1
|
Kim B, Kim J, Ahn HY, Park S, Hwang IC, Park SJ. Exploring the Role of Practical and Emotional Death Preparation in Reducing Emotional Distress Among Family Caregivers of Terminally Ill Cancer Patients: A Multicenter Cross-Sectional Study. Cancers (Basel) 2025; 17:1380. [PMID: 40282555 PMCID: PMC12026026 DOI: 10.3390/cancers17081380] [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: 03/21/2025] [Revised: 04/15/2025] [Accepted: 04/17/2025] [Indexed: 04/29/2025] Open
Abstract
Family caregivers (FCs) play a vital role in supporting terminally ill patients with cancer by providing emotional, physical, and practical care throughout the illness trajectory [...].
Collapse
Affiliation(s)
- Boram Kim
- Department of Hospice and Palliative Service, National Cancer Center, Goyang 10408, Republic of Korea;
| | - Jaemin Kim
- Bucheon Woori Hospital, Bucheon 14466, Republic of Korea;
| | - Hong Yup Ahn
- Department of Statistics, Dongguk University, Seoul 04620, Republic of Korea;
| | - Sunyoung Park
- Department of Psychiatry, National Health Insurance Service Ilsan Hospital, Goyang 10444, Republic of Korea;
| | - In Cheol Hwang
- Department of Family Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon 21565, Republic of Korea
| | - So-Jung Park
- Department of Hospice and Palliative Service, National Cancer Center, Goyang 10408, Republic of Korea;
| |
Collapse
|
2
|
Cui P, Ai J, Chen X, Cheng C, Shi J, Li S, Yang M, Chen C, Hu H. Dyadic effects of perceived burden and psychological distress on quality of life among Chinese advanced cancer patients and their caregivers. Sci Rep 2025; 15:12180. [PMID: 40204850 PMCID: PMC11982206 DOI: 10.1038/s41598-025-96861-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 04/01/2025] [Indexed: 04/11/2025] Open
Abstract
This study aims to explore the mediating role of psychological distress in the association between perceived burden and quality of life (QoL) in advanced cancer patient-caregiver dyads. 241 dyads in five tertiary hospitals in a province were investigated by using the Edmonton Symptom Assessment System, Zarit Burden Interview, the Patient Health Questionnaire-4, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 15 Palliative scores, and the Short Form Health Survey 8. The actor-partner interdependence mediation model (APIMeM), which assesses both individual (actor) and interdependent (partner) effects within dyadic relationships, was employed to analyze how burden and psychological distress interact across dyad members. Analysis was conducted using Mplus v8.0. Regarding the actor effects, the mediating role of psychological distress between perceived burden and QoL was confirmed in advanced cancer patients (B = -0.223, p = 0.001) and their caregivers (B = -0.168, p < 0.001). Regarding the partner effects, there were no significant correlations between caregiver burden and patients' psychological distress (B = 0.015, p = 0.199), patients' QoL (B = 0.113, p = 0.278), or the indirect association of caregiver burden with patients' QoL through psychological distress (B = -0.034, p = 0.259). However, caregivers' psychological distress was positively correlated with patients' symptom burden and mediated the association between patients' symptom burden and caregivers' QoL (B = -0.090, p = 0.001). The study highlights the importance of taking a dyadic perspective in the context of advanced cancer. Dyadic interventions targeting their perceived burden and psychological distress may be beneficial to their QoL.
Collapse
Affiliation(s)
- Panpan Cui
- Department of Nursing, Henan Provincial Key Medicine Laboratory of Nursing, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, No. 7 Weiwu Road, Zhengzhou, China
- School of Nursing, Zhengzhou University, Zhengzhou, China
| | - Jiansai Ai
- The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xinyi Chen
- Medical Oncology, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Chunyan Cheng
- Hematology department, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Jiaoxia Shi
- Medical Oncology, People's Hospital of Jiaozuo City, Jiaozuo, China
| | - Shifeng Li
- Medical Oncology, Xinyang Central Hospital, Xinyang, China
| | - Ming Yang
- Nursing department, Xinyang Central Hospital, Xinyang, China
| | - Changying Chen
- The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe Dong Road, Zhengzhou, China.
- Institute for Hospital Management of Henan Province, Zhengzhou, China.
| | - Hengyu Hu
- Department of Nursing, Henan Provincial Key Medicine Laboratory of Nursing, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, No. 7 Weiwu Road, Zhengzhou, China.
| |
Collapse
|
3
|
Wang SJ, Wei LC. The Impact of Spousal Mental Illness on Healthcare Utilization Among Cancer Patients: A Holistic Perspective From Taiwan. J Surg Oncol 2025; 131:554-555. [PMID: 39523899 DOI: 10.1002/jso.27917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2024] [Accepted: 09/11/2024] [Indexed: 11/16/2024]
Affiliation(s)
- Shih-Jie Wang
- Department of General Psychiatry, Taoyuan Psychiatric Center, Ministry of Health and Welfare, Taoyuan City, Taiwan
| | - Lien-Chung Wei
- Department of Addiction Psychiatry, Taoyuan Psychiatric Center, Ministry of Health and Welfare, Taoyuan City, Taiwan
| |
Collapse
|
4
|
Büyük F, Ahmet Surel A, Şahingöz Bakırcı E, Demir Karakılıç G, Şahbaz Pirinççi C, Borman P. Evaluation of the effect of accompanying lymphedema on the quality of life and anxiety level of caregivers of patients with breast and genitourinary system cancers. Turk J Phys Med Rehabil 2025; 71:11-18. [PMID: 40270627 PMCID: PMC12012913 DOI: 10.5606/tftrd.2024.13279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 02/26/2024] [Indexed: 04/25/2025] Open
Abstract
Objectives This study aims to determine the effect of accompanying lymphedema in patients with breast or genitourinary system cancer on the quality of life and anxiety levels of caregivers of these patients. Patients and methods Sixty-three caregivers (37 males, 26 females; mean age: 47.5±14.4 years; range, 20 to 80 years) of patients with breast or genitourinary system cancer and lymphedema, 40 caregivers (21 males, 19 females; mean age: 43.9±15.6 years; range, 18 to 75 years) of patients with breast or genitourinary system cancer without lymphedema, and 52 healthy volunteers (15 males, 37 females; mean age: 37.0±10.8 years; range, 23 to 68 years) as the control group were included in the cross-sectional study between May 10, 2022 and August 10, 2022. Sociodemographic information of the caregivers and information about the cancer diagnosis of the patients were recorded. The anxiety level of the caregivers was assessed with the Beck Anxiety Inventory (BAI), hopelessness level with the Beck Hopelessness Scale (BHS), and quality of life with the Caregiver Quality of Life Index-Cancer (CQOL-C). Results There was no statistically meaningful difference between the caregivers of patients with and without lymphedema and the control group regarding anxiety (p=0.818). The hopelessness level was higher in caregivers of patients with lymphedema compared to healthy controls (p=0.011). No statistically meaningful difference was found in CQOL-C burden, disruptiveness, positive adaptation, or financial concerns subscales in caregivers of patients with and without lymphedema (p=0.697, p=0.209, p=0.823, p=0.855, and p=0.257, respectively). Continuous caregiving was negatively associated with the total CQOL-C score in caregivers of patients with lymphedema (p=0.031). Complex decongestive therapy was negatively associated with high BAI and BHS scores (p=0.038 and p=0.034, respectively). Conclusion Lymphedema has a negative impact on hopelessness, while complex decongestive therapy has positive effects on anxiety and depression. Continuous caregiving may be considered a risk factor for high total CQOL-C scores.
