PSYC2102 Temple University Effects of Caregiving on Cancer Caregivers Paper

PSYC2102 Temple University Effects of Caregiving on Cancer Caregivers Paper PSYC2102 Temple University Effects of Caregiving on Cancer Caregivers Paper I’m working on a Writing question and need guidance to help me study. This short paper (about five pages, not including title page and references) should explore psychological ideas, and include five references (texts not included). use the 5 attached sources to explain my topic, an attached sample paper for an example psyc2102_sample_final_paper.doc article_1_cancer.pdf article_2_cancer.pdf article_3_cancer.pdf article_4_cancer.pdf article_5_cancer.pdf ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS Running head: TELEPSYCHOLOGY 1 Telepsychology: A Double Edged Sword As technology continues to expand in this modern world, so too must the offerings of the field of psychology. Not only are psychologists expected to meet the evolving needs of the client of the 21st century, vague ethical guidelines must be strictly followed. According to Gerald Koocher, and as quoted during his American Psychological Association (APA) TELEPSYCHOLOGY 2 presidential address, telepsychology “remains one of the most rapidly evolving areas of professional practice, and one of the ripest areas for clinical research” (2007). Several studies have been performed in the field of telepsychology, illuminating findings based on various modalities of telepsychology, as well as their perceived quality of these remote encounters (Rees & Haythornthwaite, 2004; Morgan et al, 2008; Rees & Stone, 2005) and the perception of the laws that govern telepsychology (Koocher & Morray, 2000; Barnett & Scheetz, 2003). As technology marches onward, so too do the offerings in the field of psychology. As psychology, the human science, is moving towards this less personal experience, the ethics of offering services through this modality is questioned. Besides concerns of privacy, confidentiality, and governing local laws, is telepsychology a high-quality addition to the field? New technology brings new concerns, but at the core telepsychology must be just as therapeutic as in-person sessions before it can be adopted as a practitioner’s tool (Derrig-Palumbo and Zeine, 2005). It is hypothesized that the most important aspect of telepsychology being therapeutic is the perception of the quality received, as well as the strength of the client-therapist relationship as perceived through telepsychologic means. The following literature reviews attempt to support this hypothesis. Literature Review As indicated by Gerald Koocher (2007) during the 2006 APA presidential address, the future of psychology rests firmly in the hands of telepsychology. Not only must the psychologists of the future embrace this new technology, it must be done carefully, in order to maintain beneficence and nonmaleficence. Further, extra caution must be exercised as the TELEPSYCHOLOGY 3 practitioner in order to avoid unnecessary legal or ethical risks. Koocher illustrates the planned vagueness of the current ethical principles and standards, stating that the ethical codes and standards do not prohibit services of telepsychology. A main point made by Koocher is that if future psychologists are to expand services through means of remote delivery, psychologists must maintain competence in those new arenas. Failure to do so will not result in a therapeutic relationship (Koocher, 2007). Taking the concept of forming a therapeutic alliance further, psychologists Clare Rees and Sheona Stone tested samples of practicing clinical psychologists to see if the psychologist’s own perception of the “therapeutic alliance” was altered based on the method of therapeutic delivery, thereby impacting the quality offered, rather than received (2005). Their research indicated that there was a significant difference in the perception of the therapeutic alliance as determined by the method of therapeutic delivery, finding that the psychologist’s own perception of quality of the relationship was much lower in the videoconferenced sample, as compared to the traditional method of therapy. Rees and Stone noted that less than 1% of all psychologists in the United States have used videoconferencing or other methods of telepsychology, but more than 68% have used the telephone in practice. Rees and Stone believe this incongruence is due to comfort with alternative therapy methods, or comfort level with using the new technology (2005). Other studies have been performed, focusing on the perception of the therapeutic quality by the client, rather than the clinician. This study compared the perception of quality of therapeutic services received and was delivered through two modalities: video teleconferencing, or face-to-face (traditional) therapy. PSYC2102 Temple University Effects of Caregiving on Cancer Caregivers Paper Sessions were matched on multiple factors, including length, content, and tone. The researchers indicated that the clients’ perception of quality was TELEPSYCHOLOGY 4 not statistically different between the treatment conditions; clients found similar levels of satisfaction, quality, and connection to the therapist in both groups. This