title: A labor of love: the influence of cancer caregiving on health behaviors.
abstract: BACKGROUND
  Evidence suggests that emotional distress and objective demands of cancer caregiving are comparable to those of dementia caregiving, yet little research has focused on the physical health of cancer caregivers. Whether the stress leads directly to changes in health or whether the stress leads to changes in health behaviors, which in turn affect health, has not been systematically examined.
  
  
  OBJECTIVE
  The objective of this study was to review the research literature regarding changes in health behaviors associated with caring for an individual with cancer.
  
  
  METHODS
  Literature was reviewed from multiple databases including CINAHL (Cumulative Index to Nursing and Allied Health Literature), CINAHL Plus, PsycNET, PubMed, SCOPUS, EMBASE, and Web of Science. Key words included "health behavior," "health promotion," "caregivers/caregiving," "cancer/oncology," "diet/nutrition," "exercise/physical activity," "stress management," "smoking" and "alcohol." Studies were included if they involved informal adult caregivers and at least 1 behavior associated with a healthy lifestyle. Of the 866 studies identified, 8 met the criteria.
  
  
  RESULTS
  Studies revealed conflicting information, with some suggesting deleterious changes in behaviors, whereas others found the changes protective.
  
  
  CONCLUSIONS
  The lack of uniformity of terminology and conflicting findings make it difficult to conclude the impact of the caregiving experience on the health behaviors of cancer caregivers. Something is placing caregivers at risk for illness and early death, but the mechanisms behind the risk and the role of unhealthy behaviors are not clear.
  
  
  CONCLUSIONS
  At a minimum, cancer caregivers should be screened for behavior changes and disease risk. Developing standardized measures for future research including controlled, longitudinal studies is needed.
authors.affiliation: Author Affiliation: Nursing and Patient Care Services, National Institutes of Health Clinical Center, Bethesda, Maryland.
authors.forename: Alyson
authors.initials: A
authors.lastname: Ross
authors.forename: Thiruppavai
authors.initials: T
authors.lastname: Sundaramurthi
authors.forename: Margaret
authors.initials: M
authors.lastname: Bevans
mesh_terms: D017028:Caregivers / Q000523:psychology; D019317:Evidence-Based Medicine; D015438:Health Behavior; D006304:Health Status; D006801:Humans; D008019:Life Style; D008149:Love; D009369:Neoplasms / Q000451:nursing* / Q000523:psychology; D011788:Quality of Life