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Depression in dyad: Effects of depression management in lung cancer patients, and analyses of moderators between caregiver stress and depression
lung cancer,family caregiver,depressive symptoms,dispositional mindfulness,self-compassion,dyadic patient-caregiver approach,
|Publication Year :||2019|
Patients with lung cancer and their family caregivers often suffer from psychological distress, particularly depression. This thesis composes of two studies: the effects of supportive care interventions on improving depression in patients with lung cancer and moderators of the impacts of stress on caregivers’ depression. Study one adopts the meta-analysis method to explore the effects of the supportive care interventions on improving depressive symptoms for lung cancer patients. The data based on a total of 12 studies were analyzed. The results conclude that two types of supportive care interventions (psychoeducation combined with psychotherapy and exercise) effectively reduce depressive symptoms of patients with lung cancer. However, the current effective interventions mainly focus on the patients’ depression. Very few studies examine the psychological impact of patients’ lung cancer on caregivers’ depression. Therefore, the study two with the caregiver-patient dyadic approach aimed to understand the depressive symptoms among family caregivers of lung cancer patients. Moreover, this study also explored the protective factors from both patients’ and caregivers’ trait mindfulness and caregivers’ compassionate behaviors (self-compassion and compassion from others) in buffering the impact of stress on caregivers’ depressive symptoms. A total of 72 lung cancer outpatients and their family caregivers are included in this study. The results indicate that there are correlations of depressive symptoms between lung cancer patients and their family caregivers. Caregivers’ depression is associated with patient’s treatment status, symptom distress, depressive symptoms, and caregivers’ self-reported health status. The results also show that caregivers’ mindful awareness of the present moment, and self-compassionate action are the protective factors mitigating the impact of caregiving stress on their depressive symptoms. Patients’ trait mindfulness is only related to levels of caregivers’ stress but not associated with caregivers’ depressive symptoms. Based on the findings and the limitations of this study, future research with the dyadic patient-caregiver approach can examine the individual and interaction effects of trait mindfulness and compassion on depression of lung cancer patients and their caregivers. The implications for clinical practice are providing the personalized supportive care (psychoeducation with psychotherapy or exercise program) for patients with lung cancer according to different levels of symptoms, functional impairment, causes of depressive symptoms, and patient preference; and developing mindfulness with compassion program aiming to enhancing the caregivers’ competencies of self-compassionate action with mindful awareness in order to reduce their depression A patient-caregiver dyadic depression program is also suggested based on findings of the correlations of depression between patients and caregivers.
|Appears in Collections:||護理學系所|
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