study, as performed by Robert Morgan and Amber Patrick of Texas Tech University, warrants further research as the results are only generalizable to the population selected: incarcerated male inmates, required to participate in treatment. While the findings do show promise and a possibility of wider generalization, these results are limited strictly to the population tested (2008). In an attempt to increase use of videoconferencing technology as a therapeutic tool, psychologists Rees and Haythornthwaite created specific guidelines to increase levels of comfort for both the therapist, as well as the client. Of common concern for both the therapist and the client is anxiety borne from using the new technology, a decreased amount of feedback, and more passivity by the participants of the teleconferenced session. Rees and Haythornthwaite hypothesized that the perception of these concerns negatively impacts the quality of the session at the outset. Rees and Haythornthwaite have suggested that both therapist and client would become more comfortable with the new technology by simply using it more frequently, indicating that frequency of use greatly reduces anxiety. Noted areas of concern include the legalities of delivering treatment over large distances, specifically across state lines. Rees and Haythornthwaite recommend intimate knowledge of the laws that govern both locations in order to avoid possible infractions, as well as maintenance of governing ethical standards and principles. Rees and Haythornthwaite note that with the introduction of new technologies comes new problems. In this instance, some issues of concern may be equipment failure, or ensuring that there is a local mental health professional contact available for the client, should an emergency arise. The latter concern is somewhat paradoxical, as telepsychology is being touted TELEPSYCHOLOGY 5 as a means to deliver services to those far removed from traditional therapists, among other reasons (2004). These factors from the aforementioned studies and articles combine to lend credibility to the hypothesis that perception is key in determining a quality therapeutic experience when receiving therapy through means other than in-person interaction. Therefore, perception of both the strength of the client-therapist relationship, as well as the quality of therapeutic services received will impact the overall reported therapeutic benefit of the session. While prior studies have measured various aspects of the quality of telepsychology, the results have been for a specific population and did not include females, adolescents, children, or others not presently enrolled in a corrections facility. Further, most of the published studies used “wait-list” procedures, rather than in-person therapy as a control group (Koocher, 2007). This research is warranted by a lack of information pertaining to “average” people, voluntarily seeking counseling. To better understand these results on the population at large, a more diverse base of participants must be sampled and measured. References Barnett, J. E., & Scheetz, K. (2003). Technological advances and telehealth: Ethics, law, and the practice of psychotherapy. Psychotherapy: Theory, Research, Practice, Training, 40, 86– 93. TELEPSYCHOLOGY 6 Derrig-Palumbo, K., & Zeine, F. (2005). Online therapy: A therapist’s guide to expanding your practice. New York: W.W. Norton. Koocher, G.P. (2007). APA presidential address: Twenty-first century ethical challenges for psychology. American Psychologist. 62, 375-384. Koocher, G.P., & Morray, E (2000). Regulation of telepsychology: A survey of State Attorneys General. Professional Psychology: Research and Practice. 31, 503-508. Morgan, R.D., Patrick, A.R., & Magaletta, P.R. (2008). Does the use of telemental health alter the treatment experience? Inmates’ perceptions of telemental health versus face-to-face treatment modalities. Journal of Consulting and Clinical Psychology. 76, 158-162. Rees, C. S., & Haythornthwaite, S. (2004). Telepsychology and videoconferencing: Issues, opportunities, and guidelines for psychologists. Australian Psychologist. 39, 212-219. Rees, C.S., & Stone, S. (2005). PSYC2102 Temple University Effects of Caregiving on Cancer Caregivers Paper Therapeutic alliance in face-to-face versus videoconferenced psychotherapy. Professional Psychology: Research and Practice. 36, 649-653. Seligman, M.E.P. (1995).The effectiveness of psychotherapy: The Consumer Reports study. American Psychologist. 