Article

Linkages Among Empathic Behaviors, Physical Symptoms, and Psychological Distress in Patients With Ovarian Cancer: A Pilot Study

Michelle M. Lobchuk

Sonia Anwer Bokhari

health behaviors, distress, symptom
ONF 2008, 35(5), 808-814. DOI: 10.1188/08.ONF.808-814

Purpose/Objectives: To explore linkages among empathic responding by informal caregivers with the physical symptom experiences and psychological distress of patients with ovarian cancer.

Design: Preliminary, descriptive, correlational, and cross-sectional.

Setting: Psychosocial oncology support group in Canada.

Sample: Convenience sample of 13 women with stage I-IV ovarian cancer with the majority diagnosed with disease recurrence.

Methods: Data were collected on a single telephone call using the Hospital Anxiety and Depression Scale, the Empathic Responding Scale, the Memorial Symptom Assessment Scale, and the Dyadic Perspective-Taking Scale. Analysis included a correlation of variables.

Main Research Variables: Empathic responding, physical symptom experiences, and psychological distress.

Findings: Preliminary findings provided partial support for linkages among the perceived empathic behaviors of informal caregivers and the psychological distress and physical symptom experiences of patients with ovarian cancer. Patients who were more depressed reported elevated symptom experiences. Patients also reported more anxiety and depression when they perceived that their informal caregivers were engaging in less empathic behaviors toward them.

Conclusions: The empathic behavior of informal caregivers toward patients appeared to be related to lower levels of anxiety and depression in patients with end-stage ovarian cancer.

Implications for Nursing: Clinicians need to be aware that anxiety and depression in patients with ovarian cancer appear to be related to the patients' physical symptom experiences and the degree of empathic support the patients perceive from their informal caregivers. This has implications for clinical assessment of patients' anxiety and depression, physical symptoms, and available empathic social support.

