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Dr. Michelle Lobchuk
Dr. Michelle Lobchuk
NCIC Research Scientist
Psychosocial Oncology and Cancer Nursing Research
Research Focus
Dr. Lobchuk’s theory-driven approach consists of a series of studies that will provide sufficient information to inform an intervention that enhances informal caregivers’ or support persons’ empathic process of perspective-taking and accurate understanding of patients’ symptoms, treatment decision-making, and goal setting by cancer patients, including those diagnosed with lung cancer. Her research program is supported by a CCS/NCIC Research Scientist Award and a three-year Establishment Grant awarded by the Manitoba Health Research Council.
Why is this work important?
Dr. Lobchuk’s research program meets the growing demands of an evidence-based health care culture where researchers are encouraged to clearly define and test the effectiveness of theory-based interventions in meeting the needs of cancer patients and their informal caregivers.
About Michelle M. Lobchuk, RN, PhD
Michelle Lobchuk earned her RN diploma from the Health Sciences Centre, Winnipeg, and went on to complete bachelor and master degrees in nursing at the University of Manitoba. Dr. Lobchuk received her Interdisciplinary PhD from the University of Manitoba followed by training in evidence based nursing practice. Dr. Lobchuk was appointed as Assistant Professor in the Faculty of Nursing in 2003. Her educational expertise is in teaching and mentoring in evidence based practice. She currently serves as a Research Affiliate with CancerCare Manitoba, Victoria General Hospital, and Centre of Aging at the University of Manitoba. Michelle currently serves on several local and national research committees including the Canadian Association of Nurses in Oncology, and the Victoria General Hospital, Winnipeg. She continues to be invited to participate in research journal clubs and to lecture on evidence based practice principles and related topics at various local and national events and conferences.
For more information, please contact:
Dr. Michelle Lobchuk
Phone. 204.474.7135
Fax. 204.474.7682
Email. Michelle_Lobchuk@umanitoba.ca
In Detail
Lung cancer stigma: Attributional effects on informal caregiver perspective-taking and accuracy outcomes on patient symptom experiences. Funded by the National Cancer Institute of Canada
Statement of the Problem: In light of extensive media coverage on the linkage between smoking and lung cancer, lung cancer is now being perceived as a stigmatized disease where the patient can experience negative reactions by friends and family caregivers. A small number of studies reported that family caregivers experience intense feelings of anger, worry, and fear as a result of blaming the patient, and perhaps even themselves, for engaging in a high risk behaviour such as smoking. As a result, communication patterns are reported to change where patients and caregivers may not share their fears and concerns with one another. However, patient- and caregiver–held illness attributions have not been explored in relation to help-intended communication or caregiver perspective-taking and perceptual accuracy on patient symptom experiences.
Aims: To explore the potential effects of patient and caregiver smoking history and illness attributions on caregiver perspective-taking and caregiver accuracy on patient symptom experiences. A secondary aim is to explore differences between patient and caregiver reports of their smoking history, illness attributions, perceptions of caregiver perspective-taking, and perceptions of patient symptom experiences.
Methods: A descriptive comparative study with a major correlational component to investigate the aforementioned relationships in a cohort of advanced stage lung cancer patients and their primary informal caregivers over a 36 month period.
Variables: The main criterion variables are caregiver perspective-taking activities as reported by the patient and the caregiver, and caregiver discrepancy scores on total, frequency, severity, and distress symptom experiences of the advanced lung cancer patient. The independent variables are patient- and caregiver-held illness attribution responses as represented by their “onset” (perceived control of cause for lung cancer) and “offset” (perceived control of disease progression) reactions.
Measures: Information will be collected from patients and their caregivers, and patient medical records to describe their socio-demographic characteristics, caregiving relationship, and smoking history. The Memorial Symptom Assessment Scale will capture their perceptions of the patient’s multidimensional symptom experiences over the past week. The patients and caregivers will also complete a series of 5-point Likert-type questions employed in health and social psychology research to capture ‘onset’ and ‘offset’ attribution-related reactions. The 20-item, 5-point Likert-type Caregiver Perspective-Taking Scale will be employed to capture patient and caregiver perceptions of the caregiver’s perspective-taking activities and tendencies in the caregiving relationship.
