scholarly journals Shared Care Contributions to Self-Care and Quality of Life in Chronic Cardiac Patients

2016 ◽  
Vol 38 (7) ◽  
pp. 837-857 ◽  
Author(s):  
Margaret Sebern ◽  
Roger Brown ◽  
Patricia Flatley-Brennan

Shared care is an interpersonal interaction system composed of communication, decision making, and reciprocity; it is used by patients and family caregivers (care dyads) to exchange social support. This study’s purpose was to describe the contributions of shared care to outcomes for individuals with cardiac disease. A secondary data analysis was used to answer the following questions. What is the association between elements of shared care and patient outcomes? Do dyad perceptions of shared care differentially contribute to patient outcomes? Participants in this study were 93 individuals with a cardiac disease and 93 family caregivers. Composite index structured equation modeling was the analytic tool. Caregiver communication and reciprocity were related to patient mental quality of life. Patient communication and reciprocity were related to their own mental and physical quality of life and self-care confidence. Findings from this study contribute a better understanding of how care dyads are integral to patient outcomes.

2021 ◽  
Author(s):  
Clarence Aaron Cheng Sy

Abstract Background: Though found to be a common occurrence in individuals caring for patients with debilitating illnesses such as cancer, caregiver burden remains underprioritized, and its relationship with patient outcomes is only sparingly described. Methodology: This cross-sectional, observational study included 50 patient-caregiver pairs receiving anti-cancer systemic therapy at a tertiary hospital in Cebu City. Sociodemographic and clinical characteristics were obtained. Patient quality of life was measured using the EQ-5D-5L Questionnaire, while caregiver burden was assessed with the Zarit Burden Interview. The association between caregiver burden and patient outcomes were examined using multivariate logistic regression models and bivariate analysis.Results: Patients included in the study were predominantly females, middle-aged to elderly, and in advanced stages of disease, whereas caregivers were mostly female, and younger in relation. The usual patient-caregiver relationships were spousal and parental. Educational attainment, employment status and income varied among caregivers, and were significantly associated with caregiver burden, as were patient age, a lung primary, and limitations in patient mobility, self-care and ability to perform usual activities. On the other hand, higher levels of caregiver burden were linked to quality of life impairment, increased anxiety or depression, and more frequent hospital admissions for patients.Discussion: The level of care in patients requiring continuous assistance often leads to an imbalance of care demands relative to the caregiver’s personal time and space, roles and resources, the latter being particularly relevant in the third-world setting where healthcare expenditure remains largely out-of-pocket. Patients likewise suffer from the burden they unwillingly impose on caregivers, with self-perceived burden contributing significantly to patient anxiety and depression, and influencing therapeutic choices in the direction of palliative care over curative therapy. Additionally, a higher level of caregiver burden was found to compromise the quality of care, and increase reliance on health systems, often leading to more frequent hospital admissions, perpetuating a vicious cycle of demand and burden.Conclusions: Financial standing, which can be influenced by educational attainment, employment status and income, was found to be significantly associated with caregiver burden. Patient-related factors such as age, a lung primary, and assistance requirement were also associated factors. Conversely, caregiver burden was found to influence patient quality of life via the impairment of mobility, self-care and ability to perform activities of daily living, and an increase in anxiety or depression. Higher levels of caregiver burden were also found to be associated with a higher frequency of hospital admissions for the patient.


Healthcare ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 81
Author(s):  
Amparo Oliver ◽  
Laura Galiana ◽  
Gustavo de Simone ◽  
José M. Tomás ◽  
Fernanda Arena ◽  
...  

Compassionate professional qualities traditionally have not received the most attention in either critical or end of life care. Constant exposure to death, time pressure and workload, inadequate coping with personal emotions, grieving, and depression urge the development of an inner curricula of competences to promote professional quality of life and compassionate care. The COVID-19 pandemic highlights the universality of these problems and the need to equip ourselves with rigorously validated measurement and monitoring approaches that allow for unbiased comparisons. The main objective of this study was to offer evidence on the generalizability of the awareness model of self-care across three care systems under particular idiosyncrasy. Regarding the sample, 817 palliative care professionals from Spain, Argentina, and Brazil participated in this cross-sectional study using a multigroup structural equation modeling strategy. The measures showed good reliability in the three countries. When testing the multigroup model against the configural and constrained models, the assumptions were fulfilled, and only two relationships of the model revealed differences among contexts. The hypotheses posited by the awareness model of self-care were supported and a similar predictive power on the professional quality of life dimensions was found. Self-care, awareness, and coping with death were competences that remained outstanding no matter the country, resulting in optimism about the possibility of acting with more integrative approaches and campaigns by international policy-makers with the consensus of world healthcare organizations.


