Abstract
Purpose
Caregivers of people with cancer represent a large, overburdened, and under-recognized part of the cancer care workforce. Research efforts to address the unmet needs of these caregivers are expanding with studies focused on caregivers’ skill sets, physical and psychological health, and integration into healthcare delivery. As this field of research continues to expand, integrating caregivers’ input is vital to studies to ensure that research aligns with their experiences.
Methods
This is a focus group study of 15 cancer caregivers conducted during a cancer caregiving workshop at the University of Pittsburgh in February 2020. During the workshop, caregivers reviewed, critiqued, and proposed priorities to support caregivers of adults with cancer. We used a multistage consensus building approach to identify priority areas of research and clinical practice to address caregivers’ experiences and needs. We used descriptive content analysis to summarize caregivers’ priorities.
Results
Caregiver-identified priorities included (1) training and information about cancer and treatment, (2) caregiver integration into the patient’s healthcare delivery, (3) assistance with navigating the healthcare system, (4) focus on caregiver health and well-being, and (5) policy reform to address caregiver needs. We identified ways in which these priorities can inform cancer caregiving research and practice.
Conclusion
These recommendations should be considered by researchers, clinicians, cancer center leadership, and policymakers interested in creating caregiver-focused research protocols, interventions, and support systems.
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Data availability
Data is available upon request.
References
Northouse L, Williams A-L, Given B, Mccorkle R (2012) Psychosocial care for family caregivers of patients with cancer. J Clin Oncol 30:1227–1234. https://doi.org/10.1200/JCO.2011.39.5798
Given BA, Given CW, Sherwood P (2012) The challenge of quality cancer care for family caregivers. Semin Oncol Nurs 28:205–212. https://doi.org/10.1016/j.soncn.2012.09.002
Ferrell B, Wittenberg E (2017) A review of family caregiving intervention trials in oncology. CA Cancer J Clin 67:318–325. https://doi.org/10.3322/caac.21396
Van Ryn M, Sanders S, Kahn K et al (2011) Objective burden, resources, and other stressors among informal cancer caregivers: a hidden quality issue? Psychooncology 20:44–52. https://doi.org/10.1002/pon.1703
Hunt GG, Longacre ML, Kent EE, Weber-Raley L (2016) Cancer caregiving in the U.S. An intense, episodic, and challenging care experience. In: National Alliance for Caregiving, vol 2016, p 34
Butow PN, Price MA, Bell ML, Webb PM, deFazio A, The Australian Ovarian Cancer Study Group, The Australian Ovarian Cancer Study Quality of Life Study Investigators, Friedlander M (2014) Caring for women with ovarian cancer in the last year of life: a longitudinal study of caregiver quality of life, distress and unmet needs. Gynecol Oncol 132:690–697. https://doi.org/10.1016/j.ygyno.2014.01.002
Hudson PL, Thomas K, Trauer T, Remedios C, Clarke D (2011) Psychological and social profile of family caregivers on commencement of palliative care. J Pain Symptom Manag 41:522–534. https://doi.org/10.1016/j.jpainsymman.2010.05.006
Mei GH, Mei CD, Yang F et al (2018) Prevalence and determinants of depression in caregivers of cancer patients: a systematic review and meta-analysis. Med (United States):97
Schulz R, Eden J (eds) (2016) Families caring for an aging America. National Academies Press, Washington, DC
Bowman KF, Rose JH, Radziewicz RM, O'Toole EE, Berila RA (2009) Family caregiver engagement in a coping and communication support intervention tailored to advanced cancer patients and families. Cancer Nurs 32:73–81