Collapse
Affiliation(s)
- Ferda Büyük
- Department of Physical Therapy and Rehabilitation, Yozgat City Hospital, Yozgat, Türkiye
| | - Aziz Ahmet Surel
- Ankara City Hospital, Coordinator Head Physician, Ankara, Türkiye
| | - Esra Şahingöz Bakırcı
- Department of Physical Therapy and Rehabilitation, Yozgat City Hospital, Yozgat, Türkiye
| | | | - Cansu Şahbaz Pirinççi
- University of Health Sciences, Gülhane Faculty of Physiotherapy and Rehabilitation, Ankara, Türkiye
| | - Pınar Borman
- Department of Physical Medicine and Rehabilitation, Ankara City Hospital, Ankara, Türkiye
| |
Collapse
|
5
|
Parvizi M, Ay S. The assessment of care burden and influencing factors on family caregivers for cancer patients. J Clin Nurs 2024; 33:3923-3932. [PMID: 39164944 DOI: 10.1111/jocn.17408] [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: 02/10/2024] [Revised: 07/30/2024] [Accepted: 08/05/2024] [Indexed: 08/22/2024]
Abstract
BACKGROUND The family caregivers as primary caregivers play a crucial role regarding the care of cancer patients. As defined in the literature, the care burden encompasses the negative objective and subjective outcomes including psychological and physical health problems, economic and social issues, deterioration of family relationships and feelings of loss of control that arise from caregiving responsibilities. AIMS This study aims to assess the care burden and to evaluate the associated factors among family caregivers of cancer patients receiving treatment at a state hospital in Türkiye. METHODS This cross-sectional study was conducted with the family caregivers of patients undergoing treatment in the radiation oncology department of a state hospital in Türkiye. The study population consisted of 350 individuals, with a participation rate of 80%. Participants were administered a questionnaire concerning determining daily living activities and identifying the caregiving burden through their socio-demographic characteristics. RESULTS The care burden among primary family caregivers while the delivery of health services was severe for 85.1% of them. The average ZBI score of caregivers was 55.92 ± 14.58. It was clarified that family caregivers' burden was influenced by several factors, including the duration of caregiving, difficulties experienced while caring for the patient, and the negative impact on their daily roles. CONCLUSION Our study's findings indicate the need for health professionals to support caregivers of cancer patients while over half of the caregivers were identified as having a severe level of caregiving burden. It is important to raise awareness among nurses and the oncology team with a holistic approach. In the delivery of health services, caregivers' needs should be identified first, support mechanisms should be activated and interventions should be made to meet these needs. IMPACT This study's findings highlight the need to identify and problems faced by family members during caregiving. This is important for sustainable and cost-effective holistic care. REPORTING METHOD The results of this study are reported based on the guidelines of The Strengthening the Reporting of Observational Studies (cohort, case-control studies, cross-sectional studies) in Epidemiology (STROBE). IMPLICATIONS FOR PRACTICE Our study's findings indicate the need for health professionals to support caregivers of cancer patients. It is important to raise awareness among nurses and the oncology team with a holistic approach. In the delivery of health services, caregivers' needs should be identified first, support mechanisms should be activated and interventions should be made to meet these needs.
Collapse
Affiliation(s)
- Murtaza Parvizi
- Department of Radiation Oncology Clinic, Manisa City Hospital, Manisa, Turkey
| | - Semra Ay
- Department of Medical Services and Techniques (Public Health Nursing), Vocational School of Health Services, Manisa Celal Bayar University, Manisa, Turkey
| |
Collapse
|
6
|
Durak A, Catikkas NM. Is caregiver sleep quality an important clinical issue? Sleep Biol Rhythms 2024; 22:403-410. [PMID: 38962792 PMCID: PMC11217237 DOI: 10.1007/s41105-024-00523-2] [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: 10/31/2023] [Accepted: 03/06/2024] [Indexed: 07/05/2024]
Abstract
Sleep quality is directly related to general health and quality of life. Caregivers' sleep disturbances affect not only their own health, but also the optimal care of their patients, with negative consequences such as neglect and medication errors. This study was conducted prospectively in the palliative care unit. The participants were divided into two groups: the caregivers and the control group. The caregiver groups were categorized into two subgroups: family and paid caregivers. The sleep quality of the caregivers was evaluated with the Pittsburgh Sleep Quality Index (PSQI). The demographics, body mass index, educational level, the presence of chronic diseases and medications, need for spiritual support, daytime sleepiness, duration of caregiving, nighttime awakening, and tea/coffee consumption were recorded. The study included 250 caregivers (female: 74.8%, mean age: 50.6 ± 12.1) and 103 control group members. Family caregivers significantly had an advanced age, lower educational level, more chronic diseases, and medications, need for spiritual support, and longer duration of caregiving compared to the paid caregivers (p = 0.018, < 0.001, 0.001, 0.005, < 0.001, and 0.003, respectively). The total PSQI scores of caregivers were significantly higher in the FDR, family group, females, those with need of spiritual support, and tea/coffee consumption close to bedtime (p = 0.002 < 0.004. 0.026. < 0.001, and 0.022, respectively). The fact that the sleep quality of family group caregivers is worse than that of paid caregivers may prevent healthy medical service delivery. The provision of care by paid professional caregivers will improve quality of care and quality of life.
