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Wang L, Li Y, Zhao R, Li J, Gong X, Li H. Influencing factors of home hospice care needs of family caregivers of the older adult with chronic diseases at the end of life in China: a cross-sectional study. Front Public Health 2024; 12:1348285. [PMID: 38756894 PMCID: PMC11098011 DOI: 10.3389/fpubh.2024.1348285] [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: 12/02/2023] [Accepted: 04/15/2024] [Indexed: 05/18/2024] Open
Abstract
Introduction With increased life expectancy in the Chinese population coupled with chronic disease the care needs of people at the end of life are attracting much attention. Home hospice care can help the dying older adult achieve comfort and maintain their dignity at home. However, dying at home means great responsibility and challenge for family caregivers, and there are many unmet needs. The study aimed to investigate the home hospice care needs of family caregivers of older adult people with chronic diseases at the end of life in China, and to analyze the influencing factors of home hospice care needs of caregivers. Methods In this cross-sectional study, from May to September 2023, 4 community health service centers were selected by stratified sampling from seven administrative districts in Jinzhou City, Liaoning Province, where home hospice care was piloted. Then 224 family caregivers were selected from the communities of seven community service centers by simple random sampling method. A general information questionnaire and the home hospice care needs questionnaire developed by our research group were used to investigate. Univariate analysis was used to compare the differences in the scores of different characteristics, and the factors with significant differences were selected for multivariate linear regression analysis to determine the final influencing factors. Results The total score of hospice care needs of family caregivers was 121.61 ± 15.24, among which the end-of-life knowledge need dimension score was 24.04 ± 2.71, the highest score index was 80.13%, while the symptom control need score was 15.58 ± 3.39, the lowest score index was 62.32%. In addition, Caregivers with caregiving experience, dying older adult with longer disease duration, and dying older adult with higher levels of education were the factors influencing the total need for home hospice care among family caregivers, with a variance explained of 22.7%. Discussion The needs of family caregivers of the terminally ill older adult are high, and healthcare professionals should implement services to meet their multidimensional needs and improve the quality of care according to the factors affecting their needs.
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Affiliation(s)
| | | | | | | | | | - Hongyu Li
- College of Nursing, Jinzhou Medical University, Jinzhou, China
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Ham L, Fransen HP, de Graeff A, Hendriks MP, de Jong WK, Kloover J, Kuip E, Mandigers C, Sommeijer D, van de Poll L, Raijmakers N, van Zuylen L. Relatives' Unmet Needs in the Last Year of Life of Patients With Advanced Cancer: Results of a Dutch Prospective, Longitudinal Study (eQuiPe). J Palliat Care 2024:8258597241239614. [PMID: 38515425 DOI: 10.1177/08258597241239614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
Objective(s): Unmet needs of relatives of patients with advanced cancer not only reduce their own health-related quality of life, but may also negatively affect patients' health outcomes. The aim of this study was to assess changes in relatives' unmet needs of patients with advanced cancer in the last year of life and to identify differences in unmet needs by gender and type of relationship. Methods: Relatives of patients with advanced cancer in the Netherlands were included in a prospective, longitudinal, observational study. Relatives' unmet needs were measured every 3 months with an adapted version of the Problems and Needs in Palliative Care (PNPC) questionnaire Caregiver form (44 items, 12 domains). Questionnaires completed in the patients' last year of life were analyzed. Change of unmet needs in the last year, and differences in unmet needs by gender and type of relationship were analyzed. Results: A total of 409 relatives were included with a median of 4 unmet needs in the patient's last year. Unmet needs were most prevalent at all time points during the last year in the domains "caring for the patient" (highest need = 35%) and "psychological issues" (highest need = 40%). The number of unmet needs of relatives did not change significantly during the last year of life (P=.807). There were no significant differences in the number of unmet needs between male and female partners and between partners and other relatives. Conclusion: The most unmet needs for relatives were in the domains "caring for the patient" and "psychological issues." Professional support should focus on these items. Within these domains, it seems especially important that relatives get more knowledge and support about what scenarios to expect and how to deal with them.
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Affiliation(s)
- Laurien Ham
- Department of Research & Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, the Netherlands
- Netherlands Association for Palliative Care (PZNL), Utrecht, the Netherlands
| | - Heidi P Fransen
- Department of Research & Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, the Netherlands
- Netherlands Association for Palliative Care (PZNL), Utrecht, the Netherlands
| | - Alexander de Graeff
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Mathijs P Hendriks
- Department of Medical Oncology, Northwest Clinics, Alkmaar, the Netherlands
| | - Wouter K de Jong
- Department of Pulmonology, Hospital Gelderse Vallei, Ede, the Netherlands
| | - Jeroen Kloover
- Department of Pulmonology, Elisabeth-TweeSteden Hospital, Tilburg, the Netherlands
| | - Evelien Kuip
- Department of Medical Oncology and Department of Anesthesiology, Pain and Palliative Care, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Caroline Mandigers
- Department of Internal Medicine, Canisius Wilhelmina Hospital, Nijmegen, the Netherlands
| | - Dirkje Sommeijer
- Department of Medical Oncology, Flevo Hospital, Almere, the Netherlands
| | - Lonneke van de Poll
- Department of Research & Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, the Netherlands
- Department of Medical and Clinical Psychology, CoRPS - Center for Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, the Netherlands
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Natasja Raijmakers
- Department of Research & Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, the Netherlands
- Netherlands Association for Palliative Care (PZNL), Utrecht, the Netherlands
| | - Lia van Zuylen
- Department of Medical Oncology, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, the Netherlands
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Nysaeter TM, Olsson C, Sandsdalen T, Hov R, Larsson M. Family caregivers' preferences for support when caring for a family member with cancer in late palliative phase who wish to die at home - a grounded theory study. BMC Palliat Care 2024; 23:15. [PMID: 38212707 PMCID: PMC10782637 DOI: 10.1186/s12904-024-01350-5] [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: 10/24/2023] [Accepted: 01/09/2024] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND Family caregivers are essential in end-of-life care for cancer patients who wish to die at home. The knowledge is still limited regarding family caregivers needs and preferences for support and whether the preferences change during the patient's illness trajectory. Therefore, the aim was to explore family caregivers' preferences for support from home care services over time when caring for a family member with cancer at the end of life who wished to die at home. METHODS A qualitative method was applied according to Grounded Theory. Data was collected longitudinally over the illness trajectory by means of repeated individual interviews (n = 22) with adult family caregivers (n = 11). Sampling, data collection and data analysis were undertaken simultaneously in line with the constant comparative method. RESULTS The findings are captured in the core category "hold out in duty and love". The categories "having control and readiness for action" and "being involved in care" describe the family caregivers' preferences for being prepared and able to handle procedures, medical treatment and care, and to be involved by the healthcare personnel in the patient's care and decision making. The categories "being seen and confirmed" and "having a respite" describe family caregivers' preferences for support according to their own needs to be able to persevere in the situation. CONCLUSION Despite deterioration in the patient's illness and the increasing responsibility family caregiver struggle to hold out and focus on being in the present. Over time together with deterioration in the patient's illness and changes in the situation, they expressed a need for more intense and extensive support from the home care services. To meet the family caregivers' preferences for support a systematic implementation of a person-centred care model and multicomponent psycho- educational interventions performed by nurses can be proposed. Moreover, we suggest developing a tool based on the conceptual model generated in this study to identify and map family caregivers' needs and preferences for support. Such a tool can facilitate communication and ensure person-centred interventions.
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Affiliation(s)
- Toril Merete Nysaeter
- Department of Health and Nursing Sciences, Inland Norway University of Applied Sciences, Elverum, 2400, Norway.
| | - Cecilia Olsson
- Department of Health Sciences, Karlstad University SE, Karlstad, Sweden
- Department of Bachelor Education in Nursing, Lovisenberg Diaconal University College, Oslo, Norway
| | - Tuva Sandsdalen
- Department of Health and Nursing Sciences, Inland Norway University of Applied Sciences, Elverum, 2400, Norway
| | - Reidun Hov
- Department of Health and Nursing Sciences, Inland Norway University of Applied Sciences, Elverum, 2400, Norway
- Centre for Development of Institutional and Home Care Services (USHT), Inland (Hedmark), Hamar, Norway
| | - Maria Larsson
- Department of Health Sciences, Karlstad University SE, Karlstad, Sweden
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Ma H, Zhao T, Ma Y, Yuen JWM, Ka Yan H, Yung JYK, Lam KKW, Christensen M. Family caregivers' lived experience of caring for hospitalised patients with cancer during the COVID-19 lockdown: A descriptive phenomenological study. J Clin Nurs 2023; 32:7509-7518. [PMID: 37370254 DOI: 10.1111/jocn.16817] [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: 02/22/2023] [Revised: 06/08/2023] [Accepted: 06/19/2023] [Indexed: 06/29/2023]
Abstract
AIMS This study aimed to capture and explore family caregivers' lived experience of caring for hospitalised patients with cancer during the lockdown. BACKGROUND The unprecedented lockdown episodes due to COVID-19 have brought significant changes in the hospital visiting policies and caregiving practices. As part of the precautionary measures for hospital visits, the bedside companion was restricted to one caregiver for patients with cancer in Shanghai hospitals. DESIGN This study adopted a descriptive phenomenological approach. METHODS Data were collected among 20 family caregivers recruited from the Oncology department of a tertiary hospital in Shanghai in May 2022, using purposive sampling method and followed by unstructured, open-ended interviews. Colaizzi's seven-step data analysis method was used to analyse the data to reveal the emergent themes and subthemes of the phenomenon. RESULTS Four themes were generated on family caregivers' lived experience of caring for hospitalised patients with cancer during the lockdown, including (1) Feeling scared for the patient; (2) Living a life feeling trapped under COVID-19 surveillance; (3) Feeling neglected and unseen; (4) Growing resilience and appreciation. CONCLUSIONS The lockdown exacerbated the burden of family caregivers when they cared for the hospitalised patients with cancer during the lockdown period. However, positive reframing of the lived experience facilitated their coping with the challenging situation. RELEVANCE TO CLINICAL PRACTICE Findings from this study highlighted the potential proactive roles the healthcare providers could play in improving family caregivers' health and supporting them during and beyond the COVID-19 pandemic. REPORTING METHOD The study adhered to relevant EQUATOR guidelines; the study was reported according to the COREQ checklist. PATIENT OR PUBLIC CONTRIBUTION Family caregivers of patients with cancer were involved in data collection and member-checking of the transcripts and interpretations of their experiences.
