Physical and emotional well-being and support in newly diagnosed head and neck cancer patient–caregiver dyads

Abstract

The purpose of this study was to examine the physical and emotional well-being and social support in newly diagnosed head and neck cancer (HNC) patients and caregivers and identify sociodemographic, clinical, and behavioral risk factors associated with compromised well-being in patients and caregivers. Newly diagnosed HNC patients and their primary caregivers (N = 72 dyads) completed questionnaires before treatment assessing physical and mental well-being, depression, cancer worry, and open-ended support questions. Patients reported worse physical well-being than caregivers (p < 0.05) but similar levels of mental well-being. Caregivers reported providing emotional and instrumental support most frequently with an emphasis on nutrition and assistance with speech, appearance, and addictions. Both patients and their caregivers reported suboptimal mental well-being and depression. Smoking was associated with compromised well-being in patients, caregivers, and dyads. Compromised well-being in patients and their caregivers was more likely when patients were younger, had worse symptoms, and smoked/consumed alcohol (p < 0.05). While patients face more physical strain than caregivers, both equally confront emotional challenges. Results highlight risk factors for compromised well-being in both patients and their caregivers that should be assessed at diagnosis to guide identification of needed dyadic-focused supportive care resources.

Interdependence of physical and psychological morbidity among patients with cancer and family caregivers: Review of the literature

“…Four studies 37‐40 (17.4%) included patients with various cancer types, whereas 19 (82.6%) studies narrowed their sample by recruiting patients with either a specific cancer type 5,10,30‐36,41,43‐47,49,50 or in one case, a few specific types 42 . There were 12 cross‐sectional observational, 5,10,30,32,34,35,39‐42,44‐46,48 6 longitudinal, 5,31,36,39,43,49 2 mixed methods, 30,47 2 qualitative, 33,40 and 1 retrospective study 50 . Fifteen studies (65.2%) were conducted in the United States, 5,10,30,32‐34,39‐47 while 8 (34.8%) were international.…”

“…There were 12 cross‐sectional observational, 5,10,30,32,34,35,39‐42,44‐46,48 6 longitudinal, 5,31,36,39,43,49 2 mixed methods, 30,47 2 qualitative, 33,40 and 1 retrospective study 50 . Fifteen studies (65.2%) were conducted in the United States, 5,10,30,32‐34,39‐47 while 8 (34.8%) were international.…”

“…Twelve studies 5,10,31,33,35‐37,39,40,44,46,47 (52.2%) examined associations between patients' and caregivers' physical morbidity. Seven 5,10,31,35,36,39,47 (58.3%) found those associations to be statistically significant, and one qualitative study identified interdependent physical morbidity as a major theme 33 . While Sterba et al 47 found that caregivers' physical morbidity was worse in those whose patients who had more severe symptoms, Paek et al 10 found the inverse.…”

Impact of patient symptoms and caregiving tasks on psychological distress in caregivers for head and neck cancer (HNC)

“…Psychological distress has previously been noted to increase during the course of radiation therapy and to correlate with patient symptom burden. Patient behavior such as alcohol or tobacco use, as well as financial distress, may also negatively affect caregiver well‐being . The role of caregiving tasks, however, has been underexplored.…”

Head and neck survivorship care in the times of the SARS‐CoV‐2 pandemic

“…HNC treatment can also result in poor outcomes for the caregiver, highlighting a need for caregiver interventions. 23 An additional financial burden is also placed on the patient and caregivers as Massa et al noted a higher median annual medical expense and relative out-of-pocket expenses for patients with HNCs when compared to other cancers. This higher financial burden is placed upon HNC survivors who are already more often members of a minority race/ethnicity, poor, and less educated with lower general and mental health status.…”