Symptom distress and quality of life among Black Americans with cancer and their family caregivers
Open accessAbstract
Objective: Black Americans are disproportionately affected by cancer and chronic diseases. Black patients with cancer and their family caregivers may concurrently experience symptoms that influence their wellbeing. This study investigates the influence of mental and physical symptom distress on quality of life (QOL) among Black Americans with cancer and their family caregivers from a dyadic perspective. Methods: One hundred and fifty‐one dyads comprised of a Black American with breast, colorectal, lung or prostate cancer and a Black family caregiver were included in this secondary analysis of pooled baseline data from three studies. Self‐reports of problems managing 13 symptoms were used to measure mental and physical symptom distress. Descriptive statistics and the actor‐partner interdependence model were used to examine symptom prevalence and the influence of each person's symptom distress on their own and each other's QOL. Results: Fatigue, sleep problems, pain and mental distress were prevalent. Patients and caregivers reported similar levels of mental distress; however, patients reported higher physical distress. Increased patient mental distress was associated with decreased patient QOL (overall, emotional, social, functional). Increased patient physical distress was associated with decreased patient QOL (overall, physical, emotional, functional) and decreased caregiver emotional wellbeing. Increased caregiver mental distress was associated with decreased caregiver QOL (overall, emotional, social, functional) and decreased patient overall QOL. Increased caregiver physical distress was associated with decreased caregiver QOL (overall, physical, functional), decreased patient emotional wellbeing, and better patient social wellbeing. Conclusions: Supporting symptom management in Black patient/caregiver dyads may improve their QOL.
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There is interdependence between patient and caregiver distress.
“We focused on NPIs that targeted both patients and caregivers, reflecting the growing body of literature regarding interdependence between patient and caregiver distress. 110 , 111 , 112 , 113 , 141”
From Nonpharmacologic interventions for managing distress, anxiety, and depression for patients with cancer and their family caregivers: A systematic review and meta‐analysis (2026) · cites this paper as [110]
The Results (Symptom Distress → QOL, Partner Effects; page unavailable) report that distress in one member of a Black American patient–caregiver dyad was associated with the other member’s quality of life. The Discussion calls this interdependence in their wellbeing, but the reported partner effects do not establish a direct association between patient distress and caregiver distress. (LLM, conf=0.82)
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- Authors
- Ellis, K. R., Oh, S., Hecht, H. K., & Northouse, L.
- Affiliations
- University of Michigan (US)
- School of Social Work University of Michigan Ann Arbor Michigan USA
- University of North Carolina at Chapel Hill (US)
- Corresponding author
- Ellis, Katrina R.
- Venue
- Psycho-Oncology
- Publisher
- Wiley
- Published
- 2021-04-16
- Volume
- 30
- Issue
- 8
- Pages
- 1356-1365
- ISSN
- 1057-9249 (ISSN-L)
- 1099-1611
- PMC
- PMC8672379
- OpenAlex
- W3151124065
- Cited by
- 30
- References
- 38
- Citations by year
- 2026: 6 · 2025: 7 · 2024: 8 · 2023: 6 · 2022: 3
- FWCI
- 1.55
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Psycho-Oncology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Deep Blue (University of Michigan) (submittedVersion)
- Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion)
- UNC Libraries
- Funders
- Michigan Center for Urban African American Aging Research ((No grant number))
- National Cancer Institute (P30CA046592‐S, R01CA90739, RO1CA107383)
- National Institute on Aging (P30 AG015281)
- National Heart, Lung, and Blood Institute (2R25HL126145)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Health Professions › Pharmacy › Nursing care and research
- Social Sciences › Sociology and Political Science › Family Support in Illness
- Keywords
- African Americans, cancer, family caregivers, symptom distress, quality of life, psychological distress, physical distress, fatigue, sleep disorders, pain, dyads, actor-partner interdependence, breast cancer, colorectal cancer, lung cancer, prostate cancer, caregiver well-being
- MeSH terms
- Chronic Disease, Humans, Male, Neoplasms, Quality of Life, Caregivers, Self Report
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