ASCO Perspective

"More people with cancer are being cared for an in outpatient setting, underscoring that the need for family caregivers to have support is more important than ever," said ASCO Expert Andrew S. Epstein, MD. "Caregivers are our valuable partners in caring for patients, and this research serves as an important call-to-action for the oncology community to implement support networks and services that care for the caregiver."

ALEXANDRIA, Va. – A new multi-state survey shows that nearly one-quarter to one-third of family caregivers of patients with high-mortality cancers experience high levels of depression and anxiety symptoms. The study also found that family caregivers can spend over eight hours per day providing care and that as this time increases, self-care behaviors such as sleep and exercise decline, a trend associated with poorer mental health.

As family caregivers play an essential role in the delivery of care services, the research highlights a need to increase clinician attention to the health and wellness of these individuals. This study will be presented at the upcoming 2016 Palliative Care in Oncology Symposium in San Francisco.

"Caregivers and patients are faced with an enormous physical and emotional toll when dealing with advanced cancer," said lead author J. Nicholas Dionne-Odom, PhD, RN, and post-doctoral fellow at the University of Alabama at Birmingham. "When they put their own health and wellbeing on the back burner, it can affect their care to the patient."

The researchers conducted a cross-sectional survey of 294 family caregivers of Medicare beneficiaries diagnosed with pancreatic, lung, brain, ovarian, head and neck, hematologic, or stage IV cancers. The survey was fielded across eight cancer centers in Alabama, Florida, and Tennessee. Survey questions explored measures of self-care behaviors and quality of life.

Dr. Dionne-Odom said that as a patient's health declines, caregivers' ability to take care of their own health declines as well. Data show that nearly one-quarter of survey respondents reported a high level of depressive symptoms and over one-third reported borderline or high levels of anxiety symptoms, associated with significantly lower scores for self-care. Lower self-care behavior scores were also associated with longer durations, higher hours, more days of the week of caregiving, and with fair or poor patient health.

"We hope our research rallies the oncology palliative care communities to develop assessment tools and services that support caregivers. These efforts would help ensure that caregivers are supported and healthy when they take on the important role of caring for an individual with advanced care," Dr. Dionne-Odom said.

Cancer caregivers perform a range of tasks and responsibilities that are labor intensive including administering medications, providing transportation, assisting with activities of daily life, providing emotional support, coordinating finances, and advocating for health care.

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This study was funded by a grant from the University of Alabama at Birmingham.

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