Caregivers of Individuals with Cancer in the COVID-19 Pandemic: A Phenomenological Study

Caregivers of individuals with cancer in the COVID-19 pandemic are faced with the demands of cancer and the health needs produced by it, along with their own health and self-care needs, and the uncertainties of expectations and risks. A qualitative analytical phenomenological study with caregivers of individuals with cancer registered at the state referral hospital supplying medications, who answered the sociodemographic assessment questionnaires and semi-structured questions about their feelings and perceptions in the COVID-19 pandemic. Bardin’s content analysis was used, with methodological quality assessed using SRQR Standards for Reporting Qualitative Research and the MAXQDA software. Most of the caregivers are women, married, Catholic, of low income and education, aged between 30 and 60 years, optimistic, comply with health guidelines regarding social distancing, use of masks, and routine hand hygiene, do not practice regular physical activities, mention concern for their own physical and financial survival, and that of their family. The main need identified in the affective sphere was to reframe contact with family members, seeking to strengthen the bonds of affection. The feeling of emotional vulnerability shows the importance of building effective public policies for social support consistent with the improvement of health care for this population.

"I'm Ready for You. Why Won't You Come, Baby?" A Narrative Study of Induction of Labour for Prolonged Pregnancy

<p>The voice of women's experience of prolonged pregnancy and induction of labour is largely absent in the literature. This research relays and reflects upon the stories of four women who were induced because their pregnancies were overdue. The date a woman's baby is due has assumed huge significance. However our methods for dating a pregnancy remain imprecise. Despite this, a very precise timing is recommended by some practitioners as to when to induce, since increasing length of pregnancy increases level of risk of morbidity or mortality to some babies. For the women awaiting the onset of labour and their families, the undercurrents, which affect the milieu as the days pass, include powerful dichotomies. For example the best available research makes a clear recommendation to intervene but reinforces the woman's choice of management, suggesting that it is acceptable to choose to wait. Women experience emotional vulnerability due to apprehension both about continuing to wait, and about having the increasing likelihood of an induced labour. This is a decision that comes closer and closer, yet may not be necessary - a tense 'race' of sorts is in progress. Women experience mounting physical and social pressures, and a generalised, escalating frustration. Some of the common assumptions made about what it is like for women are that it is a struggle to accept the concept of the unreliability of the due date, to parry well meaning but unhelpful comments and the associated pressure, and to remain confident and phlegmatic when there is an alternative to waiting. An increasing number of women go on to be induced. The primary indication cited is 'prolonged pregnancy'. I have employed a narrative approach, using a feminist process and story telling, to convey the experience of being overdue and being induced, together with commentary informed by the literature and reflection on practice. Here women are speaking to women. The vivid detail and openness of the stories engrave messages to caregivers regarding women's needs for support while waiting, and for more information. The stories repeat messages documented in research carried out 25 years ago. Women require best available information, wish to be included in decision making, and should be encouraged to question their midwives and other caregivers on all aspects of pregnancy and proffered interventions.</p>

"I'm Ready for You. Why Won't You Come, Baby?" A Narrative Study of Induction of Labour for Prolonged Pregnancy

<p>The voice of women's experience of prolonged pregnancy and induction of labour is largely absent in the literature. This research relays and reflects upon the stories of four women who were induced because their pregnancies were overdue. The date a woman's baby is due has assumed huge significance. However our methods for dating a pregnancy remain imprecise. Despite this, a very precise timing is recommended by some practitioners as to when to induce, since increasing length of pregnancy increases level of risk of morbidity or mortality to some babies. For the women awaiting the onset of labour and their families, the undercurrents, which affect the milieu as the days pass, include powerful dichotomies. For example the best available research makes a clear recommendation to intervene but reinforces the woman's choice of management, suggesting that it is acceptable to choose to wait. Women experience emotional vulnerability due to apprehension both about continuing to wait, and about having the increasing likelihood of an induced labour. This is a decision that comes closer and closer, yet may not be necessary - a tense 'race' of sorts is in progress. Women experience mounting physical and social pressures, and a generalised, escalating frustration. Some of the common assumptions made about what it is like for women are that it is a struggle to accept the concept of the unreliability of the due date, to parry well meaning but unhelpful comments and the associated pressure, and to remain confident and phlegmatic when there is an alternative to waiting. An increasing number of women go on to be induced. The primary indication cited is 'prolonged pregnancy'. I have employed a narrative approach, using a feminist process and story telling, to convey the experience of being overdue and being induced, together with commentary informed by the literature and reflection on practice. Here women are speaking to women. The vivid detail and openness of the stories engrave messages to caregivers regarding women's needs for support while waiting, and for more information. The stories repeat messages documented in research carried out 25 years ago. Women require best available information, wish to be included in decision making, and should be encouraged to question their midwives and other caregivers on all aspects of pregnancy and proffered interventions.</p>