Jump to a section

    References

    American Cancer Society. (2008). Cancer facts and figures 2008. Atlanta, GA: Author.
    Ben-Zur, H., Gilbar, O., & Lev, S. (2001). Coping with breast cancer: Patient, spouse, and dyad models. Psychosomatic Medicine, 63(1), 32-39.
    Bodurka-Bevers, D., Basen-Engquist, K., Carmack, C. L., Fitzgerald, M. A., Wolf, J. K., De Moor, C., et al. (2000). Depression, anxiety, and quality of life in patients with epithelial ovarian cancer. Gynecologic Oncology, 78(3, Pt. 1), 302-308.
    Bokhari, S. A. (2007). Investigation of the linkage between empathic informal caregiver behaviors, physical symptom experiences, and psychological distress experienced by ovarian cancer patients. Unpublished thesis, University of Manitoba, Winnipeg, Canada.
    Canadian Cancer Society/National Cancer Institute of Canada. (2008). Canadian cancer statistics. Toronto, Canada: Author.
    Luker, K. A., Beaver, K., Leinster, S. J., & Owens, R. G. (1996). Meaning of illness for women with breast cancer. Journal of Advanced Nursing, 23(6), 1194-1201.
    Manne, S. L., & Schnoll, R. (2001). Measuring cancer patients' psychological distress and well-being: A factor analytic assessment of the Mental Health Inventory. Psychological Assessment, 13(1), 99-109.
    Chen, M. L., Chang, H. K., & Yeh, C. H. (2000). Anxiety and depression in Taiwanese cancer patients with and without pain. Journal of Advanced Nursing, 32(4), 944-951.
    Coyne, J. C., & Bolger, N. (1990). Doing without social support as an explanatory concept. Journal of Social and Clinical Psychology, 9(1), 148-158.
    Ell, K. (1996). Social networks, social support and coping with serious illness: The family connection. Social Science and Medicine, 42(2), 173-183.
    Ferrell, B. R., Smith, S. L., Ervin, K. S., Itano, J., & Melancon, C. (2003). A qualitative analysis of social concerns of women with ovarian cancer. Psycho-Oncology, 12(7), 647-663.
    Fitch, M. I., Gray, R. E., & Franssen, E. (2001). Perspectives on living with ovarian cancer: Older women's views. Oncology Nursing Forum, 28(9), 1433-1442.
    Herschbach, P., Keller, M., Knight, L., Brandl, T., Huber, B., Henrich, G., et al. (2004). Psychological problems of cancer patients: A cancer distress screening with a cancer-specific questionnaire. British Journal of Cancer, 91(3), 504-511.
    Hipkins, J., Whitworth, M., Tarrier, N., & Jayson, G. (2004). Social support, anxiety and depression after chemotherapy for ovarian cancer: A prospective study. British Journal of Health Psychology, 9(Pt. 4), 569-581.
    Howell, D., Fitch, M. I., & Deane, K. A. (2003). Women's experiences with recurrent ovarian cancer. Cancer Nursing, 26(1), 10-17.
    Jarvis, G. E., Kirmayer, L. J., Weinfeld, M., & Lasry, J. C. (2005). Religious practice and psychological distress: The importance of gender, ethnicity, and immigrant status. Transcultural Psychiatry, 42(4), 657-675.
    Jefferies, H. (2002). Ovarian cancer patients: Are their informational and emotional needs being met? Journal of Clinical Nursing, 11(1), 41-47.
    Jemal, A., Siegel, R., Ward, E., Murray, T., Xu, J., & Thun, M. J. (2007). Cancer statistics, 2007. CA: A Cancer Journal for Clinicians, 57(1), 43-66.
    Kelly, C., Ghazi, F., & Caldwell, K. (2002). Psychological distress of cancer and clinical trial participation: A review of the literature. European Journal of Cancer Care, 11(1), 6-15.
    Kornblith, A. B., Regan, M. M., Kim, Y., Greer, G., Parker, B., Bennett, S., et al. (2006). Cancer-related communication between female patients and male partners scale: A pilot study. Psycho-Oncology, 15(9), 780-794.
    Kornblith, A. B., Thaler, H. T., Wong, G., Vlamis, V., McCarthy-Lepore, J., Loseth, D. B., et al. (1995). Quality of life of women with ovarian cancer. Gynecologic Oncology, 59(2), 231-242.
    Kramer, B. J. (1993). Expanding the conceptualization of caregiver coping: The importance of relationship-focused coping strategies. Family Relations, 42(4), 383-391.
    Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. New York: Springer Publishing.
    Lobchuk, M. M. (2001). Family caregiver "perspective-taking": A determinant of "empathic" accuracy on symptom experience in advanced stage cancer patients. Unpublished doctoral dissertation, University of Manitoba, Winnipeg, Canada.
    Lobchuk, M. M., & Stymeist, D. (1999). Symptoms as meaningful "family culture" symbols in palliative care. Journal of Palliative Care, 15(4), 24-31.
    Long, E. C. J. (1990). Measuring dyadic perspective-taking: Two scales for assessing perspective-taking in marriage and similar dyads. Educational and Psychological Measurement, 50(1), 91-103.
    Manne, S. L., Taylor, K. L., Dougherty, J., & Kemeny, J. (1997). Supportive and negative responses in the partner relationship: Their association with psychological adjustment among individuals with cancer. Journal of Behavioral Medicine, 20(2), 101-125.
    McCorkle, R., Pasacreta, J., & Tang, S. T. (2003). The silent killer: Psychological issues in ovarian cancer. Holistic Nursing Practice, 17(6), 300-308.
    Merluzzi, T. V., & Martinez Sanchez, M. A. (1997). Perceptions of coping behaviors by persons with cancer and health care providers. Psycho-Oncology, 6(3), 197-203.
    Munro, B. H. (2001). Statistical methods for health care research (4th ed.). Philadelphia: Lippincott Williams and Wilkins.
    Nordin, K., Berglund, G., Glimelius, B., & Sjoden, P. O. (2001). Predicting anxiety and depression among cancer patients: A clinical model. European Journal of Cancer, 37(3), 376-384.
    Norton, T. R., Manne, S. L., Rubin, S., Carlson, J., Hernandez, E., Edelson, M. I., et al. (2004). Prevalence and predictors of psychological distress among women with ovarian cancer. Journal of Clinical Oncology, 22(5), 919-926.
    Norton, T. R., Manne, S. L., Rubin, S., Hernandez, E., Carlson, J., Bergman, C., et al. (2005). Ovarian cancer patients' psychological distress: The role of physical impairment, perceived unsupportive family and friend behaviors, perceived control, and self-esteem. Health Psychology, 24(2), 143-152.
    O'Brien, T. B., & Delongis, A. (1996). The interactional context of problem-, emotion-, and relationship-focused coping: The role of the big five personality factors. Journal of Personality, 64(4), 775-813.
    Petersen, R. W., & Quinlivan, J. A. (2002). Preventing anxiety and depression in gynaecological cancer: A randomised controlled trial. British Journal of Obstetrics and Gynaecology, 109(4), 386-394.
    Pistrang, N., Barker, C., & Rutter, C. (1997). Social support as conversation: Analysing breast cancer patients' interactions with their partners. Social Science and Medicine, 45(5), 773-782.
    Portenoy, R. K., Kornblith, A. B., Wong, G., Vlamis, V., Lepore, J. M., Loseth, D. B., et al. (1994). Pain in ovarian cancer patients. Prevalence, characteristics, and associated symptoms. Cancer, 74(3), 907-915.
    Portenoy, R. K., Thaler, H. T., Kornblith, A. B., Lepore, J. M., Friedlander-Klar, H., Kiyasu, E., et al. (1994). The Memorial Symptom Assessment Scale: An instrument for the evaluation of symptom prevalence, characteristics, and distress. European Journal of Cancer, 30A(9), 1326-1336.
    Soukhanov, A. (Ed.). (1996). The American heritage dictionary of the English language (3rd ed.). Boston: Houghton Mifflin Publishing.
    Symister, P., & Friend, R. (2003). The influence of social support and problematic support on optimism and depression in chronic illness: A prospective study evaluating self-esteem as a mediator. Health Psychology, 22(2), 123-129.
    Thomas, C. L. (Ed.). (1997). Taber's cyclopedic medical dictionary (18th ed.). Philadelphia: F. A. Davis.
    Zabora, J., BrintzenhofeSzoc, K., Curbow, B., Hooker, C., & Piantadosi, S. (2001). The prevalence of psychological distress by cancer site. Psycho-Oncology, 10(1), 19-28.
    Zigmond, A. S., & Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavia, 67(6), 361-370.
    Zimmerman, L., Story, K. T., Gaston-Johansson, F., & Rowles, J. R. (1996). Psychological variables and cancer pain. Cancer Nursing, 19(1), 44-53.