The Effect of Caregiver Reaction on Psychological Well-being among Family Caregivers of Cancer Patients

Kyoung Hee Kim; Yong Soon Shin

doi:10.7469/KJAN.2017.29.6.647

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Kim and Shin: The Effect of Caregiver Reaction on Psychological Well-being among Family Caregivers of Cancer Patients

Original Research

Korean J Adult Nurs 2017;29(6):647-656.

Published online: 18 December 2017

DOI: https://doi.org/10.7469/KJAN.2017.29.6.647

The Effect of Caregiver Reaction on Psychological Well-being among Family Caregivers of Cancer Patients

Kyoung Hee Kim, MSN, APN¹, Yong Soon Shin, Ph.D., APN^2,

^¹Department of Nursing, Cheongam College, Suncheon, Korea

^²School of Nursing, Hanyang University, Seoul, Korea

Corresponding author: Shin, Yong Soon School of Nursing, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul 04763, Korea. Tel: +82-2-2220-0798, Fax: +82-2-2220-1163, E-mail: ysshin2k@hanyang.ac.kr

Received 7 September 201721 November 2017 Accepted 17 December 2017

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/ by-nc/3.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

This study was designed to explore positive and negative aspects of the caregiver reaction and identify factors influencing psychological well-being among family caregivers of home-based cancer patients.

Methods

The participants were 139 family caregivers from two cities. These caregivers took care of he family member in the home. Data were collected utilizing the Caregiver Reaction Assessment Scale and the Psychological Well-being Scale.

Results

Self-esteem was the highest reaction reported among the family caregivers. There were sig-nificant correlations between caregiver reaction and their psychological well-being. In multiple regression analy-sis, self-esteem and family support were predictors of psychological well-being among family caregivers (F=13.71, p<.001, Adj. R²=.393).

Conclusion

The results demonstrated that self-esteem and family support impacts the psychological well-being among cancer family caregivers. Thus, nursing intervention are needed to enhance self-esteem to improve psychological well-being among family caregivers.

Keywords: Mental health, Family caregivers, Caring, Neoplasms

REFERENCES

1.Kim KS., Kwon SH. Comfort and quality of life of cancer patients. Asian Nursing Research. 2007. 1(2):125–35. https://doi.org/10.1016/s1976-1317(08)60015-8.

2.Kim YS., Taw YS. The influencing factors on quality of life among breast cancer survivors. Asian Oncology Nursing. 2011. 11(3):221–8. https://doi.org/10.5388/jkon.2011.11.3.221.

3.Li QP., Mak YW., Loke AY. Spouses' experience of caregiving for cancer patients: a literature review. International Nursing Review. 2013. 60(2):178–87. https://doi.org/10.1111/inr.12000.

4.Kim Y., Carver CS., Shaffer KM., Gansler T., Cannady RS. Cancer caregiving predicts physical impairments: roles of earlier caregiving stress and being a spousal caregiver. Cancer. 2015. 121(2):302–10. https://doi.org/10.1002/cncr.29040.

5.Yoon SJ., Kim JS., Jung JG., Kim SS., Kim S. Modifiable factors associated with caregiver burden among family caregivers of terminally ill Korean cancer patients. Supportive Care in Cancer. 2014. 22(5):1243–50. https://doi.org/10.1007/s00520-013-2077-z.

6.Chi NC., Demiris G., Lewis FM., Walker AJ., Langer SL. Behavio-ral and educational interventions to support family caregivers in end-of-life care: a systematic review. American Journal of Hospice and Palliative Medicine. 2016. 33(9):894–908. https://doi.org/10.1177/1049909115593938.

7.Folkman S. Positive psychological states and coping with se-vere stress. Social Science & Medicine. 1997. 45(8):1207–21. https://doi.org/10.1016/S0277-9536(97)00040-3.

8.Given CW., Given B., Stommel M., Collins C., King S., Franklin S. The Caregiver Reaction Assessment (CRA) for caregivers to persons with chronic physical and mental impairments. Research in Nursing & Health. 1992. 15(4):271–83. https://doi.org/10.1002/nur.4770150406.

