Publication Date

2013-01-14

Availability

Open access

Embargo Period

2013-01-14

Degree Name

Master of Science (MS)

Department

Psychology (Arts and Sciences)

Date of Defense

2012-08-22

First Committee Member

Youngmee Kim

Second Committee Member

Sara Czaja

Third Committee Member

Neil Schneiderman

Abstract

Family members and friends who provide unpaid care to an ill relative tend to experience higher levels of stress, more depressive symptoms, and greater vulnerability to disease than the general population (Pinquart & Sörensen, 2003). This study was to determine whether cancer caregivers experience an increased risk of cardiovascular diseases (CVD) and to examine the extent to which psychosocial variables related to the disease outcomes. A total of 896 caregivers participated in a national survey at two years after the diagnosis of their relative with cancer (T1), and 607 participated again at five years post-diagnosis (T2) provided self-report data on study variables. Raw prevalence rates for CVD risk conditions (hypertension, obesity, high cholesterol, and diabetes) and CVD manifestations (angina, coronary heart disease, cardiac arrest, congestive heart failure, heart attack, and stroke) were adjusted for age, race/ethnicity, and gender for comparison with similarly adjusted U.S. population rates. Comparisons showed that although cancer caregivers have comparable cardiovascular health at both two (T1) and five (T2) years post-diagnosis, caregivers had significant increases in prevalence of all conditions studied between observations. Next, the extent to which three psychosocial variables related to the development of CVD risk conditions and manifestations was investigated using hierarchical logistic regression analysis. Subjective caregiving stress at T1 marginally significantly predicted development of any of the CVD risk factors studied by T2. Greater levels of depressive symptoms at T1 significantly predicted the development of several risk conditions and manifestations at T2: obesity, any of the CVD manifestation conditions studied, and irregular heartbeat/CHF/heart attack. Greater depressive symptoms at T1 also aggravated the adverse effect of subjective caregiving stress on development of two CVD manifestations: development of any CVD manifestation studied and irregular heartbeat/ pacemaker/murmur specifically. Men were more likely to develop the CVD risk factor of high cholesterol and CVD manifestation of cardiac arrest/CHF/heart attack by T2 than women. Gender was not a significant moderator of the link between subjective caregiving stress and CVD outcomes. Findings suggest that while cancer caregivers as a whole have comparable cardiovascular health to the national population through five years after their relative’s initial cancer diagnosis, distressed caregivers during earlier survivorship phase may be at a higher risk of developing CVDs later in the caregiving trajectory.

Keywords

Cardiovascular Disease; Caregiving; Depression; Caregiving Stress

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