Abstract
Introduction
This study examined the effects of the survivor’s cancer type (gender-specific vs nongender-specific) and the female caregiver’s spirituality and caregiving stress on the caregiver’s psychological distress. Cancer caregivers, who were nominated by cancer survivors, participated in a nationwide quality-of-life survey with 252 caregivers providing complete data for the variables.
Patients and methods
Breast and ovarian cancer were categorized as gender-specific types of cancer (GTC+), whereas kidney, lung, non-Hodgkin’s lymphoma (NHL), and skin melanoma cancers were GTC-. Spirituality, caregiving stress, and psychological distress were measured using the functional assessment of chronic illness therapy—spiritual well-being, stress overload subscale, and profile of mood states—short form, respectively.
Results and discussion
Hierarchical regression analyses revealed that female caregivers whose care recipient was diagnosed with a nongender specific type of cancer (GTC- group) reported higher psychological distress than did the GTC+ group. The GTC- group also reported lower spirituality and higher caregiving stress related to higher psychological distress than did the GTC+ group. In addition, the beneficial effect of spirituality on reducing psychological distress was more pronounced among the GTC- group or when caregiving stress increased.
Conclusions
Our findings suggest that female caregivers of survivors with a nongender-specific cancer may benefit from programs designed to reduce their psychological distress, and caregivers who are low in spirituality need help to derive faith and meaning in the context of cancer care.
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References
American Cancer Society (2007) Cancer facts and figures, 2007. American Cancer Society, Atlanta, GA
American Cancer Society (2005) Cancer facts and figures, 2005. American Cancer Society, Atlanta, GA
Rees G, Fry A, Cull A (2001) A family history of breast cancer: women’s experiences from a theoretical perspective. Soc Sci Med 52:1433–1440
Baider L, Ever-Hadani P, De-Nour AK (1999) Psychological distress in healthy women with familial breast cancer: like mother, like daughter? Int J Psychiatry Med 29:411–420
Bovbjerg DH, Valdimarsdottir HB (2001) Interventions for healthy individuals at familial risk for cancer: biobehavioral mechanisms for health benefits. Psychosocial interventions for cancer. American Psychological Association, Washington, DC
Paloutzian R, Ellison C (1982) Loneliness, spiritual well-being, and the quality of life. In: Peplau L, Perlman D (eds) Loneliness: a source book of current theory, research, and therapy. Wiley, New York
Kim Y, Seidlitz L (2002) Spirituality moderates the effect of stress. Pers Individ Differ 32:1377–1390
Creagan ET (1997) Attitude and disposition: do they make a difference in cancer survival? Mayo Clin Proc 72:160–164
Fisch MJ, Titzer ML, Kristeller JL, Shen J, Loehrer PJ, Jung SH, Passik SD, Einhorn LH (2003) Assessment of quality of life in outpatients with advanced cancer: the accuracy of clinician estimations and the relevance of spiritual well-being—a Hoosier Oncology Group Study. J Clin-Oncol 21:2754–2759
Laubmeier KK, Zakowski SG, Bair JP (2004) The role of spirituality in the psychological adjustment to cancer: a test of the transactional model of stress and coping. Int J Behav Med 11:48–55
Poindexter CC, Linsk NL (1998) Sources of support in a sample of HIV-affected older minority caregivers. Fam Soc 79:491–503
Poindexter CC, Linsk NL, Warner RS (1999) “He listens...and never gossips”: spiritual coping without church support among older, predominantly African-American caregivers of persons with HIV. Rev Relig Res 40:230–243
Kim Y, Schulz R, Carver CS (2007) Benefit finding in the cancer caregiving experience. Psychosom Med 69:283–291
Manne S, Ostroff J, Winkel G, Goldstein L, Fox K, Grana G (2004) Posttraumatic growth after breast cancer: patient, partner, and couple perspectives. Psychosom Med 66:442–454
Hileman JW, Lackey NR (1990) Self-identified needs of patients with cancer at home and their home caregivers: a descriptive study. Oncol Nurs Forum 17:907–913
Lazarus RS, Folkman S (1984) Stress, appraisal, and coping. Springer, New York
Smith T, Stein KD, Mehta CC, Kaw C, Kepner JL, Buskirk T, Stafford J, Baker F (2007) The rationale, design, and implementation of the American Cancer Society’s studies of cancer survivors. Cancer 109:1–12
Pearlin LI, Mullan JT, Semple SJ, Skaff MM (1990) Caregiving and the stress process: an overview of concepts and their measures. Gerontologist 30:583–594
Nunnally JC (1978) Psychometric theory, 2nd edn. McGraw-Hill, New York
Brady MJ, Peterman AH, Fitchett G, Mo M, Cella D (1999) A case for including spirituality in quality of life measurement in oncology. Psycho-Oncol 8:417–428
Peterman AH, Fitchett G, Brady MJ, Hernandez L, Cella D (2002) Measuring spiritual well-being in people with cancer: the functional assessment of chronic illness therapy–spiritual well-being scale (FACIT-Sp). Ann Behav Med 24:49–58
Shacham S (1983) A shortened version of the Profile of Mood States. J Pers Assess 47:305–306
McNair DM, Lorr M, Droppleman LF (1992) Profile of mood states, revised edn. EdITS/Educational and Industrial Testing Service, San Diego, CA
Kim Y, Baker F, Spillers RL (2007) Cancer caregivers’ quality of life: effects of gender, relationship, and appraisal. Journal of Pain and Symptom Management (in press)
Ware JE Jr, Kosinski M, Keller S (1994) SF-36 physical and mental health summary scales: a user’s manual, 2nd edn. Health Institute, New England Medical Center, Boston, MA
Aiken LS, West SG (1991) Multiple regression: testing and interpreting interaction. Sage, New York
Navaie-Waliser M, Feldman PH, Gould DA, Levine C, Kuerbis AN, Donelan K (2001) The experiences and challenges of informal caregivers: common themes and differences among whites, Blacks, and Hispanics. Gerontologist 41:733–741
Acknowledgment
This study was funded by the American Cancer Society National Home Office, intramural research. The authors thank all the families who participated in this project. The first author dedicates this research to the memory of Heekyoung Kim.
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Kim, Y., Wellisch, D.K., Spillers, R.L. et al. Psychological distress of female cancer caregivers: effects of type of cancer and caregivers’ spirituality. Support Care Cancer 15, 1367–1374 (2007). https://doi.org/10.1007/s00520-007-0265-4
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DOI: https://doi.org/10.1007/s00520-007-0265-4