Reike Tempelaar

Cancer and caregiving : The impact on the caregiver's health

A diagnosis of cancer affects not only the patient but also their significant others, especially when a lot of care tasks are involved. Some caregivers perceive the care as a burden, while others consider it a challenge. In this article, findings concerning the impact of cancer caregiving on informal caregivers will be described. No consistent results are reported, and little is known about patterns of caregiving changes in relation to the course of the patients illness. Attention will be given to factors which have been identified as influencing the course and consequences of caregiving. These factors form the basis of a conceptual research model for caregivers of cancer patients. As cancer progresses, care tasks are generated, which can be perceived by the caregiver as either negative (i.e. burden) or positive. Furthermore, these caregiver experiences may lead to negative as well as positive effects on the caregivers health and these relationships can be assumed to be bidirectional.

Determinants of caregiving experiences and mental health of partners of cancer patients

Research regarding informal caregiving showed considerable individual variation in responses to cancer caregiving. The current longitudinal study examined determinants of caregiver outcomes in terms of caregiver experiences at 3 months and caregivers mental health at 6 months after hospital discharge. It included both negative and positive dimensions of caregiving outcomes.

Measuring both negative and positive reactions to giving care to cancer patients: psychometric qualities of the Caregiver Reaction Assessment (CRA)

The Caregiver Reaction Assessment Scale (CRA) is an instrument designed to assess specific aspects of the caregiving situation, including both negative and positive dimensions of caregiving reactions. This paper addresses the psychometric qualities of the CRA in a multicenter study among partners of colorectal cancer patients (n = 181). No problems in feasibility were observed. Five dimensions of caregiver reactions were identified through exploratory factor analysis: the impact of caregiving on disrupted schedule, financial problems, lack of family support, health problems and the impact of caregiving on caregivers self-esteem. Reliability analyses showed that standardized Cronbachs alphas varied between 0.62 and 0.83 for the separate subscales, indicating sufficient internal consistencies. Construct validity was supported. The CRA proves to be a feasible, reliable and valid instrument for assessing both negative and positive reactions to caregiving among partners of patients with cancer.

The distinction between affect and cognition in the quality of life of cancer patients—sensitivity and stability

The distinction between affect and cognition has been put forward to clarify the lack of differences found in studies describing quality of life under deteriorated circumstances, such as serious iliness. In the study reported here, cancer patients under treatment (n=201) were compared with a random sampie from the normal population (n=200). As hypothesized, the affective component of life quality turned out to be more severely impaired than the cognitive component. Besides, it was investigated which factors contribute to the affective and the cognitive component of the quality of life of cancer patients under treatment. In cancer patients affect proved more strongly related to the physical domain. Cognition on the other hand was more strongly related to coping resources, especially personality characteristics like the level of self-esteem. It is concluded that an affective measure of quality of life is more sensitive to change in patients. The stability of life quality is attributed to the rather strong relation the affective and the cognitive component both have to coping resources.

A measurement of social support in epidemiological research: the social experiences checklist tested in a general population in The Netherlands.

STUDY OBJECTIVE--This study aimed to examine in a general population the psychometric qualities of an instrument designed to measure positive and negative social experiences that had been developed in a clinical setting. DESIGN--The Netherlands monitoring project on cardiovascular disease risk factors, a large scale population based study (comprising 36,588 men and women aged 20 to 59 years) carried out in three Dutch towns (Amsterdam, Doetinchem, and Maastricht) offered the possibility of testing the strength of this instrument cross sectionally. MEASUREMENTS AND MAIN RESULTS--The social experiences checklist (SEC) which resulted from a research project on the quality of life of cancer patients was used. The independence of positive and negative experiences was confirmed. The reliability of both the positive and negative experiences dimension was good (Cronbachs alpha = 0.82 and 0.72 respectively). In accordance with the results of a study on cancer patients, the theoretically derived four dimensions in the experience of social support did not seem to be independent. The validity of the SEC was confirmed by Pearson correlations with neuroticism and coping styles. Neuroticism seemed to be negatively correlated with positive social experiences and was positively correlated with negative social experiences. The coping style of seeking information and direct action was positively correlated with positive social experiences. Coping by withdrawal was negatively correlated with negative social experiences. Women and highly educated people seemed to have more positive and fewer negative social experiences than men and people with less education. Younger people had more positive social experiences than older people. The oldest group in the study, those aged 50 to 59, reported fewer negative social experiences than any other age group. CONCLUSIONS--Similar results were found in a study of cancer patients. This underlines the usefulness of the instrument not only for cancer patients but also in survey research in a general population.