Collapse
Affiliation(s)
- Ayfer Durak
- Division of Geriatrics, Department of Internal Medicine, Hamidiye Faculty of Medicine, Sancaktepe Prof. Dr. Ilhan Varank Training and Research Hospital, University of Health Sciences Istanbul, Sancaktepe, 34785 Istanbul, Turkey
| | - Nezahat Muge Catikkas
- Division of Geriatrics, Department of Internal Medicine, Hamidiye Faculty of Medicine, Sancaktepe Prof. Dr. Ilhan Varank Training and Research Hospital, University of Health Sciences Istanbul, Sancaktepe, 34785 Istanbul, Turkey
| |
Collapse
|
7
|
Frank P, Olshan A, Iraca T, Anthony C, Wintrich S, Sasse E. Experiences and Support Needs of Caregivers of Patients with Higher-Risk Myelodysplastic Syndrome via Online Bulletin Board in the USA, Canada and UK. Oncol Ther 2024; 12:97-114. [PMID: 38062253 PMCID: PMC10881453 DOI: 10.1007/s40487-023-00253-4] [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: 09/19/2023] [Accepted: 11/08/2023] [Indexed: 02/23/2024] Open
Abstract
INTRODUCTION Patients with higher-risk myelodysplastic syndromes (MDS) face considerable challenges in disease management and often require caregiver support. Reports on the burden of caring for patients with advanced cancer suggest that caregivers receive insufficient support. Our research aimed to identify key challenges for caregivers of patients with higher-risk MDS. METHODS Online bulletin board is a qualitative research methodology which enables data collection via a web-based platform. A mix of moderator-led discussion guide and interparticipant discussion provides the caregiver insights as online dialogue, which then undergo content analysis to extract key findings. RESULTS Sixteen caregivers participated from the USA (n = 5), UK (n = 6) and Canada (n = 5). Content analysis identified the caregiver experience in higher-risk MDS as multifactorial, with seven key categories of caregiver burden: caregiver role and burden, mental health, family dynamics, disease experience, treatment experience, healthcare professional (HCP) interactions and information and education. CONCLUSION There is significant impact and burden on caregivers of patients with higher-risk MDS, which varies depending on disease stage, choice (or lack of choice) of treatments, and the personal situation of the caregiver. Emotional stress occurs mostly at diagnosis/prognosis stage and when told to 'watch and wait', which is amplified when HCPs are perceived to lack knowledge/expertise about MDS. There is a need for better education about MDS for HCPs, patients, caregivers and the general community; a need for improved communication between patients/caregivers and HCPs; and a high unmet need for better mental health and emotional support for both patient and caregiver.
Collapse
Affiliation(s)
- Pauline Frank
- Novartis Pharma AG, Fabrikstrasse 2, 4056, Basel, Switzerland.
| | - Anne Olshan
- Olshan Patient Relations Inc, Stamford, CT, USA
| | - Tracey Iraca
- Myelodysplastic Syndromes Foundation US, Yardville, NJ, USA
| | - Cindy Anthony
- Aplastic Anemia and Myelodysplasia Association Canada, King City, ON, Canada
| | | | - Emma Sasse
- Novartis Pharma AG, Fabrikstrasse 2, 4056, Basel, Switzerland
| |
Collapse
|
8
|
Özceylan G, Findik İ. Comparison of anxiety and depression levels in caregivers of patients with percutaneous endoscopic gastrostomy for home enteral tube feeding against other enteral nutrition methods. BMC Palliat Care 2024; 23:20. [PMID: 38247011 PMCID: PMC10802060 DOI: 10.1186/s12904-024-01360-3] [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: 11/17/2023] [Accepted: 01/18/2024] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND The aim of the study was to demonstrate whether the care burden of caregivers of bedridden patients, who experience feeding difficulties, decreases according to the Hospital Anxiety and Depression Scale (HADS) (1) after the patient has undergone PEG (Percutaneous Endoscopic Gastrostomy). The hypothesis of the study was that the levels of anxiety and depression of caregivers for patients fed via PEG decrease more than those for caregivers of patients fed through other enteral methods. Based on this, the goal is to recommend to palliative care and home care professionals the type of feeding method for bedridden patients that will create less burden on their relatives. METHODS A comparison was made of the Hospital Anxiety and Depression Scale (HADS) scores among caregivers of patients receiving PEG and other enteral nutrition, focusing on changes between hospital admission and discharge. These changes were analyzed based on the caregiver's age, gender, and the duration of the patient's hospital stay. METHODS This study conducted a comparative analysis of the Hospital Anxiety and Depression Scale (HADS) scores among caregivers of patients receiving Percutaneous Endoscopic Gastrostomy (PEG) versus other forms of enteral nutrition. The focus was on the variation in these scores from the time of the patients' hospital admission to their discharge. This analysis incorporated an examination of how these changes correlated with the caregiver's age and gender, as well as the duration of the patient's hospitalization. RESULTS Despite longer hospital stays, a decrease in anxiety and depression was observed in caregivers of patients receiving PEG compared to the other group (p = 0.078). It was found that the decrease in anxiety and depression levels was less pronounced with increasing age of the caregiver (r=-0.202, p = 0.038). Hospital stay duration for patients receiving PEG was significantly longer than for those receiving other enteral nutrition methods (p = 0.017). CONCLUSIONS We believe that Percutaneous Endoscopic Gastrostomy (PEG) should be the preferred method for long-term enteral nutrition due to its facilitation of effective and comfortable feeding and medication administration by caregivers. In palliative care services, for patients requiring long-term nutrition, PEG should be considered more prominently than other enteral feeding methods to reduce the anxiety of caregivers.
Collapse
Affiliation(s)
- Gökmen Özceylan
- Tekirdağ DRIFC State Hospital palliative service, TekİrdaĞ, Turkey.
| | - İnahet Findik
- Tekirdağ DRIFC State Hospital palliative service, TekİrdaĞ, Turkey
| |
Collapse
|
9
|
Erbay Dalli Ö, Bulut H. Level of caregiving burden and affecting factors in family caregivers of patients with lung cancer: A cross-sectional study. Support Care Cancer 2023; 32:60. [PMID: 38145998 DOI: 10.1007/s00520-023-08259-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 12/15/2023] [Indexed: 12/27/2023]
Abstract
PURPOSE To determine the caregiving burden level and affecting factors of family members caring for patients with lung cancer (LC). METHODS This study used a cross-sectional design and a convenience sampling method. The study was conducted between April 2023 and August 2023 with the LC patients (n = 448) and their caregivers (n = 448) who met the inclusion criteria and were followed up in seven clinics of a specialized hospital for pulmonary diseases in Turkey. Data were collected by using (1) a demographic questionnaire (for patient and caregiver), (2) the Zarit Burden Interview (ZBI), (3) the Beck Depression Inventory (BDI), and (4) the Caregiver Quality of Life Index-Cancer (CQoLC). RESULTS The study included 448 caregivers, with a mean age of 45.09 ± 13.48 years, and 71.4% were female. The mean ZBI score of 31.45 ± 16.71 indicated mild to moderate burden. Pearson correlation analysis showed that caregivers' depression levels increased and quality of life decreased significantly as the care burden increased. Multiple regression analysis indicated a significant relationship between the caregiver burden and the patient's age (p < 0.05), caregiver's chronic disease (p < 0.05), type of treatment given to the patient (p < 0.05), patient's metastasis status (p < 0.05) and caregiver's quality of life (p < 0.01). CONCLUSION The fact that most of the risk factors identified in this study are non-modifiable highlights the necessity of identifying caregiver burden early by nurses and initiating the appropriate support processes.