9.LeSeure P., Chongkham-Ang S. The experience of caregivers living with cancer patients: a systematic review and metasyn-thesis. Journal of Personalized Medicine. 2015. 5(4):406–39. https://doi.org/10.3390/jpm5040406.

10.Cobb SC., Etkins L., Nelson M., Egleston B., Sweeney CW. A comparison of the reactions of caregivers of patients with cancer versus patients with other chronic medical conditions. Oncology Nursing Forum. 2016. 43(3):321–7. https://doi.org/10.1188/16.onf.321-327.

11.Kim MS., Kim HW., Cha KH. Analysis on the construct of psychological well-being (PWB) of Korean male and female adults. Korean Journal of Social and Personality Psychology. 2001. 15(2):19–39.

12.Evans R., Thomas F. Emotional interactions and an ethics of care: Caring relations in families affected by HIV and AIDS. Emotion, Space and Society. 2009. 2(2):111–9. https://doi.org/10.1016/j.emospa.2009.08.003.

13.Kwon IS., Eun Y. The development of a continuing nursing care program for cancer patients after discharge. Journal of Korean Academy of Nursing. 2001. 31(1):81–93. https://doi.org/10.4040/jkan.2001.31.1.81.

14.Kang MH., Moon YS., Lee YJ., Kang YS., Kim HG., Lee GW, et al. Physical symptoms and psychiatric, social, spiritual and eco-nomical care needs of patients under home-based cancer ser-vice. Korean Journal of Hospice and Palliative Care. 2014. 17(4):216–22. https://doi.org/10.14475/kjhpc.2014.17.4.216.

15.Choi YS., Bae JH., Kim NH., Tae YS. Factors influencing burden among family caregivers of elderly cancer patients. Asian On-cology Nursing. 2016. 16(1):20–9. https://doi.org/10.5388/aon.2016.16.1.20.

16.Kim HS. Correlation between stress, coping patterns and physical symptom of cancer patient' s caregiver. Korean Journal of Adult Nursing. 2001. 13(2):317–26.

17.Hudson PL., Trauer T., Graham S., Grande G., Ewing G., Payne S, et al. A systemic review of instruments related to family caregivers of palliative care patients. Palliative Medicine. 2010. 24(7):656–68. https://doi.org/10.1177/0269216310373167.

18.Petrinec A., Burant C., Douglas S. Caregiver reaction assess-ment: psychometric properties in caregivers of advanced can-cer patients. Psycho-Oncology. 2017. 26(6):862–5. https://doi.org/10.1002/pon.4159.

19.Rhee YS., Han IY., Lee IJ., Nam EJ. Cross cultural validation of Caregiver Reaction Assessment(CRA) for cancer patient's caregiver. Korean Journal of Health Promotion. 2009. 9(3):189–98.

20.Ryff CD. Happiness is everything, or is it? Explorations on the meaning of psychological well-being. Journal of Personality and Social Psychology. 1989. 57(6):1069–81. https://doi.org/10.1037/0022-3514.57.6.1069.

21.Li Q., Loke AY. The positive aspects of caregiving for cancer patients: a critical review of the literature and directions for future research. Psycho-Oncology. 2013. 22(11):2399–407. https://doi.org/10.1002/pon.3311.

22.Choi SO. Posttraumatic growth in family caregivers of patients with cancer. Korean Journal of Hospice and Palliative Care. 2014. 17(1):1–9. https://doi.org/10.14475/kjhpc.2014.17.1.1.

23.Cohen S. Psychosocial models of the role of social support in the etiology of physical disease. Health Psychology. 1988. 7(3):269–97. https://doi.org/10.1037/0278-6133.7.3.269.

24.Rha SY., Park Y., Song SK., Lee CE., Lee J. Caregiving burden and the quality of life of family caregivers of cancer patients: the re-lationship and correlates. European Journal of Oncology Nursing. 2015. 19(4):376–82. https://doi.org/10.1016/j.ejon.2015.01.004.

25.Hwang IC., Kang K-A., Ahn HY. Analysis of research papers published by the Korean Journal of Hospice and Palliative Care (The first issue-2012). Korean Journal of Hospice and Palliative Care. 2013. 16(2):74–9. https://doi.org/10.14475/kjhpc.2013.16.2.074.

