Hostname: page-component-78c5997874-94fs2 Total loading time: 0 Render date: 2024-11-12T22:23:37.022Z Has data issue: false hasContentIssue false

Informal caregivers of older Muslims diagnosed with cancer: A portrait of depression, social support, and faith

Published online by Cambridge University Press:  21 June 2021

Lea Baider
Affiliation:
Assuta Medical Center, Oncology Institute, Tel-Aviv, Israel
Gil Goldzweig*
Affiliation:
School of Behavioral Sciences, Tel-Aviv-Yaffo Academic College, Tel-Aviv, Israel
Jeremy M. Jacobs
Affiliation:
Geriatrics and Geriatric Rehabilitation Department, Hadassah University Hospital, Jerusalem, Israel
Ibtisam M. Ghrayeb
Affiliation:
Pediatric Intensive Care Unit (PICU), Makassed Hospital, East Jerusalem, Palestine, Israel
Eli Sapir
Affiliation:
Radiation Oncology Department, Samson Assuta Ashdod University Hospital, Ashdod, Israel
Yakir Rottenberg
Affiliation:
School of Behavioral Sciences, Tel-Aviv-Yaffo Academic College, Tel-Aviv, Israel Sharett Oncology Institute, Hadassah University Hospital, Jerusalem, Israel
*
Author for correspondence: Gil Goldzweig, Yasmin 3a Street, Mazkeret-Batya, Israel. E-mail: [email protected]

Abstract

Objective

Islamic population constitute more than 20% of the world population and is growing rapidly. Nevertheless, data concerning informal caregiving to older Muslim patients diagnosed with cancer are scarce. Improving the well-being of caregivers is a vital step to optimal care for the patients themselves throughout the Muslim community and the world. This study focuses on a sample of Palestinian caregivers of older Muslim patients diagnosed with cancer living in East Jerusalem, the West Bank, and Gaza. The study aims to describe the socio-demographic characteristics of the caregivers and to understand their social support, and identify predictors of caregivers’ depression.

Methods

A cross-sectional study of a convenience sample of 99 dyads of Palestinian patients (age ≥65) and their informal caregivers. Depression and social support were measured using the five items of the Geriatric Depression Scale and the Cancer Perceived Agents of Social Support questionnaire.

Results

Caregivers were most frequently adult children (52%) or spouses (32%), with male patients cared for by spouses (47.5%) or sons (32%), and female patients by daughters (50%). Clinical levels of depression were reported by 76% of the caregivers and 85% of patients. The significant predictors of caregiver depression were female gender, lower education, lower perceived social support from spouse and family, and higher perceived support from faith.

Significance of results

Healthcare providers serving the study population should determine the position and role of the caregiver within the social and family structure surrounding the patients’ families. This understanding may facilitate overcoming barriers to effective and meaningful social support.

