Trajectories of resilience and related factors in primary caregivers of patients with advanced head and neck cancer: A longitudinal cohort study

Abstract

Purpose: Primary caregivers (PC) of patients with advanced head and neck cancer (HNC) report stress during caregiving time post-treatment. We sought to identify the trajectories of resilience from initial completion of treatment to 1-year post-treatment in PC of patients with advanced HNC and to determine the factors associated with trajectories of resilience. Design: In this prospective cohort study with convenience sampling, patient-PC dyads were recruited from a medical center in northern Taiwan between August 2015 and July 2020. Methods: We recruited 120 patient-PC dyads and followed up at treatment completion and 1, 6, and 12 months post-treatment. Generalized estimating equation analysis was performed to identified factors related to resilience. Findings: PCs' overall resilience increased from initial completion of treatment to peak at 1-year post-treatment. Patient factors associated with greater overall resilience included older age, higher performance status, and shorter time since cancer diagnosis; PC factors included reporting more social support, better physical health, and better mental health. Conclusions: PC mental health was the most important factor in the resilience trajectory of patients with advanced HNC cancer. Clinical relevance: Quantifying the relevant factors of trajectories of resilience will help to identify vulnerable PCs and guide survivorship care in the early stages of the post-treatment period.

Predictors of changes in resilience among spousal caregivers of patients with advanced cancer within the first 6 months after initial treatment

“…Our findings revealed a similar trajectory of resistance development, consistent with previous studies (Chen et al, 2020;Lee et al, 2022;Sharp et al, 2022). However, the findings differed from those in a recent study (Heathcote et al, 2021) where caregivers of patients who experienced acute traumatic injury exhibited a significant decline in resilience from the acute stage to 3 months after patient discharge.…”

“…longitudinal research has consistently revealed distinct trajectories of resilient outcomes among individuals over time while providing care for serious illnesses (Bonanno et al, 2002;Lee et al, 2022;Sun et al, 2023). These resilient caregivers often demonstrate the capacity to maintain normal functioning even after traumatic events.…”

“…For instance, Heathcote et al (2021) observed a significant reduction in resilience levels from baseline to the 3month follow-up after patient discharge, underscoring the positive and independent relationship between caregivers' resilience and the patient's physical function. Moreover, Lee et al (2022) reported that the good performance status of patients with cancer significantly predicted more positive trajectories in overall resilience. A primary concern for spouses of patients with cancer consistently revolves around the physical health of the patients.…”

“…This ability to adapt, endure and persist through life's adversities is a positive resource called resilience (Southwick et al, 2014). Studies have shown that resilience remains relatively stable during the initial 6 months and extends over 12 months among family caregivers of patients with cancer when they are confronted with a cancer diagnosis (Lee et al, 2022;Sun et al, 2023). Moreover, the first 6 months after initial anti-cancer therapies represent a critical period for adaptation during advanced cancer treatment (National Cancer Institute, 2022).…”

“…Resilience is widely acknowledged as a personal protective factor for caregivers, contributing to enhanced psychosocial well‐being during and after the challenges associated with caregiving (Palacio et al., 2020; Sun et al., 2021). Prospective and longitudinal research has consistently revealed distinct trajectories of resilient outcomes among individuals over time while providing care for serious illnesses (Bonanno et al., 2002; Lee et al., 2022; Sun et al., 2023). These resilient caregivers often demonstrate the capacity to maintain normal functioning even after traumatic events.…”