THE INTERACTION OF AGE, SYMPTOMS, AND SURVIVAL STATUS ON PHYSICAL ANDMENTAL-HEALTH OF PATIENTS WITH CANCER AND THEIR FAMILIES

Background. During the course of cancer treatment and as the disease p rogresses, symptoms may worsen and physical status may deteriorate. Th e interaction of age, symptoms, and nearness to death on the physical and mental health of patients and family members has not been examined . The research questions in this paper focus on how age and survival s tatus influence the frequency and severity of patients' symptoms and d ependencies in functioning. The impact of patient age and survival sta tus on family depression, schedule, and health also are explored. Meth ods. Cancer patients in treatment and their caregiver dyads (n = 208) were followed for 12 months. Survival status was measured by those who survived the year, those who died within 6 months, and those who died between 6 and 12 months. Measures used included frequency and severit y counts of patient symptoms, functioning (activities of daily living [ADL] and immobility), depression, frequency of others' assistance to caregivers, and caregiver reactions to care. Analysis of variance was applied to test for significant differences according to age and survi val status. Results. Symptoms did vary significantly by survival statu s; however, age demonstrated no independent effect on patient variable s including: symptom severity, patient depression, and ADL or immobili ty. When controlling for symptom severity and age, survival group had no effect on ADL status. For immobility, survival status continued to have a direct impact. Survival status does not influence dependencies in ADL but is related directly to losses in mobility. Significant diff erences occurred by survival groups for caregiver depression, caregive r reactions, and patient assistance. Conclusions. Strategies for assis ting patients and families to deal with immobility are important. Fami ly members require assistance for their distress as patient status det eriorates.