Distress is Interdependent in Patients and Caregivers with Newly Diagnosed Incurable Cancers
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ORIGINAL ARTICLE
Distress is Interdependent in Patients and Caregivers with Newly Diagnosed Incurable Cancers Jamie M. Jacobs, PhD 1,2 & Kelly M. Shaffer, MS 2,3 & Ryan D. Nipp, MD 4 & Joel N. Fishbein, BA 1 & James MacDonald, BA 1 & Areej El-Jawahri, MD 4 & William F. Pirl, MD, MPH 5 & Vicki A. Jackson, MD, MPH 6 & Elyse R. Park, PhD, MPH 1,2 & Jennifer S. Temel, MD 4 & Joseph A. Greer, PhD 1,2
# The Society of Behavioral Medicine 2017
Abstract Background Individuals with advanced, incurable cancer often experience high physical and psychological symptom burden. Family and friend caregivers are at risk for emotional distress. Purpose The aim of the study is to investigate the interrelationship of distress in patient-caregiver dyads at the time of newly diagnosed incurable cancer. Methods From May 2011 to July 2015, within 8 weeks of diagnosis of advanced lung or noncolorectal gastrointestinal cancer, 350 patients and 275 family caregivers were enrolled in a randomized controlled trial of early palliative care. Actor–partner interdependence modeling was used to examine relationships between dyad’s self-reported anxiety and depressive symptoms on the Hospital Anxiety and Depression Scale at baseline. Results Comparing patients with caregivers, patients reported more depressive symptoms (Mdiff = .84; t[274] = 3.17, * Jamie M. Jacobs [email protected]
1
Center for Psychiatric Oncology and Behavioral Sciences, Massachusetts General Hospital Cancer Center & Harvard Medical School, 55 Fruit Street, Yawkey Center, Suite 10B, Boston, MA 02114, USA
2
Department of Psychiatry, Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA
3
Department of Psychology, University of Miami, Coral Gables, FL, USA
4
Department of Medicine, Division of Hematology & Oncology, Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA
5
Sylvester Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
6
Department of Medicine, Division of Palliative Care, Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA
p = .002, d = .22) and caregivers reported more anxiety symptoms (Mdiff =1.62, t[274] = 4.91, p < .001, d = .39). Dyads’ anxiety symptoms were positively associated, as were depressive symptoms (rs = .21, ps ≤ .001). Actor–partner interdependence modeling showed that patients’ anxiety symptoms were positively associated with their own depressive symptoms, with an equal effect for caregivers (actor effect βs = 0.52, ps < .001). Patients’ own anxiety was concurrently positively associated with their caregivers’ depressive symptoms, with an equal effect for caregivers to patients (partner effect βs=0.08, ps=.008). Conclusions In the context of newly diagnosed incurable cancer, caregivers experience more pronounced anxiety, while patients report greater depressive symptoms. Findings indicate that anxiety and depressive symptoms are interrelated among dyads facing newly diagnosed incurable disease. Results emphasize the importance of addressing distr
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