Cognitive dysfunction in patients with brain metastases: influences on caregiver resilience and coping

Marlon Garzo Saria, Natasia Courchesne, Lorraine Evangelista, Joshua Carter, Daniel A MacManus, Mary Kay Gorman, Adeline M Nyamathi, Linda R Phillips, David Piccioni, Santosh Kesari, Sally Maliski, Marlon Garzo Saria, Natasia Courchesne, Lorraine Evangelista, Joshua Carter, Daniel A MacManus, Mary Kay Gorman, Adeline M Nyamathi, Linda R Phillips, David Piccioni, Santosh Kesari, Sally Maliski

Abstract

Purpose: Neurologic deficits that may be manifested as cognitive impairment contribute to the challenges faced by caregivers of patients with brain metastases. To better address their needs, we examined how caregivers respond to these challenges and explore the relationship between the patient's cognitive impairment and caregiver resilience and coping.

Methods: We conducted a descriptive, cross-sectional study using self-reported data from 56 caregivers of patients with brain metastases. Study participants from a comprehensive cancer center were asked to complete a series of instruments that measured their perception of the patient's cognitive dysfunction (revised memory and behavior problems checklist, RMBC), their own personal resilience (Resilience Scale, RS), and their utilization of a broad range of coping responses (COPE inventory and Emotional-Approach Coping scale).

Results: Caregivers reported that memory-related problems occurred more frequently in the patients they cared for compared to depression and disruptive behavior (mean scores 3.52 vs 2.34 vs. 1.32, respectively). Coping strategies most frequently used by caregivers were acceptance (3.28), planning (3.08), and positive reinterpretation and growth (2.95). Most caregivers scored moderate to high on the RS (77%). The coping strategy acceptance correlated significantly with the memory and disruptive behavior subscales of the RMBC.

Conclusions: Given the protective effect of problem-focused coping and the high rate of caregivers utilizing less effective coping strategies in instances of worsening cognitive dysfunction, healthcare professionals need to systematically assess the coping strategies of caregivers and deliver a more personalized approach to enhance effective coping among caregivers of patients with brain metastases.

Keywords: Brain metastases; Caregiver burden; Cognitive dysfunction; Coping; Resilience.

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