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Cited by 29Nursing care and researchCancer survivorship and careFamily Support in Illness

The Psychosocial Impact of Spouse-Caregiver Chronic Health Conditions and Personal History of Cancer on Well-being in Patients With Advanced Cancer and Their Caregivers

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Ketcher, Dana, Otto, Amy K., Vadaparampil, Susan T., Heyman, Richard E., Ellington, Lee, Reblin, Maija·2021·Journal of Pain and Symptom Management
DOI 10.1016/j.jpainsymman.2020.12.008PMC PMC8213866
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Abstract

Context Caregiving during advanced cancer presents many physical and psychological challenges, especially for caregivers who are coping with their own history of cancer or their own chronic health conditions. There is growing recognition that caregiver health and patient health are interdependent. Objectives The objective of this study was to use quantitative and interview data to examine and explore the impact of a caregiver's personal cancer history and chronic health conditions on the psychosocial well-being of both the caregiver and patient. Methods This was a secondary analysis of data from 88 patients with advanced lung/gastrointestinal cancer and their spouse-caregivers. Participants self-reported subjective health, chronic health conditions (including cancer), anxiety and depression symptoms, and social support and social stress. Caregivers self-reported caregiving burden and preparedness for caregiving. Caregivers also completed semistructured interviews. Results Participants were mostly white, non-Hispanic, and in their mid-60s. Caregivers reported 1.40 (SD = 1.14) chronic conditions on average; 11 reported a personal history of cancer ("survivor-caregivers"). The number of caregiver chronic health conditions was positively associated with patient depression symptoms. Patients of survivor-caregivers also reported more depression symptoms than patients of caregivers without cancer (t(85) = -2.35, P = 0.021). Survivor-caregivers reported higher preparedness for caregiving than caregivers without cancer (t(85) = -2.48, P = 0.015). Interview data enriched quantitative findings and identified factors that may drive patient depression, including emotions such as resentment or guilt. Experiencing cancer personally may provide caregivers unique insight into the patient experience. Conclusion Providers should be aware of caregiver chronic conditions and cancer history, given the potential negative effects on patient psychosocial well-being.

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  • Los síntomas de depresión en los cuidadores estuvieron asociados de forma positiva al número de condiciones crónicas de salud del cuidador (p = .041).

    “Los síntomas de depresión en los cuidadores estuvieron asociados de forma positiva a el número de condiciones crónicas de salud del cuidador (p = .041).”

    From Sobrecarga de trabajo en cuidadores de pacientes en cuidados paliativos oncológicos: Una revisión bibliográfica (2023) · cites this paper as Ketcher et al., 2021

    The Results section explicitly says the number of caregiver chronic conditions was not significantly associated with caregiver depression. The positive association at p = .041 was with patient depression symptoms, not caregiver depression symptoms. (LLM, conf=0.94)

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  • Los principales factores que impulsan la depresión emocional son el resentimiento y la culpa.

    “además se identificó como principales factores que impulsan la depresión emociones como el resentimiento y la culpa.”

    From Sobrecarga de trabajo en cuidadores de pacientes en cuidados paliativos oncológicos: Una revisión bibliográfica (2023) · cites this paper as Ketcher et al., 2021

    The Abstract (Results) says interviews identified emotions such as resentment and guilt as factors that may drive depression in patients with advanced cancer. The citing sentence presents them as the principal drivers of depression without the paper’s uncertainty or patient-specific scope. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • La carga del cuidador se correlacionó con el número de condiciones tanto del cuidador como del paciente (p = 0,001).

    “La CdC se correlacionó con el número de condiciones tanto del cuidador como del pacientes (p = 0,001)”

    From Sobrecarga de trabajo en cuidadores de pacientes en cuidados paliativos oncológicos: Una revisión bibliográfica (2023) · cites this paper as Ketcher et al., 2021

    The Results section reports that caregiver stress burden was associated with the number of chronic conditions in both caregivers and patients. However, p = .001 applies only to caregiver conditions; the association with patient conditions was in the opposite direction and had p = .023. The paper found no association with objective or demand burden. (LLM, conf=0.91)

    Experimental — accuracy not yet measured

  • Los síntomas de depresión en los cuidadores están asociados al número de condiciones crónicas de salud del cuidador, y la carga del cuidador se correlaciona con el número de condiciones tanto del cuidador como del paciente.

    “los síntomas de depresión en los cuidadores estuvieron asociados a el número de condiciones crónicas de salud del cuidador y la CdC se correlacionó con el número de condiciones tanto del cuidador como del pacientes (Ketcher et al., 2021).”

    From Sobrecarga de trabajo en cuidadores de pacientes en cuidados paliativos oncológicos: Una revisión bibliográfica (2023) · cites this paper as Ketcher et al., 2021

    The quantitative Results report that caregiver stress burden was associated with the number of chronic conditions in both patients and caregivers, although the association with patient conditions was negative. They explicitly report no significant association between caregivers’ chronic conditions and caregivers’ depression symptoms; the depression association was with patients’ symptoms instead. The burden finding is limited to stress burden, not the other burden measures examined. (LLM, conf=0.91)

    Experimental — accuracy not yet measured

  • Gender differences have been linked to differences in caregiver stress, burden, anxiety, depression, and coping styles, as well as how caregiver's gender impacts patient outcomes in the context of advanced cancer patients.

    “Further, gender differences have been linked to differences in caregiver stress, burden, anxiety, depression, and coping styles, as well as how caregiver’s gender impacts patient outcomes in the context of advanced cancer patients [10, 14].”

    From Preparedness, resilience and unmet needs of informal caregivers of advanced cancer patients in a Regional Mission Hospital in Kenya: Qualitative Study (2023) · cites this paper as [14]

    The Results (Sample Characteristics; page unavailable) report caregivers’ genders, but do not compare outcomes by gender. The Methods (Data Analysis; page unavailable) and Results instead examine chronic conditions and caregivers’ cancer history. Searches for gender differences and caregiver gender found no passage linking gender to caregiver stress, burden, anxiety, depression, coping styles, or patient outcomes. (LLM, conf=0.76)

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Cited by

Sorted by citations

Authors
Ketcher, D., Otto, A. K., Vadaparampil, S. T., Heyman, R. E., Ellington, L., & Reblin, M.
Affiliations
  • Moffitt Cancer Center (US)
  • University of Miami (US)
  • New York University (US)
  • University of Utah (US)
Corresponding author
Reblin, Maija
ORCID
Venue
Journal of Pain and Symptom Management
Publisher
Elsevier BV
Published
2021-08
Volume
62
Issue
2
Pages
303-311
ISSN
0885-3924 (ISSN-L)
DOI
10.1016/j.jpainsymman.2020.12.008
PMC
PMC8213866
OpenAlex
W3113092761
Cited by
29
References
1
Citations by year
2026: 4 · 2025: 3 · 2024: 6 · 2023: 9 · 2022: 7
FWCI
6.18
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Pain and Symptom Management (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Cancer Institute (T32CA090314)
  • National Institutes of Health
  • American Cancer Society (MRSG 13\u2013234\u201301-PCSM, MRSG 13?, 01-PCSM)
Topics
  • Health Sciences › Health Professions › Pharmacy › Nursing care and research
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
  • Social Sciences › Sociology and Political Science › Family Support in Illness
Keywords
spousal caregivers, advanced cancer, patient depression, caregiver depression, caregiver burden, social support, social stress, lung cancer, gastrointestinal cancer, psychosocial well-being
MeSH terms
Adaptation, Psychological, Depression, Humans, Neoplasms, Stress, Psychological, Caregivers, Spouses

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