From the University of Miami (Kim, Carver, Antoni, Penedo), Coral Gables, Florida; and UCLA (Cole), Los Angeles, California.
Psychosom Med. 2021;83(2):149-156. doi: 10.1097/PSY.0000000000000897.
The experience of cancer elicits not only turmoil but also resilience in the family, which has been related to psychological adjustment and physical health of family caregivers. The biological pathways linking family cancer caregiving to health, however, remain poorly understood. This study examined the extent to which psychological risk and resilience factors related to a proinflammatory gene expression profile (conserved transcriptional response to adversity, or CTRA) among caregivers during the first-year postdiagnosis of a patient with colorectal cancer.
A total of 41 caregivers (mean age = 54 years, 74% female, 40% Hispanic) provided psychological data and peripheral blood samples around 4 and 12 months after diagnosis. Mixed regression models controlling for demographic and biometric factors were used to test the associations of caregiver CTRA gene expression with caregiving stress, loneliness, and lack of social support (risk factors), as well as benefit finding and meaning (resilience factors).
When individually tested, all but benefit finding were significantly related to CTRA (R2 ≥ 0.112, p < .045). When adjusted for other factors in either the risk or resilience group, loneliness, social support, and meaning effects remained significant (R2 ≥ 0.120, p < .041). When all study factors were simultaneously adjusted (R2 = 0.139), only loneliness remained significant (p = .034).
Findings suggest that caregiving-related transcriptional effects seem to be most pronounced when caregivers experience low social support and loneliness, as well as little meaning or purpose in their caregiving. These findings suggest that the development of new intervention strategies that prioritize reductions in caregiver loneliness may favorably impact biological mechanisms related to caregiver health.
癌症不仅会给患者家庭带来动荡，还会带来韧性，这与家庭照顾者的心理调整和身体健康有关。然而，将家庭癌症护理与健康联系起来的生物学途径仍知之甚少。本研究考察了在患者被诊断为结直肠癌后的第一年中，照顾者的心理风险和适应力因素在多大程度上与促炎基因表达谱（逆境相关的保守转录反应，或 CTRA）有关。
共有 41 名照顾者（平均年龄=54 岁，74%为女性，40%为西班牙裔）在诊断后 4 个月和 12 个月左右提供了心理数据和外周血样。使用混合回归模型控制人口统计学和生物统计学因素，以检验照顾者 CTRA 基因表达与照顾压力、孤独感和缺乏社会支持（风险因素）以及受益发现和意义（适应力因素）之间的关联。
当单独测试时，除受益发现外，所有因素均与 CTRA 显著相关（R2≥0.112，p<.045）。当在风险或适应力组中的其他因素调整时，孤独感、社会支持和意义的影响仍然显著（R2≥0.120，p<.041）。当同时调整所有研究因素时（R2=0.139），只有孤独感仍然显著（p=0.034）。
研究结果表明，当照顾者经历低社会支持和孤独感，以及在照顾中很少有意义或目标时，与照顾相关的转录效应似乎最为明显。这些发现表明，优先减少照顾者孤独感的新干预策略的发展可能会对与照顾者健康相关的生物学机制产生有利影响。
