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Gray TF, Do KM, Amonoo HL, Sullivan L, Kelkar AH, Pirl WF, Hammer MJ, Tulsky JA, El-Jawahri A, Cutler CS, Partridge AH. Family Caregiver Experiences in the Inpatient and Outpatient Reduced-Intensity Conditioning Allogeneic Hematopoietic Cell Transplantation Settings: A Qualitative Study. Transplant Cell Ther 2024; 30:610.e1-610.e16. [PMID: 37783339 DOI: 10.1016/j.jtct.2023.09.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 09/21/2023] [Accepted: 09/24/2023] [Indexed: 10/04/2023]
Abstract
Caregivers (ie, family and friends) are essential in providing care and support for patients undergoing hematopoietic cell transplantation (HCT) and throughout their recovery. Traditionally delivered in the hospital, HCT is being increasingly provided in the outpatient setting, potentially heightening the burden on caregivers. Extensive work has examined the inpatient HCT caregiving experience, yet little is known about how caregiver experiences may differ based on whether the HCT was delivered on an inpatient or outpatient basis, particularly during the acute recovery period post-HCT. This study explored the similarities and differences in caregiver experiences in the inpatient and outpatient settings during the early recovery from reduced-intensity conditioning (RIC) allogeneic HCT. We conducted semistructured interviews (n = 15) with caregivers of adults undergoing RIC allogeneic HCT as either an inpatient (n = 7) or an outpatient (n = 8). We recruited caregivers using purposeful criterion sampling, based on the HCT setting, until thematic saturation occurred. Interview recordings were transcribed and coded through thematic analysis using Dedoose v.9.0. The study analysis was guided by the transactional model of stress and coping and the model of adaptation of family caregivers during the acute phase of BMT. Three themes emerged to describe similar experiences for HCT caregivers regardless of setting: (1) caregivers reported feeling like they were a necessary yet invisible part of the care team; (2) caregivers described learning to adapt to changing situations and varying patient needs; and (3) caregivers recounted how the uncertainty following HCT felt like existing between life and death while also maintaining a sense of gratitude and hope for the future. Caregivers also reported distinct experiences based on the transplantation setting and 4 themes emerged: (1) disrupted routines: inpatient caregivers reported disrupted routines when caring for the HCT recipient while simultaneously trying to manage non-caregiving responsibilities at home and work, and outpatient caregivers reported having to establish new routines that included frequent clinic visits with the patient while altering or pausing home and work responsibilities; (2) timing of caregiver involvement: inpatient caregivers felt more involved in care after the patient was discharged from the HCT hospitalization, whereas outpatient caregivers were already providing the majority of care earlier in the post-transplantation period; (3) fear of missing vital information: inpatient caregivers worried about missing vital information about the patient's care and progress if not physically present in the hospital, whereas outpatient caregivers feared overlooking vital information that may warrant contacting the care team as they monitored the patient at home; and (4) perceived adequacy of resources to meet psychosocial and practical needs: inpatient caregivers reported having adequate access to resources (ie, hospital-based services), whereas outpatient caregivers felt they had more limited access and needed to be resourceful in seeking out assistance. Inpatient and outpatient HCT caregivers described both similar and distinct experiences during the acute recovery period post-HCT. Specific interventions should address caregiver psychosocial needs (ie, distress, illness uncertainty, communication, and coping) and practical needs (ie, community resource referral, preparedness for home-based caregiving, and transplantation education) of HCT caregivers based on setting.
