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Am Fam Physician. 2000;61(1):192

There are considerable individual variations in response to caregiver stress. With the increasing move of cancer treatment into the outpatient area, more responsibilities are being placed on caregivers. Most studies of caregiver issues have been cross-sectional and have not observed caregivers over an extended period of time. Nijboer and associates assessed the determinants of caregiving experiences in partners of cancer patients, in negative and positive areas.

A longitudinal database was collected on caregivers of patients with newly diagnosed colon cancer. The baseline measurement was taken as soon after surgery as possible and again at three and six months. The patient and caregiver were interviewed by a trained person using structured questionnaires, and they also completed a self-reporting questionnaire. Standardized measurements were performed on all patients and their caregivers.

There were 148 couples who completed the study. Negative caregiver experiences were associated with low income, living with only the patient in the household, a distressed relationship with the patient, a high level of patient dependency and a high level of caregiver task involvement. Caregivers with lower levels of education derived more self-esteem from the caregiver role. The quality of life scores for the caregivers did not change over time.

The mental health and well-being of caregivers is directly related to the way caregiving is perceived by the patient and less related to the intensity or amount of care provided to the patient. The authors conclude that physicians should keep caregivers informed and validate their needs. They also should identify caregivers who are at risk for stress and provide appropriate interventions.

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