Collapse
Affiliation(s)
- Öznur Erbay Dalli
- Bursa Uludag University Faculty of Health Sciences, Department of Internal Medicine Nursing, Nilüfer, BURSA, Turkey, 16059.
| | - Hülya Bulut
- Health Sciences University Izmir Dr Suat Seren Chest Diseases and Surgery Training and Research Hospital, Konak, İZMİR, Turkey, 35170
| |
Collapse
|
10
|
Jang YS, Yoon NY, Hurh K, Park EC, Ha MJ. Association between changes in having of cancer patients in the family and depression: A longitudinal panel study. J Affect Disord 2023; 333:482-488. [PMID: 37119866 DOI: 10.1016/j.jad.2023.04.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 04/06/2023] [Accepted: 04/24/2023] [Indexed: 05/01/2023]
Abstract
BACKGROUND Cancer diagnosis can cause considerable stress among patients and their families. Both may experience clinical depression and severe anxiety. Therefore, this study investigated the association between the occurrence of cancer patients in the family and the depression among family members. METHODS Data from the Korean Longitudinal Study of Aging (2006-2020) were used. A total of 6251 participants who completed the short-form Center for Epidemiologic Studies Depression Scale (CESD-10-D) questionnaire were included. General estimating equations were used to assess the temporal effects of changes on depression in the presence of cancer patients in the family. RESULTS Having cancer patients in the family was associated with a high risk of depression among both men and women (men, Odd Ratios (OR):1.78, 95 % Confidence Intervals (CI) 1.13-2.79; women, OR:1.53, 95 % CI 1.06-2.22). Depressive symptoms were particularly high in women, especially when cancer symptoms were more severe than previous surveys (OR: 2.48, 95 % CI 1.18-5.20). LIMITATIONS First, non-responders were excluded but this could be affected by underestimation bias. Second, depression was defined as the CESD-10-D score, and the biological risk factors of depression could not be identified because of survey-based database. Third, due to the retrospective design study, confirming the causal relationship clearly is difficult. Finally, residual scheming effects of unmeasured variables could not be eliminated. CONCLUSION Our findings support efforts to diagnose and manage depression in the families of cancer patients. Accordingly, healthcare services and supportive interventions to reduce the psychological factors of cancer patients' families are needed.
Collapse
Affiliation(s)
- Yun Seo Jang
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea; Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Na-Young Yoon
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea; Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Kyungduk Hurh
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea; Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eun-Cheol Park
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea; Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Min Jin Ha
- Department of Health Informatics and Biostatistics, Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea.
| |
Collapse
|
11
|
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: 4] [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.
Collapse
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
| |
Collapse
|
12
|
Krishna R, Rajkumar E, Romate J, Allen JG, Monica D. Effect of Carnatic raga-Bilahari based music therapy on anxiety, sleep disturbances and somatic symptoms among caregivers of cancer patients. Heliyon 2022; 8:e10681. [PMID: 36164509 PMCID: PMC9508548 DOI: 10.1016/j.heliyon.2022.e10681] [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: 04/06/2022] [Revised: 07/12/2022] [Accepted: 09/13/2022] [Indexed: 12/24/2022] Open
Abstract
Carnatic raga-Bilahari based intervention is a music therapy technique that enhances relaxation and positivity by reducing anxiety. With extensive empirical evidence pointing out the detrimental challenges faced by the caregivers of cancer patients, the present study intends to find out the effectiveness of a Carnatic raga based music therapy on reducing anxiety, sleep disturbances, somatic symptoms and distress level among this population A single group pre-post research design was was used to conduct the study. General Health Questionnaire (GHQ-28) was used as a screening tool to select participants, and 30 participants were chosen using the purposive sampling. These individuals received instruction in listening to Carnatic music (raga-Bilahari), 5 days a week. The vocal and instrumental recordings were given on alternative days with each session lasting 15–30 min over a month of standard care. From the findings it is observed that there is significant decrease in the anxiety (p < 0.001), sleep disturbances (p < 0.001), somatic symptoms (p < 0.001) and distress level (p < 0.001) after the intervention.The study result thus indicates that Carnatic raga-Bilahari-based music intervention is effective among caregivers of cancer patients to reduce anxiety, sleep disturbances, somatic symptoms presentation, and their distress level.
Collapse
Affiliation(s)
| | - Eslavath Rajkumar
- Department of Psychology, Central University of Karnataka, Kalaburagi, India
| | - John Romate
- Department of Psychology, Central University of Karnataka, Kalaburagi, India
| | - Joshua George Allen
- Humanities and Applied Sciences, Indian Institute of Management, Pundag, Ranchi, Jharkhand, India
| | - Daniel Monica
- Department of Psychology, Central University of Karnataka, Kalaburagi, India
| |
Collapse
|
13
|
Caregiving-related experiences associated with depression severity and its symptomatology among caregivers of individuals with a severe mental disorder: an online cross-sectional study. Eur Arch Psychiatry Clin Neurosci 2022:10.1007/s00406-022-01451-3. [PMID: 35771258 PMCID: PMC9245882 DOI: 10.1007/s00406-022-01451-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 06/12/2022] [Indexed: 11/03/2022]
Abstract
Caring for a relative with a severe mental disorder puts family caregivers to a great risk of depression. While overall caregiving burden is a strong predictor of depression, the contribution of the various dimensions of burden to caregivers' depression as well as their relationships with depressive symptoms has received little attention. 384 family caregivers completed a cross-sectional online survey including the Center for Epidemiological Studies Depression (CES-D) scale, the Zarit Burden Interview (ZBI), and the Brief Experience of Caregiving Inventory (BECI), measuring caregiving burden and experience. We estimated the structure of the relationships between caregiving experiences (i.e., ZBI and BECI subscales) and CES-D symptoms using a network approach. Negative Emotion/Consequences, (lack of) Positive Personal Experience, and Stigma/Effects on Family were the most connected caregiving dimensions to depression. To untangle the role of the Negative Emotion/Consequences component (by far the most central node in estimated networks), a secondary analysis incorporating its composing items was estimated. Losing control over life, feeling strained around the relative and impaired self-perceived health emerged as central nodes. Interestingly, these caregiving-related dimensions or experiences were differentially connected to depressive symptoms. We discuss how these findings might help future research and inform tailored psychoeducational interventions for family caregivers of people with a severe mental disorder.
Collapse
|
14
|
Factors associated with psychological distress in caregivers of patients with malignant gliomas. Support Care Cancer 2022; 30:5811-5820. [DOI: 10.1007/s00520-022-06989-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 03/11/2022] [Indexed: 10/18/2022]
|
15
|
Celik E, Aslan MS, Sengul Samanci N, Karadag M, Saglam T, Cakan Celik Y, Demirci NS, Demirelli FH. The Relationship Between Symptom Severity and Caregiver Burden in Cancer Patients Under Palliative Care: A Cross-Sectional Study. J Palliat Care 2021; 37:48-54. [PMID: 34672215 DOI: 10.1177/08258597211045780] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Hospitalization is a stressful experience both for primary caregivers (PCs) and cancer patients alike. Although there is significant evidence that PCs of cancer patients can experience significant caregiver burden (CB), less is known about the relationships between PCs and patient symptom severity that influence CB. Methods: In this cross-sectional study, measures of the symptom severity were obtained from cancer patients. The PCs were assessed for CB. Associations between patients' symptoms and demographic characteristics and CB were investigated using multivariate analyses. Results: A total of 98 participants (patient-caregiver dyads) filled the questionnaires. According to the Zarit Burden Interview results, 65.3% of PCs had a high CB. Pain, tiredness, nausea, depression, drowsiness, well-being, and dyspnea had significantly higher mean values in those with high CB (p < .05). Financial difficulties, first-degree relationships with the patient, higher anxiety levels, and more pronounced tiredness appear to be the variables most predictive with high CB. Conclusion: In conclusion, the present study showed CB of PCs among a group of hospitalized incurable cancer patients. PCs of more symptomatic cancer patients had a higher CB, according to our findings. This emphasized the significance of palliative care. Appropriate guidance should be provided for the psychostress caused by the CB.