26.Lim YJ., Cho BH., Jang HS., Jeong HJ. A study on burden and well-being of primary caregivers of patients with a stroke. Journal of Korean Academy of Fundamentals of Nursing. 2009. 16(3):272–81.

27.Lethin C., Renom-Guiteras A., Zwakhalen S., Soto-Martin M., Saks K., Zabalegui A, et al. Psychological well-being over time among informal caregivers caring for persons with dementia living at home. Aging & Mental Health. 2017. 21(11):1138–46. https://doi.org/10.1080/13607863.2016.1211621.

28.SY Kim., Kim JM., Kim SW., Kang HJ., Lee JY., Shin IS, et al. Factors associated with quality of life of family caregivers in terminally ill cancer patients. Journal of the Korean Society Biological Therapies in Psychiatry. 2014. 20(3):227–37.

29.Lee MS., Kim HJ., Suh SR. Uncertainly and nursing need according to illness phases in cancer patients. Korean Journal of Adult Nursing. 2008. 20(1):1–9.

30.Ryff CD. Psychological well-being revisited: advances in the science and practice of eudaimonia. Psychotherapy and Psy-chosomatics. 2014. 83(1):10–28. https://doi.org/10.1159/000353263.

Table 1.

Differences in Psychological Well-being based on General Characteristics (N=139)

Characteristics	Categories	n (%)	Psychological well-being
Characteristics	Categories	n (%)	M± SD	t or F	p	Scheffé
Age (year)	＜30 ^a	34 (24.5)	4.22±0.51	7.31	＜.001	a＞ b, c, d
	30~39 ^b	27 (19.4)	3.87±0.53
	40~49 ^c	43 (30.9)	3.79±0.47
	≥50 ^d	35 (25.2)	3.70±0.47
Gender	Male	42 (30.2)	4.05±0.49	2.51	.013
Gender	Female	97 (69.8)	3.81±0.53
Relationship	Spouse ^a	16 (11.5)	3.66±0.59	2.36	.044	f＞ a
	Parent ^b	8 (5.8)	3.95±0.40
	Children ^c	65 (46.8)	3.88±0.51
	Sibling ^d	16 (11.5)	3.74±0.57
	Daughter-in-law ^e	8 (5.8)	3.76±0.56
	Grandchilden ^f	26 (18.7)	4.15±0.47
Length of being a caregiver (year)	＜1 ^a	38 (27.3)	3.97±0.43	1.20	.303
	1~3 ^b	52 (37.4)	3.91±0.58
	≥3 ^c	49 (35.3)	3.80±0.54
Monthly household income (10,000 won)	＜200 ^a	28 (20.1)	3.64±0.54	4.58	.012	c＞ a
	200~400 ^b	51 (36.7)	3.89±0.48
	≥400 ^c	60 (43.2)	4.00±0.53
Occupation	Yes	88 (63.3)	4.00±0.48	3.32	.002
Occupation	No	51 (36.7)	3.70±0.55
Hours of caregiving per day	＜3 ^a	68 (48.9)	3.97±0.52	1.75	.178
	3~6 ^b	40 (28.8)	3.82±0.51
	≥6 ^c	31 (22.3)	3.78±0.54
Living arrangement	With	47 (33.8)	3.78±0.49	-1.75	.082
Living arrangement	Not living together	92 (66.2)	3.94±0.54
ECOG-PS (patient)	0 ^a	33 (23.7)	4.05±0.51	2.69	.034	a, e＞ c
	1 ^b	52 (37.4)	3.82±0.60
	2 ^c	28 (20.1)	3.68±0.36
	3 ^d	15 (10.8)	4.01±0.41
	4 ^e	11 (7.9)	4.05±0.56
Treatment progress (patient)	Waiting for treatment ^a	5 (3.6)	3.97±0.65	0.18	.912
	Under treatment ^b	31 (22.3)	3.84±0.50
	After treatment ^c	71 (51.1)	3.89±0.57
	Terminal stage ^d	32 (23.0)	3.92±0.46

ECOG-PS=eastern cooperative oncology group scale of performance status.

