Cited by 62Nursing care and researchCancer survivorship and carePalliative Care and End-of-Life Issues

Caring for a spouse with advanced cancer: similarities and differences for male and female caregivers

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Ketcher, Dana, Trettevik, Ryan, Vadaparampil, Susan T., Heyman, Richard E., Ellington, Lee, Reblin, Maija·2020·Journal of Behavioral Medicine

Abstract

Most caregiving literature has focused on women, who have traditionally taken on caregiving roles. However, more research is needed to clarify the mixed evidence regarding the impact of gender on caregiver/patient psychological outcomes, especially in an advanced cancer context. In this paper, we examine gender differences in caregiver stress, burden, anxiety, depression, and coping styles, as well as how caregiver gender impacts patient outcomes in the context of advanced cancer. Eighty-eight patients with advanced cancer and their caregivers completed psychosocial surveys. All couples were heterosexual and most caregivers were women (71.6%). Female caregivers reported significantly higher levels of perceived stress, depression, anxiety, and social strain compared with male caregivers, and female patients of male caregivers were more likely to use social support as a coping style compared with male patients of female caregivers. These findings highlight the potential differences between male and female caregivers' needs and psychological health.

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References 99 · Cited by 62

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  1. Allen SM (1994). Gender differences in spousal caregiving and unmet need for care. Journal of Gerontology, 49, S187– S195. 8014402
  2. Allen SM, Goldscheider F, & Ciambrone DA (1999). Gender roles, marital intimacy, and nomination of spouse as primary caregiver. The Gerontologist, 39, 150– 158. 10224711
  3. Andershed B (2006). Relatives in end-of-life care–part 1: A systematic review of the literature the five last years, January 1999–February 2004. Journal of Clinical Nursing, 15, 1158– 1169. 16911057
  4. Ankuda CK, Maust DT, Kabeto MU, McCammon RJ, Langa KM, & Levine DA (2017). Association between spousal caregiver well-being and care recipient healthcare expenditures. Journal of the American Geriatrics Society. 10.1111/jgs.15039 PMC5762126 28836269 · DOI
  5. Archbold PG, Stewart BJ, Greenlick MR, & Harvath T (1990). Mutuality and preparedness as predictors of caregiver role strain. Research in Nursing and Health, 13, 375– 384. 10.1002/nur.4770130605 2270302 · DOI
  6. Baider L, Ever-Hadani P, Goldzweig G, Wygoda MR, & Peretz T (2003). Is perceived family support a relevant variable in psychological distress? A sample of prostate and breast cancer couples. Journal of Psychosomatic Research, 55, 453– 460. 14581100
  7. Barnoy S, Bar-Tal Y, & Zisser B (2006). Correspondence in informational coping styles: How important is it for cancer patients and their spouses? Personality and Individual Differences, 41, 105– 115. 10.1016/j.paid.2005.12.013 · DOI
  8. Bharadwaj P, Pai MM, & Suziedelyte A (2017). Mental health stigma. Economics Letters, 159, 57– 60.
  9. Biddle BJ (1986). Recent developments in role theory. Annual Review of Sociology, 12, 67– 92.
  10. Bjelland I, Dahl AA, Haug TT, & Neckelmann D (2002). The validity of the Hospital Anxiety and Depression Scale. An updated literature review. Journal of Psychosomatic Research, 52, 69– 77. 11832252
  11. Bonin-Guillaume S, Durand A-C, Yahi F, Curiel-Berruyer M, Lacroix O, Cretel E, (2015). Predictive factors for early unplanned rehospitalization of older adults after an ED visit: Role of the caregiver burden. Aging Clinical and Experimental Research, 27, 883– 891. 10.1007/s40520-015-0347-y 25835219 · DOI
  12. Burke PJ, & Stets JE (2009). Identity theory. Oxford: Oxford University Press.
  13. Cameron JI, Franche R-L, Cheung AM, & Stewart DE (2002). Lifestyle interference and emotional distress in family caregivers of advanced cancer patients. Cancer, 94, 521– 527. 10.1002/cncr.10212 11900237 · DOI
  14. Campbell LD, & Carroll MP (2007). The incomplete revolution: Theorizing gender when studying men who provide care to aging parents. Men and Masculinities, 9, 491– 508. 10.1177/1097184x05284222 · DOI
  15. Carr D, House JS, Wortman C, Nesse R, & Kessler RC (2001). Psychological adjustment to sudden and anticipated spousal loss among older widowed persons. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 56, S237– S248. 11445616
  16. Cohen S (1988). Perceived stress in a probability sample of the United States. In Oskamp SSS (Ed.), The social psychology of health (pp. 31– 67). Thousand Oaks, CA: Sage Publications Inc.
