Our caregivers

Alexandra

In your opinion who got the short end of the stick, who is more anxious and depressed, who is going to suffer longer: you or your caregiver?

Next time I feel sorry for myself, I will remember these Australian studies.

Let's go and do something nice for our caregivers: parents, children, spouses, other family members, friends. Someone needs to care for them too.

 

Alexandra

Anxiety and depression

http://www.ncbi.nlm.nih.gov/pubmed/21542447

Prevalence and predictors of anxiety and depression in women with invasive ovarian cancer and their caregivers.

Price MA, Butow PN, Costa DS, King MT, Aldridge LJ, Fardell JE, DeFazio A, Webb PM; Australian Ovarian Cancer Study Group; Australian Ovarian Cancer Study Group Quality of Life Study Investigators.

Source

Centre for Medical Psychology and Evidence-based Decision-Making, School of Psychology, University of Sydney, NSW. melanie.price@sydney.edu.au

Erratum in

• Med J Aust. 2011 Aug 15;195(4):232.

Abstract

OBJECTIVES:

To assess the prevalence and predictors of depression and anxiety in women with ovarian cancer and their caregivers, to compare levels of depression and anxiety with community norms, and to explore the relationship between patients and their nominated caregivers.

DESIGN, SETTING AND PARTICIPANTS:

Prospective cohort study of 798 women with invasive ovarian cancer recruited between 1 January 2002 and 30 June 2006 through the nationwide Australian Ovarian Cancer Study, and 373 of their caregivers.

MAIN OUTCOME MEASURES:

Depression and anxiety as assessed with the Hospital Anxiety and Depression Scale, and the role of demographic variables, disease and treatment variables, psychosocial variables, and use of mental health and support services as potential predictors.

RESULTS:

Rates of anxiety and depression among patients were significantly lower than in previous reports, although clinical depression rates (5.9%) were significantly higher than community norms (3.0%; chi2 = 24.0; P < 0.001). Caregivers also reported higher levels of depression (chi2 = 21.1; P < 0.001) and anxiety (chi2 = 17.6; P < 0.001) compared with norms. There was no difference within patient-caregiver pairs for depression (P = 0.1), while caregivers reported significantly higher anxiety than patients (P < 0.01). In patients, higher symptom burden, lower optimism and current specialist mental health treatment all significantly predicted both depression and anxiety, while lower social support was a significant predictor of patient anxiety only. In caregivers, lower social support and lower optimism were significant predictors of depression and anxiety. Patients being treated for mental health was also a predictor of their caregiver's depression.

CONCLUSIONS:

While depression is significantly more common in women with ovarian cancer than in the general population, it is caregivers of such patients who report much higher levels of both subclinical and clinical depression and anxiety.

Alexandra

Negative lifestyle changes

http://www.ncbi.nlm.nih.gov/pubmed/21125296

Loss of lifestyle: health behaviour and weight changes after becoming a caregiver of a family member diagnosed with ovarian cancer.

Beesley VL, Price MA, Webb PM; Australian Ovarian Cancer Study Group; Australian Ovarian Cancer Study—Quality of Life Study Investigators.

Source

Queensland Institute of Medical Research, Gynaecological Cancers Group, Brisbane, Australia. Vanessa.Beesley@qimr.edu.au

Abstract

PURPOSE:

Little is known about how caring for someone affects the caregiver's health behaviours. We explore behaviour changes and their determinants in caregivers of women with ovarian cancer.

METHODS:

Caregivers of 101 women with ovarian cancer completed a questionnaire 1.5-6 years after their family member's cancer diagnosis, providing information about their current health behaviours, height, weight and changes in these compared with pre-diagnosis. Information about the impact of ovarian cancer, other stressful events and distress was also collected for patients and caregivers. Logistic regression was used to determine characteristics associated with negative changes.

RESULTS:

Half (54%) of caregivers did not meet Australian physical activity guidelines, 71% were overweight/obese, 40% ate <2 serves of fruit and 80% <5 serves of vegetables/day, 37% consumed >2 alcoholic drinks/occasion and 10% were smokers. Overall, 56% reported ≥ 1 negative change since their family member's diagnosis, with many decreasing their physical activity (42%) and/or gaining weight (35%). Caregivers were more likely to report negative changes if they had only school-level education (OR 3.0, 95%CI 1.1-8.4), they were unable to carry out usual daily activities due to caregiving (OR 2.0, 95%CI 0.7-5.4), they were clinically distressed (OR 3.4, 95%CI 1.1-10.1) or caring for a woman whose disease impacted on her usual daily activities (OR 4.3, 95%CI 1.4-13.2).

CONCLUSIONS:

Many caregivers of women with ovarian cancer do not meet Australian health guidelines and more than half describe negative changes after becoming a caregiver. More attention should be given to cancer caregivers with high physical and emotional demands.

Alexandra

PTSD

http://www.ncbi.nlm.nih.gov/pubmed/23579259

Signs of post-traumatic stress disorder in caregivers following an expected death: A qualitative study.

Sanderson C, Lobb EA, Mowll J, Butow PN, McGowan N, Price MA.

Source

Calvary Health Care Sydney, Kogarah, NSW, Australia.

Abstract

Background:Complications of grief are an important area of investigation with potential to improve the well-being of palliative care caregivers. There has been little study of the prevalence or significance of post-traumatic stress disorder for those bereaved after an expected death.

AIM:

To identify evidence suggestive of post-traumatic stress disorder symptoms in a population of bereaved caregivers of patients who have died of ovarian cancer.

DESIGN:

Caregivers' recollections of their end-of-life experiences were coded and analysed, using qualitative data obtained from interviews 6 months after the patient's death.

SETTING / PARTICIPANTS:

Australian Ovarian Cancer Study-Quality of Life Study is a population-based epidemiological study using mixed methods to explore caregivers' experiences following the expected death of a woman with ovarian cancer. Thirty-two caregivers from the Australian Ovarian Cancer Study-Quality of Life Study participated in semi-structured telephone interviews 6 months post-bereavement.

RESULTS:

When describing the patient's death at their 6-month interview, all interviewees used language consistent with some degree of shock and traumatisation. For the majority, there was also evidence suggesting resilience and resolution. However, a number of interviewees describe intrusive memories associated with physical sights and sounds that they witnessed at the deathbed.

CONCLUSION:

This exploratory study demonstrates the phenomenon of the 'shocked caregiver'. If trauma symptoms are present in bereaved carers in palliative care, it has implications for palliative care provision. Given that trauma symptoms may be distinct from prolonged grief disorder, this may also have implications for provision of bereavement counselling. Further research into this phenomenon is required.

wholfmeister

Fascinating reading!

Really, I mean it!  Illness affects the whole family on so many levels.  I especially like these studies because my dear son-in-law is an Aussie.  Thanks for sharing these!

lovesanimals

wholfmeister said:

Fascinating reading!

Really, I mean it!  Illness affects the whole family on so many levels.  I especially like these studies because my dear son-in-law is an Aussie.  Thanks for sharing these!

Interesting

My caregiver is my husband and I know he's experienced way more anxiety than what he's letting on to me.  I myself have been on an anti-depressant for mild depression, anxiety, and panic attacks for the last six years, so I feel pretty darn good.  I know my husband worries about recurrence and losing me, and I try to reassure him that I will pay attention to my body's signals see a doctor for any aches or pains that don't go away.  He does a fairly good job in taking care of his own health, thank goodness.  In the meantime, we feel lucky to have each other and we try to appreciate each day.

Kelly