Abstract
A diagnosis of colorectal cancer (CRC) and the treatment that follows is associated with considerable stress affecting both the patient and their caregiver. Whilst both patients and caregivers encounter numerous psychological and physical challenges across the duration of the cancer experience, the extent to which these challenges have an impact on both patients and caregivers can vary considerably. Positioned within the theoretical framework of the Transactional Model of Stress and Coping, this dissertation reports on two studies that explore the role of key variables, in accounting for differential outcomes in patients with CRC and their caregivers from a psychological and physiological perspective (through the measurement of telomere length).
The first study was a qualitative study (n = 20), which explored patients’ and caregivers’ experiences of social support within a treatment setting and the factors that limit or facilitate such support. The framework method of analysis revealed four themes: the treating team was identified as a source of social support; changes in existing supports were highlighted; different dimensions of support were reported; and evidence of dyadic coping emerged.
The second study explored two aims. The first aim was to explore relationships among telomere length, depression and anxiety, perceived social support, cognitive appraisal of health, and coping in patients and caregivers following a diagnosis of CRC (n = 72). No relationship between telomere length and other variables were found. The second aim was to explore whether variables from the Stress and Coping theoretical framework, namely patient/caregiver status, social support, appraisal and coping, would predict anxiety and depression in patients with CRC and their caregivers (n = 102). Hierarchical multiple regression analysis suggested differing results for anxiety and depression. Caregiver status and harm/loss appraisal were the only significant predictors of anxiety, while only harm/loss appraisal was a significant predictor of depression.
The findings of the dissertation are discussed in relation to theoretical underpinnings, highlighting avenues for future research, together with possible directions for clinical practice. The dissertation also highlights new knowledge, research limitations and implications that can help improve the understanding of psychosocial outcomes for CRC patients and their caregivers.