  17. Cohen S, Kamarck T, & Mermelstein R (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24, 385– 396. 6668417
  18. Comas-d’Argemir D, & Soronellas M (2019). Men as carers in long-term caring: Doing gender and doing Kinship. Journal of Family Issues, 40, 315– 339. 10.1177/0192513x18813185 · DOI
  19. Dionne-Odom JN, Hull JG, Martin MY, Lyons KD, Prescott AT, Tosteson T, (2016). Associations between advanced cancer patients’ survival and family caregiver presence and burden. Cancer Medicine, 5, 853– 862. 10.1002/cam4.653 26860217 PMC4864814 · DOI
  20. Dumont S, Turgeon J, Allard P, Gagnon P, Charbonneau C, & Vezina L (2006). Caring for a loved one with advanced cancer: Determinants of psychological distress in family caregivers. Journal of Palliative Medicine, 9, 912– 921. 10.1089/jpm.2006.9.912 16910806 · DOI
  21. Espnes GA, & Byrne D (2008). Gender differences in psychological risk factors for development of heart disease. Stress and Health: Journal of the International Society for the Investigation of Stress, 24, 188– 195.
  22. Ferrell BR, & Mazanec P (2009). Family caregivers. In Hurria A & Balducci L (Eds.), Geriatric oncology (pp. 135– 155). New York: Springer.
  23. Fitzell A, & Pakenham KI (2010). Application of a stress and coping model to positive and negative adjustment outcomes in colorectal cancer caregiving. Psycho-Oncology, 19, 1171– 1178. 10.1002/pon.1666 20017113 · DOI
  24. Fleming PJ, & Agnew-Brune C (2015). Current trends in the study of gender norms and health behaviors. Current Opinion in Psychology, 5, 72– 77. 10.1016/j.copsyc.2015.05.001 26075291 PMC4461071 · DOI
  25. Fletcher BS, Miaskowski C, Given B, & Schumacher K (2012). The cancer family caregiving experience: an updated and expanded conceptual model. European Journal of Oncology Nursing, 16, 387– 398. 10.1016/j.ejon.2011.09.001 22000812 PMC3290681 · DOI
  26. Flórez-Vargas O, Brass A, Karystianis G, Bramhall M, Stevens R, Cruickshank S, (2016). Bias in the reporting of sex and age in biomedical research on mouse models. Elife, 5, e13615. 26939790 PMC4821800
  27. Gabriel B, Beach SR, & Bodenmann G (2010). Depression, marital satisfaction and communication in couples: Investigating gender differences. Behavior Therapy, 41, 306– 316. 20569780
  28. Gaugler JE, Given WC, Linder J, Kataria R, Tucker G, & Regine WF (2008). Work, gender, and stress in family cancer caregiving. Supportive Care in Cancer, 16, 347– 357. 10.1007/s00520-007-0331-y 17891502 · DOI
  29. Girgis A, Lambert S, Johnson C, Waller A, & Currow D (2013). Physical, psychosocial, relationship, and economic burden of caring for people with cancer: A review. Journal of Oncology Practice, 9, 197– 202. 10.1200/jop.2012.000690 23942921 PMC3710169 · DOI · Paper page
  30. Golden-Kreutz DM, Browne MW, Frierson GM, & Andersen BL (2004). Assessing stress in cancer patients: A second-order factor analysis model for the Perceived Stress Scale. Assessment, 11, 216– 223. 10.1177/1073191104267398 15358877 PMC2746492 · DOI
  31. Goldzweig G, Hubert A, Walach N, Brenner B, Perry S, Andritsch E, (2009). Gender and psychological distress among middle- and older-aged colorectal cancer patients and their spouses: an unexpected outcome. Critical Reviews in Oncology/Hematology, 70, 71– 82. 10.1016/j.critrevonc.2008.07.014 18762432 · DOI
  32. Graham JM, Diebels KJ, & Barnow ZB (2011). The reliability of relationship satisfaction: A reliability generalization meta-analysis. Journal of Family Psychology, 25, 39. 21355645
  33. Grov EK, Dahl AA, Moum T, & Fosså SD (2005). Anxiety, depression, and quality of life in caregivers of patients with cancer in late palliative phase. Annals of Oncology, 16, 1185– 1191. 15849218
