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The impact of patient quality of life and spirituality upon caregiver depression for those with advanced cancer

Published online by Cambridge University Press:  27 November 2012

Sara L. Douglas  and
Barbara J. Daly
Sara L. Douglas*
Affiliation:
Case Western Reserve University, Cleveland, Ohio
Barbara J. Daly
Affiliation:
Case Western Reserve University, Cleveland, Ohio
*
Address correspondence and reprint requests to: Sara L. Douglas, School of Nursing, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106-4904. E-mail: [email protected]
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Abstract

Objective:

Little is known about relationships between patient spiritual well-being and caregiver outcomes for those with advanced cancer. We were interested in examining the relationship between patient physical quality of life (QOL) and caregiver depression and to also evaluate whether patient spiritual well-being (SWB) played a mediating role in this relationship.

Method:

This is a prospective longitudinal study that was conducted in the outpatient clinics at a university-affiliated comprehensive cancer center. 226 patients with Stage III or IV cancer (lung, GI, GYN) and their primary caregivers were interviewed upon enrollment into the study and three months later. Measures of spirituality, health-related quality of life, and physical functioning were included in the interviews.

Results:

Key findings were that the relationship between patient physical QOL and caregiver depression was inverse and moderate (β = −0.24, p = 0.004) and that patient SWB (meaning/peace) played a significant (p = 0.02) and medium-size role (β = −0.31) in mediating the relationship between patient physical QOL and caregiver depression. The nature of these relationships was stable over time.

Significance of results:

Patients' spirituality is central to their coping and adjusting to cancer. It is this aspect of patient overall quality of life that mediates the relationship to caregiver well-being. The most potent intervention for caregiver depression may be attending to patient spiritual distress.

Keywords

Advanced cancerOncologySpiritualityQuality of lifeDepression
Type
Original Articles
Information
Palliative & Supportive Care , Volume 11 , Issue 5 , October 2013 , pp. 389 - 396
Copyright
Copyright © Cambridge University Press 2012 

