Skip to main content

Advertisement

SpringerLink
Log in

Perceptions of economic hardship and emotional health in a pilot sample of family caregivers

  • Clinical study - patient study
  • Published:
Journal of Neuro-Oncology Aims and scope Submit manuscript

Abstract

Although several studies have quantified costs of cancer care; none to date have examined how cancer costs impact family caregivers’ emotional health. This study was designed to evaluate how perceptions of economic hardship influence burden, depressive symptoms, and anxiety in family caregivers of persons with a primary malignant brain tumor. Caregiver (CG)/patient dyads (n = 33) were recruited at the time of diagnosis; data were collected at diagnosis and 4 months, and linear regression determined the impact of economic hardship on caregivers’ emotional health. Economic hardship did not predict CG burden-schedule at diagnosis or 4 months. Economic hardship predicted burden-abandonment at diagnosis (P < 0.01), but not 4 months. There was a trend for economic hardship to predict CG depressive symptoms at 4 months (P = 0.09), but not at diagnosis. Economic hardship predicted CG anxiety at 4 months (P = 0.06), but not diagnosis. Results suggest caregivers’ economic hardship is an important and dynamic aspect of the emotional health of neuro-oncology family caregivers.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Pinquart M, Sorensen S (2003) Differences between caregivers and non-caregivers in psychological health and physical function: a meta-analysis. Psychol Aging 18(2):250–267. doi:10.1037/0882-7974.18.2.250

    Article  PubMed  Google Scholar 

  2. Sherwood P, Given B, Donovan H, Given C et al (2008) Guiding research in family care: a new approach to oncology caregiving. Psychooncology 17:986–996

    Google Scholar 

  3. Vitaliano P, Scanlan J, Zhang J (2003) Is caregiving hazardous to one’s physical health? A meta-analysis. Psychol Bull 129(6):946–972. doi:10.1037/0033-2909.129.6.946

    Article  PubMed  Google Scholar 

  4. American Cancer Society (2007) Cancer facts & figures 2007. American Cancer Society, Atlanta

    Google Scholar 

  5. Moore KA (1999) Breast cancer patients’ out-of-pocket expenses. Cancer Nurs 22(5):389–396. doi:10.1097/00002820-199910000-00007

    Article  PubMed  CAS  Google Scholar 

  6. Bradley CJ, Oberst K, Schenk M (2006) Absenteeism from work: the experience of employed breast and prostate cancer patients in the months following diagnosis. Psychooncology 15:739–747. doi:10.1002/pon.1016

    Article  PubMed  Google Scholar 

  7. Bradley CJ, Neumark D, Luo Z, Schenk M (2007) Employment and cancer: findings from a longitudinal study of breast and prostate cancer survivors. Cancer Invest 25:47–54. doi:10.1080/07357900601130664

    Article  PubMed  Google Scholar 

  8. Wimo A, Mattsson B, Adolfsson R et al (1993) Dementia day care and its effects on symptoms and institutionalization—a controlled Swedish study. Scand J Prim Health Care 11:117–123. doi:10.3109/02813439308994913

    Article  PubMed  CAS  Google Scholar 

  9. Moore MJ, Zhu CW, Clipp EC (2001) Informal costs of dementia care: estimates from the national longitudinal caregiver study. J Gerontol 56B(4):S219–S228

    Google Scholar 

  10. Kubzansky LD, Kawachi I, Spiro A et al (1997) Is worrying bad for your heart? A prospective study of worry and coronary heart disease in the normative aging study. Circulation 95:818–824

    PubMed  CAS  Google Scholar 

  11. Hagquist CEI (1998) Economic stress and perceived health among adolescents in Sweden. J Adolesc Health 22(3):250–257. doi:10.1016/S1054-139X(97)00168-7

    Article  PubMed  CAS  Google Scholar 

  12. Given B, Wyatt G, Given C et al (2004) Burden and depression among caregivers of patients with cancer at the end of life. Oncol Nurs Forum 31(6):1105–1117. doi:10.1188/04.ONF.1105-1117

    Article  PubMed  Google Scholar 

  13. Kozachik SL, Given C, Given B et al (2001) Improving depressive symptoms among caregivers of patients with cancer: results of a randomized clinical trial. Oncol Nurs Forum 28(7):1149–1157

    PubMed  CAS  Google Scholar 

  14. Bradley S, Sherwood PR, Donovan HS et al (2007) I could lose everything: understanding the cost of a brain tumor. J Neurooncol 85:329–338