  34. Grunfeld E, Coyle D, Whelan T, Clinch J, Reyno L, Earle CC, (2004). Family caregiver burden: Results of a longitudinal study of breast cancer patients and their principal caregivers. Canadian Medical Association Journal, 170, 1795– 1801. 10.1503/cmaj.1031205 15184333 PMC419766 · DOI · Paper page
  35. Hudson P (2004). Positive aspects and challenges associated with caring for a dying relative at home. International Journal of Palliative Nursing, 10, 58– 65. 15039608
  36. Kang J, Shin DW, Choi JE, Sanjo M, Yoon SJ, Kim HK, (2013). Factors associated with positive consequences of serving as a family caregiver for a terminal cancer patient. Psycho-Oncology, 22, 564– 571. 10.1002/pon.3033 22275212 · DOI
  37. Kessler ER, Moss A, Eckhardt SG, Laudenslager ML, Kilbourn K, Mauss IB, (2014). Distress among caregivers of phase I trial participants: A cross-sectional study. Supportive Care in Cancer, 22, 3331– 3340. 10.1007/s00520-014-2380-3 25120010 PMC4356007 · DOI
  38. Kiecolt-Glaser JK, & Newton TL (2001). Marriage and health: His and hers. Psychological Bulletin, 127, 472– 503. 10.1037/0033-2909.127.4.472 11439708 · DOI · Paper page
  39. Kim Y, Carver CS, Shaffer KM, Gansler T, & Cannady RS (2015). Cancer caregiving predicts physical impairments: Roles of earlier caregiving stress and being a spousal caregiver. Cancer, 121, 302– 310. 10.1002/cncr.29040 25209592 · DOI
  40. Kim Y, Loscalzo MJ, Wellisch DK, & Spillers RL (2006). Gender differences in caregiving stress among caregivers of cancer survivors. Psycho-Oncology, 15, 1086– 1092. 10.1002/pon.1049 16634112 · DOI
  41. Kim Y, & Schulz R (2008). Family caregivers’ strains: Comparative analysis of cancer caregiving with dementia, diabetes, and frail elderly caregiving. Journal of Aging and Health, 20, 483– 503. 10.1177/0898264308317533 18420838 · DOI
  42. Langer S, Abrams J, & Syrjala K (2003). Caregiver and patient marital satisfaction and affect following hematopoietic stem cell transplantation: A prospective, longitudinal investigation. Psycho-Oncology, 12, 239– 253. 10.1002/pon.633 12673808 · DOI
  43. Li QP, & Loke AY (2013). A spectrum of hidden morbidities among spousal caregivers for patients with cancer, and differences between the genders: A review of the literature. European Journal of Oncology Nursing, 17, 578– 587. 10.1016/j.ejon.2013.01.007 23465710 · DOI
  44. Matthews BA, Baker F, & Spillers RL (2004). Family caregivers’ quality of life: Influence of health protective stance and emotional strain. Psychology and Health, 19, 625– 641. 10.1080/0887044042000205594 · DOI
  45. Moen P, Robison J, & Dempster-McClain D (1995). Caregiving and women’s well-being: A life course approach. Journal of Health and Social Behavior, 36, 259– 273. 7594358
  46. Montgomery RJV, Stull DE, & Borgatta EF (1985b). Measurement and the analysis of burden. Research on Aging, 7, 137– 152. 10.1177/0164027585007001007 4059631 · DOI
  47. Morgan T, Ann Williams L, Trussardi G, & Gott M (2016). Gender and family caregiving at the end-of-life in the context of old age: A systematic review. Palliative Medicine, 30, 616– 624. 10.1177/0269216315625857 26814213 · DOI
  48. Mott J, Schmidt B, & MacWilliams B (2019). Male caregivers: Shifting roles among family caregivers. Clinical Journal of Oncology Nursing, 23, E17– E24. 10.1188/19.CJON.E17-E24 30681996 · DOI
  49. Navaie-Waliser M, Spriggs A, & Feldman PH (2002). Informal caregiving: Differential experiences by gender. Medical Care, 40, 1249– 1259. 10.1097/01.MLR.0000036408.76220.1F 12458306 · DOI
  50. Neal MB, Ingersoll-Dayton B, & Starrels ME (1997). Gender and relationship differences in caregiving patterns and consequences among employed caregivers. The Gerontologist, 37, 804– 816. 9432997