50, 965-974. Received: 10 May 2018 Revised: 1 August 2018 Accepted: 5 August 2018 DOI: 10.1002/pon.4859 PAPER Delivering problem?solving therapy to family caregivers of people with cancer: A feasibility study in outpatient palliative care | George Demiris2 Karla T. Washington1 Kevin W. Craig1 | Paul Tatum1 | Debra Parker Oliver1 | David L. Albright3 | 1 Department of Family and Community Medicine, University of Missouri, Columbia, Missouri Abstract Objective: In response to the well?documented need for evidence?based cancer 2 School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania caregiver support, we examined the feasibility of problem?solving therapy for family 3 caregivers of cancer patients receiving outpatient palliative care and investigated School of Social Work, University of Alabama, Tuscaloosa, Alabama the impact of problem?solving therapy on family caregivers’ anxiety, depression, and Correspondence Karla T. Washington, PhD, Department of Family and Community Medicine, University of Missouri, MA306 Medical Sciences Building, DC032.00 Columbia, MO 65212. Email: [email protected] quality of life. Funding information National Cancer Institute, Grant/Award Number: R21CA191165 Participants (N = 83) were randomly assigned to receive usual care or usual care plus Methods: We conducted a feasibility study of a structured problem?solving therapy intervention delivered to family caregivers of cancer patients receiving outpatient palliative care from an academic health center in the Midwestern United States. a problem?solving therapy intervention, which was delivered over three sessions via web?based videoconferencing or telephone. Descriptive statistics were used to determine feasibility relative to recruitment, retention, and fidelity to core intervention components. Outcome data were analyzed using ordinary least squares multiple regression. Results: Problem?solving therapy for family caregivers of patients with cancer was found to be highly feasible in the outpatient palliative care setting. Caregivers who received problem?solving therapy reported less anxiety than those who received only usual care (P = 0.03). No statistically significant differences were observed for caregiver depression (P = 0.07) or quality of life (P = 0.06). Conclusions: Problem?solving therapy is a feasible and promising approach to reducing cancer family caregivers’ anxiety in the outpatient palliative care setting. Further testing in multiple sites is recommended. KEY W ORDS anxiety, cancer, caregivers, depression, family, oncology, problem solving, quality of life 1 | the home, often with little support or preparation.1,2 The numerous B A CKG R O U N D stressors associated with family caregiving for cancer patients are well In recent decades, the primary setting for cancer care has shifted from documented and include insufficient or problematic communication the hospital inpatient unit to the outpatient clinic, leaving family care- with health care providers, lack of skill needed to complete specific givers (FCGs) responsible for providing the majority of patient care in tasks (eg, administering medications and changing dressings), social 2494 © 2018 John Wiley & Sons, Ltd. wileyonlinelibrary.com/journal/pon Psycho?Oncology. 2018;27:2494–2499. WASHINGTON 2495 ET AL. isolation, and unavailability of necessary information.3 These stressors Specifically, we set out to achieve the following aims: (1) to examine can lead to anxiety, depression, fatigue, neglect of self?care, and, for the feasibility of PST for FCGs of cancer patients receiving outpatient particularly strained caregivers, psychological symptoms that mirror palliative care relative to recruitment, retention, and fidelity to core those experienced by trauma survivors.3,4 Early studies involving bio- intervention components; and (2) to investigate the impact of PST markers have also identified a physiological toll associated with cancer on FCGs’ anxiety, depression, and quality of life. Our corresponding caregiving stress, suggesting that highly stressed FCGs may be at hypotheses were (1) that PST could be feasibility delivered to FCGs increased risk for morbidity and mortality from certain diseases.PSYC2102 Temple University Effects of Caregiving on Cancer Caregivers Paper 5 The of cancer patients receiving outpatient palliative care and (2) that it extant literature is clear: Cancer caregiving often takes place in a would result in decreased caregiver anxiety and depression and highly stressful emotional and social context, leaving FCGs vulnerable improved quality of life. to significant, potentially long?lasting, adverse effects. 1.1 care | Family caregiver support in palliative oncology 2 METHODS | To achieve the aforementioned aims, we conducted a single?site ran- Palliative oncology, defined as “the integration into cancer care of domized clinical trial of a structured PST intervention for FCGs of peo- therapies to address the multiple issues that cause suffering for ple with cancer receiving outpatient palliative care. The University of 6 Missouri Health Sciences Institutional Review Board (IRB) reviewed Although commonly and approved all study activities (project no. 2002215). The study patients and their families and impact their quality of life,” explicitly 7-10 espouses a commitment to supporting FCGs. misunderstood to be limited to end?of?life care, in the United States was registered at clinicaltrials.gov (identifier: NCT02427490). palliative oncology is an interdisciplinary service available to patients and families across the full cancer trajectory. Research documenting the multiple benefits of early palliative care11 has led the American 2.1 | Participant recruitment Society of Clinical Oncology (ASCO) to recommend that many patients After securing IRB approval, we recruited study participants from the and families be offered palliative services concurrent with standard ambulatory palliative care clinic of an academic health center in the 12 