Author(s):  
Haryani Haryani ◽  
Kuniarti Rachmat ◽  
Probo Suseno ◽  
Christantie Effendy

Background: Chemotherapy affects the condition of cancer patients, physically, psychologically, socially and spiritually. The Self-care Symptom Management (SSM) program is a psychoeducation program with the goal of enhancing patients' self-care abilities to manage the side effects of chemotherapy, and thus improve the Quality of Life (QOL) of adult cancer patients and their family caregivers. The objective of the study is to determine the effects of the SSM program on the QOL of cancer patients undergoing chemotherapy and their family caregivers.Methods: The study adopts a quasi-experimental design, with one group and pre- and post-intervention tests. The study was conducted in a public hospital in Yogyakarta, Indonesia, with 40 cancer patients and 30 of their family caregivers. The QOL of patients is measured using the EORTC QLQ-C30, and for their family caregivers the CQOLC is used. Data analysis are carried out using a paired t-test and Wilcoxon test, with a 95% level of significance.Results: The data show significant differences between the mean scores on a single item of sleep disturbance (15.84 points) and a single item of financial difficulties (8.34 points) before and after the implementation of the SSM program. Clinical relevance is shown on a single item of sleep disturbance (≥10 points).Conclusions:The Self-care Symptom Management program represents a promising intervention to promote self-care management for cancer care in Indonesia. 


2019 ◽  
pp. 208-216

Objectives: To elucidate the importance of mutual effects within dyads by examining the contribution of depression on quality of life (QOL) in patients with advanced cancer and their family caregivers (FCs). Sample & Setting: 716 patients with advanced cancer paired with their FCs at two large, private not-for-profit hospices. Methods & Variables: A descriptive, cross-sectional design with the baseline data of a randomized hospice clinical trial was used. Structural equation modeling helped examine four hypotheses by integrating the features of the Actor-Partner Interdependence Model. Variables included QOL and depression. Results: Depression in patients with cancer and their FCs exhibited significant actor effects on an individual’s QOL after controlling for the partner effects. Among the spousal pairs, depression in FCs exhibited a positive partner effect on the functional well-being of patients with cancer, indicating that depressive symptoms occurring in FCs may increase patients’ functional well-being. Implications for Nursing: This study suggests the importance of consistent assessment in emotional well-being for dyads with cancer because their concerns may be transmitted to each other.


2020 ◽  
Vol 24 (2) ◽  
pp. 134-140
Author(s):  
Rebecca Singer ◽  
Kathryn Kruse ◽  
Susan Swart

Nurses' exposure to suffering reduces professional quality of life, negatively impacting patient outcomes, decreasing retention, and weakening the workforce. Tell Well is a creative writing workshop designed to address Professional Quality of Life. Through improvisation, text analysis, writing, and peer-critique, nine registered nurses built a writing practice that can be a self-care tool. A survey measured the extent to which participants integrated writing into their life and their perception of how their relationship with work changed. Tell Well honored nurses' experiences, provided a forum for them to express themselves and their experiences, and encouraged nurses to engage in self-care and discovery.


2021 ◽  
Vol 28 (1) ◽  
pp. 43-55
Author(s):  
Young Ran Yeom ◽  
Aekyung Kim

Purpose: The purpose of this study was to investigate factors affecting the quality of life of middle-aged women with urinary incontinence by using Wilson and Cleary (1995)'s health-related quality of life model and previous studies. This article was done to construct a model for the collection of data on women with urinary incontinence and verifying the suitability of the model and the hypotheses presented in the model.Methods: A total of 209 valid questionnaires which met the criteria of middle-aged women who experienced urinary incontinence was used for final analysis. The exogenous and endogenous variables of the hypothesis model consisted of age, number of delivery, menstrual status, self-esteem, social support, physical symptoms, depression, anxiety, self-care agency and quality of life. The data were analyzed using IBM SPSS/WINdow 25.0 and AMOS 18.0 program.Results: The fitness of the modified model, x<sup>2</sup>/df=1.675, RMR=0.047, RMAEA=0.057, GFI=0.900, AGFI=0.855, NFI=0.923, TLI=0.957, CFI=0.9674. In the modified model, self-esteem showed the strongest total impact including the direct and indirect impacts on the quality of life of women with incontinence. In the result of verification of the modified model, quality of life explained by 58.8% through self-esteem, social support, self-care agency.Conclusion: Efforts are needed to improve self-esteem for middle-aged women with urinary incontinence, alleviate psychological symptoms, and develop self-care agency that they can manage themselves. Various aspects of physical, mental and psychological aspects can be comprehensively assessed and utilized to develop an interactive strategy system through individual programs and social support.


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