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Who will care for the caregiver? Distress and depression among spousal caregivers of older patients undergoing treatment for cancer

  • Gil GoldzweigEmail author
  • L. Schapira
  • L. Baider
  • J. M. Jacobs
  • E. Andritsch
  • Y. Rottenberg
Original Article

Abstract

Purpose

Although it is accepted that in general spousal caregivers of patients with cancer are under high emotional and physical strain, little is known about the quality of life specifically among spousal caregivers of older cancer patients. The aim of the current study is to explore the emotional toll of spousal caregivers of cancer patients aged 65–85 years.

Methods

This study surveyed 242 spousal caregivers of patients ≥ 65 years old, diagnosed with cancer, treated with curative or palliative intent, and within 6 months of treatment at enrollment. Standardized measures completed by the caregivers included depression measure (Geriatric Depression Scale); distress (Distress Thermometer); and social support (the Cancer Perceived Agents of Social Support). Logistic regression analyses were used in order to identify the predictor of clinical depression and distress. The analyses were adjusted for patient (sociodemographic, functional performance, and medical status) and caregiver (sociodemographic and social support) factors.

Results

Among the caregivers, the frequencies of clinical depression and distress were 16.5% and 28% respectively. Increasing patient age and time from diagnosis were associated with reduced levels of caregiver depression. Higher levels of friends and spousal support (support from the patients) were associated with non-clinical levels of depression and distress.

Conclusion

Increasing patient age and caregiver’s perceived spousal support may both have a positive effect on caregivers’ levels of depression. This can be utilized by clinicians in the process of empowering older patients and their spousal caregivers to confront the challenges of cancer treatment into advanced old age.

Keywords

Cancer Old age Caregiver Spouse Distress Depression 

Notes

Funding

This research was partially supported by the following:

1. A grant from the Organization for People Suffering from Cancer (“Verein für Krebskranke”), The Medical University of Graz, Graz, Austria

2. A privet grant from Harold Michaels in memory of “Henriette Michaels, beloved wife and sister”.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Data control

The authors have full control of all primary data and they agree to allow the journal to review the data if requested.

