title: Cognitive dysfunction in patients with brain metastases: influences on caregiver resilience and coping.
abstract: Neurologic deficits that may be manifested as cognitive impairment contribute to the challenges faced by caregivers of patients with brain metastases. To better address their needs, we examined how caregivers respond to these challenges and explore the relationship between the patient's cognitive impairment and caregiver resilience and coping.
  
  
  
  We conducted a descriptive, cross-sectional study using self-reported data from 56 caregivers of patients with brain metastases. Study participants from a comprehensive cancer center were asked to complete a series of instruments that measured their perception of the patient's cognitive dysfunction (revised memory and behavior problems checklist, RMBC), their own personal resilience (Resilience Scale, RS), and their utilization of a broad range of coping responses (COPE inventory and Emotional-Approach Coping scale).
  
  
  
  Caregivers reported that memory-related problems occurred more frequently in the patients they cared for compared to depression and disruptive behavior (mean scores 3.52 vs 2.34 vs. 1.32, respectively). Coping strategies most frequently used by caregivers were acceptance (3.28), planning (3.08), and positive reinterpretation and growth (2.95). Most caregivers scored moderate to high on the RS (77%). The coping strategy acceptance correlated significantly with the memory and disruptive behavior subscales of the RMBC.
  
  
  
  Given the protective effect of problem-focused coping and the high rate of caregivers utilizing less effective coping strategies in instances of worsening cognitive dysfunction, healthcare professionals need to systematically assess the coping strategies of caregivers and deliver a more personalized approach to enhance effective coping among caregivers of patients with brain metastases.
authors.affiliation: School of Nursing, University of California, Los Angeles, Factor Bldg., 700 Tiverton Ave, Los Angeles, CA, 90095, USA. sariam@jwci.org.|John Wayne Cancer Institute and Pacific Neuroscience Institute at Providence Saint John's Health Center, 2200 Santa Monica Boulevard, Santa Monica, CA, 90404, USA. sariam@jwci.org.
authors.forename: Marlon Garzo
authors.initials: MG
authors.lastname: Saria
authors.affiliation: Moores Cancer Center, University of California San Diego, 3855 Health Sciences Drive, La Jolla, CA, 92093, USA.
authors.forename: Natasia
authors.initials: N
authors.lastname: Courchesne
authors.affiliation: Nursing Science, University of California, Irvine, 299E Berk Hall, Irvine, CA, 92697-3959, USA.
authors.forename: Lorraine
authors.initials: L
authors.lastname: Evangelista
authors.affiliation: Quintiles, 10 Waterview Boulevard, Parsippany, NJ, 07054, USA.
authors.forename: Joshua
authors.initials: J
authors.lastname: Carter
authors.affiliation: Moores Cancer Center, University of California San Diego, 3855 Health Sciences Drive, La Jolla, CA, 92093, USA.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: MacManus
authors.affiliation: Moores Cancer Center, University of California San Diego, 3855 Health Sciences Drive, La Jolla, CA, 92093, USA.
authors.forename: Mary Kay
authors.initials: MK
authors.lastname: Gorman
authors.affiliation: School of Nursing, University of California, Los Angeles, Factor Bldg., 700 Tiverton Ave, Los Angeles, CA, 90095, USA.
authors.forename: Adeline M
authors.initials: AM
authors.lastname: Nyamathi
authors.affiliation: School of Nursing, University of California, Los Angeles, Factor Bldg., 700 Tiverton Ave, Los Angeles, CA, 90095, USA.
authors.forename: Linda R
authors.initials: LR
authors.lastname: Phillips
authors.affiliation: School of Medicine, University of California San Diego, 3855 Health Sciences Drive, La Jolla, CA, 92093, USA.
authors.forename: David
authors.initials: D
authors.lastname: Piccioni
authors.affiliation: John Wayne Cancer Institute and Pacific Neuroscience Institute at Providence Saint John's Health Center, 2200 Santa Monica Boulevard, Santa Monica, CA, 90404, USA.
authors.forename: Santosh
authors.initials: S
authors.lastname: Kesari
authors.affiliation: School of Nursing, University of California, Los Angeles, Factor Bldg., 700 Tiverton Ave, Los Angeles, CA, 90095, USA.|School of Nursing, University of Kansas Medical Center, Mail Stop 2029, 3901 Rainbow Blvd., Kansas City, KS, 66160, USA.
authors.forename: Sally
authors.initials: S
authors.lastname: Maliski
mesh_terms: D000223:Adaptation, Psychological / Q000502:physiology*; D001932:Brain Neoplasms / Q000556:secondary*; D017028:Caregivers / Q000523:psychology*; D060825:Cognitive Dysfunction / Q000209:etiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis
keywords: Brain metastases; Caregiver burden; Cognitive dysfunction; Coping; Resilience