Type
Original Article
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Abdullah, R, Guo, P and Harding, R (2020) Preferences and experiences of Muslim patients and their families in Muslim-majority countries for end-of-life care: A systematic review and thematic analysis. Journal of Pain and Symptom Management 60(6), 12231238.e4.CrossRefGoogle ScholarPubMed
Abu-Rmeileh, NME, Gianicolo, EAL, Bruni, A, et al. (2016) Cancer mortality in the West Bank, Occupied Palestinian Territory. BMC Public Health 16, 76. doi:10.1186/s12889-016-2715-8.CrossRefGoogle ScholarPubMed
Almutairi, KM, Alodhayani, AA, Alonazi, WB, et al. (2017) Assessment of health-related quality of life among caregivers of patients with cancer diagnosis: A cross-sectional study in Saudi Arabia. Journal of Religion and Health 56(1), 226237.CrossRefGoogle ScholarPubMed
Al-Quds University Hospitals (2018) https://www.alquds.edu/en (retrieved October 22).Google Scholar
Alsirafy, SA, Abdel-Kareem, SS, Ibrahim, NY, et al. (2017) Cancer diagnosis disclosure preferences of family caregivers of cancer patients in Egypt. Psycho-Oncology 26(11), 17581762. doi:10.1002/pon.4206.CrossRefGoogle ScholarPubMed
Alzahrani, AS, Alqahtani, A, Alhazmi, M, et al. (2018) Attitudes of cancer patients and their families toward disclosure of cancer diagnosis in Saudi Arabia: A Middle Eastern population example. Patient Preference and Adherence 12, 1659.CrossRefGoogle ScholarPubMed
Arian, M, Younesi, SJ and Khanjani, MS (2017) Explaining the experiences and consequences of care among family caregivers of patients with cancer in the terminal phase: A qualitative research. International Journal of Cancer Management 10, 10.CrossRefGoogle Scholar
Atout, MM and Carter, B (2020) Communication styles between family carers and children with leukaemia in occupied Palestinian territory. Journal of Child Health Care. https://doi.org/10.1177/1367493520949318.Google ScholarPubMed
Attum, B, Hafiz, S, Malik, A, et al. (2021) Cultural Competence in the Care of Muslim Patients and Their Families. In StatPearls. StatPearls Publishing.Google ScholarPubMed
Banning, M and Tanzeem, T (2013) Managing the illness experience of women with advanced breast cancer: Hopes and fears of cancer-related insecurity. European Journal of Cancer Care 22(2), 253260.CrossRefGoogle ScholarPubMed
Banning, M and Tanzeen, T (2014) Living with advanced breast cancer: Perceptions of Pakistani women on life expectations and fears. Cancer Nursing 37(1), E12E18. doi:10.1097/NCC.0b013e318279e479.CrossRefGoogle ScholarPubMed
Bertogg, A and Strauss, S (2020) Spousal care-giving arrangements in Europe. The role of gender, socio-economic status and the welfare state. Ageing & Society 40(4), 735758.CrossRefGoogle Scholar
Charlson, ME, Pompei, P, Ales, KL, et al. (1987) A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. Journal of Chronic Diseases 40(5), 373383.CrossRefGoogle ScholarPubMed
Çıracı, Y, Nural, N and Saltürk, Z (2016) Loneliness of oncology patients at the end of life. Supportive Care in Cancer 24(8), 35253531.CrossRefGoogle ScholarPubMed
de Graaff, FM, Mistiaen, P, Deville, WL, et al. (2012) Perspectives on care and communication involving incurably ill Turkish and Moroccan patients, relatives and professionals: A systematic literature review. BMC Palliative Care 11, 17. doi:10.1186/1472-684X-11-17.CrossRefGoogle ScholarPubMed
De Zwart, P, Bakx, P and Van Doorslaer, E (2017) Will you still need me, will you still feed me when I'm 64? The health impact of caregiving to one's spouse. Health Economics 26, 127138.CrossRefGoogle ScholarPubMed
Elsaman, RS and Arafa, MA (2012) The rights of the elderly in the Arab Middle East: Islamic theory versus Arabic practice. Marquette Elder's Adviser 14, 1.Google Scholar
East Jerusalem Hospital Network: Supporting Patient Safety and Quality Care (2019). WHO Regional Office for the Eastern Mediterranean. (retrieved October 22).Google Scholar
Goldzweig, G, Hasson-Ohayon, I, Meirovitz, A, et al. (2010) Agents of support: Psychometric properties of the Cancer Perceived Agents of Social Support (CPASS) questionnaire. Psycho-Oncology 19(11), 11791186. doi:10.1002/pon.1668.CrossRefGoogle ScholarPubMed
Goldzweig, G, Baider, L, Andritsch, E, et al. (2017) A dialogue of depression and hope: Elderly patients diagnosed with cancer and their spousal caregivers. Journal of Cancer Education 32(3), 549555. doi:10.1007/s13187-015-0975-0.CrossRefGoogle ScholarPubMed
Goldzweig, G, Baider, L, Rottenberg, Y, et al. (2018a) Is age a risk factor for depression among the oldest old with cancer? Journal of Geriatric Oncology 9(5), 476481. doi:10.1016/j.jgo.2018.03.011.CrossRefGoogle Scholar
Goldzweig, G, Schapira, L, Baider, L, et al. (2018b) Who will care for the caregiver? Distress and depression among spousal caregivers of older patients undergoing treatment for cancer IPOS 2018. In: The 20th World Congress of Psycho-Oncology and Psychosocial Academy. Hong Kong: School of Public Health, The University of Hong Kong.Google Scholar
Goldzweig, G, Schapira, L, Baider, L, et al. (2019) Who will care for the caregiver? Distress and depression among spousal caregivers of older patients undergoing treatment for cancer. Supportive Care in Cancer 27(11), 42214227.doi:10.1007/s00520-019-04711-6.CrossRefGoogle ScholarPubMed
Guerin, JM, Copersino, ML and Schretlen, DJ (2018) Clinical utility of the 15-item geriatric depression scale (GDS-15) for use with young and middle-aged adults. Journal of Affective Disorders 241, 5962. doi:10.1016/j.jad.2018.07.038.CrossRefGoogle Scholar
