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Kalla M, Bradford A, Schadewaldt V, Burns K, Bray SCE, Cain S, McAlpine H, Dhillon RS, Chapman W, Whittle JR, J Drummond K, Krishnasamy M. Co-Designing a User-Centered Digital Health Tool for Supportive Care Needs of Patients With Brain Tumors and Their Caregivers: Interview Analysis. JMIR Cancer 2025; 11:e53690. [PMID: 40408266 PMCID: PMC12124322 DOI: 10.2196/53690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 03/17/2025] [Accepted: 03/20/2025] [Indexed: 05/25/2025] Open
Abstract
Background Brain tumors are characterized by the high burden of disease that profoundly impacts the quality of life in patients and their families. Digital health tools hold tremendous potential to enhance supportive care and quality of life for patients with brain tumors and their caregivers. Objective This study aims to generate ideas and concepts, through a co-design paradigm, to inform the development of a digital health tool to address the unmet needs of people affected by brain tumors. Methods Patients with brain tumors, caregivers, and health professionals from 2 large public tertiary hospitals in Victoria, Australia, were invited to complete a qualitative interview discussing their unmet needs of care. Overall, 35 qualitative interviews focusing on unmet needs and concepts for a digital health tool were conducted with 13 patients, 11 caregivers, and 11 health professionals. Interviews were audio recorded and transcribed, and a 5-step framework analysis approach was used to analyze data. Results Four themes of unmet supportive care needs emerged: (1) emotional and psychological, (2) information, (3) physical and practical, and (4) social connectedness. Participants expressed the desire for early and proactive mental health intervention, noted the importance of providing mental health support to caregivers, and emphasized the need for positive stories and affirmative language. From an information perspective, participants noted a sense of information overload, especially at the beginning. They also underscored the variety of information needed on an ongoing basis, including life after treatment, and comprehensive care assistance to maintain quality of life. Participants also described unmet supportive care needs relating to symptom burden, and practical and administrative support to facilitate the logistics of accessing treatment and accomplishing daily life tasks. Finally, they expressed the desire for greater social connectedness and safe spaces to engage with other people in a similar situation. Our findings are consistent with previous research on this subject and were integrated into the development of a web-based platform. Conclusions Participants' perspectives informed the development of content for a web-based digital health platform called "Brain Tumours Online." The platform comprises three pillars-(1) "LEARN": a repository of vetted information about a range of biomedical and psychosocial care topics; (2) "CONNECT": a digital peer support community with a health care professional interface; and (3) "TOOLBOX": an emerging library of validated digital therapeutics for symptom management.
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Affiliation(s)
- Mahima Kalla
- Centre for Digital Transformation of Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Grattan Street, Parkville, VIC, 3010, Australia, +61 3 8344 4000
| | - Ashleigh Bradford
- Department of Health Services Research and Implementation Science, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Verena Schadewaldt
- Department of Neurosurgery, The Royal Melbourne Hospital, Parkville, VIC, Australia
- Department of Surgery, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, VIC, Australia
| | - Kara Burns
- Centre for Digital Transformation of Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Grattan Street, Parkville, VIC, 3010, Australia, +61 3 8344 4000
| | - Sarah C E Bray
- Department of Neurosurgery, The Royal Melbourne Hospital, Parkville, VIC, Australia
- Department of Surgery, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, VIC, Australia
| | - Sarah Cain
- Department of Neurosurgery, The Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Heidi McAlpine
- Department of Neurosurgery, The Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Rana S Dhillon
- Department of Surgery, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, VIC, Australia
- Barwon Health, Geelong, VIC, Australia
- St Vincent’s Hospital Melbourne, Fitzroy, VIC, Australia
| | - Wendy Chapman
- Centre for Digital Transformation of Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Grattan Street, Parkville, VIC, 3010, Australia, +61 3 8344 4000
| | - James R Whittle
- Personalised Oncology Division, Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
- Department of Medical Biology, The University of Melbourne, Parkville, VIC, Australia
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Katharine J Drummond
- Department of Neurosurgery, The Royal Melbourne Hospital, Parkville, VIC, Australia
- Department of Surgery, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, VIC, Australia
| | - Meinir Krishnasamy
- Department of Health Services Research and Implementation Science, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Department of Nursing, School of Health Sciences, Faculty of Medicine, Dentistry and Health, The University of Melbourne, Parkville, VIC, Australia
- Victorian Comprehensive Cancer Centre Alliance, Melbourne, VIC, Australia
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Nic Giolla Easpaig B, Newman B, Johnson J, Laidsaar-Powell R, Sansom-Daly UM, Jones L, Hofstätter L, Robertson EG, Mears S, Sattarshetty K, Houweling RE, Edge R, Cummings J, Harrison R. What can we learn from the evidence of psychosocial support for carers of people with cancer and how do we advance our efforts? A meta-review study. J Cancer Surviv 2025:10.1007/s11764-025-01802-8. [PMID: 40380043 DOI: 10.1007/s11764-025-01802-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2025] [Accepted: 04/02/2025] [Indexed: 05/19/2025]
Abstract
PURPOSE Literature concerning programmes to support the well-being of carers of cancer survivors is vast, complex, and difficult to navigate, posing difficulties for identifying and translating relevant evidence. This study will advance the field by mapping and synthesising reviews to address the question: "What psychosocial interventions are available to promote the well-being of carers for people diagnosed with cancer, as reported in the evidence from reviews?". METHODS A meta-review was conducted of reviews published between 2013 and 2024. PsycINFO, MEDLINE, CINAHL, and Cochrane Database of Systematic Reviews databases and relevant reference lists were searched for eligible reviews. Records were screened and assessed in accordance with the method with data from included reviews extracted and synthesised. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guided reporting. Reviews were appraised using the JBI Critical Appraisal Checklist for Systematic Reviews and Research Syntheses. RESULTS Ultimately, 54 reviews met the inclusion criteria. This evidence was mapped regarding populations, interventions, and outcomes, including depression, anxiety, quality of life, and distress. On average, reviews addressed nine of 11 quality checklist items. Insights were gained concerning the role of theory, carer populations, and intervention characteristics. CONCLUSION Key features of the body of evidence were identified that can hinder progress and which point to ways forward. It is concluded that a recalibrated carer research agenda is needed, one that is designed to synthesise evidence concerning what works, for which carers to achieve what outcomes, or to address which kinds of psychosocial support needs. IMPLICATIONS FOR CANCER SURVIVORS Despite the need to ensure that carers have access to programs that support their wellbeing as they care for their loved ones, the evidence to guide program development is complex and difficult to navigate. A refocusing of research efforts is needed to advance understanding of what is most effective for carers, and how this can be translated into clinical practice.
