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Introduction OF Caring Process For Adult Cancer Patients And Improving Wellbeing Of Caregivers
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Caregiver Support Making A Difference In The Caring Process For Adult Cancer Patients And Improving Wellbeing Of Caregivers
Caregiving for cancer patients is associated with day-to-day activities, including managing doctor visits and maintaining medicine while helping with physical therapy and other clinical tasks. It also includes coordinating care and services from a distance while providing emotional and spiritual support for cancer patients (Cancer.gov, 2023). assignment help Uk Caregiving support also requires specific training regarding physical care for the patient to maintain drain care, lifting and management of pain, medication, symptoms of side effects and the identification of infections for patients. This is followed by maintaining help, including nutrition, physical activities, managing stress, dealing with fear of recurrence and coping strategies while supporting cancer patients (Cancer.org, 2023). It also includes advocacy for effective communication with the patient and the clinical care team.
Figure 1: Role of caregivers to support cancer patients
The role of caregiver support in case of cancer patients requires the investment of time and effort while providing physical, psychological and information and social support (Ncbi.nlm.nih.gov, 2023a). In addition, approximately 1.1 million people aged 15 and over are considered carers and considerably looking after friends or family members who are suffering from cancer in the UK (Macmillan.org.uk, 2023). This is followed by supporting carer requirements for the patients to help with emotional, practical and financial requirements. This also includes providing support to cancer patients by the UK carers in 14 forms and the most common type of support refers to emotional well-being of the patient (Macmillan.org.uk, 2023). This is followed by travelling and transportation and communication, household chores, personal healthcare and economic support. The following context is intended to address whether support from carers towards the cancer patient has an impact on the overall care outcome and identifying suitable methods to identify the requirement of informal carer for cancer patients.
Aims
The following context has the aim of evaluating caregiver support in case of adult cancer patients. This is followed by identifying the issue of diversity in the case of understanding the quality of life and willingness of a career alongside the supporting factors that are given to the careers in order to provide service to the cancer patients. It also includes emotional wellbeing mental health issues among careers alongside the clinic social life working life physical health income relationship status and other areas of life in case of providing support to the patient (Macmillan.org.uk, 2023).
Figure 2: Impact on caregivers while providing support cancer patients
Methodology
While maintaining systematic review process for the following research context with can be stated that the methodological part is contemplated to address the enhanced design regarding database descriptions for collecting information while explaining PICO framework inclusion exclusion criteria, Boolean table for keywords and literature review matrix alongside discussing the impact of supporting cancer patients on caregiver, their needs, supportive approach, drawback of the study and potential recommendations.
Database descriptions
The descriptions of existing databases for the following systematic review process is associated with understanding existing information on research subjects which are significant to access effective context for the completion of the research process (König et al. 2022). The identified databases that are used in the given context refers to PubMed, EBSCO, CINAHL, ProQuest, Cochrane library and Google Scholar which are discussed below.
Databases name
|
Illustration
|
Reasons for using this
|
Scientific databases that are used for following systematic review process
|
PubMed
|
This website is considered useful to access information regarding research topic on biomedical sciences
|
It helps in accessing authentic reference, proper citation
|
Cochrane library
|
This website is known for providing information on high-quality, independent evidence regarding healthcare, decision-making and reviewing process and analysis (Cochranelibrar, 2023).
|
This website is useful for the following context as it provides collection of review papers, databases for systematic review and meta-analysis while summarising and interpreting results of medical research
|
CINAHL
|
This website is under the EBSCO search engine database which has full text PDFs, journals, peer reviewed journals, open access on information regarding the medical field including nursing, evidence-based care sheet and quick lesson (Ebsco, 2023b).
|
This is used here to access information on allied health subject, biomedicine and healthcare sector while reviewing through available study materials
|
Alternative search engines for accessing information
|
EBSCO
|
This website is useful to access various research database, e-journals and magazine subscription, e-book for academic (Ebsco, 2023a)
|
It is important for academic purposes as it has open access to information on service of different fields and provide an intuitive online research platform
|
ProQuest
|
It consists of research information on academia, corporate, government, public and school libraries across the globe (Proquest, 2023)
|
This is used here to access statistics information present data on the medical field and government information
|
Google Scholar
|
It is useful in terms of providing a simple way to access scholarly literature and different sources in the form of articles, pdfs and journals while addressing publishing format and disciplines (Scholar.google, 2023).
|
This is used here to freely access full text information and metadata regarding articles journals and other available information
|
Table 1: Description of different databases
PICO framework
The PICO framework is considered the most commonly used model in order to structure clinical questions with the aim of capturing the fundamental element of the research while focusing on questions. As without the presence of a proper research question it is considered difficult and time consuming to identify proper resource and search context to maintain relevancy, using this specific evidence-based practice framework is considered significant in order to form questions and facilitate the overall literature search for accessing proper outcome (Ncbi.nlm.nih.gov, 2023b). The framework stands for patients or problems or population (P), alongside intervention or exposure (I) and comparison or control (C) and outcome (O).