Gustafson, C and Lazenby, M (2019) Assessing the unique experiences and needs of Muslim oncology patients receiving palliative and end-of-life care: An integrative review. Journal of Palliative Care 34(1), 5261.CrossRefGoogle Scholar
Halahleh, K and Gale, RP (2018) Cancer care in the Palestinian territories. The Lancet Oncology 19(7), e359e364. doi:10.1016/S1470-2045(18)30323-1.CrossRefGoogle ScholarPubMed
Hallit, S, Hallit, R, Boulos, C, et al. (2017) Validation of the Arabic geriatric depression scale (GDS-5) among the Lebanese geriatric population. Journal of Psychopathology-Giornale di Psicopatologia 23(2), 8790.Google Scholar
Hasnain, R and Rana, S (2010) Unveiling Muslim voices: Aging parents with disabilities and their adult children and family caregivers in the United States. Topics in Geriatric Rehabilitation 26(1), 4661.CrossRefGoogle Scholar
Hoerger, M and Cullen, BD (2017) Early integrated palliative care and reduced emotional distress in cancer caregivers: Reaching the “hidden patients”. Oncologist 22(12), 14191420. doi:10.1634/theoncologist.2017-0432.CrossRefGoogle ScholarPubMed
Hoyl, MT, Alessi, CA, Harker, JO, et al. (1999) Development and testing of a five-item version of the geriatric depression scale. Journal of the American Geriatrics Society 47(7), 873878.CrossRefGoogle ScholarPubMed
Kent, EE, Rowland, JH, Northouse, L, et al. (2016) Caring for caregivers and patients: Research and clinical priorities for informal cancer caregiving. Cancer 122(13), 19871995.CrossRefGoogle ScholarPubMed
Khalil, RB (2013) Attitudes, beliefs and perceptions regarding truth disclosure of cancer-related information in the Middle East: A review. Palliative & Supportive Care 11(1), 69.CrossRefGoogle Scholar
Kristjanson, LJ and Aoun, S (2004) Palliative care for families: Remembering the hidden patients. Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie 49(6), 359365. doi:10.1177/070674370404900604.CrossRefGoogle ScholarPubMed
Mobeireek, A, Al-Kassimi, F, Al-Zahrani, K, et al. (2008) Information disclosure and decision-making: The Middle East versus the Far East and the West. Journal of Medical Ethics 34(4), 225229.CrossRefGoogle ScholarPubMed
Northouse, LL, Katapodi, MC, Song, L, et al. (2010) Interventions with family caregivers of cancer patients: Meta-analysis of randomized trials. CA: A Cancer Journal for Clinicians 60(5), 317339. doi:10.3322/caac.20081.Google ScholarPubMed
Northouse, LL, Katapodi, MC, Schafenacker, AM, et al. (2012) The impact of caregiving on the psychological well-being of family caregivers and cancer patients. Seminars in Oncology Nursing 28(4), 236245. doi:10.1016/j.soncn.2012.09.006.CrossRefGoogle ScholarPubMed
Ornstein, KA, Wolff, JL, Bollens-Lund, E, et al. (2019) Spousal caregivers are caregiving alone in the last years of life. Health Affairs (Millwood) 38(6), 964972. doi:10.1377/hlthaff.2019.00087.CrossRefGoogle ScholarPubMed
Ozdogan, M, Samur, M, Bozcuk, HS, et al. (2004) “Do not tell”: What factors affect relatives’ attitudes to honest disclosure of diagnosis to cancer patients? Supportive Care in Cancer 12(7), 497502.CrossRefGoogle ScholarPubMed
Padela, AI, Killawi, A, Forman, J, et al. (2012) American Muslim perceptions of healing: Key agents in healing, and their roles. Qualitative Health Research 22(6), 846858.CrossRefGoogle ScholarPubMed
Report on Al Makassed Hospital (2013) Israeli Ministry of Health. Available at: https://www.health.gov.il/PublicationsFiles/AL_MAKSAD_11122013.pdf (retrieved October 22).Google Scholar
Sherif, T, Jehani, T, Saadani, M, et al. (2001) Adult oncology and chronically ill patients: Comparison of depression, anxiety and caregivers’ quality of life. Eastern Mediterranean Health Journal = La Revue de Sante de la Mediterranee Orientale = al-Majallah al-Sihhiyah li-Sharq al-Mutawassit 7(3), 502509.Google ScholarPubMed
Soylu, C, Ozaslan, E, Karaca, H, et al. (2016) Psychological distress and loneliness in caregiver of advanced oncological inpatients. Journal of Health Psychology 21(9), 18961906.CrossRefGoogle ScholarPubMed
Tanriverdi, O, Yavuzsen, T, Turhal, S, et al. (2016) Depression and socio-economical burden are more common in primary caregivers of patients who are not aware of their cancer: TURQUOISE study by the Palliative Care Working Committee of the Turkish Oncology Group (TOG). European Journal of Cancer Care 25(3), 502515. doi:10.1111/ecc.12315.CrossRefGoogle Scholar
Wadhwa, D, Burman, D, Swami, N, et al. (2013) Quality of life and mental health in caregivers of outpatients with advanced cancer. Psycho-Oncology 22(2), 403410. doi:10.1002/pon.2104.CrossRefGoogle ScholarPubMed
Weeks, SK, McGann, PE, Michaels, TK, et al. (2003) Comparing various short-form Geriatric Depression Scales leads to the GDS-5/15. Journal of Nursing Scholarship 35(2), 133137.CrossRefGoogle Scholar
Worth, A, Irshad, T, Bhopal, R, et al. (2009) Vulnerability and access to care for South Asian Sikh and Muslim patients with life limiting illness in Scotland: Prospective longitudinal qualitative study. BMJ 338, b183. doi:10.1136/bmj.b183.CrossRefGoogle ScholarPubMed
Ypinazar, VA and Margolis, SA (2006) Delivering culturally sensitive care: The perceptions of older Arabian Gulf Arabs concerning religion, health, and disease. Qualitative Health Research 16(6), 773787.CrossRefGoogle ScholarPubMed