Supportive Care in Cancer

, Volume 21, Issue 2, pp 431–437

Distressed family caregivers of lung cancer patients: an examination of psychosocial and practical challenges

  • Catherine E. Mosher
  • Heather A. Jaynes
  • Nasser Hanna
  • Jamie S. Ostroff
Original Article



Lung cancer and its treatment impose many demands on family caregivers, which may increase their risk for distress. However, little research has documented aspects of the caregiving experience that are especially challenging for distressed caregivers of lung cancer patients. This study aimed to explore caregivers’ key challenges in coping with their family member’s lung cancer.


Single, semi-structured qualitative interviews were conducted with 21 distressed family caregivers of lung cancer patients.


Caregivers described three key challenges in coping with their family member’s lung cancer. The most common challenge, identified by 38 % of caregivers, was a profound sense of uncertainty regarding the future as they attempted to understand the patient’s prognosis and potential for functional decline. Another key challenge, identified by 33 % of caregivers, involved time-consuming efforts to manage the patient’s emotional reactions to the illness. Other caregivers (14 %) characterized practical tasks, such as coordinating the patient’s medical care, as their greatest challenge.


Results suggest that clinical efforts are needed to assist distressed caregivers in providing practical and emotional support to the patient and attending to their own emotional needs.


Family caregiver Lung cancer Psychological distress Health Quality of life 


  1. 1.
    Given BA, Given CW, Kozachik S (2001) Family support in advanced cancer. CA Cancer J Clin 51:213–231PubMedCrossRefGoogle Scholar
  2. 2.
    Bailes JS (1997) Health care economics of cancer in the elderly. Cancer 80:1348–1350PubMedCrossRefGoogle Scholar
  3. 3.
    Nijboer C, Tempelaar R, Sanderman R, Triemstra M, Spruijt RJ, van den Bos GA (1998) Cancer and caregiving: the impact on the caregiver’s health. Psychooncology 7:3–13PubMedCrossRefGoogle Scholar
  4. 4.
    Stajduhar K, Funk L, Toye C, Grande G, Aoun S, Todd C (2010) Part 1: home-based family caregiving at the end of life: a comprehensive review of published quantitative research (1998–2008). Palliat Med 24:573–593PubMedCrossRefGoogle Scholar
  5. 5.
    Gaugler JE, Hanna N, Linder J, Given CW, Tolbert V, Kataria R, Regine WF (2005) Cancer caregiving and subjective stress: a multi-site, multi-dimensional analysis. Psychooncology 14:771–785PubMedCrossRefGoogle Scholar
  6. 6.
    van Ryn M, Sanders S, Kahn K, van Houtven C, Griffin JM, Martin M, Atienza AA, Phelan S, Finstad D, Rowland J (2011) Objective burden, resources, and other stressors among informal cancer caregivers: a hidden quality issue? Psychooncology 20:44–52PubMedCrossRefGoogle Scholar
  7. 7.
    Siegel K, Karus DG, Raveis VH, Christ GH, Mesagno FP (1996) Depressive distress among the spouses of terminally ill cancer patients. Cancer Pract 4:25–30PubMedGoogle Scholar
  8. 8.
    Braun M, Mikulincer M, Rydall A, Walsh A, Rodin G (2007) Hidden morbidity in cancer: spouse caregivers. J Clin Oncol 25:4829–4834PubMedCrossRefGoogle Scholar
  9. 9.
    Grunfeld E, Coyle D, Whelan T, Clinch J, Reyno L, Earle CC, Willan A, Viola R, Coristine M, Janz T, Glossop R (2004) Family caregiver burden: results of a longitudinal study of breast cancer patients and their principal caregivers. Can Med Assoc J 170:1795–1801CrossRefGoogle Scholar
  10. 10.
    Carmack Taylor CL, Badr H, Lee JH, Fossella F, Pisters K, Gritz ER, Schover L (2008) Lung cancer patients and their spouses: psychological and relationship functioning within 1 month of treatment initiation. Ann Behav Med 36:129–140PubMedCrossRefGoogle Scholar
  11. 11.
    Kim Y, Duberstein PR, Sörensen S, Larson MR (2005) Levels of depressive symptoms in spouses of people with lung cancer: effects of personality, social support, and caregiving burden. Psychosomatics 46:123–130PubMedCrossRefGoogle Scholar
  12. 12.
    Spiro SG, Douse J, Read C, Janes S (2008) Complications of lung cancer treatment. Semin Respir Crit Care Med 29:302–317PubMedCrossRefGoogle Scholar
  13. 13.
    American Cancer Society (2012) Cancer facts and figures—2012. American Cancer Society, AtlantaGoogle Scholar