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Affiliation(s)
- Tamryn F Gray
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts; Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts; Division of Stem Cell Transplantation and Cellular Therapies, Dana-Farber Cancer Institute, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer, Boston, Massachusetts; Division of Palliative Medicine, Brigham and Women's Hospital, Boston, Massachusetts; Cancer Outcomes Research and Education Program, Massachusetts General Hospital Cancer Center, Boston, Massachusetts.
| | - Khuyen M Do
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Hermioni L Amonoo
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Cancer Outcomes Research and Education Program, Massachusetts General Hospital Cancer Center, Boston, Massachusetts; Department of Psychiatry, Brigham and Women's Hospital, Boston, Massachusetts
| | - Lauren Sullivan
- Division of Stem Cell Transplantation and Cellular Therapies, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Amar H Kelkar
- Division of Stem Cell Transplantation and Cellular Therapies, Dana-Farber Cancer Institute, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - William F Pirl
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Department of Psychiatry, Brigham and Women's Hospital, Boston, Massachusetts
| | - Marilyn J Hammer
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer, Boston, Massachusetts
| | - James A Tulsky
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Division of Palliative Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Areej El-Jawahri
- Harvard Medical School, Boston, Massachusetts; Cancer Outcomes Research and Education Program, Massachusetts General Hospital Cancer Center, Boston, Massachusetts; Divison of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Corey S Cutler
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts; Division of Stem Cell Transplantation and Cellular Therapies, Dana-Farber Cancer Institute, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Division of Hematologic Malignancies, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Ann H Partridge
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
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Roscoe RA. Narrating the Sociocultural Experience and Management of Stigma Related to Military Caregiving. HEALTH COMMUNICATION 2024:1-12. [PMID: 38818796 DOI: 10.1080/10410236.2024.2360177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2024]
Abstract
Despite accelerating the recovery and rehabilitation of wounded veterans and saving the U.S. substantial sums in avoided long-term care costs, military caregivers (MCs) are an underserved community lacking resources and support. On top of managing a variety of emotional, physical, relational, and occupational challenges, MCs experience stigma. Indeed, caregiving can be a stigmatized task, especially for military-affiliated individuals who may be expected to adhere to cultural norms of personal sacrifice and resilience in the face of adversity. The current study uses narrative inquiry to better understand the unique experiences and characteristics of MCs providing care for veterans experiencing posttraumatic stress. Specifically, this study examined MCs' narratives to uncover the sociocultural experience and management of stigma related to military caregiving. Interviews with 15 military caregivers of veterans experiencing PTS demonstrated that military caregivers experienced stigma for 1) staying in the relationship, 2) enabling the veteran, 3) mismanaging the condition, and 4) flaking on plans and relationships. In response to stigma, MCs often challenged stigma through strategies of denial or evasion of responsibility. This study contributes to communication scholarship by introducing co-stigma management and further interrogating processes related to stigma management communication. In addition, the results can inform Veteran Affairs (VA) healthcare, caregiver assistance programs, health practices, and support-seeking behaviors.
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Affiliation(s)
- Rikki A Roscoe
- Department of Communication Studies, University of Kansas
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Baudry AS, Delpuech M, Charton E, Hivert B, Carnot A, Ceban T, Dominguez S, Lemaire A, Aelbrecht-Meurisse C, Anota A, Christophe V. Association between emotional competence and risk of unmet supportive care needs in caregivers of cancer patients at the beginning of care. Support Care Cancer 2024; 32:302. [PMID: 38647710 DOI: 10.1007/s00520-024-08510-6] [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: 12/21/2023] [Accepted: 04/15/2024] [Indexed: 04/25/2024]
Abstract
PURPOSE This cross-sectional study explored the associations between intrapersonal and interpersonal emotional competence (EC) and the unmet supportive care needs (SCN), anxiety, and depression of informal caregivers at the beginning of gastrointestinal or haematological cancer care, i.e. during chemotherapy and within 6 months after diagnosis. METHODS The participants completed a self-reported questionnaire, comprising the Short Profile of Emotional Competence (S-PEC), the SCN survey for partners and caregivers (SCNS-P&C), and the Hospital Anxiety and Depression Scale (HADS). Multivariate logistic regression models were performed to explore the influence of EC on unmet SCN and the presence of moderate/severe anxiety or depression. RESULTS Most of the 203 caregivers were women (n = 141, 69.80%) and the partners of patients (n = 148, 73.27%) suffering from gastrointestinal (n = 112, 55.17%) and haematological (n = 91, 44.83%) cancer. Only intrapersonal EC showed a significant influence out of all the dimensions of unmet SCN related to healthcare services and information (odds ratio (OR) = 0.35 [95%CI 0.19; 0.65]), emotional and psychological needs (OR = 0.43 [95%CI 0.25; 0.74]), work and social security (OR = 0.57 [95%CI 0.37; 0.88]), and communication and family support (OR = 0.61 [95%CI 0.39; 0.95]). A one-unit increase in the intrapersonal EC score significantly reduced the probability of anxiety (OR = 0.42, [95%CI 0.26; 0.68]) and depression (OR = 0.34, [95%CI 0.21; 0.55]). CONCLUSION Intrapersonal EC of caregivers is crucial to reduce the risk of unmet SCN, anxiety, and depression from the beginning of care. Identifying caregivers with lower intrapersonal EC may be necessary to increase vigilance from healthcare professionals and psychologists.
