Academic Scientific JournalsAnxiety, depression and quality of life: a longitudinal study involving cancer patient-caregiver dyads
Keywords:
caregivers, patients, anxiety, depression, quality of lifeAbstract
Background
The objective of this study was to analyse the relationships between anxiety, depression and quality of life in cancer patient-caregiver dyads during the first 6 months after the diagnosis using the actor-partner interdependence model (APIM).
Participants and procedure
Sixty-seven cancer patient-caregiver dyads completed the following questionnaires in a prospective longitudinal design, with two assessment points at a 6month interval, T1 (45-60) and T2 (180-200 days after diagnosis): the Hospital Anxiety and Depression Scale (HADS) and the Short Form Health Survey Questionnaire (SF-36). Descriptive statistics, t-test and bivariate correlations were applied. The APIM was used to analyse the influence of anxiety and depression (T1) on own (actor effect) and partner (partner effect) quality of life in T2.
Results
The results did not reveal any differences between T1 and T2 in anxiety and depression in caregivers and patients. Assessing the differences between T1 and T2 with respect to quality of life, the caregiver results showed an improvement in physical functioning and bodily pain, but lower social functioning and mental health scores. For patients, significantly lower scores were observed in general health and vitality scores. Dyadic analysis showed an actor effect of anxiety and depression on most of the quality of life domains and a partner effect in caregiver depression (T1) and general health in patients (T2).
Conclusions
The early assessment of anxiety and depression may help to prevent declines in quality of life in the first few months following a diagnosis of cancer in patient-caregiver dyads.
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References
Baumstarck, K., Chinot, O., Tabouret, E., Farina, P., Barrié, M., Campello, C., Petrirena, G., Hamidou, Z., & Auquier, P. (2018). Coping strategies and quality of life: a longitudinal study of high-grade glioma patient-caregiver dyads. Health and Quality of Life Outcomes, 16, 157. https://doi.org/10.1186/ s12955-018-0983-y.
Chow, W. L., Tan, S. M., Aung, K. C. Y., Chua, S. Y. N., & Sim, H. C. (2020). Factors influencing quality of life of Asian breast cancer patients and their caregivers at diagnosis: perceived medical and psychosocial needs. Singapore Medical Journal, 61, 532–539. https://doi.org/10.11622/smedj.2019099.
Dorros, S. M., Card, N. A., Segrin, C., & Badger, T. A. (2010). Interdependence in women with breast cancer and their partners: an interindividual model of distress. Journal of Consulting and Clinical Psychology, 78, 121–125. https://doi.org/10.1037/ a0017724.
Drageset, S., Lindstrøm, T. C., Giske, T., & Underlid, K. (2016). Women’s experiences of social support during the first year following primary breast cancer surgery. Scandinavian Journal of Caring Sciences, 30, 340–348. https://doi.org/10.1111/scs.12250.
Edman, J. S., Greeson, J. M., Roberts, R. S., Kaufman, A. B., Abrams, D. I., Dolor, R. J., & Wolever, R. Q. (2017). Perceived stress in patients with common gastrointestinal disorders: associations with quality of life, symptoms and disease management. Explore, 13, 124–128. https://doi. org/10.1016/j.explore.2016.12.005.
El-Jawahri, A. R., Traeger, L. N., Kuzmuk, K., Eusebio, J. R., Vandusen, H. B., Shin, J. A., Keenan, T., Gallagher, E. R., Greer, J. A., Pirl, W. F., Jackson, V. A., Ballen, K. K., Spitzer, T. R., Graubert, T. A., McAfee, S. L., Dey, B. R., Chen, Y. B., & Temel, J. S. (2015). Quality of life and mood of patients and family caregivers during hospitalization for hematopoietic stem cell transplantation. Cancer, 121, 951–959. https://doi.org/10.1002/cncr.29149.
Erim, D. O., Bennett, A. V., Gaynes, B. N., Basak, R. S., Usinger, D., & Chen, R. C. (2020). Associations between prostate cancer‐related anxiety and health‐related quality of life. Cancer Medicine, 9, 4467–4473. https://doi.org/10.1002/cam4.3069.
