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Family Caregivers and Guilt in the Context of Cancer Care

Received March 8, 2006; revised February 16, 2007; accepted February 28, 2007. From the American Cancer Society; University of California, Los Angeles; Univ. of Miami; the Medical College of Wisconsin; and New York Medical College. Send correspondence and reprint requests to Rachel L. Spillers, Behavioral Research Center, American Cancer Society, 250 Williams St. NW, Atlanta, GA 30303-1002. e-mail: rachel.spillers{at}cancer.org
© 2008 The Academy of Psychosomatic Medicine

BACKGROUND: Guilt as a key emotional phenomenon in the cancer-caregiving experience is an understudied issue. OBJECTIVE: The purpose of this study is to identify demographic characteristics of cancer caregivers and care-related stress factors that are associated with their feelings of caregiver guilt, as well as to explore the effect of caregiver guilt on their adjustment outcomes. METHOD: A total of 739 caregivers of cancer survivors completed a survey (66.7% response rate), of which 635 provided complete data for the measures in this study. RESULTS: Hierarchical regression analyses revealed that certain caregiver demographics (i.e., younger age, adult offspring, employed) and care-related stress factors (i.e., greater impact on schedule, less perceived caregiving competence, poorer overall health of the care-recipient) were significantly related to caregiver guilt. Higher levels of psychological distress and poorer mental, social, and physical functioning were significantly associated with caregiver guilt, above and beyond the variance accounted for by the covariates. CONCLUSION: Results suggest that caregiver guilt compromises the psychosocial and somatic adjustment of cancer caregivers. Guilt may be a cardinal feature of the caregiving experience, and to fully understand the implications of this complex phenomenon, more research is needed.

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