Quality of Life of Cancer Survivors and Their Family Caregivers
One of my projects, the National Quality of Life Survey for Caregivers, has already documented indicators of caregivers' QOL (psychosocial, physical, spiritual, and behavioral) at 2-year post-diagnosis (N > 1,600). This project has also identified psychosocial correlates (personality, relationship quality, social support, gender) of better or poorer outcomes. Follow-up assessments at 5 and 8 years post-diagnosis provide evidence of the long-term impact of cancer on family caregivers facing each of three situations: The first is caregivers whose care recipients now are in remission; the second is caregivers whose care recipients are undergoing treatment for recurrence, a second cancer, or late side-effects; and the third is caregivers whose care recipients are deceased.
Another project, the Study of Informal Cancer Care, was conducted at community hospitals and targeted the early phase of cancer caregivership and survivorship (from the time of diagnosis to 18-month post-diagnosis). Yet another project, the Hope Lodge Study, examined the psychosocial mechanisms of social support effects on patients' and their family caregivers' quality of life while they are away from home for cancer treatment.
Hope Lodge Study
Although the salutary effect of social support on individuals who encounter stressful life events, including medical illnesses, has been studied for decades, attention to the role of social support in family caregivers' quality of life has just recently begun. In addition, little is known about the underlying mechanism of how social support facilitates person's well-being in a natural medical setting. This project was developed to investigate the nature of social support and the quality of life (QOL) of cancer patients and their family caregivers who use the American Cancer Society sponsored, free, temporary housing facility, Hope Lodge.
Psychologial Correlates and Biomarkers of Stress among Families Dealing with Prostate Cancer or Non-Hodgkin's Lymphoma
The findings of the descriptive longitudinal studies described above led us to recent investigations to further understand the associations between characteristics of cancer-related stress and biobehavioral outcomes (e.g., cortisol and proinflammatory cytokines) of prostate cancer patients and his wife or patients with Non-Hodgkin's Lymphoma and their family caregivers.
Nutrition and Physical Activity (NuPA) study
This is a randomized control trial guided by theories of motivation and behavioral changes, with over 2,500 participants, compares the effectiveness of a telephone counseling program versus self-help materials only, for the purpose of establishing weight loss or weight management and improving healthy diet and physical activity. The results revealed that the intervention was effective at 6 months after the enrollment in reducing weight in both the Self-Help and Self-Help plus Counseling groups among the overweight and obese participants and increasing fruit and vegetable consumption with all participants. The results demonstrated that using a theory-based behavioral change counseling technique and targeting multiple health behaviors among employed individuals, our findings demonstrate that a modest telephone counseling intervention is effective in promoting healthy diet and weight management.
Home-Based Intervention Targeting Multiple Cancer Preventive Behaviors
Tailoring the effective components of the NuPA intervention to individuals with personal or family history of cancer, this project examined the effectiveness of a multiple health behavior change (MHBC) intervention to enhance cancer preventive behaviors, namely dietary intake, exercise, weight management, and cancer screenings among persons diagnosed with cancer and their family members. The intervention sessions were held at the participants' home via video telephone technology. Including family members along with the survivors helped develop a fuller understand of cancer survivorship and identify major influences on optimal cancer prevention among persons at increased risk of developing cancer.
Dyadic Study of Depression and Inflammation in Cancer Patients and Caregivers
This project, funded by the Ruth L. Kirschstein National Research Service Award (F31: PI, Shaffer), aimed to examine the extent to which one's depressive symptoms predict his/her own proinflammatory markers later among cancer patients and their caregivers and to explore the extent to which patients' depressive symptoms relate to their caregivers' proinflammatory markers, and vice versa. Preliminary results showed that depressive symptoms were not correlated between patients and caregivers at T1. However, there was a high burden of depressive symptoms seen among the extant sample – 1 in 4 patients and 2 in 5 caregivers reported clinically elevated depressive symptoms by self-report. Furthermore, immune markers were significantly interdependent between patients and their caregivers, although not related to their depressive symptoms.
