road 44, Jinan, 250012, Shandong, China
| | - Danjun Feng
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Wenhuaxi Road 44, Jinan, 250012, Shandong, China.
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Li G, Qin R, Zhao X, Zhao D, Li P. Limitations on participation and global quality of life among CRC survivors with permanent stomas: moderated mediation analysis of psychological distress and family functioning. Support Care Cancer 2023; 31:526. [PMID: 37594615 DOI: 10.1007/s00520-023-07993-z] [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: 03/22/2023] [Accepted: 08/11/2023] [Indexed: 08/19/2023]
Abstract
PURPOSE Although a cancer diagnosis and stoma creation leave colorectal cancer (CRC) survivors with significant limitations on participation in life activities that would impair their global quality of life (QoL), the underlying psychological mechanisms are understudied. The aim of this cross-section study was to examine whether psychological distress mediates the association of limitations on participation in life activity with global QoL, and whether family functioning moderated the indirect effects of limitations on participation in life activities on global QoL through psychological distress. METHODS CRC survivors with permanent stomas (n = 282) completed questionnaires assessing socio-demographic and clinical characteristics, limitations on participation in life activities, psychological distress, family functioning, and global QoL. The mediation model and moderated mediation model were conducted using the PROCESS macro for SPSS. RESULTS Mediation analysis showed that the association of limitations on participation in life activities with global QoL was partially mediated by psychological distress (indirect effect = -0.087, 95% CI = -0.135 to -0.041). Moderated mediation analysis indicated that the indirect effects of limitations on participation in life activities on global QoL through psychological distress were significantly moderated by family functioning. Specifically, the indirect effects decreased were significant as family functioning levels increased. CONCLUSION CRC survivors with permanent stomas experienced poor global QoL. The moderated mediation model provides a better understanding of how limitations on participation in life activities, psychological distress, and family functioning work together to affect global QoL. Interventions aiming to improve QoL among CRC survivors with permanent stomas should consider targeting these aspects.
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Affiliation(s)
- Guopeng Li
- Department of Health Psychology, School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, 44 Wenhua West Road, Jinan, Shandong, 250012, People's Republic of China
| | - Rui Qin
- Department of Health Psychology, School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, 44 Wenhua West Road, Jinan, Shandong, 250012, People's Republic of China
| | - Xiangyu Zhao
- Department of Health Psychology, School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, 44 Wenhua West Road, Jinan, Shandong, 250012, People's Republic of China
| | - Di Zhao
- Department of Health Psychology, School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, 44 Wenhua West Road, Jinan, Shandong, 250012, People's Republic of China
| | - Ping Li
- Department of Health Psychology, School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, 44 Wenhua West Road, Jinan, Shandong, 250012, People's Republic of China.
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Peregrina HN, Maglalang DD, Hwang J, Yoo GJ. A qualitative exploration of the continuum of help-seeking among Asian American breast cancer survivors. SOCIAL WORK IN HEALTH CARE 2023; 62:345-358. [PMID: 37532433 PMCID: PMC10592301 DOI: 10.1080/00981389.2023.2244012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 07/29/2023] [Indexed: 08/04/2023]
Abstract
Breast cancer rates among Asian American women are increasing. Despite this, there are limited studies on help-seeking among this population. Through a qualitative exploration, this paper examines the help-seeking experiences of Asian American breast cancer survivors. Asian American women (n = 52) with early-stage breast cancer were interviewed. Findings illustrate a continuum of experiences including: keeping diagnosis personal and not asking for help, keeping diagnosis personal but asking for limited help, and sharing diagnosis and seeking support. Results indicate that seeking support is a complex process for Asian Americans with breast cancer, with implications for survivorship and quality of life.