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Affiliation(s)
- Anne-Sophie Baudry
- Pôle Cancérologie Et Spécialités Médicales, Centre Hospitalier de Valenciennes, Valenciennes, France.
- Univ. Lille, CNRS, UMR 9193 - SCALab - Sciences Cognitives Et Sciences Affectives, 59000, Lille, France.
- Human and Social Sciences Department, Centre Léon Bérard, Lyon, France.
- Service d'oncologie, Centre Hospitalier de Valenciennes, Avenue Désandrouin - cs 50479, 59322, Valenciennes Cedex, France.
| | - Marion Delpuech
- Human and Social Sciences Department, Centre Léon Bérard, Lyon, France
| | - Emilie Charton
- Human and Social Sciences Department, Centre Léon Bérard, Lyon, France
- Department of Clinical Research and Innovation, Centre Léon Bérard, Lyon, France
| | - Benedicte Hivert
- Service d'Onco-Hématologie, Hôpital Saint Vincent de Paul, GHICL, Lille, France
| | - Aurelien Carnot
- Pôle d'oncologie médicale, Centre Oscar Lambret, Lille, France
| | - Tatiana Ceban
- Service d'Oncologie, Centre Hospitalier de Dunkerque, Dunkerque, France
| | - Sophie Dominguez
- Service d'Onco-Hématologie, Hôpital Saint Vincent de Paul, GHICL, Lille, France
| | - Antoine Lemaire
- Pôle Cancérologie Et Spécialités Médicales, Centre Hospitalier de Valenciennes, Valenciennes, France
| | | | - Amelie Anota
- Human and Social Sciences Department, Centre Léon Bérard, Lyon, France
- Department of Clinical Research and Innovation, Centre Léon Bérard, Lyon, France
- The French National Platform Quality of Life and Cancer, Lyon, France
| | - Veronique Christophe
- Univ. Lille, CNRS, UMR 9193 - SCALab - Sciences Cognitives Et Sciences Affectives, 59000, Lille, France
- Human and Social Sciences Department, Centre Léon Bérard, Lyon, France
- Université Claude Bernard Lyon 1, CRCL, UMR Mixte INSERM 1052-CNRS 5286, Lyon, France
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McErlean G, Tapp C, Brice L, Gilroy N, Kabir M, Greenwood M, Larsen SR, Moore J, Gottlieb D, Hertzberg M, Brown L, Hogg M, Huang G, Ward C, Kerridge I. Predictors of post traumatic growth in allogeneic hematopoietic stem cell transplantation survivors: a cross-sectional survey. BMC Psychol 2023; 11:235. [PMID: 37587508 PMCID: PMC10433676 DOI: 10.1186/s40359-023-01204-4] [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: 10/20/2022] [Accepted: 05/09/2023] [Indexed: 08/18/2023] Open
Abstract
AIMS Given the increasing number of Hematopoietic Stem Cell Transplantations (HSCT) performed world-wide, the increasing likelihood of survival following HSCT, and the profound physical, psychosocial, and emotional impact of HSCT on survivors, their carers and families, it is important to identify factors that may contribute to or support post-traumatic growth (PTG) after transplant. In this study, we aimed to investigate the prevalence of PTG in an Australian cohort of long-term allogeneic HSCT survivors and describe associations between PTG and relevant clinical, sociodemographic and psychological variables. METHODS This was a large, multi-centre, cross sectional survey of Australian HSCT-survivors inviting all those transplanted in New South Wales between 2000 and 2012. Respondents completed the PTG Inventory (PTGI), the Sydney Post-BMT Survey, FACT-BMT, DASS 21, The Chronic Graft versus Host Disease (GVHD) Activity Assessment-Patient Self-Report (Form B), the Lee Chronic GVHD Symptom Scale, and the Fear of Cancer Recurrence Scale. Data was analysed using independent t-tests, one-way analysis of variance, and pearson's correlations, and hierarchical multiple regression adjusted for potential confounders and to ascertain independent associations of explanatory variables with PTG. RESULTS Of 441 respondents, 99% reported some level of PTG with 67% reporting moderate to high levels of PTG. Female gender, younger age, complementary therapy use, anxiety, psychological distress and psychosocial care, and higher quality of life were associated with higher levels of PTG. Importantly, we also found that PTG was not associated