A problem solving intervention for caregivers of cancer patients

Wyatt

et al. 2004

Oncology Nursing Forum

403

373

Purpose/Objectives-The purpose of the study was to examine the patient and family caregiver variables that predicted caregiver burden and depression for family caregivers of patients with cancer at the end-of-life.Design-A prospective, longitudinal study was implemented with an inception cohort of patients and their family caregivers who were followed after the diagnosis and treatment of cancer. Data were analyzed using quantitative methods to determine the effect of caregiver age, sex, education, relationship to the patient, employment status, reports of patients' symptoms, patient cancer type, stage of cancer, and time from the patient's diagnosis to death on caregiver burden and depression at the patient's end-of-life. This report examines the experiences of family caregivers whose patients died during the study. Setting-Patients and caregivers were accrued from community oncology sites in the Midwestern United States.Sample-152 family caregivers of patients with cancer who died during the course of the study.Methods-Telephone interviews with patients were conducted at 6-8 weeks, 12-16 weeks, 24-30 weeks, and 52 weeks following patients' diagnoses. In addition, patient medical records and state death certificates were reviewed.Findings-Caregivers aged 45-54 reported the highest levels of depressive symptoms; caregivers aged 35-44 reported the strongest sense of abandonment. Caregivers who were the adult children of patients with cancer and who were employed reported high levels of depressive symptoms. Feeling abandoned (a portion of caregiver burden) was more prevalent in female, non-spouse, and adult

Section: Caregiver Distressmentioning

confidence: 99%

Section: Correlates Of Caregiver Distressmentioning

confidence: 99%

Burden and Depression Among Caregivers of Patients With Cancer at the End of Life

Wyatt

et al. 2004

Oncology Nursing Forum

403

373

“…14 Few family-based intervention studies have been demonstrated as effective in improving QOL of subgroups of caregivers in this phase. A problem-solving skills intervention benefited more distressed spousal caregivers, 70 and a home-care intervention benefited elderly caregivers with physical problems by improving psychosocial functioning 6 months after the intervention. In addition, the home-care intervention benefited the elderly caregivers of patients with advanced-stage cancer, as demonstrated by longer survival compared with a control group.…”

Section: Middle-to Long-term Survivorship Phase With Remissionmentioning

confidence: 99%

“…For example, interventions designed to educate caregivers about how to seek out medical information, 63 identify psychosocial resources, [64][65][66] or manage symptoms 46,67,68 have helped improve caregivers' knowledge, confidence, and mood. Similarly, interventions designed to help caregivers develop problem-solving skills (eg, Coping with Cancer 69,70 or COPE 71,72 ) have demonstrated effectiveness in increasing self-efficacy in managing caregiving stress and in reducing psychological distress.…”

Section: Family Caregivers' Qol At the Acute Survivorship Phasementioning

confidence: 99%

Quality of life of family caregivers of cancer survivors

Kim

2008

Cancer

407

342

Objective: The aim of this pilot study was to determine whether early atorvastatin treatment will reduce left ventricle (LV) remodeling, infarct size, and improve microvascular perfusion. Background: In animal studies, early statin therapy reduces reperfusion injury after a percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI). Methods: Forty‐two consecutive patients (82% male, mean age 61.2 ± 9.8) who underwent a primary PCI for a first ST‐elevated AMI were randomized for pretreatment with atorvastatin 80 mg (n = 20) or placebo (n = 22) and continued with the same dosage daily for 1 week. All patients received atorvastatin 80 mg once daily 7 days after primary PCI. The LV function and infarct size were measured by magnetic resonance imaging within 1 day, at 1 week, and 3 months follow up. The primary endpoint was the end‐systolic volume index (ESVI) at 3 months. Secondary endpoints were global LV function measurements, myocardial infarct size, biochemical cardiac markers, TIMI flow, and ST‐T elevation resolution. Results: ESVI 3 months after AMI was 25.1 mL/m2 in the atorvastatin arm and 25.0 mL/m2 in the placebo arm (P = 0.74). The differences in change from baseline to 3 months follow up in global LV function and myocardial infarct size did not differ between both treatment arms. Furthermore, biochemical markers, TIMI flow, and ST‐T elevation resolution did not differ between atorvastatin and placebo arm. Conclusions: In this pilot study, pretreatment with atorvastatin in an acute myocardial infarction does not result in an improved cardiac function, microvascular perfusion, or decreased myocardial infarct size. © 2012 Wiley Periodicals Inc.

“…Those tasks are often complex and highly burdensome and can result in heightened distress levels among relatives. Research results indeed suggest that family members of cancer patients show signs of depression and anxiety, restrict roles and activities, experience strain in marital relationships and show diminished physical health [23]. Between 10 and 30% of relatives are probable cases of psychiatric morbidity-a level that is likely to increase as the illness advances and the treatment becomes palliative [22].…”

Section: Introductionmentioning

confidence: 98%

Does psychological characteristic influence physicians’ communication styles? Impact of physicians’ locus of control on interviews with a cancer patient and a relative

Libert

Merckaert

Reynaert

et al. 2005

Support Care Cancer

Context: Physicians' psychological characteristics may influence their communication styles and may thus interfere with patientcentred communication. Objective: Our aim was to test the hypothesis that, in interviews with a cancer patient and a relative, physicians with an "external" locus of control (LOC; who believe that life outcomes are controlled by external forces such as luck, fate or others) have a communication style different from that of physicians with an "internal" LOC (who believe that life outcomes are controlled by their own characteristics or actions). Design, setting, participants and intervention: Eighty-one voluntary physicians practising in the field of oncology were recorded while performing an actual and a simulated interview with a cancer patient and a relative. Main outcome measures: Physicians' communication skills were assessed using the Cancer Research Campaign Workshop Evaluation Manual. Physicians' LOC was assessed using the Rotter I-E scale. The communication skills of the upper and lower quartiles of physicians in respect of their scores on this scale were compared using Student's t test. Results: In actual interviews, physicians with an "external" LOC talked more to the relative (P=0.017) and used more utterances with an assessment function (P=0.010) than physicians with an "internal" LOC. In simulated interviews, physicians with an "external" LOC used less utterances that give premature information (P=0.031) and used more utterances with a supportive function, such as empathy and reassurance (P=0.029), than physicians with an "internal" LOC. Conclusion: These results provide evidence that physicians' LOC can influence their communication styles. Physicians' awareness of this influence constitutes a step towards a tailoring of their communication skills to every patient's and relative's concerns and needs and thus towards a patient-centred communication.