Collapse
Affiliation(s)
- Emir Celik
- Cerrahpasa Faculty of Medicine, Department of Medical Oncology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Muhammed Samil Aslan
- Cerrahpasa Faculty of Medicine, Department of Medical Oncology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Nilay Sengul Samanci
- Cerrahpasa Faculty of Medicine, Department of Medical Oncology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Mehmet Karadag
- Tayfun Ata Sokmen Medical Faculty, Department of Biostatistics, Hatay Mustafa Kemal University, Hatay, Turkey
| | - Tarik Saglam
- Halil Sivgin Cubuk State Hospital, Department of Psychiatry, Ankara, Turkey
| | - Yasemin Cakan Celik
- Gaziosmanpasa Taksim Training and Research Hospital, Department of Child and Adolescent Psychiatry, Istanbul, Turkey
| | - Nebi Serkan Demirci
- Cerrahpasa Faculty of Medicine, Department of Medical Oncology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Fuat Hulusi Demirelli
- Cerrahpasa Faculty of Medicine, Department of Medical Oncology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| |
Collapse
|
16
|
Effects of psychosocial interventions on psychological outcomes among caregivers of advanced cancer patients: a systematic review and meta-analysis. Support Care Cancer 2021; 29:7237-7248. [PMID: 34240256 DOI: 10.1007/s00520-021-06102-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 02/23/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE This systematic review aimed to synthesize the effectiveness of psychosocial interventions on caregivers of advanced cancer patients, in comparison with usual care, on caregivers' quality of life (QoL), anxiety, and depression symptoms. METHODS Comprehensive searches for published and unpublished studies were performed using nine electronic databases, two trial registers, and reference lists of included studies. Two reviewers independently screened, appraised, and extracted data. The Cochrane risk of bias tool was used to appraise the methodological quality of included studies, while the Cochrane data extraction tool was used to elicit relevant information. Meta-analysis, narrative analysis, and sensitivity analysis were conducted to synthesize data. Standardized mean differences (SMD) represented effects of psychosocial interventions. RESULTS Fifteen randomized controlled trials were included in this review. At post-intervention, findings revealed a significant small pooled effect size (SMD = 0.45) on QoL and significant moderate effect on depression (SMD = - 0.65). However, a small non-significant pooled effect size was observed on anxiety (SMD = - 0.24). At follow-up assessments, effect sizes of all outcomes were small and non-significant. Overall quality of evidence was rated very low for all outcomes and most studies had unclear or high risk of bias. Thus, results should be interpreted with caution. CONCLUSION Psychosocial interventions were effective in improving QoL and depression among caregivers of persons with advanced cancer. However, future randomized control trials with lower risk of bias, larger sample size, detailed participant characteristics, and informative interventions are desirable.
Collapse
|
17
|
van Roij J, Brom L, Sommeijer D, van de Poll-Franse L, Raijmakers N. Self-care, resilience, and caregiver burden in relatives of patients with advanced cancer: results from the eQuiPe study. Support Care Cancer 2021; 29:7975-7984. [PMID: 34215933 PMCID: PMC8549961 DOI: 10.1007/s00520-021-06365-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 06/13/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE Relatives are often involved in caregiving for patients with advanced cancer and carry a heavy burden. Self-care and resilience might be beneficial to enhance their wellbeing and burden-bearing capacity. This study assessed the engagement in self-care and resilience in relatives of patients with advanced cancer and its association with their caregiver burden. METHODS This study analyzed baseline data of the eQuiPe study, a prospective longitudinal, multicenter, observational study on quality of care and life of patients with advanced cancer and their relatives in which self-care (Self-care Practices Scale), resilience (Connor-Davidson Resilience Scale), and caregiver burden (Zarit Burden Interview (ZBI)) of relatives were included. Their scores were compared with a gender- and age-matched normative population. Multivariable logistic regression analysis was performed to assess the association between self-care and resilience with caregiver burden. RESULTS Most of the 746 relatives were the patient's partner (78%) and 54% reported to be an informal caregiver of the patient. The median hours of caregiving a week for all relatives was 15 and 11% experienced high caregiver burden (ZBI > 20). Relatives who reported a high caregiver burden engaged less often in self-care (OR = .87) and were less resilient (OR = .76) compared to relatives with low/medium caregiver burden. Relatives with high caregiver burden were younger (OR = .96), highly educated (OR = 2.08), often reported to be an informal caregiver of the patient (OR = 2.24), and were less well informed about the importance of self-care (OR = .39). CONCLUSION A significant number of relatives of patients with advanced cancer experienced high caregiver burden. As more self-care and resilience were associated with lower experienced caregiver burden, creating awareness of the beneficial potential of self-care is important. Future studies should illuminate the causal relation. TRIAL REGISTRATION NUMBER NTR6584 (date of registration: 30 June 2017).
Collapse
Affiliation(s)
- Janneke van Roij
- Research & Development, Netherlands Comprehensive Cancer Organization (IKNL), PO box 19079, 3501 DB, Utrecht, The Netherlands.,CoRPS-Center of Research On Psychology in Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.,Netherlands Association for Palliative Care (PZNL), Utrecht, The Netherlands.,Libra Rehabilitation and Audiology, Tilburg, The Netherlands
| | - Linda Brom
- Research & Development, Netherlands Comprehensive Cancer Organization (IKNL), PO box 19079, 3501 DB, Utrecht, The Netherlands.,Netherlands Association for Palliative Care (PZNL), Utrecht, The Netherlands
| | - Dirkje Sommeijer
- Department of Medical Oncology, Amsterdam University Medical Center, Amsterdam, The Netherlands.,Department of Medical Oncology, Almere, The Netherlands
| | - Lonneke van de Poll-Franse
- Research & Development, Netherlands Comprehensive Cancer Organization (IKNL), PO box 19079, 3501 DB, Utrecht, The Netherlands.,CoRPS-Center of Research On Psychology in Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.,Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Natasja Raijmakers
- Research & Development, Netherlands Comprehensive Cancer Organization (IKNL), PO box 19079, 3501 DB, Utrecht, The Netherlands. .,Netherlands Association for Palliative Care (PZNL), Utrecht, The Netherlands.
| | | |
Collapse
|
18
|
del-Pino-Casado R, Priego-Cubero E, López-Martínez C, Orgeta V. Subjective caregiver burden and anxiety in informal caregivers: A systematic review and meta-analysis. PLoS One 2021; 16:e0247143. [PMID: 33647035 PMCID: PMC7920375 DOI: 10.1371/journal.pone.0247143] [Citation(s) in RCA: 122] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 02/02/2021] [Indexed: 12/12/2022] Open
Abstract
There is increasing evidence that subjective caregiver burden is an important determinant of clinically significant anxiety in family carers. This meta-analysis aims to synthesise this evidence and investigate the relationship between subjective caregiver burden and anxiety symptoms in informal caregivers. We searched PubMed, CINAHL and PsycINFO up to January 2020. Combined estimates were obtained using a random-effects model. After screening of 4,312 articles, 74 studies (with 75 independent samples) were included. There was a large, positive association between subjective caregiver burden and anxiety symptoms (r = 0.51; 95% CI = 0.47, 0.54; I2 = 0.0%). No differences were found in subgroup analyses by type of study design (cross-sectional vs. longitudinal), sampling, control of confounders or care-recipient characteristics. Subjective caregiver burden is an important risk factor for anxiety in informal caregivers. Targeting subjective caregiver burden could be beneficial in preventing clinically significant anxiety for the increasing number of family carers worldwide.
