Caring for caregivers and patients: Research and clinical priorities for informal cancer caregiving.

Informal/family caregivers are a fundamental source of care for cancer patients in the United States, yet the population of caregivers and their tasks, psychosocial needs, and health outcomes are not well understood. Changes in the nature of cancer care and its delivery, along with the growing population of survivors and their caregivers, warrant increased attention to the roles and demands of caregiving. This article reviews current evidence presented at a 2-day meeting examining the state of the science of informal cancer caregiving that was convened by the National Cancer Institute and the National Institute of Nursing Research. The meeting sought to define who is an informal cancer caregiver, summarize the state of the science in informal cancer caregiving, and describe both the kinds of interventions developed to address caregiving challenges and the various outcomes used to evaluate their impact. This article offers recommendations for moving science forward in 4 areas: 1) improving the estimation of the prevalence and burden of informal cancer caregiving; 2) advancing the development of interventions designed to improve outcomes for cancer patients, caregivers, and patient-caregiver dyads; 3) generating and testing strategies for integrating caregivers into formal health care settings; and 4) promoting the use of technology to support informal cancer caregivers. Cancer 2016;122:1987-95. © 2016 American Cancer Society.

The case of curers, noncurers, and biomedical experts in Pichátaro, Mexico. Resiliency in folk-medical beliefs.

We explore potential conceptual and cultural change in folk-medical models within a Mexican community that may have taken place over the past 30 years. Building on a study from the 1970s, we explore the effects a government-supported biomedical clinic had on the content and distribution of folk-medical concepts. Surprisingly, we find that despite a dramatic increase in access to biomedicine and a host of socioeconomic shifts opening access to new medical ideas, folk-medical knowledge in Pichátaro, Michoacán, Mexico has remained largely unchanged with respect to its distribution and content. Curers and noncurers not only agree with one another but also continue to agree with a general model held in the 1970s. It is the medical models of clinic personnel that stand out as odd within the community. Yet, despite these conceptual differences, the biomedical facilities of the town are well attended.

Gendered experiences of migration and conceptual knowledge of illness.

Migration is a gendered process which may differentially alter conceptual models of illness as variation and change within specific sub-domains reflect unique experiences and interactions. Forty Mexican migrants completed a questionnaire consisting of 30 true/false questions regarding the symptoms, causes, and treatments of 19 illnesses (570 total questions). Results were analyzed using the Cultural Consensus Model and residual agreement analyses to measure patterns of inter-informant agreement. While men and women share overall agreement, they differ significantly in conceptions of treatment. In general, men over-extend the efficacy of treatment options while women restrict the abilities of folk healers and emphasize dietary changes in treating many illnesses. Variations reflect different social roles and interactions as migration patterns and living conditions reinforce gendered roles in medical decision-making. Women have greater experience with illnesses and interactions with biomedical services, which causes them to approximate biomedical providers' model of treatment.