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Affiliation(s)
- Haixia Ma
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Ho Man Tin, Kowloon, Hong Kong, China
| | - Tuan Zhao
- Department of Hepatobiliary Medicine, Third Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Yajing Ma
- School of Public Policy and Management, China University of Mining and Technology, Xuzhou, Jiangsu Province, China
| | - John Wai-Man Yuen
- School of Nursing, Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
| | - Ho Ka Yan
- School of Nursing, Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
| | - Jolene Y K Yung
- School of Nursing, Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
| | - Katherine Ka Wai Lam
- School of Nursing, Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
| | - Martin Christensen
- School of Nursing, Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
- The Interdisciplinary Centre for Qualitative Research, School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
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Rassouli M, Beiranvand S, Karami M, Dorcheh AE, Ashrafizadeh H. Caring ability and its related factors in the family caregivers of patients with cancer. Int J Palliat Nurs 2023; 29:422-432. [PMID: 37757807 DOI: 10.12968/ijpn.2023.29.9.422] [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] [Indexed: 09/29/2023]
Abstract
BACKGROUND Caregivers of cancer patients experience a variety of challenges caused by the prolonged burden of care. Many of these caregivers do not have the necessary knowledge, skills and caring ability to fulfil their caring role. Therefore, healthcare providers should support them in learning to provide high-quality care. Evaluating caregivers' ability will be the first step of this supportive programme. AIM The aim of this study was to determine the caring ability of the caregivers of cancer patients and its related factors. METHODS This descriptive correlational study was performed with 271 caregivers of cancer patients who were selected through convenience sampling conducted from July to December 2021 in selected hospitals in Tehran, the capital city of Iran. The data were collected using the caring ability of family caregivers of patients with cancer scale (CAFCPCS), which was developed by Nemati et al (2020). In addition, the stability reliability coefficient was calculated to be ICC=0.93. Data analysis was performed through Statistical Package for the Social Sciences (version 26), using descriptive and inferential statistics and correlation coefficient tests at a significance level of 0.05. RESULTS The mean score for the caring ability of the family caregivers of cancer patients in this study was 91.86±7.59. The mean total score of caring ability scale had a statistically significant correlation with the type of cancer and the duration of patient care (P-value=0.05). CONCLUSION The results of the study demonstrated that the family caregivers of cancer patients do not have the necessary knowledge and awareness to perform their caring role effectively. Therefore, it is recommended to empower caregivers and use strategies to improve their trust, especially in caregivers who oversee patient care for a significant period of time.
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Affiliation(s)
- Maryam Rassouli
- Cancer Research Center, Shahid Beheshti University of Medical Sciences
| | - Samira Beiranvand
- Nursing Care Research Center in Chronic Diseases, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Iran
| | - Maryam Karami
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Iran
| | - Azam Eshaghian Dorcheh
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Iran
| | - Hadis Ashrafizadeh
- Assistant professor of nursing, Student Research Committee, Faculty of Nursing, Dezful University of Medical Sciences, Iran
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Kantabanlang Y, Lin CP, Nilmanat K, Guo P. Palliative care needs of patients with hematologic malignancies and family caregivers and challenges of palliative care provision in Asia: A review of evidence. Semin Hematol 2023; 60:220-225. [PMID: 37517948 DOI: 10.1053/j.seminhematol.2023.07.002] [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: 05/15/2023] [Revised: 07/16/2023] [Accepted: 07/19/2023] [Indexed: 08/01/2023]
Abstract
Patients with hematologic malignancies often experience fatigue, lack of vitality, and energy, and high psychological distress. High levels of unmet care needs of patients with hematologic malignancies in Asia were identified. This review provides an overview of current evidence on the experiences and palliative care needs of patients with hematologic malignancies and their families and the barriers and challenges of integrating palliative care into hematology care in Asia. Patients with hematologic malignancies who received palliative care could benefit from less aggressive end-of-life treatments. However, the uncertain and variable nature of the prognosis and illness trajectories of hematologic malignancies increase the difficulties of integrating palliative care into hematologic care. Patients and their families are often referred to palliative care services late, which leaves a short window for palliative care teams to provide holistic needs assessment and person-centered care for those who need it. In addition, cultural differences in medical decision-making patterns and complex social norms and interactions among patients, families, and healthcare staff make it even more challenging to initiate palliative care conversations in Asia. Future research should focus on the development and evaluation of culturally appropriate palliative care for patients with hematologic malignancies and their family caregivers in Asia, given that the low rate of service intake and poor public awareness of the important role of palliative care in disease trajectories were reported. The socio-cultural context surrounding individuals should be taken into consideration to ensure the provision of person-centered care for this group of patients. Digital health could be one of the possible solutions forward to address local needs and challenges.
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Affiliation(s)
- Yupawadee Kantabanlang
- Boromarajonani College of Nursing Suratthani, Faculty of Nursing, Praboromarajchanok Institute, Surat Thani, Thailand
| | - Cheng-Pei Lin
- Institute of Community Health Care, College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan; Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery, and Palliative Care, King's College London, London, United Kingdom
| | - Kittikorn Nilmanat
- Division of Fundamental Nursing Faculty of Nursing, Prince of Songkla University, Songkhla, Thailand
| | - Ping Guo
- School of Nursing and Midwifery, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom.
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Zhu S, Yang C, Mei W, Kang L, Li T, Li J, Li L. Caregiver burden for informal caregivers of patients after surgical treatment of early-stage lung cancer. J Clin Nurs 2023; 32:859-871. [PMID: 35869414 DOI: 10.1111/jocn.16424] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 04/20/2022] [Accepted: 06/01/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Caregivers of lung cancer patients frequently experience psychological distress and high caregiver burden. Previous studies have focused on caregiver burden for patients with advanced lung cancer, while few studies focused on the caregiver burden among informal caregivers of postoperative patients with early-stage non-small cell lung cancer (NSCLC). OBJECTIVES This study aimed to (a) examine caregiver burden for caregivers of patients with early-stage NSCLC after surgical treatment and (b) identify predictive factors related to caregiver burden of patients with early-stage NSCLC. METHODS A cross-sectional study was conducted in a university-affiliated hospital in Changsha, China. A total of 385 patients with early-stage NSCLC and postsurgical treatment and their caregivers were included in this study. Caregiver burden was evaluated using the Zarit caregiver burden interview (ZBI). A set of questionnaires was used to assess psychosocial characteristics of participants, including simplified coping style questionnaire, social support rate scale, and hospital anxiety and depression scale. Hierarchical regression analysis was applied to identify factors associated with caregiver burden. We followed STROBE checklist for reporting the study. RESULTS The average ZBI score was 29.1 ± 11.4. Most caregivers (62.6%) demonstrated mild to moderate caregiving burden. The duration of caregiving (β = 0.18, p < .001), passive coping of caregiver (β = 0.17, p = .001) and anxiety (β = 0.13, p = .007) were significant predictors of caregiving burden. A variance of 17.6% in caregiving burden was explained by these identified factors. CONCLUSIONS Caregivers of early-stage NSCLC patients experience a mild to moderate level of caregiver burden. The duration of caregiving, passive coping and anxiety are factors associated with caregiver burden. RELEVANCE TO CLINICAL PRACTICE Clinicians should provide early care to support new roles of family members as caregivers.
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Affiliation(s)
- Song Zhu
- Clinic Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China.,Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Chen Yang
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Wei Mei
- Clinic Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China.,Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Lu Kang
- Clinic Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China.,Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Tong Li
- Clinic Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China.,Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Jina Li
- Clinic Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China.,Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Lezhi Li
- Xiangya Nursing School, Central South University, Changsha, China
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Cheng G, Chen C. End-of-Life Needs of Dying Patients and Their Families in Mainland China: A Systematic Review. OMEGA-JOURNAL OF DEATH AND DYING 2023; 86:1019-1045. [PMID: 33626990 DOI: 10.1177/0030222821997340] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVE To map the current research status and understand existing findings regarding end-of-life care needs in Mainland China. METHOD First-hand, empirical studies on the needs of dying patients and/or their families in Mainland China were searched in Web of Science, Scopus, Proquest, Taylor & Francis Online and CNKI in December 2019. Findings were synthesized. RESULTS A total of 33 (10 qualitative) studies were involved. Chinese dying patients and their families had physical, psychological, social, and spiritual needs and needs for knowledge and information. Prevalent needs of dying patients were mainly symptom control and decent look, being treated kindly by professional caregivers, family accompany, dignity, and comfortable environment. Families mainly need healthcare professionals to take good care of patients and wishes for information, knowledge, and facilities to help themselves become better caregivers. CONCLUSIONS Findings lay the foundation for effective and tailored services for Chinese clients and provided insights for future investigations.
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Affiliation(s)
- Guobin Cheng
- Department of Medical Humanities, School of Humanities, Southeast University, Nanjing, China
| | - Chuqian Chen
- Department of Medical Humanities, School of Humanities, Southeast University, Nanjing, China
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Fu C, Glasdam S. The 'good death' in Mainland China - A Scoping Review. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2022; 4:100069. [PMID: 38745620 PMCID: PMC11080441 DOI: 10.1016/j.ijnsa.2022.100069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 02/09/2022] [Accepted: 02/10/2022] [Indexed: 01/13/2023] Open
Abstract
Background Since the mid 80'ies, the western palliative care philosophy has influenced the development of palliative care in mainland China. However, it has caused several challenges. Objective To explore the understanding of the 'good death' among authorities, professionals, patients, and their relatives in end-of-life care settings in mainland China. Design Scoping review. The PRISMA-ScR checklist was used. The study is not registered. Settings End-of-life care settings, Mainland China. Participants Authorities, healthcare professionals, adult patients, and general population in mainland China. Method Literature searches were performed through Medline, CINAHL, PsycInfo, and Web of Sciences from 2001-2021, last search 21.4.2021. Inclusion criteria were: Empirical research studies investigating 'good death' or political documents about 'good death', perspectives from authorities, professionals, patients, and/or relatives, and studies following the Declaration of Helsinki. Exclusion criteria were: Literature reviews, languages other than English and Chinese, editorials, letters, comments, and children's death/dying.The analysis consisted of analysing the data including a descriptive numerical summary analysis and a qualitative thematic analysis. Results Nineteen articles and two political documents were included. The 19 studies were carried out from 2003-2020, with data collected from 1999 to 2019. The political documents were written in 2012 and 2017, respectively. The thematic analysis resulted in three themes: 'Medicalisation of death', 'Communication about death - a clash between two philosophies', and 'Dying and death were socially dependent'. The medicalisation of death meant the understanding of the 'good death' primarily focused on physical symptoms and treatments. The good death was understood as painless and symptom-free, where all symptoms could be measured and assessed. Dignity and shared decision-making were connected to the understanding of the 'good death'. However, the contents of the 'good death' varied across the different actors. The understanding of the 'good death' in mainland China was a negotiation between Chinese traditional philosophy and contemporary western medicine practice. There was a tension between openness and silence about death, which reflected the importance of death education. The understanding of the 'good death' consisted partly of a timely and practical preparation for the death and afterlife, partly of a matter of social and financial issues. Conclusions There seemed to be a clash between two different cultures in the understanding of a good death in Mainland China, where western philosophy seemed to rule the political medical actors while traditional Chinese philosophy seemed to rule parts of the population.