Data analysis: Descriptive analysis will include frequency distributions, means, standard deviations, percentages, and confidence intervals to describe the overall sample socio-demographics and illness-related variables, smoking history, caregiver relationship factors, onset and offset reactions, caregiver perspective-taking, and perceptions of patient symptom experiences. Internal consistency reliability of the Caregiver Perspective-Taking scale will be analyzed using Cronbach’s alpha coefficient. Bivariate correlational analysis will be used to determine the extent and direction of relationships. A series of regression models will be developed to determine which variables serve as best predictors of caregiver perspective-taking and caregiver accuracy on patient symptom experiences. Accuracy scores will be based on the absolute difference between patient and caregiver ratings on total, frequency, severity, and distress symptom experiences of patients. Non-parametric tests of differences and correlations for ordinal data will be employed to test relationships between patient and caregiver reports on smoking history, illness attribution reactions, caregiver perspective-taking, and perceptions of patient symptom experiences.
Relevance: The short-term impact of this study is to lay the groundwork in developing a profile of informal caregivers who are at risk for faulty assessments of lung cancer symptom experiences based on the potential effect of illness attributions held by patients and caregivers. The long-term impact is to develop interventions that target these high risk caregivers to improve their communication with lung cancer patients, enhance their understanding of patients’ symptom experiences, and optimize patient symptom management.Primary Care Oncology-New Emerging team (PC0-NET). Funded by the Canadian Institutes of Health Research.
CIHR New Emerging Team Grant- Access to Quality Cancer Care-“Colorectal Screening in Manitoba” “Primary Care Oncology-New Emergomg Team (PCO-Net)
Relevance, Innovation, and Advancement: Colorectal cancer (CRC) is the second leading cause of cancer death and cancer-related premature mortality in Canada. Although there is good evidence supporting the effectiveness of CRC screening, less than 15% of eligible Canadians currently undergoes any form of screening and many Canadians continue to present late with advanced and incurable disease. The traditional role of the family physician (FP) in cancer care has been limited to providing advice on cancer prevention and providing limited screening services. However, the lessons from breast cancer research have demonstrated that there are other potential roles that warrant study, including follow-up care after the acute treatment of colorectal cancer. The PCO-NET research program will explore methods to enhance quality in both CRC screening and the transfer of patient follow-up to primary care after cancer treatment. These goals are consistent with both CIHR and provincial research priorities. PCO-Net will focus on CRC because of the opportunities for impact on the quality of care specific to the provision of screening and follow-up in primary care for CRC.
Team Excellence: The research team is comprised of researchers from The Epidemiology Unit at CCMB, Cancer Nursing, Medicine, Primary Care Oncology, the Manitoba Centre for Health Policy and community agencies. It also includes policy makers, health services managers from CCMB as well as patient representatives.
Approach and Knowledge Translation: The team will use the highly respected participatory model of knowledge translation developed by The Need to Know Team at MCHP to ensure a collaborative linkage between the researchers and clinicians. This model of team function emphasizes capacity building, new knowledge creation, and the dissemination and application of the new knowledge.
Research Program: In year one the team will establish team function, build team cohesion and infrastructure, and initiate the first project which is to develop methods to use the administrative data housed in the Research Repository at the Manitoba Centre for Health Policy and the Manitoba Cancer Registry to measure quality indicators (for example variation by region of CRC screening rates) and other outcomes. This method will provide the team with essential tools for subsequent projects. In year two the team will measure baseline quality indicators with subsequent annual measures, and begin the qualitative project that will examine family function and its impact on health decision making, as well as identify barriers and facilitators to screening and primary care follow-up for CRC. This information will allow the team to generate new ways of addressing barriers and facilitators that will be examined in subsequent projects. In year three the team will explore and then pilot the most practical method of supporting primary care physicians in promoting CRC screening via interaction between the FP-patient dyad and Healthlinks-InfoSante, the provincial nurse-managed telephone call centre. The team will identify outcome measures derived from our administrative data. In year four the team will explore the transfer of follow-up care of CRC patients from the oncologist to the community based primary care provider by incorporating our understanding of the role of family and influential family members in follow-up interventions. The team will evaluate the patient and FP interventions drawing on outcome indicators from our administrative data linkages, and in-depth interviews.