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Affiliation(s)
- Hillary Nicole Peregrina
- Department of Social Welfare, Luskin School of Public Affairs, University of California, Los Angeles, CA, USA
| | | | - Jane Hwang
- Department of Asian American Studies, College of Ethnic Studies, San Francisco State University, San Francisco, CA, USA
| | - Grace J Yoo
- Department of Asian American Studies, College of Ethnic Studies, San Francisco State University, San Francisco, CA, USA
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Im EO, Yi JS, Chee W. Immigration Transition and Symptom Distress Changes by a Technology-Based Intervention: Asian American Breast Cancer Survivors. Comput Inform Nurs 2023; 41:316-322. [PMID: 35797029 PMCID: PMC9816349 DOI: 10.1097/cin.0000000000000938] [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] [Indexed: 01/11/2023]
Abstract
Technology-based programs using computers and mobile devices are known to be effective in providing information and support to marginalized populations including immigrants. Yet, little is still known on the factors that may influence the effectiveness of technology-based programs in improving symptom experience, including immigration transition, especially among Asian American breast cancer survivors. This study aimed to identify the characteristics related to immigration transition that significantly affected the symptom distress changes by a technology-based information and coaching/support program among Asian American breast cancer survivors. This secondary analysis was conducted with the data from 102 Asian American breast cancer survivors from a randomized clinical trial in progress. Multiple instruments were used: the questions on background characteristics and immigration transition and the Memorial Symptom Assessment Scale-Short Form. The data were analyzed using repeated-measurement analyses and decision tree analyses. The mean changes in the symptoms distress scores were as follows: -0.12 (SD, 0.47) in the Global Distress Index scores; -0.08 (SD, 0.43) in the physical symptom distress scores; and -0.15 (SD, 0.65) in the psychological symptom distress scores. The characteristics with the highest impact on the symptom distress score changes included the immigration age for Global Distress Index and physical symptom distress score and the level of acculturation for psychological symptom distress score.
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Affiliation(s)
- Eun-Ok Im
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Jee-Seon Yi
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
- College of Nursing · Institute of Health Sciences, Gyeongsang National University, Jinju, Republic of Korea
| | - Wonshik Chee
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
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Wang F, Wu Y, Sun X, Wang D, Ming WK, Sun X, Wu Y. Reliability and validity of the Chinese version of a short form of the family health scale. BMC PRIMARY CARE 2022; 23:108. [PMID: 35524178 PMCID: PMC9077878 DOI: 10.1186/s12875-022-01702-1] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 03/25/2022] [Indexed: 11/30/2022]
Abstract
Background With the release of the Health China Action (2019–2030), family health is receiving increasing attention from experts and scholars. But at present, there is no family health scale in China that involves multidimensional and interdisciplinary commonality. Aim To translate a Short Form of the Family Health Scale (FHS-SF) and to test the reliability and validity of the Chinese version of the FHS-SF. Method A Short Form of the Family Health Scale was Chinese translated with the consent of the original author. A total of 8912 residents were surveyed in 120 cities across China using a multistage sampling method, with gender, ethnicity, and education level as quota variables. Seven hundred fifty participants were selected to participate in this study, and 44 participants were randomly selected to be retested 1 month later. Results The Cronbach’s alpha of the Chinese version of a Short Form the Family Health Scale was 0.83,the Cronbach’s alphas of the four subscales ranged from 0.70 to 0.90, the retest reliability of the scale was 0.75, the standardized factor loadings of the validation factor analysis were above 0.50, GFI = 0.98; NFI = 0.97; RFI = 0.95; RMSEA = 0.07, all within acceptable limits. Conclusion The Chinese version of a Short Form the Family Health Scale has good reliability and validity and can be used to assess the level of family health of Chinese residents. Supplementary Information The online version contains supplementary material available at 10.1186/s12875-022-01702-1.