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Affiliation(s)
- Brona Nic Giolla Easpaig
- School of Nursing, Charles Darwin University, Sydney, Australia.
- Australian Institute for Health Innovation, Macquarie University, Sydney, Australia.
| | - Bronwyn Newman
- Australian Institute for Health Innovation, Macquarie University, Sydney, Australia
| | - Judith Johnson
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester, Manchester, UK
- School of Psychology, University of Leeds, Leeds, UK
| | - Rebekah Laidsaar-Powell
- Psycho-Oncology Co-Operative Group (PoCoG), School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
| | - Ursula M Sansom-Daly
- School of Clinical Medicine, Discipline of Paediatrics & Child Health, UNSW Medicine and Health, University of New South Wales, Sydney, Australia
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children'S Hospital, Sydney, Australia
- Sydney Youth Cancer Service, Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Sydney, Australia
| | - Lucy Jones
- Neuroblastoma Australia, Sydney, Australia
| | | | - Eden G Robertson
- School of Clinical Medicine, Discipline of Paediatrics & Child Health, UNSW Medicine and Health, University of New South Wales, Sydney, Australia
- Redkite, Sydney, Australia
| | - Stephen Mears
- Australian Institute for Health Innovation, Macquarie University, Sydney, Australia
| | | | - Rachel E Houweling
- School of Clinical Medicine, Discipline of Paediatrics & Child Health, UNSW Medicine and Health, University of New South Wales, Sydney, Australia
| | | | - Joanne Cummings
- Redkite, Sydney, Australia
- Community First Step, Sydney, Australia
| | - Reema Harrison
- Australian Institute for Health Innovation, Macquarie University, Sydney, Australia
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Boele FW, Hertler C, Sherwood P, Cachia D, Dirven L, Young JS, Walbert T, Stockdill M, Rodriguez Almaraz E, Piil K. Reporting standards in randomized controlled trials involving neuro-oncology caregivers: A systematic review report from the RANO-Cares working group. Neurooncol Pract 2025; 12:19-33. [PMID: 39917763 PMCID: PMC11798602 DOI: 10.1093/nop/npae086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2025] Open
Abstract
Background Family caregivers in neuro-oncology (eg, spouse, family member, friend to a patient) have high unmet support needs, yet intervention trials and effective support options are scarce. The Response Assessment in Neuro-Oncology (RANO)-Cares working group investigated the methodological quality of neuro-oncology caregiver outcomes reporting in randomized controlled trials (RCTs). Methods A systematic review was performed to evaluate to what extent RCTs assessing outcomes of caregivers of adult primary brain tumor patients adhere to minimum reporting standards. A 33-item checklist (23 applicable to secondary analysis reports) based on the International Society for Quality of Life Research (ISOQOL) criteria for patient-reported outcome reporting was used. Risk of bias was assessed per RCT. Results Fifteen publications from 11 unique RCTs included 676 neuro-oncology caregivers, with low overall risk of bias. Ten publications (66%) reported on caregiver outcomes as a primary aim, of which 8 (80%) satisfied ≥2/3 of the key methodological criteria. Of the 5 secondary analysis reports (33%), 2 (40%) met ≥2/3 of applicable key criteria. Criteria often not reported adequately included sample size calculations (reported adequately in n = 8, 53%), participant flow (n = 9, 60%) window for data collection (n = 1, 6%), and extent of (n = 10, 66%), reasons for (n = 9, 60%), and statistical approaches in dealing with (n = 4, 26%) missing data. Conclusions Whilst there are opportunities to enhance reporting standards, RCTs that include neuro-oncology caregiver outcomes generally adhere to high-quality reporting standards and have low risk of bias, indicating good potential to impact clinical practice.
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Affiliation(s)
- Florien W Boele
- Faculty of Medicine and Health, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
- Leeds Institute of Medical Research at St James’s, St James’s University Hospital, University of Leeds, Leeds, UK
| | - Caroline Hertler
- Department of Radiation Oncology, Competence Center Palliative Care, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Paula Sherwood
- School of Nursing, University of Virginia, Charlottesville, Virginia, USA
| | - David Cachia
- Division of Hematology/Oncology, Department of Medicine, University of Massachusetts, Worcester, Massachusetts, USA
| | - Linda Dirven
- Department of Neurology, Haaglanden Medical Center, The Hague, the Netherlands
- Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands
| | - Jacob S Young
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA
| | - Tobias Walbert
- Department of Neurosurgery and Neurology, Henry Ford Health, Wayne State University and Michigan State University, Detroit, Michigan, USA
| | - Macy Stockdill
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Eduardo Rodriguez Almaraz
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
- Neuro-Oncology Division, Department of Neurological Surgery, University of California, San FranciscoSan Francisco, California, USA
| | - Karin Piil
- Department of People and Technology, Roskilde University, Roskilde, Denmark
- Department of Oncology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
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Walbert T, Avila EK, Boele FW, Hertler C, Lu-Emerson C, van der Meer PB, Peters KB, Rooney AG, Templer JW, Koekkoek JAF. Symptom management in isocitrate dehydrogenase mutant glioma. Neurooncol Pract 2025; 12:i38-i48. [PMID: 39776527 PMCID: PMC11703367 DOI: 10.1093/nop/npae088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2025] Open
Abstract
According to the 2021 World Health Organization classification of CNS tumors, gliomas harboring a mutation in isocitrate dehydrogenase (mIDH) are considered a distinct disease entity, typically presenting in adult patients before the age of 50 years. Given their multiyear survival, patients with mIDH glioma are affected by tumor and treatment-related symptoms that can have a large impact on the daily life of both patients and their caregivers for an extended period of time. Selective oral inhibitors of mIDH enzymes have recently joined existing anticancer treatments, including resection, radiotherapy, and chemotherapy, as an additional targeted treatment modality. With new treatments that improve progression-free and possibly overall survival, preventing and addressing daily symptoms becomes even more clinically relevant. In this review we discuss the management of the most prevalent symptoms, including tumor-related epilepsy, cognitive dysfunction, mood disorders, and fatigue, in patients with mIDH glioma, and issues regarding patient's health-related quality of life and caregiver needs in the era of mIDH inhibitors. We provide recommendations for practicing healthcare professionals caring for patients who are eligible for treatment with mIDH inhibitors.