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Affiliation(s)
- Cong Fu
- Integrative Health Research, Department of Health Sciences, Faculty of Medicine, Lund University, Margaretavägen 1 B, S- 222 41 Lund, Sweden
| | - Stinne Glasdam
- Integrative Health Research, Department of Health Sciences, Faculty of Medicine, Lund University, Margaretavägen 1 B, S- 222 41 Lund, Sweden
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Khanali Mojen L, Rassouli M, Ashrafizadeh H, Fathollah Zadeh E, Dadashi N, Khoubbin Khoshnazar TA, Pourazarhagh P, Nasrabadi T. Unmet needs of the Iranian mothers of the children with cancer and the identification of the related factors: A descriptive-correlational study. Front Psychol 2022; 13:964424. [PMID: 36211837 PMCID: PMC9541099 DOI: 10.3389/fpsyg.2022.964424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 08/23/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction Parents' caring responsibilities lead to imbalances in roles, functions, and emotions, confronting them with new needs that, if left unaddressed, have adverse consequences for the lives of all family members. Therefore, this study aimed to identify the significant unmet needs of the mothers of the children with cancer. Materials and methods This descriptive cross-sectional study was conducted in Tehran in 2019-2020 on 215 mothers of the children with cancer visiting the hospitals affiliated with medical universities. The study population was selected through convenience sampling method and according to the inclusion criteria. The FIN questionnaire consisting of two subscales, FIN-Import and FIN-Fulfillment, with 40 items, was used to collect data. Results The mean age of the mothers participating in the study was 34.77 ± 7.91 years, and the mean age of the children with cancer was 9.77 ± 14.37 years. The mean scores of FIN-Import and FIN-Fulfillment were 92.88 ± 7.97 and 70.82 ± 17.89, respectively. The phrase "To know the facts concerning my child's prognosis" with 23%, and the phrase "To be told about the people who could help with problems" with 22.8% were the most common unmet needs reported by the parents. Conclusion The present study indicated that caring for a child with cancer had confronted mothers with new needs to be met; however, not all of these needs had been satisfied. Awareness about the unmet needs of these mothers and planning to manage those needs can lay the groundwork to improve their health.
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Affiliation(s)
- Leila Khanali Mojen
- Pediatric Congenital Hematologic Disorders Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Rassouli
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hadis Ashrafizadeh
- Student Research Committee, Faculty of Nursing, Dezful University of Medical Sciences, Dezful, Iran
| | | | - Nasrin Dadashi
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Parand Pourazarhagh
- Mofid Hospital, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran
| | - Tahereh Nasrabadi
- Department of Nursing, Faculty of Nursing and Midwifery, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
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Rosenkilde S, Missel M, Wagner MK, Dichman C, Hermansen AS, Larsen MK, Joshi VL, Zwisler AD, Borregaard B. Caught between competing emotions and tensions while adjusting to a new everyday life: a focus group study with family caregivers of out-of-hospital cardiac arrest survivors. Eur J Cardiovasc Nurs 2022; 22:320-327. [PMID: 35801906 DOI: 10.1093/eurjcn/zvac056] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 06/09/2022] [Accepted: 06/13/2022] [Indexed: 11/13/2022]
Abstract
AIMS Caring for an out-of-hospital cardiac arrest (OHCA) survivor may impact family caregivers' lives due to the sudden onset of the illness and possible secondary cognitive, emotional, and physical challenges. However, experiences of caring for an OHCA survivor are sparsely described. Thus, this study aimed to explore how family caregivers of OHCA survivors experience the potential burden. METHODS AND RESULTS Using an explorative qualitative approach, six focus group interviews were conducted with a sample of 25 family caregivers of OHCA survivors and analysed using a phenomenological hermeneutic approach inspired by the philosophy of Ricoeur. The OHCA survivors attended a rehabilitation course, and the family caregivers were interviewed as part of the course.Based on the analysis, three themes emerged: (i) feeling unexpectedly alone and invisible; the family caregivers experienced an emotional burden that could not be shared-leading to caregiving being a lonely experience, (ii) fear of loss; the fear of losing a loved one was a constant companion contributing to the burden, and (iii) adjusting to a new everyday life; the family caregivers had difficulties adjusting to living their lives on the premise of the survivors' needs. CONCLUSION The findings of this study emphasize the burden experienced by family caregivers and how they can be trapped in competing emotions and tensions. The possible caregiver burden following OHCA should be acknowledged. Interventions to reduce the burden should be tested and implemented as part of the clinical care of OHCA survivors and their families.
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Affiliation(s)
- Siri Rosenkilde
- Department of Cardiology, Odense University Hospital, J.B. Winsløws Vej 4, 5000 Odense C Odense, Denmark
| | - Malene Missel
- Department of Cardiothoracic Surgery, Copenhagen University Hospital, Rigshospitalet, Denmark
| | | | - Camilla Dichman
- Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Anne Sofie Hermansen
- Department of Cardiology, Odense University Hospital, J.B. Winsløws Vej 4, 5000 Odense C Odense, Denmark
| | - Malene K Larsen
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Department of Surgery, Odense University Hospital, Denmark
| | - Vicky L Joshi
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Nyborg, Denmark
| | - Ann Dorthe Zwisler
- Department of Cardiology, Odense University Hospital, J.B. Winsløws Vej 4, 5000 Odense C Odense, Denmark.,REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Nyborg, Denmark
| | - Britt Borregaard
- Department of Cardiology, Odense University Hospital, J.B. Winsløws Vej 4, 5000 Odense C Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, Odense, Denmark
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12
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Hart NH, Crawford-Williams F, Crichton M, Yee J, Smith TJ, Koczwara B, Fitch MI, Crawford GB, Mukhopadhyay S, Mahony J, Cheah C, Townsend J, Cook O, Agar MR, Chan RJ. Unmet supportive care needs of people with advanced cancer and their caregivers: a systematic scoping review. Crit Rev Oncol Hematol 2022; 176:103728. [PMID: 35662585 DOI: 10.1016/j.critrevonc.2022.103728] [Citation(s) in RCA: 55] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 05/24/2022] [Accepted: 05/26/2022] [Indexed: 01/11/2023] Open
Abstract
Examining and addressing unmet care needs is integral to improving the provision and quality of cancer services. This review explored the prevalence of unmet supportive care needs, and factors associated with unmet need, in adults with advanced cancers (solid and hematological malignancies) and their caregivers. Electronic databases (PubMed, CINAHL, EMBASE) were searched, producing 85 papers representing 81 included studies. People with advanced cancer reported the highest unmet needs in financial, health system and information, psychological, and physical and daily living domains, whereas caregivers reported the highest unmet needs in psychological, and patient care and support domains. Distress, depression, and anxiety were associated with higher unmet needs across all unmet need domains for people with advanced cancer and their caregivers. Substantial heterogeneity in study populations and methods was observed. Findings from this review can inform targeted strategies and interventions to address these unmet needs in people with advanced cancer.
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Affiliation(s)
- Nicolas H Hart
- Caring Futures Institute, College of Nursing and Health Science, Flinders University, SA, Australia; Exercise Medicine Research Institute, School of Medical and Health Sciences, Edith Cowan University, WA, Australia; Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, QLD, Australia; Institute for Health Research, University of Notre Dame Australia, WA, Australia.
| | - Fiona Crawford-Williams
- Caring Futures Institute, College of Nursing and Health Science, Flinders University, SA, Australia; Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, QLD, Australia
| | - Megan Crichton
- Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, QLD, Australia; Nutrition and Dietetics Research Group, Bond University, QLD, Australia
| | - Jasmine Yee
- Centre for Medical Psychology and Evidence-Based Decision-Making, Faculty of Medicine and Health, University of Sydney, NSW, Australia
| | - Thomas J Smith
- Division of General Internal Medicine, John Hopkins Medical Institutions, Baltimore, MD, USA
| | - Bogda Koczwara
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, SA, Australia; Flinders Cancer and Innovation Centre, Flinders Medical Centre, SA, Australia
| | - Margaret I Fitch
- School of Graduate Studies, Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Gregory B Crawford
- Discipline of Medicine, University of Adelaide, SA, Australia; Northern Adelaide Local Health Network, SA, Australia
| | - Sandip Mukhopadhyay
- Burdwan Medical College, West Bengal, Kolkata, India; Indian Council of Medical Research, National Institute of Cholera and Enteric Diseases, Kolkata, India
| | | | - Chan Cheah
- Internal Medicine, UWA Medical School, University of Western Australia, WA, Australia; Department of Haematology, Sir Charles Gairdner Hospital, WA, Australia; Department of Haematology, Hollywood Private Hospital, WA, Australia
| | | | - Olivia Cook
- McGrath Foundation, NSW, Australia; School of Nursing and Midwifery, Monash University, VIC, Australia
| | - Meera R Agar
- IMPACCT Centre, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Raymond J Chan
- Caring Futures Institute, College of Nursing and Health Science, Flinders University, SA, Australia; Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, QLD, Australia
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13
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Lu Q, Mårtensson J, Zhao Y, Johansson L. Needs of family members caring for stroke survivors in china: A deductive qualitative content analysis study by using the caregiver task inventory-25. BMC Geriatr 2022; 22:96. [PMID: 35114940 PMCID: PMC8812361 DOI: 10.1186/s12877-022-02774-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 01/07/2022] [Indexed: 11/12/2022] Open
Abstract
Background In China, family caregivers are usually the main carers of relatives after stroke due to traditional Chinese culture and the limited development of the primary healthcare system. This responsibility often results in burdens and negative health outcomes. However, family caregivers seldom receive support. To improve informal care, as well as the health and well-being of family caregivers, it is important to identify their needs. Objective This study aimed to deductively explore the needs of family members caring for stroke survivors in China. Methods Twenty-six semi-structured interviews were performed with family caregivers of stroke survivors who were selected from one city and three communities by purposive sampling. A deductive qualitative content analysis method was performed by using the Caregiver Task Inventory-25 (CTI-25), an instrument measuring the needs of family caregivers, as a framework. Results All subscales, as well as all belonging items in the CTI-25, were identified in the present study, meaning that the family caregivers had needs related to learning to cope with new role, providing care according to care-receiver’s needs, managing own emotional needs, appraising supportive resources, and balancing caregiving needs and one’s own needs. Moreover, needs related to financial support, both direct and indirect, were identified but not part of the CTI-25. Conclusion These findings identified that family caregivers of stroke survivors in China had various needs, which is important knowledge when assessing needs and improving health care for family caregivers. Cultural adjustments and modifications should be made if CTI-25 is used in mainland China. This study also indicated a comprehensive and holistic perspective (individual, community, and social level) when identifying, assessing needs or implementing interventions to support family caregivers.
