title: Burden of spousal caregivers of stage II and III esophageal cancer survivors 3 years after treatment with curative intent.
abstract: OBJECTIVE
  The aim of this study is to examine caregiver burden of spousal caregivers of patients with esophageal cancer after curative treatment with neoadjuvant chemoradiation followed by resection and to assess factors associated with caregiver burden.
  
  
  METHODS
  In this exploratory, cross-sectional study, spousal caregivers and patients were eligible if the caregiver was the patient's spouse and the patient had been treated with chemoradiation followed by surgery after esophageal carcinoma diagnosis. Forty-seven couples were included. Spousal caregivers completed a questionnaire, examining caregivers' burden (Self-Perceived Pressure from Informal Care (SPPIC, Dutch)), caregiver unmet needs (SCNS-P&S), anxiety and depression (Hospital Anxiety and Depression Scale (HADS)), and marital satisfaction (Maudsley Marital Questionnaire (MMQ)). Patients completed the latter two questionnaires and a cancer specific quality of life questionnaire (EORTC-QLQ C30 and OES18 (oesophageal module). Logistic regression analysis was performed to identify correlates for caregiver burden.
  
  
  RESULTS
  The median time after esophagectomy was 38 months. Thirty-four percent of the spousal caregivers reported moderate or high burden. Spousal caregivers most frequently reported unmet needs were managing concerns about the cancer coming back (43%), dealing with others not acknowledging the impact on your life of caring for a person with cancer (38%), and balancing the needs of the person with cancer and one's own needs. A comparable proportion of spousal caregivers and patients showed symptoms of anxiety (23 vs 17%) and depression (17 vs 17%). Spousal caregivers reported significantly more dissatisfaction than patients on the marital scale (p < 0.01). Factors independently associated with higher caregiver burden were fatigue of the patient (OR = 1.66, 95% CI 1.12-2.47) and depression of the spousal caregiver (OR = 1.44, 95% CI 1.11-1.86).
  
  
  CONCLUSIONS
  More than a third of the spousal caregivers of patients with esophageal cancer treated with curative intent report moderate or high burden 3 years after treatment. Fatigue of the patient and depression of the spousal caregiver are associated with caregiver burden. To improve clinical care, identification of spousal caregivers at risk for experiencing higher caregiver burden and implementation of specific interventions is needed.
authors.affiliation: Department of Medical Oncology, Academic Medical Center, University of Amsterdam, F4-222, Meibergdreef 9, PO box 22600, 1100 DD, Amsterdam, The Netherlands. n.hajmohammad@amc.nl.
authors.forename: N
authors.initials: N
authors.lastname: Haj Mohammad
authors.affiliation: Department of Medical Oncology, Academic Medical Center, University of Amsterdam, F4-222, Meibergdreef 9, PO box 22600, 1100 DD, Amsterdam, The Netherlands.
authors.forename: A W
authors.initials: AW
authors.lastname: Walter
authors.affiliation: Department of Medical Oncology, Academic Medical Center, University of Amsterdam, F4-222, Meibergdreef 9, PO box 22600, 1100 DD, Amsterdam, The Netherlands.
authors.forename: M G H
authors.initials: MG
authors.lastname: van Oijen
authors.affiliation: Department of Radiation Oncology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: M C C M
authors.initials: MC
authors.lastname: Hulshof
authors.affiliation: Department of Gastroenterology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: J J G H M
authors.initials: JJ
authors.lastname: Bergman
authors.affiliation: Department of Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: M C J
authors.initials: MC
authors.lastname: Anderegg
authors.affiliation: Department of Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: M I
authors.initials: MI
authors.lastname: van Berge Henegouwen
authors.affiliation: Department of Medical Psychology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: I
authors.initials: I
authors.lastname: Henselmans
authors.affiliation: Department of Medical Psychology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: M A G
authors.initials: MA
authors.lastname: Sprangers
authors.affiliation: Department of Medical Oncology, Academic Medical Center, University of Amsterdam, F4-222, Meibergdreef 9, PO box 22600, 1100 DD, Amsterdam, The Netherlands.
authors.forename: H W M
authors.initials: HW
authors.lastname: van Laarhoven
mesh_terms: D000368:Aged; D001007:Anxiety; D017028:Caregivers / Q000523:psychology*; D003430:Cross-Sectional Studies; D003863:Depression; D004938:Esophageal Neoplasms / Q000401:mortality / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011788:Quality of Life; D018454:Spouses; D017741:Survivors
keywords: Burden; Caregiver; Esophageal cancer; Unmet needs