Alice Yuen Loke

Spouses' experience of caregiving for cancer patients: a literature review.

Background The spouse is generally the primary informal caregiver for cancer patients. Many studies have explored the experience of caregiving for cancer patients, but it is unclear whether there are gender differences in the spousal caring experience for cancer patients. Aim This review describes the recent published research on the stress process of spousal caregiving experience for cancer patients, and aims to identify any gender differences in the caregiving experience. Methods Electronic, manual and authors searches were conducted. Articles included were published in English and Chinese, from January 2000 to March 2012. Study population is couples coping with cancer. Focus is on caregiving experience for spouse with cancer, and findings include both male and female spousal caregivers in quantitative studies. The databases searched included MEDLINE, CINAHL, Science Citation Index Expanded, Scopus, PsycINFO and the China Academic Journal Full-text Database. The key search terms used were ‘cancer’ or ‘oncology’ or ‘carcinoma’ AND ‘caregiver’ or ‘caregiving’ or ‘carer’ AND ‘gender differences’ or ‘gender’ AND ‘spouse’ or ‘couple’ or ‘partner’. Spousal caregiving experiences of cancer patients were explored by adopting the ‘stress process’ of the Cancer Family Caregiving Experience Model from the gender perspective. Results Twenty-five articles were identified and included in this review. It was revealed that female spousal caregivers perceived higher level negative experience in caregiving, such as lower mental health, lower physical health, poorer health-related quality of life, lower life satisfaction and decreased marital satisfaction than male spousal caregivers. However, female spousal caregivers are more likely to experience personal growth than male spousal caregivers. Conclusion This review identified that female spousal caregivers for cancer patients had higher levels of negative experience in caregiving. A better understanding of the spousal caregiving experience will provide healthcare professionals with the information needed to develop interventions to support and prepare spousal caregivers to care for their loved ones with cancer.

Family Process and Peer Influences on Substance Use by Adolescents

This study explores the association of family process and peer influences with risk behaviors of adolescents. A total of 805 students were recruited from secondary schools. The results showed that adolescents who have parents who are “authoritarian” (OR = 1.856) were more likely to smoke. Adolescents who have conflicts with their parents (OR = 1.423) were more likely to drink. Those who have parents who are “permissive” were less likely to drink (OR = 0.885). Having friends who smoked (OR = 5.446) or drank (OR = 1.894), and friends’ invitation to smoke (OR = 10.455) or drink (OR = 11.825) were the dominant contributors to adolescent smoking and drinking. Interventions are needed that recognize the strength of the parent-child relationship, as well as strengthen family functioning through improved interpersonal, parenting, and monitoring skills.

The Experiences of Chinese Couples Living With Cancer: A Focus Group Study.

Background: With the research focus on family caregiving shifting from the individual to the dyadic level, there is a need to explore cancer dyads’ concerns and needs and to understand their experiences of coping together with cancer. Objective: To objectives of this study were to gain a better understanding of the experience of couples living with cancer and to explore cancer couples’ concerns and needs related to the caring role and experience of spousal caregivers. Methods: The focus group study design with a purposeful sampling strategy was adopted. We conducted 4 focus group interviews with 11 cancer patients and 17 spousal caregivers in a hospital. Results: Four themes and 15 subthemes emerged after a conventional content analysis. The 4 themes include communication dynamics, living with changes, negative and positive impacts, and network of support. Based on the findings, we drew a preliminary conceptualization of the couples’ experience of coping and living with cancer as a whole. Conclusions: This study provided insights to healthcare professionals regarding daily struggles of couples living with cancer and the development of intervention programs to support these couples. Implications for Practice: Healthcare professionals need to (1) be sensitive to the couples’ needs and concerns, (2) offer sufficient and useful information to couples who are coping with cancer, (3) encourage and help spousal caregivers to take care of themselves while coping with the changes in their spouses, and (4) instill realistic hopes in couples and help them to sustain a positive attitude with a focus on the future, not just on the present.

The Need for a Definition of Big Data for Nursing Science: A Case Study of Disaster Preparedness

The rapid development of technology has made enormous volumes of data available and achievable anytime and anywhere around the world. Data scientists call this change a data era and have introduced the term “Big Data”, which has drawn the attention of nursing scholars. Nevertheless, the concept of Big Data is quite fuzzy and there is no agreement on its definition among researchers of different disciplines. Without a clear consensus on this issue, nursing scholars who are relatively new to the concept may consider Big Data to be merely a dataset of a bigger size. Having a suitable definition for nurse researchers in their context of research and practice is essential for the advancement of nursing research. In view of the need for a better understanding on what Big Data is, the aim in this paper is to explore and discuss the concept. Furthermore, an example of a Big Data research study on disaster nursing preparedness involving six million patient records is used for discussion. The example demonstrates that a Big Data analysis can be conducted from many more perspectives than would be possible in traditional sampling, and is superior to traditional sampling. Experience gained from the process of using Big Data in this study will shed light on future opportunities for conducting evidence-based nursing research to achieve competence in disaster nursing.