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Affiliation(s)
- Tobias Walbert
- Department of Neurology and Neurosurgery, Henry Ford Health, Wayne State and Michigan State University, Detroit, Michigan, USA
| | - Edward K Avila
- Department of Neurology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Florien W Boele
- Academic Unit of Health Economics, Leeds Institute of Health Sciences, Faculty of Medicine and Health, University of Leeds, Leeds, UK
- Patient Centred Outcomes Research, Leeds Institute of Medical Research at St. James’s, St. James’s University Hospital, University of Leeds, Leeds, UK
| | - Caroline Hertler
- Competence Center for Palliative Care, Department of Radiation Oncology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Christine Lu-Emerson
- Department of Neurology, Maine Health/Maine Medical Center, Scarborough, Maine, USA
| | - Pim B van der Meer
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Katherine B Peters
- The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina, USA
| | - Alasdair G Rooney
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Jessica W Templer
- Department of Neurology, Northwestern University, Chicago, Illinois, USA
| | - Johan A F Koekkoek
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
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Forst DA, Podgurski AF, Strander SM, Whitman JD, Datta S, Pintro K, Horick NK, Willis KD, Sannes TS, Greer JA, El-Jawahri A, Jacobs JM, Temel JS. NeuroCARE: A Randomized Controlled Trial of a Psychological Intervention for Caregivers of Patients With Primary Malignant Brain Tumors. J Clin Oncol 2024; 42:4252-4262. [PMID: 39284103 DOI: 10.1200/jco.24.00065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 04/25/2024] [Accepted: 07/12/2024] [Indexed: 12/19/2024] Open
Abstract
PURPOSE Caregivers of patients with primary malignant brain tumors (PMBT) experience significant psychological distress. We assessed the effect of a psychological intervention (NeuroCARE) on anxiety symptoms among PMBT caregivers. METHODS We conducted a randomized trial of NeuroCARE versus usual care in PMBT caregivers with elevated anxiety (Generalized Anxiety Disorder-7 score ≥5) within 6 months of the patient's diagnosis. NeuroCARE was developed for PMBT caregivers and consists of six telehealth sessions with a behavioral health specialist. Participants completed surveys at baseline, 11-week (postintervention), and 16-week (1-month postintervention) time points. The primary outcome was 11-week anxiety symptoms (Hospital Anxiety and Depression Scale [HADS]-Anxiety Subscale). We also measured depression symptoms (HADS-Depression Subscale), quality of life (QOL; Caregiver QOL survey), caregiver burden (Caregiver Reaction Assessment), self-efficacy (Lewis Cancer Self-Efficacy Scale), coping (Measure of Current Status), and post-traumatic stress disorder (PTSD) symptoms (PTSD Checklist for DSM-5). We conducted analysis of covariance and linear mixed-effects regression analyses to examine intervention effects on study outcomes. RESULTS We enrolled 120 caregivers (60/group) between October 2019 and June 2022; 105 were evaluable for the primary outcome. At 11 weeks, NeuroCARE participants reported significantly lower anxiety symptoms than usual care participants (M, 8.87 v 10.69; P = .008). NeuroCARE caregivers also reported significantly lower depression symptoms (M, 6.08 v 7.77; P = .004), and better self-efficacy (M, 128.81 v 111.17; P < .001) and coping (M, 32.25 v 25.65; P < .001) at 11 weeks. Study groups did not differ significantly in 11-week QOL, caregiver burden, or PTSD symptoms. In longitudinal analyses, intervention effects on depression symptoms, self-efficacy, and coping were sustained. CONCLUSION A novel, population-specific psychological intervention led to improved anxiety and depression symptoms, self-efficacy, and coping among PMBT caregivers.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Timothy S Sannes
- University of Massachusetts Memorial Medical Center, Worcester, MA
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Gambarin M, Malgrati T, Di Censo R, Modenese A, Balestro G, Muti G, Cappellesso M, Fonte C, Varalta V, Gallinaro Y, Pinto M, Carlucci M, Picelli A, Smania N. An Overview of Reviews on Predictors of Neurorehabilitation in Surgical or Non-Surgical Patients with Brain Tumours. Life (Basel) 2024; 14:1377. [PMID: 39598176 PMCID: PMC11595827 DOI: 10.3390/life14111377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2024] [Revised: 10/17/2024] [Accepted: 10/23/2024] [Indexed: 11/29/2024] Open
Abstract
(1) Background. People suffering from brain cancer, regardless of histological tumour characteristics, often experience motor disturbances, cognitive-behavioural difficulty, language impairments, and functional and social limitations. The current treatment approach entails surgery and adjuvant therapy such as chemotherapy and radiotherapy combined with intensive rehabilitation. The primary focus of rehabilitation is usually motor and functional recovery, without specifically addressing the patient's quality of life. The present systematic review identifies and evaluates the predictors of functional and cognitive rehabilitation outcomes and their influence on quality of life in adult patients with brain cancer. (2) Methods. Three electronic databases (PubMed, Elsevier, Cochrane) were searched for reviews about functional, cognitive, and quality-of-life outcomes in patients with central nervous system tumours, including articles published between January 2018 and May 2024. (3) Results. The search retrieved 399 records, 40 of which were reviewed. Five main areas of predictive factors were identified: diagnosis, therapy, complications, outcomes (in the motor, cognitive, and quality-of-life categories), and tailored rehabilitation. (4) Conclusions. These indicators may inform integrated care pathways for patients with primary central nervous system tumours.