Table 2.

Scores of Caregiver Reaction and Psychological Well-being (N=139)

Variables	Subscales	Range	Min	Max	M± SD
Caregiver reaction	Disrupted schedule	1~5	1.00	4.80	2.97±0.75
	Financial problems	1~5	1.00	5.00	2.84±0.79
	Health problems	1~5	1.00	5.00	2.71±0.80
	Lack of family support	1~5	1.00	4.00	2.27±0.74
	Caregiver self-esteem	1~5	1.67	4.83	3.16±0.62

Psychological well-being 1~6 2.39 5.11 3.89±0.53

Table 3.

Differences in Caregiver Reaction based on General Characteristics (N=139)

Characteristics	Categories	Disrupted schedule		Lack of family support		Health problem		Financial problem		Self-esteem
Characteristics	Categories	M± SD	t or F (p) Scheffé	M± SD	t or F (p) Scheffe	M± SD	t or F (p) Scheffe	M± SD	t or F (p) Scheffe	M± SD	t or F (p) Scheffe
Age (year)	＜30 ^a	2.66±0.74	5.60	1.94±0.73	33.83	2.36±0.81	4.64	2.79±0.83	1.31	3.28±0.65	1.15
	30~39 ^b	2.87±0.63	(.001)	2.24±0.70	0(.011)	2.63±0.78	(.004)	2.62±0.74	(.274)	3.09±0.51	(.332)
	40~49 ^c	2.95±0.73	d＞ a	2.42±0.72	2 d＞ a	2.78±0.80	d＞ a	2.99±0.68		3.05±0.55
	≥50 ^d	3.35±0.74		2.44±0.70	0	3.04±0.68		2.86±0.89		3.22±0.72
Gender	Male	2.78±0.67	-1.94	2.13±0.65	5-1.49	2.48±0.78	-2.25	3.00±0.79	1.62	3.23±0.54	0.94
Gender	Female	3.05±0.77	(.054)	2.33±0.77	7(.140)	2.81±0.79	(.026)	2.77±0.78	(.108)	3.13±0.65	(.350)
Relationship	Spouse ^a	3.58±0.83	4.60	2.44±0.62	21.49	3.10±0.85	3.37	2.81±1.06	0.20	3.33±0.88	2.33
	Parent ^b	3.13±0.74	(.001)	2.48±0.95	5(.197)	3.13±0.83	(.007)	2.92±0.68	(.962)	2.88±0.79	(.046)
	Children ^c ^d	2.97±0.65	a＞ f	2.21±0.78	8	2.65±0.81	b＞ f	2.83±0.75		3.24±0.55	a＞ e
	Sibling ^d	2.93±0.68		2.56±0.60	0	3.02±0.56		2.81±0.60		3.31±0.50
	Daughter-in-law ^e	3.13±0.60		2.45±0.69	9	2.75±0.61		3.08±0.66		2.71±0.71
	Grandchildren ^f	2.52±0.79		2.05±0.67	7	2.31±0.74		2.78±0.90		2.99±0.48
Length of being a caregiver (year)	＜1 ^a	2.86±0.69	3.12	2.10±0.59	92.62	2.50±0.80	1.94	2.70±0.71	1.17	3.21±0.52	2.32
	1~3 ^b	3.17±0.67	(.047)	2.24±0.78	8(.077)	2.82±0.76	(.148)	2.82±0.81	(.315)	3.26±0.61	(.102)
	≥3 ^c	2.84±0.83	b＞ c	2.45±0.76	6	2.76±0.82		2.96±0.82		3.01±0.67
Monthly household income (10,000 won)	＜200 ^a	3.34±0.77	4.64	2.56±0.83	32.66	2.99±0.85	2.22	3.00±0.95	0.95	3.35±0.77	6.30
	200~400 ^b ^c	2.86±0.71	(.011)	2.20±0.71	1(.074)	2.61±0.75	(.113)	2.75±0.71	(.390)	3.29±0.49	(.002)
	≥400 ^c	2.88±0.73	a＞ b, c	2.20±0.69	9	2.67±0.80		2.84±0.77		2.96±0.58	a, b＞ c

