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


CONCLUSIONS
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.
Passik
Steven D
SD
Memorial Sloan Kettering Cancer Center, Department of Psychiatry and Behavioral Sciences, 641 Lexington Avenue, New York, NY 10022, USA. passiks@mskcc.org
Kirsh
Kenneth L
KL
D000041:Absenteeism; D000203:Activities of Daily Living / Q000523:psychology; D000328:Adult; D000339:Affect; D000368:Aged; D000740:Anemia / Q000139:chemically induced / Q000523:psychology; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy / Q000523:psychology; D017028:Caregivers / Q000523:psychology*; D017281:Cost of Illness; D005221:Fatigue / Q000139:chemically induced / Q000523:psychology*; D005260:Female; D006452:Hemoglobinometry; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D008393:Marriage / Q000523:psychology; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy / Q000523:psychology*; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000523:psychology; D010865:Pilot Projects; D011471:Prostatic Neoplasms / Q000188:drug therapy / Q000523:psychology; D011788:Quality of Life / Q000523:psychology*; D007319:Sleep Initiation and Maintenance Disorders / Q000523:psychology; D012919:Social Behavior; D018454:Spouses / Q000523:psychology*
D000970:Antineoplastic Agents