Engagement in health-promoting behaviors and patient–caregiver interdependence in dyads facing advanced cancer: an exploratory study

Abstract

Diet and exercise are important for the wellbeing of people with cancer and their family caregivers. Unfortunately, little is known about their behaviors over time or factors that may influence their engagement in these behaviors. This exploratory study examined the influence of chronic conditions, symptom distress, and perceived social support on exercise and diet behaviors of patients with advanced cancer and their caregivers using the actor-partner interdependence mediation model (APIMeM) and interdependence theory as guiding frameworks. This secondary analysis uses self-report data from a large RCT (N = 484 patient-caregiver dyads) at three time points: baseline data was collected within three months of the diagnosis, at 3 months post-baseline, and 6 months post-baseline. A number of actor effects were observed: patient and caregiver prior exercise and diet were significant predictors of their own future exercise and diet behaviors; more patient-reported social support was associated with less patient exercise; more patient symptom distress was associated with poorer patient diet; and, more caregiver-reported social support was associated with more caregiver exercise and better caregiver diet. Partner effects were also observed: more patient exercise was positively associated with more caregiver exercise; more patient comorbidities were associated with better caregiver diet; more caregiver-reported social support was associated with better patient diet; and, more patient-reported social support was associated with better caregiver diet. Despite the challenges of advanced cancer and caregiving, past exercise and diet behavior remained a significant predictor of future behavior. Other health problems and perceptions of social support within the dyad may exert a positive or negative influence on patient/caregiver diet and exercise.

The role of social support in physical activity for cancer survivors: A systematic review

“…Observing PA role models was positively associated with PA in one study, but unrelated in another . Positive correlations were observed when the role model was the survivors' spouse but were not significant for caregivers, family, or other cancer survivors . Having other people to participate with, including a spouse, support person, PA partner, or friends was largely not associated with PA .…”

“…Providing support to a spouse/partner was positively associated with PA . One study with advanced cancer patients showed general support from a caregiver was negatively associated with PA, possibly reflecting greater needs.…”

Improving the delivery of physical activity services in lung cancer: A qualitative representation of the patient’s perspective

“…This is, however, a complex issue and carers of people with advanced lung cancer report established relationship boundaries often prevent them from promoting physical activity despite being aware of its importance (Rhudy, Dose, Basford, Griffin, & Cheville, ). Notably, increased social support has been associated with reduced patient physical activity levels in advanced cancer (Ellis et al, ). The role of the carer ideally should be transformed to be a source of motivation for physical activity adherence (Ellis et al, ).…”

Dyadic associations between perceived social support and cancer patient and caregiver health: An actor‐partner interdependence modeling approach

“…A study of gastrointestinal cancer patients and caregivers found that one's emotional support alleviates loneliness, leading to better mental health outcomes; however, no interrelationships between patients' and caregivers' emotional support and outcomes were found . A study of caregivers and patients with advanced breast, colorectal, lung, or prostate cancer, found that one's social support was positively associated with their own exercise and diet and interrelationships varied over time; specifically, caregiver social support at baseline was associated with patient exercise and diet at 3 months, but patient social support at 3 months was only associated with caregiver diet at 6 months post intervention. In a study of distress and coping among cancer patients and caregivers, perceived social support was found to be positively associated with hope for their future while the interrelationship showed a negative association.…”