Quality of life of family caregivers 5 years after a relative's cancer diagnosis: follow-up of the national quality of life survey for caregivers.

Although cancer has been considered as a chronic disease for those diagnosed, the long-term impact of cancer on the family caregivers' quality of life (QOL) remains unknown. Thus, the current study aimed: (a) to characterize family caregivers of cancer survivors, (b) to describe the multidimensional aspects of QOL of family caregivers of cancer survivors, and (c) to identify demographic and caregiving experience factors that may play significant roles in the caregivers' QOL around 5 years after the relative's initial diagnosis. Methods. A total of 1218 caregivers participated in the 5-year follow-up nationwide QOL Survey for Caregivers. Demographics and caregiving experiences were measured 2 years post-diagnosis of their relative's cancer. Multidimensional aspects of QOL were assessed, including mental and physical health, psychological adjustment, and spirituality at 5 years post-diagnosis. Three groups of caregivers were identified: former caregivers due to the recipients being in remission, former caregivers whose recipients were deceased, and current caregivers. Current caregivers reported worst levels of QOL. Bereaved caregivers reported lower levels of psychological and spiritual adjustment than former caregivers whose recipients were in remission. In addition, caregivers' age and stress were consistent predictors of QOL across three caregiver groups at 5 years post-diagnosis. The findings help to increase evidence-based awareness of the long-term impact of cancer on the family caregivers' QOL. Findings also have implications for developing programs, whereby family caregivers in the various phases of caregivership will benefit by improving their QOL.

Kim Y ，Spillers RL ，Hall DL 《-》

Quality of life of family caregivers at 2 years after a relative's cancer diagnosis.

Although a growing body of research has documented the quality of life (QOL) of cancer survivors beyond the initial phase of the survivorship, similar knowledge about family caregivers of cancer survivors remains limited. Thus, the current study aimed: (a) to characterize the multidimensional aspects of the QOL of family caregivers of cancer survivors at 2 years after the diagnosis and (b) to predict certain aspects of caregivers' QOL by their demographic and caregiving characteristics. A total of 1635 caregivers of cancer survivors participated in the nationwide Quality of Life Survey for Caregivers. Multidimensional aspects of QOL were assessed, including mental and physical health, as well as psychological adjustment and spirituality at 2 years post-diagnosis of their relatives' cancer. Family caregivers reported normal levels of QOL after 2 years post-diagnosis, except that they were more likely to experience increased awareness of spirituality than do individuals who personally experience a chronic illness. In addition, caregivers' age and income and care-recipients' poor mental and physical functioning were significant predictors of their QOL at 2 years post-diagnosis. The findings suggest that younger, relatively poor caregivers who are providing care to relatives with poor mental and physical functioning may benefit from interventions to help in their spirituality and psychological and physical adjustment, 2 years after the initial cancer diagnosis. In addition, older, relatively poor caregivers may benefit from programs to reduce the physical burden of caregiving. These findings have implications for advancing public health research and practice.

Kim Y ，Spillers RL 《-》

Quality of life of family caregivers 8 years after a relative's cancer diagnosis: follow-up of the National Quality of Life Survey for Caregivers.

The long-term impact of cancer caregiving on the family caregivers' quality of life (QOL) is currently not known. This study aimed (a) to characterize family caregivers of cancer survivors at 8 years post-diagnosis in terms of multidimensional aspects of QOL and (b) to identify demographic and early caregiving experience characteristics that may play significant roles in predicting the caregivers' longer-term QOL. A total of 1087 caregivers participated in the 8-year follow-up National Quality of Life Survey for Caregivers. Demographics and early caregiving experiences were measured 2 years post-diagnosis of their relative's cancer. Multidimensional aspects of QOL were assessed, including mental and physical health, psychological adjustment, and spirituality at both 2-year and 8-year post-diagnosis. Approximately 90% of family caregivers ceased the caregiver role by 8 years. One-fourth of them were due to bereavement. Caregivers' demographic and early caregiving characteristics were significantly associated with QOL. In addition, being bereaved by the 8-year mark predicted poorer mental health and greater psychological distress independent of contributions of demographic and early caregiving characteristics. Findings provided the first evidence that 8 years after the initial cancer diagnosis in the family, family members who became bereaved suffer from poorer mental health and greater psychological distress. Findings have theoretical implications for better understanding bereavement to cancer and practical implications for developing integrative programs to improve QOL among family members in the various phases of caregivership.

Kim Y ，Shaffer KM ，Carver CS ，Cannady RS ... -  《-》

Prevalence and predictors of depressive symptoms among cancer caregivers 5 years after the relative's cancer diagnosis.

Few studies address the longer term psychological adjustment of family caregivers who provide care to a relative with cancer. This study aimed to document levels of depressive symptoms among caregivers 5 years after their relative's initial diagnosis and to identify psychosocial factors that may prospectively predict caregivers' depressive symptoms at that time. Cancer caregivers participated in a prospective longitudinal study (N = 416; mean age = 55, 65.4% female, 92.9% non-Hispanic White). Demographics and caregiving experiences were measured 2 years after their relative's cancer diagnosis at Time 1 (T1). Depressive symptoms were assessed with the Center for Epidemiologic Studies-Depression scale (Radloff, 1977) at T1 and again at 5 years postdiagnosis (T2). By T2, caregivers had emerged into 3 groups: former caregivers whose recipients were now in remission, current caregivers, and bereaved caregivers. Controlling for T1 depressive symptoms, T1 caregiving stress and lack of social support were both significant prospective predictors of greater depressive symptoms at T2 (ps < .02). Independently, bereaved caregivers reported the greatest depressive symptoms both prior to and after the relative's death. Those who were actively caregiving at T2 displayed the largest increase in depressive symptoms from T1 to T2 (p < .001). The findings highlight the importance of caregiving stress and social support early in caregivership, even for outcomes that emerge 3 years later. Findings suggest that family members who are actively involved in cancer care at the 5-year mark may benefit from programs designed to improve their adjustment to long-term caregiving.

Kim Y ，Shaffer KM ，Carver CS ，Cannady RS ... -  《-》

Cancer caregiving predicts physical impairments: roles of earlier caregiving stress and being a spousal caregiver.

The objective of this study was to investigate associations between earlier caregiving experience and the development of physical impairments over the subsequent 6 years among family caregivers of patients with cancer. Family caregivers of cancer survivors participated in a nationwide survey 2 years after their relative's cancer diagnosis (T1) (N=1517) with follow-up at 5 years (T2) and 8 years (T3) postdiagnosis. Caregivers self-reported their demographics and levels of caregiving stress at T1. Caregiving status ("former" for those whose patient was remission, "bereaved" for those whose patient had died, and "current") and the presence of 3 physical impairments (arthritis, chronic back pain, and heart-related diseases) at the time of assessment were measured at T1 through T3. Caregiving stress was significantly related to concurrent presence of the 3 impairment markers at T1. Stressed caregivers also were more likely to develop heart diseases, and spousal caregivers were more likely than other caregivers to develop arthritis and chronic back pain several years after the initial caregiving experience (at T2 and T3). These effects were independent of age, sex, education, and income at T1, and they were also independent of caregiving status at each assessment. The current findings suggest that the adverse long-term health effects of earlier caregiving stress and of being a spousal caregiver should be acknowledged and that caregiving-related stress management programs should be incorporated into routine health care for family caregivers of cancer patients.

Kim Y ，Carver CS ，Shaffer KM ，Gansler T ，Cannady RS ... -  《-》