Determinants of caregiving experiences and mental health of partners of cancer patients

BACKGROUND. Research regarding informal caregiving showed considerable indi vidual variation in responses to cancer caregiving. The current longitudina l study examined determinants of caregiver outcomes in terms of caregiver e xperiences at 3 months and caregiver's mental health at 6 months after hosp ital discharge. It included both negative and positive dimensions of caregi ving outcomes. METHODS. One hundred forty-eight patients with newly diagnosed colorectal c arcinoma and their partners were included. Caregiver experiences were asses sed by the Caregiver Reaction Assessment Scale, which contains four negativ e subscales (disrupted schedule, financial problems, lack of family support , and loss of physical strength) and one positive subscale (self-esteem). T he mental health of the caregiver was assessed in terms of depression and q uality of life. Possible determinants of the caregiver's experiences and me ntal health were categorized according to characteristics of the caregiver, the patient, and the care situation. Caregiving experiences were studied a s a fourth additional category of possible determinants of the caregiver's mental health. RESULTS. Each domain of the caregiving experience was explained by differen t factors, with total explained variances ranging between 11-46%. Negative caregiver experiences were associated with a low income, living with only t he patient, a distressed relationship, a high level of patient dependency, and a high involvement in caregiving tasks. Caregivers with a low level of education and caregivers of patients with a stoma were able to derive more self-esteem from caregiving. Although caregiving may lead to depression, es pecially in those experiencing loss of physical strength, caregivers may su stain their quality of life by deriving self-esteem from caregiving. CONCLUSIONS. It is important that professionals involved in the ongoing car e of cancer patients and their families be aware of the increasing demands made on caregivers and the specific problems and uplifts they perceive in c aregiving. Professional caregivers are urged to involve informal caregivers with care explicitly and continuously. However, specific attention to thos e caregivers who live only with the patient, those with a low income, those with a distressed relationship, and those with a high level of patient dep endency and care involvement is warranted. Cancer 1999;86:577-88. (C) 1999 American Cancer Society.