title: Cancer family caregiver depression: are religion-related variables important?
abstract: OBJECTIVE
  Prevalence estimates for clinical depression among cancer family caregivers (CFC) range upwards to 39%. Research inconsistently reports risk for CFC depressive symptoms when evaluating age, gender, ethnicity, or length of time as caregiver. The discrepant findings, coupled with emerging literature indicating religiosity may mitigate depression in some populations, led us to investigate religion-related variables to help predict CFC depressive symptoms.
  
  
  METHODS
  We conducted a cross-sectional study of 150 CFC. Explanatory variables included age, gender, spousal status, length of time as caregiver, attendance at religious services, and prayer. The outcome variable was the Center for Epidemiological Studies Depression Scale score.
  
  
  RESULTS
  Compared with large national and state datasets, our sample has lower representation of individuals with no religious affiliation (10.7% vs. 16.1% national, p = 0.07 and 23.0% state, p = 0.001), higher rate of attendance at religious services (81.3% vs. 67.2% national, p < 0.001 and 30.0% state, p < 0.001), and higher rate of prayer (65.3% vs. 42.9% national, p < 0.001; no state data available). In unadjusted and adjusted models, prayer is not significantly associated with caregiver depressive symptoms or clinically significant depressive symptomology. Attendance at religious services is associated with depressive symptoms (p = 0.004) with an inversely linear trend (p = 0.002).
  
  
  CONCLUSIONS
  The significant inverse association between attendance at religious services and depressive symptoms, despite no association between prayer and depressive symptoms, indicates that social or other factors may accompany attendance at religious services and contribute to the association. Clinicians can consider supporting a CFC's attendance at religious services as a potential preventive measure for depressive symptoms.
authors.affiliation: Frank H. Netter MD School of Medicine at Quinnipiac University, Hamden, CT, USA.
authors.forename: Anna-Leila
authors.initials: AL
authors.lastname: Williams
authors.affiliation: Yale University School of Nursing, New Haven, CT, USA.
authors.forename: Jane
authors.initials: J
authors.lastname: Dixon
authors.affiliation: Frank H. Netter MD School of Medicine at Quinnipiac University, Hamden, CT, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Feinn
authors.affiliation: Yale University School of Nursing, New Haven, CT, USA.
authors.forename: Ruth
authors.initials: R
authors.lastname: McCorkle
mesh_terms: D000328:Adult; D000368:Aged; D017028:Caregivers / Q000523:psychology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology* / Q000523:psychology; D003866:Depressive Disorder / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000451:nursing*; D015995:Prevalence; D012069:Religion and Psychology; D012944:Social Support; D011795:Surveys and Questionnaires
keywords: cancer; depression; family caregiver; oncology; prayer; religiosity
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