References

  1. 1.
    Northouse LL, Katapodi MC, Schafenacker AM, Weiss D (2012) The impact of caregiving on the psychological well-being of family caregivers and cancer patients. Semin Oncol Nurs 28(4):236–245.  https://doi.org/10.1016/j.soncn.2012.09.006
  2. 2.
    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(5):317–339.  https://doi.org/10.3322/caac.20081 PubMedPubMedCentralGoogle Scholar
  3. 3.
    Borges EL, Franceschini J, Costa LHD, Fernandes ALG, Jamnik S, Santoro IL (2017) Family caregiver burden: the burden of caring for lung cancer patients according to the cancer stage and patient quality of life. J Bras Pneumol 43(1):18–23.  https://doi.org/10.1590/S1806-37562016000000177 PubMedPubMedCentralGoogle Scholar
  4. 4.
    Kent EE, Rowland JH, Northouse L, Litzelman K, Chou WYS, Shelburne N, Timura C, O'mara A, Huss K (2016) Caring for caregivers and patients: research and clinical priorities for informal cancer caregiving. Cancer 122(13):1987–1995PubMedPubMedCentralGoogle Scholar
  5. 5.
    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(2):123–130PubMedGoogle Scholar
  6. 6.
    Li Q, Mak Y, Loke A (2013) Spouses’ experience of caregiving for cancer patients: a literature review. Int Nurs Rev 60(2):178–187PubMedGoogle Scholar
  7. 7.
    Seal K, Murray CD, Seddon L (2015) The experience of being an informal “carer” for a person with cancer: a meta-synthesis of qualitative studies. Palliat Support Care 13(3):493–504PubMedGoogle Scholar
  8. 8.
    Goldzweig G, Baider L, Andritsch E, Pfeffer R, Rottenberg Y (2017) A dialogue of depression and hope: elderly patients diagnosed with cancer and their spousal caregivers. J Cancer Educ 32(3):549–555.  https://doi.org/10.1007/s13187-015-0975-0 PubMedGoogle Scholar
  9. 9.
    Litzelman K, Kent EE, Mollica M, Rowland JH (2016) How does caregiver well-being relate to perceived quality of care in patients with cancer? Exploring associations and pathways. J Clin Oncol 34(29):3554–3561.  https://doi.org/10.1200/JCO.2016.67.3434 PubMedPubMedCentralGoogle Scholar
  10. 10.
    Shahi V, Lapid MI, Kung S, Atherton PJ, Sloan JA, Clark MM, Rummans TA (2014) Do age and quality of life of patients with cancer influence quality of life of the caregiver? J Geriatr Oncol 5(3):331–336.  https://doi.org/10.1016/j.jgo.2014.03.003 PubMedPubMedCentralGoogle Scholar
  11. 11.
    Valeberg BT, & Grov EK (2013) Symptoms in the cancer patient–of importance for their caregivers' quality of life and mental health? Eur J Oncol Nurs 17(1):46–51Google Scholar
  12. 12.
    Given B, Sherwood PR (2006) Family care for the older person with cancer. Semin Oncol Nurs 22(1):43–50.  https://doi.org/10.1016/j.soncn.2005.10.006 PubMedGoogle Scholar
  13. 13.
    Given B, Stommel M, Collins C, King S, Given CW (1990) Responses of elderly spouse caregivers. Res Nurs Health 13(2):77–85.  https://doi.org/10.1002/nur.4770130204 PubMedGoogle Scholar
  14. 14.
    Jayani R, Hurria A (2012) Caregivers of older adults with cancer. Semin Oncol Nurs 28(4):221–225.  https://doi.org/10.1016/j.soncn.2012.09.004 PubMedPubMedCentralGoogle Scholar
  15. 15.
    Oken MM, Creech RH, Tormey DC, Horton J, Davis TE, McFadden ET, Carbone PP (1982) Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol 5(6):649–655PubMedGoogle Scholar
  16. 16.
    Charlson ME, Pompei P, Ales KL, MacKenzie CR (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40(5):373–383PubMedGoogle Scholar
  17. 17.
    Hoyl MT, Alessi CA, Harker JO, Josephson KR, Pietruszka FM, Koelfgen M, Mervis JR, Fitten LJ, Rubenstein LZ (1999) Development and testing of a five-item version of the Geriatric Depression Scale. J Am Geriatr Soc 47(7):873–878PubMedGoogle Scholar
  18. 18.
    Weeks SK, McGann PE, Michaels TK, & Penninx BW (2003) Comparing various short‐form Geriatric Depression Scales leads to the GDS‐5/15. J Nurs Scholarsh 35(2):133–137Google Scholar
  19. 19.
    Zalsman G, Weizman A, Carel CA, Aizenberg D (2001) Geriatric Depression Scale (GDS-15): a sensitive and convenient instrument for measuring depression in young anorexic patients. J Nerv Ment Dis 189(5):338–339PubMedGoogle Scholar
  20. 20.
    Cohen M, Gagin R, Cinamon T, Stein T, Moscovitz M, Kuten A (2012) Translating ‘distress’ and screening for emotional distress in multicultural cancer patients in Israel. Qual Life Res Int J Qual Life Asp Treat Care Rehab 21(4):555–562.  https://doi.org/10.1007/s11136-011-9972-x Google Scholar
  21. 21.
    Cohen M (2014) Depression, anxiety, and somatic symptoms in older cancer patients: a comparison across age groups. Psychooncology 23(2):151–157.  https://doi.org/10.1002/pon.3383 PubMedGoogle Scholar
  22. 22.
    Goldzweig G, Hasson-Ohayon I, Meirovitz A, Braun M, Hubert A, Baider L (2010) Agents of support: psychometric properties of the Cancer Perceived Agents of Social Support (CPASS) questionnaire. Psychooncology 19(11):1179–1186.  https://doi.org/10.1002/pon.1668 PubMedGoogle Scholar
  23. 23.
    IBM_Corp R (2010) IBM SPSS statistics for windows (version 21.0)[computer program]. IBM Corp, ArmonkGoogle Scholar
  24. 24.
    Linden W, Vodermaier A, Mackenzie R, Greig D (2012) Anxiety and depression after cancer diagnosis: prevalence rates by cancer type, gender, and age. J Affect Disord 141(2–3):343–351.  https://doi.org/10.1016/j.jad.2012.03.025 PubMedGoogle Scholar
  25. 25.
    Rhee YS, Yun YH, Park S, Shin DO, Lee KM, Yoo HJ, Kim JH, Kim SO, Lee R, Lee YO, Kim NS (2008) Depression in family caregivers of cancer patients: the feeling of burden as a predictor of depression. J Clin Oncol 26(36):5890–5895.  https://doi.org/10.1200/jco.2007.15.3957 PubMedGoogle Scholar
  26. 26.
    Goldzweig G, Merims S, Ganon R, Peretz T, Altman A, Baider L (2013) Informal caregiving to older cancer patients: preliminary research outcomes and implications. Ann Oncol 24(10):2635–2640.  https://doi.org/10.1093/annonc/mdt250 PubMedGoogle Scholar
  27. 27.
    de Boer AGEM, Taskila T, Ojajärvi A, van Dijk FJH, Verbeek JHAM (2009) Cancer survivors and unemployment: a meta-analysis and meta-regression. JAMA 301(7):753–762.  https://doi.org/10.1001/jama.2009.187 PubMedGoogle Scholar
  28. 28.
    Chernichovsky D (2009) Not “socialized medicine” — an Israeli view of health care reform. N Engl J Med 361(21):e46.  https://doi.org/10.1056/NEJMp0908269 PubMedGoogle Scholar
  29. 29.
    Baider L (2008) Communicating about illness: a family narrative. Support Care Cancer 16(6):607–611.  https://doi.org/10.1007/s00520-007-0370-4 PubMedGoogle Scholar
  30. 30.
    Baider L, Surbone A (2010) Cancer and the family: the silent words of truth. J Clin Oncol 28(7):1269–1272.  https://doi.org/10.1200/JCO.2009.25.1223 PubMedGoogle Scholar
  31. 31.
    Braun M, Mikulincer M, Rydall A, Walsh A, Rodin G (2007) Hidden morbidity in cancer: spouse caregivers. J Clin Oncol 25(30):4829–4834.  https://doi.org/10.1200/jco.2006.10.0909 PubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.School of Behavioral SciencesThe Academic College of Tel-Aviv YaffoTel-AvivIsrael
  2. 2.Stanford University School of MedicinePalo AltoUSA
  3. 3.Assuta Medical CenterOncology InstituteTel-avivIsrael
  4. 4.Department of Geriatrics and Geriatric RehabilitationHadassah University HospitalJerusalemIsrael
  5. 5.Division of Clinical OncologyThe medical University of GrazGrazAustria
  6. 6.Sharett Oncology InstituteHadassah University HospitalJerusalemIsrael

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