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Chee W, Yi JS, Im EO. Information Needs of Asian American Breast Cancer Survivors: a Decision Tree Analysis. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:1902-1911. [PMID: 34176104 PMCID: PMC9233757 DOI: 10.1007/s13187-021-02059-2] [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] [Accepted: 06/15/2021] [Indexed: 06/13/2023]
Abstract
Through a decision tree analysis, this study aimed to determine the characteristics of Asian American breast cancer survivors who had higher decreases in their need for information by a technology-based information and coaching/support program compared with their counterparts. This is a part of a larger randomized controlled trial; only the data from 99 Asian American breast cancer survivors were used for this analysis. The measurement scales included the Memorial Symptom Assessment Scale-Short Form, the Cancer Behavior Inventory, the Questions on Attitudes, Subjective Norm, Perceived Behavioral Control and Behavioral Intention, and the Supportive Care Needs Survey-Short Form 34. The data analysis was done using t-tests, chi-square tests, repeated measurement analyses, and a decision tree analysis. The information needs scores of all the participants decreased during the 3-month intervention period (p < .005). However, only the intervention group had statistically significant decreases in the information needs scores during the 3 months (dif. = - 8.545; p < .005). Those with low social influence scores and high self-efficacy scores had significantly larger decreases in their information needs scores compared with the average change scores (100%, p < 01). Asian American breast cancer survivors with low social influences and high self-efficacy would highly benefit from a technology-based intervention for their need for information.
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Affiliation(s)
- Wonshik Chee
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road, Atlanta, GA, 30322, USA
| | - Jee-Seon Yi
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road, Atlanta, GA, 30322, USA
- College of Nursing, Institute of Health Sciences, Gyeongsang National University, Jinju, Republic of Korea
| | - Eun-Ok Im
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road, Atlanta, GA, 30322, USA.
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Zhang Y, Ding Y, Liu C, Li J, Wang Q, Li Y, Hu X. Relationships Among Perceived Social Support, Family Resilience, and Caregiver Burden in Lung Cancer Families: A Mediating Model. Semin Oncol Nurs 2022:151356. [DOI: 10.1016/j.soncn.2022.151356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 10/12/2022] [Indexed: 11/13/2022]
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Tao L, Hu X, Fu L, Zhang X, Chen H. Effects of family beliefs and family strength on individual resilience and quality of life among young breast cancer survivors: A cross‐sectional study. J Clin Nurs 2022; 32:2616-2626. [PMID: 35426197 DOI: 10.1111/jocn.16321] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 03/12/2022] [Accepted: 03/23/2022] [Indexed: 02/05/2023]
Abstract
AIMS AND OBJECTIVES This study examines the effects of family beliefs and family strength on individual resilience and quality of life among young breast cancer survivors and determines whether family strength mediates the effect of family beliefs on individual resilience and quality of life. BACKGROUND Family beliefs and family strength are meaningful protective factors that help individuals maintain physical and mental health. However, few studies have explored their impact on individual resilience and quality of life. DESIGN This study was conducted using a cross-sectional survey with a three-stage, stratified, convenience sampling approach following the STROBE guideline. METHODS From August 2020 to May 2021, participants completed the shortened Chinese version of the Connor-Davidson Resilience Scale, the Chinese version of the Family Beliefs Scale, the Family Strength Scale and the Functional Assessment of Cancer Therapy-Breast scale. Structural equation modelling and multiple mediation effects test were used to explore the relationships among family beliefs, family strength, individual resilience and quality of life. RESULTS The final model accounted for 44.5% and 78.1% of the total variance of individual resilience and quality of life, respectively. Family beliefs had an indirect effect on both individual resilience and quality of life through family strength. Family strength had a direct effect on individual resilience and had both a direct and an indirect effect on quality of life. Family strength mediated the correlations of family beliefs with individual resilience and quality of life. CONCLUSION Mobilising family resources to establish healthy family beliefs and exert positive family strength will help increase young breast cancer survivors' individual resilience and improve quality of life. RELEVANCE TO CLINICAL PRACTICE This study confirms the importance for clinical nursing practice to mobilise family resources and develop interventions centred on family beliefs and family strength.
