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.
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Data availability
The data that support the findings of this study are available from the corresponding author upon reasonable request.
Code availability
Not applicable.
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Acknowledgements
We thank all the clinicians and staff at the O’Neal Comprehensive Cancer Center at the University of Alabama at Birmingham for supporting this study. We also thank Julie Schach, James Mapson, Gjuana Cleveland, Tawny S. Martin, Diane Williams, Gail Averett, and Beth Ruf for assisting with the recruitment and data collection and Charis Smith for the study coordination. Most of all, we thank all the family caregivers and patients for contributing their time to this study.
Funding
The study was supported by funding from the National Institute of Nursing Research (R00NR015903) and the National Palliative Care Research Center (no grant #).
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Drs. J. Nicholas Dionne-Odom, Andres Azuero, and Abby R. Rosenberg contributed to the study conception and design. Study oversight, material preparation, and data collection were performed by Drs. J. Nicholas Dionne-Odom, Andres Azuero, Richard Taylor, Sally Engler, Peggy McKie, and Marie Bakitas. Analyses were performed by Drs. J. Nicholas Dionne-Odom and Andres Azuero. The first draft of manuscript was written by Drs. J. Nicholas Dionne-Odom and Abby R. Rosenberg. All authors commented on prior versions of the manuscript. All authors read and approved the final manuscript.
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This study was approved by the University of Alabama at Birmingham Institutional Review Board (IRB Protocol Numbers: 300000979 and 300003601) and was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments. Informed consent was obtained from all individual participants in this study.
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Dionne-Odom, J.N., Azuero, A., Taylor, R.A. et al. Resilience, preparedness, and distress among family caregivers of patients with advanced cancer. Support Care Cancer 29, 6913–6920 (2021). https://doi.org/10.1007/s00520-021-06265-y
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DOI: https://doi.org/10.1007/s00520-021-06265-y