title: Mutuality and preparedness moderate the effects of caregiving demand on cancer family caregiver outcomes.
abstract: BACKGROUND
  Family caregiving researchers have explored the moderating or stress-buffering effects of variables such as coping and social support. However, the quality of the family caregiver-patient relationship and preparedness for caregiving have received little attention as potential moderators.
  
  
  OBJECTIVE
  To explore whether relationship quality and preparedness moderate the effects of caregiving demand on caregiver outcomes during cancer treatment.
  
  
  METHODS
  Eighty-seven family caregivers of patients receiving treatment for cancer completed the Demand and Difficulty subscales of the Caregiving Burden Scale, Mutuality and Preparedness Scales of the Family Care Inventory, and the short form of the Profile of Mood States. Using hierarchical multiple regression analyses, caregiving difficulty and total mood disturbance were regressed on two- and three-way interaction terms for demand, mutuality, and preparedness, controlling for caregiver age and gender, and the simple effect of each independent variable.
  
  
  RESULTS
  Negligible effects for two-way interactions were found. However, the three-way interaction between demand, mutuality, and preparedness explained statistically significant variance in both perceived difficulty of caregiving and total mood disturbance. High mutuality in combination with high preparedness protected caregivers from adverse outcomes when demand was high. When either mutuality or preparedness was low, caregivers were at greater risk for negative outcomes when demand was high, but not when demand was low. When both mutuality and preparedness were low, caregivers were at risk for mood disturbance even when demand was low.
  
  
  CONCLUSIONS
  Analysis of three-way interactions provided new theoretical insights into the protective effects of mutuality and preparedness and demonstrated conditions under which caregivers are at increased risk for negative outcomes.
authors.affiliation: College of Nursing, University of Nebraska Medical Center, Omaha, NE 68198-5330, USA. ckschumacher@unmc.edu
authors.forename: Karen L
authors.initials: KL
authors.lastname: Schumacher
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Stewart
authors.forename: Patricia G
authors.initials: PG
authors.lastname: Archbold
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D005195:Family Relations; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000451:nursing; D012044:Regression Analysis; D012944:Social Support; D014481:United States