Congress Abstracts 2004

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NEURO-ONCOLOGY CAREGIVERS: CORRELATES OF DISTRESS. Paula Sherwood, RN, PhD(c), CNRN, Barbara Given, RN, PhD, FAAN, and Charles Given, PhD, Michigan State University, East Lansing, MI; Rachel Schiffman, RN, PhD, University of Wisconsin, Madison, WI; and Mary Lovely, RN, PhD, Consultant, San Francisco, CA.

Improving the emotional health of caregivers of persons with a primary malignant brain tumor (PMBT).

Caregivers of cancer and dementia patients are at risk for increased mortality, depression, and anxiety. However, there have been minimal efforts to describe the impact of providing care for persons with both oncological and neurological sequelae. The purpose of this study was to determine the effects of patient functional, cognitive, and neuropsychiatric (NP) status and caregiver mastery and perceived adequacy of information to care (PAIC) on burden and depression of caregivers of persons with a PMBT.

Based on Lazarus’ Theory of Stress and Coping, the patient’s functional, cognitive, and NP status dictate care demands during the primary appraisal that are met using resources identified during the secondary appraisal (mastery and PAIC). Caregivers’ stress response is operationalized as caregiver burden and depression.

The cross-sectional, descriptive study consisted of telephone interviews with 95 adult caregivers of persons with a PMBT recruited from two national brain tumor support groups, two urban cancer centers, and a statewide cancer registry. The 45–60 minute interview consisted of sociodemographic questions and the following instruments: ADL/IADL scale (á=.93); Cognitive Performance Scale (á=.71); Neuropsychiatric Inventory (á=.78); Patient Satisfaction Questionnaire (á=.96); Caregiver Mastery (á=.73); Caregiver Reaction Assessment (subscales: self esteem á =.79, abandonment á =.83, finances á =.87, schedule á =.75, health á =.70); and Center for Epidemiologic Studies-Depression (á=.89).

Using structural equation modeling, relationships were formulated among variables, model fit was assessed, and respecification was done as necessary to interpret the relationships.

The overall model demonstrated good fit indices (rmsea=.05, ÷2=11.6 p=.24, gfi=.93) Patients’ NP status and caregiver mastery predicted caregiver depression and portions of caregiver burden (self esteem, finances, and schedule). Patients’ NP status also predicted other portions of caregiver burden (abandonment and health). Oncology nurses should target interventions for improving caregiver health at assisting caregivers to manage and deal with patients’ NP symptoms. Because oncology nurses are largely responsible for teaching and monitoring caregiver skills and knowledge, nurses are in a prime position to assist caregivers to increase mastery, thereby affecting caregiver, and ultimately patient, outcomes.