Paper
Monday, November 5, 2007
462
Biobehavioral Interactions in Neuro-Oncology Caregivers
Paula R. Sherwood, PhD, RN, CNRN1, Heidi Donovan, PhD, RN1, Barbara A. Given, RN, PhD, FAAN2, Allison Hricik, MS, BS1, Catherine M. Bender, RN, PhD3, Alyssa G. Newberry1, Sarah Bradley, BS1, and Frank Lieberman, MD4. (1) School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA, (2) College of Nursing, Michigan State University, East Lansing, MI, USA, (3) Department of Acute and Tertiary Care, University of Pittsburgh, Pittsburgh, PA, USA, (4) Neurology, University of Pittsburgh, Pittsburgh, PA, USA
| Learning Objective #1: describe how IL-1 and IL-6 may change as a response to the stress of providing care. |
| Learning Objective #2: identify psycho-behavioral responses associated with changes in immune function. |
Although negative biological and behavioral responses have been identified in family caregivers, little research has examined bio-behavioral interactions in caregivers, particularly over the course of the care situation. The purpose of this longitudinal, descriptive pilot study, based on the Pittsburgh Mind Body Center Model, was to evaluate whether changes in caregivers’ biological responses [measured by interleukin (IL) 1 and 6] are associated with changes in behavioral responses to care. Ten adult caregivers (
³21 years of age) of persons with a primary malignant brain tumor were recruited within one month of diagnosis. Data were collected at baseline and 3-months. Behavioral responses (e.g. anxiety, sleep disturbance) were gathered via telephone interviews. Specimens for IL-1 and IL-6 were obtained via venipuncture and analyzed using enzyme-linked immunosorbent assays. Spearman’s rho coefficients were generated and p≤.07 was considered meaningful due to the small sample size. Several bio-behavioral relationships were found. A decrease in social support during the first three months following diagnosis was associated with an increase in IL-6 (r = -.87, p=.02). Similarly, a decrease in caregivers’ sleep quality was associated with an increase in IL-6 (r = -.90, p=.04). An increase in caregiver anxiety was associated with an increase in IL-1 levels (r = .77, p=.07). These preliminary data suggest caregivers may be at risk for altered immune function resulting from behavioral responses to the stress of providing care, which may occur as early as the first three months following the care recipient’s diagnosis. Data also underscore the importance of concomitantly assessing biological and behavioral phenomena when evaluating an individual’s response to stress. Results may help health care practitioners identify which caregivers will suffer negative physical health as a result of the stress of providing care, so that interventions to lessen caregiver distress may be implemented.