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Activity restriction and prior relationship history as contributors to mental health outcomes among middle-aged and older spousal caregivers

In a sample of cancer patients (n = 75) and spousal caregivers (24 men and 51 women), restriction in caregiver routine activities mediated associations between caregiving stress (patient symptom severity) and caregiver depressed affect and resentment. Moreover, the antecedents and affective consequences of caregiver activity restriction were consistent with the theory of communal relationships. If a relationship had been communal in the past (i.e., characterized by mutual concern for and responsiveness to one another’s needs), activity restriction was predicted by intimacy and affectional loss (rather than by the severity of patient symptoms) and in turn predicted caregiver depressed affect. Among caregivers in less communal relationships, activity restriction was predicted by severity of patient symptoms (rather than by intimacy and affectional loss) and in turn predicted resentment of care recipients and the caregiving role.

Data from our total sample of cancer patients and their spousal caregivers supported this model. That is, activity restriction totally mediated associations between caregiving stress (operationalized as the severity of patient symptoms) and caregiver resentment and depressed affect. In other words, the severity of patient symptoms was associated with negative affective outcomes for caregivers largely to the extent that it disrupted caregivers’ normal activities. Thus, a process model in which activity restriction is conceptualized as a pivotal factor in the relation between stress and psychosocial outcomes holds for family care providers as well as for patients studied in previous research.


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