Jacqueline Galica

From Treatment to Recovery: Gynecological Survivors’ and Caregivers’ Perspectives About the Usability of an Educational Resource

Coping with fear of cancer recurrence among ovarian cancer survivors living in small urban and rural settings: A qualitative descriptive study

Fear of cancer recurrence (FCR) is a paramount concern among ovarian cancer survivors. Evidence shows that cancer survivors living in regional or rural areas have higher psychological morbidity; however, no known studies have explored how ovarian cancer survivors living in small urban and rural areas cope with FCR. In this qualitative descriptive study, a semi-structured questioning process was developed in accordance with Carver et al.'s conceptualization of coping. Focus groups or 1:1 telephone interviews were used to collect data from a convenience sample of ovarian cancer survivors. Participants completed a demographic form and the Fear of Cancer Recurrence Inventory, and clinical information was extracted from hospital charts. The average age of participants (n = 15) was 62.8 years (Range 51-76 years) and the average time since diagnosis was 2.7 years (Range 1-19 years). Most women had elevated levels of FCR. Five themes for coping were expressed by all women: 1) health care provider support; 2) knowing, trusting, and prioritizing self; 3) finding what works; 4) uniqueness and belonging; and 5) redirecting thoughts and actions. One additional theme was expressed by most women (n = 11): 6) preparing for the future. Fear of cancer recurrence was a concern for most ovarian cancer survivors who used a variety of ways to cope. Results can be used to guide nurses' discussions with post-treatment ovarian cancer survivors or be used to inform refinement and development of resources to assist ovarian cancer survivors living in small urban and rural settings to cope with FCR.

An Investigation of the Effect of Attachment on Distress among Partners of Patients with Ovarian Cancer and Their Relationship with the Cancer Care Providers

Caregivers of patients with ovarian cancer experience distress related to caregiving difficulties within cancer care. Attachment insecurity is a well-known protector of distress, particularly as it relates to support from others. Using multivariate analyses, this study sought to determine the contribution of attachment insecurity and experiences with cancer care on symptoms of depression and anxiety, and investigated whether attachment insecurity moderated the relationship between caregiving experiences and distress. Multiple hierarchical regression analyses were conducted as part of a larger cross-sectional questionnaire study of distress among partners of patients with ovarian cancer. Participants (n = 82) were predominantly male, white, had household incomes over $100,000 and postsecondary education. Caregiving experiences explained 56% of the variance in depression, and 28% of the variance in anxiety. Specifically, lack of time for social relations as a result of caregiving significantly predicted depression and anxiety. Attachment anxiety correlated with both depression and anxiety, but attachment avoidance did not. Neither attachment anxiety nor attachment avoidance significantly contributed to distress variance, and neither moderated any of the relationships between caregiving experiences and distress outcomes. This study highlights the importance for cancer care to recognize the effect of caregiving responsibilities upon caregivers’ mental health, regardless of vulnerability to distress.

An investigation of fear of recurrence, attachment and caregiving experiences among ovarian cancer partner‐caregivers

AbstractObjectiveFear of cancer recurrence (FCR) is a common concern for both cancer patients and their caregivers. Attachment insecurity is an established contributor to poorer mental health, particularly as it relates to social support. This study sought to evaluate whether attachment and caregiver experiences in cancer care were predictors of FCR.MethodsA cross‐sectional questionnaire study involving partner‐caregivers of patients with ovarian cancer was conducted. Correlation analyses and multiple hierarchical regressions were used to determine the roles of attachment and caregiving experiences in cancer care on FCR, including the possible moderating role of attachment on the relationship between caregiving experiences and FCR.ResultsParticipants (n = 82), mostly identified as white men, had post‐secondary education and incomes of over $100,000 CAD, and cared for patients with advanced ovarian cancer. Forty percent of participants had clinically elevated FCR. Among the evaluated caregiving experiences in cancer care, caregiving workload (r = 0.33; p = 0.005), needing more help from healthcare providers (r = 0.28; p = 0.02), and lacking time for social relations because of caregiving (r = 0.47; p < 0.001) correlated with FCR. Attachment anxiety correlated significantly with FCR (r = 0.43; p < 0.001), but attachment avoidance did not. Attachment anxiety (ΔR2 = 0.14; p = 0.002) and lacking time for social relations (ΔR2 = 0.18; p < 0.001) contributed to the variance on FCR. Attachment insecurity did not moderate the relationships between caregiving experiences and FCR.ConclusionsPartner‐caregiver attachment anxiety correlates with FCR; however, this does not influence FCR's relationship with poorer perceived support from cancer care institutions. Partner‐caregivers may benefit from psychotherapies for FCR and more practical support from cancer care teams.