Collapse
Affiliation(s)
- Rafael del-Pino-Casado
- Faculty of Health Sciences, Department of Nursing, University of Jaén, Jaén, Andalusia, Spain
- * E-mail:
| | - Emilia Priego-Cubero
- Faculty of Health Sciences, Department of Nursing, University of Jaén, Jaén, Andalusia, Spain
| | - Catalina López-Martínez
- Faculty of Health Sciences, Department of Nursing, University of Jaén, Jaén, Andalusia, Spain
| | - Vasiliki Orgeta
- Division of Psychiatry, University College London, London, United Kingdom
| |
Collapse
|
19
|
Poor patient health is associated with higher caregiver burden for older adults with advanced cancer. J Geriatr Oncol 2021; 12:771-778. [PMID: 33478890 DOI: 10.1016/j.jgo.2021.01.002] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 10/12/2020] [Accepted: 01/05/2021] [Indexed: 01/01/2023]
Abstract
OBJECTIVES Family caregiver burden among older adults with advanced cancer remains poorly understood. We sought to (1) identify patient factors associated with caregiver burden and (2) examine how amount of time caregiving modifies these relationships. METHODS Cross-sectional analysis of baseline data from a cluster-randomized palliative care intervention trial including patients with advanced cancer and their family caregivers, recruited from 17 oncology practices in Pennsylvania. Caregiver burden was measured using Zarit Burden Interview (ZBI-12; range 0-48). Patient factors included functional status (Eastern Cooperative Oncology Group), symptom burden (Edmonton Symptom Assessment Scale), anxiety and depression (Hospital Anxiety and Depression Scale), and quality of life (Functional Assessment of Chronic Illness Therapy - Palliative Care). Using adjusted multivariable regression, we analyzed (1) independent associations between patient factors and caregiver burden and (2) how weekly caregiving hours modified these relationships. RESULTS Among 441 patient-caregiver dyads, mean patient age was 70 ± 10 and caregiver age was 62 ± 13 years. Most caregivers (59%) were patients' partners. Caregivers reported 44.5 ± 53.5 average hours spent caregiving weekly; mean ZBI-12 scores were 10.3 ± 7.3. Worse patient functional status (β = 4.20, p < 0.01), poorer quality of life (β = -0.07, p < 0.01), more anxiety (β = 0.33, p < 0.01) and depression (β = 0.33, p < 0.01) were associated with higher caregiver burden; caregiving hours did not affect these relationships. CONCLUSIONS In advanced cancer, poor patient physical and mental health is associated with higher caregiver burden regardless of hours caregiving; future studies should examine interventions tailored to alleviate caregiver burden for this group.
Collapse
|
20
|
Unsar S, Erol O, Ozdemir O. Caregiving burden, depression, and anxiety in family caregivers of patients with cancer. Eur J Oncol Nurs 2021; 50:101882. [PMID: 33421929 DOI: 10.1016/j.ejon.2020.101882] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 11/13/2020] [Accepted: 11/20/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE The purpose of this cross-sectional study was to determine the caregiving burden, depression and anxiety of family caregivers of Turkish patients with cancer and the affecting factors. METHODS This cross-sectional study was conducted between January-May 2018 with one hundred and fifty-eight caregivers and one hundred and fifty-eight patients with cancer who were treated at a university hospital in Edirne, Turkey. Data were collected with a questionnaire form, Zarit Burden Interview (ZBI) Scale and the Hospital Anxiety Depression Scale (HADS). RESULTS This study found that 51.3% of the patients with cancer were male, 70.3% of the caregivers were female and more than half of them (57.0%) were the spouses of the patients. The mean ZBI score of the caregivers was 24.62 ± 14.19. There was a positive relationship between the ZBI scores and HADS scores of family caregivers (p < 0.05). As the caregiving burden of caregivers increased, their anxiety and depression levels were increased too. It was found that as the caregiving duration of family caregivers increased, the caregiving burden increased, and caregivers' anxiety depression scores got worse (p < 0.05). In the multivariate analysis, the duration of caregiving per day/hours, ECOG score and the age of the caregiver independently affected the caregiving burden (p < 0.05). As the functional status of the patient with cancer got worse, caregiving burden increased. Caregiving burden was found to be higher in those who were younger, female and giving care for longer times per day (p < 0.05). CONCLUSION This study found that as the caregiving burden and caregivers' daily patient care duration increased, the level of anxiety and depression increased too. Caregivers of patients with cancer should take appropriate psychological intervention to decrease their distress. In addition, we thought that healthcare professionals must consider the factors affecting the caregiving burden which affect the patient care directly.
Collapse
Affiliation(s)
- Serap Unsar
- Trakya University, Faculty of Health Sciences, Department of Internal Medicine Nursing, Balkan Campus, Edirne, Turkey.
| | - Ozgul Erol
- Trakya University, Faculty of Health Sciences, Department of Internal Medicine Nursing, Balkan Campus, Edirne, Turkey.
| | - Ozlem Ozdemir
- Kırklareli University, School of Health, Health Management Department, Kırklareli, Turkey.
| |
Collapse
|
21
|
Long NX, Phung TT, Ngoc NB, Linh DTD, Anh TN, Lan NTM, Thang NT, Trang VT, Hung NV, Thuong NH, Hieu NV, Minh HV. Self-reported psychological distress among caregivers of patients with cancer: Findings from a health facility-based study in Vietnam 2019. Health Psychol Open 2020; 7:2055102920975272. [PMID: 33329896 PMCID: PMC7720337 DOI: 10.1177/2055102920975272] [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: 11/17/2022] Open
Abstract
In Vietnam, little is elucidated in scientific literatures about the mental health of caregivers of people with cancer. We conducted a cross-sectional study to report the situation and correlates of self-reported psychological distress among caregivers of cancer patients in Vietnam in 2019. Multiple logistic and linear regression analyses were performed. A total of 16.5% of the study participants had psychological distress. Respondent’s mean score of negative emotion was 7.6 ± 2. Educational level and type of support were significantly associated with having psychological distress among caregivers. Gender, occupation, financial difficulty, treatment belief and social support significantly correlated to psychological distress level of caregivers.
