The Interdependence of Advanced Cancer Patients’ and Their Family Caregivers’ Mental Health, Physical Health, and Self-Efficacy over Time

Abstract

Background The challenges of advanced cancer have health implications for patients and their family caregivers from diagnosis through end-of-life. The nature of the patient/caregiver experience suggests that their mental and physical health may be interdependent, but limited empirical evidence exists. Purpose This study used Social Cognitive Theory as a framework to investigate individual and interpersonal influences on patients’ and their family caregivers’ mental health, physical health, and self-efficacy as individuals to manage the challenges of advanced disease over time. Methods Patients and caregivers (484 patient-caregiver dyads) completed surveys at baseline, 3 months and 6 months. Longitudinal dyadic analysis techniques were used to examine (i) the influence that patients and caregivers had on their own mental health, physical health, and self-efficacy (actor effects) and (ii) the influence that they had on each other’s health outcomes (partner effects). We also examined the influence of self-efficacy on mental and physical health over time. Results Consistent with our hypotheses, each person’s mental health, physical health, and self-efficacy had significant effects on their own outcomes over time (actor effects). Patients and caregivers influenced one another’s mental and physical health (partner effects), but not their self-efficacy. In addition, patients and caregivers with higher self-efficacy had better mental health, and their partners had better physical health. Conclusions Patient and caregiver mental and physical health were interdependent. Each person’s cancer-related self-efficacy influenced their own mental and physical health. However, a person’s self-efficacy did not influence the other person’s self-efficacy.

Savouring and psychological well‐being in family dyads coping with cancer: An actor–partner interdependence model

“…In addition to probing into the benefit of perceived capability of savouring the moment on cancer patients and caregivers’ own psychological well‐being, an interdependence component was included in the current study using APIM. Dyadic interdependence of cancer patients and caregivers in psychological adaptation along the trajectory was consistently demonstrated in previous studies (Giannousi, Karademas, & Dimitraki, ; Kershaw et al, ). Among 49 breast cancer survivors and their partners, significant interdependence in physical and psychological symptoms was found over time (Sergin, Badger, & Pasvogel, ).…”

“…Therefore, the results could be seen as demonstrating the adverse impact of maladaptive emotion regulation on mental health of patients and family caregivers. Patients’ cancer‐specific self‐efficacy has been found to predict higher physical and emotional well‐being of their own as well as physical well‐being of their caregivers, with the majority of them being spouses (Kershaw et al, ). In contrast, caregivers’ cancer‐specific self‐efficacy was positively associated with their own but not patients’ physical and emotional well‐being.…”

Predictors and interdependence of family support in a random sample of long‐term young breast cancer survivors and their biological relatives

“…Relatives are expected to provide support to cancer survivors, although they also experience stressors and need support; when relatives are depressed, they may perceive receiving less support, possibly as appreciation for their efforts . In a prior APIM analyses with a different sample of cancer survivors and their family caregivers, we also identified significant longitudinal partner effects between cancer patients’ depression and their family caregivers . Helping YBCS and relatives identify and manage depression is an important intervention area.…”

Family caregivers' level of mastery predicts survival of patients with glioblastoma: A preliminary report

“…A study in 100 patients with breast cancer hinted in this direction because distress within the marital relationship was found to influence patients' recovery and symptom severity, and a small number of other studies have found that caregiver distress can influence the physical functioning of patients with cancer . However, another recent, large study in patients with advanced cancer (484 patients) failed to demonstrate any specific effects of caregivers' mental health or self‐efficacy (a construct similar to mastery) on the patients' physical health . It should be noted that the studies described above did not include patient survival as an outcome.…”