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Affiliation(s)
- Qi Lu
- School of Health and Welfare, Jönköping University, Jönköping, Sweden. .,School of Nursing, Tianjin Medical University, Tianjin, China.
| | - Jan Mårtensson
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Yue Zhao
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Linda Johansson
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
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14
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Zhu S, Zhu H, Zhang X, Liu K, Chen Z, Yang X, Sun C, Xie W, Xu Q, Li W, Pang D, Cui Y, Wang H. Care needs of dying patients and their family caregivers in hospice and palliative care in mainland China: a meta-synthesis of qualitative and quantitative studies. BMJ Open 2021; 11:e051717. [PMID: 34740931 PMCID: PMC8573656 DOI: 10.1136/bmjopen-2021-051717] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To investigate the care needs of dying patients and their family caregivers in hospice and palliative care in mainland China. METHODS A search for English and Chinese quantitative and qualitative studies was performed using the following English databases: PubMed (Medline), CINAHL and PsycINFO, as well as Chinese databases: SinoMed and CNKI. The records were independently screened by two reviewers and critiqued using Joanna Briggs Institute Critical Appraisal tools. All quantitative data were transformed into qualitative data, which were converted into textual descriptions. Due to the diversity of included studies, a three-step analysis was performed: narrative summary, thematic analysis and presentation of integrated results in a narrative form. The qualitative findings were pooled using the meta-aggregation approach. RESULTS The literature search identified 2964 papers after removing duplicates, from which 18 were included (9 quantitative and 9 qualitative studies). All studies were conducted in mainland China. Quantitative studies involved cross-sectional surveys, and qualitative studies involved interviews for data collection. Two synthesised results of patients' needs were identified, including needs to be comfortable and experience a good death. Another two synthesised results of family caregivers' needs included needs to care for and improve the quality of life of patients, and to care for themselves well. CONCLUSION This study identified that patients and family caregivers have an increasing demand for professional care at the end of life. Professionals, especially nurses, should enact a patients' demand-centred practice to overcome the challenges of organisation, education, emotion and communication to provide high-quality end-of-life care.
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Affiliation(s)
- Shuqin Zhu
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Hanfei Zhu
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xintong Zhang
- Emergency, Nantong First People's Hospital, Nantong, Jiangsu, China
| | - Kouying Liu
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Zumei Chen
- China Jiliang University Hospital, Hangzhou, Zhejiang, China
| | - Xiaowen Yang
- Nanjing Medical University Library, Nanjing, Jiangsu, China
| | - Changxian Sun
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China
- Jiangsu Vocational Institute of Commerce, Nanjing, Jiangsu, China
| | - Weiping Xie
- Department of Respiratory and Critical Care Medicine, Nanjing Medical University, Nanjing, Jiangsu, China
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Qin Xu
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Weiying Li
- LKS Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Dong Pang
- School of Nursing, Peking University, Beijing, China
- Evidence-Based Nursing: A Joanna Briggs Institute Centre of Excellence, Peking University Health Science Centre, Beijing, China
| | - Yan Cui
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Hong Wang
- Department of Respiratory and Critical Care Medicine, Nanjing Medical University, Nanjing, Jiangsu, China
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
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15
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Mojen LK, Rassouli M, Ashrafizadeh H, Beykmirza R, Masoudifar Z, Jamsahar M, Ansari M, Hatamipour K, Salmani N, Nazari O, Varzeshnejad M. Psychometric evaluation of "Family Inventory of Needs" in parents of cancer children. Eur J Oncol Nurs 2021; 54:102021. [PMID: 34601226 DOI: 10.1016/j.ejon.2021.102021] [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: 11/04/2020] [Revised: 05/16/2021] [Accepted: 08/22/2021] [Indexed: 11/20/2022]
Abstract
PURPOSE Early childhood cancer creates various challenges in parents' lives and influences new needs, the identification of which requires a valid and reliable tool. The aim of this study was to translate and validate the Family Inventory of Needs (FIN) with the parents of children with cancer. METHOD In this methodological research, 210 parents of children with cancer visiting pediatric oncology referral centers in Iran were selected through convenience sampling, based on the study inclusion criteria. The Farsi version of FIN was developed through translation and back-translation. Face validity as well as construct validity using the confirmatory factor analysis (CFA) were performed. The correlation between the score of FIN and the score of Caring Ability of Family Caregivers of Patients with Cancer-mothers' version (CAFCPC-mother's version) was also calculated in order to evaluate the convergent validity. Furthermore, the stability and internal consistency reliability were investigated using software packages LISREL and SPSS. RESULTS The results of CFA showed that the single-factor structure of the tool with 20 items has an appropriate fit with the data and is therefore approved. Pearson coefficient (r) of the correlation between the mean scores of the NFI and the CAFCPC-mothers' version was calculated to be 0.17 (p < 0.01). The Cronbach's alpha of the tool was calculated as 0.90, and the test-retest correlation coefficient as ICC = 0.91. CONCLUSION The Farsi version of the FIN has appropriate psychometric properties among the population of Iranian parents of children with cancer. It may therefore be a suitable tool for measuring the emotional, physical, and psychological support provided for the parents of children with cancer.
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Affiliation(s)
- Leila Khanali Mojen
- Pediatric Congenital Hematologic Disorders Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Rassouli
- Department of Pediatric Nursing, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Hadis Ashrafizadeh
- Student Research Committee, Nursing & Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Raziyeh Beykmirza
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Zeynab Masoudifar
- Pediatric Nursing, Oncology Ward, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Jamsahar
- Department of Medical- Surgical, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mojgan Ansari
- Department of Nursing and Midwifery, Iranian Research Center on Healthy Aging School of Paramedical, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Khadijeh Hatamipour
- Department of Nursing, Tonekabon Branch, Islamic Azad University, Tonekabon, Iran
| | - Nayereh Salmani
- Department of Pediatrics, Nursing Faculty, Meybod Nursing School, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | | - Maryam Varzeshnejad
- Department of Pediatric Nursing, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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16
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Preferences of quality delivery of palliative care among cancer patients in low- and middle-income countries: A review. Palliat Support Care 2021; 20:275-282. [PMID: 33952378 DOI: 10.1017/s1478951521000456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND All forms of cancer pose a tremendous and increasing problem globally. The prevalence of cancer across the globe is anticipated to double over the next two decades. About 50% of most cancer cases are expected to occur in low- and middle-income countries (LMICs), where there is a greater disproportionate level in mortality. Access to effective and timely care for cancer patients remains a challenge, especially in LMICs due to late disease diagnosis and detection, coupled with the limited availability of appropriate therapeutic options and delay in proper interventions. METHODOLOGY This study explored several mixed-method researches and randomized trials that addressed the preferences of quality delivery of palliative care among cancer patients in LMICs. A designated set of keywords such as Palliative Care; Preferences; Cancer patients; Psycho-social Support; End-of-life Care; Low and Middle-Income Countries were inserted on electronic databases to retrieve articles. The databases include PubMed, Scinapse, Medline, The Google Scholar, Academic search premier, SAGE, and EBSCO host. RESULTS Findings from this review discussed the socioeconomic and behavioral factors, which address the quality delivery of palliative care among cancer patients. These factors if measured with acceptance level in cancer patients could help to address areas that need improvement from the stage of disease diagnosis to the end-of-life. SIGNIFICANCE OF THE RESULTS Valuable collaborations among international and local health institutions are needed to build and implement a systematic framework for palliative care in LMICs. Policies and programs that are country and culturally specific, encompassing both theoretical and practical models of care in the milieu of existing quandaries should be developed.
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17
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Sato T, Fujisawa D, Arai D, Nakachi I, Takeuchi M, Nukaga S, Kobayashi K, Ikemura S, Terai H, Yasuda H, Kawada I, Sato Y, Satomi R, Takahashi S, Hashiguchi MH, Nakamura M, Oyamada Y, Terashima T, Sayama K, Saito F, Sakamaki F, Inoue T, Naoki K, Fukunaga K, Soejima K. Trends of concerns from diagnosis in patients with advanced lung cancer and their family caregivers: A 2-year longitudinal study. Palliat Med 2021; 35:943-951. [PMID: 33761790 PMCID: PMC8114458 DOI: 10.1177/02692163211001721] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Both advanced cancer patients and their family caregivers experience distress and have a range of concerns after cancer diagnosis. However, longitudinal studies on this topic have been lacking. AIM To investigate concerns in both patients with advanced lung cancer and their family caregivers longitudinally from diagnosis. DESIGN A multi-center prospective questionnaire-based study. SETTING/PARTICIPANTS We recruited patients with newly diagnosed advanced lung cancer and their family caregivers at 16 hospitals in Japan. We prospectively assessed the prevalence of their concerns using the Concerns Checklist and investigated the associations between their concerns and mental status as well as quality of life until 24 months after diagnosis. RESULTS A total of 248 patients and their 232 family caregivers were enrolled. The prevalence of serious concerns was highest at diagnosis (patients: 68.3%, family caregivers: 65.3%). The most common serious concern was concern about the future in both groups at diagnosis (38.2% and 40.5%, respectively) and this remained high in prevalence over time, while the high prevalence of concern about lack of information improved 3 months after diagnosis in both groups. Approximately one-third of patient-family caregiver dyads had discrepant reports of serious concerns. The presence of serious concerns was significantly associated with anxiety and depression continuously in both groups. CONCLUSIONS The majority of advanced lung cancer patients and their family caregivers have serious concerns from diagnosis, which is associated with their psychological distress. The spectrum of concerns alters over the disease trajectory, warranting efficient tailored care and support for both groups immediately after diagnosis.
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Affiliation(s)
- Takashi Sato
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.,Department of Medicine, Keiyu Hospital, Yokohama, Japan.,Department of Medicine, Sano-kosei General Hospital, Sano, Japan
| | - Daisuke Fujisawa
- Division of Patient Safety, Keio University School of Medicine, Tokyo, Japan.,Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Daisuke Arai
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.,Pulmonary division, Internal Medicine, Saiseikai Utsunomiya Hospital, Utsunomiya, Japan
| | - Ichiro Nakachi
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.,Pulmonary division, Internal Medicine, Saiseikai Utsunomiya Hospital, Utsunomiya, Japan
| | - Mari Takeuchi
- Palliative Care Center, Keio University Hospital, Tokyo, Japan
| | - Shigenari Nukaga
- Respiratory Medicine, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Keigo Kobayashi
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.,Department of Medicine, Sano-kosei General Hospital, Sano, Japan
| | - Shinnosuke Ikemura
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Hideki Terai
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.,Clinical and Translational Research Center, Keio University Hospital, Tokyo, Japan
| | - Hiroyuki Yasuda
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Ichiro Kawada
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Yasunori Sato
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
| | - Ryosuke Satomi
- Department of Medicine, Sano-kosei General Hospital, Sano, Japan.,Respiratory Medicine, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Saeko Takahashi
- Department of Medicine, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - Mizuha Haraguchi Hashiguchi
- Department of Medicine, Keiyu Hospital, Yokohama, Japan.,Department of Respiratory Medicine, Nippon Kokan Hospital, Kawasaki, Japan
| | - Morio Nakamura
- Department of Medicine, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - Yoshitaka Oyamada
- Respiratory Medicine, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Takeshi Terashima
- Department of Respiratory Medicine, Tokyo Dental College Ichikawa General Hospital, Ichikawa, Japan
| | - Koichi Sayama
- Division of Pulmonary Medicine, Kawasaki Municipal Hospital, Kawasaki, Japan
| | - Fumitake Saito
- Department of Pulmonary Medicine, Eiju General Hospital, Tokyo, Japan
| | - Fumio Sakamaki
- Division of Pulmonary Medicine, Department of Medicine, Tokai University Hachioji Hospital, Hachioji, Tokyo, Japan
| | - Takashi Inoue
- Department of Medicine, Sano-kosei General Hospital, Sano, Japan
| | - Katsuhiko Naoki
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.,Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Koichi Fukunaga
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Kenzo Soejima
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.,Clinical and Translational Research Center, Keio University Hospital, Tokyo, Japan
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18
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Guirimand F, Bouleuc C, Sahut d'Izarn M, Martel-Samb P, Guy-Coichard C, Picard S, Devalois B, Ghadi V, Aegerter P. Development and Validation of the QUALI-PALLI-FAM Questionnaire for Assessing Relatives' Perception of Quality of Inpatient Palliative Care: A Prospective Cross-Sectional Survey. J Pain Symptom Manage 2021; 61:991-1001.e3. [PMID: 32979519 DOI: 10.1016/j.jpainsymman.2020.09.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 09/16/2020] [Accepted: 09/18/2020] [Indexed: 11/22/2022]
Abstract
CONTEXT Relatives of patients receiving palliative care are at risk for psychological and physical distress, and their perception of quality of care can influence patients' quality of life. OBJECTIVES The purpose of this study was to develop and validate the QUALI-PALLI-FAM questionnaire (QUAlity of PALLIative car from FAMilies' perspective) to measure families' perception of and satisfaction with palliative care. METHODS An exploratory factor analysis was conducted, and we evaluated the questionnaire's internal consistency using Cronbach's alpha, its stability across various strata, and the correlation between the QUALI-PALLI-FAM (factors, total score, and global satisfaction) and the total score of the FAMCARE (FAMily satisfaction with CARE) questionnaire. RESULTS This multicentric prospective cross-sectional survey was conducted in seven French hospitals, namely, three palliative care units and four standard medical units with a mobile palliative care team. The questionnaire was completed by 170 relatives of patients (more than 90% of patients had advanced cancer). The final questionnaire included 14 items across three domains: organization of care and availability of caregivers, medical information provision, and confidence and involvement of relatives. Internal consistency was good for all subscales (Cronbach's α = 0.74-0.86). Our questionnaire was stable across various strata: age and gender (patients and relatives), Palliative Performance Scale scores, and care settings. The QUALI-PALLI-FAM total score was correlated with the total FAMCARE score. CONCLUSION The QUALI-PALLI-FAM appears to be a valid, reliable, and well-accepted tool to explore relatives' perception of quality of inpatient palliative care and complements the QUALI-PALLI-PAT questionnaire. Further testing is required in various settings and countries.