Collapse
Affiliation(s)
- Nguyen Xuan Long
- University of Languages and International Studies, Vietnam National University, Vietnam
| | | | | | - Dao Thi Dieu Linh
- University of Languages and International Studies, Vietnam National University, Vietnam
| | - Ta Nhat Anh
- University of Languages and International Studies, Vietnam National University, Vietnam
| | | | - Nguyen Thi Thang
- University of Languages and International Studies, Vietnam National University, Vietnam
| | | | | | | | | | | |
Collapse
|
22
|
Caregiver Burden Domains and Their Relationship with Anxiety and Depression in the First Six Months of Cancer Diagnosis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17114101. [PMID: 32526823 PMCID: PMC7312950 DOI: 10.3390/ijerph17114101] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 06/05/2020] [Accepted: 06/06/2020] [Indexed: 12/16/2022]
Abstract
Cancer caregiving is associated with burden and a poor psychological state. However, there is no previous information about the predictive utility of specific burden domains on anxiety and depression in the first six months after a partner's cancer diagnosis. In a longitudinal study, 67 caregivers completed the Zarit Burden Interview (ZBI) and Hospital Anxiety and Depression Scale (HADS) at T1 (45-60 days after diagnosis) and T2 (180-200 days after diagnosis). Most of the caregivers were female (65.7%, mean age = 51.63, SD = 13.25), while patients were mostly male (56.7%). The TRIPOD checklist was applied. ZBI scores were moderate and HADS anxiety reached significant values. There were no differences in ZBI and HADS between T1 and T2. The relationship between burden, anxiety, and depression were more consistent at T2, while emotional burden at T1 were related and predicted anxiety and depression at T2. Some burden domains were related and predicted anxiety in caregivers in the first six months after partner cancer diagnosis. This information could be useful to prevent the onset of these symptoms in the first six months after diagnosis.
Collapse
|
23
|
Lee Wong C, Choi KC, Mei Nok Lau, Lam KL, Wei So WK. Caregiving burden and sleep quality amongst family caregivers of Chinese male patients with advanced cancer: A cross-sectional study. Eur J Oncol Nurs 2020; 46:101774. [PMID: 32460141 DOI: 10.1016/j.ejon.2020.101774] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 03/15/2020] [Accepted: 05/10/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE To examine the level of caregiving burden and sleep quality as well as their interrelationship amongst family caregivers of Chinese male patients with advanced cancer. METHOD A cross-sectional study was conducted in Hong Kong. The Caregiver Reaction Assessment (CRA) and the Pittsburgh Sleep Quality Index (PSQI) were used to measure caregiving burden and sleep quality of the family caregivers. RESULTS A total of 96 family caregivers were recruited. Disrupted schedule (3.8; SD = 0.8) was rated as the most affected consequence of caregiving burden. Around 78.1% of the caregivers suffered from sleep problems. Hierarchical multiple regression revealed that health problems due to caregiving burden was independently associated with poor sleep quality after controlling for socio-demographic characteristics of both patients and caregivers (regression coefficient, B = 2.09, P = 0.012). CONCLUSIONS Caregiving burden amongst family caregivers of male patients with advanced cancer was remarkably high and associated with poor sleep quality. Strategies aiming to alleviate caregiving burden of caregivers may help break this vicious cycle to enhance the sleep quality of caregivers. Results also underscore the need to assess and develop intervention to relieve caregiving burden for family caregivers of cancer patients.
Collapse
Affiliation(s)
- Cho Lee Wong
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
| | - Kai Chow Choi
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
| | - Mei Nok Lau
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
| | - Ka Ling Lam
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
| | - Winnie Kwok Wei So
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
| |
Collapse
|
24
|
García-Torres F, Jacek Jabłoński M, Gómez Solís Á, Moriana JA, Jaén-Moreno MJ, Moreno-Díaz MJ, Aranda E. Social support as predictor of anxiety and depression in cancer caregivers six months after cancer diagnosis: A longitudinal study. J Clin Nurs 2020; 29:996-1002. [PMID: 31793095 DOI: 10.1111/jocn.15123] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 11/20/2019] [Accepted: 11/21/2019] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To establish the predictive utility of specific social support domains for emotional well-being in cancer caregivers, six months after their partner's cancer diagnosis. BACKGROUND In cancer caregivers, social support has been consistently related to anxiety and depression. There is little information, however, about the predictive utility of specific social support domains for psychological well-being in the first six months after a partner's cancer diagnosis. DESIGN Longitudinal research study. METHODS Sixty-seven caregivers of recently diagnosed cancer patients were recruited from the Reina Sofia University Hospital in Cordoba (Spain). Participants completed a set of questionnaires including the Berlin Social Support Scale (BSSS), the Hospital Anxiety and Depression Scale (HADS) and a socio-demographic questionnaire. Data were collected at two time points: T1 (30-45 days after diagnosis) and T2 (180-200 days after). TRIPOD checklist was used. RESULTS Most of the caregivers were female (65%) and the partner of the patient (58%), with an average age of 51.63 years (SD = 13.25). Statistical differences were observed between the two assessment points for the social support domains of perceived emotional support, satisfaction with support and protective buffering. Logistic regression analysis showed that less physical and sports activity, more support seeking and less informational support received at T1 predicted anxiety at T2, while less perceived available support predicted depression. CONCLUSIONS Accurate information and support from other members of the community and the promotion of physical and sports routines for cancer caregivers may help to alleviate symptoms of anxiety and depression in the first months after a partner's cancer diagnosis. RELEVANCE TO CLINICAL PRACTICE Clinicians must pay attention to the social support needs and physical activity of caregivers in the first days after diagnosis, in order to prevent anxiety and depression.
Collapse
Affiliation(s)
- Francisco García-Torres
- Department of Psychology, University of Cordoba, Cordoba, Spain / IMIBIC Health Research Institute / Reina Sofía University Hospital of Cordoba, Cordoba, Spain
| | - Marcin Jacek Jabłoński
- Institute of Psychology, Faculty of Philosophy, Jesuit University Ignatianum in Krakow, Poland
| | | | - Juan Antonio Moriana
- Department of Psychology, University of Cordoba, Cordoba, Spain / IMIBIC Health Research Institute / Reina Sofía University Hospital of Cordoba, Cordoba, Spain
| | - Maria José Jaén-Moreno
- IMIBIC Health Research Institute / Department of Social Health Sciences, Radiology and Physical Medicine/ University of Córdoba, Córdoba, Spain
| | - Maria José Moreno-Díaz
- Department of Social Health Sciences, Radiology and Physical Medicine / University of Córdoba, Córdoba, Spain
| | - Enrique Aranda
- Medical Oncology Department, Reina Sofía University Hospital, Córdoba, Spain
| |
Collapse
|
25
|
Crawford L, Loprinzi PD. Effects of Exercise on Memory Interference in Neuropsychiatric Disorders. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1228:425-438. [PMID: 32342475 DOI: 10.1007/978-981-15-1792-1_29] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
There are several mechanisms that cause memory impairment, including motivated forgetting, active forgetting, natural decay, and memory interference. Interference occurs when one is attempting to recall something specific, but there is conflicting information making it more difficult to recall the target stimuli. In laboratory settings, it is common to measure memory interference with paired associate tasks-usually utilizing the AB-CD, AB-AC, AB-ABr, or AB-DE AC-FG method. Memory impairments are frequent among those with neuropsychiatric disorders such as depression, schizophrenia, and multiple sclerosis. The memory effects of each condition differ, but are all related to alterations in brain physiology and general memory deterioration. Exercise, or physical activity, has been demonstrated to attenuate memory interference in some cases, but the mechanisms are still being determined. Further research is needed on memory interference, in regard to exercise and neuropsychiatric disorders.
