Moderating Effects of Optimism and Family Support on the Depression of Family Caregivers of Cancer Patients

BACKGROUND: This study examined moderating effects of optimism and family support on the depression of family caregivers of cancer patients aged 55 and over by adopting stress process model. METHODS: 359 family caregivers who accompanied with cancer patients to out-patient clinics were recruited and completed questionnaire at three university hospitals located in Seoul and Gyeonggi province. Exploratory factor analysis was applied to test validity of the construction of the scale. Hierarchical multiple regression analysis was used to determine moderating effects of optimism and family support on depression after making mean centering of each variable. RESULTS: Results showed that spouse caregivers have more depression than do adult children as the nursing period gets longer. Education and income status were significant variables affecting depression of family caregivers. Optimism and family support for family caregivers have moderating effects on the association between stressors (emotional functioning of cancer patients and role overload of family caregivers) and depression of family caregivers. CONCLUSIONS: The findings suggest that more attentions are needed to the depression of spouse caregivers. Interventions are strongly recommended for health professionals to provide cancer patients and their family caregivers with "holding environments" caring for emotions and facilitating adjustment.

A Comparative Study on the Assessment of the Quality of Life by Older Cancer Patients and Caregivers and Assessment of Performance Status by Medical Staff

BACKGROUND: The study examined the correlations among the results of the European Organization for Research and Treatment of Cancer (EORTC)-Quality of Life Questionnaire, Core 30 (QLQ-C30) completed by elderly cancer patients and their family caregivers and the Eastern Cooperative Oncology Group (ECOG)-performance status (PS) evaluated by medical doctors. METHODS: The study sample included 269 persons with cancer aged 55 years or older and their family caregivers recruited from hospitals located in Seoul and Gyeonggi-do. The results of the ECOG-PS evaluated by medical doctors were obtained from medical records. Intra-class correlation analysis was used to assess rater reliability between the elderly cancer patients and their family caregivers. Correlations among the EORTC QLQ-C30 and the ECOG-PS were tested using the Kruskal-Wallis test and Spearmen's correlation. RESULTS: The results showed that four subscales of quality of life (physical functioning, emotional functioning, social functioning, and global health status) and three items under symptoms (fatigue, pain, and financial difficulties) in the EORTC QLQ-C30 were highly consistent between patients and their family caregivers. From the EORTC QLQ-C30 results, social functioning, role functioning, health status, fatigue, pain, and appetite loss (patients results) and physical functioning (family caregivers results) were highly consistent with the results of the ECOG-PS by the physicians. CONCLUSIONS: The findings suggest that when the older persons with cancer have difficulty expressing their own thoughts or feelings, the EORTC QLQ-C30 completed by their family caregivers and the results of the ECOG-PS completed by the physicians could be used as substitutes.