Ferlay, J., Colombet, M., Soerjomataram, I., Parkin, D. M., Piñeros, M., Znaor, A., & Bray, F. (2021). Cancer statistics for the year 2020: an overview. International Journal of Cancer, 149, 778–789. https://doi.org/10.1002/ijc.33588.
Geng, H. M., Chuang, D. M., Yang, F., Yang, Y., Liu, W. M., Liu, L. H., & Tian, H. M. (2018). Prevalence and determinants of depression in caregivers of cancer patients: a systematic review and meta-analysis. Medicine, 97, e11863. https://doi. org/10.1097/MD.0000000000011863.
Huang, L. T., & McMillan, S. C. (2019). Mutual effects of depression on quality of life in patients and family caregivers. Oncology Nursing Forum, 46, 208–216. https://doi.org/10.1188/19.ONF.208-216.
Kent, E. E., Rowland, J. H., Northouse, L., Litzelman, K., Chou, W. Y. S., Shelburne, N., Timura, C., O’Mara., & Huss, K. (2016). Caring for caregivers and patients: Research and clinical priorities for informal cancer caregiving. Cancer, 122, 1987–1995. https:// doi.org/10.1002/cncr.29939.
Kenny, D. A., Kashy, D. A., & Cook, W. L. (2020). Dyadic data analysis. Guilford Publications. Kershaw, T., Ellis, K. R., Yoon, H., Schafenacker, A., Katapodi, M., & Northouse, L. (2015). The interdependence of advanced cancer patients’ and their family caregivers’ mental health, physical health, and self-efficacy over time. Annals of Behavioral Medicine, 49, 901–911. https://doi.org/10.1007/ s12160-015-9743-y.
Lambert, S. D., Girgis, A., Lecathelinais, C., & Stacey, F. (2013). Walking a mile in their shoes: Anxiety and depression among partners and caregivers of cancer survivors at 6 and 12 months post-diagnosis. Supportive Care in Cancer, 21, 75–85. https:// doi.org/10.1007/s00520-012-1495-7.
Lee, C. Y., Lee, Y., Wang, L. J., Chien, C. Y., Fang, F. M., & Lin, P. Y. (2017). Depression, anxiety, quality of life, and predictors of depressive disorders in caregivers of patients with head and neck cancer: a sixmonth follow-up study. Journal of Psychosomatic Research, 100, 29–34. https://doi.org/10.1016/j.jpsychores.2017.07.002.
Li, Q., & Loke, A. Y. (2014). A literature review on the mutual impact of the spousal caregiver-cancer patients dyads: ‘Communication’,‘reciprocal influence’, and ‘caregiver-patient congruence’. European Journal of Oncology Nursing, 18, 58–65. https:// doi.org/10.1016/j.ejon.2013.09.003.
Lin, Y., Luo, X., Li, J., Xu, Y., & Li, Q. (2021). The dyadic relationship of benefit finding and its impact on quality of life in colorectal cancer survivor and spousal caregiver couples. Supportive Care in Cancer, 29, 1477–1486. https://doi.org/10.1007/s00520- 020-05602-x.
Lin, Y., Hu, C., Xu, Y., Zhao, J., & Li, Q. (2020). The mutual impact and moderating factors of quality of life between advanced cancer patients and their family caregivers. Supportive Care in Cancer, 28, 5251–5262. https://doi.org/10.1007/s00520-020- 05351-x.
Mitchell, A. J., Meader, N., & Symonds, P. (2010). Diagnostic validity of the Hospital Anxiety and Depression Scale (HADS) in cancer and palliative settings: a meta-analysis. Journal of Affective Disorders, 126, 335–348. https://doi.org/10.1016/j.jad.2010.01.067.
Park, J. H., Jung, Y. S., Kim, J. Y., Jo, Y., & Bae, S. H. (2020). Trajectories of health-related quality of life in breast cancer patients. Supportive Care in Cancer, 28, 3381–3389. https://doi.org/10.1007/s00520- 019-05184-3.
Peh, C. X., Liu, J., & Mahendran, R. (2020). Quality of life and emotional distress among caregivers of patients newly diagnosed with cancer: Understanding trajectories across the first year postdiagnosis. Journal of Psychosocial Oncology, 38, 557–572. https://doi.org/10.1080/07347332.2020.17 60994 .
