Family caregivers of advanced cancer patients: self-perceived competency and meaning-making

Abstract

BackgroundFamily caregivers of patients with advanced cancer have been reported to provide long hours of care and be at risk for poor psychological outcomes. Although research has focused on the nature of caregiving burden, little attention has been paid to identifying protective factors that improve caregiver psychological outcomes.AimWe examined the relationship between caregivers’ time spent caregiving and the following psychological outcomes: anxiety, depression and caregiving esteem. Subsequently, we explored the main and moderating effects of caregiver-perceived self-competency and sense of meaning on caregiver psychological outcomes.Design/participantsCross-sectional analysis was conducted using the baseline data from an ongoing cohort study. Family caregivers of advanced cancer patients (n=287) were recruited from two tertiary hospitals in Singapore.ResultsTime spent caregiving was not significantly associated with caregiver anxiety, depression or caregiving esteem. However, significant main effects of self-competency on anxiety and caregiving esteem; and sense of meaning on anxiety, depression and caregiving esteem were observed. Moderator analyses further indicated that self-competency attenuated the positive relationship between time spent caregiving and anxiety, while sense of meaning attenuated the negative relationship between time spent caregiving and caregiving esteem.ConclusionGreater perceived self-competency and sense of meaning are related to better caregiver psychological outcomes, and protect caregivers from worsening outcomes as caregiving hours increase. Our findings suggest that screening caregivers for distress is an important part of care, and that supportive interventions for caregivers should aim to enhance their perceived caregiving competencies and the ability to make meaning of their caregiving role.

Family caregivers’ perceived communication self-efficacy with physicians

“…A somewhat surprising finding was that communication self-efficacy was not associated with anxiety in our sample. This finding appears to be contrary to previous research on caregiver anxiety (Teo et al, 2019) and warrants future investigation. However, our results suggest that a caregiver's ability to manage information and express concerns or doubts is more strongly associated with their perceptions of emotional, social, financial, and physical quality of life than feelings of nervousness, worry, or anxiety.…”

“…Our study findings confirm that Carrier caregivers have the lowest perceived communication self-efficacy, which likely contributes to feeling unprepared. Caregiver perceptions of their own competency are directly related to psychological outcomes of caregivers (Teo et al, 2019). Of significance to the typology of caregivers, having a sense of mastery over caregiver tasks lowers risk of depression and is associated with lower anxiety (Teo et al, 2019).…”

Development and evaluation of the Singapore Caregiver Quality of Life Scale - Dementia

“…hours spent in caregiving per week, caregiver role and level of functional limitation. The stronger correlation between QOL scores and caregiving hours among those with below average EM scores than in the whole sample was as predicted by the previous study that showed caregivers who reported lower level of selfcompetency and sense-making tended to suffer more impact [28]. We note that MW was only weakly associated with the objective measurements (each P > 0.05), but it correlated well with the psychometric measurements, suggesting the subjective nature of mental well-being.…”

“…Spearman's correlation coefficient was calculated between the QOL scores and the validity criterion variables. Furthermore, a recent cohort study of caregivers in Singapore has demonstrated that there was no correlation between mental well-being and caregiving hours in the cohort as a whole, but there was a negative correlation among cohort members who had low level of selfcompetency and sense-making [28]. Given the similarity of the Experience & Meaning (EM) domain and selfcompetency and sense-making, we also estimated the Spearman's correlation coefficient between QOL total and domain scores (except EM) and caregiving hours among caregivers who had EM scores below the mean.…”

Study Protocol for the Evaluation of Individual Psychological Interventions for Family Caregivers of Advanced Cancer Patients

“…Psychological problems, mainly anxiety and depression, also have profound adverse effects on the quality of life QOL of both patients and caregivers (Sun et al, 2019;Teixeira et al, 2019). The prevalence rates of significant anxiety and depression among FCs of advanced cancer patients vary largely, from 40 to 47% and from 16 to 67%, respectively (Oechsle et al, 2019;Teo et al, 2019;Alam et al, 2020).…”