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caregiver coping strategies ‘affects level of distress,’ study says
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the team focused on the effectiveness of two broad coping strategies: avoidant and approach-oriented. getty
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a new study has found that the coping strategies caregivers use have a direct impact on the anxiety, depression and quality of life they experience.
the timely research, which arrives in the middle of caregiver awareness month, revealed that strategies focusing on problem-solving and acceptance were most beneficial to caregivers as they performed their vital work. the study was funded by the national cancer institute and the leukemia and lymphoma society and published in the journal blood advances.
“this study highlights that the psychological distress caregivers experience is real and how caregivers cope with the challenges they face in supporting their loved one affects their level of distress and their quality of life,” said hermioni amonoo, principal investigator of the study, from the dana-farber cancer institute in boston. “we also know from prior research that caregivers’ psychological well-being affects patient outcomes.”
caregivers are often referred to as the backbone of canada’s healthcare system because close to eight million people over the age of 15 devote an average of 20 hours a week to tending to the medical needs of others. this contribution, which currently amounts to a whopping 5.7 billion hours of unpaid care, will only increase as the country’s population continues to age. the study, which focused on 170 primary caregivers for patients who received a stem cell transplant for a blood cancer diagnosis, was prompted by a desire to make life more manageable for this growing population.
caregivers play an integral role in the 100 days following a stem cell transplant, amonoo said, supporting patients as they receive induction chemotherapy, which essentially wipes out their entire immune system. in addition to acting as a coordinator between hospitals and patients, caregivers must ensure medications are taken on time, diets are followed and life-threatening infections are avoided. it is an intense experience that research has shown can result in a host of issues, including distress, loneliness, fatigue and financial worry. this is made more problematic by research linking fatigue among caregivers to slower recovery among patients.
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the majority of caregivers in the study, who could be a spouse, relative or friend, were white (86.5 per cent), female (76.5 per cent) and had a median age of 53. they were asked to complete a survey about coping strategies, anxiety, depression and quality of life shortly after patients were admitted to hospital for their stem cell procedure. religious beliefs were also explored as a coping strategy.
the team focused on the effectiveness of two broad coping strategies: avoidant and approach-oriented. avoidant coping strategies include self-blame (where caregivers admonish themselves for missing an appointment or dose of medication) and denial (where the reality of the situation is minimized). approach-oriented coping strategies, on the other hand, rely on active problem solving, positive reframing and finding sources of emotional support.
the team found that a significant number of caregivers relied on different elements of coping strategies, including acceptance (55.9 per cent), positive reframing (45.9 per cent) and religion (44.1 per cent). however, the 49.4 per cent of caregivers who used approach-oriented strategies were found to have fewer symptoms of anxiety and depression and better quality of life compared to the 32.9 per cent who relied on avoidant strategies.
“strategies such as active problem-solving and positive reframing seemed to be more helpful for caregivers than strategies such as denial and self-blame,” amonoo said. “we didn’t find an association between religious coping strategies and caregiver distress or quality of life, although some previous smaller studies have found such an association.”
the team is now focused on developing interventions and resources that will bolster the mental health of caregivers as they perform their important work.
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“coping strategies aren’t good or bad — you have to meet people where they are,” amonoo said. “and caregivers can be taught to use coping strategies that may be more helpful and may enable them to feel less anxious, depressed or overwhelmed.
“so, if a caregiver is thinking, ‘my life will never be the same again,’ we can help them reframe that in a more positive way. for example, ‘i know there will be a lot of uncertainty as my loved one recovers from their stem cell transplant, but i’m not in this alone — i can talk to the care team when questions come up or when i feel inadequate about something i need to do.’”
dave yasvinski is a writer with healthing.ca
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