Supportive Care in Cancer

, Volume 5, Issue 1, pp 53–60

Predictors of postbereavement depressive symptomatology among family caregivers of cancer patients

  • Margot E. Kurtz
  • J. C. Kurtz
  • Charles W. Given
  • Barbara Given
Original Article
  • 148 Downloads

Abstract

The present study investigated two aspects of the sequelae of recent bereavement among family caregivers following the death of their cancer patient: (1) the extent to which depressive symptomatology among family caregivers measured following the death of their patient could be predicted by their levels of depressive symptomatology in the months prior to death, their physical health, the setting in which the patient's death occurred, patient age, gender of the caregiver, consanguinity, financial stress, social support from family and friends during the terminal stage, impact of caregiving activities on caregiver's daily schedule, caregiver optimism, perceived esteem attributed to caregiving, the time between the prebereavement assessment and death, and the time between death and the postbereavement assessment; and (2) whether these same explanatory variables could successfully differentiate those bereaved caregivers whose psychological health improved during the first 3 months following bereavement from those who did not improve. A sample of 114 family caregivers of cancer patients were surveyed for approximately 3 months before and 3 months after the death of their patient. A multivariate analysis of variance using the regression approach was undertaken to determine the primary predictors of postbereavement depressive symptomatology. In addition, a logistic regression analysis was used to attempt to predict those caregivers whose depressive symptomatology would improve during the postbereavement period. Critical factors in determining levels of postbereavement depressive symptomatology were caregiver optimism, prebereavement depressive symptomatology, and levels of social support from friends. Caregiver optimism and prebereavement depressive symptomatology were important in predicting whether caregivers' depressive symptomatology would improve or not. Physicians must be aware that if the social history of a patient reveals that he/she is anticipating or has recently experienced the loss of a family member for whom they were the primary caregiver, this information may be critical in determining whether the illness behavior exhibited by the patient has medical or psychosocial origins.

Key words

Family caregiver Bereavement Depression Cancer patients 

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References

  1. 1.
    Bass DM, Bowman K (1990) The transition from caregiving to bereavement: the relationship of care-related strain and adjustment to death. Gerontologist 30:35–42PubMedGoogle Scholar
  2. 2.
    Ensel W (1986) Measuring depression: the CES-D scale. In: Lin N, Dean A, Ensel W (eds) Social support, life events, and depression. Academic Press, Orlando, Fla, pp 49–70Google Scholar
  3. 3.
    Given CW, Stommel M, Given B, Osuch J, Kurtz ME, Kurtz JC (1993) The influence of cancer patient symptoms, functional states on patient depression and family caregiver reaction and depression. Health Psychol 12:277–285PubMedGoogle Scholar
  4. 4.
    Hertzog C, Van Alstine J, Usala PD, Hultsch DF, Dixon R (1990) Measurement properties of the Center for Epidemiological Studies Depression Scale (CES-D) in older populations. Psychol Assess 2:64–72Google Scholar
  5. 5.
    Houts PS, Lipton A, Harvey HA, Simmonds MA, Bartholomew MJ (1989) Predictors of grief among spouses of deceased cancer patients. J Psychosoc Oncol 7:113–126Google Scholar
  6. 6.
    Koocher GP (1986) Coping with a death from cancer. J Consult Clin Psychol 54:623–631PubMedGoogle Scholar
  7. 7.
    Kurtz ME, Given BA, Kurtz JC, Given CW (1994) Interaction of age, symptoms and survival status on physical and mental health of cancer patients and their families. Cancer 74:7:1–8PubMedGoogle Scholar
  8. 8.
    McHorney CA, Mor V (1988) Predictors of bereavement depression and its health services consequences. Med Care 26:882–893PubMedGoogle Scholar
  9. 9.
    Mola GD, Tamburini M, Fusco C (1990) The role of volunteers in alleviating grief. J Palliat Care 6:6–10Google Scholar
  10. 10.
    Mor V, McHorney C, Sherwood S (1986) Secondary morbidity among the recently bereaved. Am J Psychiatry 143:158–163PubMedGoogle Scholar
  11. 11.
    Mor V, Morris J, Hiris J, Sherwood S (1988) The effect of hospice on where patients die and whether families are satisfied with that outcome. In: Mor V, Greer D, Kastenbaum R (eds) The hospice experiment: is it working? Johns Hopkins University Press, Baltimore, pp 133–146Google Scholar
  12. 12.
    Mullan JT (1992) The bereaved caregiver: a prospective study of changes in well-being. Gerontologist 32:673–683PubMedGoogle Scholar
  13. 13.
    Mulligan JCA (1992) Dying at home: an evaluation of a specialist home care service. Dissert Abstr Int 53:772B–773BGoogle Scholar
  14. 14.
    Norris FH, Murrell SA (1990) Social support, life events, and stress as modifiers of adjustment to bereavement by older adults. Psychol Aging 5:429–436PubMedGoogle Scholar
  15. 15.
    Radloff LS (1977) The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Measure 1:385–401Google Scholar
  16. 16.
    Sable P (1992) Attachment, loss of spouse, and disordered mourning. Fam Soc J Contemp Hum Serv May:266–273Google Scholar
  17. 17.
    Sankar A (1991) Ritual and dying: a cultural analysis of social support for caregivers. Gerontologist 31:43–50PubMedGoogle Scholar
  18. 18.
    Scheier MF, Carver CS (1987) Dispositional optimism and physical wellbeing: the influence of generalized outcome expectancies on health. J Pers 55:169PubMedGoogle Scholar
  19. 19.
    Shanfield SB, Benjamin AH, Swain BJ (1984) Parents' reactions to the death of an adult child from cancer. Am J Psychiatry 141:1092–1094PubMedGoogle Scholar
  20. 20.
    Siegel K, Weinstein L (1983) Anticipatory grief reconsidered. J Psychosoc Oncol 1:61–73Google Scholar
  21. 21.
    Siegel K, Mesagno FP, Christ C (1990) A prevention program for bereaved children. Am J Orthopsychiatry 60:168–175PubMedGoogle Scholar
  22. 22.
    Vachon ML, Freedman K, Formo A, Rogers J, Lyall W, Freeman S (1977) The final illness in cancer: the widow's perspective. Can Med Assoc J 117:1151–1153PubMedGoogle Scholar
  23. 23.
    Yalom ID, Vinogradov S (1988) Bereavement groups: techniques and themes. Int J Group Psychother 38:419–446PubMedGoogle Scholar
  24. 24.
    Zisook S, Shuchter SR (1991) Depression through the first year after the death of a spouse. Am J Psychiatry 148:1346–1352PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1997

Authors and Affiliations

  • Margot E. Kurtz
    • 1
  • J. C. Kurtz
    • 2
  • Charles W. Given
    • 3
  • Barbara Given
    • 4
  1. 1.Department of Family MedicineMichigan State UniversityEast LansingUSA
  2. 2.Department of MathematicsMichigan State UniversityEast LansingUSA
  3. 3.Department of Family PracticeMichigan State UniversityEast LansingUSA
  4. 4.College of NursingMichigan State UniversityEast LangsingUSA

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