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Affiliation(s)
- Mattia Gambarin
- Neurorehabilitation Unit, Department of Neurosciences, Hospital Trust of Verona, 37126 Verona, Italy
| | - Tullio Malgrati
- Neuromotor and Cognitive Rehabilitation Research Centre (CRRNC), Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37129 Verona, Italy
| | - Rita Di Censo
- Neurorehabilitation Unit, Department of Neurosciences, Hospital Trust of Verona, 37126 Verona, Italy
- Neuromotor and Cognitive Rehabilitation Research Centre (CRRNC), Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37129 Verona, Italy
| | - Angela Modenese
- Neurorehabilitation Unit, Department of Neurosciences, Hospital Trust of Verona, 37126 Verona, Italy
| | - Giulio Balestro
- Neurorehabilitation Unit, Department of Neurosciences, Hospital Trust of Verona, 37126 Verona, Italy
- Neuromotor and Cognitive Rehabilitation Research Centre (CRRNC), Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37129 Verona, Italy
| | - Gloria Muti
- Neuromotor and Cognitive Rehabilitation Research Centre (CRRNC), Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37129 Verona, Italy
| | - Marta Cappellesso
- Neuromotor and Cognitive Rehabilitation Research Centre (CRRNC), Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37129 Verona, Italy
| | - Cristina Fonte
- Neurorehabilitation Unit, Department of Neurosciences, Hospital Trust of Verona, 37126 Verona, Italy
- Neuromotor and Cognitive Rehabilitation Research Centre (CRRNC), Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37129 Verona, Italy
| | - Valentina Varalta
- Neurorehabilitation Unit, Department of Neurosciences, Hospital Trust of Verona, 37126 Verona, Italy
- Neuromotor and Cognitive Rehabilitation Research Centre (CRRNC), Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37129 Verona, Italy
| | - Ylenia Gallinaro
- Neuromotor and Cognitive Rehabilitation Research Centre (CRRNC), Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37129 Verona, Italy
- National Cancer Institute Pascale Foundation IRCSS, 80131 Napoli, Italy
| | - Monica Pinto
- National Cancer Institute Pascale Foundation IRCSS, 80131 Napoli, Italy
| | - Matilde Carlucci
- Healthcare Directorate, Hospital Trust of Verona, 37126 Verona, Italy
| | - Alessandro Picelli
- Neurorehabilitation Unit, Department of Neurosciences, Hospital Trust of Verona, 37126 Verona, Italy
- Neuromotor and Cognitive Rehabilitation Research Centre (CRRNC), Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37129 Verona, Italy
| | - Nicola Smania
- Neurorehabilitation Unit, Department of Neurosciences, Hospital Trust of Verona, 37126 Verona, Italy
- Neuromotor and Cognitive Rehabilitation Research Centre (CRRNC), Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37129 Verona, Italy
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Lion KM, Jamieson A, Billin A, Jones S, Pinkham MB, Ownsworth T. 'It was never about me': A qualitative inquiry into the experiences of psychological support and perceived support needs of family caregivers of people with high-grade glioma. Palliat Med 2024; 38:874-883. [PMID: 38916277 DOI: 10.1177/02692163241261211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
BACKGROUND Family caregivers of people with high-grade glioma often report high rates of psychological distress, which has been attributed to the unique aspects of the disease and onerous care demands. Clinical practice guidelines advocate for caregiver support from diagnosis through to end-of-life and bereavement. Yet, research has identified that caregivers' support needs are often overlooked. AIM To explore caregivers' experiences of psychological support and perceptions of what constitutes optimal psychological support for caregivers in the context of high-grade glioma. DESIGN Qualitative study involving semi-structured interviews with data analysed using reflexive thematic analysis. SETTING/PARTICIPANTS Eighteen current (n = 11) and bereaved (n = 7) family caregivers (73% female, aged 33-69 years) of adults with high-grade glioma participated. Interviews explored caregivers' perceptions of psychological support. RESULTS Two major themes were generated. The first theme, 'It was never about me', reflected caregivers prioritise for people with high-grade glioma to be well supported despite experiencing their own unmet psychological support needs. The second theme, 'Continuous, coordinated and personalised support', highlighted the importance of timely and tailored interventions addressing caregivers' practical, educational and emotional support needs throughout the illness journey. CONCLUSIONS Caregivers commonly prioritise the support needs of people with high-grade gliomas; yet, have their own distinct needs that vary throughout the illness. Primary care providers have a potential role in facilitating timely access to palliative care, practical support and brain tumour-specific psychological support to meet caregivers' diverse needs across the care continuum in the context of high-grade glioma.
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Affiliation(s)
- Katarzyna M Lion
- School of Applied Psychology, Griffith University, Brisbane, QLD, Australia
- Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
| | - Anthony Jamieson
- School of Applied Psychology, Griffith University, Brisbane, QLD, Australia
| | - Abigail Billin
- School of Applied Psychology, Griffith University, Brisbane, QLD, Australia
- Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
| | - Stephanie Jones
- School of Applied Psychology, Griffith University, Brisbane, QLD, Australia
- Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
| | - Mark B Pinkham
- School of Medicine, University of Queensland, Saint Lucia, QLD, Australia
- Department of Radiation Oncology, Princess Alexandra Hospital, Woolloongabba, QLD, Australia
| | - Tamara Ownsworth
- School of Applied Psychology, Griffith University, Brisbane, QLD, Australia
- Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
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8
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Willis KD, Reid MP, Fox A, Kleva CS, Sherwood P, Loughan AR. The impact of a primary brain tumor diagnosis on caregivers: Insights from the patients' perspective. Support Care Cancer 2024; 32:595. [PMID: 39160352 PMCID: PMC11333512 DOI: 10.1007/s00520-024-08783-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 08/02/2024] [Indexed: 08/21/2024]
Abstract
PURPOSE The diagnosis of a primary brain tumor (PBT) causes significant distress for the caregiver-patient dyad, warranting increased supportive care intervention. Although researchers have previously assessed caregivers' perceptions of their own supportive care needs, no study to date has identified how patients perceive the caregiving experience and/or patients' recommendations for integrating supportive care of caregivers in neuro-oncology. This qualitative study examined caregiver distress as well as caregiver supportive care needs from the patients' perspective to inform future intervention development. METHODS Adults with PBT (N = 15; Mage = 45; 53% female; 93% White) were divided into four, 90-min focus groups moderated by a clinical neuropsychologist. Patients responded to semi-structured interview questions regarding various supportive care needs throughout the course of disease. Each discussion was transcribed and coded using thematic content analysis and NVivo software. Inter-rater reliability was excellent (MKappa = 0.92, range = 0.85-0.93). RESULTS Seven distinct codes related to PBT caregivers emerged and were classified into two broader themes: Caregiver Impact (47% of coded content) and Caregiver Support (53% of coded content). Caregiver Impact refers to patients' perspective of the practical and emotional demands of caregiving. Under Caregiver Support, patients cited a strong need for increased support of caregivers, including bereavement care, individual psychotherapy, and joint caregiver-patient dyad sessions. CONCLUSION Patients with PBT expressed profound concerns regarding the demands of caregiving and its impact on the well-being of their loved ones. Findings emphasize the need for comprehensive dyadic support in neuro-oncology throughout the disease trajectory to enhance the overall quality-of-life for both patients and their caregivers.
