Longitudinal associations between caregiver burden and patient and spouse distress in couples coping with lung cancer

Abstract

Purpose While spouses play a vital role in the care of cancer patients, caregiving exerts a physical and psychological toll. Caregiving burden may not only compromise spouses’ quality of life but also the quality of care and support they are able to provide. Consequently, spousal caregiving burden may also negatively impact patients’ psychological adjustment. However, the effect of caregiving burden on patients’ psychological distress is unknown. Thus, this 6-month longitudinal study examined the associations between caregiving burden and distress in both lung cancer patients and their spouses. Methods Patients and their spouses individually completed questionnaires within 1 month of treatment initiation (baseline) and at 3-month and 6-month follow-up. Distress was measured with the Brief Symptom Inventory and caregiving burden with the Caregiver Reaction Assessment. Results Multilevel modeling of data from 158 couples revealed that baseline spouses’ reports of caregiving-related health problems were significantly associated with 3-month (p<0.001) and 6-month (p=0.01) follow-up distress in both patients and spouses even when controlling for baseline distress and dyadic adjustment. Further, there was evidence that baseline spouses’ reports of schedule disruption (p=0.05) predicted 3-month patients’ distress and baseline spouses’ reports of financial strain (p<0.05) and lack of support (p<0.10) predicted their own distress at 6-months. Conclusion Caregiving burden is problematic for both patients and spouses. Couples in which spouses report caregiving-related health problems may be at particular high risk of long-term elevated distress. Targets of future couple-focused interventions such as self-care and use of social support are discussed.

Perceived health, caregiver burden, and quality of life in women partners providing care to Veterans with traumatic brain injury

“…Furthermore, our participants reported higher levels of financial problems as a result of caring than other informal caregivers [50][51][52]. These results may be attributed to caregivers in our sample being younger and having less life experience than informal caregivers in other studies [50][51]53] or, as suggested in other studies, a result of exhausting personal savings, reductions in income from reducing or terminating paid working hours in order to provide care [54], or Veteran's impulsive spending habits that can affect family finances. Mean subscale scores for caregiver self-esteem were similar to scores of spousal caregivers of patients 3 yr after stroke [51] and caregivers of lung transplant candidates [32].…”

The dyadic effects of coping and resilience on psychological distress for cancer survivor couples

“…Understanding the role of resilience in the relationship between coping and distress at a dyadic level can be also beneficial to health care practitioners and encourage the application of strength- and couple-based approaches to improve psychosocial adaptation among cancer survivors-spouses dyads. Given that caregiving burden undermines the long-term psychological adjustment of spouses and to some extent cancer patients [34], supportive care programs that are effective to manage spouses’ burden and cope with their stress may be also necessary in reducing psychological distress.…”

Understanding Family Caregiver Communication to Provide Family-Centered Cancer Care

“…As the patient’s cancer and treatment-specific symptoms increase, patients’ and caregivers’ distress levels also increase, 11 caregiver physical and psychological health are negatively impacted, 12–15 and caregivers' depression and burden increases. 16 Caregiving-related health problems cause further distress within the patient-caregiver dyad 17 and caregiver depression is likely to have a direct influence on patient outcomes. 18–24 For instance, a patient's fear of recurrence at 3 months post-diagnosis is predictive of a caregiver’s increased distressed over time.…”