with either chronic GVHD or post-HSCT morbidity. CONCLUSIONS In this study - the largest study of PTG in long-term allogeneic HSCT survivors - we found that growth appears ubiquitous, with 99% of survivors reporting some degree of PTG and 67% reporting moderate-high levels of PTG. Importantly, we found no association with GVHD or chronic physical post-HSCT morbidity, or adverse financial, occupational or sexual impacts. This suggests that it is the necessity for and experience of, HSCT itself that foments personal growth. Accordingly, healthcare professionals should be alert to the profound and wide-ranging impact of HSCT - and the degree to which survivor's may experience PTG. Identifying interventions that may assist HSCT survivors cope and building their resilience is of utmost importance.
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Affiliation(s)
- Gemma McErlean
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia.
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia.
| | - Caley Tapp
- School of Public Health, University of Queensland, Herston, QLD, Australia
- Queensland Centre for Mental Health Research, Wacol, QLD, Australia
| | - Lisa Brice
- Department of Haematology, Royal North Shore Hospital, Sydney, NSW, Australia
| | - Nicole Gilroy
- Centre for Infectious Diseases and Microbiology, Westmead Hospital, Sydney, NSW, Australia
| | - Masura Kabir
- Westmead Breast Cancer Institute, Sydney, NSW, Australia
| | - Matt Greenwood
- Department of Haematology, Royal North Shore Hospital, Sydney, NSW, Australia
- Northern Blood Research Centre, Kolling Institute, University of Sydney, Sydney, NSW, Australia
| | - Stephen R Larsen
- Institute of Haematology, Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - John Moore
- Department of Haematology, St Vincents Hospital, Sydney, NSW, Australia
| | - David Gottlieb
- Department of Haematology, Westmead Hospital, Sydney, NSW, Australia
- Faculty of Medicine and Health Sciences, University of Sydney, Sydney, NSW, Australia
| | - Mark Hertzberg
- Department of Haematology, Prince of Wales Hospital, Sydney, NSW, Australia
| | - Louisa Brown
- Department of Haematology, Calvary Mater Hospital, Newcastle, NSW, Australia
| | - Megan Hogg
- Department of Haematology, Westmead Hospital, Sydney, NSW, Australia
| | - Gillian Huang
- Department of Haematology, Westmead Hospital, Sydney, NSW, Australia
| | - Christopher Ward
- Department of Haematology, Royal North Shore Hospital, Sydney, NSW, Australia
- Northern Blood Research Centre, Kolling Institute, University of Sydney, Sydney, NSW, Australia
- Faculty of Medicine and Health Sciences, University of Sydney, Sydney, NSW, Australia
| | - Ian Kerridge
- Department of Haematology, Royal North Shore Hospital, Sydney, NSW, Australia
- Northern Blood Research Centre, Kolling Institute, University of Sydney, Sydney, NSW, Australia
- Faculty of Medicine and Health Sciences, University of Sydney, Sydney, NSW, Australia
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Emotional processes in partners’ quality of life at various stages of breast cancer pathway: a longitudinal study. Qual Life Res 2022; 32:1085-1094. [PMID: 36418525 DOI: 10.1007/s11136-022-03298-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2022] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Several studies have shown that emotional competence (EC) impacts cancer adjustment via anxiety and depression symptoms. The objective was to test this model for the quality of life (QoL) of partners: first, the direct effect of partners' EC on their QoL, anxiety and depression symptoms after cancer diagnosis (T1), after chemotherapy (T2) and after radiotherapy (T3); Second, the indirect effects of partners' EC at T1 on their QoL at T2 and T3 through anxiety and depression symptoms. METHODS 192 partners of women with breast cancer completed a questionnaire at T1, T2 and T3 to assess their EC (PEC), anxiety and depression symptoms (HADS) and QoL (Partner-YW-BCI). Partial correlations