Relationship of caregiver reactions and depression to cancer patients' symptoms, functional states and depression--a longitudinal view.

This research examined, in a sample of N = 150 cancer patients and caregivers, the relationships among patient's physical functioning, depression and symptomatology, impact on caregivers' schedule and health, and caregiver depression, as well as the changes in these variables over time. A measure of caregivers' optimism was also included in the analyses. The disposition of caregiver optimism was a strong predictor of caregiver reactions to the burdens of caring, and seemed to play the role of a personality characteristic which was for the most part independent of patient variables. Levels of patient symptoms and their change over time were both strongly linked to change in patient immobility over time. Patient symptoms, and to a lesser degree patient immobility, were strong predictors of patient depression which in turn predicted caregiver depression. In general, as patients' needs subsided, caregivers perceived fewer reactions to the burdens of caring. Caregivers' reactions were clearly distinct, and were influenced differently by different patient variables. However, all three types of caregivers' reactions were influenced by caregivers' optimism. Oncologists, nurses and other health care professionals involved in the care of patients with cancer should consider this potentially important personal characteristic in the assessment of need for and the development of interventions designed to assist patients with cancer and their family caregivers.