Implementation of e-mental health interventions for informal caregivers of adults with chronic diseases: a protocol for a mixed-methods systematic review with a qualitative comparative analysis.
BMJ Open. 2020 Jun 21;10(6):e035406
Authors: Coumoundouros C, von Essen L, Sanderman R, Woodford J
INTRODUCTION: Informal caregivers provide the majority of care to individuals with chronic health conditions, benefiting the care recipient and reducing use of formal care services. However, providing informal care negatively impacts the mental health of many caregivers. E-mental health interventions have emerged as a way to provide accessible mental healthcare to caregivers. Much attention has been given to reviewing the effectiveness and efficacy of such interventions, however, factors related to implementation have received less consideration. Therefore, this mixed-methods systematic review will aim to examine factors associated with the effectiveness and implementation of e-mental health interventions for caregivers.
METHODS AND ANALYSIS: Eligible studies published since 1 January 2007 will be searched for in several electronic databases (CINAHL Plus with Full Text, the Cochrane Library, EMBASE, PsycINFO, PubMed and Web of Science), clinical trial registries and OpenGrey, with all screening steps conducted by two independent reviewers. Studies will be included if they focus on the implementation or effectiveness of e-mental health interventions designed for informal adult caregivers of adults with cancer, heart disease, stroke, diabetes, dementia or chronic obstructive pulmonary disease. Pragmatic randomised controlled trials quantitatively reporting on caregiver anxiety, depression, psychological distress or stress will be used for a qualitative comparative analysis to identify combinations of conditions that result in effective interventions. Qualitative and quantitative data on implementation of e-mental health interventions for caregivers will be integrated in a thematic synthesis to identify barriers and facilitators to implementation. These results will inform future development and implementation planning of e-mental health interventions for caregivers.
ETHICS AND DISSEMINATION: Ethical approval is not required for this study as no primary data will be collected. Results will be disseminated in the form of a scientific publication and presentations at academic conferences and plain language summaries for various stakeholders.
PROSPERO REGISTRATION NUMBER: CRD42020155727.
PMID: 32565461 [PubMed – in process]
Distress and mental health care and medication use among survivors of multiple primary cancer diagnoses: Findings from the 2016 National Health Interview Survey.
J Psychosom Res. 2020 May 11;134:110137
Authors: Andrykowski MA, Goedendorp MM
OBJECTIVE: Over 1 million survivors of multiple primary cancer (MPC) diagnoses reside in the USA. Information regarding their physical and mental health status is limited. This study examined distress and mental health care use among MPC survivors relative to survivors of a single primary cancer (SPC) diagnosis.
METHODS: Using the 2016 National Health Information Survey, MPC survivors (n = 265), SPC survivors (n = 2103), and no cancer controls (NCC; n = 28,320) were identified. The MPC group was compared to the SPC and NCC groups with regard to multiple distress indices and use of mental health care and anxiety and depression medication.
RESULTS: Relative to the SPC group, the MPC group reported more Total Distress (M = 9.59 vs. 8.84; p < .001), and were more likely to report daily or weekly anxiety feelings (OR = 2.07; p < .001), meet criteria for serious psychological distress (OR = 1.49; p = .02) and have talked to a mental health professional (OR = 1.75; p = .01). Comparison of MPC and NweCC groups yielded similar results. The MPC group did not differ from the SPC or NCC groups in severity of anxiety or depression feelings, distress interference, or anxiety and depression medication use.
CONCLUSIONS: MPC survivors reported greater distress relative to SPC survivors. The clinical significance of this greater distress is unclear, however. While MPC survivors were more likely to have talked to a mental health professional, uptake of mental health care appeared to be suboptimal. MPC and SPC survivors might be considered distinct subgroups and increased attention devoted to potentially unique mental and physical health needs of MPC survivors.
PMID: 32417691 [PubMed – as supplied by publisher]
Beating Cancer-Related Fatigue With the Untire Mobile App: Protocol for a Waiting List Randomized Controlled Trial.
JMIR Res Protoc. 2020 Feb 14;9(2):e15969
Authors: Spahrkäs SS, Looijmans A, Sanderman R, Hagedoorn M
BACKGROUND: Many cancer patients and survivors worldwide experience disabling fatigue as the main side effect of their illness and the treatments involved. Face-to-face therapy is effective in treating cancer-related fatigue (CRF), but it is also resource-intensive. Offering a self-management program via a mobile phone app (ie, the Untire app), based on elements of effective face-to-face treatments, might increase the number of patients receiving adequate support for fatigue and decrease care costs.
OBJECTIVE: The aim of this protocol is to describe a randomized controlled trial (RCT) to assess the effectiveness of the Untire app in reducing fatigue in cancer patients and survivors after 12 weeks of app use as compared with a waiting list control group. Substudies nested within this trial include questions concerning the reach and costs of online recruitment and uptake and usage of the Untire app.
