Thursday, January 17, 2013
Author on Call Blog (36:1) Part 2
Enjoy the following dialogue between Dr. Pam Hinds and Dr. Brenda Sabo with Dr. Deborah McLeod, two of the authors of the article “The Experience of Caring for a Spouse Undergoing Hematopoietic Stem Cell Transplantation: Opening Pandora's Box” published in CANCER NURSING Volume 36 Issue 1. We look forward to receiving your feedback! Please leave comments or questions for Drs. Sabo and McLeod on our blog.
Dr. Hinds: On page 2, a statement is made 'rather than respond to the situation on an individual level, families and cancer patients react to cancer and its treatment as one emotional system'. Is vulnerability of the caregiver also experienced as a family/ as a couple?
Dr. Sabo and Dr. McLeod: A family systems lens invites one to think about families on an interactional level. Family members are understood to be affected by multiple interactions at the micro, meso, macro and exo levels. From this perspective, vulnerability of the caregiver would certainly affect other members of the family. Vulnerability experienced by one member of a family or a couple would have a reciprocal effect on other members of the family. If the caregiver experiences distress it would seem reasonable to suggest that the family or couple, as a whole, would interpret and react to that distress.
Dr. Hinds: What additional reasons might there be for the discrepancy between the interview and questionnaire data at the 6 month post-transplant data point?
Dr. Sabo and Dr. McLeod: Interviews provided an opportunity to delve more deeply into the personal experience of caregiving and the meaning given to this role by spouses as life unfolded for them post-transplant. While the questionnaires at the 6 month post-transplant point suggested a decrease in the overall risk for depression and secondary trauma, caregiver burden (quality of life) remained relatively low. Since the questionnaires targeted depression, secondary trauma and caregiver burden, other factors such as ongoing waiting for a return to normal, continuance of the caregiver role rather than a return to spousal role and pre-illness role-related tasks and their meaning may not be adequately captured by these instruments.