title: Cancer caregiving predicts physical impairments: roles of earlier caregiving stress and being a spousal caregiver.
abstract: BACKGROUND
  The objective of this study was to investigate associations between earlier caregiving experience and the development of physical impairments over the subsequent 6 years among family caregivers of patients with cancer.
  
  
  METHODS
  Family caregivers of cancer survivors participated in a nationwide survey 2 years after their relative's cancer diagnosis (T1) (N=1517) with follow-up at 5 years (T2) and 8 years (T3) postdiagnosis. Caregivers self-reported their demographics and levels of caregiving stress at T1. Caregiving status ("former" for those whose patient was remission, "bereaved" for those whose patient had died, and "current") and the presence of 3 physical impairments (arthritis, chronic back pain, and heart-related diseases) at the time of assessment were measured at T1 through T3.
  
  
  RESULTS
  Caregiving stress was significantly related to concurrent presence of the 3 impairment markers at T1. Stressed caregivers also were more likely to develop heart diseases, and spousal caregivers were more likely than other caregivers to develop arthritis and chronic back pain several years after the initial caregiving experience (at T2 and T3). These effects were independent of age, sex, education, and income at T1, and they were also independent of caregiving status at each assessment.
  
  
  CONCLUSIONS
  The current findings suggest that the adverse long-term health effects of earlier caregiving stress and of being a spousal caregiver should be acknowledged and that caregiving-related stress management programs should be incorporated into routine health care for family caregivers of cancer patients.
authors.affiliation: Department of Psychology, University of Miami, Coral Gables, Florida.
authors.forename: Youngmee
authors.initials: Y
authors.lastname: Kim
authors.forename: Charles S
authors.initials: CS
authors.lastname: Carver
authors.forename: Kelly M
authors.initials: KM
authors.lastname: Shaffer
authors.forename: Ted
authors.initials: T
authors.lastname: Gansler
authors.forename: Rachel S
authors.initials: RS
authors.lastname: Cannady
mesh_terms: D000328:Adult; D000368:Aged; D001168:Arthritis / Q000453:epidemiology* / Q000209:etiology; D001416:Back Pain / Q000453:epidemiology* / Q000209:etiology; D017028:Caregivers / Q000523:psychology / Q000706:statistics & numerical data*; D002908:Chronic Disease; D005260:Female; D006304:Health Status; D006331:Heart Diseases / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000451:nursing*; D011788:Quality of Life; D012307:Risk Factors; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000150:complications* / Q000209:etiology / Q000517:prevention & control; D011795:Surveys and Questionnaires; D013997:Time Factors; D014481:United States / Q000453:epidemiology
keywords: arthritis; cancer caregivers; caregiving stress; chronic back pain; heart diseases; longitudinal study