METHODS: The Untire app study is a waiting list RCT targeting cancer patients and survivors who experience moderate to severe fatigue via social media (Facebook and Instagram) across 4 English-speaking countries (Australia, Canada, the United Kingdom, and the United States). The Untire app includes psychoeducation and exercises concerning energy conservation, activity management, optimizing restful sleep, mindfulness-based stress reduction, psychosocial support, cognitive behavioral therapy, and physical activity. After randomization, participants in the intervention group could access the Untire app immediately, whereas control participants had no access to the Untire app until the primary follow-up assessment at 12 weeks. Participants completed questionnaires at baseline before randomization and after 4, 8, 12, and 24 weeks. The study outcomes are fatigue (primary) and quality of life (QoL; secondary). Potential moderators and mediators of the hypothesized treatment effect on levels of fatigue and QoL were also assessed. Link clicks and app activation are used to assess reach and uptake, respectively. Log data are used to explore the characteristics of app use. Sample size calculations for the primary outcome showed that we needed to include 164 participants with complete 12-week measures both in the intervention and the control groups. The intention-to-treat approach is used in the primary analyses, which refers to analyzing all participants regardless of their app use.
RESULTS: Participants were recruited from March to October 2018. The last participant completed the 24-week assessment in March 2019.
CONCLUSIONS: This mobile health (mHealth) RCT recruited participants online in multiple countries to examine the uptake and effectiveness of the Untire self-management app to reduce CRF. Many advantages of mHealth apps are assumed, such as the immediate access to the app, the low thresholds to seek support, and the absence of contact with care professionals that will reduce costs. If found effective, this app can easily be offered worldwide to patients experiencing CRF.
TRIAL REGISTRATION: Netherlands Trial Register NL6642; https://www.trialregister.nl/trial/6642.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/15969.
PMID: 32130185 [PubMed – as supplied by publisher]
A Closer Look at Loneliness: Why Do First-Generation Migrants Feel More Lonely Than Their Native Dutch Counterparts?
Gerontologist. 2020 Jan 16;:
Authors: Ten Kate RLF, Bilecen B, Steverink N
BACKGROUND AND OBJECTIVES: Along with the current aging demographics in the Netherlands, the number of older first-generation migrants is also increasing. Despite studies suggesting a higher quantity of social contacts of migrants, loneliness is more common among migrants as compared to native Dutch. We theorize that migrants experience more emotional and social loneliness due to a lower satisfaction with social relationships and lower participation in social activities, respectively, compared to their native counterparts.
RESEARCH DESIGN AND METHODS: We use data from Statistics Netherlands (N = 7,920) with first-generation migrants aged 40 years and older and their Dutch counterparts. Contact frequency, household composition, satisfaction with social relationships, relationship quality with the partner, and social activities, are used as main predictors and separate regression models for social and emotional loneliness are analyzed.
RESULTS: Compared to the native Dutch, first-generation migrants are both socially and emotionally more lonely. Migrants have a similar contact frequency as the native Dutch, but are less satisfied with their social relationships, which contributes to their higher emotional, social, and overall loneliness. Migrants engage less in social activities but this does not put them at additional risk of loneliness.
DISCUSSION AND IMPLICATIONS: Migrants experience more social and emotional loneliness and are less satisfied with their social relationships compared to their native counterparts. Interventions should focus on reducing both social and emotional loneliness among older migrants. Specific attention should be paid to fostering satisfying social interactions. Additionally, encouraging migrants to broaden their social network may reduce social loneliness.
PMID: 31944240 [PubMed – as supplied by publisher]
A planning intervention to quit smoking in single-smoking couples: does partner involvement improve effectiveness?
Psychol Health. 2019 Dec 27;:1-15
Authors: Buitenhuis AH, Tuinman MA, Hagedoorn M
Objective: Smoking cessation interventions that use implementation intentions have shown promising results. Implementation intentions are if-then plans that specify certain behaviour within a situational context. This study examines whether dyadic planning (i.e., involving a non-smoking partner) is more effective than individual planning in quitting smoking.Design: This longitudinal single-blind randomized controlled trial involves a baseline questionnaire, end-of-day measurements for three weeks, and a follow-up questionnaire after three months. Single-smoking couples were randomized to a dyadic or individual planning condition. After the intervention, which 176 couples received, smokers attempted to quit smoking, and the diary measurements started.Main Outcome Measures: smoking abstinence, number of cigarettes smoked and relationship satisfaction.Results: At follow-up, both planning groups showed similar quit rates (33%, dyadic; 30%, individual) and a similar significant decline in number of cigarettes smoked (almost 50%). For most smokers, the smoking pattern shown in the diary seemed to be indicative of smoking behaviour at follow-up. Relationship satisfaction declined minimally, in both intervention groups and in both smokers and partners.Conclusion: The involvement of a non-smoking partner in the planning did not increase its effectiveness. However, couple participation and daily measurements during a quit attempt could be important components of future interventions.
PMID: 31880171 [PubMed – as supplied by publisher]
The Dutch Comparative Scale for Assessing Volunteer Motivations among Volunteers and Non-Volunteers: An Adaptation of the Volunteer Functions Inventory.