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Affiliation(s)
- Kelcie D Willis
- Department of Psychiatry, Center for Psychiatric Oncology, Massachusetts General Hospital, Boston, MA, USA
| | - Morgan P Reid
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Amber Fox
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Christopher S Kleva
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Paula Sherwood
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ashlee R Loughan
- Division of Neuro-Oncology, Department of Neurology, VCU School of Medicine, 1201 East Marshall St, Richmond, VA, 23298, USA.
- Massey Cancer Center, VCU School of Medicine, Richmond, VA, USA.
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Rathnayaka Mudiyanselage AC, Saini R, Coyne E. Evaluation of the understandability, actionability and reliability of YouTube videos for brain, head, and neck cancer information. Eur J Oncol Nurs 2024; 70:102605. [PMID: 38795450 DOI: 10.1016/j.ejon.2024.102605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 03/12/2024] [Accepted: 05/03/2024] [Indexed: 05/28/2024]
Abstract
PURPOSE Online videos accessed via YouTube are a popular method to provide health education. Videos need to be critically evaluated for educational qualities as the information could influence health outcomes. The present study aimed to evaluate the understandability, actionability and reliability of videos available on YouTube regarding brain, head, and neck cancer information. METHODS A scoping review was conducted with a specific search strategy and inclusion/exclusion criteria based on previous studies. For each video, video characteristics and user engagement activities were recorded. Videos were evaluated using the PEMAT-A/V and modified DISCERN criteria. Spearman's rank correlation, Kruskal-Wallis test and Mann-Whitney U test were used for analysis. RESULTS Out of 200 retrieved videos, 37 were included and analysed. The median length of the video was 3 min and 33 s. The majority of videos were published by health institutional and private channels (43.2%, n = 16). Health institutional channels received the highest actionability (Md = 37.5, p = 0.049), while private channels resulted in lower views/day (Md = 0.46, p = 0.001) and likes/day (Md = 0.01, p = 0.002). Animated and narrated videos acquired the highest understandability score (Md = 92.31, p < 0.001). Videos with professional transcripts reported higher actionability (Md = 62.5, p = 0.004), reliability (Md = 3.33, p = 0.028), views/day (Md = 29.31, p = 0.026), and likes/day (Md = 0.272, p = 0.023). CONCLUSION YouTube videos pertaining to brain and head and neck cancer have low understandability, low actionability and moderate reliability. It is beneficial to have a stronger representation of trustworthy and credible organisations for sharing essential health information via YouTube. Including animations and professional video transcripts may improve their overall quality and consumer engagement.
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Affiliation(s)
- Anjali Chamika Rathnayaka Mudiyanselage
- School of Nursing & Midwifery, Griffith University, Queensland, 4215, Australia; Department of Nursing, Faculty of Allied Health Sciences, University of Peradeniya, Sri Lanka.
| | - Rashi Saini
- School of Nursing & Midwifery, Griffith University, Queensland, 4215, Australia
| | - Elisabeth Coyne
- School of Nursing & Midwifery, Griffith University, Queensland, 4215, Australia
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10
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Piil K, Locatelli G, Skovhus SL, Tolver A, Jarden M. A Shifting Paradigm Toward Family-Centered Care in Neuro-Oncology: A Longitudinal Quasi-Experimental Mixed-Methods Feasibility Study. JOURNAL OF FAMILY NURSING 2024; 30:127-144. [PMID: 38531858 DOI: 10.1177/10748407241236678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
Family-centered intervention can help families facing illness-related issues. We investigated the feasibility of Family and Network Conversations (FNCs) in high-grade glioma patients and their families. Quasi-experimental feasibility study with longitudinal mixed-methods design. Patients and families were invited to three FNCs over 1 year. They completed questionnaires at four time points and expressed their perspectives on the intervention through telephone interviews. Nurses' perspectives were collected in a focus group. Twenty-one patients and 47 family members were included. On average, patients were 66 years old, mainly male, married, living with caregivers, with unifocal cancer. On average, caregivers were 47 years old, mainly female, being spouses or children of the patient. Quantitative and qualitative data did not always match and expanded each other. Nurse-delivered FNCs holistically addressed families' needs while strengthening family's dialogue and union. Nurses felt empowered, underling that advanced competencies were required. Nurse-delivered FNCs are feasible to provide family-centered care, but they should be tailored to each family's needs.
