Distress about Caregiver Proximity and Availability: Self-Reports from Breast Cancer Survivors

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The Ohio State University

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Distress is a common side effect of a cancer diagnosis and treatment, and is often referred to as the sixth vital sign. Prolonged exposure to distress can have adverse effects on physical and mental health; unresolved distress may even increase the risk of metastatic disease. The purpose of this study was to identify and compare the level and source of distress in acute leukemia (n=100) and breast cancer survivors (n=100) during early survivorship; a multi-group, cross-sectional design was used. This paper will discuss data associated with self-reported distress from breast cancer survivors related to caregiver proximity and availability. The level and sources of self-reported distress were collected from survivors during active cancer treatment, at its end, and at 3-, and 6-month post-treatment follow-up. The National Comprehensive Cancer Network (NCCN) Distress Thermometer (DT) was used to quantify the level of distress (analog score, 0-10). A demographic questionnaire included items about caregivers and support persons. The Charleston Index was used to identify survivors’ comorbidities; electronic chart reviews validated disease-related information. Data were analyzed with descriptive statistics to define the sample; analysis of variance (ANOVA) was used to measure differences. Breast cancer patients reported ‘moderate to severe’ levels of distress (e.g. ≥ 4) during active treatment (5, sd=2.6), upon completion (4.9, sd=3.6), and 3-months following end of treatment (4.8, sd=2.9). Survivors were concerned when their caregivers were not available, such as living (p=0.02) and working outside the home (p=0.04), and working full-time (p=0.04). Age was a significant factor (p=0.00); younger women reported more difficulties than older women. Survivors uniformly reported concerns with work, transportation, and relationship issues. In summary, identification of distress related to availability or proximity perhaps can not change caregiver or support person circumstances, although may provide an opportunity to develop interventions for the patient to cope and reduce his/her distress.



distress, breast cancer, caregiver, support, symptoms