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Racial Variation in the Cancer Caregiving Experience: A Multisite Study of Colorectal and Lung Cancer Caregivers

Martin, Michelle Y. PhD; Sanders, Sara PhD; Griffin, Joan M. PhD; Oster, Robert A. PhD; Ritchie, Christine MD, MPSH; Phelan, Sean M. PhD, MPH; Atienza, Audie A. PhD; Kahn, Katherine MD; van Ryn, Michelle PhD

doi: 10.1097/NCC.0b013e3182330850

Background: As cancer care shifts from hospital to outpatient settings, the number of cancer caregivers continues to grow. However, little is known about the cancer caregiving experience. This gap in knowledge is especially evident for racially diverse caregivers.

Objective: This study, part of a multisite study of care recipients with either lung or colorectal cancer and their caregivers, examined the caregiving experiences of African American (AA) and white caregivers.

Methods: Caregivers were identified by cancer patients in the Cancer Care Outcomes Research and Surveillance consortium. Caregivers completed a self-administered, mailed questionnaire that assessed their characteristics and experiences. Analysis of covariance was used to compare racial groups by objective burden and caregiving resources while controlling for covariates.

Results: Despite greater preparedness for the caregiving role (P = .006), AA caregivers reported more weekly hours caregiving than whites did (26.5 ± 3.1 vs 18.0 ± 1.7; P = .01). In later phases of caregiving, AAs reported having more social support (P = .02), spending more hours caregiving (31.9 ± 3.5 vs 16.9 ± 1.9; P < .001), and performing more instrumental activities of daily living on behalf of their care recipient (P = .021).

Conclusion: Racial differences in the caregiving experience exist.

Implications for Practice: Nurses play a key role in educating cancer patients and their caregivers on how to effectively cope with and manage cancer. Because AA caregivers seem to spend more time in the caregiving role and perform more caregiving tasks, AA caregivers may benefit from interventions tailored to their specific caregiving experience.

Author Affiliations: University of Alabama at Birmingham, Alabama (Drs Martin and Oster); School of Social Work, University of Iowa, Iowa City (Dr Sanders); Minneapolis VA Medical Center, Center for Chronic Disease Outcomes Research and University of Minnesota (Dr Griffin); Birmingham VA Medical Center Geriatric Research, Education and Clinical Center and University of Alabama at Birmingham (Dr Ritchie); University of Minnesota, Twin Cities, Minneapolis (Drs Phelan and van Ryn); National Cancer Institute, Bethesda, Maryland (Dr Atienza); RAND Corporation, Santa Monica and David Geffen School of Medicine, University of Los Angeles, California (Dr Kahn). 

This study was supported by grants from the National Cancer Institute (U01 CA93324, U01 CA93326, U01 CA93329, U01 CA93332, U01 CA93339, U01 CA93344, and U01 CA93348) and the Department of Veterans Affairs (CRS 02-164).

The views expressed in this article represent those of the authors and not of the National Cancer Institute.

The authors have no conflicts of interest to disclose.

Correspondence: Michelle Y. Martin, PhD, Division of Preventive Medicine, University of Alabama at Birmingham, 1530 3rd Ave S, MT 617, Birmingham, AL 35294-1150 (

Accepted for publication August 13, 2011.

© 2012 Lippincott Williams & Wilkins, Inc.