Charles S. Carver

Shaffer, K. M., Kim, Y., Carver, C. S., & Cannady, R. S. (2017). Depressive symptoms predict cancer caregivers' physical health decline. Cancer, 123, 4277-4285

PURPOSE: Cancer caregiving, particularly when distressing, has been associated with worsening health among caregivers themselves. The extent to which various demographic and psychosocial factors relate to caregivers' worsening long-term physical health is less known. This study examines changes in caregivers' physical health across the 8 years following their family members' cancer diagnosis and prospective predictors of that change.

METHODS: Caregivers (N=664; age M=53.20) participated in a nationwide study at 2 (T1), 5 (T2), and 8 (T3) years after their family members' cancer diagnosis. Physical health (MOS SF-12 Physical Component Score) was assessed T1 through T3 as outcome. Predictors were self-reported at T1: caregiver demographics (age, gender, education, income, relationship to patient, and employment status), patient cancer severity (from medical records), and caregiver psychosocial factors (caregiving stress, caregiving esteem, social support, and depressive symptoms). Latent growth modeling tested predictors of caregivers' initial physical health and their physical health change across time.

RESULTS: At T1, caregivers reported slightly better physical health than the U.S. population (M=51.22, p=.002), which declined over the following 6 years (Mslope=-0.27, p<.001). All demographic factors, patient cancer severity, and T1 caregiving stress were related to caregivers' initial physical health (ps<.03). Depressive symptoms were not associated with initial physical health, but were the only significant predictor of caregivers' physical health decline (B=-0.02, p=.004): higher depressive symptoms at T1 predicted more rapid physical health decline.

CONCLUSION: Findings highlight the unique contribution of caregivers' depressive symptoms to their subsequent physical health decline. Assessing and addressing depressive symptoms among caregivers early in the cancer survivorship trajectory may help to prevent premature health decline among this important, yet vulnerable population.

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