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Affiliation(s)
- Frédéric Guirimand
- Pôle Recherche SPES 'Soins Palliatifs en Société' Maison Médicale Jeanne Garnier, Paris and Université Paris-Saclay, UVSQ, Versailles, France.
| | - Carole Bouleuc
- Institut Curie, Département interdisciplinaire des Soins de Support, Paris, France
| | - Marine Sahut d'Izarn
- AP-HP, Hôpital Ambroise Paré, Equipe Mobile de Soins Palliatifs, Boulogne, France
| | - Patricia Martel-Samb
- AP-HP, Unité de Recherche Clinique URC HU PIFO, Hôpital Ambroise Paré, Boulogne, France
| | | | - Stéphane Picard
- Groupe Hospitalier Diaconesses Croix Saint-Simon, Unité de Soins Palliatifs, Paris, France
| | - Bernard Devalois
- Centre de Recherche et d'Enseignement interprofessionnel Bientraitance et fin de vie and AGORA (EA7892) université CY Cergy Paris Université, Cergy, France
| | | | - Philippe Aegerter
- GIRCI-IDF, Cellule Méthodologie, Paris, France et Université Paris-Saclay, UVSQ, Inserm, Équipe d'Épidémiologie respiratoire intégrative, CESP - Centre de recherche en Epidémiologie et Santé des Populations U1018 INSERM UPS UVSQ, 94807, Villejuif, France
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19
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Niu A, Guo C, Zhong D, He G, Zhong W, Wang L, Chen Y, Shang L, Fu J. Identifying the Unmet Supportive Care Needs, with Concomitant Influencing Factors, in Family Caregivers of Cancer Patients in China. Asia Pac J Oncol Nurs 2021; 8:276-286. [PMID: 33850961 PMCID: PMC8030597 DOI: 10.4103/apjon.apjon_52_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 08/19/2020] [Indexed: 12/24/2022] Open
Abstract
Objective The objective of the study is to assess the unmet needs of cancer caregivers and to identify the possible predictors of their supportive care needs in China. Methods This multicenter, cross-sectional study enrolled 449 cancer patients' family caregivers' dyads. Patients provided general information and Karnofsky performance status (KPS); caregivers provided general information and completed a survey of Chinese version of the Supportive Care Needs Survey-Partners and Caregivers Scale. The independent samples t-test, one-way analysis of variance, and multiple stepwise regression were used to analyze the factors that influence the needs of caregivers. Results A proportion of caregivers who had no needs were 5.6%. A proportion of caregivers with ≥ 5 moderate or high unmet needs and with ≥ 10 moderate or high unmet needs were 77.7% and 63.2%, respectively. Healthcare services and information needs and communication and relationship needs were the most prominent areas of caregivers' unmet needs. The item "Finding out about financial support and government benefits for you and/or the person with cancer" was the highest level of unmet needs at 78.6%. The level of unmet needs was related to the patient's physical function (KPS score), caregiver's educational levels, financial burden of healthcare, as well as the level of burden related to caregiving (working status, caring for others, caregiving experience, and total caregiving time). Conclusions The level of unmet needs of family caregivers of cancer patients in China was higher. In clinical practice, more attention should be paid to family caregivers who take care of the patient with poor physical function, those who are highly educated, faced with higher financial burden of healthcare, and are currently working, as well as those who need to take care of others, spend more time caregiving, and have no caregiving experience.
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Affiliation(s)
- Aifang Niu
- Department of Internal Medicine, 947 Army Hospital, Kashgar, China
| | - Chunyong Guo
- Department of Internal Medicine, 947 Army Hospital, Kashgar, China
| | - Daozhu Zhong
- Department of Internal Medicine, 947 Army Hospital, Kashgar, China
| | - Guirong He
- Department of Internal Medicine, 947 Army Hospital, Kashgar, China
| | - Wenbo Zhong
- Department of Internal Medicine, Xinjiang Military District General Hospital, Urumqi, Xinjiang, China
| | - Lanmei Wang
- Department of Internal Medicine, 947 Army Hospital, Kashgar, China
| | - Yu Chen
- Department of Internal Medicine, 947 Army Hospital, Kashgar, China
| | - Lei Shang
- Department of Preventive Medicine, Air Force Medical University, Xi'an, Shaanxi, China
| | - Jufang Fu
- Nursing Department, Shenzhen University General Hospital, Shenzhen, Guangdong, China
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20
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Gabriel I, Creedy D, Coyne E. Quality of life and associated factors among adults living with cancer and their family caregivers. Nurs Health Sci 2021; 23:419-429. [PMID: 33605071 DOI: 10.1111/nhs.12823] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 02/09/2021] [Accepted: 02/14/2021] [Indexed: 12/26/2022]
Abstract
This study examined the association of needs, health literacy, and quality of life among adult Nigerians with cancer and family caregivers. A descriptive study was conducted involving 240 adults with cancer and family caregivers attending a tertiary hospital. More than two-thirds of participants reported moderate or high needs. Information (90.8%) and spiritual support (85%) were the domains of highest need among adults with cancer. Family/social support (85%) and spiritual support (81.7%) ranked the highest among family caregivers. A negative correlation was found between needs and quality of life. Stepwise regression analysis showed that needs and literacy explained 36% of the variance in adults with cancer's quality of life and 28% of the variance in family caregivers' quality of life. Spiritual need accounted l for 9.5% and 9.1% of variation for adults with cancer and family caregivers, respectively. Findings suggest that interventions with a focus on social/family and spiritual needs may improve wellbeing of adults with cancer and caregivers in Nigeria. This research are generalizable to other low-income countries where family values and spirituality are often a strong feature of daily life.
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Affiliation(s)
- Israel Gabriel
- School of Nursing and Midwifery, Griffith University, Logan Campus, Meadowbrook, Queensland, Australia.,School of Post Basic Nursing Programmes, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | - Debra Creedy
- Perinatal Mental Health, School of Nursing and Midwifery, Transforming Maternity Care Collaborative, Griffith University, Brisbane, Queensland, Australia
| | - Elisabeth Coyne
- School of Nursing and Midwifery, Griffith University, Logan Campus, Meadowbrook, Queensland, Australia
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Guerriere D, Husain A, Marshall D, Zagorski B, Kennedy J, Coyte PC. Transitions in Labour Force Participation over the Palliative Care Trajectory. Healthc Policy 2020; 16:25-40. [PMID: 33337312 PMCID: PMC7710958 DOI: 10.12927/hcpol.2020.26355] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
BACKGROUND Home-based palliative programs rely on family caregivers, who often miss time from employment. This article identified changes in caregivers' labour force participation over the palliative trajectory. METHODS Family caregivers (n = 262) were interviewed biweekly to measure transitions across four employment categories. RESULTS More than half of the caregivers had one employment transition and 29% had three or more. The highest proportion of transitions occurred for caregivers who were employed part-time. INTERPRETATION Understanding these transitions is critical to the development of strategies tailored to caregivers to contain labour force losses and to support caregivers during a time of high caregiving demands.
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Affiliation(s)
- Denise Guerriere
- Adjunct Professor, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON
| | - Amna Husain
- Clinician Scientist, Temmy Latner Centre for Palliative Care, Lunenfeld Tanenbaum Research Institute, Sinai Health System, Toronto, ON
| | - Denise Marshall
- Medical Director, Niagara West Palliative Care Team and McNally House Hospice, Grimsby, ON; Professor, Department of Family Medicine, Division of Palliative Care, David Braley Health Sciences Centre, McMaster University, Hamilton, ON
| | - Brandon Zagorski
- Adjunct Professor, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON
| | - Julia Kennedy
- Consultant, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON
| | - Peter C Coyte
- Professor of Health Economics, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON
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Liu Z, Heffernan C, Tan J. Caregiver burden: A concept analysis. Int J Nurs Sci 2020; 7:438-445. [PMID: 33195757 PMCID: PMC7644552 DOI: 10.1016/j.ijnss.2020.07.012] [Citation(s) in RCA: 144] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 06/29/2020] [Accepted: 07/21/2020] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVE Caregiver burden is used frequently within the nursing literature. It has not yet been clearly defined as there are different opinions regarding this concept. The purpose of this paper is to provide clarity surrounding the concept caregiver burden. METHODS An electronic search of MEDLINE, CINAHL, Health Source Nursing/Academic Edition and Academic Search Complete (ASC) of EBSCO, China National Knowledge Infrastructure (CNKI) and Google Scholar were searched with a limit of 10 years and published in the English or Chinese language. The paper adopted the framework by Walker and Avant. The attributes, antecedents, consequences and uses of the concept were identified. RESULTS At total of 33 articles were included. The three attributes of caregiver burden were identified as self-perception, multifaceted strain, and over time. The antecedents included insufficient financial resources, multiple responsibility conflict, lack of social activities. The consequences of caregiver burden resulted in negative change which included decreased care provision, decrease in quality of life, physical and psychological health deterioration. CONCLUSION A definition of caregiver burden was developed. Tools to measure caregiver burden were identified. The findings from this analysis can be used in nursing practice, nursing education, research and administration.
