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      Experiences of End-of-Life Care of Older Adults with Cancer From the Perspective of Stakeholdersin Iran: A Content Analysis Study

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          Abstract

          Objectives:

          To describe end-of-life care forolder adults with cancer admitted to the hospital in Tehran, Iranto determine if there were any gaps in care for older adultsthat can be improved.

          Materials:

          This study used a qualitative descriptive study design. In total, 37 individualsincluding patients, healthcare team members, and family caregivers, participated in the study. Semi-structured interviews using topic guides were conducted, and the thematic content analysis method described by Braun and Clarke (2006), was used to analyze the data.

          Results:

          In total, 37 Iranian participants (12 male and 25 female), including 14 nurses, 3 oncologists, 1 social worker, 1 chaplain, 1 psychologist, 11 family members and 6 patientsinterviewed.Our main themes of end-of-life carewere:1) barriers to providing and receiving quality care for families and patients; and 2) coping strategies and empowerment of families and patients.

          Conclusion:

          Healthcare providers are recommended to familiarize themselves with the burden faced by patients and family caregivers who take care of older adults with chronic diseases at home, and they should organize their supportive and consulting actions. In order to improve the quality of life of older patientsand their family caregivers.

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          Most cited references43

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          Interventions with family caregivers of cancer patients: meta-analysis of randomized trials.

          Family caregivers of cancer patients receive little preparation, information, or support to perform their caregiving role. However, their psychosocial needs must be addressed so they can maintain their own health and provide the best possible care to the patient. The purpose of this article is to analyze the types of interventions offered to family caregivers of cancer patients, and to determine the effect of these interventions on various caregiver outcomes. Meta-analysis was used to analyze data obtained from 29 randomized clinical trials published from 1983 through March 2009. Three types of interventions were offered to caregivers: psychoeducational, skills training, and therapeutic counseling. Most interventions were delivered jointly to patients and caregivers, but they varied considerably with regard to dose and duration. The majority of caregivers were female (64%) and Caucasian (84%), and ranged in age from 18 to 92 years (mean age, 55 years). Meta-analysis indicated that although these interventions had small to medium effects, they significantly reduced caregiver burden, improved caregivers' ability to cope, increased their self-efficacy, and improved aspects of their quality of life. Various intervention characteristics were also examined as potential moderators. Clinicians need to deliver research-tested interventions to help caregivers and patients cope effectively and maintain their quality of life. Copyright 2010 American Cancer Society, Inc.
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            The Effect of Cancer Patients’ and Their Family Caregivers’ Physical and Emotional Symptoms on Caregiver Burden

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              Coping Well with Advanced Cancer: A Serial Qualitative Interview Study with Patients and Family Carers

              Objectives To understand successful strategies used by people to cope well when living with advanced cancer; to explore how professionals can support effective coping strategies; to understand how to support development of effective coping strategies for patients and family carers. Design Qualitative serial (4–12 week intervals) interview study with people with advanced cancer and their informal carers followed by focus groups. The iterative design had a novel focus on positive coping strategies. Interview analysis focused on patients and carers as individuals and pairs, exploring multiple dimensions of their coping experiences. Focus group analysis explored strategies for intervention development. Participants 26 people with advanced (stage 3–4) breast, prostate, lung or colorectal cancer, or in receipt of palliative care, and 24 paired nominated informal/family carers. Setting Participants recruited through outpatient clinics at two tertiary cancer centres in Merseyside and Manchester, UK, between June 2012 and July 2013. Results 45 patient and 41 carer interviews were conducted plus 4 focus groups (16 participants). People with advanced cancer and their informal/family carers develop coping strategies which enable effective management of psychological wellbeing. People draw from pre-diagnosis coping strategies, but these develop through responding to the experience of living with advanced cancer. Strategies include being realistic, indulgence, support, and learning from others, which enabled participants to regain a sense of wellbeing after emotional challenge. Learning from peers emerged as particularly important in promoting psychological wellbeing through the development of effective ‘everyday’, non-clinical coping strategies. Conclusions Our findings challenge current models of providing psychological support for those with advanced cancer which focus on professional intervention. It is important to recognise, enable and support peoples’ own resources and coping strategies. Peer support may have potential, and could be a patient-centred, cost effective way of managing the needs of a growing population of those living with advanced cancer.
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                Author and article information

                Journal
                Asian Pac J Cancer Prev
                Asian Pac J Cancer Prev
                APJCP
                Asian Pacific Journal of Cancer Prevention : APJCP
                West Asia Organization for Cancer Prevention (Iran )
                1513-7368
                2476-762X
                January 2021
                : 22
                : 1
                : 295-300
                Affiliations
                [1 ] Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
                [2 ] Department of Nursing, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto , Toronto, Ontario, Canada.
                Author notes
                [* ]For Correspondence: ahmadif@modares.ac.ir
                Article
                10.31557/APJCP.2021.22.1.295
                8184189
                33507711
                7d25da41-f5e0-42eb-98c7-736e8d5b76ef

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, ( http://creativecommons.org/licenses/by/3.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 27 August 2019
                : 10 January 2021
                Categories
                Research Article

                end of life,cancer care,geriatrics
                end of life, cancer care, geriatrics

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