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Affiliation(s)
- Karin Piil
- Copenhagen University Hospital, Rigshospitalet, Denmark
- Roskilde University, Denmark
| | | | | | | | - Mary Jarden
- Copenhagen University Hospital, Rigshospitalet, Denmark
- University of Copenhagen, Denmark
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11
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Rimmer B, Balla M, Dutton L, Lewis J, Burns R, Gallagher P, Williams S, Araújo-Soares V, Finch T, Sharp L. 'A Constant Black Cloud': The Emotional Impact of Informal Caregiving for Someone With a Lower-Grade Glioma. QUALITATIVE HEALTH RESEARCH 2024; 34:227-238. [PMID: 37967320 PMCID: PMC10768339 DOI: 10.1177/10497323231204740] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
Those closest to people with lower-grade gliomas (LGGs) often assume the role of informal caregiver (IC). The additional responsibilities mean ICs of people with cancer can experience adverse impacts on their own lives. We explored the emotional impact of informal caregiving for people with LGGs. This was a descriptive qualitative study within the multi-method Ways Ahead project. We conducted semi-structured interviews with individuals from the United Kingdom, who currently, or in the past 5 years, informally cared for someone with an LGG. Interviews encompassed experiences of emotional impact as a consequence of caregiving for someone with an LGG. Inductive thematic analysis was undertaken. We interviewed 19 ICs (mean age 54.6 years; 14 females, 5 males). Participants reported substantial emotional impact. Four themes and associated subthemes were generated: Emotional responses to the illness (e.g. feeling helpless), Emotional responses to the unknown (e.g. anxiety about future uncertainty), Emotional consequences of care recipient changes (e.g. challenges of changed relationship dynamics), and Emotional weight of the responsibility (e.g. feeling burnout). Emotional impact in one area often exacerbated impact in another (e.g. future uncertainty impacted feelings of helplessness). Participants detailed the factors that helped them manage the emotional impact (e.g. being resilient). ICs of people with LGGs can experience wide-ranging emotional responses to and impacts of the illness, uncertain prognosis, care recipient changes, and the toll of caregiving. Adjustment and resilience are key protective factors, though further consideration of ways to identify and fulfil the emotional support needs of ICs of people with LGGs is required.
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Affiliation(s)
- Ben Rimmer
- Population Health Sciences Institute, Newcastle University, Newcastle University Centre for Cancer, Newcastle upon Tyne, England
| | - Michelle Balla
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, England
| | - Lizzie Dutton
- Population Health Sciences Institute, Newcastle University, Newcastle University Centre for Cancer, Newcastle upon Tyne, England
| | - Joanne Lewis
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, England
| | - Richéal Burns
- Faculty of Science, Atlantic Technological University, Sligo, Ireland
- Health and Biomedical Strategic Research Centre, Atlantic Technological University, Sligo, Ireland
| | | | - Sophie Williams
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, England
| | - Vera Araújo-Soares
- Population Health Sciences Institute, Newcastle University, Newcastle University Centre for Cancer, Newcastle upon Tyne, England
- Centre for Preventive Medicine and Digital Health, Department for Prevention of Cardiovascular and Metabolic Disease, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Tracy Finch
- Department of Nursing, Midwifery and Health, Northumbria University, Newcastle upon Tyne, England
| | - Linda Sharp
- Population Health Sciences Institute, Newcastle University, Newcastle University Centre for Cancer, Newcastle upon Tyne, England
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12
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Haydon HM, Blackler A, Nowak AK, Langbecker D, Collier J, Halkett G. Exploratory multi-methods evaluation of an online intervention for carers of people with high-grade glioma. Neurooncol Pract 2023; 10:544-554. [PMID: 38026580 PMCID: PMC10666811 DOI: 10.1093/nop/npad032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023] Open
Abstract
Background Inadequate knowledge and skills and a lack of confidence to provide care have been identified as major unmet needs for carers of people with brain cancer. An online intervention was developed to address the unmet needs of carers of people with high-grade glioma. Methods Ten carers evaluated the intervention through multiple methods. Acceptability and usability were measured through online data analytics (unique page views, time on page), surveys, and interviews. Questionnaires measured potential impacts on distress (Distress Thermometer), depression, anxiety (Hospital Anxiety and Depression Scale), carer competence (Carer Competence Scale), carer preparedness (Caregiving Preparedness Scale), unmet needs (Supportive Care Needs Scale - Brain Tumor Specific for carers), usability and acceptability (USE). Results Results suggested the intervention had high levels of usability (usability scales' means range = 5.1 to 6.7 out of 7) and acceptability (M = 76.3/100). Correlations indicated the potential to impact depression. Qualitative findings highlighted benefits of the intervention as a comprehensive reliable resource that could validate and normalize carer experiences. Interview findings guided further improvements (eg, additional carer videos, content organization). Conclusions The study indicated high acceptability and usability of an online intervention for carers of people with high-grade glioma. This exploratory study also provided preliminary indications of a potential to decrease depression. However, a more robust, potentially longitudinal, investigation is needed with a larger and broader sample. Informed by this study, the intervention has been amended and a randomized controlled trial will further evaluate the enhanced intervention.
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Affiliation(s)
- Helen M Haydon
- Centre for Online Health, The University of Queensland, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
- Centre for Health Services Research, The University of Queensland, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Alethea Blackler
- School of Design, Queensland University of Technology, Brisbane City, Queensland, Australia
| | - Anna K Nowak
- School of Medicine, University of Western Australia, Perth, Western Australia, Australia
| | - Danette Langbecker
- Centre for Online Health, The University of Queensland, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
- Centre for Health Services Research, The University of Queensland, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Justin Collier
- Centre for Online Health, The University of Queensland, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
- Centre for Health Services Research, The University of Queensland, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Georgia Halkett
- School of Nursing, Curtin University, Bently Western Australia, Australia
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13
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McDougall E, Breen LJ, Nowak AK, Dhillon HM, Halkett GKB. Psychosocial interventions for personality and behavior changes in adults with a brain tumor: A scoping review. Neurooncol Pract 2023; 10:408-417. [PMID: 37720389 PMCID: PMC10502785 DOI: 10.1093/nop/npad031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2023] Open
Abstract
Background The objective of this scoping review was to describe the intervention characteristics and effectiveness of psychosocial interventions aimed at managing personality and behavior changes in people with brain tumors. A secondary objective was to explore if these interventions had an impact on outcomes for carers. Personality and behavior changes considered included aggression, apathy, paranoia, disinhibition, and emotional lability. Methods This review was conducted following the Joanna Briggs Institute methodology for scoping reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews. Searches were conducted in PsycINFO, CINAHL, Medline (Ovid), and Scopus. We synthesized studies published from 1996 to 2022 that evaluated interventions to manage brain tumor related personality and behavioral changes in adults. A data extraction tool were used based on the Joanna Briggs Institute template. Results are presented in a summary table and a narrative synthesis was conducted. Results Three thousand and five hundred and ninety-four records were screened. Title and abstract screening resulted in 29 potentially eligible studies. Full screening excluded 24 articles and 5 interventions met the inclusion criteria. The interventions were diverse in duration, delivery modality, setting, and participation (eg, the patient individually or patient and carer). The interventions reported improvements in the targeted personality and behavior change symptoms for patients with primary brain tumors. Four studies included a measure of personality and behavior change symptoms and two studies included a measure of outcomes for carers and reported improvements in carer knowledge and a reduction in carer distress. All studies sampled fewer than 100 participants. Studies had limited follow-up data and different tools were used to assess the presence and nature of personality and behavior changes. Conclusions There is a dearth of psychosocial interventions to support patients and their carers to manage brain tumor related personality and behavior changes.
