Does blaming the patient with lung cancer affect the helping behavior of primary caregivers?

Abstract

Purpose/objectives: To examine whether primary caregivers' helping behaviors are predicted by their illness attribution reactions as proposed in Weiner's model.

Design: Latent-variable structural equation modeling.

Setting: Five oncology outpatient settings in central Canada.

Sample: 100 dyads consisting of patients with lung cancer and their primary caregivers.

Methods: Self-report questionnaires, abstracted medical record data, confirmatory factor analysis, and structural equation modeling.

Main research variables: Smoking history, judgments of responsibility for controlling the disease, anger, pride, and helping behaviors.

Findings: An interrelation was seen between judgments of responsibility toward patients to control aspects of the disease, affective reactions of anger and pride, and helping behavior. Anger and pride had a stronger influence on helping behavior than smoking history did.

Conclusions: Judgments of responsibility for controlling lung cancer and anger toward patients put caregivers at risk for dysfunctional helping behavior, particularly if patients had a history of tobacco use.

Implications for nursing: Primary caregivers' affective states directly affect their helping behavior toward patients with lung cancer. Clinicians should be aware that caregivers who perceive the patient to be largely responsible for managing the disease also may be angry toward that patient. Angry caregivers are at risk of providing suboptimal helping behavior.