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Affiliation(s)
- Lin Tao
- West China School of Nursing Sichuan University Chengdu China
- Department of Breast Surgery West China Hospital Sichuan University Chengdu China
| | - Xiaoxia Hu
- Department of Breast Surgery West China Hospital Sichuan University Chengdu China
| | - Lan Fu
- Department of Breast Surgery West China Hospital Sichuan University Chengdu China
| | - Xiaoxia Zhang
- Department of Breast Surgery West China Hospital Sichuan University Chengdu China
| | - Hong Chen
- West China School of Nursing Sichuan University Chengdu China
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Fang SY, Wang YM, Lee KT. "The Continuous Shadow of My Mother's Breast Cancer": exploring the voice of daughters. Support Care Cancer 2021; 30:1473-1481. [PMID: 34532754 DOI: 10.1007/s00520-021-06551-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 09/07/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE Women whose mothers have been diagnosed with breast cancer are concerned about their mothers' illness and fear developing cancer themselves. This study, conducted in Taiwan, aims to understand daughters' lived experiences after their mothers were diagnosed with breast cancer. METHOD In-depth interviews were conducted to understand daughters' emotional reactions to their mothers' diagnoses, their challenges with taking care of their mothers, and their concerns or perceptions regarding their own risks of developing breast cancer. Themes were identified using a phenomenological approach with 18 transcripts. RESULTS Six themes were identified: "taking care of my mother is my responsibility", "desiring sufficient information/support", "feeling helplessness in providing care", "expecting a cancer diagnosis in fear", "anticipating reassurance other than surveillance", and "worrying about myself is not a priority". In addition, these themes reflected their concerns about how to support their mothers physically and psychologically, how to manage their own worries about cancer, and how to maintain their health. CONCLUSION The daughters prioritized the responsibility of caring for their mothers physically and psychologically rather than managing their own cancer concerns. Health care professionals should be aware of these priorities to provide education regarding the care of high-risk populations and psychological support to adult daughters.
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Affiliation(s)
- Su-Ying Fang
- Department of Nursing, College of Medicine, National Cheng Kung University, University Rd, No. 1, Tainan, 701, Taiwan.
| | - Yu-Ming Wang
- Department of Psychology, Chung Shan Medical University, and Clinical Psychological Room, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Kuo-Ting Lee
- Department of Surgery, National Cheng Kung University Hospital, Tainan, Taiwan
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Typology of Family Relationships, Psychological Distress, and Quality of Life in Chinese Patients With Advanced Lung Cancer. Cancer Nurs 2021; 45:E655-E662. [DOI: 10.1097/ncc.0000000000000968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Wang H, Yue H, Ren M, Feng D. Dyadic effects of family-functioning and resilience on quality of life in advanced lung cancer patients and caregivers: An actor-partner interdependence mediation model. Eur J Oncol Nurs 2021; 52:101963. [PMID: 34004522 DOI: 10.1016/j.ejon.2021.101963] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 01/23/2021] [Accepted: 04/11/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Lung cancer as a stressful event profoundly impacts the entire family, especially patients and their family caregivers. This study uses a dyadic analysis approach to explore the dyadic effects of family functioning on the quality of life (QoL), and whether resilience acts as a mediator in advanced lung cancer patient-caregiver dyads. METHODS This was a cross-sectional study, and 287 dyads of advanced lung cancer patients and their caregivers were enrolled. Family-functioning, resilience, and QoL were assessed by the General Functioning subscale of the Family Assessment Device (FAD), the 10-item Connor-Davidson Resilience Scale, and the Short Form-8 (SF-8) Health Survey, respectively. Data were analyzed using the actor-partner interdependence mediation model. RESULTS This study found that, for patients and caregivers, resilience mediates the actor effects of family-functioning on QoL. That is, family-functioning was positively related to their resilience, which improved QoL. Another important finding is that caregivers' family-functioning had significant indirect effects on patients' QoL through their resilience. CONCLUSIONS Positive family functioning perceived by patients and caregivers can improve their QoL by developing their own resilience. Furthermore, family-functioning perceived by caregivers can also improve patients' QoL through their resilience. Medical staff should identify vulnerable patients and caregivers with poorer family-functioning and resilience, and make focused intervention to improve the QoL of both lung cancer patients and their family caregivers.