    Google Scholar 

  15. Barrera M, Caples H, Tein J (2001) The psychological sense of economic hardship: measurement models, validity and cross ethnic equivalence for urban families. Am J Community Psychol 29:493–517. doi:10.1023/A:1010328115110

    Article  PubMed  Google Scholar 

  16. Nijboer C, Tempelaar R, Triemstra M et al (2001) The role of social and psychologic resources in caregiving of cancer patients. Cancer 91(5):1029–1039. doi: 10.1002/1097-0142(20010301)91:5<1029::AID-CNCR1094>3.0.CO;2-1

    Article  PubMed  CAS  Google Scholar 

  17. Gaugler J, Davey A, Pearlin LI, Zarit SH (2000) Modeling caregiver adaptation over time: the longitudinal impact of behavior problems. Psychol Aging 15(3):437–450. doi:10.1037/0882-7974.15.3.437

    Article  PubMed  CAS  Google Scholar 

  18. Bookwala J, Schulz R (1998) The role of neuroticism and mastery in spouse caregivers’ assessment of and response to a contextual stressor. J Gerontol Ser B 53(3):155–164

    Google Scholar 

  19. Jang Y, Clay OJ, Roth DL et al (2004) Neuroticism and longitudinal change in caregiver depression: impact of a spouse-caregiver intervention program. Gerontologist 44(3):311–317

    PubMed  Google Scholar 

  20. Goldstein NE, Concato J, Fried TR et al (2004) Factors associated with caregiver burden among caregivers of terminally ill patients with cancer. J Palliat Care 20(1):38–43

    PubMed  Google Scholar 

  21. Goode KT, Haley WE, Roth DL, Ford GR (1998) Predicting longitudinal changes in caregiver physical and mental health: a stress process model. Health Psychol 17(2):190–198. doi:10.1037/0278-6133.17.2.190

    Article  PubMed  CAS  Google Scholar 

  22. Fillit HM, Gutterman EM, Brooks RL (2000) Impact of donepezil on caregiving burden for patients with Alzheimer’s disease. Am J Manag Care 6(22):S1149–S1155

    PubMed  CAS  Google Scholar 

  23. Kaufer DI, Cummings JL, Ketchel P et al (2000) Validation of the NPI-Q, a brief clinical form of the neuropsychiatric inventory. J Neuropsychiatry Clin Neurosci 12(2):233–239. doi:10.1176/appi.neuropsych.12.2.233

    PubMed  CAS  Google Scholar 

  24. Sherwood PR (PI) (2003) Family care of persons with a brain tumor (grant # F31 NR8069), Funded by the National Institute for Nursing Research, 8/02–8/04

  25. Sherwood PR, Given B, Doorenbos AZ, Given CW (2004) Forgotten voices: lessons from bereaved caregivers of persons with a brain tumor. Int J Palliat Nurs 10(2):67–75

    PubMed  Google Scholar 

  26. Sherwood PR, Given B, Given CW et al (2006) Predictors of distress in caregivers of persons with a primary malignant brain tumor. Res Nurs Health 29(2):105–120. doi:10.1002/nur.20116

    Article  PubMed  Google Scholar 

  27. Schulz R, Belle SH, Czaja SJ et al (2004) Long-term care placement of dementia patients and caregiver health and well-being. JAMA 292(8):961–967. doi:10.1001/jama.292.8.961

    Article  PubMed  CAS  Google Scholar 

  28. McNair DM, Lorr M (1964) An analysis of mood in neurotics. J Abnorm Soc Psychol 69:620–627. doi:10.1037/h0040902

    Article  CAS  Google Scholar 

  29. Goldberg L (1992) The development of markers for the big five factor structure. Psychol Assess 4:26–42. doi:10.1037/1040-3590.4.1.26

    Article  Google Scholar 

  30. Cohen S, Mermelstein R, Kamarck T, Hoberman H (1985) Measuring the functional components of social support. In: Sarason IG, Sarason BR (eds) Social support: theory, research and applications. Martinus Nijhoff, The Hague, pp 73–94

    Google Scholar 

  31. Kiernan RJ, Mueller J, Langston JW, Van Dyke C (1987) The neurobehavioral cognitive status examination: a brief but quantitative approach to cognitive assessment. Ann Intern Med 107(4):481–485

