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Effects of the Caregiving Experience on the Neuroendocrine Functioning of Family Caregivers of Adult Patients with Cancer
Location: 52
Mentor: Dr. Youngmee Kim
Family caregivers of patients with cancer experience significant stress, which has substantial impact on their quality of life (QOL). Although the roles of individual and social resources in caregivers’ mental health have been well-studied, the compatible evidence in physical health and their long-term impact is lacking. Furthermore, caring for older patients may impose unique challenges. Thus, this study investigated the extent to which caregiving experiences are associated with physical QOL and the moderating effects of patient age during the first year of cancer survivorship.
Family caregivers (n=94, M age=52 years, 68% female, 50% Hispanic) of patients with colorectal cancer (M age=56 years, range=31-89 years, 76% advanced cancer) completed questionnaires assessing caregiver’s esteem, loneliness, and family support approximately four months after the patient’s diagnosis (T1). Caregivers also collected four saliva samples per day for two consecutive days at T1 and one year later (T2), from which cortisol levels at waking and bedtime, cortisol awakening response (CAR), and diurnal patterns were quantified. Caregivers’ age and gender, and patient cancer stage were covariates.
Caregivers reported high levels of esteem and family support, and low levels of loneliness. Caregivers had elevated waking and bedtime cortisol levels, and more blunted CAR and diurnal patterns, compared with those of non-caregivers. Hierarchical regression models indicated that greater loneliness was concurrently associated with lower cortisol levels at waking and at bedtime (b≤-4.94, p≤.034). Controlling for covariates and T1 cortisol values, less family support was associated with larger CAR and flatter cortisol slope at T2 (b≥1.67, p≤.021), and greater esteem was marginally associated with higher cortisol levels at waking at T2 (b=18.64, p=.073), which was the case only in caregivers of older patients.
Findings suggest that family cancer caregivers have compromised physical health and unique aspects of caregiving experience are differentially related to physical QOL by patient age across the first year of cancer survivorship. Investigating the psychosocial pathways that underly the contemporaneous roles of caregivers’ loneliness and the delayed responses of esteem and family support is warranted. Interventions tailored for caregivers’ coping resources and the geriatric care context across the cancer survivorship trajectory may help improve caregivers’ health.
