Predictors of psychoneurological symptoms in cancer caregivers over time: Role of caregiving burden, stress, and patient symptoms.

PURPOSE: In cancer patients, stress is associated with a psychoneurologic (PN) symptom cluster of depressed mood, anxiety, pain, fatigue, and sleep disturbance. The stress of caregiving may trigger similar symptoms among caregivers and warrants investigation. The purpose of this analysis was to characterize correlates of PN symptom burden in cancer caregivers. METHODS: Cancer patient-caregiver dyads (n = 29) provided eight weekly symptom reports using a web-based survey. Primary and secondary stressors of caregiving were also assessed. Mixed models accounting for repeated measurement were used to assess the between- and within-dyad predictors of caregiver PN symptom burden. The interaction of patient PN symptom burden and stress was tested. Exploratory cross-lagged Actor-Partner Interdependence Models were used to assess the week-to-week interdependence between patient and caregiver symptoms. RESULTS: Caregivers most frequently reported feeling anxious (44% on average across timepoints), sleep problems (31%), fatigue (25%), and depressed mood (24%). Mixed models indicated that within dyads, greater hours of care and more patient symptoms were associated with greater caregiver PN symptom burden. Greater baseline perceived stress was also associated with higher caregiver PN symptom burden and moderated the association between patient and caregiver PN symptom burden. Cross-lagged Actor-Partner Interdependence Models indicated longitudinal interdependence among survivor and caregiver symptom burden. CONCLUSIONS: The findings provide preliminary evidence of the interrelationship of PN symptom burden in caregivers and patients and the potential for stress to amplify this interrelationship, with implications for symptom management and supportive care practice.

A Systematic Review of the Characteristics and Effects of Physical Activity Interventions on Physical Activity Engagement, Long-Term and Late Effects, and Quality of Life in Adolescent and Young Adult Cancer Survivors.

Physical activity (PA) may minimize long-term and late effects experienced by cancer survivors. However, the efficacy of PA interventions in increasing PA engagement among adolescent and young adult (AYA) cancer survivors diagnosed between 15 and 39 is not well understood. This systematic review aimed to examine the effects of moderate- to high-intensity or strength training PA interventions on PA engagement in AYA cancer survivors. Secondary aims included describing intervention components unique to efficacious interventions, identifying symptom management in PA interventions, and evaluating intervention effects on quality of life (QoL), and long-term or late effects of cancer. We searched PubMed, CINAHL, PsycINFO, SportDiscus, Cochrane Library, and Scopus databases from inception to August 2022 and identified 12 articles, including 8 randomized controlled trials and 4 quasi-experimental studies. The effect of PA interventions on PA engagement was mixed, with four studies reporting increases in PA engagement ranging from 18.4 to 113.8 min/week postintervention. There was great diversity in PA intervention components. Motivational interviewing, supervised and unsupervised PA sessions together, moderate-intensity PA only, and mindful meditation were components unique to efficacious interventions. No intervention incorporated symptom management components. Studies provided some evidence of PA interventions on potential long-term effects of cancer, with positive impact on fatigue, and some evidence of improved anxiety, sleep, and QoL. Given limited research with AYA cancer survivors, additional research is needed to identify effective intervention components, integrate symptom management strategies into PA interventions, and track effects of PA interventions on late and long-term effects of cancer in this population.