Graduation Year

2009

Document Type

Dissertation

Degree

Ph.D.

Degree Granting Department

Nursing

Major Professor

Susan C. McMillan, Ph.D.

Keywords

End of life, Hospice, Symptom distress, Quality of life, Support

Abstract

While the duration of the cancer illness may be shorter than that of other serious diseases, such as Alzheimer's disease, cancer caregivers provide many more hours of care during a week. Research directed at the intensive experience of caregiving of hospice cancer patients is needed as there is limited research of predictors of hospice cancer caregiver depression symptomatology. The purpose of the study was to examine predictors of depression symptomatology in caregivers of hospice cancer patients. A secondary analysis was conducted using baseline assessment data of patients and caregivers from a larger study of patient/caregiver dyads from two large hospices (NIH 5R01 NR 008252). Statistical methods included Pearson's, point bi-serial, and phi correlation. Multiple regression and logistic regression were used to examine prediction. The variables of wife caregiver, patient symptom global distress, and caregiver support satisfaction accounted for 13% of the variance in caregiver depression symptomatology as measured by the CES-D 10 (M = 2.97, SD = 2.15) in the patient/caregiver dyad sample (n = 578). Approximately 38% of the 578 caregivers had CES-D 10 scores of 4 or greater upon patient admission to hospice. CES-D 10 scores 4 or greater have been found predictive for a diagnosis of depression (Irwin, Artin and Oxman, 1999). Examining odd ratios, wife caregiver was positively predictive and caregiver support satisfaction was negatively predictive of CES-D 10 scores of 4 or greater. The results support the need for depression symptom screening of caregivers, the importance of support satisfaction and the need to examine additional caregiver factors, along with patient factors, that may contribute to depression symptomatology in caregivers of hospice cancer patients.

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