Int J Environ Res Public Health. 2019 Dec 11;16(24):
Authors: Niebuur J, Liefbroer AC, Steverink N, Smidt N
Currently, no valid scales exist to compare volunteer motivations between volunteers and non-volunteers. We aimed to adapt the Dutch version of the Volunteer Functions Inventory (VFI) in order to make it applicable for the comparison of volunteer motivations between Dutch older volunteers and non-volunteers. The Dutch version of the VFI was included in the Lifelines ‘Daily Activities and Leisure Activities add on Study’, which was distributed among participants aged 60 to 80. Confirmatory factor analysis (CFA) models were estimated for volunteers and non-volunteers separately, and subsequently a CFA model was created based on all observations irrespective of volunteer status. Finally, group-based CFA models were estimated to assess measurement invariance. The resulting measurement instrument (6 factors, 18 items), containing both a volunteer version and a non-volunteer version, indicated an acceptable model fit for the separate and the combined CFA models (root mean square error of approximation (RMSEA) = 0.06, comparative fit index (CFI) = 0.95). Group-based models demonstrated strong invariance between the samples. The current study provides support for the validity of the Dutch Comparative Scale for Assessing Volunteer Motivations among Volunteers and Non-Volunteers, among Dutch older adults.
PMID: 31835759 [PubMed – in process]
Satisfaction with hospital care in older patients with colorectal cancer, the importance of a warm welcome.
J Geriatr Oncol. 2019 Dec 03;:
Authors: van Ee B, Slaets J, Smits C, Honkoop A, Kamper A, Hagedoorn M
PMID: 31810789 [PubMed – as supplied by publisher]
Positive affect and functional somatic symptoms in young adults.
J Psychosom Res. 2019 Oct 23;127:109847
Authors: Acevedo-Mesa A, Rosmalen JGM, Ranchor AV, Roest AM
BACKGROUND: Functional Somatic Symptoms (FSS) are symptoms for which an underlying pathology cannot be found. High negative affect (NA) has been linked to the etiology of FSS, but little is known about the role of Positive Affect (PA).
OBJECTIVE: The aim of this study was to test if PA is related to current and future lower levels of FSS. We also examined the interactions between PA and NA, and PA and sex on FSS.
METHOD: Data from the Dutch Tracking Adolescents’ Individual Lives Survey (TRAILS) cohort were used (N = 1247 cases, 60% females, mean age T5 = 22.2, T6 = 25.6). PA was measured with the PANAS schedule and FSS with the Adult Self Report questionnaire (ASR). A Principal Component Analysis (PCA) was performed on the physical complaints subscale of the ASR. Regression analyses with bootstrapping were performed to assess the associations and interactions.
RESULTS: PA had a significant negative association with current FSS when adjusted for NA, age, sex and socioeconomic status (B = -0.004; BCa 95% CI = [-0.006; -0.002]), but the association was not significant longitudinally. No interactions were found. In secondary analysis, PA was significantly related to the component “General Physical Symptoms” (B = -0.019; BCa 95% CI = [-0.0028; -0.011]) but not to the component “Gastrointestinal Symptoms” (B = -0.008; BCa 95% CI = [-0.016;0.001]) in the cross-sectional analysis.
CONCLUSION: In conclusion, high PA was significantly related to current lower levels of FSS, but the effect was small. Further research on individual variations in affect is needed to obtain more insight in their contribution to FSS.
PMID: 31706069 [PubMed – as supplied by publisher]
The pains and reliefs of the transitions into and out of spousal caregiving. A cross-national comparison of the health consequences of caregiving by gender.
Soc Sci Med. 2019 Aug 27;240:112517
Authors: Uccheddu D, Gauthier AH, Steverink N, Emery T
Spousal caregiving offers a unique opportunity to investigate how gender shapes the influence of care responsibilities on health at older ages. However, empirical evidence supporting a causal link between the transitions into and out of caregiving and health is mixed. This study investigates the influence of spousal care transitions on the health of older men and women living in 17 European countries. We use five waves of the Survey of Health, Ageing and Retirement in Europe (SHARE) between the years 2004 and 2015 for a total of 43,435 individuals and 117,831 observations. Health is defined as a Frailty Index calculated from 40 items. Caregiving is defined as intensive help with personal care provided to spouses. Results from asymmetric fixed-effects linear regression models show that the transitions into caregiving have a detrimental effect on health. On the contrary, the transitions out of caregiving have in most cases no beneficial consequences on health. Most importantly, we found evidence supporting differential effects of caregiving transitions by gender and welfare arrangement: the transitions out of caregiving are associated with better health conditions only for Southern and Eastern European women. Our study highlights the asymmetric and gendered nature of care transitions and suggests that the impact of caregiving is somewhat permanent and has long lasting effects for the caregiver. Policies should account for this asymmetry when assessing the impact and consequences of caregiving.
PMID: 31561110 [PubMed – as supplied by publisher]
Extraordinary claims require compelling evidence: Concerns about “loving-kindness meditation slows biological aging in novices”.
Psychoneuroendocrinology. 2019 Aug 17;:104410
Authors: Friedman HL, MacDonald DA, Brown NJL, Coyne JC
PMID: 31455579 [PubMed – as supplied by publisher]