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References

REFERENCES

Ano, G.G. & Vasconcelles, E.B. (2005). Religious coping and psychological adjustment to stress: A meta-analysis. Journal of Clinical Psychology, 61, 461–480.Google Scholar
Babbie, E.R. (1993). Survey Research Methods. Belmont, CA: Wadsworth Press.Google Scholar
Baron, R.M. & Kenny, D.A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personal and Social Psychology, 51, 1173–1182.CrossRefGoogle ScholarPubMed
Bland, J. (1988). Statistical methods for assessing agreement between two methods of clinical measurement. The Lancet, 8, 307–310.Google Scholar
Boyle, P.A., Barnes, L.L., Buchman, A.S., et al. (2009). Purpose of life is associated with mortality among community-dwelling older persons. Psychosomatic Medicine, 71, 574–579.Google Scholar
Charlson, M.E., Pompei, P., Alex, K.L., et al. (1987). A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. Journal of Chronic Disease, 40, 373–383.Google Scholar
Chida, Y., Steptoe, A. & Powell, L.H. (2009). Religiosity/spirituality and mortality. Psychotherapy and Psychosomatics, 78, 81–90.CrossRefGoogle ScholarPubMed
Ellison, C.W. (1983). Spiritual well-being: Conceptualization and measurement. Journal of Psychology and Theology, 11, 330–340.Google Scholar
Erdfelder, E., Faul, F. & Buchner, A. (1996). GPOWER: A general power analysis program. Behavior Research Methods, Instruments, & Computers, 28, 1–11.Google Scholar
Ferrell, B.R., Rhiner, M., Cohen, M.Z., et al. (1991). Pain as a metaphor of illness. Part 1: Impact of cancer pain on family caregivers. Oncology Nursing Forum, 18, 1303–1309.Google Scholar
Fitchett, G. & Canada, A.L. (2010). The role of religion/spirituality in coping with cancer: Evidence, assessment, and intervention. In Psycho-Oncology, Holland, J.C., Breitbart, W.S., Jacobsen, P.B., et al. (eds.). Oxford: Oxford University Press.Google Scholar
Given, B., Wyatt, G., Given, C., et al. (2004). Burden and depression among caregivers of patients with cancer at the end of life. Oncology Nursing Forum, 31, 1105–1115.Google Scholar
Grunfeld, E., Coyle, D., Whelan, T., et al. (2004). Family caregiver burden: Results of a longitudinal study of breast cancer patients and their principal caregivers. Canadian Medical Association Journal, 170, 1795–801.CrossRefGoogle ScholarPubMed
Imai, K., Keele, L. & Tingley, D. (2010). A general approach to causal mediation analysis. Psychological Methods, 15, 309–334.Google Scholar
Kenny, D.A. (2011). Mediation. http://davidakenny.net/cm/mediate.htm (Accessed February 15, 2012).Google Scholar
Kenny, D.A., Korchmaros, J.D & Bolger, N. (2003). Lower level mediation in multilevel models. Psychological Methods, 8, 115–128.CrossRefGoogle ScholarPubMed
Kim, Y., Carver, C.S., Spillers, R.L., et al. (2011). Individual and dyadic relations between spiritual well-being and quality of life among cancer survivors and their spousal caregivers. Psycho-oncology, 20, 762–770.Google Scholar
Landis, J.R. & Koch, G.G. (1977). The measurement of observer agreement for categorical data. Biometrics, 33, 159–174.Google Scholar
Lubans, D.R. & Sylva, K. (2009). Mediators of change following a senior school physical activity intervention. Journal of Science and Medicine in Sport, 12, 134–140.Google Scholar
McClain, C.S., Rosenfeld, B. & Breitbart, W. (2003). Effect of spiritual well-being on end-of-life despair in terminally-ill cancer patients. The Lancet, 361, 1603–1607.Google Scholar
McCullough, M.B., Hoyt, W.T., Larson, D.B. et al. (2000). Religious involvement and mortality: A meta-analytic review. Health Psychology, 19, 211–222.CrossRefGoogle ScholarPubMed
McNair, D., Lorr, M. & Doppleman, L. (1992). POMS Manual Profile of Mood States. San Diego, CA: EdITS Press.Google Scholar
Nelson, C., Jacobson, C.M., Weinberger, M.I., et al. (2009). The role of spirituality in the relationship between religiosity and depression in prostate cancer patients. Annals of Behavioral Medicine, 38, 105–114.Google Scholar
Nelson, C.J., Rosenfeld, B., Breitbart, W., et al. (2002). Spirituality, religion, and depression in the terminally ill. Psychosomatics, 43, 213–220.Google Scholar
Oken, M.M., Creech, R.H., Tormey, D.C., et al. (1982). Toxicity and response criteria of the Eastern Cooperative Oncology Group. American Journal of Clinical Oncology, 5, 649–655.Google Scholar
Pearl, J. (2011). The causal mediation formula — A guide to the assessment of pathways and mechanisms. ftp://ftp.cs.ucla.edu/pub/stat_ser/r379.pdf (Accessed on February 4, 2012).Google Scholar
Peterman, A.H., Fitchett, G., Brady, M.J., et al. (2002). Measuring spiritual well-being in people with cancer: The functional assessment of chronic illness therapy—Spiritual Well-being Scale (FACIT-Sp). Annals of Behavioral Medicine, 24, 49–58.Google Scholar
Preacher, K.J. & Hayes, A.F. (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavioral Research Methods, 40, 879–891.CrossRefGoogle ScholarPubMed
Sobel, M.E. (1982). Asymptotic confidence intervals for indirect effects in structural equation models. In Sociological Methodology, Leinhardt, S.(ed.), pp. 290–312. Washington, DC: American Sociological Association Press.Google Scholar
Victorson, D., Barocas, J., Song, J., et al. (2008). Reliability across studies from the functional assessment of cancer therapy-general (FACT-G) and its subscales: A reliability generalization. Quality of Life Research, 17, 1137–46.Google Scholar
Yanez, B., Edmondson, D., Stanton, A.L., et al. (2009). Facets of spirituality as predictors of adjustment to cancer: Relative contributions of having faith and finding meaning. Journal of Consulting and Clinical Psychology, 77, 730–741.Google Scholar