    PubMed  CAS  Google Scholar 

  32. Given CW, Given B, Stommel M et al (1992) The caregiver reaction assessment (CRA) for caregivers to persons with chronic physical and mental impairments. Res Nurs Health 15(4):271–283. doi:10.1002/nur.4770150406

    Article  PubMed  CAS  Google Scholar 

  33. Nijboer C, Triemstra M, Tempelaar R et al (1999) Measuring both negative and positive reactions to giving care to cancer patients: psychometric qualities of the Caregiver Reaction Assessment (CRA). Soc Sci Med 48:1259–1269. doi:10.1016/S0277-9536(98)00426-2

    Article  PubMed  CAS  Google Scholar 

  34. Radloff L (1977) The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas 1:385–401. doi:10.1177/014662167700100306

    Article  Google Scholar 

  35. Radloff LS (1991) The use of the center for epidemiologic studies depression scale in adolescents and young adults. J Youth Adolesc 20(2):149–166. doi:10.1007/BF01537606

    Article  Google Scholar 

  36. Hann D, Winter K, Jacobsen P (1999) Measurement of depressive symptoms in cancer patients: evaluation of the center for epidemiological studies depression scale (CES-D). J Psychosom Res 46:437–443. doi:10.1016/S0022-3999(99)00004-5

    Article  PubMed  CAS  Google Scholar 

  37. Usala P, Hertzog C (1989) Measurement of affective states in adults: evaluation of an adjective rating scale instrument. Res Aging 11(4):403–426. doi:10.1177/0164027589114001

    Article  PubMed  CAS  Google Scholar 

  38. Poverty Thresholds (2006) U.S. Census Bureau. http://www.census.gov/hhes/www/poverty/poverty.html. Cited 11 June 2008

  39. Blood GW, Simpson KC, Dineen M et al (1994) Spouses of laryngeal cancer: caregiver strain and burden. J Commun Disord 27:19–35. doi:10.1016/0021-9924(94)90008-6

    Article  PubMed  CAS  Google Scholar 

  40. Zarit SH, Todd PA, Zarit JM (1986) Subjective burden of husbands and wives as caregivers: a longitudinal study. Gerontologist 26:260–266

    PubMed  CAS  Google Scholar 

  41. Nabors J, Seacat J, Rosenthal M (2002) Predictors of caregiver burden following traumatic brain injury. Brain Inj 16(12):1039–1050. doi:10.1080/02699050210155285

    Article  PubMed  Google Scholar 

  42. Chumbler N, Grimm JW, Cody M, Beck C (2003) Gender, kinship, and caregiver burden: the case of community-dwelling memory impaired seniors. Int J Geriatr Psychiatry 18:722–732. doi:10.1002/gps.912

    Article  PubMed  Google Scholar 

  43. Bookwala J, Schulz R (2000) A comparison of primary stressors, secondary stressors, and depressive symptoms between elderly caregiving husbands and wives: the caregiver health effects study. Psychol Aging 15(4):607–616. doi:10.1037/0882-7974.15.4.607

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Graduate School of Public Health, University of Pittsburgh, Pittsburgh, USA

    Sarah E. Bradley, Candace M. Kammerer, Elizabeth A. Gettig & Wesley M. Rohrer

  2. School of Nursing, University of Pittsburgh, 336 Victoria Building, 3500 Victoria Street, Pittsburgh, PA, 15261, USA

    Paula R. Sherwood, Jean Kuo, Dianxu Ren, Heidi S. Donovan, Allison Hricik & Alyssa Newberry

  3. Department of Neurosurgery, School of Medicine, University of Pittsburgh, Pittsburgh, USA

    Paula R. Sherwood

  4. School of Health & Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, USA

    Wesley M. Rohrer

  5. College of Nursing, Michigan State University, East Lansing, USA

    Barbara Given

Authors
  1. Sarah E. Bradley
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Paula R. Sherwood
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jean Kuo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Candace M. Kammerer
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Elizabeth A. Gettig
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Dianxu Ren
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Wesley M. Rohrer
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Heidi S. Donovan
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Allison Hricik
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Alyssa Newberry
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Barbara Given
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Paula R. Sherwood.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bradley, S.E., Sherwood, P.R., Kuo, J. et al. Perceptions of economic hardship and emotional health in a pilot sample of family caregivers. J Neurooncol 93, 333–342 (2009). https://doi.org/10.1007/s11060-008-9778-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11060-008-9778-z

Keywords

Search

Navigation