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Affiliation(s)
- Hui Wang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China.
| | - Haorun Yue
- Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, 250017, China.
| | - Minmin Ren
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China.
| | - Danjun Feng
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China.
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Effects of family participatory dignity therapy on the psychological well-being and family function of patients with haematologic malignancies and their family caregivers: A randomised controlled trial. Int J Nurs Stud 2021; 118:103922. [PMID: 33812296 DOI: 10.1016/j.ijnurstu.2021.103922] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 02/17/2021] [Accepted: 02/24/2021] [Indexed: 01/19/2023]
Abstract
BACKGROUND Strong family ties appear to buffer patient's and family members' difficult experiences during life and health crises. The family participatory dignity therapy programme, a patient-family-centred psychological intervention, was developed based on dignity therapy and performed by one therapist in the form of interview according to a specific question prompt. OBJECTIVES This study aimed to confirm the efficacy of the family participatory dignity therapy programme in improving the psychological well-being and family cohesion and adaptability of patients with haematologic malignancies and their family caregivers. DESIGN A single-blinded, two-arm parallel group, randomised controlled trial was conducted. SETTING(S) and Participants: Participants were patient-family caregiver dyads recruited from Fujian Medical University Union Hospital from March to September 2019. METHODS A total of 68 eligible dyads agreed to participate and were randomly assigned to the intervention group (n = 33) or control group receiving usual care (n = 35). Each pair of patient-family dyads in the intervention group received two or three interviews (each interview approximately lasting 45 to 60 min) performed by one therapist according to a specific question prompt containing 10 questions for patients and 10 corresponding questions for their family caregivers. To evaluate the effects of the intervention, we assessed patients' hope, spiritual well-being, and family cohesion and adaptability, as well as their family caregivers' depression, anxiety, and family cohesion and adaptability at baseline (T0), 1 week (T1), 4 weeks (T2), and 8 weeks post-intervention (T3) and compared the scores between the groups. A two-way repeated-measures analysis of variance was conducted to examine the effects of time, group, and their interaction. RESULTS For patients, there was a significant difference in hope (p = 0.001), spiritual well-being (p = 0.002), and family cohesion (p<0.001) and adaptability (p<0.001) between the intervention and control groups. The difference over time was also significant in family cohesion (p = 0.018) and adaptability (p = 0.003). The interaction effects were significant for hope (p = 0.034), spiritual well-being (p<0.001), and family cohesion (p<0.001) and adaptability (p<0.001). For family caregivers, there was a significant difference in anxiety (p = 0.037), depression (p = 0.001), and family adaptability (p = 0.036) between the intervention and control groups. Within groups, a significant difference in family adaptability (p = 0.012) was found. Moreover, the interaction effects were significant on anxiety (p = 0.001) and family cohesion (p = 0.038). CONCLUSIONS The family participatory dignity therapy programme showed a positive effect on promoting patients' hope, spiritual well-being, and family cohesion and adaptability; amongst family caregivers, it decreased anxiety and depression, and enhanced family cohesion and adaptability. Registration number: ChiCTR1900021433 Tweetable abstract: The family participatory dignity therapy programme promoted patients' hope, spiritual well-being, and family cohesion and adaptability, decreased their family caregivers' anxiety and depression, and enhanced the caregivers' family cohesion and adaptability.