Public Policy Institute A (2014) Caregiving in the U.S. 2015 Report Acknowledgments
Lambert SD, Ould Brahim L, Morrison M, Girgis A, Yaffe M, Belzile E, Clayberg K, Robinson J, Thorne S, Bottorff JL, Duggleby W, Campbell-Enns H, Kim Y, Loiselle CG (2019) Priorities for caregiver research in cancer care: an international Delphi survey of caregivers, clinicians, managers, and researchers. Support Care Cancer 27:805–817. https://doi.org/10.1007/s00520-018-4314-y
Brett J, Staniszewska S, Mockford C, Herron-Marx S, Hughes J, Tysall C, Suleman R (2014) Mapping the impact of patient and public involvement on health and social care research: a systematic review. Health Expect 17:637–650. https://doi.org/10.1111/j.1369-7625.2012.00795.x
Brown BB (1968) Delphi process: a methodology used for the elicitation of opinions of experts | RAND
Curry LA, Nembhard IM, Bradley EH (2009) Qualitative and mixed methods provide unique contributions to outcomes research. Circulation 119:1442–1452
Elo S, Kyngäs H (2008) The qualitative content analysis process. J Adv Nurs 62:107–115. https://doi.org/10.1111/j.1365-2648.2007.04569.x
Sandelowski M, Leeman J (2012) Writing usable qualitative health research findings. Qual Health Res 22:1404–1413. https://doi.org/10.1177/1049732312450368
Harvey L (2015) Beyond member-checking: a dialogic approach to the research interview. Int J Res Method Educ 38:23–38. https://doi.org/10.1080/1743727X.2014.914487
Kent EE, Rowland JH, Northouse L, Litzelman K, Chou WYS, Shelburne N, Timura C, O'Mara A, Huss K (2016) Caring for caregivers and patients: research and clinical priorities for informal cancer caregiving. Cancer 122:1987–1995
Harvath TA, Mongoven JM, Bidwell JT, Cothran FA, Sexson KE, Mason DJ, Buckwalter K (2020) Research priorities in family caregiving: process and outcomes of a conference on family-centered care across the trajectory of serious illness. Gerontologist 60:S5–S13. https://doi.org/10.1093/geront/gnz138
Hendrix CC, Bailey DE, Steinhauser KE et al (2016) Effects of enhanced caregiver training program on cancer caregiver’s self-efficacy, preparedness, and psychological well-being. Support Care Cancer 24:327–336. https://doi.org/10.1007/s00520-015-2797-3
DuBenske LL, Gustafson DH, Namkoong K et al (2014) CHESS improves cancer caregivers’ burden and mood: results of an eHealth RCT. Health Psychol 33:1261–1272. https://doi.org/10.1037/a0034216
Dionne-Odom JN, Azuero A, Lyons KD, Hull JG, Tosteson T, Li Z, Li Z, Frost J, Dragnev KH, Akyar I, Hegel MT, Bakitas MA (2015) Benefits of early versus delayed palliative care to informal family caregivers of patients with advanced cancer: outcomes from the ENABLE III randomized controlled trial. J Clin Oncol 33:1446–1452. https://doi.org/10.1200/JCO.2014.58.7824
Berry LL, Dalwadi SM, Jacobson JO (2017) Supporting the supporters: what family caregivers need to care for a loved one with cancer. J Oncol Pract 13:35–41. https://doi.org/10.1200/jop.2016.017913
Alfano CM, Leach CR, Smith TG et al (2019) Equitably improving outcomes for cancer survivors and supporting caregivers: a blueprint for care delivery, research, education, and policy. CA Cancer J Clin 69:35–49. https://doi.org/10.3322/CAAC.21548@10.3322/(ISSN)1542-4863.ACS_CANCER_CONTROL_BLUEPRINTS
Bradley CJ (2019) Economic burden associated with cancer caregiving. Semin Oncol Nurs 35:333–336
Lopez V, Copp G, Molassiotis A (2012) Male caregivers of patients with breast and gynecologic cancer. Cancer Nurs 35:402–410. https://doi.org/10.1097/NCC.0b013e318231daf0
Matthews AB (2003) Role and gender differences in cancer-related distress: a comparison of survivor and caregiver self-reports. Oncol Nurs Forum 30:493–499. https://doi.org/10.1188/03.ONF.493-499
