The Dyadic Effects of Self-Efficacy on Quality of Life in Advanced Cancer Patient and Family Caregiver Dyads: The Mediating Role of Benefit Finding, Anxiety, and Depression

Self-Efficacy and e-Health Literacy Among Caregivers of Patients With Lung Cancer: The Chain-Mediating Roles of Negative Emotions and Caregiver Readiness

OBJECTIVES

To explore the chain-mediating roles of negative emotions and caregiver readiness between self-efficacy and e-health literacy among caregivers of patients with lung cancer.

BACKGROUND

With the rise of Internet health services, caregivers of patients with lung cancer, who are one of the health decision makers, are encountering new challenges. In order to develop appropriate interventions, it is necessary to explore in depth the various influencing factors associated with them.

DESIGN

A cross-sectional survey.

METHODS

A total of 293 caregivers of patients with lung cancer were recruited between November 2023 and April 2024 through a convenience sampling method. These participants completed the demographic data questionnaire, General Self-Efficacy Scale (GSES), Hospital Anxiety and Depression Scale (HADS), Caregivers Preparedness Scale (CPS), and eHealth Literacy Scale (eHEALS). Independent samples t-tests and a one-way ANOVA were employed to identify the primary influencing factors. Structural equation modelling was employed to detect the mediating effects of negative emotions and caregiver readiness.

REPORTING METHOD

The STROBE checklist was used for this study.

RESULTS

The total e-health literacy score of caregivers of patients with lung cancer was 29.65 ± 7.11, and there was a correlation between self-efficacy, negative emotions, caregiver readiness, and e-health literacy. The results of the path analysis showed that negative emotions and caregiver readiness had chain-mediating roles between self-efficacy and e-health literacy among caregivers of patients with lung cancer, with the total indirect effect accounting for 31.17% of the total effect.

CONCLUSIONS

Caregivers of patients with lung cancer exhibit moderate levels of e-health literacy. This research suggests that self-efficacy not only has a direct and positive influence on e-health literacy but may also amplify it by mediating the interplay between negative emotions and caregiver readiness.

RELEVANCE TO CLINICAL PRACTICE

Healthcare providers should be cognizant of the negative emotions and readiness displayed by family caregivers in the hospital setting to aid them in cultivating strong health literacy for more efficient management of illness care tasks.

PATIENT OR PUBLIC CONTRIBUTION

Nurses at the hospitals assisted us in collecting data from family caregivers of patients with lung cancer, and the caregivers actively cooperated in completing the questionnaires.

Strategies for recruitment and retention of diverse and underserved cancer survivor and caregiver dyads in clinical trials

Background

Cancer survivor-caregiver dyads from underrepresented racial and ethnic groups and those with lower socioeconomic status are less likely to participate in clinical research. Sociocultural and socioeconomic barriers perpetuate health inequity and increase disparities in cancer care.

Purpose

We describe our systematic approach to recruiting and retaining diverse survivor-caregiver dyads in supportive cancer care studies.

Methods

Matsuda's research recruitment guidelines of evaluate, engage, reflect, and carefully match ("EERC") were adapted and applied through a framework of six guiding principles.

Results

A systematic approach to recruitment of underrepresented dyads in cancer support research includes 1) Developing a bilingual, bicultural study team with shared language and culture of the study population, 2) Ensuring team members share a passion for cancer health equity and are trained with a community-centric approach, 3) Designing accessible interventions, study materials, and shared data collection tools across similar studies with community and stakeholder input, 4) Engaging local and regional stakeholders with expertise of health disparities among the catchment area, 5) Partnering with Community Health Workers (CHWs) and gatekeepers to enhance community presence, and 6) Ensuring careful application of matching study team members and participants beyond race and ethnicity to prioritize the cultural values and social factors that impact cancer survivors and caregivers.

Conclusion

Applying a systematic approach to recruiting and retaining underrepresented dyads in cancer research can potentially reduce sociocultural and socioeconomic barriers to cancer health equity.

A dyadic analysis of family adaptation among breast cancer patients and their spouses based on the framework of family stress coping theory

Background

The active coping strategies of family members can help breast cancer patients better handle the crisis, and family adaptation is a manifestation of the family's active coping with the crisis. In the study of breast cancer, a disease that predominantly affects women, we explored the influence of spouses on patients' family adaptation. This aspect has not been explored in previous studies.

