title: Hope as determinant for psychiatric morbidity in family caregivers of advanced cancer patients.
abstract: Home care of advanced cancer patients often has adverse effects on physical and mental health of family caregivers. Little is known about the long-term effects of continuous caregiving on mental health as compared with the effects of bereavement. The objectives of this study were to describe the course of psychiatric morbidity in family caregivers over time, to identify the impact of the patients' death on caregivers, and to explore possible predictor variables for psychiatric morbidity.
  
  
  
  This multi-institutional, prospective study included 80 family caregivers of 80 advanced cancer patients for baseline and 9 months follow-up assessment. Possible psychiatric disorders (ie, depression, anxiety, posttraumatic stress disorder, and alcohol abuse/dependence) as well as potentially predictive factors (ie, sociodemographic factors, burden, hope, and coping mechanisms) were assessed.
  
  
  
  Follow-up assessment was conducted on average 9.2 months (±2.9) after baseline assessment. Prevalence rates of anxiety and posttraumatic stress disorder decreased significantly over time, whereas depression and alcoholism remained stable. Bereavement was experienced by 53% of caregivers in the follow-up period. The patients' death had no influence on psychiatric morbidity at follow-up. Predictors for the development of a psychiatric disorder varied according to condition, with hope and emotion-oriented coping identified as important influences, especially for anxiety and depression.
  
  
  
  Family caregivers with certain psychiatric disorders might need targeted psychosocial support to ensure their mental well-being and prevent long-term disability. Supporting hope and functional coping strategies early after the patient's diagnosis might limit development and extent of psychiatric morbidity.
authors.affiliation: Division of Palliative Care, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria.|Department of Radiation Oncology, Medical University of Vienna, Vienna, Austria.
authors.forename: T
authors.initials: T
authors.lastname: Rumpold
authors.affiliation: Division of Palliative Care, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria.
authors.forename: S
authors.initials: S
authors.lastname: Schur
authors.affiliation: Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria.
authors.forename: M
authors.initials: M
authors.lastname: Amering
authors.affiliation: Division of Palliative Care, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria.
authors.forename: A
authors.initials: A
authors.lastname: Ebert-Vogel
authors.affiliation: Department of Radiation Oncology, Medical University of Vienna, Vienna, Austria.
authors.forename: K
authors.initials: K
authors.lastname: Kirchheiner
authors.affiliation: Division of Palliative Care, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria.
authors.forename: E
authors.initials: E
authors.lastname: Masel
authors.affiliation: Division of Palliative Care, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria.
authors.forename: H
authors.initials: H
authors.lastname: Watzke
authors.affiliation: Department of Psychiatry and Psychotherapy, University Hospital Tulln, Karl Landsteiner University of Health Sciences, Tulln, Austria.
authors.forename: B
authors.initials: B
authors.lastname: Schrank
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001601:Bereavement; D017028:Caregivers / Q000523:psychology*; D003863:Depression / Q000523:psychology; D005260:Female; D065026:Hope; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D011446:Prospective Studies; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology
keywords: cancer; caregiver; family; hope; oncology; palliative care; psychiatric morbidity