Correlates of and interrelationships among social stressors, relationship quality, and family functioning among informal cancer caregivers.

230 Background: Informal/family caregivers play a critical role in supporting cancer patients and are often an important part of the palliative care team. To better understand how informal caregivers are influenced by their role and inform future interventions, this study sought to evaluate the distribution and correlates of social and family factors among caregivers of cancer patients. Methods: This cross-sectional study used data from the Cancer Care Outcomes Research & Surveillance Consortium (CanCORS). Lung and colorectal cancer patients nominated an informal caregiver to participate in a caregiving survey. Caregivers reported their sociodemographic and caregiving characteristics, social stress, relationship quality with the patient, and family functioning. Descriptive statistics were used to assess the distribution of caregivers’ social factors. Multivariable linear regressions were used to examine the independent correlates of each social factor. Results: Most caregivers reported low-to-moderate levels of social stress and good relationship quality and family functioning. In multivariable analyses older age was associated with lower social stress and better family functioning, but worse relationship quality, with effect sizes (Cohen’s D) up to 0.40 (p < 0.05). Caring for a female patient was associated with lower social stress and better relationship quality, but worse family functioning (effect sizes up to 0.16, p < 0.05). Few caregiving characteristics were associated with social stress, while several were significant independent correlates of relationship quality. Finally, social factors were important independent correlates of one another. Conclusions: The results highlight the importance of personal and caregiving-related characteristics and the broader family context to social factors. As social factors may play an important role in the health, quality of life, and caregiving efficacy of informal caregivers, future work is needed to better understand these pathways and assess whether interventions targeting social factors can improve caregiver well-being, thereby potentially improving patient-centered palliative care.

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Acculturation, Communication Competence, and Family Functioning in Mexican–American Mother–Daughter Dyads

Journal of Immigrant and Minority Health ◽

10.1007/s10903-021-01256-x ◽

2021 ◽

Author(s):

Becky Marquez ◽

Tanya Benitez ◽

Zephon Lister

Keyword(s):

Family Functioning ◽

Relationship Quality ◽

Communication Skills ◽

Adult Children ◽

Indirect Effect ◽

Mediation Analysis ◽

Mexican American ◽

Communication Competence ◽

Well Being ◽

Actor Partner Interdependence Model

AbstractLittle is known of how intergenerational acculturation discrepancy relates to communication skills differences that may influence relationship quality among parents and adult children. Mexican–American mother–daughter dyads (n = 59) were studied using the Actor Partner Interdependence Model to examine dyadic associations of acculturation and communication competence with family functioning and mediation analysis to determine the indirect effect of acculturation discrepancy on family functioning through communication competence differences. Communication competence of mothers exerted significant actor and partner effects on daughter-perceived cohesion and closeness. Higher acculturation discrepancy predicted greater communication competence difference which in turn was associated with lower cohesion and closeness. There was a significant indirect effect of acculturation discrepancy on daughter-perceived cohesion through communication competence difference. Communication competence of mothers impacts their own as well as their daughters’ perceptions of dyad cohesion and closeness. Intergenerational discrepant acculturation contributes to discordant communication skills that impair family functioning, which has implications for psychological well-being.

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Validation of the Holistic Comfort Questionnaire- caregiver in Portuguese-Brazil in a cohort of informal caregivers of palliative care cancer patients

Supportive Care in Cancer ◽

10.1007/s00520-014-2370-5 ◽

2014 ◽

Vol 23 (2) ◽

pp. 343-351 ◽

Cited By ~ 7

Author(s):

Bianca Sakamoto Ribeiro Paiva ◽

André Lopes de Carvalho ◽

Katharine Kolcaba ◽

Carlos Eduardo Paiva

Keyword(s):

Palliative Care ◽

Cancer Patients ◽

Informal Caregivers

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Verbalized desire for death or euthanasia in advanced cancer patients receiving palliative care

Palliative & Supportive Care ◽

10.1017/s1478951514000121 ◽

2014 ◽

Vol 13 (2) ◽

pp. 295-303 ◽

Cited By ~ 7

Author(s):

Ernest Güell ◽

Adelaida Ramos ◽

Tania Zertuche ◽

Antonio Pascual

Keyword(s):