Terms
|
Requirements
|
Determinants
|
P
|
Population
|
Caregivers of adult cancer patients with the age of 15 years and above in the UK
|
I
|
Intervention
|
Caregivers background and reasons behind supporting informal care process for the cancer patients
|
C
|
Control
|
Caregivers for formal care process to the adult cancer patients
|
O
|
Outcome
|
Using caregivers support towards adult cancer patients in palliative care and improving quality of care process
|
Inclusion and exclusion criteria
The establishment of Inclusion and exclusion criteria for systematic review is a significant step in terms of continuing the research process and identifying information on the basis of study context. This technique is implied in systematic review to write and collect information from suitable literature and inclining methodological aspects regarding existing articles to access information for the research subject (Mastan et al. 2022). While the criteria for inclusion refers to the identification of type of studies, it is important to select articles with appropriate study design while meeting the requirement for research questions. The exclusion criteria refer to the factors that are considered ineligible while including for the present study subject (Rico-González et al. 2022).
Factors
|
Inclusion
|
Exclusion
|
Language
|
English language-based literature is included
|
Non-English language articles are excluded from the list of information
|
PDF
|
Full text PDFs are included
|
Publications without the availability of full text PDFs are removed
|
Journals
|
Peer reviewed journals are prioritised in terms of collecting information for the review process
|
Random study materials are removed
|
Subject
|
Article focusing on the caregiver support for adult cancer patients and informal care process for the cancer patients are prioritised in order to collect information
|
Any other information-based articles and journals are excluded from the list
|
Focusing population
|
Articles are collected while focusing on the adult cancer patients
|
Old age and paediatrics cancer related information are tried to be excluded while collecting information
|
Research type
|
Systematic review-based articles are included in the list of information
|
Other than systematic review process, articles are removed from the list
|
Time frame
|
Last five years of articles, journals are included for collecting information
|
Older articles beyond the timelines of 5 years are excluded from the list of collecting information
|
Country
|
UK based research information are prioritised here
|
Other than UK based research information are excluded from the list
|
Boolean table
The use of Boolean tables refers to the identification of similar words which are considered effective for addressing the primary context of the research process. This table is included in the case of a systematic review process in terms of accessing an outcome which is more focused and productive alongside saving time and effort regarding the elimination of inappropriate keywords for the research context (Wang et al. 2022). For the following systematic review process, the suitable keywords are caregivers, supportive care, cancer patients, informal care and palliative care.
Caregiver
|
And
|
Supportive care
|
And
|
Cancer
|
And
|
Informal care process
|
And
|
Palliative care
|
Caretakers
or
Guardians
Or
Nanny
Or
Nurse
Or
Custodian
Or
Protector
|
Helpful
Or
Caring
Or
Encouraging
Or
Understanding
Or
Reassuring
Or
Sympathetic
|
Malignancy
Or
Carcinoma
Or
Canker
Or
Melanoma
Or
Polyp
Or
Lymphoma
|
Heedlessness
Or
Carefulness
Or
Meticulousness
Or
Watchfulness
Or
Inconspicuous
|
End of life care
Or
Hospice care
Or
Remedial
Or
Beneficial
Or
EoLC
Or
Comfort care
|
List of literatures
[Refers to appendix 1]
Literature review matrix
Authors
|
Year
|
Type of study
|
Sample size
|
Limitation
|
Key points to inform the topic
|
Ullgren et al.
|
2018
|
Qualitative
|
1270
|
Improper decision making by family members
|
Psychosocial support, motivating patients and maintaining social engagement
|
Marzorati et al.
|
2018
|
Qualitative
|
3301
|
Some patients were early-stage benign tumours
|
Caregivers wellbeing relied on psychosocial and behavioural contexts
|
Sedrak et al.
|
2021
|
Qualitative
|
4598
|
Low quality evidence and including older patients
|
Improved participation towards caregiver of cancer patients
|
Fereidouni et al.
|
2021
|
Qualitative
|
14,920
|
Time limitation
|
Preferring home setting for caregiving
|
Wang et al.
|
2018
|
Qualitative
|
6754
|
Emotional health of caregivers in case of palliative care
|
Cost effective and availability of health resources
|
Grosse et al.
