Family caregiver burden: results of a longitudinal study of breast cancer patients and their principal caregivers
By E. Grunfeld, D. Coyle, T. Whelan, J. Clinch, L. Reyno, C. Earle, Andrew R. Willan, R. Viola, M. Coristine, T. Janz and 1 more. Canadian Medical Association Journal, 2004
983 citations recorded by the source corpus.
Background: The vital role played by family caregivers in supporting dying cancer patients is well recognized, but the burden and economic impact on caregivers is poorly understood. We prospectively examined the psychosocial, occupational and economic impact of caring for a person with a terminal illness. Methods: We studied 89 caregivers of women with advanced breast cancer receiving care at either the Ottawa or Hamilton regional cancer centres in Ontario. Patients were followed until their death or study completion at 3 years. Patients identified a principal caregiver to participate in the study. The Karnofsky Performance Status (KPS) index, the Medical Outcomes Study 36-item Short Form (SF-36), the Hospital Anxiety and Depression Scale, the Zarit Burden Inventory, FAMCARE and the Medical Outcomes Study Social Support Survey were administered during follow-up. Economic data were collected by means of a questionnaire administered by an interviewer. Assessments were conducted every 3 months during the palliative period (KPS score > 50) and every 2 weeks during the terminal period (KPS score ≤ 50). Results: Over half of the caregivers were male (55%) and the patient's spouse or partner (52%), with a mean age of 53 years. At the start of the palliative period, the caregivers' mean physical functioning score was better than the patients' (51.3 v. 35.1, 95% confidence interval [CI] 13.3–20.0); there were similar mean mental functioning scores (46.6 and 47.1 respectively); similar proportions were depressed (11% and 12%); and significantly more caregivers than patients were anxious (35% v. 19%, p = 0.009). More caregivers were depressed (30% v. 9%, p = 0.02) and had a higher level of perceived burden (26.2 v. 19.4, p = 0.02) at the start of the terminal period than at the start of the palliative period. Burden was the most important predictor of both anxiety and depression. Of employed caregivers, 69% reported some form of adverse impact on work. In the terminal period 77% reported missing work because of caregiving responsibilities. Prescription drugs were the most important component of financial burden. Interpretation: Caregivers' depression and perceived burden increase as patients' functional status declines. Strategies are needed to help reduce the psychosocial, occupational and economic burden associated with caregiving.
Subfields: Oncology, Public Health, Environmental and Occupational Health, Sociology and Political Science
View Paper: https://www.semanticscholar.org/paper/33eb5e90301132c43fd6a960a5c6299bc002a770
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Citations in the corpus
- Major depression after breast cancer: a review of epidemiology and treatment. (2008, background): “Patient depression and caregiver burden and distress are significant problems in families of breast cancer patients [105–110].”
- Making the good even better: A review and theoretical model of interpersonal capitalization (2018, result): “These findings are highly consistent with research on the difficulties of providing responsive support (e.g., Rafaeli & Gleason, 2009) as well as evidence on caregiver burden (Grunfeld et al., 2004).”
- Aggressiveness of cancer care near the end of life: is it a quality-of-care issue? (2008, neutral): “We have examined data from a prospective cohort study looking at patient and family needs among women with hormone-refractory metastatic breast cancer treated at two Canadian regional cancer centers, and limited analysis to the patients who died during follow-up.(31) Family members were asked to com”
- Does couple identity mediate the stress experienced by caregiving spouses? (2007, background): “, 2004), poor patient functional status (Grunfeld et al., 2004) and patient cognitive decline (Tooth, McKenna, Barnett, Prescott, & Murphy, 2005) have been associated with more caregiver burden and distress, social support and positive views of the caregiving experience have been shown to be associa”