Impact of Relationship and Communication Variables on Ambulatory Blood Pressure in Advanced Cancer Caregivers

Amy K Otto; Emily C Soriano; Wendy C Birmingham; Susan T Vadaparampil; Richard E Heyman; Lee Ellington; Maija Reblin

doi:10.1093/abm/kaab057

Impact of Relationship and Communication Variables on Ambulatory Blood Pressure in Advanced Cancer Caregivers

Ann Behav Med. 2022 Apr 2;56(4):405-413. doi: 10.1093/abm/kaab057.

Authors

Amy K Otto¹, Emily C Soriano², Wendy C Birmingham³, Susan T Vadaparampil¹, Richard E Heyman⁴, Lee Ellington⁵, Maija Reblin^{1

6}

Affiliations

¹ Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA.
² Department of Psychological and Brain Sciences, University of Delaware, Newark, DE, USA.
³ Department of Psychology, Brigham Young University, Provo, UT, USA.
⁴ Family Translational Research Group, New York University, New York, NY, USA.
⁵ College of Nursing, University of Utah, Salt Lake City, UT, USA.
⁶ College of Medicine, University of Vermont, Burlington, VT, USA.

Abstract

Background: Cancer impacts both patients and their family caregivers. Evidence suggests that caregiving stress, including the strain of taking on a new role, can elevate the risk of numerous health conditions, including high blood pressure (BP). However, the caregiver's psychosocial experiences, including their interpersonal relationship with the patient, may buffer some of the negative physiological consequences of caregiving.

Purpose: To examine the influence of psychosocial contextual variables on caregiver ambulatory BP.

Methods: Participants were 81 spouse-caregivers of patients with advanced gastrointestinal or thoracic cancer. For an entire day at home with the patient, caregivers wore an ambulatory BP monitor that took readings at random intervals. Immediately after each BP reading, caregivers reported on physical circumstances (e.g., posture, activity) and psychosocial experiences since the last BP measurement, including affect, caregiver and patient disclosure, and role perceptions (i.e., feeling more like a spouse vs. caregiver). Multilevel modeling was used to examine concurrent and lagged effects of psychosocial variables on systolic and diastolic BP, controlling for momentary posture, activity, negative affect, and time.

Results: Feeling more like a caregiver (vs. spouse) was associated with lower systolic BP at the same time point. Patient disclosure to the caregiver since the previous BP reading was associated with higher diastolic BP. No lagged effects were statistically significant.

Conclusions: Caregivers' psychosocial experiences can have immediate physiological effects. Future research should examine possible cognitive and behavioral mechanisms of these effects, as well as longer-term effects of caregiver role perceptions and patient disclosure on caregiver psychological and physical health.

Keywords: Ambulatory blood pressure monitoring; Cancer; Caregiver; Couples; Disclosure; Role.

Publication types

Research Support, Non-U.S. Gov't
Research Support, N.I.H., Extramural

MeSH terms

Blood Pressure
Blood Pressure Monitoring, Ambulatory
Caregivers* / psychology
Communication
Humans
Neoplasms* / psychology
Stress, Psychological / psychology

Grants and funding

T32 CA090314/CA/NCI NIH HHS/United States