  51. Northouse LL, Templin T, & Mood D (2001). Couples’ adjustment to breast disease during the first year following diagnosis. Journal of Behavioral Medicine, 24, 115– 136. 11392915
  52. Northouse LL, Williams A-L, Given B, & McCorkle R (2012). Psychosocial care for family caregivers of patients with cancer. Journal of Clinical Oncology, 30, 1227– 1234. 10.1200/jco.2011.39.5798 22412124 · DOI · Paper page
  53. Oechsle K, Goerth K, Bokemeyer C, & Mehnert A (2013). Anxiety and depression in caregivers of terminally ill cancer patients: Impact on their perspective of the patients’ symptom burden. Journal of Palliative Medicine, 16, 1095– 1101. 10.1089/jpm.2013.0038 23909373 · DOI
  54. Palos GR, Mendoza TR, Liao K-P, Anderson KO, Garcia-Gonzalez A, Hahn K, (2011). Caregiver symptom burden: The risk of caring for an underserved patient with advanced cancer. Cancer, 117, 1070– 1079. 10.1002/cncr.25695 20960510 PMC3065823 · DOI
  55. Parkerson GR Jr., Broadhead WE, & Tse CK (1991). Validation of the duke social support and stress scale. Family Medicine, 23, 357– 360. 1884930
  56. Parkerson GR Jr., Michener JL, Wu LR, Finch JN, Muhlbaier LH, Magruder-Habib K, (1989). Associations among family support, family stress, and personal functional health status. Journal of Clinical Epidemiology, 42, 217– 229. 2785165
  57. Perz J, Ussher JM, Butow P, & Wain G (2011). Gender differences in cancer carer psychological distress: An analysis of moderators and mediators. European Journal of Cancer Care (English Language Edition), 20, 610– 619. 10.1111/j.1365-2354.2011.01257.x 21545568 · DOI
  58. Peus D, Newcomb N, & Hofer S (2013). Appraisal of the Karnofsky performance status and proposal of a simple algorithmic system for its evaluation. BMC Medical Informatics and Decision Making, 13, 72. 10.1186/1472-6947-13-72 23870327 PMC3722041 · DOI
  59. Pinquart M, & Duberstein PR (2005). Optimism, pessimism, and depressive symptoms in spouses of lung cancer patients. Psychology and Health, 20, 565– 578. 10.1080/08870440412331337101 · DOI
  60. Polit DF, & Beck CT (2008). Nursing research: Generating and assessing evidence for nursing practice. Philadelphia: Lippincott Williams & Wilkins.
  61. Prigerson HG, Cherlin E, Chen JH, Kasl SV, Hurzeler R, & Bradley EH (2003). The Stressful Caregiving Adult Reactions to Experiences of Dying (SCARED) Scale: A measure for assessing caregiver exposure to distress in terminal care. American Journal of Geriatric Psychiatry, 11, 309– 319. 12724110
  62. Reblin M, Heyman RE, Ellington L, Baucom BRW, Georgiou PG, & Vadaparampil ST (2018). Everyday couples’ communication research: Overcoming methodological barriers with technology. Patient Education and Counseling, 101, 551– 556. 10.1016/j.pec.2017.10.019 29111310 · DOI
  63. Robles TF (2014). Marital quality and health: Implications for marriage in the 21st century. Current Directions in Psychological Science, 23, 427– 432. 10.1177/0963721414549043 25544806 PMC4275835 · DOI
  64. Rossi Ferrario S, Cardillo V, Vicario F, Balzarini E, & Zotti AM (2004). Advanced cancer at home: Caregiving and bereavement. Palliative Medicine, 18, 129– 136. 10.1191/0269216304pm870oa 15046409 · DOI
  65. Rumpold T, Schur S, Amering M, Kirchheiner K, Masel E, Watzke H, (2016). Informal caregivers of advanced-stage cancer patients: Every second is at risk for psychiatric morbidity. Supportive Care in Cancer, 24, 1975– 1982. 10.1007/s00520-015-2987-z 26476628 · DOI
  66. Russell R (2007). Men doing “Women’s Work:” Elderly men caregivers and the gendered construction of care work. The Journal of Men’s Studies, 15, 1– 18.
