Anny T H R Fenton1, Nancy L Keating2,3,4, Katherine A Ornstein5,6, Erin E Kent7,8, Kristin Litzelman9,10, Julia H Rowland11, Alexi A Wright1,4,12. 1. Division of Population Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts. 2. Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts. 3. Division of General Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts. 4. Department of Medicine, Havard Medical School, Boston, Massachusetts. 5. Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York. 6. Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, New York. 7. Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina. 8. Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina. 9. Department of Human Development and Family Studies, University of Wisconsin-Madison, Madison, Wisconsin. 10. University of Wisconsin Carbone Cancer Center, Madison, Wisconsin. 11. Smith Center for Healing and the Arts, Washington, DC. 12. Division of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.
Abstract
BACKGROUND: Adult-children caring for a parent with cancer comprise a significant segment of caregivers. Yet less is known about adult-child caregivers, their burden, or caregivers' and patients' gender's impact, which may differ from the well-studied spousal caregiver. This knowledge gap may hinder efforts to ameliorate adult-children's caregiver burden. METHODS: We analyzed caregiver surveys from the Cancer Care Outcomes Research and Surveillance Consortium, a multi-regional population-based study of patients with colorectal or lung cancer. Using t tests and multivariate regression models, we assessed whether adult-child and spousal caregivers' caregiving responsibilities and social/emotional and financial burdens differed and used structural equation models (SEMs) to examine mediating factors. RESULTS: Compared with spouses/partners (N = 1007), adult-children (N = 227) spent less time caregiving (14 vs 23 hours/week; P < .001), but experienced higher social/ emotional burden (P < .01). In models adjusted for objective caregiving burden measures and demographics, adult-children's social/emotional (P < .05) and financial burdens (P < .01) were greater than spouses'. Poor communication quality was associated with greater social/emotional burden for both groups (P < .05). SEMs indicated that gender concordance between caregivers and patients (eg, daughters caring for mothers) and caregiver employment increased the difference between adult-child and spouses' social/emotional burden, whereas caregiver-patient relationship quality reduced it. CONCLUSIONS: Adult-children spend less time caregiving than spouses/partners, but have higher social/emotional and financial caregiving burdens, partially due to adult-children's employment, caregiver-patients' gender concordance, and relationship quality. Gender concordance's contribution to greater social/emotional burden adds important context to prior findings, indicating female caregivers experience the most burden. Interventions that improve caregiver-patient communication may reduce both adult-child and spousal caregiver burden.
BACKGROUND: Adult-children caring for a parent with cancer comprise a significant segment of caregivers. Yet less is known about adult-child caregivers, their burden, or caregivers' and patients' gender's impact, which may differ from the well-studied spousal caregiver. This knowledge gap may hinder efforts to ameliorate adult-children's caregiver burden. METHODS: We analyzed caregiver surveys from the Cancer Care Outcomes Research and Surveillance Consortium, a multi-regional population-based study of patients with colorectal or lung cancer. Using t tests and multivariate regression models, we assessed whether adult-child and spousal caregivers' caregiving responsibilities and social/emotional and financial burdens differed and used structural equation models (SEMs) to examine mediating factors. RESULTS: Compared with spouses/partners (N = 1007), adult-children (N = 227) spent less time caregiving (14 vs 23 hours/week; P < .001), but experienced higher social/ emotional burden (P < .01). In models adjusted for objective caregiving burden measures and demographics, adult-children's social/emotional (P < .05) and financial burdens (P < .01) were greater than spouses'. Poor communication quality was associated with greater social/emotional burden for both groups (P < .05). SEMs indicated that gender concordance between caregivers and patients (eg, daughters caring for mothers) and caregiver employment increased the difference between adult-child and spouses' social/emotional burden, whereas caregiver-patient relationship quality reduced it. CONCLUSIONS: Adult-children spend less time caregiving than spouses/partners, but have higher social/emotional and financial caregiving burdens, partially due to adult-children's employment, caregiver-patients' gender concordance, and relationship quality. Gender concordance's contribution to greater social/emotional burden adds important context to prior findings, indicating female caregivers experience the most burden. Interventions that improve caregiver-patient communication may reduce both adult-child and spousal caregiver burden.
Authors: Paul J Catalano; John Z Ayanian; Jane C Weeks; Katherine L Kahn; Mary Beth Landrum; Alan M Zaslavsky; Jeannette Lee; Jane Pendergast; David P Harrington Journal: Med Care Date: 2013-02 Impact factor: 2.983
Authors: Carma L Bylund; Easton N Wollney; Gemme Campbell-Salome; Allison J Applebaum; Samantha R Paige; Kennan DeGruccio; Elisa Weiss; Maria Sae-Hau; Jason Arnold; Domenic Durante; Tithi B Amin; Chelsea N Hampton; Carla L Fisher Journal: JMIR Cancer Date: 2022-07-05