Addressing Unmet Care Needs in Breast Cancer Survivors and Caregivers: The Role of Family Resilience

About This Grant

PROJECT SUMMARY/ABSTRACT More than 80% of breast cancer survivors and nearly all family caregivers experience unmet supportive care needs during cancer treatment and throughout survivorship. These unmet supportive care needs are key factors that contribute to poor quality of life for cancer survivors and their caregivers. Emotional, informational, and relational needs are among the most reported unmet needs by cancer survivors and their caregivers, and result from gaps in cancer care services. Interventions to support the unmet needs of cancer survivors have provided no evidence of an underlying mechanism for reducing unmet needs for the survivors, and many caregiver interventions have yielded small effects. Given the known interdependence between cancer survivors and family caregivers’ well-being and the promising effects of mindful resilience-based interventions in other populations such as transplant patients, a systems-level resilience-based approach may be key in addressing these unmet needs. Family resilience, or the ability of family to rebound and grow from adversity, is associated with greater quality of life in cancer survivors and their caregivers. While the relationship between family resilience and unmet needs is unknown, there is evidence that more individual or intrapersonal resilience is associated with fewer unmet supportive care needs. Furthermore, as unmet needs change over the course of the illness trajectory and throughout survivorship, identifying a mechanism that adapts over time and leverages the strengths of the family to cope and manage needs is crucial. This observational cross- sectional study aims to determine the relationship between unmet supportive care needs, family resilience, and quality of life in breast cancer dyads (survivors and caregivers) during two phases of cancer care (active treatment and reentry phase). Using latent variable structural equation modeling, specifically the Actor-Partner Interdependence Model, we will examine whether family resilience partially mediates the relationship between unmet supportive care needs and quality of life in cancer dyads. This advanced statistical method allows us to simultaneously evaluate the actor effects (how we affect ourselves) of survivors’ unmet needs and family resilience on their own quality of life as well as the partner effects (how we affect each other) on their caregivers’ quality of life, and vice versa. A total of 260 dyads will be recruited from a large NCI designated Cancer Center serving over 47 communities in the Midwest and through online platforms throughout the US. Results from this study will identity a critical underlying mechanism, informing future research to design, test, and disseminate mindful resilience-based interventions for families experiencing cancer. The training plan consists of mentorship, courses, and workshops that will facilitate the development of expertise in dyadic research within the context of breast oncology as well as future mindful resilience-based intervention development.