Resilience, preparedness, and distress among family caregivers of patients with advanced cancer

J Nicholas Dionne-Odom; Andres Azuero; Richard A Taylor; Rachel D Wells; Bailey A Hendricks; Avery C Bechthold; Rhiannon D Reed; Erin R Harrell; Chinara K Dosse; Sally Engler; Peggy McKie; Deborah Ejem; Marie A Bakitas; Abby R Rosenberg

doi:10.1007/s00520-021-06265-y

Resilience, preparedness, and distress among family caregivers of patients with advanced cancer

Support Care Cancer. 2021 Nov;29(11):6913-6920. doi: 10.1007/s00520-021-06265-y. Epub 2021 May 24.

Authors

Affiliations

¹ School of Nursing, University of Alabama At Birmingham, Birmingham, AL, USA. dionneod@uab.edu.
² School of Nursing, University of Alabama At Birmingham, Birmingham, AL, USA.
³ Comprehensive Transplant Institute, University of Alabama At Birmingham, Birmingham, AL, USA.
⁴ Department of Psychology, University of Alabama, Tuscaloosa, AL, USA.
⁵ Division of Hematology-Oncology, Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA.
⁶ Cambia Palliative Care Center of Excellence, University of Washington, Seattle, WA, USA.
⁷ Palliative Care and Resilience Lab, Seattle Children's Research Institute, Seattle, WA, USA.

Abstract

Objective: Resilience has been proposed as a primary factor in how many family caregivers of patients with advanced cancer are able to resist psychological strain and perform effectively in the role while bearing a high load of caregiving tasks. To evaluate this hypothesis, we examined whether self-perceived resilience is associated with distress (anxiety and depressive symptoms), caregiver preparedness, and readiness for surrogate decision-making among a racially diverse sample of family caregivers of patients with newly diagnosed advanced cancer.

Methods: Secondary analysis of baseline data from two small-scale, pilot clinical trials that both recruited family caregivers of patients with newly diagnosed advanced cancer. Using multivariable linear regression, we analyzed relationships of resilience as a predictor of mood, caregiving preparedness, and readiness for surrogate decision-making, controlling for sociodemographics.

Results: Caregiver participants (N = 112) were mean 56 years of age and mostly female (76%), the patient's spouse/partner (52%), and White (56%) or African-American/Black (43%). After controlling for demographics, standardized results indicated that higher resilience was relevantly associated with higher caregiver preparedness (beta = .46, p < .001), higher readiness for surrogate decision-making (beta = .20, p < .05) and lower anxiety (beta = - .19, p < .05), and depressive symptoms (beta = - .20, p < .05).

Conclusions: These results suggest that resilience may be critical to caregivers' abilities to manage stress, be effective sources of support to patients, and feel ready to make future medical decisions on behalf of patients. Future work should explore and clinicians should consider whether resilience can be enhanced in cancer caregivers to optimize their well-being and ability to perform in the caregiving and surrogate decision-making roles.

Keywords: Cancer; Decision-making; Distress; Family caregiving; Resilience.

Publication types

Clinical Trial

MeSH terms

Anxiety
Caregivers*
Emotions
Family
Female
Humans
Male
Neoplasms* / therapy
Stress, Psychological

Abstract

Publication types

MeSH terms

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