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A pilot examination of the impact of cancer patients' fatigue on their spousal caregivers

Published online by Cambridge University Press:  13 April 2006

STEVEN D. PASSIK
Affiliation:
Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
KENNETH L. KIRSH
Affiliation:
Pharmacy Practice and Science, University of Kentucky, Lexington, Kentucky, USA

Abstract

Objective: In this pilot project we examined the quality of life of spouses of cancer patients who had significant fatigue.

Methods: We assessed both the spouses of cancer patients and the patients who presented with chemotherapy-induced fatigue and anemia. Study endpoints included the impact that cancer patients' fatigue had on their spouses' quality of life, including their own levels of fatigue, depressive symptoms, activity levels, work absenteeism, and marital adjustment. We examined the extent to which changes in patients' fatigue from baseline to one month follow-up were associated with changes in spouses' quality of life indices.

Results: 25 couples completed the study. Seven (28%) spousal caregivers reported handling fewer responsibilities at work, 8 (32%) had reduced their work hours, and 8 (32%) felt that they were less effective overall at work. Spousal caregivers also missed a significant amount of time at work during the month long study, missing an average of 2.7 (SD = 2.95) days, with an additional 1.29 (SD = 2.97) sick days and 1.76 (SD = 2.63) vacation days during that time. Spouses reporting greater levels of caregiver strain were more likely to have increased fatigue at baseline (F1,23 = 8.11, p < .01), and worse dyadic adjustment at both time points (baseline: F1,23 = 7.80, p < .01; follow-up: F1,21 = 9.24, p < .01). Also, those with more caregiver strain were less likely to engage in social activity at baseline (F1,23 = 6.11, p < .05) and more likely to engage in less work by the one month follow-up (F1,20 = 8.36, p < .01).

Significance of results: Spouses who were identified as having elevated burden experienced more personal fatigue, had worse dyadic adjustment, reported poor energy levels, and tended to engage in fewer work and social activities; the impact of patient's fatigue level on these parameters was highly variable in this small pilot study.

Type
ORIGINAL ARTICLES
Copyright
© 2005 Cambridge University Press

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References

REFERENCES

Baider, L. & De-Nour, A.K. (1988). Adjustment to cancer: Who is the patient—the husband or the wife? Israel Journal of Medical Sciences, 24, 631636.Google Scholar
Curt, G.A. (2000a). The impact of fatigue on patients with cancer: Overview of FATIGUE 1 and 2. Oncologist, 5(Suppl. 2), 912.Google Scholar
Curt, G.A. (2000b). Impact of fatigue on quality of life in oncology patients. Seminars in Hematology, 37(Suppl. 6), 1417.Google Scholar
Curt, G.A & Johnston, P.G. (2003). Cancer fatigue: The way forward. Oncologist, 8(Suppl. 1), 2730.Google Scholar
Dugan, W., McDonald, M.V., Passik, S.D., et al. (1998). Use of the Zung Self-rating Depression Scale in cancer patients: Feasibility as a screening tool. Psycho-Oncology, 7, 483493.Google Scholar
Edstrom, S. & Woehning-Miller, M. (1981). Preparing the family to care for the cancer patient at home: Home care course. Cancer Nursing, 4, 4952.Google Scholar
Hahn, D.M., Garavoy, N., Finklestein, B., et al. (1999). Measurement of fatigue in cancer patients: Development and validation of the Fatigue Symptom Inventory. Quality of Life Research, 7, 301310.Google Scholar
Knop, D.S., Bergman-Evans, B., & McCabe, B.W. (1998). In sickness and in health: An exploration of the perceived quality of the marital relationship, coping, and depression in caregivers of spouses with Alzheimer's disease. Journal Psychosocial Nursing and Mental Health Service, 36, 1621.Google Scholar
Mailick, M. (1979). The impact of severe illness of the individual and family: An overview. Social Work Health Care, 5, 117128.Google Scholar
Mendoza, T.R., Wang, X.S., Cleeland, C.S., et al. (1999). The rapid assessment of fatigue severity on cancer patients: Use of the brief fatigue inventory. Cancer, 85, 11861196.Google Scholar
Northouse, L. (1984). The impact of cancer on the family: An overview. International Journal of Psychiatry Medicine, 14, 215242.Google Scholar
Oberst, M.T. & James, R.H. (1985). Going home: Patient and spouse adjustment following cancer surgery. Topics in Clinical Nursing, 7, 4657.Google Scholar
Portenoy, R.K. & Itri, L.M. (1999). Cancer-related fatigue: Guidelines for evaluation and management. Oncologist, 4, 110.Google Scholar
Robinson, B.C. (1983). Validation of a caregiver strain index. Journal of Gerontology, 38, 344348.Google Scholar
Smith, G.C., Smith, M.F., & Toseland, R.W. (1991). Problems identified by family caregivers in counseling. The Gerontologist, 31, 1522.Google Scholar
Spanier, G.B. (1976). Measuring dyadic adjustment: New scales for assessing the quality of marriage and similar dyads. Journal of Marriage and the Family, 38, 1528.Google Scholar
Vogelzang, N.J., Breitbart, W., Cella, D., et al. (1997). Patient, caregiver, and oncologist perceptions of cancer-related fatigue: Results of a tri-part assessment survey. Seminars in Hematology, 34(Suppl. 2), 412.Google Scholar
Zung, W.W.K. (1965). A self-rating depression scale. Archives of General Psychiatry, 12, 6370.Google Scholar