Refereed Journals – Past Five Years
Zloty, A., Roger, K., & Lobchuk, M. (2011, September). A model for the development of caregiver networks. Accepted for publication in WORK: A Journal of Prevention, Assessment and Rehabilitation, 40(1).
Lobchuk, M., & Udod, S. (2011). Oncology Nurses’ perceptions of their relations with family members in an ambulatory cancer care setting: A mixed methods study. Accepted for publication in Canadian Oncology Nursing Journal.
Lobchuk, M. (2010). How lucky am I to be awarded a CANO grant! One part luck, major party strategy. CONJ, 20(4), 163. Invited
McClement, S., Lobchuk, M., Chochinov, H.M., & Dean, R. (2010). Broken covenant: health care aides’ experiences of the ethical in caring for dying seniors in a personal care home. The Journal of Clinical Ethics, 21(3), 201-211.
Urbanik, C., & Lobchuk, M. (2009). Encouraging family caregivers to “Step inside the patient’s shoes”. Home Healthcare Nurse: The VNAA Official Journal for Clinical Practice and Official Journal of the Home Healthcare Nurses Association, 27(4), 213-218.
Lobchuk, M.M., Murdoch, T., McClement, S.E., & McPherson, C. (2008). A dyadic affair: who’s to blame for causing and controlling the patient’s lung cancer? Cancer Nursing, 31(6), 435-443.
Lobchuk, M.M., & Bokhari, S.A. (2008). What is the impact of empathic behaviour of informal caregivers on physical symptoms and psychological distress by ovarian cancer patients? Oncology Nursing Forum, 35(5), 808-814.
Lobchuk, M.M., McClement, S.E., McPherson, C., Cheang, M. (2008). Does blaming the lung cancer patient impact the helping behavior of primary support persons? Oncology Nursing Forum, 34(4), 681-689.
McPherson, C.J., Wilson, K.G., Lobchuk, M.M., & Brajtman, S. (2008) Family caregivers’ assessment of symptoms in patients with advanced cancer: Reliability and factors affecting accuracy. Journal of Pain & Symptom Management, 35(1), 70-82.
McPherson, C.J., Wilson, K.G., Lobchuk, M.M., & Brajtman, S. (2007) Self-perceived burden to others: Patient and family caregiver correlates. Journal of Palliative Care, 23(3), 135-142.
Lobchuk, M.M., McClement, S.E., Daeninck, P., & Elands, H. (2007). Caregiver thoughts and feelings in response to different perspective-taking prompts. Journal of Pain and Symptom Management, 33(4), 420-433.
Lobchuk, M.M., McClement, S.E., Daeninck, P., Shay, C., & Elands, E. (2007). Asking the right question of informal caregivers about patient symptom experiences: Proxy perspectives and reducing inter-rater gap. Journal of Pain and Symptom Management, 33(2), 130-145.
In preparation, submitted, under review
McPherson, C., Lobchuk, M., & McClement, S.E. (2011). Cigarette smoking and illness attributions in lung cancer. Manuscript in preparation for submission to Journal of Behavioral Medicine.
Lobchuk, M., McPherson, C., & McClement, S.E., & Cheang, M. (2010). A comparison of patient and family caregiver prospective control over lung cancer. Manuscript submitted to the Journal of Advanced Nursing.
Lobchuk, M., McPherson, C., & McClement, S.E., & Cheang, M. (2010). Impact of patient smoking behavior on empathic helping by family caregivers in lung cancer: Final results. Manuscript under review in Oncology Nursing Forum.
Avery, L., & Lobchuk, M. (2010). A conceptual map – gaining an understanding of tensions for evidence informed practice. Manuscript in preparation.
Hansen, F., Lobchuk, M., Clarke, D., & Richman-Eisenstate, J. (November 2010). Does empathy differ between patients and caregivers with smoking or non-smoking related illnesses. Manuscript in preparation for submission to Oncology Nursing Forum.
Lobchuk, M., & Urbanik, C. (2010). Predictors of empathic communication and understanding by support persons on psychological distress along the trajectory of advanced stage lung cancer. In preparation for publication.
