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Cognitive dysfunction in patients with brain metastases: influences on caregiver resilience and coping

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Abstract

Purpose

Neurologic deficits that may be manifested as cognitive impairment contribute to the challenges faced by caregivers of patients with brain metastases. To better address their needs, we examined how caregivers respond to these challenges and explore the relationship between the patient’s cognitive impairment and caregiver resilience and coping.

Methods

We conducted a descriptive, cross-sectional study using self-reported data from 56 caregivers of patients with brain metastases. Study participants from a comprehensive cancer center were asked to complete a series of instruments that measured their perception of the patient’s cognitive dysfunction (revised memory and behavior problems checklist, RMBC), their own personal resilience (Resilience Scale, RS), and their utilization of a broad range of coping responses (COPE inventory and Emotional-Approach Coping scale).

Results

Caregivers reported that memory-related problems occurred more frequently in the patients they cared for compared to depression and disruptive behavior (mean scores 3.52 vs 2.34 vs. 1.32, respectively). Coping strategies most frequently used by caregivers were acceptance (3.28), planning (3.08), and positive reinterpretation and growth (2.95). Most caregivers scored moderate to high on the RS (77%). The coping strategy acceptance correlated significantly with the memory and disruptive behavior subscales of the RMBC.

Conclusions

Given the protective effect of problem-focused coping and the high rate of caregivers utilizing less effective coping strategies in instances of worsening cognitive dysfunction, healthcare professionals need to systematically assess the coping strategies of caregivers and deliver a more personalized approach to enhance effective coping among caregivers of patients with brain metastases.

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Acknowledgments

Dr. Marlon Garzo Saria would like to thank Dr. Annette Stanton for her assistance in reviewing the research proposal and the manuscript as a member of his dissertation committee.

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Authors and Affiliations

  1. School of Nursing, University of California, Los Angeles, Factor Bldg., 700 Tiverton Ave, Los Angeles, CA, 90095, USA

    Marlon Garzo Saria, Adeline M. Nyamathi, Linda R. Phillips & Sally Maliski

  2. John Wayne Cancer Institute and Pacific Neuroscience Institute at Providence Saint John’s Health Center, 2200 Santa Monica Boulevard, Santa Monica, CA, 90404, USA

    Marlon Garzo Saria & Santosh Kesari

  3. Moores Cancer Center, University of California San Diego, 3855 Health Sciences Drive, La Jolla, CA, 92093, USA

    Natasia Courchesne, Daniel A. MacManus & Mary Kay Gorman

  4. Nursing Science, University of California, Irvine, 299E Berk Hall, Irvine, CA, 92697-3959, USA

    Lorraine Evangelista

  5. Quintiles, 10 Waterview Boulevard, Parsippany, NJ, 07054, USA

    Joshua Carter

  6. School of Medicine, University of California San Diego, 3855 Health Sciences Drive, La Jolla, CA, 92093, USA

    David Piccioni

  7. School of Nursing, University of Kansas Medical Center, Mail Stop 2029, 3901 Rainbow Blvd., Kansas City, KS, 66160, USA

    Sally Maliski

Authors
  1. Marlon Garzo Saria
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  2. Natasia Courchesne
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  3. Lorraine Evangelista
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  4. Joshua Carter
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  5. Daniel A. MacManus
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  7. Adeline M. Nyamathi
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  8. Linda R. Phillips
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  10. Santosh Kesari
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  11. Sally Maliski
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Corresponding author

Correspondence to Marlon Garzo Saria.

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Conflict of interest

Dr. Marlon Garzo Saria has received academic scholarship grants from the American Cancer Society and the Oncology Nursing Society Foundation while completing this study as part of his doctoral work. In addition, the study was supported by a research grant from The Daisy Foundation. None of the organizations had a role in the study design, data collection and analysis, report writing, and decision for manuscript submission for publication. The authors have full access to all of the data in this study and take complete responsibility for the integrity of the data and the accuracy of the data analysis.

Disclosures

American Cancer Society Doctoral Degree Scholarships in Cancer Nursing

Oncology Nursing Society Doctoral Scholarship

The DAISY Foundation Research Grant

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Saria, M.G., Courchesne, N., Evangelista, L. et al. Cognitive dysfunction in patients with brain metastases: influences on caregiver resilience and coping. Support Care Cancer 25, 1247–1256 (2017). https://doi.org/10.1007/s00520-016-3517-3

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  • DOI: https://doi.org/10.1007/s00520-016-3517-3

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