The hidden morbidity of cancer: An exploratory study of burden in caregivers of cancer patients with brain metastases

Abstract

<p>Caregiving is a highly individualized experience. While numerous papers have&nbsp;been published on caregiver burden in the context of a variety of diagnoses and&nbsp;conditions, this paper presents the unique features of caregiving in cancer patients with&nbsp;brain metastases. Improved long-term survival of patients, concerns about disease&nbsp;recurrence or progression, the mileposts of the cancer experience (initial diagnosis,&nbsp;treatment, survivorship, recurrence, progression, and end of life), and the increasing&nbsp;complexity of cancer treatments add to the demands placed upon the caregiver of patients with brain metastases.</p> <p>The aim of this dissertation was to explore the antecedents and outcomes of&nbsp;caregiver burden within the context of brain metastases using the Comprehensive&nbsp;Health Seeking and Coping Paradigm as a framework to describe the highly interactive&nbsp;iii&nbsp;relationship among the variables. The first paper derived from this dissertation is a&nbsp;literature review that describes the challenges of caring for a patient with brain&nbsp;metastases and highlights the implications for healthcare professionals. The second&nbsp;paper presents the analysis of the relationships between caregiver burden and the&nbsp;affective disorders anxiety and depression. It describes the higher risk of screening positive for anxiety and depression for caregivers who report increased schedule&nbsp;burden. The third paper examines the impact of the patient&rsquo;s cognitive impairment on&nbsp;caregiver resilience and caregiver coping strategies. This paper reports the significant&nbsp;correlation found between the coping strategy acceptance and the two dimensions of&nbsp;the patient&rsquo;s cognitive/behavioral status, i.e., patient&rsquo;s memory problems and disruptive<br />behavior.&nbsp;</p> <p>Caregivers of patients with brain metastases are the hidden morbidity of cancer.&nbsp;While the healthcare industry has consistently recognized the contributions of&nbsp;caregivers, we have fallen behind in identifying and managing their needs. Healthcare&nbsp;providers need to continue to be perceptive of caregiver burden and be ready to&nbsp;administer the appropriate interventions that must be as unique and individualized as&nbsp;their experiences.</p>