| The overall purpose of this dissertation research was to increase the understanding of biopsychosocial factors affecting health in young caregivers of cancer patients. The aims of this research were to: identify competing conceptualizations of the effects of caregiving, to present a multidimensional framework with which to examine the caregiver experience from a biopsychosocial perspective, and to test the feasibility of a methodology for studying relationships among contextual, intervening, and outcome variables related to stress and health outcomes in spouses of patients with cancer. Literature was reviewed to form the basis of a concept analysis and theory construction. These were used as the basis for the design of the pilot study. The framework for this study combines aspects of the Transactional Model of Stress, Appraisal, and Coping with Psychoneuroimmunology (PNI). A descriptive, cross-sectional design was used. The convenience sample consisted of spouses of patients with a non-recurrent, non-terminal diagnosis of cancer who were diagnosed within the previous 12 months. The couples were all parents with at least one dependent child. Measures included both self-report and physiological measures of stress, health, and immune function. Physiologic stress was measured by salivary cortisol assay, and immune function by salivary secretory IgA. Data were analyzed by Pearson, Spearman and eta correlations, and the size and direction of correlations were analyzed according to theoretical expectations and previous research. In addition, the feasibility of the study methodology was evaluated. The sample included 13 subjects, and was 61.5% female Results of the correlational analyses revealed a mean morning cortisol level of 0.9036 ug/dL (SD = .1825 ug/dL), and mean sIgA level of 299.97 ug/ml (SD = 320.66 ug/ml). Potential problems with including salivary assays in research are discussed. It is uncertain whether sIgA is a good measure of the effects of chronic stress on immune function because acute stressors may be a confounding variable. Gender had a positive relationship with general health in this sample, with women having lower general health scores than men. Individuals with larger family incomes reported better general health, had higher sIgA levels and, unexpectedly, also had higher cortisol levels than lower income individuals. Further, lower income individuals reported higher perceived stress. High perceived stress was associated with lower general health scores regardless of occupational status or gender. (Abstract shortened by UMI.)... |
