Family Cancer Caregiving and Negative Outcomes: The Direct and Mediational Effects of Psychosocial Resources

Abstract

This study tested the hypothesis that various components of the stress process model were related to negative outcomes (depression, guilt, negative health) in cancer caregivers. This study also tested the hypothesis that psychosocial resources (mastery, socioemotional support) mediated the relationship between the various domains of the stress process model and negative outcomes. A total of 238 cancer caregivers were recruited from radiation medicine clinics at the University of Maryland Greenebaum Cancer Center (n = 186) and the University of Minnesota Cancer Center (n = 52). A comprehensive interview battery was administered. A multivariate regression found that primary subjective stressors were the strongest predictors of depression and negative health impact. A path analysis indicated that mastery mediated the relationship between role captivity and negative health impact. These results emphasize the importance of multidimensional assessment in cancer caregiving. The findings also suggest refinements to the stress process model when examining family cancer care.

Psychological distress in different social network members of breast and prostate cancer survivors

“…The findings on relationship satisfaction and sex differences are consistent with elements of the stress process model (Pearlin et al, 1990) as applied to informal caregiving with cancer survivors (e.g., Gaugler et al, 2009). In this model, caregiver sex is a key variable in the context of care, and relationship closeness is a psychosocial resource.…”

“…Some of the secondary stressors and distress associated with caregiving appear to be affected by social relationship issues, such as whether the caregiver is the spouse of the care recipient or lives with the care recipient, and whether the caregiver has lost intimate exchange with the care recipient (Gaugler et al, 2008, 2009). These findings suggest that the nature of the relationship between the caregiver and care recipient may potentially influence the caregiver's distress.…”

“…In the stress process model (Pearlin, Mullan, Semple, & Skaff, 1990), which has been applied to family caregiving, relationship closeness is conceptualized as a psychosocial resource that can minimize negative outcomes for the caregiver (Gaugler et al, 2009). Interpersonal relationship satisfaction is a stronger predictor of lower psychological distress in spouses of men with prostate cancer than the severity of the men's medical condition (Eton, Lepore, & Helgeson, 2005).…”

“…Bergelt et al (2008) noted that female partners of cancer survivors had lower scores on mental and physical dimensions of quality of life than male partners. In Pearlin et al's (1990) stress process model, sex of the caregiver is conceptualized as an element in the context of care, where being female is commonly associated with more negative psychological outcomes (Gaugler et al, 2009). …”

CHESS improves cancer caregivers’ burden and mood: Results of an eHealth RCT.

“…But many caregivers of people with advanced cancer lack the knowledge, skills or resources to make appropriate coping choices. Furthermore, the clinical team’s ability to help control cancer-related stressors is limited by caregivers’ and patients’ reluctance to communicate distress to clinicians between visits (Gaugler et al, 2009; Docherty et al, 2008; van den Beuken-van Everdingen, de Rijke, Kessels, Schouten, van Kleef, & Patijn,.2007). …”