Communication of emotion in home hospice cancer care: Implications for spouse caregiver depression into bereavement

Abstract

Objective: Family caregivers of cancer hospice patients likely benefit from clinician provision of verbal support and from expression of positive emotions. Our aim was to identify the effects of hospice nurse supportive communication as well as caregiver-nurse exchange of positive emotions on family caregiver depression during bereavement. Methods: This prospective, observational longitudinal study included hospice nurses (N = 58) and family caregivers of cancer patients (N = 101) recruited from 10 hospice agencies in the United States. Digitally recorded nurse home visit conversations were coded using Roter interaction analysis system to capture emotion-focused caregiver-nurse communication and supportive nurse responses. Caregivers completed the Hospital Anxiety and Depression Scale Anxiety Subscale and Geriatric Depression Scale-Short Form at study enrollment and at 2, 6, and 12 months after patient death. Results: Caregivers had moderate levels of depression at study enrollment and throughout bereavement. Multilevel modeling revealed that caregiver positive emotion communication and nurse emotional response communication are associated with caregiver depression in bereavement. There was no significant association between caregiver distress communication and depression in bereavement.Conclusions: This is the first study to demonstrate that communication demonstrating emotional expression between cancer spouse caregivers and nurses during home hospice may have implications for caregiver depression up to a year after patient death. Our findings may help identify caregivers who may be coping well in the short term but may struggle more over time.

Long-Term Effect of Receiving a Family Strengths-Oriented Intervention on Family Cancer Caregiver Stress, Anxiety, and Depression Symptoms: A Longitudinal Quasi-Experimental Study

“…Thus, it might be important to offer the FAM-SOTC intervention over a longer post-loss period to benefit from this impact. This finding (Reblin et al, 2019) demonstrates the potential benefit of providing participation in a therapeutic conversation conducted by a nurse during bereavement for spouses of patients who have died because of cancer.…”

“…However, it may have been more beneficial for the caregivers to receive the intervention even earlier in the post-loss phase to eventually reduce these strong emotions experienced around the time of the patients’ death. Furthermore, findings from a recent longitudinal study suggest that supportive communications, between nurses and spouse caregivers who are caring at home for a family member with cancer, may have implications for caregiver depression (Reblin et al, 2019). Emotional communication between the caregiver and the nurse was associated with bereavement depression that could have an impact up to 12 months after the patients’ death.…”

Contents of Care and Perception of Home Hospice Nurses Who Work at Visiting Medical Treatment Hospitals

“…Since family caregivers worry about the physical and emotional symptoms at the very end of care, support for this point may be important. Reblin, et al [7] described that communication demonstrating emotional expression between cancer spouse caregivers and nurses during home hospice may have implications for caregiver depression up to a year after a patient's death. That is, expressing emotion promotes a caregiver's mental health.…”

“…Family caregivers at home hospice had moderate-tosevere anxiety or similar symptoms [5], and they experienced crisis, such as patient signs and symptoms, emotional distress, and burdens [6]. Also, Reblin, et al [7] showed that caregivers had moderate levels of depression. These researches suggest the need for support for a patient and a family caregiver in home hospice.…”

An analysis of observation length requirements for machine understanding of human behaviors from spoken language

“…Among these, the ability to reliably and accurately assess a person's behavior 1 by observing their verbal and non-verbal cues is a considerably complex and important one. Such a skill is especially important for both delivery and assessment in psychological research clinical practice as varied as Couples Therapy (Christensen et al, 2004), Addiction Counseling (Baer et al, 2009) and Cancer Care (Reblin et al, 2019). Analysis of the provider and client behaviors in these encounters, often through formal behavioral coding by human experts, is carried out during interactions in order to provide feedback and improve the clinical effectiveness of care.…”