The influence of dyadic symptom distress on threat appraisals and self-efficacy in advanced cancer and caregiving.
- Resource Type
- Academic Journal
- Authors
- Ellis, Katrina; Janevic, Mary; Kershaw, Trace; Caldwell, Cleopatra; Janz, Nancy; Northouse, Laurel; Ellis, Katrina R; Janevic, Mary R; Caldwell, Cleopatra H; Janz, Nancy K
- Source
- Supportive Care in Cancer (SUPPORT CARE CANCER), Jan2017; 25(1): 185-194. (10p)
- Subject
- Language
- English
- ISSN
- 0941-4355
Purpose: Physical and psychological symptoms experienced by patients with advanced cancer influence their well-being; how patient and family caregiver symptom distress influence each other's well-being is less understood. This study examined the influence of patient and caregiver symptom distress on their threat appraisals and self-efficacy to cope with cancer.Methods: We conducted a secondary analysis of baseline data from an RCT that enrolled patients with advanced cancer and their family caregivers (N = 484 dyads). Structural equation modeling and the actor-partner interdependence mediation model (APIMeM) were used to examine two models: threat appraisals as a mediator of the relationship between symptom distress and individual and family-related self-efficacy; and, self-efficacy (individual and family dimensions) as mediators of the relationship between symptom distress and threat appraisals.Results: Data suggest the self-efficacy mediation model was the preferred model. More patient and caregiver symptom distress was directly associated with their own lower self-efficacy and more threatening appraisals. Patient and caregiver individual self-efficacy also mediated the relationship between their own symptom distress and threat appraisals. There were also significant interdependent effects. More patient symptom distress was associated with less caregiver family-related self-efficacy, and more caregiver symptom distress was directly associated with more threatening patient appraisals.Conclusions: Patient and caregiver symptom distress influenced their own and in some cases each other's cognitive appraisals. Limitations of this study include the use of cross-sectional data and assessments of individually-focused (vs. family-focused) threat appraisals. These findings highlight the need to consider the management of patient and caregiver symptoms during advanced cancer.