title: Family caregiving challenges in advanced colorectal cancer: patient and caregiver perspectives.
abstract: OBJECTIVE
  Family caregivers of advanced colorectal cancer patients may be at increased risk for psychological distress. Yet their key challenges in coping with the patient's illness are not well understood. Soliciting both patient and caregiver perspectives on these challenges would broaden our understanding of the caregiving experience. Thus, the purpose of this research was to identify caregivers' key challenges in coping with their family member's advanced colorectal cancer from the perspective of patients and caregivers.
  
  
  METHODS
  Individual, semi-structured qualitative interviews were conducted with 23 advanced colorectal cancer patients and 23 primary family caregivers. Interview data were analyzed via thematic analysis.
  
  
  RESULTS
  In nearly all cases, patient and caregiver reports of the caregiver's key challenge were discrepant. Across patient and caregiver reports, caregivers' key challenges included processing emotions surrounding the patient's initial diagnosis or recurrence and addressing the patient's practical and emotional needs. Other challenges included coping with continual uncertainty regarding the patient's potential functional decline and prognosis and observing the patient suffer from various physical symptoms.
  
  
  CONCLUSIONS
  Findings suggest that eliciting the perspectives of both patients and caregivers regarding caregivers' challenges provides a more comprehensive understanding of their experience. Results also point to the need to assist caregivers with the emotional and practical aspects of caregiving.
authors.affiliation: Department of Psychology, Indiana University-Purdue University Indianapolis, 402 North Blackford Street, LD 124, Indianapolis, IN, 46202, USA. cemosher@iupui.edu.
authors.forename: Catherine E
authors.initials: CE
authors.lastname: Mosher
authors.affiliation: Department of Psychology, Indiana University-Purdue University Indianapolis, 402 North Blackford Street, LD 124, Indianapolis, IN, 46202, USA.
authors.forename: Rebecca N
authors.initials: RN
authors.lastname: Adams
authors.affiliation: Department of Medicine, Indiana University School of Medicine, Indiana Cancer Pavilion, 535 Barnhill Drive, Room 473, Indianapolis, IN, 46202, USA.
authors.forename: Paul R
authors.initials: PR
authors.lastname: Helft
authors.affiliation: Department of Medicine, Indiana University School of Medicine, Indiana Cancer Pavilion, 535 Barnhill Drive, Room 473, Indianapolis, IN, 46202, USA.
authors.forename: Bert H
authors.initials: BH
authors.lastname: O'Neil
authors.affiliation: Department of Medicine, Indiana University School of Medicine, Indiana Cancer Pavilion, 535 Barnhill Drive, Room 473, Indianapolis, IN, 46202, USA.
authors.forename: Safi
authors.initials: S
authors.lastname: Shahda
authors.affiliation: Center for Health Information and Communication, Richard L. Roudebush VA Medical Center, 1481 West 10th Street, 11H, Indianapolis, IN, 46202, USA.
authors.forename: Nicholas A
authors.initials: NA
authors.lastname: Rattray
authors.affiliation: Indiana University School of Nursing, 1111 Middle Drive, NU 340G, Indianapolis, IN, 46202, USA.
authors.forename: Victoria L
authors.initials: VL
authors.lastname: Champion
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D017028:Caregivers / Q000523:psychology*; D015179:Colorectal Neoplasms / Q000473:pathology / Q000523:psychology; D004644:Emotions; D005195:Family Relations / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D036301:Qualitative Research; D013315:Stress, Psychological / Q000209:etiology / Q000517:prevention & control; D035501:Uncertainty; D014481:United States
keywords: Colorectal cancer; Coping; Distress; Family caregivers; Psychological; Qualitative