Three our of four families in the United States will have at least one family member diagnosed with cancer. In many of these families, one of more members be responsible for providing care to the cancer patient. Family caregiving is likely to grow as the delivery of cancer treatment continues to move into the outpatient setting and treatment-related side- effects must be managed at home. Outpatient treatment may serve to reduce expenditures; however, this must be weighed against the potential impact that caring for a relative with cancer may have on family members'quality of life (i.e. mental and physical health). Attention to caregiving issues is important in order to understand how this major, unpaid segment of our health care system works and what we can do to minimize the stress of caregiving. TO address these issues, we propose to conduct a study whose aims are: (1) to determine the impact that caregiving has on the quality of life (QOL) of spouses of cancer patients; (2) to test the explanatory value of a stress process model designed to predict individual differences in QOL among spousal caregiver; (3) to further evaluate the validity and factor structure of an instrument specifically designed to measure the QOL of caregivers of patients with cancer; and (4) to evaluate a stress process model-based coping skills intervention designed to improve caregiver's QOL. The proposed research will be conducted in two phases. The first phase will be controlled cross-sectional study comparing the QOL of spousal caregivers of cancer patients to that of noncaregivers. The impact of caregiving on quality of life will be evaluated further by conducting standardized assessments of stress appraisal, coping, and social support and determining how these variables affect depression, overall physical health. Through completion of these standardized assessments, we will able to test the explanatory value of the stress process model and evaluate the validity of a cancer caregiver QOL measure developed by the principal investigator. The second phase of the research will consist of an evaluation of a coping skills intervention based on as tress process model and designed to improve the QOL of distressed spousal caregivers. We will study the clinical effectiveness of this intervention using a randomized controlled experimental design that includes standardized assessments of depression, overall physical health before and after the intervention to determine changes in QOL.
