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Gender differences in the association between unmet support service needs and mental health among American cancer caregivers

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Abstract

Purpose

Cancer caregiving can be distressing, and many caregivers have support service needs. Given the role gender has played in shaping norms around caring, gender may influence caregiving experiences. Using Behavioral Risk Factor Surveillance System data, 2015–2018, we aimed to examine gender as an effect modifier of the unmet support service needs and mental health association among cancer caregivers.

Methods

Our n = 5814 sample represented approximately 4.8 million caregivers. Mental health was operationalized as number of mentally unhealthy days over the past 30 (MUDs) and Frequent Mental Distress (FMD, MUDs ± 14 days). Unmet supportive care needs included endorsement of needing but not receiving caregiving classes, help accessing services, support groups, counseling, and respite care. We conducted zero-inflated negative binomial (ZINB) and logistic regression analyses to examine the associations between unmet needs with MUDs and FMD and then tested gender as an effect modifier.

Results

Cancer caregivers reported an average of 6 MUDs. Approximately 20% of caregivers reported FMD, and 17% reported having any unmet needs. Gender moderated the unmet needs and FMD association. Among female caregivers, those with unmet needs were more likely to report FMD (aOR: 2.167; 95%CI: 1.447, 3.243); among male caregivers, no association was found (aOR: 0.970; 95%CI: 0.471, 2.001). In the ZINB model of MUDs, no significant moderation effect of gender was found.

Conclusion

Though distress does not appear to vary by gender, having unmet support needs may negatively affect mental health in female cancer caregivers. Studies on gendered experiences can inform strategies to meet caregiver needs.

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Availability of data and materials

The data are publicly available from the Centers for Disease Control and Prevention.

References

  1. Hunt GH, Longacre ML, Kent EE, Weber-Raley L (2016) Cancer caregiving in the U.S.: an intense. episodic, and challenging experience. National Alliance for Caregiving 2016: 34

  2. Mosher CE, Bakas T, Champion VL (2013) Physical health, mental health, and life changes among family caregivers of patients with lung cancer. Oncol Nurs Forum 40(1):53–61

    Article  Google Scholar 

  3. Trevino KM, Prigerson HG, Maciejewski PK (2018) Advanced cancer caregiving as a risk for major depressive episodes and generalized anxiety disorder. Psychooncology 27(1):243–249

    Article  Google Scholar 

  4. Stenberg U, Ruland CM, Miaskowski C (2010) Review of the literature on the effects of caring for a patient with cancer. Psychooncology 1025(19):1013–1025

    Article  Google Scholar 

  5. Fletcher BS, Miaskowski C, Given B, Schumacher K (2012) The cancer family caregiving experience: an updated and expanded conceptual model. Eur J Oncol Nurs 16(4):387–398

    Article  Google Scholar 

  6. Kent EE, Dionne-Odom JN (2019) Population-based profile of mental health and support service need among family caregivers of adults with cancer. J Oncol Pract 15(2):e122–e131

    Article  Google Scholar 

  7. Martin MY, Sanders S, Griffin JM et al (2012) Racial variation in the cancer caregiving experience: a multi-site study of colorectal and lung cancer caregivers. Cancer Nurs 35(4):249

    Article  Google Scholar 

  8. Ugalde A, Blaschke S, Boltong A et al (2019) Understanding rural caregivers’ experiences of cancer care when accessing metropolitan cancer services: a qualitative study. BMJ Open 9(7):e028315

    Article  Google Scholar 

  9. Kim Y, Mitchell HR, Ting A (2019) Application of psychological theories on the role of gender in caregiving to psycho-oncology research. Psychooncology 28(2):228–254

    Article  Google Scholar 

  10. Eagly A, Wood W (2012) Social Role Theory. In: Van LCPAM, Rusbult CE, Van LPAM, Kruglanski AW, Higgins ET (eds) Handbook of theories of social psychology, vol 2. SAGE Publications Ltd, London, pp 251–272

    Google Scholar 

  11. Pinquart M, Sörensen S (2006) Gender differences in caregiver stressors, social resources, and health: an updated meta-analysis. J Gerontol Ser B Psychol Sci Soc Sci 61(1):P33-45

