The Dyadic Cancer Outcomes Framework: A general framework of the effects of cancer on patients and informal caregivers

Tess Thompson, Dana Ketcher, Tamryn F. Gray, Erin E. Kent

Research output: Contribution to journalReview articlepeer-review

Abstract

It is widely acknowledged that cancer affects not only patients but also their friends and family members who provide informal, and typically unpaid, care. Given the dual impact that cancer often has on patients and their informal caregivers (i.e., family members, partners, or friends), an expanded dyadic framework that encompasses a range of health and psychosocial outcomes and includes primary caregivers with a range of relationships to the patients is critically needed. Moreover, an emphasis on the role of social and contextual factors may help the framework resonate with a broader range of patient-caregiver relationships and allow for the development of more effective dyadic interventions. This article describes the development of the Dyadic Cancer Outcomes Framework, which was created to guide future research and intervention development. Using an iterative process, we conducted a conceptual review of currently used dyadic and/or caregiving models and frameworks and developed our own novel dyadic framework. Our novel Dyadic Cancer Outcomes Framework highlights individual- and dyad-level predictors and outcomes, as well as incorporating the disease trajectory and the social context. This framework can be used in conjunction with statistical approaches including the Actor Partner Interdependence Model to evaluate outcomes for different kinds of partner-caregiver dyads. This flexible framework can be used to guide intervention development and evaluation for cancer patients and their primary caregivers, with the ultimate goal of improving health, psychosocial, and relationship outcomes for both patients and caregivers. Future research will provide valuable information about the framework's effectiveness for this purpose.

Original languageEnglish (US)
Article number114357
JournalSocial Science and Medicine
Volume287
DOIs
StatePublished - Oct 2021
Externally publishedYes

Bibliographical note

Funding Information:
Dr. Thompson was supported by a Mentored Research Scholar Grant from the American Cancer Society (MRSG-19-086-01-CPPB, PI: Thompson). Dr. Ketcher was funded through the National Cancer Institute (5T32CA090314-16). Dr. Gray was supported by the Cambia Health Foundation Sojourns Scholar Leadership Program and the Robert Wood Johnson Foundation Future of Nursing Scholars Program. The authors would like to acknowledge the Harvard Research Methods in Supportive Oncology Workshop (NCI R25 CA 181000), where they developed the idea for this paper.

Funding Information:
Dr. Thompson was supported by a Mentored Research Scholar Grant from the American Cancer Society ( MRSG-19-086-01-CPPB , PI: Thompson). Dr. Ketcher was funded through the National Cancer Institute ( 5T32CA090314-16 ). Dr. Gray was supported by the Cambia Health Foundation Sojourns Scholar Leadership Program and the Robert Wood Johnson Foundation Future of Nursing Scholars Program. The authors would like to acknowledge the Harvard Research Methods in Supportive Oncology Workshop (NCI R25 CA 181000), where they developed the idea for this paper.

Publisher Copyright:
© 2021

Keywords

  • Cancer
  • Caregiving
  • Dyadic research
  • Family
  • Patient-reported outcomes
  • Social determinants of health

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