Qiuping, L. I., Yi, L. I. N., Yinghua, X. U., & Huiya, Z. H. O. U. (2018). The impact of depression and anxiety on quality of life in Chinese cancer patient-family caregiver dyads, a cross-sectional study. Health and Quality of Life Outcomes, 16, 1–15. https://doi.org/10.1186/s12955-018-1051-3.
Quintana, J. M., Padierna, A., Esteban, C., Arostegui, I., Bilbao, A., & Ruiz, I. (2003). Evaluation of the psychometric characteristics of the Spanish version of the Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 107, 216–221. https://doi.org/10.1034/j.1600-0447.2003.00062.x.
Rosseel, Y. (2012). Lavaan: an R package for structural equation modeling. Journal of Statistical Software, 48, 1–36. https://doi.org/10.18637/jss.v048.i02.
Sadoughi, M., & Salehi, Z. M. (2017). The relationship between anxiety, depression, and quality of life among women with breast cancer. International Journal of Academic Research in Psychology, 4, 11–19. https://doi.org/10.46886/IJARP/v4-i1/2602.
Sociedad Española de Oncología Médica (2021). Las cifras del cáncer en España 2021. SEOM. Stas, L., Kenny, D. A., Mayer, A., & Loeys, T. (2018). Giving dyadic data analysis away: a user‐friendly app for actor-partner interdependence models. Personal Relationships, 25, 103–119. https://doi. org/10.1111/pere.12230.
Sterba, K. R., Zapka, J., Armeson, K. E., Shirai, K., Buchanan, A., Day, T. A., & Alberg, A. J. (2017). Physical and emotional well-being and support in newly diagnosed head and neck cancer patient-caregiver dyads. Journal of Psychosocial Oncology, 35, 646– 665. https://doi.org/10.1080/07347332.2017.1323817.
Streck, B. P., Wardell, D. W., LoBiondo‐Wood, G., & Beauchamp, J. E. (2020). Interdependence of physical and psychological morbidity among patients with cancer and family caregivers: Review of the literature. Psycho‐Oncology, 29, 974–989. https://doi.org/10.1002/pon.5382.
Taarnhøj, G. A., Johansen, C., Lindberg, H., Basch, E., Dueck, A., & Pappot, H. (2020). Patient reported symptoms associated with quality of life during chemo‐ or immunotherapy for bladder cancer patients with advanced disease. Cancer Medicine, 9, 3078–3087. https://doi.org/10.1002/cam4.2958.
Terro, W., & Crean, S. J. (2017). Prospective, longitudinal assessment of quality of life in patients with cancer of the head and neck and their primary carers. British Journal of Oral & Maxillofacial Surgery, 55, 613–617. https://doi.org/10.1016/j. bjoms.2017.04.004.
Thomeer, M. B., Umberson, D., & Pudrovska, T. (2013). Marital processes around depression: a gendered and relational perspective. Society and Mental Health, 3, 151–169. https://doi.org/10.1177/215686 9313487224.
Vespa, A., Spatuzzi, R., Merico, F., Ottaviani, M., Fabbietti, P., Meloni, C., Raucci, L., Ricciuti, M., Bilancia, D., Pellicioni, G., & Giulietti, M. V. (2018). Spiritual well-being associated with personality traits and quality of life in family caregivers of cancer patients. Supportive Care in Cancer, 26, 2633–2640. https://doi.org/10.1007/s00520-018-4107-3.
Vilagut, G., Ferrer, M., Rajmil, L., Rebollo, P., Permanyer-Miralda, G., Quintana, J. M., Santad, R., Valderas, J. M., Ribera, A., Domingo-Salvany, A., & Alonso, J. (2005). El Cuestionario de Salud SF-36 español: una década de experiencia y nuevos desarrollos [The Spanish version of the Short Form 36 Health Survey: a decade of experience and new developments]. Gaceta Sanitaria, 19, 135–150. https://doi.org/10.1157/13074369.
Zigmond, A. S., & Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67, 361–370. https://doi.org/10.1111/ j.1600-0447.1983.tb09716.x.