  67. Sims-Gould J, Martin-Matthews A, & Rosenthal CJ (2010). Family caregiving and helping at the intersection of gender and kinship. In Martin-Matthews A & Phillips JE (Eds.), Aging and caring at the intersection of work and home life: Blurring the boundaries (p. 312). London: Psychology Press.
  68. Stetz KM (1987). Caregiving demands during advanced cancer: The spouse’s needs. Cancer Nursing, 10, 260– 268. 3500774
  69. Swinkels J, Tilburg TV, Verbakel E, & Broese van Groenou M (2019). Explaining the gender gap in the caregiving burden of partner caregivers. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 74, 309– 317. 10.1093/geronb/gbx036 PMC6327655 28379560 · DOI
  70. Taylor SE, Klein LC, Lewis BP, Gruenewald TL, Gurung RAR, & Updegraff JA (2000). Biobehavioral responses to stress in females: Tend-and-befriend, not fight-or-flight. Psychological Review, 107, 411– 429. 10.1037/0033-295X.107.3.411 10941275 · DOI · Paper page
  71. Ussher JM, & Sandoval M (2008). Gender differences in the construction and experience of cancer care: The consequences of the gendered positioning of carers. Psychology and Health, 23, 945– 963. 10.1080/08870440701596585 25160921 · DOI
  72. Van den Berg B, & Spauwen P (2006). Measurement of informal care: An empirical study into the valid measurement of time spent on informal caregiving. Health Economics, 15, 447– 460. 16389664
  73. Wagner CD, Bigatti SM, & Storniolo AM (2006). Quality of life of husbands of women with breast cancer. Psycho-Oncology, 15, 109– 120. 10.1002/pon.928 15852406 · DOI
  74. Williams LA, Giddings LS, Bellamy G, & Gott M (2017). ‘Because it’s the wife who has to look after the man’: A descriptive qualitative study of older women and the intersection of gender and the provision of family caregiving at the end of life. Palliative Medicine, 31, 223– 230. 27371629
  75. Wolf MS, Chang CH, Davis T, & Makoul G (2005). Development and validation of the Communication and Attitudinal Self-Efficacy scale for cancer (CASE-cancer). Patient Education and Counseling, 57, 333– 341. 10.1016/j.pec.2004.09.005 15893217 · DOI
  76. Wong WT, Ussher J, & Perz J (2009). Strength through adversity: Bereaved cancer carers’ accounts of rewards and personal growth from caring. Palliative and Supportive Care, 7, 187– 196. 19538801

Authors
Ketcher, D., Trettevik, R., Vadaparampil, S. T., Heyman, R. E., Ellington, L., & Reblin, M.
Affiliations
  • Moffitt Cancer Center (US)
  • University of Utah (US)
  • New York University (US)
Corresponding author
Reblin, Maija
Venue
Journal of Behavioral Medicine
Published
2019-12-16
Volume
43
Issue
5
Pages
817-828
ISSN
  • 0160-7715 (ISSN-L)
  • 1573-3521
OpenAlex
W2995058642
Cited by
62
References
99
Citations by year
2026: 7 · 2025: 15 · 2024: 9 · 2023: 11 · 2022: 10 · 2021: 6 · 2020: 4
FWCI
9.28
Type
journal article
Language
en
Open access
Locations
  • Journal of Behavioral Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
American Cancer Society (MRSG 13-234-01-PCSM)
Topics
  • Health Sciences › Health Professions › Pharmacy › Nursing care and research
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
Keywords
caregiver gender, advanced cancer, spousal caregiving, caregiver stress, caregiver burden, anxiety, depression, coping styles, social support, patient outcomes, gender differences, couples
MeSH terms
Adaptation, Psychological, Depression, Female, Humans, Male, Neoplasms, Surveys and Questionnaires, Stress, Psychological, Caregivers, Spouses

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