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Affiliation(s)
- Emma McDougall
- Faculty of Health Sciences, Curtin School of Nursing/Curtin Health Innovation Research Institute (CHIRI), Curtin University, Perth, WA, Australia
| | - Lauren J Breen
- Curtin School of Population Health, Curtin University, Perth, WA, Australia
- Curtin enAble Institute, Curtin University, Perth, WA, Australia
| | - Anna K Nowak
- Medical School, University of Western Australia Perth, Perth, WA, Australia
- Department of Medical Oncology, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Haryana M Dhillon
- Centre for Medical Psychology and Evidence-Based Decision-Making, School of Psychology Faculty of Science, The University of Sydney, Camperdown, NSW, Australia
- Psycho-Oncology Cooperative Research Group, School of Psychology Faculty of Science, The University of Sydney, Camperdown, NSW, Australia
| | - Georgia K B Halkett
- Faculty of Health Sciences, Curtin School of Nursing/Curtin Health Innovation Research Institute (CHIRI), Curtin University, Perth, WA, Australia
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14
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Halkett GKB, Lobb EA, Phillips JL, McDougall E, Clarke J, Campbell R, Dhillon HM, McGeechan K, Hudson P, King A, Wheeler H, Kastelan M, Long A, Nowak AK. Carer preparedness improved by providing a supportive educational intervention for carers of patients with high-grade glioma: RCT results. J Neurooncol 2023; 161:501-513. [PMID: 36658381 PMCID: PMC9992082 DOI: 10.1007/s11060-023-04239-0] [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: 11/09/2022] [Accepted: 12/24/2022] [Indexed: 01/21/2023]
Abstract
BACKGROUND High-grade glioma (HGG) is a rapidly progressing and debilitating disease. Family carers take on multiple responsibilities and experience high levels of distress. We aimed to deliver a nurse-led intervention (Care-IS) to carers to improve their preparedness to care and reduce distress. METHODS We conducted a randomised controlled trial (ACTRN:12612001147875). Carers of HGG patients were recruited during patients' combined chemoradiation treatment. The complex intervention comprised four components: (1) initial telephone assessment of carer unmet needs; (2) tailored hard-copy resource folder; (3) home visit; and, (4) monthly telephone support for up to 12 months. Primary outcomes included preparedness for caregiving and distress at 2, 4, 6 and 12 months. Intervention effects were estimated using linear mixed models which included a time by group interaction. Secondary outcomes included anxiety, depression, quality of life, carer competence and strain. RESULTS We randomised 188 carers (n = 98 intervention, n = 90 control). The intervention group reported significantly higher preparedness for caregiving at 4 months (model β = 2.85, 95% CI 0.76-4.93) and all follow-up timepoints including 12 months (model β = 4.35, 95% CI 2.08-6.62), compared to the control group. However, there was no difference between groups in carer distress or any secondary outcomes. CONCLUSIONS This intervention was effective in improving carer preparedness. However, carer distress was not reduced, potentially due to the debilitating/progressive nature of HGG and ongoing caring responsibilities. Future research must explore whether carer interventions can improve carer adjustment, self-efficacy and coping and how we support carers after bereavement. Additionally, research is needed to determine how to implement carer support into practice.
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Affiliation(s)
- Georgia K B Halkett
- Curtin School of Nursing/Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, GPO Box U1987, Bentley, Perth, WA, 6005, Australia.
