Low cognitive flexibility, lack of social support predict depression among caregivers of cancer patients
Low cognitive flexibility levels among caregivers of hospitalized advanced cancer patients are associated with depression and anxiety symptoms, according to a Turkey study.
“In Turkey, people generally prefer to act as their family members’ primary caregivers rather than leave their care to professional caregivers or care centres,” researchers said. “Therefore, interventions to improve the well-being of caregivers are important.”
A total of 69 primary informal caregivers of patients with stage 4 cancer were included. The following methods were used in this study: diagnostic semi-structured interviews, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Zarit Caregiver Burden Inventory and cognitive flexibility inventory.
Caregivers who cared for men had significantly higher BDI scores compared to those who cared for women (20.44±2.06 vs 13.29±1.81; t, 2.60; p=0.01). Caregivers who received help with caregiving had statistically lower BDI mean scores compared to those who did not (t, 2.62; p=0.01). [Singapore Med J 2018;59:572-577]
Predictors of caregiver depression were as follows: cognitive flexibility level, burden level and lack of social support.
“[W]e found that caregivers of male cancer patients have statistically higher mean scores for BDI and BAI than those who cared for female patients,” researchers said, adding that a study by Bedard and colleagues reported that women who looked after male patients were at risk of experiencing excess role burden. [Int Psychogeriatr 2005;17:99-118]
In the area of caregiving, other studies also suggested that women are usually assumed to be more capable of conducting household and personal care tasks than men. [http://www.womenandhealthcarereform.ca/publications/synthesis.pdf]
“Our study found that male patients may need more help in the area of personal care, and this factor could have an impact on their caregivers’ depression and anxiety levels,” researchers said.
Additionally, cognitive flexibility was found to be one of the predictors of depression and anxiety in caregivers of cancer patients. An aspect of executive functioning, cognitive flexibility refers to “a trait or ability that allows an individual to consider multiple ideas, flexibly switch cognitive sets and inhibit habitual response patterns when environmental contingencies change. [Semin Speech Lang 2000;21:121-132; Sociometry 1962;25:405-414]
“Caregivers should be encouraged to ask for help from other family members or friends whenever they feel overwhelmed by their caregiver role,” researchers suggested. [CA Cancer J Clin 2001;51:213-231]
“In addition, positive coping strategies should be reinforced. Healthcare professionals can help caregivers to face new life situations as well as deal with negative behaviours. It may also be useful to evaluate the cognitive flexibility abilities of caregivers and establish cognitive interventions that address their needs,” they said. [Eur J Oncol Nurs 2012;16:258-263]
The present study was limited by its small number of caregivers, so data could not be generalized to all caregivers. In addition, further studies are warranted to determine the effect of cognitive interventions on caregivers’ depression and anxiety levels.