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Affiliation(s)
- Zhu Liu
- Department of Hepatobiliary Surgery, The People’s Hospital of Deyang City, Deyang, Sichuan, China
| | - Catrina Heffernan
- Department of Nursing and Healthcare Sciences, Institute of Technology Tralee, Co. Kerry, Ireland
| | - Jie Tan
- Department of Hepatobiliary Surgery, The People’s Hospital of Deyang City, Deyang, Sichuan, China
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23
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Li Q, Xu Y, Lin Y, Chen Y. Validating the Chinese version of the Cancer Survivors' Partners Unmet Needs measure (C-CaSPUN) and exploring unmet needs in Chinese cancer survivor-family caregiver dyads. Eur J Cancer Care (Engl) 2020; 30:e13341. [PMID: 33090586 DOI: 10.1111/ecc.13341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 08/10/2020] [Accepted: 08/17/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To evaluate the psychometric properties of the C-CaSPUN in Chinese family caregivers (FCs) of cancer survivors (CaS) and to compare the unmet needs of CaS-FC dyads. METHODS A questionnaire survey, consisting of five Chinese version measurement scales, was used to collect data from CaS-FC dyads. Statistical methods used included exploratory factor analysis (EFA), confirmatory factor analysis (CFA), Cronbach's α, intraclass correlation coefficient (ICC) and Pearson's correlation. RESULTS Participants consisted of 610 survivor-caregiver dyads. EFA and CFA established the four-factor construct C-CaSPUN, comprising relationship impact and life perspective, information and health care, quality of life (QoL) and survivorship care. All of the C-CaSPUN scales had good internal reliability (Cronbach's α ≥ 0.752). The ICC for test-retest ranged from 0.645 to 0.782 at the scale level, with an average ICC value of 0.653. The concurrent validity was evidenced by C-CaSPUN being negatively associated with SF-12 MCS and positively related to anxiety and/or depression. In addition, the correlation coefficient scores between C-CaSPUN factors and the C-CaSUN total scale ranged from moderate to good (r = 0.505-0.671). CONCLUSIONS Study findings may support the reliability and validity of the C-CaSPUN in measuring the unmet needs of FCs of Chinese CaS.
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Affiliation(s)
- Qiuping Li
- Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | | | - Yi Lin
- Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Ying Chen
- Affiliated Hospital, Jiangnan University, Wuxi, China
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24
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Wang T, Molassiotis A, Tan JY, Chung BPM, Huang HQ. Prevalence and correlates of unmet palliative care needs in dyads of Chinese patients with advanced cancer and their informal caregivers: a cross-sectional survey. Support Care Cancer 2020; 29:1683-1698. [PMID: 32776164 DOI: 10.1007/s00520-020-05657-w] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 07/24/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To examine palliative care needs of advanced cancer patients and their informal caregivers and correlates of their needs within Chinese context. METHODS This was a cross-sectional survey conducted in two study sites in Mainland China. Patients and caregivers were recruited in dyads. Patients completed the following questionnaires: Problems and Needs in Palliative Care-short version, Hospital Anxiety and Depression Scale (HADS), Edmonton Symptom Assessment Scale (ESAS), Medical Outcomes Study-Social Support Survey (MOS-SSS), Brief Coping Orientation to Problems Experienced Scale (Brief-COPE), and Quality-of-Life Questionnaire Core 15-Palliative Care Scale. Questionnaires for caregivers were as follows: Comprehensive Needs Assessment Tool in Cancer for Caregivers, HADS, ESAS, MOS-SSS, Brief-COPE, and Caregiver Quality of Life Index-Cancer. All of the outcome variables were selected based on a conceptual framework of palliative care needs assessment. RESULTS Four hundred nineteen patient-caregiver dyads completed this survey. Patients' unmet palliative care needs were mainly related to financial (85.2%), informational (82.3%), physical (pain) (69.7%), and psychological (64.9%) domains. Caregivers' commonly reported unmet needs mainly focused on the domains of healthcare staff (95.0%), information (92.1%), and hospital facilities and services (90.5%). Patients' greater severity of symptom distress, presence of anxiety and/or depression, use of coping strategies particularly the less use of problem-focused coping, and caregivers' poorer quality of life were identified as key negative predictors of the needs of both patients and caregivers (p < 0.05). CONCLUSIONS Both patients and caregivers had context-bounded palliative care needs. In addition to increasing the amount of external asistance, more emphasis should be placed on screening for physical and psychological distress, the use of coping strategies, and the well-being of caregivers to help identify those in need for more clinical attention and specific interventions.
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Affiliation(s)
- Tao Wang
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
- College of Nursing and Midwifery Brisbane Centre, Charles Darwin University, Brisbane, Australia
| | - Alex Molassiotis
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
| | - Jing-Yu Tan
- College of Nursing and Midwifery Brisbane Centre, Charles Darwin University, Brisbane, Australia
| | - Betty Pui Man Chung
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Hou-Qiang Huang
- Department of Nursing, The Affiliated Hospital of Southwest Medical University, Luzhou, China
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25
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Wu VS, Smith AB, Girgis A. The unmet supportive care needs of Chinese patients and caregivers affected by cancer: A systematic review. Eur J Cancer Care (Engl) 2020; 31:e13269. [PMID: 32495473 DOI: 10.1111/ecc.13269] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 12/04/2019] [Accepted: 04/16/2020] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Cancer patients and caregivers have myriad unmet needs which can have detrimental consequences on their psychosocial wellbeing. This systematic review aims to identify the unmet supportive care needs of immigrant and native Chinese cancer patients and caregivers. METHODS We systematically searched various electronic databases (e.g. Scopus, CINAHL, PsycInfo, etc.) from the earliest date available until January 2018. Additional studies were identified through reference lists and citation tracking. Eligibility criteria included: (a) qualitative, quantitative and/or mixed methods studies published in English; (b) immigrant and native Chinese cancer patients and/or caregivers (age ≥18 years); (c) unmet needs and/or their correlates. Studies were assessed for their risk of bias, and a narrative synthesis of findings was performed. RESULTS Forty-seven papers from 45 studies met eligibility criteria. The most prevalent area of unmet needs was health system and information. Patients most commonly desired one member of the hospital to talk to about all aspects of their care. Caregivers preferred information about the patient's prognosis and likely outcome. Anxiety was most commonly associated with higher levels of health system and information needs. CONCLUSION Chinese patients and caregivers experience a range of unmet health system and information needs, which differ depending on their stage along the cancer trajectory.
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Affiliation(s)
- Verena Shuwen Wu
- Psycho-Oncology Research Group, Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, The University of New South Wales, Liverpool, NSW, Australia
| | - Allan Ben Smith
- Psycho-Oncology Research Group, Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, The University of New South Wales, Liverpool, NSW, Australia
| | - Afaf Girgis
- Psycho-Oncology Research Group, Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, The University of New South Wales, Liverpool, NSW, Australia
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26
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Zhao XS, Wang HY, Zhang LL, Liu YH, Chen HY, Wang Y. Prevalence and risk factors associated with the comprehensive needs of cancer patients in China. Health Qual Life Outcomes 2019; 17:102. [PMID: 31196089 PMCID: PMC6567519 DOI: 10.1186/s12955-019-1171-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 06/03/2019] [Indexed: 01/09/2023] Open
Abstract
Background The incidence and mortality rates of cancer have been increasing in developing countries, particularly in Asia. Therefore to provide optimal comprehensive care to the cancer patients, the care plan must focus on the comprehensive needs of cancer patients. The purpose of this study was to investigate the comprehensive needs of cancer patients, and explore the associated factors. Methods In a cross-sectional questionnaire study, a total of 200 cancer patient-caregiver dyads were selected and interviewed in Mainland China by convenient sampling method. Patients’ comprehensive needs were assessed with Comprehensive Needs Assessment Tool in cancer for Patients (CNAT), including seven domains (Information, Psychological Problems, Health Care Staffs, Physical Symptoms, Hospital Facilities and Services, Social/Religious/Spiritual Support and Practical Support). Both cancer patients and caregivers completed the sociodemographic survey. The mean differences in domain scores for different characteristics groups were compared by one-way ANOVA or non-parametric analyses, and influencing factors defined with multivariate regression analysis. Results The cancer patients’ need for Health Care Staffs (78.35 ± 13.08) was the highest among the seven domains, followed by the need for Information (71.18 ± 17.39) and the need for Hospital Facilities and Services (52.65 ± 13.35). The lowest score was the need for Physical Symptoms (35.12 ± 16.68). Patients who were female, with low family monthly income, at their own expense, and with highly educated caregivers had higher score of CNAT. Also sociodemographic characteristics were associated with each domain need of cancer patients. Conclusion This study shows that cancer patients experience high levels of needs for health-care staff and information, and the different needs are closely related to their sociological characteristics. The provision of health care can be adapted to meet the different needs of cancer patients of different epidemiological characteristics at different times during the course of treatment.
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Affiliation(s)
- Xin-Shuang Zhao
- College of Nursing, Henan University of Science and Technology, Luoyang, 471023, People's Republic of China
| | - Hong-Yun Wang
- College of Nursing, Henan University of Science and Technology, Luoyang, 471023, People's Republic of China.
| | - Luo-Ling Zhang
- The 1st Affiliated Hospital of Henan University of Science and Technology, Luoyang, 471023, People's Republic of China
| | - Yan-Hua Liu
- The 1st Affiliated Hospital of Henan University of Science and Technology, Luoyang, 471023, People's Republic of China
| | - Hai-Yan Chen
- College of Nursing, Henan University of Science and Technology, Luoyang, 471023, People's Republic of China
| | - Ying Wang
- Henan University of Science and Technology, Luoyang, 471023, People's Republic of China
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27
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Chen RW, Yang SL, Xu ZY, Peng M, Chen MN, Wang QS, Chang J, Hu JL. Validation and Application of the Chinese Version of the M. D. Anderson Symptom Inventory Gastrointestinal Cancer Module (MDASI-GI-C). J Pain Symptom Manage 2019; 57:820-827. [PMID: 30684634 DOI: 10.1016/j.jpainsymman.2019.01.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Revised: 01/14/2019] [Accepted: 01/14/2019] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To validate and use the Chinese Version of the M. D. Anderson Symptom Inventory Gastrointestinal Cancer Module (MDASI-GI-C) to assess the symptom burden of Chinese-speaking patients with gastrointestinal cancer. METHODS In total, 527 patients with postoperative or advanced digestive tract tumors were enrolled in the trial, who had definitive diagnoses and different treatments in our cancer center. MDASI-GI-C was administered to these patients between February and December 2017. The item-scale correlations and internal consistency were evaluated. Construct validity was established by factor analysis. Hierarchical cluster analysis was performed. RESULTS Cronbach's alpha of the symptom severity and interference subscales was 0.842 and 0.859, respectively. Construct validity revealed a four-factor structure. Known-group validity was established by comparing the MDASI-GI-C scores between patients having different Karnofsky Performance Status scores (≤70 or >70), which were observed to have significant differences. The overall mean subscale scores for the core and interference subscales were 1.63 ± 2.02 and 2.17 ± 2.34, respectively. Fatigue, disturbed sleep, and lack of appetite had the highest scores for most serious symptoms. No significant differences in age, working status, and educational level were found. CONCLUSIONS MDASI-GI-C is a reliable and valid tool for assessing cancer-related symptoms in Chinese-speaking patients with digestive tract tumors, facilitates the understanding of the common symptoms of patients with digestive tract tumors, and enables timely management of these symptoms. Cognitive debriefing demonstrated that the patients found MDASI-GI-C to be an easy-to-use and understandable instrument.
