title: Social factors in informal cancer caregivers: The interrelationships among social stressors, relationship quality, and family functioning in the CanCORS data set.
abstract: BACKGROUND
  Social and family factors can influence the health outcomes and quality of life of informal caregivers. Little is known about the distribution and correlates of such factors for caregivers of cancer patients. This study sought to fill this gap with data from the Cancer Care Outcomes Research and Surveillance consortium.
  
  
  METHODS
  Lung and colorectal cancer patients nominated an informal caregiver to participate in a caregiving survey. Caregivers reported their sociodemographic and caregiving characteristics, social stress, relationship quality with the patient, and family functioning. Descriptive statistics and Pearson correlations were used to assess the distribution of caregivers' social factors. Multivariable linear regressions assessed the independent correlates of each social factor.
  
  
  RESULTS
  Most caregivers reported low to moderate levels of social stress and good relationship quality and family functioning. In multivariable analyses, older age was associated with less social stress and better family functioning but worse relationship quality, with effect sizes (Cohen's d) up to 0.40 (P < .05). Caring for a female patient was associated with less social stress and better relationship quality but worse family functioning (effect sizes ≤ 0.16, P < .05). Few caregiving characteristics were associated with social stress, whereas several were significant independent correlates of relationship quality. Finally, social factors were important independent correlates of one another.
  
  
  CONCLUSIONS
  The results indicate the importance of personal and caregiving-related characteristics and the broader family context to social factors. Future work is needed to better understand these pathways and assess whether interventions targeting social factors can improve health or quality-of-life outcomes for informal cancer caregivers. Cancer 2016;122:278-286. © 2015 American Cancer Society.
authors.affiliation: National Cancer Institute, Rockville, Maryland.
authors.forename: Kristin
authors.initials: K
authors.lastname: Litzelman
authors.affiliation: National Cancer Institute, Rockville, Maryland.
authors.forename: Erin E
authors.initials: EE
authors.lastname: Kent
authors.affiliation: National Cancer Institute, Rockville, Maryland.
authors.forename: Julia H
authors.initials: JH
authors.lastname: Rowland
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D017028:Caregivers / Q000523:psychology*; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000628:therapy; D003430:Cross-Sectional Studies; D005195:Family Relations / Q000523:psychology; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008175:Lung Neoplasms / Q000175:diagnosis / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D018570:Risk Assessment; D012737:Sex Factors; D012934:Social Isolation / Q000523:psychology; D013315:Stress, Psychological / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D017741:Survivors; D055815:Young Adult
keywords: Cancer Care Outcomes Research and Surveillance (CanCORS); cancer; caregivers; family functioning; family relations; humans; interpersonal relations; negative social interaction; neoplasms; relationship quality; social stress