Katrina R Ellis1, Mary R Janevic2, Trace Kershaw3, Cleopatra H Caldwell2, Nancy K Janz2, Laurel Northouse4. 1. Gillings School of Global Public Health, University of North Carolina, 302C Rosenau Hall, CB 7440, Chapel Hill, NC, 27559, USA. katrina.ellis@unc.edu. 2. School of Public Health, University of Michigan, Ann Arbor, MI, USA. 3. Yale School of Public Health, New Haven, CT, USA. 4. School of Nursing, University of Michigan, Ann Arbor, MI, USA.
Abstract
PURPOSE: Physical and psychological symptoms experienced by patients with advanced cancer influence their well-being; how patient and family caregiver symptom distress influence each other's well-being is less understood. This study examined the influence of patient and caregiver symptom distress on their threat appraisals and self-efficacy to cope with cancer. METHODS: We conducted a secondary analysis of baseline data from an RCT that enrolled patients with advanced cancer and their family caregivers (N = 484 dyads). Structural equation modeling and the actor-partner interdependence mediation model (APIMeM) were used to examine two models: threat appraisals as a mediator of the relationship between symptom distress and individual and family-related self-efficacy; and, self-efficacy (individual and family dimensions) as mediators of the relationship between symptom distress and threat appraisals. RESULTS: Data suggest the self-efficacy mediation model was the preferred model. More patient and caregiver symptom distress was directly associated with their own lower self-efficacy and more threatening appraisals. Patient and caregiver individual self-efficacy also mediated the relationship between their own symptom distress and threat appraisals. There were also significant interdependent effects. More patient symptom distress was associated with less caregiver family-related self-efficacy, and more caregiver symptom distress was directly associated with more threatening patient appraisals. CONCLUSIONS: Patient and caregiver symptom distress influenced their own and in some cases each other's cognitive appraisals. Limitations of this study include the use of cross-sectional data and assessments of individually-focused (vs. family-focused) threat appraisals. These findings highlight the need to consider the management of patient and caregiver symptoms during advanced cancer.
PURPOSE: Physical and psychological symptoms experienced by patients with advanced cancer influence their well-being; how patient and family caregiver symptom distress influence each other's well-being is less understood. This study examined the influence of patient and caregiver symptom distress on their threat appraisals and self-efficacy to cope with cancer. METHODS: We conducted a secondary analysis of baseline data from an RCT that enrolled patients with advanced cancer and their family caregivers (N = 484 dyads). Structural equation modeling and the actor-partner interdependence mediation model (APIMeM) were used to examine two models: threat appraisals as a mediator of the relationship between symptom distress and individual and family-related self-efficacy; and, self-efficacy (individual and family dimensions) as mediators of the relationship between symptom distress and threat appraisals. RESULTS: Data suggest the self-efficacy mediation model was the preferred model. More patient and caregiver symptom distress was directly associated with their own lower self-efficacy and more threatening appraisals. Patient and caregiver individual self-efficacy also mediated the relationship between their own symptom distress and threat appraisals. There were also significant interdependent effects. More patient symptom distress was associated with less caregiver family-related self-efficacy, and more caregiver symptom distress was directly associated with more threatening patient appraisals. CONCLUSIONS:Patient and caregiver symptom distress influenced their own and in some cases each other's cognitive appraisals. Limitations of this study include the use of cross-sectional data and assessments of individually-focused (vs. family-focused) threat appraisals. These findings highlight the need to consider the management of patient and caregiver symptoms during advanced cancer.
Authors: Laurel L Northouse; Darlene W Mood; Ann Schafenacker; Gregory Kalemkerian; Mark Zalupski; Patricia LoRusso; Daniel F Hayes; Maha Hussain; John Ruckdeschel; A Mark Fendrick; Peter C Trask; David L Ronis; Trace Kershaw Journal: Psychooncology Date: 2012-01-31 Impact factor: 3.894
Authors: Carla L Fisher; Michaela D Mullis; Amanda Kastrinos; Easton Wollney; Elisa S Weiss; Maria Sae-Hau; Carma L Bylund Journal: Support Care Cancer Date: 2020-10-13 Impact factor: 3.603
Authors: Megan C Thomas Hebdon; Lorinda A Coombs; Pamela Reed; Tracy E Crane; Terry A Badger Journal: Eur J Oncol Nurs Date: 2021-03-10 Impact factor: 2.588
Authors: Katrina R Ellis; Kristin Z Black; Stephanie Baker; Carol Cothern; Kia Davis; Kay Doost; Christina Goestch; Ida Griesemer; Fatima Guerrab; Alexandra F Lightfoot; Neda Padilla; Cleo A Samuel; Jennifer C Schaal; Christina Yongue; Eugenia Eng Journal: Fam Community Health Date: 2020 Jul/Sep
Authors: Wagahta Semere; Andrew D Althouse; Ann-Marie Rosland; Douglas White; Robert Arnold; Edward Chu; Thomas J Smith; Yael Schenker Journal: J Geriatr Oncol Date: 2021-01-18 Impact factor: 3.929
Authors: Maria C Katapodi; Katrina R Ellis; Franziska Schmidt; Christos Nikolaidis; Laurel L Northouse Journal: Cancer Med Date: 2018-09-05 Impact factor: 4.452