Factors Associated with Anxiety and Depression among Family Caregivers of Patients Undergoing Palliative Radiotherapy

Ourania Govina, Eugenia Vlachou, Ioannis Kalemikerakis, Demetrios Papageorgiou, Anna Kavga, Theocharis Konstantinidis, Ourania Govina, Eugenia Vlachou, Ioannis Kalemikerakis, Demetrios Papageorgiou, Anna Kavga, Theocharis Konstantinidis

Abstract

Objective: The family caregivers of patients receiving palliative care experience high levels of anxiety and depression. The aim of the present study was to investigate the factors associated with family caregivers' anxiety and depression when caring for patients with advanced cancer in Greece.

Methods: The sample consisted of 100 patients undergoing palliative radiotherapy and their respective caregivers. Patients completed the Hospital Anxiety and Depression Scale (HADS) and the MD Anderson Symptom Inventory. Their respective caregivers completed the Oberst Caregiving Burden Scale, the Bakas Caregiving Outcomes Scale, and the HADS. Correlational and multiple regression analyses were conducted to identify potential predictors of anxiety and depression.

Results: The majority of patients were male (63.0%), whereas the majority of their caregivers were female (76.0%). The mean ages of patients and caregivers were 63.9 ± 10.8 and 53.3 ± 12.6 years, respectively. Caregiving anxiety and depression were associated with patients' variables, such as gender (P < 0.0005), primary cancer (P = 0.008), and past surgery (P = 0.002), and caregiver's variables, such as gender (P = 0.001), co-residence (P = 0.05), previous care experience (P = 0.04), and means of transport (P = 0.038). In multiple regression analyses, caregiving anxiety and depression were significantly predicted by caregivers' and patients' characteristics, in a model that accounted for 48% of the anxiety variance (P < 0.0005) and 39% of the depression variance (P < 0.0005).

Conclusion: The caregivers who experienced more anxiety and depression shared the following traits: they were women, cared for men with lung cancer, cared for patients not undergoing surgery, lived together, were younger, went to the hospital by private means of transport, had previous care experience, and perceived an increased degree of general burden. Further investigation of the factors that may affect caregivers' psychological state is required to better identify parameters that may predict it.

Keywords: Advanced cancer; anxiety; burden; depression; family caregivers.

Conflict of interest statement

There are no conflicts of interest.

