title: The self-care practices of family caregivers of persons with poor prognosis cancer: differences by varying levels of caregiver well-being and preparedness.
abstract: Little is known about the impact of family caregiving for adults with poor prognosis cancer on caregivers' own individual self-care practices. We explored differences in caregivers' discrete self-care practices associated with varying levels of caregiver well-being, preparedness, and decision-making self-efficacy.
  
  
  
  Cross-sectional survey within eight community-based southeastern U.S. cancer centers was conducted. Family caregivers of Medicare beneficiaries ≥65 years with pancreatic, lung, brain, ovarian, head and neck, hematologic, or stage IV cancer completed measures of individual self-care practices (health responsibility, physical activity, nutrition, spiritual growth, interpersonal relations, stress management, and sleep), well-being (anxiety, depression, and health-related quality of life [HRQoL]), preparedness, and decision-making self-efficacy.
  
  
  
  Caregivers (n = 294) averaged 66 years, were mostly female (72.8%), white (91.2%), Protestant (76.2%), retired (54.4%), and patients' spouse/partner (60.2%). Approximately, half were rural-dwellers (46.9%) with incomes <$50,000 (53.8%). Most provided support 6-7 days/week (71%) for >1 year (68%). Nearly a quarter (23%) reported high depression and 34% reported borderline or high anxiety. Low engagement in all self-care practices was associated with worse caregiver anxiety, depression, and mental HRQoL (all p values < .05). Caregivers with lower health responsibility, spiritual growth, interpersonal relation, and stress management scores had lower preparedness and decision-making self-efficacy.
  
  
  
  A significant proportion of caregivers simultaneously report low engagement in all forms of self-care practices, high depression and anxiety, and low HRQoL mental health scores. Caregiver well-being, preparedness, and decision-making self-efficacy might be optimized through interventions targeted at enhancing health responsibility, stress management, interpersonal relationships, and spiritual growth self-care practices.
authors.affiliation: School of Nursing, University of Alabama at Birmingham (UAB), 1720 2nd Avenue South, 2M019H, Birmingham, AL, 35294-1210, USA. dionneod@uab.edu.
authors.forename: J Nicholas
authors.initials: JN
authors.lastname: Dionne-Odom
authors.affiliation: Department of Nutrition Sciences, UAB, 1675 University Blvd, Birmingham, AL, 35233, USA.
authors.forename: Wendy
authors.initials: W
authors.lastname: Demark-Wahnefried
authors.affiliation: School of Nursing, University of Alabama at Birmingham (UAB), 1720 2nd Avenue South, 2M019H, Birmingham, AL, 35294-1210, USA.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Taylor
authors.affiliation: UAB Comprehensive Cancer Center, 1824 6th Avenue South, Birmingham, AL, 35233, USA.
authors.forename: Gabrielle B
authors.initials: GB
authors.lastname: Rocque
authors.affiliation: School of Nursing, University of Alabama at Birmingham (UAB), 1720 2nd Avenue South, 2M019H, Birmingham, AL, 35294-1210, USA.
authors.forename: Andres
authors.initials: A
authors.lastname: Azuero
authors.affiliation: Department of Preventive Medicine, UAB, 1720 2nd Avenue South, Birmingham, AL, 35294, USA.
authors.forename: Aras
authors.initials: A
authors.lastname: Acemgil
authors.affiliation: Department of Preventive Medicine, University of Tennessee Health Science Center, 66 N. Pauline Street, Memphis, TN, 38163, USA.
authors.forename: Michelle Y
authors.initials: MY
authors.lastname: Martin
authors.affiliation: School of Nursing, University of Alabama at Birmingham (UAB), 1720 2nd Avenue South, 2M019H, Birmingham, AL, 35294-1210, USA.
authors.forename: Meka
authors.initials: M
authors.lastname: Astin
authors.affiliation: School of Nursing, University of Alabama at Birmingham (UAB), 1720 2nd Avenue South, 2M019H, Birmingham, AL, 35294-1210, USA.
authors.forename: Deborah
authors.initials: D
authors.lastname: Ejem
authors.affiliation: Department of Medicine, Division of Geriatrics, Gerontology, and Palliative Care, UAB Center for Palliative and Supportive Care, 1720 2nd Avenue South, Birmingham, AL, 35294, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Kvale
authors.affiliation: School of Nursing, University of Alabama at Birmingham (UAB), 1720 2nd Avenue South, 2M019H, Birmingham, AL, 35294-1210, USA.
authors.forename: Karen
authors.initials: K
authors.lastname: Heaton
authors.affiliation: Department of Preventive Medicine, UAB, 1720 2nd Avenue South, Birmingham, AL, 35294, USA.
authors.forename: Maria
authors.initials: M
authors.lastname: Pisu
authors.affiliation: UAB Comprehensive Cancer Center, 1824 6th Avenue South, Birmingham, AL, 35233, USA.
authors.forename: Edward E
authors.initials: EE
authors.lastname: Partridge
authors.affiliation: School of Nursing, University of Alabama at Birmingham (UAB), 1720 2nd Avenue South, 2M019H, Birmingham, AL, 35294-1210, USA.|Department of Medicine, Division of Geriatrics, Gerontology, and Palliative Care, UAB Center for Palliative and Supportive Care, 1720 2nd Avenue South, Birmingham, AL, 35294, USA.
authors.forename: Marie A
authors.initials: MA
authors.lastname: Bakitas
mesh_terms: D000368:Aged; D017028:Caregivers / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000534:rehabilitation*; D011379:Prognosis; D011788:Quality of Life / Q000523:psychology*; D012648:Self Care / Q000523:psychology*; D013315:Stress, Psychological
keywords: Cancer; Caregivers; Self-care; Well-being