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postgraduate thesis: A nurse-led telephone-based psycho-educational intervention on the psychological well-being and quality of life among Chinese caregivers of colorectal cancer patients

TitleA nurse-led telephone-based psycho-educational intervention on the psychological well-being and quality of life among Chinese caregivers of colorectal cancer patients
Authors
Issue Date2013
PublisherThe University of Hong Kong (Pokfulam, Hong Kong)
Citation
Shum, N. [沈雅芬]. (2013). A nurse-led telephone-based psycho-educational intervention on the psychological well-being and quality of life among Chinese caregivers of colorectal cancer patients. (Thesis). University of Hong Kong, Pokfulam, Hong Kong SAR. Retrieved from http://dx.doi.org/10.5353/th_b5157947
AbstractColorectal cancer has been a major health issue worldwide. Not only it affects the patients but it also carries physical and psychological influences to their caregivers. Despite the concerns of the psychological needs of caregivers of colorectal cancer patients, there has been a lack of a good understanding of their needs, and how to intervene in order to alleviate their psychological problems and burdens. Therefore, this thesis aimed at designing and evaluating a nurse-led telephone based psychosocial education program for improving the psychological conditions and quality of life among Chinese caregivers of patients with colorectal cancer. The nurse-led telephone based psycho-educational program was designed based on the transactional model of stress and copying. It was piloted on 6 caregivers and refined. Its efficacy over the patients discharged under the ‘usual routine hospital standard discharge care procedure’ was assessed in a randomized controlled trial on 140 Chinese caregivers of colorectal cancer patients. Caregivers in the intervention group received three telephone calls from an experienced Nurse Interventionist at 1, 3 and 5 weeks after the patients’ discharge. Each call addressed any unmet needs of the caregivers with the provision of education and psychological support. At baseline, 2 weeks, 4 weeks and 8 weeks, all caregivers were assessed for the primary outcome of depression measured by the Depression Anxiety Stress Scale (DASS), and for the secondary outcomes of anxiety, stress, burden of care and quality of life. The mixed effects model, which takes into account the extra-covariance among repeated measurements, and which is consistent with the intention-to-treat principle, was used in the efficacy analysis. Of the 140 caregivers recruited in the randomized controlled study, 5 dropped out before the end of the study. However, all the caregivers were included in the analysis. There was no significant baseline difference between the intervention and ‘usual care’ groups. The psycho-education program reduced depression more than the ‘usual care’ group by2.7 (95% CI = 0.6 to 4.8, p=0.013) units in DASS at 2 weeks, and even more by 3.5 (95% CI = 1.7 to 5.24, p<0.001) at 4 weeks. However, the ‘usual care’ group caught up at 8 weeks, and no significant effect of the psycho-education program was found (p=0.144). Moreover, the program also reduced anxiety and stress more than the ‘usual care’ group by1.83 (95% CI = 0.61 to 3.50, p=0.004) and 3.50 (95% CI = 1.74 to 5.25, p<0.001) respectively at follow-up. In addition, the burden of care and quality of life were also generally improved more in the psycho-education program group. Furthermore, strong positive associations among depression, stress, anxiety, and burden of care were found. Caregivers perceived to have a high burden of care would be associated with more depression, stress or anxiety(r = 0.53, p<0.001). Moreover, depression, anxiety, and stress had a strong negative association with the physical, psychological, social relationship and environmental well-being but not with social relationships(r = -0.16, p = 0.550). In conclusion, this thesis has developed the first nurse-led telephone based psycho-education program for caregivers of colorectal cancer patients. The program can effectively help caregivers in reducing their feelings of stress from depression, anxiety, stress and the burden of care, as well as improving their quality of life. It paves the way for a new direction for a comprehensive colorectal cancer care service in addressing the caregivers’ needs.
DegreeDoctor of Nursing
SubjectColon (Anatomy) - Cancer - Patients - Care
Caregivers - Psychology
Rectum - Cancer - Patients - Care
Dept/ProgramNursing Studies
Persistent Identifierhttp://hdl.handle.net/10722/198851

 

