Can how well family caregivers master and cope with the challenges of caring for a loved one with cancer impact survival? Along with the expertise of healthcare professionals from a variety of disciplines is essential, having a solid team of family caregivers may be just as important, according to a recent study conducted by researchers from the University of Pittsburgh and Michigan State University focused on caregiver–patient dyads in the setting of glioblastoma multiforme (GBM).
The study examined 164 newly diagnosed patients with GBM and their caregivers to explore how caregivers’ depression, anxiety, and mastery of caregiving may affect patient survival. Studying caregiver coping skills and competence in the GBM setting reflects how the neurologic and cognitive symptoms these patients experience pose unique challenges to their family caregivers, researchers noted.
Patients and their caregivers were assessed at 3 months from diagnosis (baseline) then again 4, 8, and 12 months later. As per standard protocol, 85% of patients were treated with postoperative chemotherapy and radiotherapy. About three-fourths of patients were being cared for by their spouses.
“Caregivers’ level of mastery, which can be defined as the feeling of being in control of the care situation, can influence the amount of distress perceived by family caregivers,” the authors wrote. “Indeed, mastery has been shown to have a significant effect on the amount of distress reported by the family caregiver as a result of providing care in neuro-oncology and in other caring populations.”
The median overall survival rate for the patients was 14.5 months, and about half of the patients (46%) were alive at the 12-month assessment mark.
Caregivers in the study ranked their mastery by determining, on a scale of 1 (strongly disagree) to 4 (strongly agree), how in control they felt in their role. They were then ranked into 3 categories: low, moderate, or high level of mastery. With each increase in ranking, researchers saw a 16.1% reduced risk of the patient dying.
A GBM diagnosis can be extremely anxiety-inducing for both the patient and the caregiver. The study cites previous research that noted that caregiver emotional health can impact quality of care.
After examining anxiety, depression, and caregiver burden, researchers also found that there was a 7.9% increase in the probability of the patient dying sooner for each point decrease in caregiver self-esteem; however, the correlation was not statistically significant.
The researchers agree that more research is needed to confirm their findings, and more support should be offered to family caregivers, especially as improving their mastery can lead to increased survival and better quality of life for patients with GBM.
“Providing neuro-oncology caregivers with more structured support and guidance in clinical practice might be enough to empower them and lower their levels of distress, thus influencing patients’ health for the better,” the authors wrote.
Boele FW, Given CW, Given BA. Family caregivers' level of mastery predicts survival of patients with glioblastoma: A preliminary report. Cancer. 2017;123(5):832-840.