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Decreasing menopausal symptoms of Asian American breast cancer survivors through a technology-based information and coaching/support program. Menopause 2020; 26:373-382. [PMID: 30461556 DOI: 10.1097/gme.0000000000001249] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE One of the most prevalent and distressing symptoms after breast cancer treatment is menopausal symptoms. Asian American breast cancer survivors have lower quality of life and often receive inadequate management of menopausal symptoms compared to other racial/ethnic groups. Technology-based programs could be a solution to fill the gap in care. The purpose of this study was to test the efficacy of a technology-based information and coaching/support program on menopausal symptoms of Asian American breast cancer survivors. METHODS This study adopted a randomized pretest/post-test group design among 91 Asian American breast cancer survivors (42 in an intervention group who used the program and the American Cancer Society Web site and 49 in a control group who used only the American Cancer Society Web site). The intervention was a theory-driven and culturally tailored intervention program that aimed to provide information and coaching/support using computers and mobile devices. Multiple instruments were used to measure background characteristics and menopausal symptoms at pretest, post 1-month, and post 3 months. An intent-to-treat linear mixed-model growth curve analysis was used to analyze the data. RESULTS The intervention group showed a significant decrease in the distress scores of menopausal symptoms over time: physical (β = -0.07, P = 0.08), psychological (β = -0.13, P = 0.05), psychosomatic (β = -0.17, P = 0.06), and total symptoms (β = -0.19, P = 0.01). Theory-based variables including attitudes, social influences, and self-efficacy partially mediated the impact of the intervention on the distress scores of menopausal symptoms (P < 0.10). CONCLUSIONS The program was effective in alleviating menopausal symptoms of Asian American breast cancer survivors.
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Lim JW, Shon EJ. The Dyadic Effects of Family Cohesion and Communication on Health-Related Quality of Life: The Moderating Role of Sex. Cancer Nurs 2019; 41:156-165. [PMID: 28114262 PMCID: PMC5519452 DOI: 10.1097/ncc.0000000000000468] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Spouses' ability to care for survivors can be particularly challenging because patients and spouses are interdependent and mutually influence one another. Family functioning such as family cohesion and communication may play a primary role in improving the health-related quality of life (HRQOL) of couples, given that cancer can influence family dynamics. OBJECTIVE The aims of this study were to investigate the mediating effect of family communication on the relationship between family cohesion and HRQOL and examine the moderating effect of sex on this relationship among cancer survivor-spouse dyads. METHODS A total of 91 cancer survivors with a diagnosis of breast, colorectal, or prostate cancer and their spouses were recruited from the University Hospital Registry in Cleveland, Ohio. The dyadic data were analyzed using structural equation modeling with the actor-partner interdependence mediation model. RESULTS Findings demonstrated that the spouses' own perceived family communication mediated the associations between their own family cohesion and physical HRQOL and between the survivors' family cohesion and physical HRQOL. The spouse actor effects between family communication and HRQOL significantly differed by sex. CONCLUSIONS Enhancing family cohesion and communication within the family can improve the spouses' HRQOL. Findings regarding sex differences serve as a rationale for gender-based approaches to improving HRQOL in survivorship care in the family context. IMPLICATIONS FOR PRACTICE Couple- and/or family-based interventions should be designed to enhance family cohesion and improve family communication skills for effective adjustments within couples and families. Supportive care within the family context can be promoted to address the diverse challenges of survivorship care.
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Affiliation(s)
- Jung-Won Lim
- Author Affiliations: College of Social Welfare, Kangnam University, Yongin, Gyeonggi, Korea (Dr Lim); and Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH (Ms Shon)
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Zhang Y. Family functioning in the context of an adult family member with illness: A concept analysis. J Clin Nurs 2018; 27:3205-3224. [PMID: 29700875 DOI: 10.1111/jocn.14500] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2018] [Indexed: 11/29/2022]
Abstract
AIM To describe and explain how the concept of family functioning has been used in the targeted sample of health literature on adult family members with illness. BACKGROUND Understanding the influence of illness on family functioning is central to the provision of patient- and family-centred care. There is lack of consistency in utilising family functioning which creates confusion about the concept and can interfere with theory development in nursing science. A clear conceptual definition of attributes of family functioning based on concept analysis could act as a guide in the development of instruments to assess family functioning, the design of family-based interventions and their application in clinical practice. DESIGN Concept analysis. DATA SOURCES Academic Search Premier, ProQuest Research Library, Family & Society Studies Worldwide, PsycINFO, SocINDEX, PubMed and CINAHL databases were searched within the last 20 years (1997-Dec. 2016) using the terms "family function*" and "patient." Studies of paediatric patients and non-English articles were excluded. METHOD Rodgers' evolutionary perspective. RESULTS The findings suggest that family functioning in the context of illness is defined as family members' ability to maintain cohesive relationships with one another, fulfil family roles, cope with family problems, adjust to new family routines and procedures and effectively communicate with each other. CONCLUSION Further research is needed to inform nurses' practice when assessing families or providing patient- and family-centred interventions to support family functioning across different sociocultural and political contexts, and further identification and evaluation of antecedents and consequences regarding family functioning from a nursing perspective. RELEVANCE TO CLINICAL PRACTICE Having a comprehensive understanding of the attributes, antecedents and consequences of ineffective family functioning can facilitate healthcare providers' ability to identify strengths and potential targets to improve family functioning among their clients.