  14. 14.
    Lobchuk MM, Murdoch T, McClement SE, McPherson C (2008) A dyadic affair: who is to blame for causing and controlling the patient's lung cancer? Cancer Nurs 31:435–443PubMedCrossRefGoogle Scholar
  15. 15.
    Persson C, Östlund U, Wennman-Larsen A, Wengström Y, Gustavsson P (2008) Health-related quality of life in significant others of patients dying from lung cancer. Palliat Med 22:239–247PubMedCrossRefGoogle Scholar
  16. 16.
    Badr H, Carmack Taylor CL (2008) Effects of relationship maintenance on psychological distress and dyadic adjustment among couples coping with lung cancer. Health Psychol 27:616–627PubMedCrossRefGoogle Scholar
  17. 17.
    Badr H, Carmack Taylor CL (2006) Social constraints and spousal communication in lung cancer. Psychooncology 15:673–683PubMedCrossRefGoogle Scholar
  18. 18.
    Murray SA, Kendall M, Boyd K, Grant L, Highet G, Sheikh A (2010) Archetypal trajectories of social, psychological, and spiritual wellbeing and distress in family care givers of patients with lung cancer: secondary analysis of serial qualitative interviews. BMJ 340:c2581PubMedCrossRefGoogle Scholar
  19. 19.
    Murray SA, Kendall M, Boyd K, Worth A, Benton TF (2004) Exploring the spiritual needs of people dying of lung cancer or heart failure: a prospective qualitative interview study of patients and their carers. Palliat Med 18:39–45PubMedCrossRefGoogle Scholar
  20. 20.
    Lindau ST, Surawska H, Paice J, Baron SR (2011) Communication about sexuality and intimacy in couples affected by lung cancer and their clinical-care providers. Psychooncology 20:179–185PubMedCrossRefGoogle Scholar
  21. 21.
    Krishnasamy M, Wells M, Wilkie E (2007) Patients and carer experiences of care provision after a diagnosis of lung cancer in Scotland. Support Care Cancer 15:327–332PubMedCrossRefGoogle Scholar
  22. 22.
    Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67:361–370PubMedCrossRefGoogle Scholar
  23. 23.
    Bjelland I, Dahl AA, Haug TT, Neckelmann D (2002) The validity of the Hospital Anxiety and Depression Scale: an updated literature review. J Psychosom Res 52:69–77PubMedCrossRefGoogle Scholar
  24. 24.
    Braun V, Clarke V (2006) Using thematic analysis in psychology. Qual Res Psychol 3:77–101CrossRefGoogle Scholar
  25. 25.
    Thomas C, Morris SM, Harman JC (2002) Companions through cancer: the care given by informal carers in cancer contexts. Soc Sci Med 54:529–544PubMedCrossRefGoogle Scholar
  26. 26.
    Erickson RJ (2005) Why emotion work matters: sex, gender, and the division of household labor. J Marriage Fam 67:337–351CrossRefGoogle Scholar
  27. 27.
    Östlund U, Wennman-Larsen A, Persson C, Gustavsson P, Wengström Y (2010) Mental health in significant others of patients dying from lung cancer. Psychooncology 19:29–37PubMedCrossRefGoogle Scholar
  28. 28.
    Institute of Medicine (ed) (2008) Cancer care for the whole patient: meeting psychosocial health needs. The National Academies Press, Washington DCGoogle Scholar
  29. 29.
    Vanderwerker LC, Laff RE, Kadan-Lottick NS, McColl S, Prigerson HG (2005) Psychiatric disorders and mental health service use among caregivers of advanced cancer patients. J Clin Oncol 23:6899–6907PubMedCrossRefGoogle Scholar
  30. 30.
    Kim Y, Given BA (2008) Quality of life of family caregivers of cancer survivors: across the trajectory of the illness. Cancer 112:2556–2568PubMedCrossRefGoogle Scholar
  31. 31.
    Wen K-Y, Gustafson D (2004) Needs assessment for cancer patients and their families. Health Qual Life Outcomes 2:11PubMedCrossRefGoogle Scholar
  32. 32.
    Northouse LL, Katapodi MC, Song L, Zhang L, Mood DW (2010) Interventions with family caregivers of cancer patients: meta-analysis of randomized trials. CA Cancer J Clin 60:317–339PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Catherine E. Mosher
    • 1
    • 2
  • Heather A. Jaynes
    • 3
  • Nasser Hanna
    • 4
  • Jamie S. Ostroff
    • 1
  1. 1.Department of Psychiatry and Behavioral SciencesMemorial Sloan-Kettering Cancer CenterNew YorkUSA
  2. 2.Department of PsychologyIndiana University–Purdue University IndianapolisIndianapolisUSA
  3. 3.Department of Pharmacy PracticePurdue UniversityWest LafayetteUSA
  4. 4.Department of MedicineIndiana University School of MedicineIndianapolisUSA

Personalised recommendations