Hope as determinant for psychiatric morbidity in family caregivers of advanced cancer patients.

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OBJECTIVE:

Home care of advanced cancer patients often has adverse effects on physical and mental health of family caregivers. Little is known about the long-term effects of continuous caregiving on mental health as compared to the effects of bereavement. The objectives of this study were to describe the course of psychiatric morbidity in family caregivers over time, to identify the impact of the patients’ death on caregivers, and to explore possible predictor variables for psychiatric morbidity.

METHODS:

This multi-institutional, prospective study included 80 family caregivers of 80 advanced cancer patients for baseline and nine months follow-up assessment. Possible psychiatric disorders (i.e. depression, anxiety, posttraumatic stress disorder (PTSD), and alcohol abuse/dependence) as well as potentially predictive factors (i.e. socio-demographic factors, burden, hope, and coping mechanisms) were assessed.

RESULTS:

Follow-up assessment was conducted on average 9.2 months (±2.9) after baseline assessment. Prevalence rates of anxiety and PTSD decreased significantly over time, whereas depression and alcoholism remained stable. Bereavement was experienced by 53% of caregivers in the follow-up period. The patients’ death had no influence on psychiatric morbidity at follow-up. Predictors for the development of a psychiatric disorder varied according to condition, with hope and emotion-oriented coping identified as important influences, especially for anxiety and depression.

CONCLUSION:

Family caregivers with certain psychiatric disorders might need targeted psychosocial support to ensure their mental wellbeing and prevent long-term disability. Supporting hope and functional coping strategies early after the patient’s diagnosis might limit development and extent of psychiatric morbidity.

This article is protected by copyright. All rights reserved.

KEYWORDS:

Cancer; Family caregiver; Hope; Oncology; Palliative Care; Psychiatric morbidity

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