Palliative Care ◽

Cancer Patients ◽

Terminally Ill ◽

Well Being ◽

Semistructured Interview ◽

Advanced Cancer Patients ◽

Terminally Ill Cancer Patients ◽

Symptom Intensity ◽

Edmonton Symptom Assessment Scale ◽

Desire To Die

AbstractObjective:We aimed to address the prevalence of desire-to-die statements (DDSs) among terminally ill cancer patients in an acute palliative care unit. We also intended to compare the underlying differences between those patients who make desire-to-die comments (DDCs) and those who make desire-for-euthanasia comments (EUCs).Method:We conducted a one-year cross-sectional prospective study in all patients receiving palliative care who had made a DDC or EUC. At inclusion, we evaluated symptom intensity, anxiety and depression, and conducted a semistructured interview regarding the reasons for these comments.Results:Of the 701 patients attended to during the study period, 69 (9.8%; IC95% 7.7–12.3) made a DDS: 51 (7.3%) a DDC, and 18 (2.5%) an EUC. Using Edmonton Symptom Assessment Scale (ESAS) DDC group showed higher percentage of moderate-severe symptoms (ESAS > 4) for well-being (91 vs. 25%; p = 0.001), depression (67 vs. 25%; p = 0.055), and anxiety (52 vs. 13%; p = 0.060) than EUC group. EUC patients also considered themselves less spiritual (44 vs. 84%; p = 0.034). The single most common reason for a DDS was pain or physical suffering, though most of the reasons given were nonphysical.Significance of results:Almost 10% of the population receiving specific oncological palliative care made a DDC (7.3%) or EUC (2.5%). The worst well-being score was lower in the EUC group. The reasons for both a DDC and EUC were mainly nonphysical. We find that emotional and spiritual issues should be identified and effectively addressed when responding to a DDS in terminally ill cancer patients.

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Assessing hope at the end of life: Validation of an experience of hope scale in advanced cancer patients

Palliative & Supportive Care ◽

10.1017/s1478951504040337 ◽

2004 ◽

Vol 2 (3) ◽

pp. 243-253 ◽

Cited By ~ 26

Author(s):

CHERYL L. NEKOLAICHUK ◽

EDUARDO BRUERA

Keyword(s):

Palliative Care ◽

Cancer Patients ◽

Advanced Cancer ◽

Symptom Assessment ◽

Well Being ◽

Assessment System ◽

Validity Evidence ◽

Advanced Cancer Patients ◽

Factor I ◽

Factor Ii

Objective:The purpose of this study was to gather validity evidence for an innovative experience of hope scale, theHope Differential-Short (HDS), and evaluate its clinical utility for assessing hope in advanced cancer patients.Methods:A consecutive sampling approach was used to recruit 96 patients from an inpatient tertiary palliative care unit and three hospice settings. Each participant completed an in-person survey interview, consisting of the following measures: HDS (nine items), Herth Hope Index (HHI), hope visual analog scale (Hope-VAS) and Edmonton Symptom Assessment System (ESAS).Results:Using factor analytic procedures, a two-factor structure for the HDS was identified, consisting ofauthentic spirit(Factor I) andcomfort(Factor II). The HDS factors had good overall internal consistency (α = 0.83), with Factor I (α = 0.83) being higher than Factor II (α = 0.69). The two factors positively correlated with the HHI, Hope-VAS, and one of the ESAS visual analog scales, well-being (range: 0.38 to 0.64) and negatively correlated with depression and anxiety, as measured by the ESAS (range: −0.25 to −0.42).Significance of results:This is the first validation study of the HDS in advanced cancer patients. Its promising psychometric properties and brief patient-oriented nature provide a solid initial foundation for its future use as a clinical assessment measure in oncology and palliative care. Additional studies are warranted to gather further validity evidence for the HDS before its routine use in clinical practice.

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The PROVIEW+ tool: Developing and validating a tool to predict risk of poor performance status and severe symptoms in cancer patients over time.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.12095 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. 12095-12095

Author(s):

Hsien Seow ◽

Rinku Sutradhar ◽

Lisa Catherine Barbera ◽

Peter Tanuseputro ◽

Dawn Guthrie ◽

...