References

    1. National Alliance for Caregiving. Cancer Caregiving in the U.S.: An Intense, Episodic, and Challenging Care Experience. 2016
    1. Given BA, Given CW, Kozachik S. Family support in advanced cancer. CA Cancer J Clin. 2001;51:213–31.
    1. Fletcher BS, Paul SM, Dodd MJ, Schumacher K, West C, Cooper B, et al. Prevalence, severity, and impact of symptoms on female family caregivers of patients at the initiation of radiation therapy for prostate cancer. J Clin Oncol. 2008;26:599–605.
    1. Teschendorf B, Schwartz C, Ferrans CE, O’Mara A, Novotny P, Sloan J, et al. Caregiver role stress: When families become providers. Cancer Control. 2007;14:183–9.
    1. Ferrell B, Hanson J, Grant M. An overview and evaluation of the oncology family caregiver project: Improving quality of life and quality of care for oncology family caregivers. Psychooncology. 2013;22:1645–52.
    1. Yun YH, Rhee YS, Kang IO, Lee JS, Bang SM, Lee WS, et al. Economic burdens and quality of life of family caregivers of cancer patients. Oncology. 2005;68:107–14.
    1. Hagedoorn M, Sanderman R, Bolks HN, Tuinstra J, Coyne JC. Distress in couples coping with cancer: A meta-analysis and critical review of role and gender effects. Psychol Bull. 2008;134:1–30.
    1. Chung C, Hwang E. Couples’ experiences of breast cancer in Korea: A descriptive qualitative study. Cancer Nurs. 2012;35:211–20.
    1. Lopez V, Copp G, Molassiotis A. Male caregivers of patients with breast and gynecologic cancer: Experiences from caring for their spouses and partners. Cancer Nurs. 2012;35:402–10.
    1. Sterba KR, Swartz RJ, Basen-Engquist K, Black PC, Pettaway CA. Long-term quality of life after radical prostatectomy in wives of men in the postoperative adjuvant androgen deprivation trial. Support Care Cancer. 2011;19:1117–24.
    1. Gilbar O, Zusman A. The correlation between coping strategies, doctor-patient/spouse relationships and psychological distress among women cancer patients and their spouses. Psychooncology. 2007;16:1010–8.
    1. Fletcher BS, Miaskowski C, Given B, Schumacher K. The cancer family caregiving experience: An updated and expanded conceptual model. Eur J Oncol Nurs. 2012;16:387–98.
    1. Thrush A, Hyder AA. The neglected burden of caregiving in low- and middle-income countries. Disabil Health J. 2014;7:262–72.
    1. Sörensen S, Duberstein P, Gill D, Pinquart M. Dementia care: Mental health effects, intervention strategies, and clinical implications. Lancet Neurol. 2006;5:961–73.
    1. Kramer BJ. Gain in the caregiving experience: Where are we? What next? Gerontologist. 1997;37:218–32.
    1. Parks SH, Pilisuk M. Caregiver burden: Gender and the psychological costs of caregiving. Am J Orthopsychiatry. 1991;61:501–9.
    1. Given B, Wyatt G, Given C, Sherwood P, Gift A, DeVoss D, et al. Burden and depression among caregivers of patients with cancer at the end of life. Oncol Nurs Forum. 2004;31:1105–17.
    1. Li Q, Loke AY. A literature review on the mutual impact of the spousal caregiver-cancer patients dyads: ‘communication’, ‘reciprocal influence’, and ‘caregiver-patient congruence’. Eur J Oncol Nurs. 2014;18:58–65.
    1. Rha SY, Park Y, Song SK, Lee CE, Lee J. Caregiving burden and the quality of life of family caregivers of cancer patients: The relationship and correlates. Eur J Oncol Nurs. 2015;19:376–82.
    1. Matthews BA. Role and gender differences in cancer-related distress: A comparison of survivor and caregiver self-reports. Oncol Nurs Forum. 2003;30:493–9.
    1. Grunfeld E, Coyle D, Whelan T, Clinch J, Reyno L, Earle CC, et al. Family caregiver burden: Results of a longitudinal study of breast cancer patients and their principal caregivers. CMAJ. 2004;170:1795–801.
    1. Rumpold T, Schur S, Amering M, Kirchheiner K, Masel EK, Watzke H, et al. Informal caregivers of advanced-stage cancer patients: Every second is at risk for psychiatric morbidity. Support Care Cancer. 2016;24:1975–82.
    1. Trevino KM, Prigerson HG, Maciejewski PK. Advanced cancer caregiving as a risk for major depressive episodes and generalized anxiety disorder. Psychooncology. 2018;27:243–9.
    1. Govina O, Kotronoulas G, Mystakidou K, Katsaragakis S, Vlachou E, Patiraki E, et al. Effects of patient and personal demographic, clinical and psychosocial characteristics on the burden of family members caring for patients with advanced cancer in Greece. Eur J Oncol Nurs. 2015;19:81–8.
    1. Iconomou G, Viha A, Kalofonos HP, Kardamakis D. Impact of cancer on primary caregivers of patients receiving radiation therapy. Acta Oncol. 2001;40:766–71.
    1. Papastavrou E, Charalambous A, Tsangari H. Exploring the other side of cancer care: The informal caregiver. Eur J Oncol Nurs. 2009;13:128–36.