|
2018
|
Qualitative
|
3456
|
post bereavement mental health
|
mental health of adult caregivers of cancer patients
|
McCauley et al.
|
2021
|
Qualitative
|
12376
|
Mutual support between family members and caregivers
|
Greater emotional engagement
|
Guan et al.
|
2021
|
Qualitative
|
14567
|
Caregiving via telephone
|
Emotional support and appraisal support
|
Hawken et al.
|
2018
|
Qualitative
|
1345
|
Physiological adjustment
|
Using emotion-focussed coping and cognitive strategies for caregiving
|
Gilbertson et al.
|
2019
|
Qualitative
|
5432
|
Heterogeneity in study design
|
Quality of life of caregivers
|
Green et al.
|
2018
|
Qualitative
|
2390
|
In experienced clinical responsibility of caregivers
|
Continuity of care and communication
|
Wang et al.
|
2021
|
Qualitative
|
1209
|
Long distance caregiving
|
Enhancing technological literacy
|
Table 5: Literature review matrix
Discussion
Impact of cancer on caregiver
As cancer progresses the caregiving tasks are generated which can be passed by the family member or recruited persons. While cancer is not considered as a patient diagnosis it also impacts family members and the experience of related individuals (Alzehr et al. 2022). The diagnosis and the subsequent face of treatment are capable of causing extreme anxiety operations and caregivers and those caregivers often face severe issues in order to cope with the anxiety from caregiving cancer patients. Caregiving process is capable of developing physical symptoms including tiredness and trouble sleeping among caregivers alongside psycho-social experience including high stress and issues of physical health (Ejoncologynursing, 2023). Besides careers, emotional welding and mental health are affected as well. In the UK approximately 45% of caregivers have reported to face experience of anxiety alongside experience of depression among 26% of the total carers while dealing with cancer patients (Cancer.gov, 2023). Women who are associated with caregiver jobs in the UK have experienced several emotional impacts including stress and anxiety. In comparison with the gender roles, approximately 56% of women have faced emotional stress in comparison with 40% of men alongside 50% of women experienced anxiety in comparison with 33% of men while caring for adult cancer patients (Macmillan.org.uk, 2023).
On the other hand, while addressing the time of support for caring cancer patients, the caregivers in the UK spent the average time of 17.5 hours per week (Macmillan.org.uk, 2023). As the UK Government has passed the recommendation for guide lining working hours the 48 hours schedule is fixed per week on average for the workers in order to balance their individual responsibilities and caregiving patients in the work life (Thomson et al. 2022). The experiences of caregivers who are living with cancer patients have both positive and negative impacts on their overall well-being. This factor includes a high level of satisfaction in terms of maintaining their responsibilities and providing support to the patients. In addition, while providing caregiving support towards adult cancer patients the stronger psychosocial support motivating patients and maintaining social engagement are for the patients wellbeing (Ullgren et al. 2018). This also includes preferring home sitting and cost-effective care setting by the family members in an informal way which provides a greater emotional engagement for the patient and the family members (McCauley et al. 2021). In contrast, the burden of physical and psychological well-being alongside financial situation, social and personal relationships are also affected by maintaining their professional work in the case of caring for adult cancer patients. This factor also includes physical stress in the form of fatigue, difficulties with work and school alongside high anxiety and depression symptoms while maintaining the care process (Bmcpalliatcare.biomedcentral, 2023).
Methods of assessing caregiver needs
While the giving process is relational, the importance of employing interconnectedness between the patient and caregiver in the case of cancer patients requires high awareness. The primary requirements that caregivers face during the supportive care of cancer patients refer to the psychological well-being while influencing the patient’s evaluation for the quality of care process (Sak?Dankosky et al. 2022). This includes emotional processing alongside managing the practical and psychological aspects to maintain patient care. However, it also includes emotional processing for the initial diagnosis and recurrence alongside facing an uncertain future and encountering symptom best suffering while caring for the patient (Karimollahi et al. 2022). While addressing the snapshot of informal caregiving process in case of adult cancer patients it can be stated that 39% were reported being involved in home care and 54% were asked for association at post discharge state (Cancer.gov, 202). While addressing the palliative care of cancer patients, caregivers are reported to face high financial strain (25%), emotional stress (50%), working average 35 hours per week (50%), requirements of needing emotional management and controlling physical stress (43%) and 33% were helping their friends and relatives at home (Cancer.gov, 2023). Therefore, it could be addressed that caregivers' job of cancer patients requires emotional and medical support while caring full-time for the patients in order to cope with the distress.
