title: A spectrum of hidden morbidities among spousal caregivers for patients with cancer, and differences between the genders: a review of the literature.
abstract: OBJECTIVE
  To explore the spectrum of hidden morbidities and gender differences in the spousal caregiving experience with regard to cancer patients across the cancer trajectory, and to discuss directions for future research and the implications for interventions to improve the caregiving experience.
  
  
  METHODS
  A systematic search was conducted to identity articles published in English or Chinese from January 2000 to July 2012. Studies were located using an electronic search, a manual search, and an author search.
  
  
  RESULTS
  A total of 19 articles were identified and included in this review. This review of the literature revealed that female spousal caregivers, in general, experienced more mental morbidity (higher levels of distress, depression, and anxiety, lower levels of mental health), physical morbidity (lower physical health scores, poorer physical functioning, and loss of physical strength), and social morbidity (lower marital satisfaction and less social support) than male spousal caregivers.
  
  
  CONCLUSIONS
  This review of the literature revealed that spousal caregivers, particularly female spousal caregivers for cancer patients, are at a high risk of falling victim to a wide spectrum of hidden morbidities due to their caregiving experience. The cultural influences on the couples and their patterns of communication that influence the caregiving experience for cancer patients should be further explored. A tailored-made intervention for spousal caregivers, both males and females, in the context of cancer care should be developed to cater to the needs of this population, which suffers from a spectrum of hidden morbidities.
authors: School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China; Wuxi Medical School, Jiangnan University, Wuxi, Jiangsu Province, China.
authors: Qiuping
authors: Q
authors: Li
authors: Alice Yuen
authors: AY
authors: Loke
mesh_terms: D000328:Adult; D001007:Anxiety / Q000453:epidemiology; D017028:Caregivers / Q000523:psychology*; D002681:China; D003863:Depression / Q000453:epidemiology; D054541:Family Conflict / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D009369:Neoplasms / Q000628:therapy*; D011788:Quality of Life; D018570:Risk Assessment; D012737:Sex Factors; D012934:Social Isolation / Q000523:psychology; D018454:Spouses / Q000523:psychology*; D013315:Stress, Psychological
keywords: Cancer; Caregiving experience; Gender differences; Hidden morbidity; Spousal caregivers