Persons with a primary malignant brain tumor (PMBT) often suffer significant functional and neurologic morbidity causing family caregivers to assume the care recipient's familial, social, and financial obligations. Research has shown that caregivers of persons with other chronic diseases develop negative consequences as a result of providing care. Despite high morbidity (and mortality) rates for persons with a PMBT, caregiver issues in neuro-oncology have been virtually ignored. In response to PA-05-027, the purposes of this study are to use a multidisciplinary, integrative model, the Pittsburgh Mind Body Center Model, to (1) examine the psycho-behavioral responses (i.e. depressive symptoms and sleep), biologic responses (i.e. blood pressure and ihterleukins) and overall physical health of family members of persons with a PMBT at the time of diagnosis, and (2) to describe how relationships within the model vary over time in response to changes in the care recipient's illness trajectory as the family member transitions to a family caregiver.
The specific aims of the project are to: 1) examine how care recipients' disease characteristics and caregivers' psycho- behavioral responses, biologic responses, and overall physical health change over time (from PBMT diagnosis to 12 months after diagnosis); and during this 12-month period, to 2) examine how caregivers' personal characteristics moderate the relationship between care recipients' disease characteristics and caregivers' psycho-behavioral responses; 3) examine how caregiver psycho-behavioral responses mediate the relationship between care recipients' disease characteristics and caregivers' biologic responses; and 4) examine how caregivers' biologic responses mediate the relationship between their psycho-behavioral responses and overall physical health. A descriptive longitudinal design will be used to collect data to address the aims of the project. Linear and logistic regression analysis will be used to model baseline responses. Repeated measures analysis (random coefficients modeling) will be used to examine change over time and latent growth curve modeling will be used to further explore longitudinal data. The relevance of the project to public health is to identify caregivers at specific time-points during the care recipient's disease trajectory who are vulnerable to changes in their emotional and physical health. Improving caregivers' emotional and physical health may improve the delivery of care and quality of life for the care recipient. ? ? ?
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