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Affiliation(s)
- Ren-Wang Chen
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Sheng-Li Yang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhong-Yu Xu
- Department of Epidemiology and Biostatistics, Huazhong University of Science and Technology, Wuhan, China
| | - Miao Peng
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Meng-Ni Chen
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qiu-Shuang Wang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jian Chang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jian-Li Hu
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Han Y, Zhou Y, Wang J, Hall A, Zhao Q, Qin H, Fan Y, Song Y, Cui S. Chinese version of the Cancer Support Person's Unmet Needs Survey-Sort Form: A psychometric study. Eur J Cancer Care (Engl) 2018; 28:e12963. [PMID: 30474275 DOI: 10.1111/ecc.12963] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 07/30/2018] [Accepted: 10/21/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Psychometrically rigorous and comprehensive needs assessment measures for Chinese general cancer caregivers are relatively scarce. We described the development and psychometric evaluation of the Chinese version of the Cancer Support Person's Unmet Needs Survey-Short Form (SPUNS-SFC). METHODS A forward-backward translation method was utilised to develop the SPUNS-SFC. The construct validity, internal consistency, convergent validity and discriminant validity of the SPUNS-SFC were evaluated. RESULTS A total of 1,026 Chinese cancer caregivers completed the SPUNS-SFC. Items 10, 11, 13, 24 and 26 were removed as more than 80% of respondents reported having no unmet needs on these items. Exploratory factor analysis revealed a five-factor structure, which accounted for 78.47% of the total variance, and consisted of the following domains: information, healthcare access and continuity, personal and emotional needs, worries about the future, and financial needs. Internal consistency of the measure was high, with Cronbach's alpha coefficients ranging from 0.87 to 0.95 for the five domains. The measure illustrated adequate evidence of convergent validity, demonstrated by significant correlations with multiple measures of psychological well-being. Known-groups validity was established, as 87.5% of the hypotheses were supported. CONCLUSION This study indicates the SPUNS-SFC is a reliable and valid measure of the unmet needs of Chinese cancer caregivers.
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Affiliation(s)
- Yuan Han
- School of Nursing, Guangzhou Medical University, Guangzhou, China.,Cancer Center of Guangzhou Medical University, Guangzhou, China
| | - Ying Zhou
- School of Nursing, Guangzhou Medical University, Guangzhou, China
| | - Jing Wang
- School of Nursing, The University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Alix Hall
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Qian Zhao
- School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Huiying Qin
- Sun Yat-sen University Cancer Center, Sun Yat-sen University, Guangzhou, China
| | - Yuying Fan
- Sun Yat-sen University Cancer Center, Sun Yat-sen University, Guangzhou, China
| | - Yalan Song
- Cancer Center of Guangzhou Medical University, Guangzhou, China
| | - Shuzhong Cui
- Cancer Center of Guangzhou Medical University, Guangzhou, China
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Wang T, Molassiotis A, Chung BPM, Tan JY. Unmet care needs of advanced cancer patients and their informal caregivers: a systematic review. BMC Palliat Care 2018; 17:96. [PMID: 30037346 PMCID: PMC6057056 DOI: 10.1186/s12904-018-0346-9] [Citation(s) in RCA: 319] [Impact Index Per Article: 53.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 06/25/2018] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND This systematic review aimed to identify the unmet care needs and their associated variables in patients with advanced cancer and informal caregivers, alongside summarizing the tools used for needs assessment. METHODS Ten electronic databases were searched systematically from inception of each database to December 2016 to determine eligible studies. Studies that considered the unmet care needs of either adult patients with advanced cancer or informal caregivers, regardless of the study design, were included. The Mixed Methods Appraisal Tool was utilized for quality appraisal of the included studies. Content analysis was used to identify unmet needs, and descriptive analysis was adopted to synthesize other outcomes. RESULTS Fifty studies were included, and their methodological quality was generally robust. The prevalence of unmet needs varied across studies. Twelve unmet need domains were identified in patients with advanced cancer, and seven among informal caregivers. The three most commonly reported domains for patients were psychological, physical, and healthcare service and information. The most prominent unmet items of these domains were emotional support (10.1-84.4%), fatigue (18-76.3%), and "being informed about benefits and side-effects of treatment" (4-66.7%). The most commonly identified unmet needs for informal caregivers were information needs, including illness and treatment information (26-100%) and care-related information (21-100%). Unmet needs of patients with advanced cancer were associated with their physical symptoms, anxiety, and quality of life. The most commonly used instruments for needs assessment among patients with advanced cancer were the Supportive Care Needs Survey (N = 8) and Problems and Needs in Palliative Care questionnaire (N = 5). The majority of the included studies investigated unmet needs from the perspectives of either patients or caregivers with a cross-sectional study design using single time-point assessments. Moreover, significant heterogeneity, including differences in study contexts, assessment methods, instruments for measurement, need classifications, and reporting methods, were identified across studies. CONCLUSION Both advanced cancer patients and informal caregivers reported a wide range of context-bound unmet needs. Examining their unmet needs on the basis of viewing patients and their informal caregivers as a whole unit will be highly optimal. Unmet care needs should be comprehensively evaluated from the perspectives of all stakeholders and interpreted by using rigorously designed mixed methods research and longitudinal studies within a given context.
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Affiliation(s)
- Tao Wang
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Alex Molassiotis
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Betty Pui Man Chung
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Jing-Yu Tan
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
- College of Nursing and Midwifery, Charles Darwin University, Darwin, Australia
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30
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Wang T, Molassiotis A, Chung BPM, Tan JY. Current Research Status of Palliative Care in Mainland China. J Palliat Care 2018; 33:215-241. [DOI: 10.1177/0825859718773949] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives: This study aimed to obtain an overview of the current research status of palliative care in Mainland China and identify research directions for future studies by characterizing palliative care studies conducted among patients with any life-limiting illness in Mainland China and published in a peer-reviewed journal before November 2016. Methods: A review guide with 7 categories was initially developed based on existing international palliative care definitions and guidelines through content analysis. Ten databases were used to identify relevant studies from the inception of online cataloging to November 2016. Studies conducted in Mainland China and their research topic that fell within one of the categories of the review guide were included for further analysis. Descriptive analysis was adopted to summarize the relevant findings. Results: 54 studies found to be relevant were included for the analysis. Three studies on “palliative care education and training” (category 1) asserted that education and training programs were scant in Mainland China and that only 1 program had been devised within the health-care context of Shanghai. Five studies on “palliative care screening and timely identification” (category 2) highlighted the absence of early screening criteria or checklists and referral procedures for palliative care. Thirty-one studies on “palliative care needs assessment (n = 12/31) and implementation (n = 19/31)” (category 3) were identified, and various methodological flaws were observed in most of these included studies. Twelve studies on “advanced decision-making” (category 4) were identified, all of which focused on investigating the attitudes of patients with cancer, their families, and/or health-care professionals toward advanced decision-making only. The percentage of patients, family members, and health-care professionals who held positive attitudes toward advanced decision-making were varied and suboptimal, particularly for family members (51.4%-58.0%). Five studies on “caring for patients at the end of life” (category 5) were identified, and the experience of health-care professionals in caring for those patients was explored. No studies relating to “death and bereavement care” (Category 6) and “psychological support for palliative care providers” (Category 7) were identified. Conclusion: The current research status of palliative care in Mainland China remains at an early stage with minimal palliative care services used. Although several knowledge gaps were identified, the first step, which should be addressed, is assessing the palliative care needs. An appropriate and ongoing needs assessment could provide important information for constructing comprehensive education and training programs of palliative care, identifying prognostic factors of timely palliative care referral, and developing evidence-based and tailored palliative care services.
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Affiliation(s)
- Tao Wang
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Alex Molassiotis
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Betty Pui Man Chung
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Jing-Yu Tan
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
- College of Nursing and Midwifery, Charles Darwin University, Darwin, NT, Australia
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Ashrafian S, Feizollahzadeh H, Rahmani A, Davoodi A. The Unmet Needs of the Family Caregivers of Patients with Cancer Visiting a Referral Hospital in Iran. Asia Pac J Oncol Nurs 2018; 5:342-352. [PMID: 29963598 PMCID: PMC5996589 DOI: 10.4103/apjon.apjon_7_18] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Objective: The complex process of taking care of patients with cancer can affect various aspects of the needs and health of their family caregivers. The present study aims to determine the unmet needs of the family caregivers of patients with cancer and to compare it according to background variables. Methods: The present descriptive study recruited 200 family caregivers of patients with cancer visiting a referral hospital in Iran. Sampling was carried out through the convenience method. Data were collected using Shin's comprehensive needs assessment tool in seven domains (health and psychological problems, family/social support, healthcare staff, information, religious/spiritual support, hospital facilities/services, and practical support). Results: The mean (±standard deviation) of the total scores of the unmet needs of the family caregivers was 81.73 (±16.82), with a possible range of 0–123. A significant percentage of the family caregivers of patients with cancer had unmet needs in all of the seven domains with different severities. The mean scores were higher in the information, healthcare staff (physicians and nurses), and health and psychological problems domains as compared to the other domains. Conclusions: The results showed that the majority of the family caregivers of patients with cancer have many unmet needs, which should be addressed by professional care providers through the development of holistic care programs targeting family caregivers by focusing on information needs and a proper communication process.
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Affiliation(s)
- Shima Ashrafian
- Department of Medical-Surgical Nursing, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hossein Feizollahzadeh
- Department of Medical-Surgical Nursing, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Azad Rahmani
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Arefeh Davoodi
- Department of Medical-Surgical Nursing, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
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Lefranc A, Pérol D, Plantier M, Chatelain P, de Rohan-Chabot H, Schell M. Assessment of informal caregiver's needs by self-administered instruments: a literature review. Eur J Public Health 2017; 27:796-801. [PMID: 28957482 DOI: 10.1093/eurpub/ckx103] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Clinicians, researchers and politicians are seeking to better assess caregiver's needs. Challenges exist in broadly implementing this so as to provide appropriate support. The aim of this review was to compile self-administered instruments for assessment of caregiver's needs that are deemed to be scientifically robust. Methods The Medline database was searched for publications reporting self-administered instruments assessing caregiver's needs with acceptable psychometric properties. These instruments were analyzed in terms of the development context, target population, concept, purpose, structure, content and psychometric properties. The dimensions of the needs were listed and categorized. Results A total of nine self-administered instruments were analyzed. They averaged 32 items, they were specifically developed for a targeted subpopulation of caregivers and dedicated to epidemiological research. Response devices were based on Likert scales. The main dimensions of the needs identified were 'Health and Care', 'Psychological - Emotional Support', 'Information-Knowledge', 'Social Life-Work-Finance'. None was specifically geared toward caregivers for the elderly, children or teenagers. In the absence of transcultural validation, no instrument was directly usable in Europe. Conclusions Assessing caregivers' needs is a key part in providing caregivers with appropriate support. The development of self-administered instruments constitutes a complex field that is still underexplored at the international level; strict specifications with psychometric validation are essential. To be efficient, the instrument should be integrated in a larger process including: upstream, recognition, identification and assessment of the overall situation of the caregiver; and downstream, guidance, establishment and follow-up of a suitable action plan.