    Google Scholar 

  12. Kim Y, Baker F, Spillers RL (2007) Cancer caregivers’ quality of life: effects of gender, relationship, and appraisal. J Pain Symptom Manag 34(3):294–304

    Article  Google Scholar 

  13. Ussher JM, Sandoval M (2008) Gender differences in the construction and experience of cancer care: the consequences of the gendered positioning of carers. Psychol Heal 23(8):945–963

    Article  Google Scholar 

  14. Chappell NL, Dujela C, Smith A (2015) Caregiver well-being: intersections of relationship and gender. Res Aging 37(6):623–645

    Article  Google Scholar 

  15. Chesley N, Poppie K (2009) Assisting parents and in-laws: gender, type of assistance, and couples’ employment. J Marriage Fam 71(2):247–262

    Article  Google Scholar 

  16. Mott J, Schmidt B, MacWilliams B (2019) Male caregivers. Clin J Oncol Nurs 23(1):E17–E24

    PubMed  Google Scholar 

  17. Mokdad AH (2009) The behavioral risk factors surveillance system: past, present, and future. Annu Rev Public Health 30:43–54

    Article  Google Scholar 

  18. Moriarty DG, Zack MM, Kobau R (2003) The centers for disease control and prevention’s healthy days measures - population tracking of perceived physical and mental health over time. Health Qual Life Outcomes 1:1–8

    Article  Google Scholar 

  19. Slabaugh SL, Shah M, Zack M et al (2017) Leveraging health-related quality of life in population health management: the case for healthy days. Popul Health Manag 20(1):13–22

    Article  Google Scholar 

  20. Zhou H, Siegel PZ, Barile J et al (2014) Models for count data with an application to healthy days measures: are you driving in screws with a hammer? Prev Chronic Dis 11(3):1–11

    Google Scholar 

  21. Team RC. R: a language and environment for statistical computing. 2020. https://www.r-project.org/

  22. StataCorp. Stata Statistical Software: Release 16. 2019

  23. Robinson CA, Bottorff JL, Pesut B, Oliffe JL, Tomlinson J (2014) The male face of caregiving: a scoping review of men caring for a person with dementia. Am J Mens Health 8(5):409–426

    Article  Google Scholar 

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Acknowledgements

The authors wish to thank the Odum Institute at the University of North Carolina at Chapel Hill for their support in statistical methods.

Funding

Funding for this research was provided by the Graduate School at the University of North Carolina at Chapel Hill through 2020 Summer Research Fellowship (recipient: Yiqing Qian). Funding was also provided to Erin E. Kent by Lineberger Comprehensive Cancer Center at the University of North Carolina at Chapel Hill.

Author information

Authors and Affiliations

  1. Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Yiqing Qian

  2. Department of Health Policy and Management, 1102-B McGavran-Greenberg Hall, CB # 7411, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599-7411, USA

    Erin E. Kent

  3. Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Erin E. Kent

Authors
  1. Yiqing Qian
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  2. Erin E. Kent
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Contributions

Y.Q. conducted the literature review and statistical analyses and wrote the manuscript. Y.Q. and E.E.K. conceptualized the research questions and conducted data interpretations and manuscript revision. Both authors gave final approval of the version to be submitted.

Corresponding author

Correspondence to Erin E. Kent.

Ethics declarations

Ethics approval and consent to participate

This study used de-identified and publicly available BRFSS data. Therefore, this study was deemed exempt from institutional review board approval. The BRFSS study obtained consent from all study participants. This study used de-identified and publicly available data.

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N/A

Conflict of interest

The authors declare no competing interests.

Prior presentation

Parts of this study were presented in abstract from the 2021 Society of Behavioral Medicine Annual Meeting & Scientific Session, Virtual, April 2021.

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Appendix

Appendix

Table 5 States that participated in caregiver module, BRFSS 2015–2018
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Qian, Y., Kent, E.E. Gender differences in the association between unmet support service needs and mental health among American cancer caregivers. Support Care Cancer 30, 5469–5480 (2022). https://doi.org/10.1007/s00520-022-06966-y

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  • DOI: https://doi.org/10.1007/s00520-022-06966-y

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