Collapse
Affiliation(s)
- Lindsay Crawford
- Department of Health, Exercise Science, and Recreation Management, Exercise and Memory Laboratory, The University of Mississippi, MS, Oxford, USA
| | - Paul D Loprinzi
- Department of Health, Exercise Science, and Recreation Management, Exercise and Memory Laboratory, The University of Mississippi, MS, Oxford, USA.
| |
Collapse
|
26
|
Teo I, Baid D, Ozdemir S, Malhotra C, Singh R, Harding R, Malhotra R, Yang MG, Neo SHS, Cheung YB, Neo PSH, Kanesvaran R, Kumarakulasinghe NB, Lee LH, Koh GCH, Finkelstein EA. Family caregivers of advanced cancer patients: self-perceived competency and meaning-making. BMJ Support Palliat Care 2019; 10:435-442. [PMID: 31806656 DOI: 10.1136/bmjspcare-2019-001979] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 10/03/2019] [Accepted: 11/10/2019] [Indexed: 11/04/2022]
Abstract
BACKGROUND Family caregivers of patients with advanced cancer have been reported to provide long hours of care and be at risk for poor psychological outcomes. Although research has focused on the nature of caregiving burden, little attention has been paid to identifying protective factors that improve caregiver psychological outcomes. AIM We examined the relationship between caregivers' time spent caregiving and the following psychological outcomes: anxiety, depression and caregiving esteem. Subsequently, we explored the main and moderating effects of caregiver-perceived self-competency and sense of meaning on caregiver psychological outcomes. DESIGN/PARTICIPANTS Cross-sectional analysis was conducted using the baseline data from an ongoing cohort study. Family caregivers of advanced cancer patients (n=287) were recruited from two tertiary hospitals in Singapore. RESULTS Time spent caregiving was not significantly associated with caregiver anxiety, depression or caregiving esteem. However, significant main effects of self-competency on anxiety and caregiving esteem; and sense of meaning on anxiety, depression and caregiving esteem were observed. Moderator analyses further indicated that self-competency attenuated the positive relationship between time spent caregiving and anxiety, while sense of meaning attenuated the negative relationship between time spent caregiving and caregiving esteem. CONCLUSION Greater perceived self-competency and sense of meaning are related to better caregiver psychological outcomes, and protect caregivers from worsening outcomes as caregiving hours increase. Our findings suggest that screening caregivers for distress is an important part of care, and that supportive interventions for caregivers should aim to enhance their perceived caregiving competencies and the ability to make meaning of their caregiving role.
Collapse
Affiliation(s)
- Irene Teo
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore .,Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore.,Program in Health Services & Systems Research, Duke-NUS Medical School, Singapore
| | - Drishti Baid
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
| | - Semra Ozdemir
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore.,Program in Health Services & Systems Research, Duke-NUS Medical School, Singapore
| | - Chetna Malhotra
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore.,Program in Health Services & Systems Research, Duke-NUS Medical School, Singapore
| | - Ratna Singh
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
| | - Richard Harding
- Department of Palliative Care and Policy, King's College London, London, UK
| | - Rahul Malhotra
- Program in Health Services & Systems Research, Duke-NUS Medical School, Singapore.,Centre for Aging Research and Education, Duke-NUS Medical School, Singapore
| | - Meijuan Grace Yang
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore.,Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore
| | - Shirlyn Hui-Shan Neo
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore
| | - Yin Bun Cheung
- Program in Health Services & Systems Research, Duke-NUS Medical School, Singapore.,Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore.,Center for Child Health Research, Tampere University, Tampere, Pirkanmaa, Finland
| | - Patricia Soek Hui Neo
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore
| | | | | | - Lai Heng Lee
- Department of Haematology, Singapore General Hospital, Singapore
| | - Gerald Choon Huat Koh
- Program in Health Services & Systems Research, Duke-NUS Medical School, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Eric A Finkelstein
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore.,Program in Health Services & Systems Research, Duke-NUS Medical School, Singapore
| | | |
Collapse
|
27
|
del-Pino-Casado R, Rodríguez Cardosa M, López-Martínez C, Orgeta V. The association between subjective caregiver burden and depressive symptoms in carers of older relatives: A systematic review and meta-analysis. PLoS One 2019; 14:e0217648. [PMID: 31141556 PMCID: PMC6541277 DOI: 10.1371/journal.pone.0217648] [Citation(s) in RCA: 121] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 05/15/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Family carers are an important source of care for older people. Although several studies have reported that subjective caregiver burden is related to depressive symptoms there are no systematic reviews quantifying this association. OBJECTIVE To establish the extent to which subjective caregiver burden is associated with depressive symptoms and whether this association would vary by study or care characteristics. METHODS We searched major databases such as PubMed, CINAHL, PsycINFO, Scopus and ISI Proceedings up to March 2018, and conducted a meta-analysis of included studies. Summary estimates of the association were obtained using a random-effects model to improve generalisation of findings. RESULTS After screening of 4,688 articles, 55 studies were included providing a total of 56 independent comparisons with a total of 9,847 carers from data across 20 countries. There was a large, positive association between subjective caregiver burden and depressive symptoms ([Formula: see text] = 0.514; 95% CI = 0.486, 0.541), with very low heterogeneity amongst individual studies (I2 = 8.6%). Sensitivity analyses showed no differences between cross-sectional or repeated measures ([Formula: see text] = 0.521; 95% CI = 0.491, 0.550; 51 samples) and longitudinal studies ([Formula: see text] = 0.454; 95% CI = 0.398, 0.508; 6 samples). We found a higher effect size for those caring for people living with dementia compared to those caring for frail older people, and stroke survivors. Carer sex, age and kinship did not change the estimate of the effect. CONCLUSIONS Subjective caregiver burden is a significant risk factor for depressive symptoms in carers of older people and may precipitate clinical depression. Those caring for people with dementia experience greater burden. There is a need for longitudinal evaluations examining the effects of potential mediators of the association of subjective burden and depressive symptoms. Future interventions should test whether minimizing subjective burden may modify the risk of developing depression in carers of older relatives.
Collapse
Affiliation(s)
| | | | | | - Vasiliki Orgeta
- Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom
| |
Collapse
|
28
|
Han S, Toh HC. The empowerment of all modalities against cancer. Singapore Med J 2018; 59:560-561. [PMID: 30498843 PMCID: PMC6250756 DOI: 10.11622/smedj.2018133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Shuting Han
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
| | - Han Chong Toh
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
- Duke-NUS School of Medicine, Singapore
| |
Collapse
|