Thompson Tess, Rodebaugh Thomas L, Haun Polly, Han Karin, Ramchander Naitra, Chauhan Krutika, Meads Jada, Margenthaler Julie A, Glover-Collins Katherine, Colditz Graham A
School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Cancer Control. 2025 Jan-Dec;32:10732748251362950. doi: 10.1177/10732748251362950. Epub 2025 Aug 6.
IntroductionHealth and psychosocial outcomes are often interdependent for people with cancer and their informal caregivers. However, few studies have examined interdependence among U.S. Black patients and their caregivers. In this prospective study, we analyzed whether Black women with breast cancer and their caregivers demonstrated interdependence in depressive symptoms and other outcomes over time.MethodsPatient and caregiver data were collected via telephone surveys at three timepoints (baseline, two months, four months). Actor-Partner Interdependence Models (random-intercept cross-panel models in Mplus) were used to analyze depressive symptoms (Center for Epidemiology Studies Depression scale; CES-D), physical and mental health quality of life, perceived social support, and health behaviors. We hypothesized patients and caregivers would demonstrate interdependence for these outcomes both cross-sectionally and over time.ResultsWe enrolled 210 participants. All patients and 93% of caregivers identified as Black/African American; 70% of caregivers identified as female. Two-thirds (66%) of dyads did not live together. Mean baseline CES-D score was 15.0 ( = 10.9) for patients and 11.9 ( = 9.0) for caregivers. We did not find prospective interdependence for any outcomes. Dyad members were moderately correlated in overall levels (intercepts) of physical health quality of life ( = .25), mental health quality of life ( = .28), social support ( = .37), and health behavior scores ( = .33).ConclusionThis study is one of the first longitudinal, dyadic examinations of outcomes for Black breast cancer patients and their informal caregivers. Although our hypothesis of prospective interdependence was not supported, we observed moderate correlations of overall levels of several measures. These results suggest that patients with lower social support, poor health behaviors, and worse quality of life may also have caregivers who could benefit from intervention.
引言
健康和心理社会结果对于癌症患者及其非正式照护者而言往往相互依存。然而，很少有研究考察美国黑人患者及其照护者之间的相互依存关系。在这项前瞻性研究中，我们分析了患有乳腺癌的黑人女性及其照护者在抑郁症状和其他结果方面是否随时间呈现相互依存关系。
方法
通过电话调查在三个时间点（基线、两个月、四个月）收集患者和照护者的数据。采用行为者 - 伙伴相互依存模型（Mplus中的随机截距交叉面板模型）来分析抑郁症状（流行病学研究中心抑郁量表；CES - D）、身心健康生活质量、感知到的社会支持和健康行为。我们假设患者和照护者在这些结果方面在横断面和随时间上都会呈现相互依存关系。
结果
我们招募了210名参与者。所有患者以及93%的照护者自认为是黑人/非裔美国人；70%的照护者为女性。三分之二（66%）的二元组不住在一起。患者的平均基线CES - D评分为15.0（标准差 = 10.9），照护者为11.9（标准差 = 9.0）。我们未发现任何结果存在前瞻性相互依存关系。二元组成员在身心健康生活质量（相关系数 = 0.25）、心理健康生活质量（相关系数 = 0.28）、社会支持（相关系数 = 0.37）和健康行为得分（相关系数 = 0.33）的总体水平（截距）上呈中度相关。
结论
本研究是对黑人乳腺癌患者及其非正式照护者的结果进行的首批纵向二元组研究之一。尽管我们关于前瞻性相互依存关系的假设未得到支持，但我们观察到几项指标总体水平之间存在中度相关性。这些结果表明，社会支持较低、健康行为较差且生活质量较差的患者可能也有照护者，这些照护者可能会从干预中受益。
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