Spouse caregivers of patients with advanced cancer are a high-risk population for depression. Subjective caregiving burden and relational variables, such as caregivers' attachment orientations and marital dissatisfaction, are important predictors of caregiver depression.

Objective: The current study examines the effect of perceived support from different agents (spouse, family, friends, religion-spirituality) on psychological distress experienced by women with advanced breast cancer and their male spouses.Methods: In all, 150 couples consisting of women with advanced breast cancer and their spouses completed the Cancer Perceived Agent of Support Questionnaire and the Brief Symptom Inventory Scale.Results: Spouses reported more psychological distress (global, depression and anxiety) than patients. Both patients and spouses report a similar level of spousal support, and spouses reported a lower level of support provided from family and friends. Perceived support in the current study contributed significantly to the explanations of global psychological distress, depression and anxiety both for patients and their spouses. However, the specific agents of support that were significant in explaining these outcomes varied between patients and their spouses. For patients, family support received by both patient and partner was the most important source of support, protecting from psychological distress, while for the male partners, support from friends was most important. Religious-based support was found to contribute negatively to the psychological distress of the patient and spouse.Conclusions: This study emphasizes the role of breast cancer spouses as care receivers in parallel to their role as caregivers, which is especially important in light of the high psychological distress reported by the spouses. The findings support the buffering effect, which different agents of support have against psychological distress while facing cancer for both patients and spouses. Patients and spouses differ with regard to the agents of support possessing this buffering effect.