Depression and physical health among family caregivers of geriatric patients with cancer--a longitudinal view.
BACKGROUND
We investigated, in a sample of 491 cancer patient/caregiver dyads, the impact of caregiving on caregivers' mental and physical health over a period of one year (four assessments). Our model postulates that patient and caregiver characteristics impact caregiver experiences, and all of these in turn affect the mental and physical health of the caregiver.


METHODS
Random-effects regression methods were employed to investigate how patient and caregiver characteristics affect caregiver experiences, and how these same patient and caregiver characteristics affect caregiver physical and psychological health, and are mediated by caregiver experiences.


RESULTS
Caregivers' personal perceptions of the caregiving experience (impact on schedule, social functioning, abandonment) played a central role as determinants of caregiver outcomes (depression and physical health). The contextual elements that came to the foreground as either direct or indirect determinants of caregiver outcomes were the patient characteristics symptoms, depression, treatment, comorbidity and cancer site, and the caregiver characteristics education, esteem derived from caregiving, and living arrangement.


CONCLUSIONS
Our findings suggest that physicians, oncologists and other health care providers involved in the care of cancer patients should be cognizant of the demands put on caregivers. Periodic assessments and dialogue with the caregiver about their experiences, needs and concerns in combination with a review of the patient's illness trajectory may be necessary to insure that caregivers are able to provide quality care to their patients and not succumb to the burdens of caregiving.
Kurtz
Margot E
ME
Department of Family and Community Medicine, B211 West Fee Hall, Michigan State University, East Lansing, MI 48824, USA. kurtzm@msu.edu
Kurtz
J Cleo
JC
Given
Charles W
CW
Given
Barbara A
BA
D017028:Caregivers; D003863:Depression / Q000523:psychology*; D005192:Family Health; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D019964:Mood Disorders / Q000523:psychology; D009369:Neoplasms / Q000451:nursing* / Q000523:psychology; D013315:Stress, Psychological