Purpose

In recent years, with the development of family stress coping theory, cancer coping styles have shifted from an individual focus to a whole-family approach. This shift has the potential to help families of cancer patients adapt to the crisis. This study aimed to explore the correlation between dyadic coping, family adaptation, and benefit finding in couples with breast cancer.

Methods

Using convenience sampling, the study included 325 pairs consisting of breast cancer patients and their spouses who attended breast surgery, oncology, and chemotherapy sessions between April and November 2023. The survey utilized the General Information Questionnaire for patients and spouses, the Dyadic Coping Scale, the Benefit Finding Scale, and the Family Adaptability and Cohesion Evaluation Scales. Data analysis was conducted using SPSS 25.0 and Amos 24.0 software.

Results

In the actor effect of dyadic coping on family adaptation, the benefit finding of patients and their spouses played a mediating role. Regarding the partner effect (B = 0.019, 95% CI = 0.003-0.045, P < 0.05), the dyadic coping of spouses indirectly affected the family adaptation of patients through the benefit findings of patients. The patient's dyadic coping can directly affect the spouse's family adaptation. The spouse's dyadic coping can influence the patient's benefit finding.

Conclusion

There is a partial interaction between breast cancer patients and their spouses' dyadic coping, benefit finding, and family adaptation. Therefore, clinical staff should promptly identify patients and spouses with poor coping abilities and provide them with positive psychological interventions to enhance the dyadic coping abilities of both partners and assist them in overcoming the problems encountered during the treatment process, ultimately helping them better cope with family crises.

Self-efficacy as mediators of the association between dyadic coping and quality of life among spousal caregiver of patients with cervical cancer

Objective

This study aims to explore the influence of dyadic coping (DC) on the quality of life (QoL) of spousal caregivers for patients with cervical cancer and to investigate the mediating role of self-efficacy in this relationship.

Methods

A convenience sample of 206 spouses of cervical cancer patients from five hospitals in Jiangsu Province, China, was included in the study. The participants completed three instruments: the 12-item Short-Form Health Survey, the General Self-Efficacy Scale, and the Dyadic Coping Inventory. Structural Equation Modeling (SEM) was used to analyze the mediating effect of self-efficacy in the DC and QoL relationship.

Results

The study found a positive correlation between self-efficacy and DC. Self-efficacy partially mediated the impact of DC on QoL, accounting for 16% of the total effect. Self-efficacy played a mediating role in facilitating the indirect positive effects of DC on QoL.

Conclusions

Spousal caregivers of cervical cancer patients frequently experience a relatively low QoL. The results suggest that interventions aimed at enhancing DC among spousal caregivers should incorporate strategies to improve self-efficacy, given its mediating role in the positive relationship between DC and QoL.

A qualitative study about colorectal cancer patients and spousal caregivers' experience and needs during COVID-19: implications for self-efficacy intervention

Objective

This study aims to understand the experiences of colorectal cancer (CRC) patients and their spousal caregivers during the COVID-19 pandemic and to refine a self-efficacy (SE) intervention for these couples.

Methods

A descriptive phenomenological approach was used in this study. Data were collected from 11 CRC couples. All interviews were recorded, transcribed, and analyzed using the Colaizzi strategy.

Results

Three themes and eight subthemes emerged: (1) Get and contribute support, (2) Life's challenges, and (3) Journey of reconstruction. The CRC couples encountered escalating challenges in coping with cancer during COVID-19. At the same time, they have received considerable support and developed confidence in rebuilding themselves in the process. Healthcare providers are advised to focus on giving appropriate support to CRC couples, so they can go further.

Conclusions

This study gave insights into healthcare providers on the experiences of CRC couples and the development of SE intervention program to support these couples: (1) initially providing caregiving training for spousal caregivers and psychological support for patients, (2) encouraging self-care for CRC couples in the middle stage, (3) guiding them to view life positively in the later stage, and (4) assessing their situation in time to identify their needs and to provide support. Healthcare providers are recommended to increase flexibility in the SE intervention program delivery format to reduce the impact of COVID-19 on CRC couples.