Supportive approaches
As per the NICE guideline regarding the improvement of quality of care and services of the cancer patient, the practical steps involve the maintenance of focus on the quality of care. This is followed by improving interest in practice and being aware of NHS guidelines, local authorities and social care providers and voluntary organisations (Nice.org.uk, 2023). This also includes inputting evidence-based practices for the patients to improve the overall care and services. In addition, the providence of a multitude of supportive functions for the adult cancer patients in terms of emotional information and functional support are effective for practical assistant and care activities (Ugalde et al. 2011). This helps the caregivers to support high quality cancer care for the patients and that improves the quality of life for the patients.
Figure 3: Practical steps from improving care quality
On the other hand, in terms of decision-making gathering information providing emotional support advocating oncology appointments impact the relationship between patient and the caregivers and skilling their cognitive capabilities (Ncbi.nlm.nih.gov, 2023c). In this case, keeping in touch with local nice implementation leads associates caregivers with proper support and resources to meet the job criteria. While working with cancer patients, supporting steps to reduce the psychological distress among caregivers refer to working with cancer networks alongside undergoing systematic psychological assessment and intervention which is suggested under the guidance of NICE 2004 (Nice.org.uk, 2023). This is effective for ensuring medical and nursing services for the patients and accessing specialist advice for caregivers to deal with the situation in the palliative care system (Ugalde et al. 2011). In this context, the use of the Gold Standard Framework is effective to provide proper training for the informal caregivers in order to manage the palliative care for the cancer patients (Nice.org.uk, 2023).
Conclusion and recommendation
While concluding the given context it can be stated that the primary aim of the following contains realisation on the evaluation of caregivers support in the case of caring adult cancer patients. While the diversity of the role of caregivers impacts on the outcome of care processes and improves the quality of life for the patient, it also sheds light on the positive and negative approach of care giving us life while dealing with the care process. As the positive factor of informal care in the form of family and friends towards cancer patients relies on the satisfaction of the care process and emotional bonding alongside social engagement, the negative approach highlights high emotional dishes in the form of depression and anxiety. The following context successfully discussed these and mythology in the form of describing used databases alongside the implementation of PICO framework, Inclusion and exclusion technique and Boolean table for gathering crucial information regarding the subject. It also discussed the impact of Cancer on caregivers and supportive approaches towards care given in order to deal with the situation.
While recommending it can be stated that the improvement of caregiving can be obtained by communicating and supporting the patients. This is followed by using a proactive approach for family caregivers while supporting their own right and protecting the overall well-being. It also includes accessing proper training and discussing with cancer support groups in terms of improving the quality of care and lowering emotional distress while taking care of cancer patients.
References
- Alzehr, A., Hulme, C., Spencer, A., & Morgan-Trimmer, S. (2022). The economic impact of cancer diagnosis to individuals and their families: a systematic review. Supportive Care in Cancer, 30(8), 6385-6404.https://link.springer.com/article/10.1007/s00520-022-06913-x
- Bmcpalliatcare.biomedcentral. (2023)., “Psychosocial distress and the quality of life of cancerpatients”https://bmcpalliatcare.biomedcentral.com/articles/10.1186/s12904-022-00981-w
- Cancer.gov. (2023)., “Support for Caregivers of Cancer Patients”https://www.cancer.gov/about-cancer/coping/caregiver-support
- Cancer.org. (2023)., “Caregivers and Family” https://www.cancer.org/treatment/caregivers.html
- Cochranelibrar. (2023)., “cochrane library” https://www.cochranelibrary.com/
- Ebsco. (2023a)., “EBSCO” https://www.ebsco.com/
- Ebsco. (2023b)., “CINAHL-COMPLETE” https://www.ebsco.com/products/research-databases/cinahl-complete
- Ejoncologynursing. (2023).,“European Journal of Oncology Nursing” https://www.ejoncologynursing.com/content/authorinfo