Girgis A, Lambert SD, McElduff P, Bonevski B, Lecathelinais C, Boyes A, Stacey F (2013) Some things change, some things stay the same: a longitudinal analysis of cancer caregivers’ unmet supportive care needs. Psychooncology 22:1557–1564. https://doi.org/10.1002/pon.3166
Heynsbergh N, Heckel L, Botti M, Livingston PM (2018) Feasibility, usability and acceptability of technology-based interventions for informal cancer carers: a systematic review. BMC Cancer 18:244. https://doi.org/10.1186/s12885-018-4160-9
Treanor CJ, Santin O, Prue G, Coleman H, Cardwell CR, O'Halloran P, Donnelly M, Cochrane Consumers and Communication Group (2019) Psychosocial interventions for informal caregivers of people living with cancer. Cochrane Database Syst Rev 2019. https://doi.org/10.1002/14651858.CD009912.pub2
Ugalde A, Gaskin CJ, Rankin NM, Schofield P, Boltong A, Aranda S, Chambers S, Krishnasamy M, Livingston PM (2019) A systematic review of cancer caregiver interventions: appraising the potential for implementation of evidence into practice. Psychooncology 28:687–701. https://doi.org/10.1002/pon.5018
Longacre ML, Weber-Raley L, Kent EE (2020) Toward engaging caregivers: inclusion in care and receipt of information and training among caregivers for cancer patients who have been hospitalized. https://doi.org/10.1007/s13187-019-01673-5
Jivraj N, Ould Gallagher L, Papadakos J, Abdelmutti N, Trang A, Ferguson SE (2018) Empowering patients and caregivers with knowledge: the development of a nurse-led gynecologic oncology chemotherapy education class. Can Oncol Nurs J 28:4–7. https://doi.org/10.5737/2368807628147
Wittenberg E, Buller H, Ferrell B, Koczywas M, Borneman T (2017) Understanding family caregiver communication to provide family-centered cancer care. Semin Oncol Nurs 33:507–516
Wittenberg E, Ferrell B, Goldsmith J, Ruel NH (2017) Family caregiver communication tool: a new measure for tailoring communication with cancer caregivers. Psychooncology. 26:1222–1224
Lincoln YS, Guba EG (1985) Naturalistic inquiry. In: Naturalistic inquiry. SAGE Publications, Newbury Park
Funding
(Donovan) The contents of this manuscript were developed under a grant from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR grant number 90RTGE0002-01-00). NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this manuscript do not necessarily represent the policy of NIDILRR, ACL, or HHS, and you should not assume endorsement by the Federal Government.
(Donovan) Health Policy Institute, University of Pittsburgh
(Thomas) American Cancer Society Mentored Research Scholar Grant MSRG-18-051-51
(Thomas) National Palliative Care Research Center Career Development Award
(UPMC Hillman Cancer Center) P30CA047904
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Study conceptualization: Thomas, Donovan, Posluszny, and Sherwood
Data collection: Thomas, Campbell, Lee, Roberge, Kent, Steel, Posluszny, Arida, Belcher, and Donovan
Data analysis: Thomas, Campbell, Lee, Roberge, Kent, Steel, Posluszny, Arida, Belcher, and Donovan
Manuscript review and approval: Thomas, Campbell, Lee, Roberge, Kent, Steel, Posluszny, Arida, Belcher, Sherwood, and Donovan
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This study was approved by the University of Pittsburgh Institutional Review Board (STUDY20010122).
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Thomas, T.H., Campbell, G.B., Lee, Y.J. et al. Priorities to improve cancer caregiving: report of a caregiver stakeholder workshop. Support Care Cancer 29, 2423–2434 (2021). https://doi.org/10.1007/s00520-020-05760-y
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DOI: https://doi.org/10.1007/s00520-020-05760-y