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Affiliation(s)
| | - David Pérol
- Clinical Research and Innovation Department Centre Léon Bérard, Lyon, France
| | - Morgane Plantier
- Clinical Research and Innovation Department Centre Léon Bérard, Lyon, France
| | - Pierre Chatelain
- Fondation France Répit, Lyon, France.,University Claude Bernard Lyon 1, Lyon, France
| | | | - Matthias Schell
- Fondation France Répit, Lyon, France.,Clinical Research and Innovation Department Centre Léon Bérard, Lyon, France
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Caregivers needing care: the unmet needs of the family caregivers of end-of-life cancer patients. Support Care Cancer 2017; 26:759-766. [PMID: 28952034 DOI: 10.1007/s00520-017-3886-2] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 09/11/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE Family caregivers play a significant role in the care of cancer patients, especially in their end of life. Identifying and meeting the needs of these caregivers is essential to improving their quality of patient care. This study was conducted to identify the unmet needs of the caregivers of end-of-life cancer patients. METHODS A total of 18 semi-structured interviews were held with the family caregivers of end-of-life cancer patients using purposive sampling. The interviews were recorded, transcribed, and analyzed using qualitative content analysis. RESULTS The analysis of the data led to the formation of three main categories, including social needs, cognitive needs, and psychological needs. The social needs category comprised of the subcategories of support for care, effective communication and financial support. The cognitive needs category comprised of educational support and support in decision-making. The psychological needs category comprised of support for psychological trauma, preparation to confront the reality of the death of a loved one, and support for mourning. CONCLUSIONS The family caregivers of end-of-life cancer patients take on the responsibility of many aspects of care for their patient, but many of their own needs remain unmet. The findings of this study can be used for healthcare policy planning and the development of palliative interventions, particularly for the family caregivers of end-of-life cancer patients.
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Bangerter LR, Griffin JM, Zarit SH, Havyer R. Measuring the Needs of Family Caregivers of People With Dementia: An Assessment of Current Methodological Strategies and Key Recommendations. J Appl Gerontol 2017; 38:1304-1318. [DOI: 10.1177/0733464817705959] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
While dementia caregivers are regarded as a population with high unmet needs, there is little consensus as to how caregivers’ needs should be conceptualized and measured. This article describes how dementia caregivers’ needs are currently assessed in the scientific literature with the goal of suggesting guidelines for the enhancement of future measurement of caregiver needs. A review of 26 articles identified overarching themes within measurement approaches including variation in methodological rigor, proxy indicators of need, dual needs assessment of caregiver and person with dementia (PWD), and third-party needs assessment. We recommend future research dedicate theoretical attention to the conceptualization and classification of caregivers’ needs to build a stronger foundation for measurement. The measurement development process should capitalize on mixed-methodology and follow instrument development and validation guidelines set forth by measurement theory. Reliable and valid instruments are essential to developing services and policies that address dementia caregivers’ needs.
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Affiliation(s)
- Lauren R. Bangerter
- Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
| | - Joan M. Griffin
- Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
| | - Steven H. Zarit
- Department of Human Development and Family Studies,The Pennsylvania State University, University Park, USA
| | - Rachel Havyer
- Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, MN, USA
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Lim BT, Butow P, Mills J, Miller A, Goldstein D. Information needs of the Chinese community affected by cancer: A systematic review. Psychooncology 2017; 26:1433-1443. [DOI: 10.1002/pon.4347] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Revised: 10/14/2016] [Accepted: 12/08/2016] [Indexed: 01/09/2023]
Affiliation(s)
- Bee Teng Lim
- Practical Support Unit; Cancer Council NSW; Woolloomooloo New South Wales Australia
| | - Phyllis Butow
- The Psycho-oncology Co-operative Research Group; the University of Sydney; Sydney New South Wales Australia
| | - Jill Mills
- Practical Support Unit; Cancer Council NSW; Woolloomooloo New South Wales Australia
| | - Annie Miller
- Practical Support Unit; Cancer Council NSW; Woolloomooloo New South Wales Australia
| | - David Goldstein
- Department of Medical Oncology; Prince of Wales Hospital; Randwick New South Wales Australia
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Yi TW, Deng YT, Chen HP, Zhang J, Liu J, Huang BY, Wang YQ, Jiang Y. The discordance of information needs between cancer patients and their families in China. PATIENT EDUCATION AND COUNSELING 2015; 99:863-9. [PMID: 26763870 DOI: 10.1016/j.pec.2015.12.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 12/04/2015] [Accepted: 12/28/2015] [Indexed: 02/05/2023]
Abstract
OBJECTIVE We aimed at studying information needs of patients and their families, and their attitude towards the counterparts' information needs. Factors influencing psychological status of patients were investigated. METHODS Self-designed questionnaires for information needs and attitude were delivered to participants. Patient Health Questionnaire 9-item and Generalized Anxiety Disorder 7-item scale were used to evaluate psychological status of patients. RESULTS 183 eligible pairs of patients and families were involved. Except for the patients' expected life span, most patients and families needed information for all other subscales of disease-related information. Most patients wished families know more information; however, caregivers tended to prevent this. The occurrence of patients' psychiatric disorders was related to their needs for expected life span (OR 3.06 95%CI 1.36-6.93), as well as the attitude of caregivers about whether to provide more information about treatment outcomes (OR 0.24 95% CI 0.10-0.63). CONCLUSIONS Information discordance between cancer patients and their families tended to happen when it came to patients' prognostic information. The psychological status of cancer patients was found in association with their information needs and families' attitude towards it. PRACTICE IMPLICATIONS To guide oncology professionals and cancer patients' families for information provision.
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Affiliation(s)
- Ting-wu Yi
- Institutions Department of Medical Oncology, Cancer Center State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
| | - Yao-tiao Deng
- Institutions Department of Medical Oncology, Cancer Center State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
| | - Hui-ping Chen
- Institutions Department of Medical Oncology, Cancer Center State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
| | - Jie Zhang
- Institutions Department of Medical Oncology, Cancer Center State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
| | - Jie Liu
- Institutions Department of Medical Oncology, Cancer Center State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
| | - Bo-yan Huang
- Institutions Department of Medical Oncology, Cancer Center State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
| | - Yu-qing Wang
- Institutions Department of Medical Oncology, Cancer Center State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
| | - Yu Jiang
- Institutions Department of Medical Oncology, Cancer Center State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
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Gröpper S, van der Meer E, Landes T, Bucher H, Stickel A, Goerling U. Assessing cancer-related distress in cancer patients and caregivers receiving outpatient psycho-oncological counseling. Support Care Cancer 2015; 24:2351-2357. [DOI: 10.1007/s00520-015-3042-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 11/23/2015] [Indexed: 11/24/2022]
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Weller D, Knott VE. Occupational stress, survivorship issues and key themes in this issue: occupational stress, survivorship interventions, cancer in Chinese populations. Eur J Cancer Care (Engl) 2015; 23:423-5. [PMID: 24934717 DOI: 10.1111/ecc.12212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- D Weller
- University of Edinburgh, Edinburgh, UK; Cancer and Primary Care Research International Network (Ca-PRI), Edinburgh, UK
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Patient and caregiver needs in oncology. An Italian survey. TUMORI JOURNAL 2015; 101:621-5. [PMID: 26108244 DOI: 10.5301/tj.5000362] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2015] [Indexed: 11/20/2022]
Abstract
AIMS AND BACKGROUND Cancer is a disease that has far-reaching consequences for patients and their families. The present study targets unmet caregiver needs so that better support can be provided and planned for. METHODS The first phase of the study was to conduct a survey designed to explore basic needs (medical and nursing information, psychological support, social welfare). The survey also investigated the caregiver's personal details (age, sex, degree of kinship). The survey was distributed to caregivers coming to the day hospitals of the 4 oncology departments involved in the study. RESULTS A total of 137 relatives of cancer patients completed the survey. Among the explored needs, the most recurrent was the availability of a doctor who provides full information on the treatment choices. A further important request was for consistency between the information provided by doctors and that provided by other health-care workers, with specific reference to a patient-centered approach that can be easily and fully understood, available therapeutic options especially at home, and prognosis. CONCLUSIONS The study showed that the need for exhaustive and simple information provided by a referral physician is still an unmet need in the Internet age.
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Jia M, Li J, Chen C, Cao F. Post-traumatic stress disorder symptoms in family caregivers of adult patients with acute leukemia from a dyadic perspective. Psychooncology 2015; 24:1754-60. [PMID: 26014209 DOI: 10.1002/pon.3851] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Revised: 04/18/2015] [Accepted: 04/20/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND Acute leukemia is a fatal disease in adults that not only affects the patients who suffer from it but also their family caregivers. No studies have investigated post-traumatic stress disorder symptoms (PTSS) in family caregivers of adult patients with acute leukemia using a matched sample. The current study examined PTSS in adult patients with acute leukemia and their family caregivers and investigated the factors associated with caregivers' PTSS. METHODS A total of 163 patient-caregiver dyads completed questionnaires assessing their PTSS, psychological resilience, and perceived social support. Hierarchical linear regression was used to explore the related factors of caregivers' PTSS. RESULTS More caregivers than patients met caseness criteria for PTSS (36.8% vs. 18.4%, p < 0.001). Among caregivers, being more closely related to the patients (e.g., spouses and parents), having patients with higher PTSS and having lower psychological resilience were independently associated with more severe PTSS. CONCLUSIONS Caregivers of acute leukemia patients had significantly more severe PTSS than did their patients. This study is the first to investigate PTSS among family caregivers of adult patients with acute leukemia and its related factors in a matched sample. More attention should be paid to the caregivers of patients with acute leukemia to minimize their PTSS and thus improve mental health of caregivers and reduce potential negative consequences for the patients themselves.
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Affiliation(s)
- Mutian Jia
- Department of Hematology, Qilu Hospital, Shandong University, Jinan, Shandong, China
| | - Jie Li
- Department of Health Psychology, School of Nursing, Shandong University, Jinan, Shandong, China
| | - Chunyan Chen
- Department of Hematology, Qilu Hospital, Shandong University, Jinan, Shandong, China
| | - Fenglin Cao
- Department of Health Psychology, School of Nursing, Shandong University, Jinan, Shandong, China
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