- Karimollahi, M., Abazari, M., Tazakori, Z., & Ramazanzadeh, N. (2022). Caregiving burden and social support in family caregivers of patients with cancer: A cross-sectional study.International Journal of Care Coordination,25(4), 115–123.https://doi.org/10.1177/20534345221121067
- König, L. M., Van Emmenis, M., Nurmi, J., Kassavou, A., & Sutton, S. (2022). Characteristics of smartphone-based dietary assessment tools: A systematic review. Health Psychology Review, 16(4), 526-550.https://www.tandfonline.com/doi/abs/10.1080/17437199.2021.2016066
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- Mastan, I. A., Sensuse, D. I., Suryono, R. R., & Kautsarina, K. (2022). Evaluation of distance learning system (e-learning): a systematic literature review. Jurnal Teknoinfo, 16(1), 132-137.https://ejurnal.teknokrat.ac.id/index.php/teknoinfo/article/view/1736
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- Nice.org.uk. (2023)., “Improving supportive and palliative care for adults with cancer” https://www.nice.org.uk/guidance/csg4
- Proquest. (2023)., “ProQuest” https://www.proquest.com/
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- Sak?Dankosky, N., Sherwood, P., Vehviläinen?Julkunen, K., & Kvist, T. (2022). Interventions improving the well?being of adult cancer patients’ caregivers: A systematic review.Journal of Advanced Nursing,78(9), 2747–2764.https://doi.org/10.1111/jan.15320
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Appendices
Appendix 1: List of articles for the following context
- Fereidouni, A., Rassouli, M., Salesi, M., Ashrafizadeh, H., Vahedian-Azimi, A., & Barasteh, S. (2021). Preferred place of death in adult cancer patients: a systematic review and meta-analysis. Frontiers in psychology, 12, 704590.https://www.frontiersin.org/articles/10.3389/fpsyg.2021.704590/full
- Gilbertson, E. L., Krishnasamy, R., Foote, C., Kennard, A. L., Jardine, M. J., & Gray, N. A. (2019). Burden of care and quality of life among caregivers for adults receiving maintenance dialysis: a systematic review. American Journal of Kidney Diseases, 73(3), 332-343.https://www.sciencedirect.com/science/article/pii/S0272638618310114
- Green, E., Knight, S., Gott, M., Barclay, S., & White, P. (2018). Patients’ and carers’ perspectives of palliative care in general practice: a systematic review with narrative synthesis. Palliative Medicine, 32(4), 838-850.https://journals.sagepub.com/doi/pdf/10.1177/0269216317748862
- Grosse, J., Treml, J., & Kersting, A. (2018). Impact of caregiver burden on mental health in bereaved caregivers of cancer patients: A systematic review. Psycho?Oncology, 27(3), 757-767.https://onlinelibrary.wiley.com/doi/abs/10.1002/pon.4529
- Guan, T., Qan’ir, Y., & Song, L. (2021). Systematic review of illness uncertainty management interventions for cancer patients and their family caregivers. Supportive Care in Cancer, 29, 4623-4640.https://link.springer.com/article/10.1007/s00520-020-05931-x
- Hawken, T., Turner-Cobb, J., & Barnett, J. (2018). Coping and adjustment in caregivers: A systematic review. Health psychology open, 5(2), 2055102918810659.https://journals.sagepub.com/doi/pdf/10.1177/2055102918810659
- Marzorati, C., Renzi, C., Russell-Edu, S. W., & Pravettoni, G. (2018). Telemedicine use among caregivers of cancer patients: systematic review. Journal of medical Internet research, 20(6), e223.https://www.jmir.org/2018/6/e223/
- McCauley, R., McQuillan, R., Ryan, K., & Foley, G. (2021). Mutual support between patients and family caregivers in palliative care: a systematic review and narrative synthesis. Palliative Medicine, 35(5), 875-885.https://journals.sagepub.com/doi/pdf/10.1177/0269216321999962
- Sedrak, M. S., Freedman, R. A., Cohen, H. J., Muss, H. B., Jatoi, A., Klepin, H. D., ... & Cancer and Aging Research Group (CARG). (2021). Older adult participation in cancer clinical trials: a systematic review of barriers and interventions. CA: a cancer journal for clinicians, 71(1), 78-92.https://acsjournals.onlinelibrary.wiley.com/doi/abs/10.3322/caac.21638
- Ullgren, H., Tsitsi, T., Papastavrou, E., & Charalambous, A. (2018). How family caregivers of cancer patients manage symptoms at home: A systematic review. International journal of nursing studies, 85, 68-79.https://www.sciencedirect.com/science/article/pii/S0020748918301160
- Wang, J., Fu, Y., Lou, V., Tan, S. Y., & Chui, E. (2021). A systematic review of factors influencing attitudes towards and intention to use the long-distance caregiving technologies for older adults. International journal of medical informatics, 153, 104536.https://www.sciencedirect.com/science/article/pii/S1386505621001623
- Wang, T., Molassiotis, A., Chung, B. P. M., & Tan, J. Y. (2018). Unmet care needs of advanced cancer patients and their informal caregivers: a systematic review. BMC palliative care, 17(1), 1-29.https://bmcpalliatcare.biomedcentral.com/articles/10.1186/s12904-018-0346-9