Keyword(s):

Decision Making ◽

Palliative Care ◽

Cancer Patients ◽

Severe Pain ◽

Performance Status ◽

Well Being ◽

Assessment System ◽

Low Performance ◽

Performance Scale ◽

Over Time

12095 Background: There are numerous predictive cancer tools that focus on survival. However, no tools predict risk of low performance status or severe symptoms, which are important for patient decision-making and early integration of palliative care. The aim of this study was to develop and validate a model for all cancer types that predicts the risk for having low performance status and severe symptoms. Methods: A retrospective, population-based, predictive study using linked administrative data from cancer patients from 2008-2015 in Ontario, Canada. Patients were randomly selected for model derivation (60%) and validation (40%). The derivation cohort was used to develop a multivariable logistic regression model to predict the risk of having the reported outcomes in the subsequent 6 months. Model performance was assessed using discrimination and calibration plots. The main outcome was low performance status using the Palliative Performance Scale. Secondary outcomes included severe pain, dyspnea, well-being, and depression using the Edmonton Symptom Assessment System. Outcomes were recalculated after each of 4 annual survivor marks. Results: We identified 255,494 cancer patients (57% female; median age of 64; common cancers were breast (24%) and lung (13%)). At diagnosis, the risk of having low performance status, severe pain, well-being, dyspnea, and depression in 6-months is 1%, 3%, 6%, 13% and 4%, respectively for the reference case (i.e. male, lung cancer, stage I, no symptoms). Generally these covariates increased the outcome risk by > 10% across all models: obstructive lung disease, dementia, diabetes; radiation treatment; hospital admission; high pain; depression; Palliative Performance Scale score of 60-10; issues with appetite; or homecare. Model discrimination was high across all models. Conclusions: The model accurately predicted changing cancer risk for low performance status and severe symptoms over time. Providing accurate predictions of future performance status and symptom severity can support decision-making and earlier initiation of palliative care, even alongside disease modifying therapies.

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Solution-focused brief therapy to improve child well-being and family functioning outcomes with substance using parents in the child welfare system

Developmental Child Welfare ◽

10.1177/2516103219829479 ◽

2019 ◽

Vol 1 (2) ◽

pp. 124-142 ◽

Cited By ~ 1

Author(s):

Johnny S. Kim ◽

Becci A. Akin ◽

Jody Brook

Keyword(s):

Child Welfare ◽

Family Functioning ◽

Child Behavior Checklist ◽

Brief Therapy ◽

Short Form ◽

Well Being ◽

Effect Sizes ◽

Control Group ◽

Solution Focused Brief Therapy ◽

Solution Focused

This study examined the effectiveness of solution-focused brief therapy (SFBT) on child well-being and family functioning outcomes for child welfare involved parents. A randomized controlled trial design was used to evaluate the effectiveness of SFBT as compared to treatment-as-usual in an outpatient substance abuse treatment center. Mixed linear models tested within and between-group changes using intent-to-treat analysis ( N = 180). Hedges’s g effect sizes examined the magnitude of treatment effects. Both conditions reported improvements on the child well-being measures (Behavior Rating Inventory of Executive Function [BRIEF]-Parent Report and Child Behavior Checklist-School Age Form [CBCL-SA]) and family functioning measures (Adult-Adolescent Parenting Inventory [AAPI-2] and Center for Epidemiologic Studies-Depression [CES-D] Short Form) at posttest. While none of the between group analyses were statistically significant on either outcome domains, effect sizes did show improvements in the small to medium range for both groups. SFBT effect sizes for BRIEF subscales ranged from .024 to .267 and for control group ranged from .136 to .363. SFBT effect sizes on CBCL-SA subscales ranged from .059 to .321 and for control group ranged from .101 to .313. SFBT effect sizes on AAPI-2 subscales ranged from .006 to .620 and control group ranged from .023 to .624. SFBT effect sizes on CES-D measure were .428 and for control group were .317. Results show SFBT to be an effective intervention for helping parents around child well-being and family functioning outcomes similar to current empirically-supported therapies. SFBT provides a more strengths-based approach to help families improve family well-being and thus help improve their child’s well-being.

