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Support Care Cancer. 2015 Dec;23(12):3589-98. doi: 10.1007/s00520-015-2727-4. Epub 2015 Apr 18.

Burden of spousal caregivers of stage II and III esophageal cancer survivors 3 years after treatment with curative intent.

Author information

1
Department of Medical Oncology, Academic Medical Center, University of Amsterdam, F4-222, Meibergdreef 9, PO box 22600, 1100 DD, Amsterdam, The Netherlands. n.hajmohammad@amc.nl.
2
Department of Medical Oncology, Academic Medical Center, University of Amsterdam, F4-222, Meibergdreef 9, PO box 22600, 1100 DD, Amsterdam, The Netherlands.
3
Department of Radiation Oncology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
4
Department of Gastroenterology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
5
Department of Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
6
Department of Medical Psychology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.

Abstract

OBJECTIVES:

The aim of this study is to examine caregiver burden of spousal caregivers of patients with esophageal cancer after curative treatment with neoadjuvant chemoradiation followed by resection and to assess factors associated with caregiver burden.

METHODS:

In this exploratory, cross-sectional study, spousal caregivers and patients were eligible if the caregiver was the patient's spouse and the patient had been treated with chemoradiation followed by surgery after esophageal carcinoma diagnosis. Forty-seven couples were included. Spousal caregivers completed a questionnaire, examining caregivers' burden (Self-Perceived Pressure from Informal Care (SPPIC, Dutch)), caregiver unmet needs (SCNS-P&S), anxiety and depression (Hospital Anxiety and Depression Scale (HADS)), and marital satisfaction (Maudsley Marital Questionnaire (MMQ)). Patients completed the latter two questionnaires and a cancer specific quality of life questionnaire (EORTC-QLQ C30 and OES18 (oesophageal module). Logistic regression analysis was performed to identify correlates for caregiver burden.

RESULTS:

The median time after esophagectomy was 38 months. Thirty-four percent of the spousal caregivers reported moderate or high burden. Spousal caregivers most frequently reported unmet needs were managing concerns about the cancer coming back (43%), dealing with others not acknowledging the impact on your life of caring for a person with cancer (38%), and balancing the needs of the person with cancer and one's own needs. A comparable proportion of spousal caregivers and patients showed symptoms of anxiety (23 vs 17%) and depression (17 vs 17%). Spousal caregivers reported significantly more dissatisfaction than patients on the marital scale (p < 0.01). Factors independently associated with higher caregiver burden were fatigue of the patient (OR = 1.66, 95% CI 1.12-2.47) and depression of the spousal caregiver (OR = 1.44, 95% CI 1.11-1.86).

CONCLUSIONS:

More than a third of the spousal caregivers of patients with esophageal cancer treated with curative intent report moderate or high burden 3 years after treatment. Fatigue of the patient and depression of the spousal caregiver are associated with caregiver burden. To improve clinical care, identification of spousal caregivers at risk for experiencing higher caregiver burden and implementation of specific interventions is needed.

KEYWORDS:

Burden; Caregiver; Esophageal cancer; Unmet needs

PMID:
25894882
PMCID:
PMC4624832
DOI:
10.1007/s00520-015-2727-4
[Indexed for MEDLINE]
Free PMC Article

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