Format

Send to

Choose Destination
See comment in PubMed Commons below
Support Care Cancer. 2017 Jan;25(1):185-194. Epub 2016 Sep 8.

The influence of dyadic symptom distress on threat appraisals and self-efficacy in advanced cancer and caregiving.

Author information

1
Gillings School of Global Public Health, University of North Carolina, 302C Rosenau Hall, CB 7440, Chapel Hill, NC, 27559, USA. katrina.ellis@unc.edu.
2
School of Public Health, University of Michigan, Ann Arbor, MI, USA.
3
Yale School of Public Health, New Haven, CT, USA.
4
School of Nursing, University of Michigan, Ann Arbor, MI, USA.

Abstract

PURPOSE:

Physical and psychological symptoms experienced by patients with advanced cancer influence their well-being; how patient and family caregiver symptom distress influence each other's well-being is less understood. This study examined the influence of patient and caregiver symptom distress on their threat appraisals and self-efficacy to cope with cancer.

METHODS:

We conducted a secondary analysis of baseline data from an RCT that enrolled patients with advanced cancer and their family caregivers (N = 484 dyads). Structural equation modeling and the actor-partner interdependence mediation model (APIMeM) were used to examine two models: threat appraisals as a mediator of the relationship between symptom distress and individual and family-related self-efficacy; and, self-efficacy (individual and family dimensions) as mediators of the relationship between symptom distress and threat appraisals.

RESULTS:

Data suggest the self-efficacy mediation model was the preferred model. More patient and caregiver symptom distress was directly associated with their own lower self-efficacy and more threatening appraisals. Patient and caregiver individual self-efficacy also mediated the relationship between their own symptom distress and threat appraisals. There were also significant interdependent effects. More patient symptom distress was associated with less caregiver family-related self-efficacy, and more caregiver symptom distress was directly associated with more threatening patient appraisals.

CONCLUSIONS:

Patient and caregiver symptom distress influenced their own and in some cases each other's cognitive appraisals. Limitations of this study include the use of cross-sectional data and assessments of individually-focused (vs. family-focused) threat appraisals. These findings highlight the need to consider the management of patient and caregiver symptoms during advanced cancer.

KEYWORDS:

Advanced cancer; Caregiving; Cognitive appraisal; Dyad; Self-efficacy; Symptoms

PMID:
27631435
PMCID:
PMC5130593
[Available on 2018-01-01]
DOI:
10.1007/s00520-016-3385-x
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Springer
    Loading ...
    Support Center