Caregiver-oncologist prognostic concordance, caregiving esteem, and caregiver outcomes.
Caregiver
Depressive symptom
Distress
Prognostic understanding
Quality of life
Journal
Journal of geriatric oncology
ISSN: 1879-4076
Titre abrégé: J Geriatr Oncol
Pays: Netherlands
ID NLM: 101534770
Informations de publication
Date de publication:
07 2022
07 2022
Historique:
received:
01
06
2021
revised:
17
02
2022
accepted:
26
02
2022
pubmed:
13
3
2022
medline:
19
7
2022
entrez:
12
3
2022
Statut:
ppublish
Résumé
Caregiver-oncologist concordance regarding the patient's prognosis is associated with worse caregiver outcomes (e.g., depressive symptoms), but mechanisms underpinning these associations are unclear. We explored whether caregiving esteem mediates these associations. At enrollment, caregivers and oncologists used a 5-point ordinal scale to estimate patient survival; identical responses were considered concordant. At 4-6 weeks, caregivers completed an assessment of the extent to which caregiving imparts self-esteem (Caregiver Reaction Assessment self-esteem subscale; range 0-5; higher score indicates greater esteem). They also completed Patient Health Questionnaire-2 (PHQ-2) for depressive symptoms, Distress Thermometer, and 12-Item Short Form Survey for quality of life (QoL). Mediation analysis with bootstrapping (PROCESS macro by Hayes) was used to estimate the extent to which caregiving mediated the effects of prognostic concordance on caregiver outcomes through caregiving esteem. Prognostic concordance occurred in 28% the caregiver-oncologist dyads; 85% of the discordance were due to caregivers estimating a longer patient's survival. At 4-6 weeks, mean caregiving esteem score was 4.4 (range 1.5-5.0). Lower caregiving esteem mediated the associations of concordance with higher PHQ-2 [indirect effect = 0.12; 95% Confidence Interval (CI) 0.03, 0.27], greater distress (indirect effect =0.25; 95% CI 0.08, 0.48), and poorer QoL (indirect effect = -1.50; 95% CI -3.06, -0.41). Caregiving esteem partially mediated 39%, 64%, and 48% of the associations between caregiver-oncologist concordance and PHQ-2, distress, and SF-12, respectively. Caregiver-oncologist concordance was associated with lower caregiving esteem. Lower caregiving esteem mediated the negative relationship between caregiver-oncologist concordance and caregiver outcomes.
Identifiants
pubmed: 35277372
pii: S1879-4068(22)00046-7
doi: 10.1016/j.jgo.2022.02.018
pmc: PMC9283218
mid: NIHMS1787452
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
828-833Subventions
Organisme : NCI NIH HHS
ID : R00 CA237744
Pays : United States
Organisme : NIA NIH HHS
ID : R21 AG059206
Pays : United States
Organisme : NCI NIH HHS
ID : R01 CA168387
Pays : United States
Organisme : NCI NIH HHS
ID : K99 CA237744
Pays : United States
Organisme : NCI NIH HHS
ID : UG1 CA189961
Pays : United States
Organisme : NIA NIH HHS
ID : R33 AG059206
Pays : United States
Organisme : NIA NIH HHS
ID : K76 AG064394
Pays : United States
Organisme : NIA NIH HHS
ID : K24 AG056589
Pays : United States
Informations de copyright
Copyright © 2022 Elsevier Ltd. All rights reserved.
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