Abstracts Accepted (Refereed Conference Proceedings) – Recent
Lobchuk, M., McClement, S., & McPherson, C. (2009). Do moral judgments, blame, and anger affect the empathic behavior of family caregivers towards their loved one who has lung cancer? Abstract accepted for presentation at the 13th World Conference on Lung Cancer, July 31 to August 4, 2009, San Francisco, CA.
McPherson, C., Wilson, K.G., Lobchuk, M.M., & Brajtman, S. (2009). Factors affecting agreement between patients and their family caregivers on cancer symptom experiences. Abstract accepted for presentation at the 11th European Association for Palliative Care (EAPC) Congress, May 7 to 10, 2009, Vienna, Austria.
McPherson, C., Hadjistavropoulos, T., & Lobchuk, M. (2009). Pain assessment and management in the home: Perspectives of older patients with advanced cancer and their family caregivers. Abstract accepted for presentation at the 11th European Association for Palliative Care (EAPC) Congress, May 7 to 10, 2009, Vienna, Austria.
Research Awards
2004-2010, National Cancer Institute of Canada (NCIC), Canadian Cancer Society (CCS) CCS Research Scientist Award ($342,878)
2010, College of Registered Nurses of Manitoba, 2010 Excellence in Professional Nursing Award
2009, CANO/Pfizer Excellence in Nursing Research Award, Canadian Association of Nurses in Oncology, Excellence Committee
2009, Winnipeg RH Foundation Award for Outstanding Contributions to Scholarship and Research in Health Sciences category, Office of the Vice-President (Research) University of Manitoba ($10,000.00)
Funds for PhD Studies
1998 to 2002 National Cancer Institute of Canada – Terry Fox Research Studentship (July 1998 to September 2002)
Declined:
1) Canadian Cancer Society-Maurice Legault Clinical Cancer Nursing Fellowship;
2) Social Sciences and Humanities Research Council of Canada (SSHRC) – Doctoral Fellowship;
3) Manitoba Health Research Council (MHRC) – Studentship Award
Grants and Contracts (Currently Funded):
McPherson, C.J., & Lobchuk, M. “The responsive care relationships: Examining dyadic dynamics between care recipients with cancer and their partner caregivers”; The University of Ottawa, Department of Health Sciences, Research Development Fund. Dec 01, 2010 – Dec 31, 2011. Amount Awarded: $10,000.00.
Raina, P. (P.I), Wolfson, C., & Kirkland, S. (Co-P.I.s), Lobchuk, M. (Co-investigator, Manitoba CLSA team) the “Canadian Longitudinal Study on Aging”(CLSA); 135 Co-inv. Across Canada CIHR funding ($23,500,000) for Operational funds and CFI to fund Infrastructure ($25 million). April 01, 2009 – Mar 31, 2014.
Lobchuk, M., & McClement, S. “Internet Support Community for Individuals Affected by Lung Cancer: Discussion Content and Implications for Health Care Providers.” The Canadian Lung Association; Amount requested: $15,699 (one year). July 01, 2009 – Sept 30, 2011. (ext)
Harding, G., Czaykowsi, P., Lobchuk, M., Johnston, P. “Developing and Testing a Family Resource Tool for Non-Small Cell Lung Cancer: Phase I & II”. Letter of intent accepted (January 19, 2009). Cancer Care Manitoba Research Foundation (Awarded funds: $25,000.00). July 01, 2009 – July 31, 2011. (ext)
Allan Katz (PI), Michelle Lobchuk, Pat Martens, Donna Turner (Co-PIs) CIHR New Emerging Team Grant – Access to Quality Cancer Care – “Colorectal Screening in Manitoba”. “Primary Care Oncology – New Emerging Team (PCO-NET).” ($1,483,191). April 01, 2007 – April 30, 2010.
Grants and Contracts (Past):
Lobchuk, M., Udod, S., & Loiselle,C.” A pilot study of oncology nurses’ perceptions of their relations with family members within a cancer care setting?” Submitted to CANO (Awarded funds: $5,000.00). September 01, 2008 – November 30, 2010.
