Rachel L. Spillers

Individual and dyadic relations between spiritual well-being and quality of life among cancer survivors and their spousal caregivers

Objectives: There is evidence that cancer generates existential and spiritual concerns for both survivors and caregivers, and that the survivors spiritual well‐being (SWB) is related to his/her own quality of life (QOL). Yet the degree to which the SWB of each member of the couple has an independent association with the partners QOL is unknown. Thus, this study examined individual and dyadic associations of SWB with the QOL of couples dealing with cancer.

Psychological distress of female cancer caregivers: effects of type of cancer and caregivers’ spirituality

IntroductionThis study examined the effects of the survivor’s cancer type (gender-specific vs nongender-specific) and the female caregiver’s spirituality and caregiving stress on the caregiver’s psychological distress. Cancer caregivers, who were nominated by cancer survivors, participated in a nationwide quality-of-life survey with 252 caregivers providing complete data for the variables.Patients and methodsBreast and ovarian cancer were categorized as gender-specific types of cancer (GTC+), whereas kidney, lung, non-Hodgkin’s lymphoma (NHL), and skin melanoma cancers were GTC-. Spirituality, caregiving stress, and psychological distress were measured using the functional assessment of chronic illness therapy—spiritual well-being, stress overload subscale, and profile of mood states—short form, respectively.Results and discussionHierarchical regression analyses revealed that female caregivers whose care recipient was diagnosed with a nongender specific type of cancer (GTC- group) reported higher psychological distress than did the GTC+ group. The GTC- group also reported lower spirituality and higher caregiving stress related to higher psychological distress than did the GTC+ group. In addition, the beneficial effect of spirituality on reducing psychological distress was more pronounced among the GTC- group or when caregiving stress increased.ConclusionsOur findings suggest that female caregivers of survivors with a nongender-specific cancer may benefit from programs designed to reduce their psychological distress, and caregivers who are low in spirituality need help to derive faith and meaning in the context of cancer care.

Family Caregivers and Guilt in the Context of Cancer Care

BACKGROUND Guilt as a key emotional phenomenon in the cancer-caregiving experience is an understudied issue. OBJECTIVE The purpose of this study is to identify demographic characteristics of cancer caregivers and care-related stress factors that are associated with their feelings of caregiver guilt, as well as to explore the effect of caregiver guilt on their adjustment outcomes. METHOD A total of 739 caregivers of cancer survivors completed a survey (66.7% response rate), of which 635 provided complete data for the measures in this study. RESULTS Hierarchical regression analyses revealed that certain caregiver demographics (i.e., younger age, adult offspring, employed) and care-related stress factors (i.e., greater impact on schedule, less perceived caregiving competence, poorer overall health of the care-recipient) were significantly related to caregiver guilt. Higher levels of psychological distress and poorer mental, social, and physical functioning were significantly associated with caregiver guilt, above and beyond the variance accounted for by the covariates. CONCLUSION Results suggest that caregiver guilt compromises the psychosocial and somatic adjustment of cancer caregivers. Guilt may be a cardinal feature of the caregiving experience, and to fully understand the implications of this complex phenomenon, more research is needed.

Effects of psychological distress on quality of life of adult daughters and their mothers with cancer

Introduction: As the population continues to age, adult daughters are more likely to be involved in caregiving. Given the fact that sharing emotional experiences is common in female relationships, (dis)similarity between mothers with cancer and their adult caregiving daughters is expected. However, the extent to which the (dis)similarity in psychological distress influences the quality of life of each person remains unknown.

Family caregivers' quality of life: influence of health protective stance and emotional strain

The goal of this cross-sectional study was to examine whether health protective behaviors and emotional strain is associated with the quality of life of family members who provide care to cancer survivors and to examine some of the factors that might explain this association. The relative influence of these factors on each of the domains of caregiver quality of life (CGQOL) was examined. A total of 203 family caregivers completed self-report questionnaires; only those without missing data on any measure (N = 152) were included in the current analyses. Measures of physical, psychological, social, and spiritual well being were assessed by the 36-item CGQOL tool. Predictor variables included caregiver sociodemographic data (age, income, and gender), care characteristics (cancer stage, duration of care, and time since care), health stance (positive expectancies and physical behavior generally thought to be healthy), and emotional strain (feelings of entrapment, overload, and isolation). Data were analyzed using regression methods. Results demonstrated that health stance and emotional strain are inversely related and that both contribute significantly to overall and separate dimensions of CGQOL. Pinpointing domain-specific effects may suggest ways to more precisely target challenges associated with caregiving and develop effective interventions accordingly.

Oncology professionals and patient requests for cancer support services

ObjectiveTo examine the kinds of psychosocial support services that cancer patients most often request across a multidisciplinary sample of currently practicing U.S. oncological health care professionals (OHCPs) representative of a typical cancer care team.ParticipantsPrimary data collection. A randomly selected sample of 1,180 OHCPs (44% physicians, 24% nurses, 32% social workers) who were active members of their respective oncological associations completed a brief four-page mailed survey during the spring of 2001.MethodsCross-sectional, descriptive study. Descriptive statistics were computed for all study variables. ANOVA procedures were used to examine demographic difference between respondents and nonrespondents. Frequencies were calculated for patient inquires for cancer support services inquiries, and logistic regression was used to evaluate professional group differences on inquiries. Chi-square statistics were used to test for significant differences between professional groups.ResultsApproximately 94% of OHCPs were asked about cancer-related support services by their patients. Quantitative data indicated that information and education about cancer (72%), support groups (65%), and hospice referral (52%) were paramount among patient concerns. Qualitatively, comments about transportation, lodging during treatment, and alternative medicine reflected the general sentiment that basic needs and opportunities for options may still be unmet. Patient inquiries for services varied significantly by professional group (p <.001).ConclusionThis information reflects the need for a multidisciplinary perspective and will be useful for planning patient-based cancer education and support initiatives, refining existing programs, and targeting materials to specific oncological professionals.

Psychosocial Characteristics of Adult Daughters of Breast Cancer Patients: Comparison of Clinic and Community Caregivers Samples

Objective: The long-term psychosocial impact of adult daughters caring for their mothers with breast cancer has been recognized but understudied. The objectives of this study were to characterize the psychosocial functioning of women who served as informal caregivers during their mothers. treatment for breast cancer in two distinct samples, community and high risk clinic, and to determine differences in psychosocial functioning between the two samples. Methods: Using a cross-sectional design, a sample of mostly married, Caucasian and college educated women (N = 59) were administered a battery of questionnaires assessing socio-demographic and psychosocial factors (i.e. coping, caregiving tasks and difficulty, social support, spirituality, mental distress, depressive symptoms). Results: Using descriptive analysis, chi-square and T tests, results demonstrated significant differences between the two samples in time since caregiving, with the community sample reporting few years since the caregiving episode (e.g. 2.1 versus 15.1 years); coping strategies, with the clinic sample reporting higher scores on active coping, behavioral disengagement, planning, and self-blame; support type care tasks difficulty, with the clinic sample reporting higher scores on emotional support and tangible support, and all domains of spirituality (e.g. peace, meaning, faith), with higher levels being reported by the community sample. Although participants did not exhibit clinically significant levels of emotional distress, almost 25% of the community sample and 10% of the clinic sample had clinically significant depressive symptoms. Conclusions: Findings underscore the need for interventions tailored for caregivers to consider the unique psychosocial characteristics of caregivers across settings.