DC FieldValueLanguage
dc.contributor.authorShum, Nga-fan-
dc.contributor.author沈雅芬-
dc.date.accessioned2014-07-10T04:22:06Z-
dc.date.available2014-07-10T04:22:06Z-
dc.date.issued2013-
dc.identifier.citationShum, N. [沈雅芬]. (2013). A nurse-led telephone-based psycho-educational intervention on the psychological well-being and quality of life among Chinese caregivers of colorectal cancer patients. (Thesis). University of Hong Kong, Pokfulam, Hong Kong SAR. Retrieved from http://dx.doi.org/10.5353/th_b5157947-
dc.identifier.urihttp://hdl.handle.net/10722/198851-
dc.description.abstractColorectal cancer has been a major health issue worldwide. Not only it affects the patients but it also carries physical and psychological influences to their caregivers. Despite the concerns of the psychological needs of caregivers of colorectal cancer patients, there has been a lack of a good understanding of their needs, and how to intervene in order to alleviate their psychological problems and burdens. Therefore, this thesis aimed at designing and evaluating a nurse-led telephone based psychosocial education program for improving the psychological conditions and quality of life among Chinese caregivers of patients with colorectal cancer. The nurse-led telephone based psycho-educational program was designed based on the transactional model of stress and copying. It was piloted on 6 caregivers and refined. Its efficacy over the patients discharged under the ‘usual routine hospital standard discharge care procedure’ was assessed in a randomized controlled trial on 140 Chinese caregivers of colorectal cancer patients. Caregivers in the intervention group received three telephone calls from an experienced Nurse Interventionist at 1, 3 and 5 weeks after the patients’ discharge. Each call addressed any unmet needs of the caregivers with the provision of education and psychological support. At baseline, 2 weeks, 4 weeks and 8 weeks, all caregivers were assessed for the primary outcome of depression measured by the Depression Anxiety Stress Scale (DASS), and for the secondary outcomes of anxiety, stress, burden of care and quality of life. The mixed effects model, which takes into account the extra-covariance among repeated measurements, and which is consistent with the intention-to-treat principle, was used in the efficacy analysis. Of the 140 caregivers recruited in the randomized controlled study, 5 dropped out before the end of the study. However, all the caregivers were included in the analysis. There was no significant baseline difference between the intervention and ‘usual care’ groups. The psycho-education program reduced depression more than the ‘usual care’ group by2.7 (95% CI = 0.6 to 4.8, p=0.013) units in DASS at 2 weeks, and even more by 3.5 (95% CI = 1.7 to 5.24, p<0.001) at 4 weeks. However, the ‘usual care’ group caught up at 8 weeks, and no significant effect of the psycho-education program was found (p=0.144). Moreover, the program also reduced anxiety and stress more than the ‘usual care’ group by1.83 (95% CI = 0.61 to 3.50, p=0.004) and 3.50 (95% CI = 1.74 to 5.25, p<0.001) respectively at follow-up. In addition, the burden of care and quality of life were also generally improved more in the psycho-education program group. Furthermore, strong positive associations among depression, stress, anxiety, and burden of care were found. Caregivers perceived to have a high burden of care would be associated with more depression, stress or anxiety(r = 0.53, p<0.001). Moreover, depression, anxiety, and stress had a strong negative association with the physical, psychological, social relationship and environmental well-being but not with social relationships(r = -0.16, p = 0.550). In conclusion, this thesis has developed the first nurse-led telephone based psycho-education program for caregivers of colorectal cancer patients. The program can effectively help caregivers in reducing their feelings of stress from depression, anxiety, stress and the burden of care, as well as improving their quality of life. It paves the way for a new direction for a comprehensive colorectal cancer care service in addressing the caregivers’ needs.-
dc.languageeng-
dc.publisherThe University of Hong Kong (Pokfulam, Hong Kong)-
dc.relation.ispartofHKU Theses Online (HKUTO)-
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.rightsThe author retains all proprietary rights, (such as patent rights) and the right to use in future works.-
dc.subject.lcshColon (Anatomy) - Cancer - Patients - Care-
dc.subject.lcshCaregivers - Psychology-
dc.subject.lcshRectum - Cancer - Patients - Care-
dc.titleA nurse-led telephone-based psycho-educational intervention on the psychological well-being and quality of life among Chinese caregivers of colorectal cancer patients-
dc.typePG_Thesis-
dc.identifier.hkulb5157947-
dc.description.thesisnameDoctor of Nursing-
dc.description.thesislevelDoctoral-
dc.description.thesisdisciplineNursing Studies-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.5353/th_b5157947-

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