Distress Screening in Transplant Family Caregivers: What Have We Learned?

An estimated 65.7 million people in the U.S serve as unpaid caregivers. Evidence suggests that caregiving can be deleterious to one's health and contribute to illness. The impact of caregiving for adults with cancer has been found to be more burdensome than caring for those with other condition...

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Veröffentlicht in:Psycho-oncology (Chichester, England) England), 2012-02, Vol.21, p.28
1. Verfasser: Bevans, M
Format: Artikel
Sprache:eng
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Zusammenfassung:An estimated 65.7 million people in the U.S serve as unpaid caregivers. Evidence suggests that caregiving can be deleterious to one's health and contribute to illness. The impact of caregiving for adults with cancer has been found to be more burdensome than caring for those with other conditions particularly during treatments such as allogeneic hematopoietic stem cell transplantation (HSCT). Reliable and valid measures to evaluate distress in adult HSCT caregivers, application of screening across the treatment trajectory, and effective interventions will be presented. Longitudinal data (n = 91) from an intervention study were analyzed to explore the psychometric characteristics of the Distress Thermometer (DT) and its relationship to the Brief Symptom Inventory 18 (BSI- 18) and scales of the Multidimensional Fatigue Symptom Inventory (MFSI). Literature on the translation of distress screening in practice and effective interventions for HSCT caregivers will be reviewed. Construct validity is supported (p < 0.001) between the DT and the BSI- 18 Global Symptom Index and the MFSI-Emotional scale for caregivers but the diagnostic utility was less than ideal (AUC = 0.61 + 0.08, p = 0.28). The number of problems reported was strongly correlated with the level of distress while the type of problem (practical, family, physical and emotional) changed based on the transplant trajectory. Cancer caregivers providing higher levels of support while balancing multiple responsibilities are more likely to report negative outcomes, less likely to be effective as a partner in the patient's disease management, and are more likely to postpone health-promoting self-care behaviors. Brief screening measures can provide insight into the distress level as well as the specific problems that are contributing to the distress. Future research is needed to explore screening measures in cancer caregivers and to identify clinically meaningful guidelines for practice. Studies are also needed to evaluate the impact distress screening procedures (e.g. real time collection) have on practice. It is possible to identify caregivers experiencing distress across the transplant trajectory. Determining the context of the caregiving experience begins with an expanded patient history and physical including the caregiver's level of distress. This work is supported by the Intramural Research Program of the NIH, Clinical Center.
ISSN:1057-9249
1099-1611