Michelle Lobchuk (PI),Christine McPherson, and Susan McClement (Co-investigators). “Lung cancer stigma: Attributional effects on informal caregiver perspective-taking and accuracy outcomes on symptom experiences.” National Cancer Institute of Canada, Operating Grant ($204,592). July 01, 2005 – December 31, 2010. (no cost extension)
Jones, J.M. (PI), Blacker, S.,Cohen, R., Lobchuk, M., Rodin, G., & Zimmerman, C. “Feasibility study to test the impact of an intervention to promote patient and family caregiver congruence on quality of life and symptoms ratings.” Awarded funds: $20,000 from an NCIC, Sociobehavioral Cancer Research Network Grant. July 01, 2008 – July 31, 2009.
McPherson, C. (PI), Hadjistavropoulos T., & Lobchuk, M. “Pain perceptions, assessment and management in the home: Perspectives of older patients with advanced cancer and their family caregivers”. (Awarded funds: $18,284.17 from a CIHR Team Grant on Pain Management in the Aged, PI: Hadjistavropoulos T.). September 01, 2007 – September 30, 2009.
Michelle Lobchuk (PI) “Enhancing family caregiver communication competence in the monitoring and interpreting of cancer patient symptom experiences”. Manitoba Health Research Council, Establishment Grant,($74,536). July 01, 2004 – December 31, 2008 (extension).
McClement, S.E., Chochinov, H.M., Lobchuk, M., and Dean, R. “A phenomenological study of health care aides’ experiences of the ethical in caring for dying patients in a personal care home.” Operating grant submitted to CIHR ($39,538). March 01, 2007 – February 28,2008
Allan Katz (PI), Michelle Lobchuk, Pat Martens, Donna Turner (Co-PIs) CIHR New Emerging Team Grant – Access to Quality Cancer Care – “Colorectal Screening in Manitoba”. “Primary Care Oncoogy – New Emerging Team (PCO-NET).” ($7,876). Accepted Letter of Intent: April 1, 2006; Full application: November 2006.
Michelle Lobchuk (Principal Investigator), Susan McClement, and Paul Daeninck (Co-investigators). “What do family caregivers think and feel when they are induced to perspective-take on cancer patients’ symptom experiences?”. Canadian Institutes of Health Research ($35,515 declined). March 01, 2004 – March 31, 2005.
Michelle Lobchuk (Principal investigator), Susan McClement and Paul Daeninck (Co-investigators). “What do family caregivers think and feel when they are induced to perspective-take on cancer patients’ symptom experiences?”. National Cancer Institute of Canada ($35,515). July 01, 2004 – October 31, 2005.
Michelle Lobchuk (Principal investigator), Jacquie Vorauer, and Lesley Degner (Co-investigators). “Induced perspective-taking: Assisting family caregivers to achieve enhanced perceptual accuracy on lung cancer patient symptom experiences”. Canadian Nurses’ Respiratory Society/Canadian Lung Association Grant, ($30,000). August 01, 2003 – July 31, 2004.
Christine McPherson (Principal Investigator), Keith Wilson, Michelle Lobchuk, and Susan Brajtman (Co-investigators).“Family caregivers’ recognition of cancer patients’ symptoms at the end of life.” Supported by funds from the CIHR New Emerging Team In Palliative Care for Seniors ($20,000). April 01, 2004 – April 30, 2005.
Christine McPherson (Principal Investigator),Keith Wilson, Michelle Lobchuk, and Susan Brajtman (Co-investigators). “Family caregivers’ recognition of cancer patients’ symptoms at the end of life.” Supported by funds from the NCIC Sociobehavioural Cancer Research Network ($10,000). April 01, 2004 – May 31, 2005.
Grant Applications – Pending
Lobchuk, M. (P.I.) & Rosenberg, F. (co-investigator), “An exploration of older adult and family caregiver empathic responding to post-stroke urinary incontinence quality of life: A pilot study”. Riverview Health Centre grant. Funding request: $15,000 for one year. (Duplication of grant submission to Centre of Aging cited below). February 01, 2011 – February 28, 2012.
Holtslander, L (P.I.), Lobchuk, M. Co-inv.). “Aging and Bereavement” CIHR Catalyst Grant: Pilot Projects in Aging. CIHR Funding Request: $50,000 for one year.
There are no opportunities available at this time.