Occupation	Yes	2.93±0.64	-0.66	2.18±0.69	9-2.04	2.70±0.77	-0.22	2.93±0.81	1.81	3.19±0.60	0.70
Occupation	No	3.03±0.91	(.511)	2.44±0.79	9(.043)	2.73±0.85	(.825)	2.68±0.72	(.073)	3.11±0.65	(.484)
Hours of caregiving per day	＜3 ^a	2.67±0.70	21.44	2.06±0.70	08.16	2.44±0.76	12.07	2.75±0.83	3.52	3.08±0.61	1.02
	3~6 ^b ^c	2.98±0.71	(＜.001)	2.35±0.70	0(＜.001)	2.79±0.78	(＜.001)	2.74±0.78	(.032)	3.23±0.69	(.365)
	≥6 ^c	3.61±0.48	c＞ a, b	2.66±0.70	0 c＞ a	3.22±0.64	c＞ a, b	3.16±0.62	c＞ b	3.24±0.52
Living arrangement	With	3.30±0.71	3.90	2.45±0.78	82.00	2.94±0.82	2.40	2.89±0.74	0.61	3.22±0.70	0.87
Living arrangement	Not living together	2.80±0.72	(＜.001)	2.19±0.70	0(.047)	2.60±0.77	(.018)	2.81±0.81	(.546)	3.13±0.57	(.384)
ECOG-PS (patient)	0 ^a	2.71±0.71	1.97	2.00±0.80	01.88	2.34±0.81	2.42	2.58±0.71	1.77	3.23±0.66	1.64
	1 ^b	3.05±0.59	(.103)	2.33±0.67	7(.117)	2.83±0.58	(.052)	2.84±0.82	(.140)	3.12±0.65	(.169)
	2 ^c	2.89±0.85		2.41±0.66	6	2.81±0.94		2.92±0.80		2.98±0.63
	3 ^d	3.24±1.10		2.50±0.91	1	2.82±1.05		2.98±0.88		3.46±0.42
	4 ^e	3.16±0.58		2.18±0.62	2	2.88±0.65		3.21±0.54		3.17±0.29
Treatment phase (patient)	Waiting fortreatment ^a ^b	2.64±0.54	2.05	2.28±0.70	00.21	2.47±0.90	2.19	2.33±0.62	0.95	2.83±0.53	2.74
	Under treatment ^b	2.96±0.59	(.110)	2.30±0.73	3(.893)	2.63±0.75	(.092)	2.87±0.85	(.420)	3.35±0.62	(.046)
	After treatment ^c ^d	2.87±0.78		2.23±0.75	5	2.62±0.81		2.81±0.78		3.05±0.61	d＞ a
	Terminal state ^d	3.23±0.80		2.35±0.73	3	3.02±0.77		2.95±0.76		3.27±0.58

ECOG-PS=eastern cooperative oncology group scale of performance status.

Table 4.

Correlations between Caregiver Reaction and Psychological Well-being (N=139)

Variables	Caregiver reaction
	Disrupted schedule	Lack of family support	Health problem	Financial problem	Self-esteem
	r (p)	r (p)	r (p)	r (p)	r (p)
Psychological well-being	-.216 (.011)	-.472 (＜.001)	-.290 (.001)	-.178 (.036)	.238 (.005)

Table 5.

Influencing Factors on Psychological Well-being among Family Caregivers of Home based Cancer Patients (N=139)

Variables	B	SE	β	t	p
(Constant)	4.18	.30		13.75	＜.001
Lack of family support	-0.19	.05	-.27	-3.68	＜.001
Caregiver self-esteem	0.22	.06	.25	3.40	.001
Occupation: Yes (reference=No)	0.25	.07	.23	3.44	.001
Age	-0.01	.00	-.23	-3.20	.002
Monthly household income: ＞400(reference＜200) (10,000 won)	0.23	.08	.22	3.05	.003
Relationship: Grandchildren (reference=Spouses)	0.25	.10	.19	2.61	.010
	F=13.71, p＜.001, Adjusted R²=.393, R²=.424

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