Cancer trajectory as guiding framework of understanding caregivers’ depression — ASN Events

Cancer trajectory as guiding framework of understanding caregivers’ depression (#225)

Youngmee Kim 1 , Charles S Carver 1 , Rachel L. Spillers 2 , Kelly M Shaffer 1
  1. University of Miami, Coral Gables, FL, United States
  2. American Cancer Society, Atlanta, USA

Aims. Few studies address the psychological adjustment of family caregivers who have provided care to long-term cancer survivors.  This study aimed to (a) document the levels of depressive symptoms among caregivers 5 years after their relative’s initial diagnosis and (b) identify factors that may play significant prospective roles in caregivers’ psychological adjustment as the patients’ illness trajectory diverged at that time.

Methods. Demographics and caregiving experiences were measured among cancer caregivers 2 years after their relative’s cancer diagnosis. Depressive symptoms were assessed using the CES-D at 2 years (T1) and 5 years (T2) post-diagnosis. A total of 350 provided complete data for the study at both T1 and T2. At T2, three groups of caregivers were identified: former caregivers whose recipients were now in remission, current caregivers, and bereaved caregivers.

Results.  At T1, caregiving stress, caregiving esteem, and social support were significant correlates of depressive symptoms (ts > 3.32, ps <.001). Even after accounting for depressive symptoms at T1, T1 caregiving stress and lack of social support were significant prospective predictors of greater depressive symptoms at T2 (t = 2.47; p <.01). At both times, bereaved caregivers reported the greatest depressive symptoms -- 50% displayed clinical level of depression. Current caregivers at T2 displayed the largest increase in depressive symptoms from T1 to T2 (p < .0001).

Conclusions. The findings highlight the importance of caregiving stress early in caregivership, even for outcomes that emerge three years later. The illness trajectory of the patient played significant role in caregivers’ depression. Family members who are actively involved in cancer care at the five year mark may benefit from programs designed to improve their adjustment to long-term caregiving.

This abstract is part of a symposium, "Optimizing Family's Adjustment During the Transitino from Palliative Care to Bereavement," chaired by Youngmee Kim.