Creativity, Optimism, Planning, and Expert Advise (COPE): A Problem-Solving Intervention for Supporting Cancer Patients and Their Family Caregivers

Cancer patients and their family caregivers experience various losses when patients become terminally ill, yet little is known about the grief experienced by patients and caregivers and factors that influence grief as patients approach death. Additionally, few, if any, studies have explored associations between advance care planning (ACP) and grief resolution among cancer patients and caregivers. To fill this knowledge gap, the current study examined changes in grief over time in patients and their family caregivers and whether changes in patient grief are associated with changes in caregiver grief. We also sought to determine how grief changed following the completion of advance directives. The sample included advanced cancer patients and caregivers (n = 98 dyads) from Coping with Cancer III, a federally funded, multi-site prospective longitudinal study of end-stage cancer care. Participants were interviewed at baseline and at follow-up roughly 2 months later. Results suggest synchrony, whereby changes in patient grief were associated with changes in caregiver grief. We also found that patients who completed a living will (LW) experienced increases in grief, while caregivers of patients who completed a do-not-resuscitate (DNR) order experienced reductions in grief, suggesting that ACP may prompt “grief work” in patients while promoting grief resolution in caregivers.

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Distress experienced by lung cancer patients and their family caregivers in the first year of their cancer journey

Palliative & Supportive Care ◽

10.1017/s1478951521000377 ◽

2021 ◽

pp. 1-7

Author(s):

Michèle Aubin ◽

Lucie Vézina ◽

René Verreault ◽

Sébastien Simard ◽

Éveline Hudon ◽

...

Keyword(s):

Lung Cancer ◽

Cancer Patients ◽

Family Caregivers ◽

Screening Program ◽

Depression Scale ◽

Participation Rate ◽

Quebec City ◽

Lung Cancer Patients ◽

Distress Score ◽

Ambulatory Oncology

Abstract Objectives Diagnosis of cancer is emotionally threatening not only for patients but also for their family caregivers (FC) who witness and share much of the illness experience. This study compares distress experienced by lung cancer patients and their FC during the year following the diagnosis. Methods A prospective cohort study of 206 patients recently diagnosed with inoperable lung cancer (participation rate 79.5%) and 131 FC (participation rate 63.6%) was conducted in an ambulatory oncology clinic in Quebec City (Canada). They completed validated questionnaires regarding their personal and psychological characteristics (Hospital and Anxiety Depression Scale—HADS), in the first months after the diagnosis of lung cancer and after 6 and 12 months. Univariate, bivariate, and linear mixed models were conducted to compare patient and FC distress. Results At baseline, 7.8% of patients reported distress (HADS total score >15) and their mean distress score was 7.0 ± 4.9 (range 0–42). In contrast, 33.6% of FC presented significant distress and their mean distress score was 12.0 ± 7.2 (P < 0.0001). Proportions of patients and FC with distress remained relatively stable at 6 and 12 months, and at every time point, FC reported higher levels of distress compared to their relative with cancer (P < 0.0001). Comparable trends were found when looking at the mean scores of distress, anxiety, and depression throughout the study. Significance of results Being diagnosed with lung cancer and going through its different phases seems to affect more FC than patients. The psychological impact of such diagnosis appears early after the diagnosis and does not significantly change over time. These findings reinforce the importance for oncology teams, to include FC in their systematic distress screening program, in order to help them cope with their own feelings and be able to play their role in patient support and care throughout the cancer journey.

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A Resilient Care of the Patient With COVID-19: A Phenomenological Study

International Quarterly of Community Health Education ◽

10.1177/0272684x211033454 ◽

2021 ◽

pp. 0272684X2110334

Author(s):

Parvaneh Asgari ◽

Alun C. Jackson ◽

Ali Khanipour-Kencha ◽

Fatemeh Bahramnezhad

Keyword(s):

Problem Solving ◽

Family Caregivers ◽

Spiritual Care ◽

Phenomenological Study ◽

Psychiatric Nurses ◽

Religious Practices ◽

Iranian Family ◽

Data Saturation ◽

Multiple Media ◽

Media Channels

This study a utilized phenomenological hermeneutic design. Fourteen Iranian family caregivers of patients with COVID-19 who were isolated at home were included in the study using purposive sampling. In-depth unstructured interviews were conducted via WhatsApp. Sampling continued until data saturation. Interviews were transcribed and analyzed using Van Manen’s approach. Three primary themes and eight subthemes emerged. The primary themes included: “captured in a whirlpool of time”, “resilient care’ and “feeling helpless”. It seems that the families of patients with COVID-19 attempt to resist the pressures of this disease with religious practices and problem solving. However, due to the nature of the disease and its severity, they sometimes feel ashamed or lonely and are afraid of losing their loved ones. It is recommended that psychiatric nurses should develop programs in the form of comprehensive spiritual care packages or psychological support and utilize multiple media channels to deliver these.

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