Association of physical activity, health-related outcomes, and patients' confidence in fighting cancer between cancer patients and family caregivers

Abstract

BACKGROUND/PURPOSE: Cancer affects patients and family caregivers, physically and psychologically. However, few studies investigated the effect of cancer on both. This study aims to investigate patient–caregiver dyads in terms of physical activity (PA) and health-related outcomes, as well as role of patients’ confidence in fighting cancer. METHODS: Two hundred and thirty-three mixed cancer patient–caregiver dyads completed an online questionnaire. Their associations were assessed by correlation coefficients in terms of International Physical Activity Questionnaire (IPAQ) and health-related outcomes including short form 12 (SF-12), Hospital Anxiety and Depression Scale (HADS), Pittsburg Sleep Quality Index (PSQI), and Perceived Stress Scale (PSS), plus a single item on confidence in fighting cancer. RESULTS: Mean age was 57.4 for patients and 53.6 for caregivers, and 59.2% of patients and 62.7% of caregivers were female. There were positive associations in PA (r = 0.156, p = 0.002) between the dyads. Most outcomes had positive associations in SF-12 mental health (MH) (r=0.249, p<0.001), HADS (anxiety: r=0.407, p<0.001; depression: r=0.424, p<0.001), PSQI (r=0.200, p=0.002), and PSS (r=0.385, p<0.001), but not for physical health (PH) (r=0.088, p=0.182). Patients’ confidence was negatively associated with their PSQI (r=-0.186, p=0.004), HADS-anxiety (r=-0.344, p<0.001), depression (r=-0.429, p<0.001), and PSS (r=-0.382, p<0.001) and positively associated with PH (r=0.259, p<0.001) and MH (r=0.278, p<0.001), but not for PA (r=0.078, p=0.250). Patients’ confidence was negatively associated with caregivers’ PSQI (r=-0.196, p=0.003), HADS-anxiety (r=-0.294, p<0.001), depression (r=-0.331, and PSS (r=_0.266, p<0.001) and positively associated with MH (r=0.247, p<0.001) and PA (r=0.211, p<0.001), but not for PH (r = 0.105, p = 0.110). CONCLUSIONS: This study indicated close association in terms of PA and health-related outcomes between cancer patient and caregiver dyads, and patients’ confidence in fighting cancer also plays an important role in shaping their behavior and health outcomes. Research Implications: This study demonstrated the close associations in physical activity and health-related outcomes between cancer patient and caregiver dyads, which implied that their behavior and health-related conditions influence each other. In addition, to enhance the patients’ confidence in fighting cancer will be an important strategy in reducing their negative symptoms and improving their healthy behavior and health-related quality of life for the dyads. Practice Implications: This study offers hints on designing intervention for cancer patients–caregivers dyad. It might shed light on enhancing patients’ confidence in fighting cancer for the improvement of physical activity and health-related outcomes for both patients and caregivers. Validated scales of self-efficacy and self-esteem should be used in future studies instead of a single item on confidence of fighting cancer.