and regression analyses were performed to test direct and indirect effects of EC on issues. RESULTS EC at T1 predicted fewer anxiety and depression symptoms at each time and all dimensions of QoL, except for career management and financial difficulties. EC showed different significant indirect effects (i.e. via anxiety or depression symptoms) on all sub-dimensions of QoL, except for financial difficulties, according to the step of care pathway (T2 and T3). Anxiety and depression played a different role in the psychological processes that influence QoL. CONCLUSION Findings confirm the importance of taking emotional processes into account in the adjustment of partners, especially regarding their QoL and the support they may provide to patients. It, thus, seems important to integrate EC in future health models and psychosocial interventions focused on partners or caregivers.
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Wang X, Tu Q, Huang D, Jin P, Cai X, Zhao H, Lu Z, Dong C. A latent profile analysis of emotional expression among patients with unintentional injuries. BMC Psychiatry 2022; 22:729. [PMID: 36424565 PMCID: PMC9694566 DOI: 10.1186/s12888-022-04390-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 11/14/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Emotional expression has been suggested to affect the well-being of individuals with unintentional injuries. However, few studies have investigated it as a heterogeneous phenomenon. The purpose of this study was to characterize the patterns of emotional expression among patients with unintentional injuries using latent profile analysis, and to examine the relationship among these latent profiles and cognitive processing, posttraumatic growth, and posttraumatic stress disorder. METHODS A cross-sectional study was carried out at two general hospitals in Wenzhou, China. In total, 352 patients with unintentional injuries completed the socio-demographic questionnaire, Berkeley Expressivity Questionnaire, Ambivalence Over Emotional Expression Questionnaire, Event-Related Rumination Inventory, the Posttraumatic Growth Inventory, and PTSD Checklist-Civilian Version. RESULTS: Three unique profiles were identified: high emotional expressivity (n = 238, 67.6%), moderate emotional expressivity (n = 45, 12.8%), and low emotional expressivity (n = 69, 19.6%). The ANOVA and chi-square tests demonstrated significant differences among the three groups concerning deliberate rumination and posttraumatic growth. Multinomial logistic regression analysis indicated that monthly income and time since injury significantly predicted profile membership. CONCLUSIONS Most patients showed high emotional expressivity after an unintentional injury. Emotional expression profiles were associated with deliberate rumination and posttraumatic growth. Emotional expression interventions tailored for different profiles are warranted after an unintentional injury.
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Affiliation(s)
- Xinlu Wang
- grid.268099.c0000 0001 0348 3990School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang China
| | - Qiongyao Tu
- grid.268099.c0000 0001 0348 3990School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang China
| | - Dongdong Huang
- grid.268099.c0000 0001 0348 3990School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang China
| | - Pinpin Jin
- grid.268099.c0000 0001 0348 3990School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang China
| | - Xue Cai
- grid.268099.c0000 0001 0348 3990School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang China
| | - Haifeng Zhao
- grid.268099.c0000 0001 0348 3990School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang China ,grid.416271.70000 0004 0639 0580Ningbo City First Hospital, Ningbo, China
| | - Zhongqiu Lu
- Emergency Intensive Care Unit, Emergency Department, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
| | - Chaoqun Dong
- School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang, China.
