Caregiver Characteristics Associated With Cognitive Complaints in Women With Breast Cancer

The Congruence and Interrelationship: A Dyadic Perspective on the Subjective Cognitive Impairment in the Patients with Colorectal Cancer and Their Spousal Caregivers

OBJECTIVES

Patients with colorectal cancer (CRC) reported experiencing subjective cognitive impairment (SCI), and their spousal caregivers perceived the patients' SCI. This cross-sectional study assessed the congruence of SCI between the patients' self-reports and the spousal caregivers' perceptions and examined the factors affecting SCI from the dyadic perspective.

METHODS

A total of 200 dyads of patients with CRC and their spousal caregivers were invited to complete the survey, which evaluated the SCI, dyadic coping (DC), quality of life, anxiety, and depression for the dyads. Congruence was analyzed using the intraclass correlation coefficient (ICC) and paired-sample t test. Impacting factors analysis was conducted using Pearson correlations, hierarchical multiple regression, and actor-partner interdependence mediation model.

RESULTS

The congruency of SCI between the patient-reported and the spouse-perceived ranged from moderate to good (ICC = 0.75 to 0.86). After controlling demographic variables (the patients' gender and spouses' work status), the DC of both patients and spousal caregivers, and the emotional health of patients were significant predictors for patients' SCI (all P < .05). In the actor-partner interdependence mediation model, there was an actor effect between DC and SCI for both patients and spousal caregivers and a partner effect between DC and SCI for patients. Moreover, patients' emotional health (anxiety and depression) had the mediating effect between DC and SCI for both patients and spousal caregivers.

CONCLUSION

Spousal caregivers played a vital role in assessment and management in the SCI of patients. The DC of patients and spousal caregivers and the emotional health of patients (eg, anxiety and depression) were major predictors for the SCI of patients.

IMPLICATIONS FOR NURSING

Nursing providers should consider the importance of patients' and spousal caregivers' perspectives in assessing and managing SCI. This study supports nurses focusing on the congruence and interrelationship of SCI to enhance DC for CRC patients and their spousal caregivers. This approach aims to reduce emotional distress and develop cognitive interventions from a dyadic perspective.

The Association of Self-esteem With Caregiving Demands, Coping, Burden, and Health Among Caregivers of Breast Cancer Patients: A Structural Equation Modeling Approach

BACKGROUND

We investigated how caregiver self-esteem was associated with caregiving demands, coping, burden, and health.

OBJECTIVE

The aim of this study was to investigate how caregiver self-esteem is associated with caregiving demands, coping, burden, and health.

METHODS

Sixty-one caregivers of breast cancer patients were selected from a study conducted at a cancer clinic in the Southeastern region of the United States. Guided by the revised Stress and Coping Theory, a secondary analysis of cross-sectional data was conducted. We used structural equation modeling to analyze paths between caregiver self-esteem and caregiving demands (ie, hours spent on caregiving), coping, burden, and health.

RESULTS

Caregivers who effectively coped with stressful situations through strategies such as positive thinking, seeking social support, and problem solving were more likely to have higher levels of self-esteem; in turn, higher levels of self-esteem decreased caregiver burden and improved caregiver overall health.

CONCLUSIONS

This study highlights the importance of self-esteem among caregivers of breast cancer patients. Additional research is needed to provide more insight into the influence of coping strategies on caregiver self-esteem, as well as the role of caregiver self-esteem on caregivers' and patients' well-being.

IMPLICATION FOR PRACTICE

Healthcare providers need to consider caregiver self-esteem and other associated caregiver characteristics to identify caregivers at risk of higher perceived levels of burden and poor overall health.