    1. Kim Y, Kashy DA, Wellisch DK, Spillers RL, Kaw CK, Smith TG. Quality of life of couples dealing with cancer: Dyadic and individual adjustment among breast and prostate cancer survivors and their spousal caregivers. Ann Behav Med. 2008;35:230–8.
    1. Mystakidou K, Tsilika E, Parpa E, Katsouda E, Galanos A, Vlahos L. The hospital anxiety and depression scale in Greek cancer patients: Psychometric analyses and applicability. Support Care Cancer. 2004;12:821–5.
    1. Govina O, Kotronoulas G, Mystakidou K, Giannakopoulou M, Galanos A, Patiraki E, et al. Validation of the revised Bakas caregiving outcomes scale in Greek caregivers of patients with advanced cancer receiving palliative radiotherapy. Support Care Cancer. 2013;21:1395–404.
    1. Carey PJ, Oberst MT, McCubbin MA, Hughes SH. Appraisal and caregiving burden in family members caring for patients receiving chemotherapy. Oncol Nurs Forum. 1991;18:1341–8.
    1. Mystakidou K, Cleeland C, Tsilika E, Katsouda E, Primikiri A, Parpa E, et al. Greek M.D. Anderson symptom inventory: Validation and utility in cancer patients. Oncology. 2004;67:203–10.
    1. Snaith RP. The hospital anxiety and depression scale. Health Qual Life Outcomes. 2003;1:29.
    1. Kotronoulas G, Wengström Y, Kearney N. Sleep and sleep-wake disturbances in care recipient-caregiver dyads in the context of a chronic illness: A critical review of the literature. J Pain Symptom Manage. 2013;45:579–94.
    1. Kim Y, Duberstein PR, Sörensen S, Larson MR. Levels of depressive symptoms in spouses of people with lung cancer: Effects of personality, social support, and caregiving burden. Psychosomatics. 2005;46:123–30.
    1. Kurtz ME, Kurtz JC, Given CW, Given BA. Depression and physical health among family caregivers of geriatric patients with cancer – A longitudinal view. Med Sci Monit. 2004;10:CR447–56.
    1. Grov EK, Dahl AA, Moum T, Fosså SD. Anxiety, depression, and quality of life in caregivers of patients with cancer in late palliative phase. Ann Oncol. 2005;16:1185–91.
    1. Vahidi M, Mahdavi N, Asghari E, Ebrahimi H, Eivazi Ziaei J, Hosseinzadeh M, et al. Other side of breast cancer: Factors associated with caregiver burden. Asian Nurs Res (Korean Soc Nurs Sci) 2016;10:201–6.
    1. Couper J, Bloch S, Love A, Macvean M, Duchesne GM, Kissane D, et al. Psychosocial adjustment of female partners of men with prostate cancer: A review of the literature. Psychooncology. 2006;15:937–53.
    1. Li Q, Loke AY. A spectrum of hidden morbidities among spousal caregivers for patients with cancer, and differences between the genders: A review of the literature. Eur J Oncol Nurs. 2013;17:578–87.
    1. Haley WE. The costs of family caregiving: Implications for geriatric oncology. Crit Rev Oncol Hematol. 2003;48:151–8.
    1. Baider L, Ever-Hadani P, Goldzweig G, Wygoda MR, Peretz T. Is perceived family support a relevant variable in psychological distress? A sample of prostate and breast cancer couples? J Psychosom Res. 2003;55:453–60.
    1. Goldzweig G, Hubert A, Walach N, Brenner B, Perry S, Andritsch E, et al. Gender and psychological distress among middle- and older-aged colorectal cancer patients and their spouses: An unexpected outcome. Crit Rev Oncol Hematol. 2009;70:71–82.
    1. Brouwer WB, van Exel NJ, van Gorp B, Redekop WK. The CarerQol instrument: A new instrument to measure care-related quality of life of informal caregivers for use in economic evaluations. Qual Life Res. 2006;15:1005–21.
    1. Mazanec SR, Daly BJ, Douglas SL, Lipson AR. Work productivity and health of informal caregivers of persons with advanced cancer. Res Nurs Health. 2011;34:483–95.
    1. Pinquart M, Duberstein PR. Optimism, pessimism, and depressive symptoms in spouses of lung cancer patients. Psychol Health. 2005;20:565–78.
    1. Lambert S, Girgis A, Descallar J, Levesque JV, Jones B. Trajectories of mental and physical functioning among spouse caregivers of cancer survivors over the first five years following the diagnosis. Patient Educ Couns. 2017;100:1213–21.
    1. Given B, Sherwood PR. Family care for the older person with cancer. Semin Oncol Nurs. 2006;22:43–50.
    1. Wagner CD, Bigatti SM, Storniolo AM. Quality of life of husbands of women with breast cancer. Psychooncology. 2006;15:109–20.
    1. Northouse LL, Katapodi MC, Schafenacker AM, Weiss D. The impact of caregiving on the psychological well-being of family caregivers and cancer patients. Semin Oncol Nurs. 2012;28:236–45.
    1. Viana MC, Gruber MJ, Shahly V, Alhamzawi A, Alonso J, Andrade LH, et al. Family burden related to mental and physical disorders in the world: Results from the WHO world mental health (WMH) surveys. Braz J Psychiatr. 2013;35:115–25.

Source: PubMed

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