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Santerre-Theil A, Brown TL, Körner A, Loiselle CG. Exploring healthcare professionals' experiences with informal family cancer caregiving. Support Care Cancer 2022; 30:7745-7754. [PMID: 35701633 PMCID: PMC9197331 DOI: 10.1007/s00520-022-07207-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 06/06/2022] [Indexed: 11/26/2022]
Abstract
Caring for a family member with cancer is often associated with significant cognitive, emotional, and physical demands. Although considerable research has explored informal cancer caregiver role burden, research has seldom focused on the experiences of individuals who hold the dual role of informal caregiver and healthcare professional. This qualitative study begins to explore this dual role experience. Participants (N = 12) who had at least 1 year of prior professional experience and cared for a family member with cancer were recruited conveniently from a large university-affiliated hospital in Montreal, Quebec. Individual face-to-face semi-structured interviews were conducted. Using thematic analysis, key themes were developed from verbatim transcripts: (1) salient dual role advantages, (2) significant challenges related to this role, (3) changes in professional practice as a consequence of informal caregiving, and (4) important palliative and end-of-life care access issues. Whereas professional knowledge helped advocate on behalf of patients, the dual role often came with over-solicitation from others, enhanced sense of responsibility, increased burden, and significant distress. Further study of critical ramifications linked to jointly enacting informal and professional caregiving across various health contexts should continue to inform supportive care strategies for this understudied yet increasingly prevalent segment of the caregiver population.
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Affiliation(s)
- Ariane Santerre-Theil
- Department of Educational and Counselling Psychology, Faculty of Education, McGill University, Montreal, QC, Canada
| | - Tyler L Brown
- Department of Oncology, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Annett Körner
- Department of Educational and Counselling Psychology, Faculty of Education, McGill University, Montreal, QC, Canada
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
- Segal Cancer Centre, Jewish General Hospital, Montreal, QC, Canada
- Psychosocial Oncology Program, McGill University Health Centre, Montreal, QC, Canada
| | - Carmen G Loiselle
- Department of Oncology, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada.
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada.
- Segal Cancer Centre, Jewish General Hospital, Montreal, QC, Canada.
- Ingram School of Nursing, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada.
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Cheng L, Liu L. Exploring posttraumatic growth after the COVID-19 pandemic. TOURISM MANAGEMENT 2022; 90:104474. [PMID: 34924667 PMCID: PMC8664663 DOI: 10.1016/j.tourman.2021.104474] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 11/04/2021] [Accepted: 12/09/2021] [Indexed: 05/16/2023]
Abstract
Although it is undeniable that the COVID-19 pandemic presented new threats and traumas for human beings, posttraumatic growth that took place after the struggle with this highly challenging crisis cannot be ignored. Therefore, based on the posttraumatic growth theory, the present research focuses on aspects of tourists' positive changes after the COVID-19 outbreak. A total of 1165 potential tourists from 197 cities in 31 provinces of China were analyzed using symmetrical and asymmetrical approaches. The results of the partial least squares test revealed the net effects of social support, psychological distress, and infection risk perception on the three dimensions of tourists' posttraumatic growth, namely, travel risk aversion, social identity, and altruistic behavior. Fuzzy-set qualitative comparative analysis provided causal recipes for realizing posttraumatic growth, and necessary condition analysis supplemented the necessary antecedents. The implications of the findings and the paths for future research are also presented.
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Affiliation(s)
- Li Cheng
- Tourism School, Sichuan University 29, Wangjiang Road, Chengdu, Sichuan, 610064, PR China
| | - Lijun Liu
- Tourism School, Sichuan University 29, Wangjiang Road, Chengdu, Sichuan, 610064, PR China
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Abstract
Although it is undeniable that the COVID-19 pandemic presented new threats and traumas for human beings, posttraumatic growth that took place after the struggle with this highly challenging crisis cannot be ignored. Therefore, based on the posttraumatic growth theory, the present research focuses on aspects of tourists' positive changes after the COVID-19 outbreak. A total of 1165 potential tourists from 197 cities in 31 provinces of China were analyzed using symmetrical and asymmetrical approaches. The results of the partial least squares test revealed the net effects of social support, psychological distress, and infection risk perception on the three dimensions of tourists' posttraumatic growth, namely, travel risk aversion, social identity, and altruistic behavior. Fuzzy-set qualitative comparative analysis provided causal recipes for realizing posttraumatic growth, and necessary condition analysis supplemented the necessary antecedents. The implications of the findings and the paths for future research are also presented.