Vulnerability and informal caregiver: a scoping review

ObjectiveThis review paper examines the concept of vulnerability in the overall literature and its relation to informal caregivers.Vulnerability is frequently associated with the sense of being at risk of harm instead of being acknowledged as a human trait to embrace.Taking a cue from two well-known videos of Brené Brown on how to enact “vulnerability,” we aimed to see if emotional vulnerability - posed/explored as strength or weakness - exists in the informal care context, potentially acting as a powerful resource that teaches individuals to look inward and inspires them to work on themselves.DesignScoping reviewData sourcesFollowing PRISMA-ScR checklist for scoping review, the literature was searched in various databases, including PubMed, Scopus and ScienceDirect.Study selection and data extractionWe systematically searched for: 1) observational studies, experimental studies, and systematic reviews 2) that examined the topic of emotional vulnerability in a caregiving context 3) that were relevant to informal caregivers of older adults 4) that were published from 1976 to 2021 5) in English 6) that included populations ≥18 years old 7) and excluded conceptualization of vulnerability outside of the emotional perspective (i.e., environmental, financial, social, biological, genetic, medical). Two reviewers independently reviewed titles and abstracts, reviewed the full text of relevant articles, and extracted the dataResultsFrom 2502 articles, 21 were determined as eligible.ConclusionThe reviewed articles showed the complexity of the vulnerability construct and several different approaches taken to explore this topic. This research concludes the value of vulnerability for human beings. The paucity of literature on the concept of vulnerability for informal caregivers offers a promising avenue for future research in this field.Article summary: Strengths and limitations of this studyThis study reviews the conceptualization of vulnerability across literature from 1976 to date, which was never done beforeThis study draws a unique parallel between vulnerability in formal care settings and informal careThis study re-defines the concept of emotional vulnerability in informal careThe study lacks more concrete first-person perspectives on vulnerability shared by informal caregivers, hence more concrete involvement of informal caregivers would be desirable for representative understanding of the concept of emotional vulnerability in informal care.

‘What is immediate and obvious feels real’: National identity and emotional vulnerabilities in the field

This article provides a critical reflection on methodological issues at the interface of researcher national identity and emotional vulnerability. This aspect of social research is often neglected in discussions of positionality, primarily in relation to emotional risk in the field, and here we address this gap in the literature. Rather than reflecting on access and rapport, or issues related to the complexities of insider or outsider research, the national identity of the researcher is considered alongside emotional entanglements experienced in the field. The emotion work that is performed, and the emotional risks that are experienced by the researcher as a consequence of nationality reveal much about the complexities of identity and power relations in the field. The fieldwork informing this article was undertaken as part of an Economic and Social Research Council (ESRC)-funded study (ES/N019423/1) that examined how seafarers from different ethnic and faith backgrounds interact with each other on board and how their religious/spiritual and welfare needs are addressed ashore.

The Impact of COVID-19 Outbreak on Emotional and Cognitive Vulnerability in Iranian Women With Breast Cancer

The psychological cost on emotional well-being due to the collateral damage brought about by COVID-19 in accessing oncological services for breast cancer diagnosis and treatment has been documented by recent studies in the United Kingdom. The current study set out to examine the effect of delays to scheduled oncology services on emotional and cognitive vulnerability in women with a breast cancer diagnosis in Iran, one of the very first countries to be heavily impacted by COVID-19. One hundred thirty-nine women with a diagnosis of primary breast cancer answered a series of online questionnaires to assess the current state of rumination, worry, and cognitive vulnerability as well as the emotional impact of COVID-19 on their mental health. Results indicated that delays in accessing oncology services significantly increased COVID related emotional vulnerability. Regression analyses revealed that after controlling for the effects of sociodemographic and clinical variables, women’s COVID related emotional vulnerability explained higher levels of ruminative response and chronic worry as well as poorer cognitive function. This study is the first in Iran to demonstrate that the effects of COVID-19 on emotional health amongst women affected by breast cancer can exaggerate anxiety and depressive related symptoms increasing risks for clinical levels of these disorders. Our findings call for an urgent need to address these risks using targeted interventions exercising resilience.