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Caregivers - LoneStar Blood Cancer Conference

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Laura Howe-Martin

on 12 August 2013

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Transcript of Caregivers - LoneStar Blood Cancer Conference

Mental Health of Caregivers
Increased with shift toward cancer as chronic
Requires mastery of skills...
Caregiver Roles
Defined: "Perception of distress related to caregiving tasks"

The "Have To's"

Inversely related to QOL
Caregiver Burden
Risk Factors for
Caregiver Distress
Lack of Education
Poor Self-Care
"What's a little walking pneumonia, compared to cancer?
Primary forms of distress
"Welcome to CancerLand!"
Caregivers Have
Cancer, Too!

Laura Howe-Martin, PhD
Clinical Psychologist
Moncrief Cancer Institute
UT Southwestern Medical Center

Patient-Related Factors
Relationship Aspects
Demographic Factors
"Yes, I have a pain on my leg. I wanted to see the doctor but I thought that my wife needed to be treated first and then I'd see the doctor later... it's not really serious."
Actual findings:
Increased morbidity (including CAD)
Decline in personal health status
Neurohormonal/inflammatory changes
From Northouse, L., et al. (2012). Psychosocial care for family caregivers of patients with cancer. Journal of Clinical Oncology, 30 (11), 1227-1234.
Ongoing case manager
Up to date information
Social services resources
Job-related concerns
Valued activities/Interests
Perception of burden
Coping style (active vs. avoidant)
Relationship satisfaction
Avoidant attachment
Less family/social support
Additional dependents
Lower education/income
Functional impairments
Illness severity
Mental health
Flu shot?
Annual check-up?
Annual well-woman exam?
Medical adherence?
Diet/Activity Level?
Emotional Contagion
Contrast with Patients
Survivorship Phase
Hospice/Palliative Phase
12-24 months post-dx!
QOL not associated
Longer survival post-palli
Lower income
Poor relationship
Depression & suicide risk
Complicated cases

Find MODIFIABLE risk factors

Healthcare behaviors
Sleep Hygiene 101

Education (Early Stage)

Mental health
Coping Style/Skills (Later Stage)
Group/Individual intervention

Specific protective factors
So What Can We Do?
Beattie, S., & Lebel, S. The experience of caregivers of hematological cancer patients undergoing a hematopoietic stem cell transplant: A comprehensive literature review. Psycho-Oncology, 20, 1137-1150.

Girgis, A., Lambert, S., & Lecathelinais, C., (2011). The supportive care needs survey for partners and caregivers of cancer survivors: Development and psychometric evaluation. Psycho-Oncology, 20(4), 387-393.

Kim, Y., et al. (2011). Individual and dyadic relations between spiritual well-being and quality of life among cancer survivors and their spousal caregivers. Psycho-Oncology, 20, 762-770.

Lichtenthal, W. G., et al. (2011). Underutilization of mental heatlh services among bereaved caregivers with prolonged grief disorder. Psychiatric Services, 62(10), 1225-1229.

Northouse, L, et al. (2012). Psychosocial care for family caregivers of patients with cancer. Journal of Clinical Oncology, 30(11), 1227-1234.

Papastavrou, E., Charalambous, A., & Tsangari, H. (2009). Exploring the other side of cancer care: The informal caregiver. European Journal of Oncology Nursing, 13, 128-136.

Porter, L.S., et al. (2011). Caregiver-assisted coping skills training for lung cancer: Results of a randomized clinical trial. Journal of Pain and Symptom Management, 41(1), 1-13.

Song, J., et al. (2012). Quality of life and mental health in the bereaved family members of patients with terminal cancer. Psycho-Oncology, 21, 1158-1166.

Turkoglu, N., & Kilic, D. (2012). Effects of care burdens of caregivers of cancer patients on their quality of life. Asian Pacific Journal of Cancer Prevention, 13, 4141-4145.

Wadwha, D., et al. (2013). Quality of life and mental health in caregivers of outpatients with advanced cancer. Psycho-Oncology, 22, 403-410.
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