Caregiver Symptom Burden: The Risk of Caring for an Underserved Patient With Advanced Cancer

Cancer (Impact Factor: 4.89). 03/2011; 117(5):1070 - 1079. DOI: 10.1002/cncr.25695


BACKGROUND:The growing diversity of the population of the United States and the high burden of cancer-related symptoms reflect the need for caregiver research within underserved groups. In this longitudinal study, the authors assessed changes in symptom severity in caregivers and underserved minority patients diagnosed with advanced solid tumors who were being treated at public hospitals.METHODS:A total of 85 matched patient-caregiver dyads completed the M. D. Anderson Symptom Inventory 3 times during 20 weeks of chemotherapy. At each time point, symptom severity and interference with daily activities were assessed. Group-based trajectory modeling was used to classify caregivers into high-symptom or low-symptom burden groups.RESULTS:Sadness and distress were more prevalent among caregivers (P = .005). Symptom burden remained stable among caregivers in the high-symptom group (40%), whereas the low-symptom group (60%) demonstrated a statistically significant decrease over time. Multivariate analysis found being a family-member caregiver (adjusted odds ratio [ADJ-OR], 4.1; 95% confidence interval [95% CI], 1.4-11.6) and caring for a highly symptomatic patient (ADJ-OR, 8.0; 95% CI, 1.5-41.4), rather than race, ethnicity, or sociodemographic characteristics, were significant predictors of the caregiver's membership in the high-symptom burden group.CONCLUSIONS:Approximately 40% of the caregivers in the current study were found to be at an increased risk for moderate to severe sadness and distress, which remained severe throughout the patient's treatment course at public hospitals. To the authors' knowledge, this study marks the first time that the concept of symptom burden has been used to measure caregiver burden, and the first time that symptom burden has been measured and documented in dyads of caregivers and underserved minority patients. Cancer 2011. © 2010 American Cancer Society.

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Available from: Araceli Garcia-Gonzalez, Dec 13, 2013
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    • "Tools should be utilized to identify family caregivers at risk, based on age, gender, and employment , or other contextual factors such as social and economic resources (Daly et al., 2009; Donnelly et al., 2008; Gaugler, Given, et al., 2008; Kuscu et al., 2009; Kim & Carver, 2012; Williams & Bakitas, 2012). Culturally appropriate caregiver interventions will lead to better caregiver outcomes and allow them to provide optimal care to the cancer patient (Palos et al., 2011). "
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    ABSTRACT: Abstract To help family caregivers (FCs), social workers need to understand the complexity of FC's experiences and challenges. For this systematic review, several relevant, multidisciplinary electronic databases were searched. Of 1643 titles identified, 108 articles met the inclusion criteria and are included in this review. Various experiences, symptoms and burden related to caregiving responsibilities are described and discussed. The understanding evolving from this study about the FC's own health risk, caregiver burden and experiences over time can enhance social worker's awareness of FC's challenging situation and the potential impact this has on the FC's ability to provide care to the patient.
    Full-text · Article · Mar 2014 · Journal of Gerontological Social Work
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    • "In a recent study reported by Palos et al. [8], who assessed the risk of caring for underserved patients with advanced cancer, sadness and distress were more prevalent among caregivers compared with cancer patients, and approximately 40% of caregivers were found to be at an increased risk for moderate to severe sadness and distress. This finding suggests that more attention is required for family members, and knowing how to support them is imperative. "
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    ABSTRACT: A population-based study was conducted in order to examine the characteristics of family members of cancer patients in comparison with the general population and also to evaluate the psychosocial impact of cancer patients on their family members. From the Fourth Korea National Health and Nutrition Examination Surveys (KNHANES IV) (2007-2009) dataset, we identified 460 cancer patients and then selected family members of these patients who were aged 20 years or older (n=565). The control group was sampled from members of families without a cancer patient with matching for sex and age (n=2,260). Serial conditional logistic regression models were used for comparison of characteristics between family members of cancer patients and subjects in the control group. Family members of cancer patients were less employed (57.9% vs. 63.0%, p<0.001), more functionally limited (20.2% vs. 16.5%, p=0.032), and had lower self-rated health (p=0.023) compared with sex and age-matched control subjects. They also had a significantly higher level of stress (79.7% vs. 76.1%, p=0.008), history of depression (12.9% vs. 10.2%, p=0.035), and current depressive symptoms (5.5% vs. 3.5%, p=0.038). However, higher physical activity was reported in family members of cancer patients (13.6% vs. 9.6%, p=0.003) than in control subjects. The presence of a cancer patient in the family showed an association with current depressive symptoms (odds ratio, 1.62; 95% confidence interval, 1.05 to 2.48; p=0.028), however, the association was no longer significant after adjustment for household income, education level, and employment status (p=0.304). Family members of cancer patients are more susceptible to depression, probably due to adverse change in socioeconomic status. Use of multidisciplinary approaches for promotion of psychological health and well-being is essential.
    Full-text · Article · Sep 2013 · Cancer Research and Treatment
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    • "Caregivers ' life is affected by the demanding and overwhelming process they go through while offering care for their family members ( Sternberg et al . , 2010 ; Tamayo et al . , 2010 ) . It was shown that in the former studies , family caregivers experience increased physical burden ( Aoun et al . , 2005 ; Dumont et al . , 2006 ; Palos et al . , 2011 ; Song et al . , 2011 ; Gaugler et al . , 2012 ) , anxiety , depression ( Grov et al . , 2005 ; Dumont et al . , 2006 ; Chang et al . , 2007 ; Mystakidou et al . , 2007 ; Song et al . , 2011 ; Fridriksdottir et al . , 2011 ; Gorgi et al . , 2012 ) , restricted daily activities and social roles , strain in marital relationships ( Gaugler"
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    ABSTRACT: Background: Measuring effects of cancer on family caregivers is important to develop methods which can improve their quality of life (QOL) . Nevertheless, up to now, only a few tools have been developed to be used in this group. Among those, the Caregiver Quality of Life Index-Cancer Scale (CQOLC) has met minimum psychometric criteria in different populations in spite of conflicting results. The present study was conducted to evaluate reliability and validity of CQOLC among Turkish cancer family caregivers. Materials and methods: The CQOLC was administered to 120 caregivers, along with Beck Depression Inventory (BDI), Medical Outcomes Study MOS 36- Item Short Form Health Survey (SF-36), State-Trait Anxiety Inventory (STAI), and Multidimensional Scale of Perceived Social Support (MSPSS). Internal consistency and test-retest stability were used to investigate reliability. Construct validity was examined by using known group method, convergent, and divergent validity. For the known group method, we hypothesized that CQOLC scores would differ between depressed and non-depressed subjects. We investigated convergent validity by correlating scores for CQOLC with scores for other similar measures including SF-36 and STAI. The MSPSS was completed at the same time as CQOLC to provide divergent validity. Results: The values for internal consistency and test-retest correlation were 0.88 and 0.96, respectively. The CQOLC discriminated those who were depressed from those who were not. Convergent validity supported strong correlations between CQOLC scores and two main component scores (PCS, MCS) in SF-36 although there was a weak correlation between CQOLC and STAI scores. Regarding divergent validity, the correlation between CQOLC and MSPSS was in the low range, as expected. Conclusions: The Turkish CQOLC is a reliable and valid tool and it can be utilized to determine QOL of family caregivers.
    Full-text · Article · Jul 2013 · Asian Pacific journal of cancer prevention: APJCP
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