The acceptance and commitment therapy for smoking cessation in the primary health care setting: a study protocol

BackgroundAccess to effective smoking cessation programs is crucial to reducing smoking-related morbidity and mortality. Several studies have shown promising results for the application of Acceptance and Commitment Therapy (ACT) in managing psychological or behavioral health problems. However, to date, only one study has examined the feasibility of a telephone-based ACT for smoking cessation and it was conducted among a Western population, in the United States. This study reports a protocol for a randomized controlled trial (RCT) examining the feasibility and potential efficacy of an individual, telephone-delivered ACT for smoking cessation in primary healthcare settings among a Chinese population.MethodsA randomized, two-group design was chosen, with assessment at baseline (before intervention) and via telephone follow-ups at three and six months. Subjects will be proactively recruited from primary healthcare centers. Eligible participants will be randomized to either the intervention (ACT) or control group following the baseline assessment. Both groups will receive self-help materials on smoking cessation. Those in the ACT group will undergo an initial face-to-face session and two telephone ACT sessions at one week and one month following the first session, to be delivered by a counselor based on the treatment protocol. All of the participants will be contacted by telephone for follow-up assessments at three and six months. Treatment fidelity will be assessed by reviewing around one-fifth of audio-recorded telephone calls.DiscussionTo the best of our knowledge, this protocol describes the first RCT of a telephone-based ACT for smoking cessation. It is also the first RCT of ACT for smoking cessation on a Chinese population. The study will provide us with information about the feasibility of a telephone-delivered ACT within a Chinese sample. If effective, this trial will support the development of ACT treatment protocols that could be made available for use by a greater range of clinicians, and offer an evidence base to support alternative treatments for smoking cessation.Trial registrationClinicalTrials.gov ID NCT01652508. Registered on 26th July 2012.

Nursing Intervention Practices for Smoking Cessation: A Large Survey in Hong Kong

Previous studies have shown that nursing interventions are effective in helping people to stop smoking, but that the participation of nurses in tobacco control activities has been far from satisfactory. The primary objective of this study is to identify factors that encourage or discourage nurses from participating in providing smoking-cessation interventions to their clients, based on the 5 A’s (ask, advise, assess, assist, arrange) framework. A cross-sectional survey was conducted among 4413 nurses in Hong Kong from different clinical specialties. A logistics regression analysis found that predictors for the practicing of all of the 5 A’s are nurses who want to receive training in smoking-cessation interventions, those who have received such training, and those who are primarily working in a medical unit or in ambulatory/outpatient settings. The regression model also showed that attitude towards smoking cessation was positively associated with all of the 5 A’s. The results indicate a need to encourage and provide nurses with opportunities to receive training on smoking-cessation interventions. Strategies to persuade nurses to provide smoking-cessation interventions are also important, since nurses are motivated to perform smoking-cessation interventions when they feel a stronger sense of mission to control tobacco use.

Factors Associated with Atopy in Toddlers: A Case-Control Study

In this case-control study the association between the approaches used to feed infants, together with known family and environmental factors, and the occurrence of atopic illness in toddlers between the ages of 4 months to 3 years in Hong Kong was examined. A total of 206 subjects were recruited from April to June of 2014. The results obtained by binary logistic regression indicated that atopy is associated with boys (OR 2.072, CI 1.089–3.941), the maternal use of antibiotics in utero or while breast feeding (OR 2.276, CI 1.151–4.504), the later commencement of mixed feeding (OR 2.497, CI 1.025–6.082), breast feeding exclusively for 3 months (OR 1.972, CI 1.009–3.857), and having a mother who was diagnosed with eczema (OR 4.510, CI 1.764–11.530). Although an exclusive reliance on breast feeding has been shown to be predictive of atopy among toddlers, the positive qualities of breast milk cannot be ignored. A further study of the contents and nutritional values of breast milk is warranted.

Abstract 1369: Cancer-related communication and decision making between patients and their spousal caregivers.

Aims: Patients with cancer and their spousal caregivers face dynamic communication and difficult decision making needs throughout the cancer trajectory. This literature review aims to delineate the current pattern of cancer-related communication (or non-communication) and decision making between patients and their spousal caregivers; and to discuss the support needs of couples on communication and decision making across the cancer trajectory. Methods: A systematic search was conducted to identity the articles on cancer-related communication and decision making of couples coping with cancer. The search for relevant literature included studies published in English from January 2000 to October 2012. Studies were located using several strategies, including an electronic search, a manual search for the bibliography of related studies, and an author search. The PICO (Population/problem, Intervention/exposure, Comparison, and Outcome) format was applied to guide the identification of the key terms for literature search. The databases searched included MEDLINE, CINAHL, SCI Expanded, Scopus, and PsychINFO. Articles were extracted according to predefined inclusion and exclusion criteria. The PRISMA flow diagram was used to outline the literature search and selection process. Results: Findings revealed that open and effective communication between couple9s coping with cancer facilitated the overall process of decision making, which also led to improved stressful mood, marital relationship, and quality of life of both partners. However, the results also showed that most patients and their spousal caregivers lacked effective communication, which related to both cancer patients and spousal caregivers psycho-sociological distress, created tension in their marital relationship and impaired their quality of life. Patients and their spousal caregivers had vast differences in opinion regarding decision making in treatment and care needs, including medical information on diagnosis, treatment, remission, end of life care, and caregivers’ needs in different cancer stage. Conclusions: These findings underline the importance of open communication between patients and their spousal caregivers in the study of couples coping with cancer. It is recognized that effective communication within couples may have positive effects on couple9s intimacy, decision making, and to improve both the patients and caregiving outcomes. Lack of communication may relate to negative effects on their health care outcomes. Further research is needed to explore interventions that facilitate couples’ communication and address both the patient9s and their spouse9s needs on decision making throughout the cancer trajectory. Key words: Cancer; Spousal caregivers; Communication; Decision making Citation Format: Qiu Ping Li, Alice Yuen Loke, Jolene Ying King Yung, Yim Wah Mak, Wan Chaw Shae. Cancer-related communication and decision making between patients and their spousal caregivers. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 1369. doi:10.1158/1538-7445.AM2013-1369