as palliative Midwestern United States from October 2015 to February 2017. Cli- care can be provided either alongside interventions with a curative nicians provided an informational brochure to FCGs accompanying intent or as an alternative to disease?directed therapies. Although patients with cancer to the palliative care clinic and requested permis- most palliative oncology in the United States is presently provided sion to share their contact information with the research team. In oncologic care as early as the time of initial diagnosis, on an inpatient basis, it is increasingly being offered in outpatient addition, we placed study brochures in high?traffic clinical areas clinics,13 creating a potentially ideal opportunity to provide additional (eg, oncology waiting rooms and patient and family resource centers). support to FCGs in an effort to decrease their distress and improve The study research nurse reached out to interested FCGs via tele- their quality of life. However, palliative oncology teams wishing to phone or email to assess their eligibility and schedule a face?to?face capitalize on this opportunity are limited by the paucity of evidence? informational meeting at the clinic, the FCG’s home, or another agreed based interventions to support FCGs in general14 and in the outpa- upon location. During the informational meeting, FCGs read, discussed, and—if willing to participate—signed an informed consent tient palliative care setting in particular. document, retaining a copy for their personal records. Inclusion 1.2 | criteria required that participants were English?speaking adult FCGs Problem?solving therapy for FCGs of adult patients diagnosed with cancer who were receiving palliative Problem?solving therapy (PST) is a psychosocial intervention that aims care. Family caregivers included those individuals who provided signif- to enhance coping effectiveness for individuals facing stressors rang- icant, unpaid care to a person living with cancer; a biological or legal 15 The theoretical relationship was not required. In addition, participants were required framework underpinning PST is the relational/problem?solving model to have sufficient hearing (either naturally or with assistive devices) of stress,16 which conceptualizes psychological distress such as anxi- to allow their participation in a technologically?mediated intervention. ety and depression as the consequence of ineffective coping. The Individuals not receiving formal services from the specialty palliative model suggests that, by enhancing problem?solving ability, PST can care clinic were deemed eligible for participation if the patient for minimize the negative effects of stressful life events, leading to whom they provided care was receiving treatment with a palliative improved well?being (ie, decreased anxiety and depression and greater intent from the primary oncology team, as understood by the FCG. quality of life). Multiple FCGs per patient were allowed to enroll in the study. After ing from daily hassles to major traumatic events.PSYC2102 Temple University Effects of Caregiving on Cancer Caregivers Paper While prior studies have identified PST as a promising strategy to the FCG signed the informed consent document, the research nurse reduce distress and improve the quality of life of individuals opened a numbered sealed envelope, prepared in advance, revealing experiencing stressors associated with cancer caregiving,17-20 its feasi- whether the FCG had been randomly assigned to receive usual care bility and efficacy as a stand?alone intervention in outpatient palliative (Group 1) or usual care in addition to PST (Group 2). A CONSORT flow oncology settings remains unknown. Thus, in preparation for a large diagram21 summarizing participant recruitment and randomization is multisite trial, our research team sought to test the feasibility of a provided in Figure 1 (all participants were analyzed in their random- PST intervention for FCGs in the ambulatory palliative care setting. ized groups regardless of their duration in the study). 2496 WASHINGTON FIGURE 1 2.2 2.2.1 CONSORT flow diagram Study arms | | ET AL. applicable problem?solving techniques and to apply them to an acute caregiving stressor. Group 1: usual care Family caregivers randomized to Group 1 experienced no changes in the care they or their patient received due to their participation in 2.3 Study measures | the research study. For these individuals, usual care continued accord- 2.3.1 ing to each patient and family’s individualized treatment plan based on To measure progress toward recruiting and retaining an adequately previously established goals of care. While the specific constellation of large study sample, we established monthly recruitment and reten- services provided as part of usual care varied, services available to all tion goals (established by a priori power analysis, des … Purchase answer to see full attachment Student has agreed that all tutoring, explanations, and answers provided by the tutor will be used to help in the learning process and in accordance with Studypool’s honor code & terms of service . Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10

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