A cancer experience: Relationship of patient psychosocial responses to care‐giver burden over time

Abstract

Cancer affects not only ill persons but also family members and close friends. An original study from which this report is derived used a longitudinal design to follow patients discharged from one of seven hospitals with one or more complex care problems requiring home care. A total of 233 patients with multiple solid tumors diagnoses and 103 care-givers were included in the original study. Interviews were conducted at discharge and at three and six months post-discharge. This report examined the responses of a subset of 34 subjects (17 patients and their care-givers) for whom patient and care-giver variables were complete on all three occasions. Findings indicate that these patients were being discharged from the hospital with acute care needs. By three and six months posthospitalization, patients' conditions stabilized or improved but their care-givers continued to report similar levels of burden. Patient psychosocial responses were strongly correlated with care-givers' financial impact, impact on schedule, and physical care-giving responsibility at three and six months. Results highlight the importance of developing interventions that reduce family care-givers' burden in providing post-hospital nursing care for patients with complex care requirements.

A comparison of inpatient and outpatient ASCT

“…McCorkle and colleagues 12 reported that high levels of patient morbidity or symptom distress were associated with an increased burden on the caregiver. We did not see the same effect in our study.…”

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

“…Baider and Kaplan DeNour (1984) also noticed an increasing burden in spouse caregivers over time in addition to treatment. However, McCorkle et al (1993) reported that even though patients improved in time, their caregivers continued to report similar levels of burden. Patients' health was strongly related to caregivers' financial impact, impact on schedule, and physical caregiving tasks.…”

“…Several studies show that caregiving is a dynamic, ongoing process, for which there may be several trajectories (Oberst and James, 1985;Schulz and Williamson, 1991;McCorkle et al, 1993). Care tasks, caregiver burden and caregiver's health may fluctuate in response to changes in the patient's health.…”

“…During periods of active treatment, assistance with patient's selfcare, transportation, procedures, medication and symptom management seems to be needed . More and more researchers emphasize the importance of including the early phases of the illness in studying caregiver's health (Zarit and Toseland, 1986;Northouse, 1988;Given and Given, 1991;McCorkle et al, 1993). Moreover, Schulz and Williamson (1991) stated that it would be ideal to obtain data from caregivers in advance to taking on the caregiving role, so that the effects on health of becoming a caregiver can be established.…”

Symptoms in the cancer patient – Of importance for their caregivers' quality of life and mental health?

“…Studies have been performed during different stages of the cancer patients' disease trajectory, and for caregivers there are reported burden (Given et al, 2004;Goldstein et al, 2004;Doorenbos et al, 2007;Higginson et al, 2008), reaction in terms of particular burden and well-being (McCorkle et al, 1993;Nijboer et al, 1999;Hagedoorn et al, 2002;Grov et al, 2006c), quality of life (QOL) (Grov, 2005;Clark, 2006;Grov et al, 2006b), mental health (Edwards et al, 2004;Grov, 2005) , and a large number of specific aspects influencing the caregivers' situation, e.g. work and economy (Goldzweig et al, 2009), and the impact of educational level and educational programs facilitated for caregivers (Clark, 2006;Goldzweig et al, 2009).…”