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The Impact of Social Factors on Job Crafting: A Meta-Analysis and Review

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17218016 ◽

2020 ◽

Vol 17 (21) ◽

pp. 8016

Author(s):

Huatian Wang ◽

Peikai Li ◽

Shi Chen

Keyword(s):

Social Factors ◽

Meta Analysis ◽

Empirical Studies ◽

Critical Role ◽

Well Being ◽

Job Crafting ◽

Work Outcomes ◽

Coworker Support ◽

Positive Leadership ◽

The Impact

Despite the considerable focus on job characteristics and individual differences in job crafting research, the influence of social factors on job crafting has not been well-acknowledged. Based on social interaction and job crafting literature, this meta-analysis estimates the associations between social factors (i.e., organizational insiders and outsiders) and job crafting, and how these social factors contribute to employee outcomes through their job crafting. Based on a sample of 51 empirical studies that included 54 independent samples (N = 17,863), we found that social factors of positive leadership styles (e.g., empowering and transformational) and coworker support were positively related to employee job crafting. Moreover, leadership showed a stronger correlation with employee job crafting than coworker support and Leader-Member-Exchange (LMX). Further, our study showed that employee job crafting positively mediates the relationships between social factors and work outcomes (e.g., job performance and well-being). Our study contributes to job crafting literature by integrating social factors into the job crafting model and demonstrating that the social context of work (in particular organizational insiders) plays a crucial role in shaping employees’ job crafting behavior. We also emphasize the critical role that job crafting plays in transmitting valuable social resources into improved work outcomes. Building on our results, we provide future direction for job crafting research and discuss how our results can imply practice in terms of job crafting training.

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Differences in performance status assessments between palliative care specialists, nurses, and oncologists.

Journal of Clinical Oncology ◽

10.1200/jco.2014.32.31_suppl.19 ◽

2014 ◽

Vol 32 (31_suppl) ◽

pp. 19-19

Author(s):

YuJung Kim ◽

Yi Zhang ◽

Ji Chan Park ◽

David Hui ◽

Gary B. Chisholm ◽

...

Keyword(s):

Palliative Care ◽

Cancer Patients ◽

Advanced Cancer ◽

Performance Status ◽

Well Being ◽

Assessment Tools ◽

Advanced Cancer Patients ◽

Care Clinic ◽

Edmonton Symptom Assessment Scale ◽

Ecog Ps

19 Background: The Eastern Cooperative Oncology Group (ECOG) performance status (PS) is one of the most commonly used assessment tools among oncologists and palliative care specialists caring advanced cancer patients. However, the inter-observer difference between the oncologist and palliative care specialist has never been reported. Methods: We retrospectively reviewed the medical records of all patients who were first referred to an outpatient palliative care clinic in 2013 and identified 278 eligible patients. The ECOG PS assessments by palliative care specialists, nurses, and oncologists, and the symptom burden measured by Edmonton Symptom Assessment Scale (ESAS) were analyzed. Results: According to the pairwise comparisons using Sign tests, palliative care specialists rated the ECOG PS grade significantly higher than oncologists (median 0.5 grade, P<0.0001) and nurses also rated significantly higher (median 1.0 grade, P<0.0001). The assessments of palliative care specialists and nurses were not significantly different (P=0.10). Weighted kappa values for inter-observer agreement were 0.26 between palliative care specialists and oncologists, and 0.61 between palliative care specialists and nurses. Palliative care specialists’ assessments showed a moderate correlation with fatigue, dyspnea, anorexia, feeling of well-being, and symptom distress score measured by ESAS. The ECOG PS assessments by all three groups were significantly associated with survival (P<0.001), but the assessments by oncologists could not distinguish survival of patients with PS 2 from 3. Independent predictors of discordance in PS assessments between palliative care specialists and oncologists were the presence of an effective treatment option (odds ratio [OR] 2.39, 95% confidence interval [CI] 1.09-5.23) and poor feeling of well-being (≥4) by ESAS (OR 2.38, 95% CI 1.34-4.21). Conclusions: ECOG PS assessments by the palliative care specialists and nurses were significantly different from the oncologists. Systematic efforts to increase regular interdisciplinary meetings and communications might be crucial to bridge the gap and establish a best care plan for each advanced cancer patients.

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