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Affiliation(s)
- Yingzi Zhang
- School of Nursing, University of Wisconsin-Madison, Madison, Wisconsin
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Liu Y, Li Y, Chen L, Li Y, Qi W, Yu L. Relationships between family resilience and posttraumatic growth in breast cancer survivors and caregiver burden. Psychooncology 2018; 27:1284-1290. [DOI: 10.1002/pon.4668] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 01/09/2018] [Accepted: 01/30/2018] [Indexed: 11/11/2022]
Affiliation(s)
- Ye Liu
- Qilu Hospital of Shandong University; Qingdao P.R. China
| | - Yuli Li
- School of Nursing; Shandong University of Traditional Chinese Medicine; Jinan P. R. China
- School of Nursing; Shandong University; Jinan P. R. China
| | - Lijun Chen
- School of Nursing; Shandong University of Traditional Chinese Medicine; Jinan P. R. China
| | - Yurong Li
- School of Public Health; Qingdao University; Qingdao P. R. China
| | - Weiye Qi
- School of Nursing; Shandong University of Traditional Chinese Medicine; Jinan P. R. China
| | - Li Yu
- School of Nursing; Shandong University of Traditional Chinese Medicine; Jinan P. R. China
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Perceived Stress, Parent-Adolescent/Young Adult Communication, and Family Resilience Among Adolescents/Young Adults Who Have a Parent With Cancer in Taiwan. Cancer Nurs 2018; 41:100-108. [DOI: 10.1097/ncc.0000000000000488] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Yoon H, Chatters L, Kao TS, Saint-Arnault D, Northouse L. Factors Affecting Quality of Life for Korean American Cancer Survivors: An Integrative Review. Oncol Nurs Forum 2017; 43:E132-42. [PMID: 27105204 DOI: 10.1188/16.onf.e132-e142] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PROBLEM IDENTIFICATION Understanding of Korean American cancer survivors' quality of life (QOL) within a cultural context is limited. This article examines factors associated with the QOL of Korean American cancer survivors.
. LITERATURE SEARCH A systematic literature search was conducted of PubMed, CINAHL®, Google Scholar, and EBSCO databases from January 2000 to January 2014.
. DATA EVALUATION The studies were assessed for the relevance to the purpose of the review. Each study was rated on a two-point scale using an 11-item quality criteria checklist.
. SYNTHESIS The 13 studies that met the criteria for inclusion included 7 descriptive, 5 qualitative, and 1 mixed-method.
. CONCLUSIONS Social support, communication, and acculturation were key factors associated with Korean Americans' QOL. Cultural differences were evident for Korean Americans versus other Asian American ethnic groups.
. IMPLICATIONS FOR PRACTICE More innovative and culturally driven research is needed to understand each minority group's cultural barriers, as well as to improve cancer survivors' QOL. Improving the doctor-patient relationship is critical to promoting better cancer experiences for Korean American cancer survivors.