| | - Elizabeth A Lobb
- Calvary Health Care Kogarah, Sydney, NSW, Australia.,School of Medicine, The University of Notre Dame, Sydney, NSW, Australia.,Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Jane L Phillips
- Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia.,School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Emma McDougall
- Curtin School of Nursing/Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, GPO Box U1987, Bentley, Perth, WA, 6005, Australia
| | - Jenny Clarke
- Curtin School of Nursing/Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, GPO Box U1987, Bentley, Perth, WA, 6005, Australia
| | - Rachel Campbell
- Psycho-Oncology Cooperative Research Group, School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia
| | - Haryana M Dhillon
- Psycho-Oncology Cooperative Research Group, School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia.,Centre for Medical Psychology & Evidence-Based Decision-Making, University of Sydney, Sydney, NSW, Australia
| | - Kevin McGeechan
- School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Peter Hudson
- Centre for Palliative Care St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia.,Department of Nursing, University of Melbourne, Melbourne, VIC, Australia.,Vrije University Brussels, Brussels, Belgium
| | - Anne King
- Cancer Network Western Australia, North Metropolitan Health Service, Perth, WA, Australia
| | - Helen Wheeler
- Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - Marina Kastelan
- Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards, NSW, Australia.,The Brain Cancer Group, North Shore Private Hospital, St Leonards, NSW, Australia
| | - Anne Long
- Department of Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
| | - Anna K Nowak
- Department of Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia.,Medical School, University of Western Australia, Nedlands, WA, Australia
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15
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Jones D, Pinkham MB, Wallen MP, Hart NH, Joseph R, Strodl E, Ownsworth T, Beesley V, Crichton M, Chan RJ. Benefits of supportive strategies for carers of people with high-grade glioma: a systematic review : Strategies for addressing the needs of high-grade glioma carers. Support Care Cancer 2022; 30:10359-10378. [PMID: 36282336 PMCID: PMC9715523 DOI: 10.1007/s00520-022-07419-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 10/13/2022] [Indexed: 01/31/2023]
Abstract
PURPOSE To systematically review and examine current evidence for the carer-reported benefits of supportive care strategies for carers of adults with high-grade glioma (HGG). METHODS Four databases (CINAHL, EMBASE, PubMed, PsycINFO) were searched for articles published between January 2005 and April 2022 that assessed strategies for addressing the supportive care needs of carers of adults with HGG (WHO grade 3-4). Study selection and critical appraisal were conducted independently by three authors (DJ/MC, 2021; DJ/RJ 2022). Data extraction was conducted by one author (DJ) and checked by a second author (RJ). Results were synthesised narratively. RESULTS Twenty-one studies involving 1377 caregivers were included, targeting the carer directly (n = 10), the patient-carer dyad (n = 3), or focused on people with HGG + / - their carers (n = 8). A paucity of high-quality evidence exists for effective and comprehensive support directly addressing outcomes for carers of adults with HGG. Strategies that demonstrated some benefits included those that built carer knowledge or provided emotional support, delivered by health professionals or through peer support. Supportive and early palliative care programmes have potential to reduce unmet carer needs while providing ongoing carer support. CONCLUSION Strategies incorporating an educational component, emotional support, and a regular needs assessment with corresponding tailored support are most valued by carers. Future practice development research should adopt a value-based approach and exceed evaluation of efficacy outcomes to incorporate evaluation of the experience of patients, carers, and staff, as well as costs.
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Affiliation(s)
- Diana Jones
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Road, Bedford Park, Adelaide, SA, 5042, Australia
- Princess Alexandra Hospital, Metro South Hospital and Health Service, Brisbane, QLD, Australia
| | - Mark B Pinkham
- Princess Alexandra Hospital, Metro South Hospital and Health Service, Brisbane, QLD, Australia
- Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, Brisbane, QLD, Australia
| | - Matthew P Wallen
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Road, Bedford Park, Adelaide, SA, 5042, Australia
- School of Science, Psychology and Sport, Federation University Australia, Ballarat, VIC, Australia
| | - Nicolas H Hart
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Road, Bedford Park, Adelaide, SA, 5042, Australia
- Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, Brisbane, QLD, Australia
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
- Institute for Health Research, University of Notre Dame Australia, Perth, WA, Australia
| | - Ria Joseph
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Road, Bedford Park, Adelaide, SA, 5042, Australia
| | - Esben Strodl
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, QLD, Australia
| | - Tamara Ownsworth
- School of Applied Psychology & The Hopkins Centre, Menzies Health Institute Queensland Griffith University, Brisbane, QLD, Australia
| | - Vanessa Beesley
- Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, Brisbane, QLD, Australia
- Supportive Care in Cancer Group, QIMR Berghofer Medical Research Institute, Herston, QLD, Australia
| | - Megan Crichton
- Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, Brisbane, QLD, Australia
- Bond University Nutrition and Dietetics Research Group, Bond University, Robina, QLD, Australia
| | - Raymond J Chan
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Road, Bedford Park, Adelaide, SA, 5042, Australia.
- Princess Alexandra Hospital, Metro South Hospital and Health Service, Brisbane, QLD, Australia.
- Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, Brisbane, QLD, Australia.
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16
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Boele F, Hertler C, Dirven L, Piil K, Sherwood P. Family caregiver constructs and outcome measures in neuro-oncology: A systematic review. Neurooncol Pract 2022; 9:465-474. [DOI: 10.1093/nop/npac058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
As a first step to reach consensus on the key constructs and outcomes in neuro-oncology caregiver research, we performed a systematic review to evaluate the constructs that are being evaluated in research studies and how these have been assessed.
Methods
All peer-reviewed publications with primary data reporting on outcomes of family caregivers of adult primary brain tumor patients were eligible. Electronic databases PubMed/Medline, Embase, Web of Science, Emcare, Cochrane Library, and PsycINFO were searched up to September 2021. Using Covidence, title and abstract screening, full-text review, and data extraction were done by two researchers independently, with a third guiding consensus. Constructs as reported in each study, and how these were assessed were the primary result.
Results
Searches yielded 1090 unique records, with 213 remaining after title/abstract screening. Of these, 157 publications met inclusion criteria, comprising 120 unique studies. These originated from 18 countries and were published between 1996 and 2022. Most were observational (75%) cross-sectional (61%) studies, reporting on quantitative methods (62%). Twenty-seven different constructs were assessed and mapped along the Caregiver Health Model (CGHM) categories, namely, caregiver health, needs, tasks, beliefs and attitudes, and environment. Seventeen questionnaires were used >2 times to measure the same construct, with the vast majority of questionnaires only used across one or two studies.
Conclusions
Neuro-oncology caregiving research is a field gaining traction, but lags behind in clear definition of key constructs, and consistency in assessment of these constructs. Developing consensus or guidance will improve comparability of studies, meta-analyses, and advance the science more quickly.
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Affiliation(s)
- Florien Boele
- Leeds Institute of Medical Research at St James’s, St James’s University Hospital, University of Leeds , Leeds , UK
- Faculty of Medicine and Health, Leeds Institute of Health Sciences, University of Leeds , Leeds , UK
| | - Caroline Hertler
- Department of Radiation Oncology, Competence Center Palliative Care, University Hospital Zurich and University of Zurich , Zurich , Switzerland
| | - Linda Dirven
- Department of Neurology, Leiden University Medical Center , Leiden , The Netherlands
- Department of Neurology, Haaglanden Medical Center , The Hague , The Netherlands
| | - Karin Piil
- Department of Oncology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital, Rigshospitalet , Copenhagen , Denmark
- Department of Public Health, Aarhus University , Aarhus , Denmark
| | - Paula Sherwood
- School of Nursing, University of Pittsburgh , Pittsburgh, Pennsylvania , USA
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