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Hidden Morbidity in Cancer: Spouse Caregivers
Open accessAbstract
PURPOSE: This study assesses psychological distress among advanced cancer patients and their spouse caregivers, while examining the relative contribution of caregiving burden and relational variables (attachment orientation and marital satisfaction) to depressive symptoms in the spouse caregivers. METHODS: A total of 101 patients with advanced GI or lung cancer and their spouse caregivers were recruited for the study. Measures included Beck Depression Inventory-II (BDI-II), Caregiving Burden scale, Experiences in Close Relationships scale, and ENRICH Marital Satisfaction scale. RESULTS: A total of 38.9% of the caregivers reported significant symptoms of depression (BDI-II > or = 15) compared with 23.0% of their ill spouses (P < .0001). In a hierarchical regression predicting caregiver's depression, spouse caregiver's age and patient's cancer site were entered in the first step, objective caregiving burden was entered in the second step, subjective caregiving burden was entered in the third step, caregiver's attachment scores were entered in the fourth step, and caregiver's marital satisfaction score was entered in the fifth step. The final model accounted for 37% of the variance of caregiver depression, with subjective caregiving burden (beta = .38; P < .01), caregiver's anxious attachment (beta = .21; P < .05), caregiver's avoidant attachment (beta = .20; P < .05), and caregiver's marital satisfaction (beta = -.18; P < .05) making significant contributions to the model. CONCLUSION: Spouse caregivers of patients with advanced cancer are a high-risk population for depression. Subjective caregiving burden and relational variables, such as caregivers' attachment orientations and marital dissatisfaction, are important predictors of caregiver depression.
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“Family caregivers of cancer patients exhibit high levels of stress and depression, lower subjective well-being, worse physical health, and higher mortality compared to non-caregivers [2–8, 19–25], yet few studies focus on improving outcomes for caregivers [26].”
From Being present: A single-arm feasibility study of audio-based mindfulness meditation for colorectal cancer patients and caregivers (2018) · cites this paper as [2]
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“A cancer diagnosis is associated with high levels of distress, leading to frequent anxiety, depression, fear of recurrence/progression, sleep disturbance, and fatigue in both patients and caregivers [1–8].”
From Being present: A single-arm feasibility study of audio-based mindfulness meditation for colorectal cancer patients and caregivers (2018) · cites this paper as [2]
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“Conversely, longer survival comes at a cost for caregivers: the negative effects of caregiving, including a higher mortality rate, are most pronounced in caregivers of patients with advanced cancer [2, 3, 20], particularly when patients have a protracted disease course [25] and are receiving palliative care [4, 21].”
From Being present: A single-arm feasibility study of audio-based mindfulness meditation for colorectal cancer patients and caregivers (2018) · cites this paper as [2]
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“Distress in caregivers contributes to distress in patients [24], in addition to negatively impacting the health of caregivers themselves [2–4, 20, 21, 25], and likely other family members (e.g. many of our participants had young children).”
From Being present: A single-arm feasibility study of audio-based mindfulness meditation for colorectal cancer patients and caregivers (2018) · cites this paper as [2]
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“A metastatic cancer diagnosis is associated with high levels of distress in patients and caregivers.”
From Being present: A single-arm feasibility study of audio-based mindfulness meditation for colorectal cancer patients and caregivers (2018) · cites this paper as [2]
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“Yet we found comparable distress levels in patients and caregivers, and emotional distress in particular may be even higher in caregivers, corroborating previous findings [2–6].”
From Being present: A single-arm feasibility study of audio-based mindfulness meditation for colorectal cancer patients and caregivers (2018) · cites this paper as [2]
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Metadata
- Authors
- Braun, M., Mikulincer, M., Rydall, A., Walsh, A., & Rodin, G.
- Affiliations
- University Health Network (CA)
- Venue
- Journal of Clinical Oncology
- Published
- 2007-10-20
- Volume
- 25
- Issue
- 30
- Pages
- 4829-4834
- ISSN
- 0732-183X (ISSN-L)
- 1527-7755
- OpenAlex
- W2132645593
- Cited by
- 526
- References
- 58
- Citations by year
- 2026: 7 · 2025: 8 · 2024: 26 · 2023: 20 · 2022: 32 · 2021: 30 · 2020: 41 · 2019: 30 · 2018: 35 · 2017: 26 · 2016: 30 · 2015: 32 · 2014: 40 · 2013: 44 · 2012: 43
- FWCI
- 55.01
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Clinical Oncology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Princess Margaret Hospital Foundation
- Canadian Institutes of Health Research
- Topics
- Health Sciences › Nursing › Research and Theory › Nursing care and research
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Social Sciences › Psychology › Social Psychology › Attachment and Relationship Dynamics
- Keywords
- spousal caregivers, caregiver depression, advanced cancer, caregiver burden, attachment orientation, marital satisfaction, gastrointestinal cancer, lung cancer, psychological distress, marital relationships
- MeSH terms
- Adaptation, Psychological, Adult, Aged, Aged, 80 and over, Depression, Emotions, Female, Humans, Male, Middle Aged, Morbidity, Neoplasms, Palliative Care, Risk Factors, Terminal Care, Caregivers
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