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Abstract
BACKGROUND Individuals with cancer and their partners often experience communication difficulties. However, questions still remain regarding the influence of gender and role in cancer survivor-partner communication within couples. OBJECTIVE The current study intended to examine the communication patterns in breast, colorectal, and prostate cancer survivor-partner couples during cancer survivorship and whether gender and role differences in couples communication exist. METHODS The dominant-less dominant method of sequential mixed design was used. Ten couples who were recruited from the University Hospital registry in Cleveland, Ohio, participated in both mail surveys and individual interviews. Family and cancer-related communication was assessed in the quantitative phase. RESULTS Both male survivors and partners demonstrated better family communication scores compared with their female counterparts, whereas there were no gender differences in the cancer-related communication scores. In the qualitative phase, 3 major themes were identified: (1) selective sharing of cancer-related issues, (2) initiation of cancer-related communication, and (3) emotional reaction in communication. The patterns associated with these themes differed between the male survivor-female partner and female survivor-male partner couples. CONCLUSIONS This study provides new knowledge about family and cancer-related communication. Our findings highlight the importance of understanding different perspectives in the quality of communication by gender and role. IMPLICATIONS FOR PRACTICE Exploring couples' communication patterns by gender and role stimulates the research and the development of effective consumer-centered communication interventions. The findings provide assessment tools to inform dyadic communication patterns for clinical and scientific purposes.
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Lim JW, Shon EJ. Decisional Conflict: Relationships Between and Among Family Context Variables in Cancer Survivors. Oncol Nurs Forum 2016; 43:480-8. [DOI: 10.1188/16.onf.480-488] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Bellin MH, Oktay J, Scarvalone S, Appling S, Helzlsouer K. A Qualitative Description of a Family Intervention for Breast Cancer Survivors Experiencing Fatigue. J Psychosoc Oncol 2015; 33:395-413. [PMID: 25996056 DOI: 10.1080/07347332.2015.1046010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Breast cancer survivors commonly experience fatigue, but family-focused interventions as a means to reduce fatigue are understudied. This qualitative study explored the experience of adding a family component to a multimodal group intervention for fatigue. Data were collected from group observations, in-depth interviews, and debriefing sessions with the program social worker. Fourteen survivors completed the family intervention (mean age 57 years) with a family member or close friend. Four themes associated with the family intervention were identified: (a) importance of family inclusion, (b) education of family members about fatigue,
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Affiliation(s)
- Melissa H Bellin
- a University of Maryland School of Social Work , Baltimore , MD , USA
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Ramadas A, Qureshi AM, Dominic NA, Botross NP, Riad A, Arasoo VJT, Elangovan S. Socio-Demography and Medical History as Predictors of Health-Related Quality of Life of Breast Cancer Survivors. Asian Pac J Cancer Prev 2015; 16:1479-85. [DOI: 10.7314/apjcp.2015.16.4.1479] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Lim JW. Communication, coping, and quality of life of breast cancer survivors and family/friend dyads: a pilot study of Chinese-Americans and Korean-Americans. Psychooncology 2014; 23:1243-51. [PMID: 24700695 DOI: 10.1002/pon.3532] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Revised: 01/23/2014] [Accepted: 03/04/2014] [Indexed: 11/11/2022]
Abstract
OBJECTIVE This study aimed to understand the dyadic relationships between family communication and quality of life (QOL) and between coping and QOL in Chinese-American and Korean-American breast cancer survivor (BCS)-family member dyads. METHODS A cross-sectional survey design was used. A total of 32 Chinese-American and Korean-American BCS-family member dyads were recruited from the California Cancer Surveillance Program and area hospitals in Los Angeles County, California, USA. The dyadic data were analyzed using a pooled regression actor-partner interdependence model. RESULTS The study findings demonstrated that the survivors' general communication and use of reframing coping positively predicted their own QOL. The survivors' and family members' general communication was also a strong predictor of the family members' physical-related QOL score specifically. Meanwhile, each person's use of mobilizing coping negatively predicted his or her partner's QOL. CONCLUSIONS The study findings add important information to the scarce literature on the QOL of Asian-American survivors of breast cancer. The findings suggest that Chinese-American and Korean-American BCS and their family members may benefit from interventions that enhance communication and coping within the family unit.
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Affiliation(s)
- Jung-Won Lim
- College of Social Welfare, Kangnam University, Korea
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