Moderating Effects of Optimism and Family Support on the Depression of Family Caregivers of Cancer Patients
- Kyoungwon Choi1, Dae Ro Choi2,, Dae Young Zang3, Young Suk Park4, Seok Yun Kang5, Hyunsook Yoon1, Yeon Ok Lim6, Yojin Kim1, Ilsung Nam7, Hyen Joo Lee8
- Received January 07, 2016 Accepted May 10, 2016
- ABSTRACT
-
- Background
- This study examined moderating effects of optimism and family support on the depression of family caregivers of cancer patients aged 55 and over by adopting stress process model.
- Methods
- 359 family caregivers who accompanied with cancer patients to out-patient clinics were recruited and completed questionnaire at three university hospitals located in Seoul and Gyeonggi province. Exploratory factor analysis was applied to test validity of the construction of the scale. Hierarchical multiple regression analysis was used to determine moderating effects of optimism and family support on depression after making mean centering of each variable.
- Results
- Results showed that spouse caregivers have more depression than do adult children as the nursing period gets longer. Education and income status were significant variables affecting depression of family caregivers. Optimism and family support for family caregivers have moderating effects on the association between stressors (emotional functioning of cancer patients and role overload of family caregivers) and depression of family caregivers.
- Conclusions
- The findings suggest that more attentions are needed to the depression of spouse caregivers. Interventions are strongly recommended for health professionals to provide cancer patients and their family caregivers with "holding environments" caring for emotions and facilitating adjustment.
Table 1.
Socio-demographic characteristics of caregivers of patients with cancer (n=354)
Table 2.
Cancer characteristics of the patients (n=354)
Table 3.
Depressive tendency of a caregivers according to treatment period of cancer patients (n=110)
Table 5.
Moderator effect between Stressor and depression of cancer caregivera: step 1, 2
| Step 1 | Step 2 | |||||
|---|---|---|---|---|---|---|
| B | β | P | B | β | P | |
| Controls | ||||||
| Genderb | 0.452 | 0.040 | 0.397 | –0.023 | –0.002 | 0.966 |
| Age | –.0037 | –0.096 | 0.052 | –0.032 | –0.082 | 0.267 |
| Education | 1.990 | 0.365 | <0.001 | 1.167 | 0.214 | <0.001 |
| Self-rated health | –0.355 | –0.078 | 0.107 | –0.073 | –0.016 | 0.726 |
| Subjective economic status | –1.347 | –0.245 | <0.001 | –0.827 | –0.150 | 0.002 |
| Primary objective stress | ||||||
| Relationships with patientsc | – | – | – | 1.108 | 0.102 | 0.206 |
| Nursing periodd | –0.002 | –0.013 | 0.761 | |||
| Physical function of patientse | 0.012 | 0.058 | 0.360 | |||
| Emotional function of patientse | –0.046 | –0.190 | 0.001 | |||
| Role function of patientse | –0.002 | –0.011 | 0.864 | |||
| Cognitive function of patientse | –0.003 | –0.011 | 0.839 | |||
| Social function of patientse | –0.015 | –0.080 | 0.168 | |||
| Secondary stress | ||||||
| Role overload | 1.432 | 0.186 | 0.001 | |||
| Caregiving competence | –0.429 | –0.051 | 0.233 | |||
| Relational change | 1.306 | 0.143 | 0.006 | |||
| Moderators | ||||||
| Optimism | – | – | – | – | – | – |
| Family support | – | – | – | – | – | – |
| Moderation effect | ||||||
| Emotional function∗optimism | – | – | – | – | – | – |
| Emotional function∗family support | – | – | – | – | – | – |
| Role overload∗optimism | – | – | – | – | – | – |
| Role overload∗family support | – | – | – | – | – | – |
| F | 26.989 (P<0.001) | 16.964 (P<0.001) | ||||
| R2 | 0.283 | 0.434 | ||||
| △R2 | – | 0.151 | ||||
| △F | – | 8.853 (P<0.001) | ||||
Table 6.
Moderator effect between Stressor and depression of cancer caregivera: step 3, 4
| Step 3 | Step 4 | |||||
|---|---|---|---|---|---|---|
| B | β | P | B | β | P | |
| Control | ||||||
| Genderb | 0.013 | 0.001 | 0.979 | 0.048 | 0.004 | 0.923 |
| Age | –0.048 | –0.122 | 0.084 | –0.046 | –0.117 | 0.090 |
| Education | 0.974 | 0.178 | <0.001 | 0.903 | 0.165 | 0.001 |
| Self-rated health | 0.193 | 0.042 | 0.349 | 0.207 | 0.045 | 0.306 |
| Subjective economic status | –0.708 | –0.129 | 0.006 | –0.659 | –0.120 | 0.009 |
| Primary objective stress | ||||||
| Relationships with patientsc | 1.246 | 0.114 | 0.132 | 1.273 | 0.117 | 0.117 |
| Nursing periodd | –0.002 | –0.011 | 0.787 | –0.003 | –0.020 | 0.601 |
| Physical function of patientse | 0.017 | 0.077 | 0.193 | 0.014 | 0.065 | 0.271 |
| Emotional function of patientse | –0.039 | –0.162 | 0.004 | –0.031 | –0.127 | 0.023 |
| Role function of patientse | –0.005 | –0.025 | 0.688 | –0.005 | –0.026 | 0.670 |
| Cognitive function of patientse | –0.004 | –0.015 | 0.774 | –0.011 | –0.044 | 0.380 |
| Social function of patientse | –0.015 | –0.076 | 0.169 | –0.011 | –0.056 | 0.311 |
| Secondary stress | ||||||
| Role overload | 1.254 | 0.162 | 0.003 | 1.291 | 0.167 | 0.002 |
| Caregiving competence | –0.058 | –0.007 | 0.869 | –0.296 | –0.035 | 0.398 |
| Relationship changes | 0.666 | 0.073 | 0.161 | 0.440 | 0.048 | 0.350 |
| Moderators | ||||||
| Optimism | –1.540 | –0.221 | <0.001 | –4.350 | –0.623 | <0.001 |
| Family support | –1.217 | –0.179 | 0.001 | 0.791 | 0.116 | 0.431 |
| Moderation effect | ||||||
| Emotional function∗optimism | – | – | – | 0.035 | 0.397 | 0.019 |
| Emotional function∗family support | – | – | – | –0.026 | –0.259 | 0.058 |
| Role overload∗optimism | – | – | – | –0.413 | –0.042 | 0.368 |
| Role overload∗family support | – | – | – | –1.364 | –0.167 | 0.002 |
| F | 1 | 19.422 (P<0.001) | ) | 1 | 17.393 (P<0.001) | ) |
| R2 | 0.500 | 0.528 | ||||
| △R2 | 0.066 | 0.028 | ||||
| △F | 2 | 21.862 (P<0.001) | ) | 4.884 (P<0.001) | ||
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