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Affiliation(s)
- Li Cheng
- Tourism School, Sichuan University 29, Wangjiang Road, Chengdu, Sichuan, 610064, PR China
| | - Lijun Liu
- Tourism School, Sichuan University 29, Wangjiang Road, Chengdu, Sichuan, 610064, PR China
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Dyadic effects of rumination and self-disclosure on posttraumatic growth in newly diagnosed gynecological cancer couples: an actor-partner interdependence modeling approach. Support Care Cancer 2022; 30:5167-5174. [PMID: 35246728 DOI: 10.1007/s00520-022-06869-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 01/24/2022] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To examine the dyadic effects of rumination and self-disclosure on posttraumatic growth among newly diagnosed gynecological cancer couples. METHODS This cross-sectional study recruited 400 newly diagnosed gynecological cancer couples from a tertiary general hospital from July to December 2020. Questionnaires were administered to collect information on demographic and cancer-related characteristics, rumination, self-disclosure, and posttraumatic growth. The actor-partner interdependence model was used to explore the dyadic effects of rumination and self-disclosure on posttraumatic growth. RESULTS Gynecological cancer survivors reported more posttraumatic growth than their spouses. The patients' deliberate rumination and self-disclosure and spouses' self-disclosure had actor and partner effects on their own and their spouses' posttraumatic growth. Besides, the patients' intrusive rumination and spouses' deliberate rumination had actor effects on their own posttraumatic growth. CONCLUSIONS Spouses' posttraumatic growth was influenced by their own and their wives' deliberate rumination and self-disclosure, while survivors' posttraumatic growth was affected by their own deliberate rumination, intrusive rumination, self-disclosure, and their spouses' self-disclosure. Promoting deliberate rumination and self-disclosure could facilitate the couples' posttraumatic growth. Besides, reducing intrusive rumination may be useful for the survivors and indirectly contribute to spouses' posttraumatic growth. This study indicates that couple-centered interventions may be crucial and more effective in facilitating posttraumatic growth among newly diagnosed gynecological cancer couples.
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Pan Y, Zhao H, Xu H, Huang Y, Dong C. Post accidental injury: Mediating roles of emotional expressivity, rumination, and posttraumatic growth. Nurs Health Sci 2022; 24:236-244. [PMID: 35049106 DOI: 10.1111/nhs.12919] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 12/28/2021] [Accepted: 01/06/2022] [Indexed: 11/30/2022]
Abstract
This study explored the relationship between rumination (deliberate or intrusive), emotional expressivity (positive or negative), and posttraumatic growth among patients within 1 month after an accidental injury. Using a cross-sectional design, 313 patients were investigated in two comprehensive hospitals. The results revealed that intrusive rumination had a significant positive effect on posttraumatic growth, partly through four different pathways: (i) the mediating role of deliberate rumination; (ii) the chain mediating role of deliberate rumination and negative emotional expressivity; (iii) the chain mediating role of negative emotional expressivity and positive emotional expressivity; and (iv) the chain mediating role of negative emotional expressivity, positive emotional expressivity, and deliberate rumination. Interventions to encourage emotional expressivity and facilitate the transition from intrusive rumination to deliberate rumination may promote posttraumatic growth soon after an accidental injury.
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Affiliation(s)
- Yinzhu Pan
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Haifeng Zhao
- Ningbo First Hospital, Ningbo Hospital of Zhejiang University, Niongbo, China
| | - Huan Xu
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Yingying Huang
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Chaoqun Dong
- School of Nursing, Wenzhou Medical University, Wenzhou, China
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