title: A pilot study of the experience of family caregivers of patients with advanced pancreatic cancer using a mixed methods approach.
abstract: BACKGROUND
  Pancreatic cancer presents a wide spectrum of significant symptomatology. The high symptom burden, coupled with a rapidly fatal diagnosis, limits preparation or time for adjustment for both patients and their family caregivers. From the initial diagnosis and throughout the illness experience, the physical and emotional demands of caregiving can predispose caregivers themselves to illness and a greater risk of mortality. Understanding the negative and positive aspects of caregiving for patients with advanced pancreatic cancer will inform interventions that promote positive caregiver outcomes and support caregivers in their role.
  
  
  OBJECTIVE
  To provide feasibility data for a larger, mixed methods, longitudinal study focused on the experience of family caregivers of patients with advanced pancreatic cancer and preliminary qualitative data to substantiate the significance of studying this caregiver population.
  
  
  METHODS
  This was a mixed methods study guided by the Stress Process Model. Eight family caregivers of patients with advanced pancreatic cancer from oncology practices of a university-affiliated medical center were surveyed.
  
  
  RESULTS
  The pilot results supported the ability to recruit and retain participants and informed recruitment and data collection procedures. The qualitative results provided preliminary insights into caregiver experiences during the diagnosis and treatment phases. Key findings that substantiated the significance of studying these caregivers included the caregiving context of the history of sentinel symptoms, the crisis of diagnosis, the violation of assumptions about life and health, recognition of the circle of association, and contextual factors, as well as primary and secondary stressors, coping strategies, resources, discoveries, gains and growth, associated changes/transitions, and unmet caregiver needs.
  
  
  CONCLUSIONS
  Findings indicated caregivers' willingness to participate in research, highlighted the negative and positive aspects of the caregiver experience, and reinforced the significance of the future study and the need to develop interventions to support family caregivers in their roles.
authors.affiliation: University of Maryland School of Nursing, Baltimore, Maryland, USA. Electronic address: desherma@fiu.edu.
authors.forename: Deborah W
authors.initials: DW
authors.lastname: Sherman
authors.affiliation: University of Maryland School of Nursing, Baltimore, Maryland, USA.
authors.forename: Deborah B
authors.initials: DB
authors.lastname: McGuire
authors.affiliation: Department of Pain Medicine and Palliative Care, Beth Israel Medical Center, New York, New York, USA.
authors.forename: David
authors.initials: D
authors.lastname: Free
authors.affiliation: University of Maryland School of Nursing, Baltimore, Maryland, USA.
authors.forename: Joo Young
authors.initials: JY
authors.lastname: Cheon
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D005190:Family / Q000523:psychology*; D005240:Feasibility Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000451:nursing*; D005791:Patient Care / Q000523:psychology*; D010865:Pilot Projects; D012720:Severity of Illness Index; D013315:Stress, Psychological; D014481:United States
keywords: Family caregivers; advanced pancreatic cancer; mixed methods; qualitative research