For caregivers, the stress and isolation that comes with taking care of a loved one with cancer can be tremendous. A University of Iowa College of Nursing researcher is conducting a study to see if adult caregivers can use writing about their thoughts and feelings regarding care giving as a strategy to help manage stress. Howard Butcher, PhD, RN, LPMHCNS-BC, associate professor of nursing and principal investigator of the study, talks about the study:
Who is invited to participate in the study?
It's going to focus on:
- Caregivers who are 55 years or older
- Who are caring for a family member, friend, or relatives that have been diagnosed with cancer
- Who are living at home where they're caring for their loved one
- Who are not paid in this role
They need to be able to read English because all of the instruments are in English.
What will participants do as part of the study?
They call me and I'll answer any questions they have about the study and then arrange where we can meet. Usually I visit the person's home or where it's convenient for them. We need to meet once and I provide them with everything they need for the study.
The first meeting usually lasts about an hour or so. They complete all the pre-tests and I give them all the materials they need for the rest of the study, including the writing instructions. They will be asked to write on six occasions. Each writing session is no longer than 20 minutes, so it's pretty short. They can write any time during the day, a time of their convenience.
The writing instructions are in the envelopes and when they complete the writing, they complete the post-test. These are the same instruments they completed initially, but now they're completing them to see if they made a difference in terms of the writing. They mail all of the materials back in envelopes that are stamped and preaddressed.
Do participants have to have experience in writing or journaling?
None at all--matter of fact, the instructions for the writing is that you don't pay any attention to grammar, sentence structure, or spelling. The idea is to be able to write freely, without much effort. Write what you're feeling at that moment about being a caregiver and 20 minutes goes pretty fast, so you don't want to be restructuring your writing or anything like that. It's just kind of like a free-write and you don't need to be a person who even likes to write, necessarily, but it's an opportunity for you to express what your thoughts or feelings are of the experience.
Do they need to live or work in the Iowa City area to participate?
Pretty much in eastern Iowa because we need to meet somewhere and I go to their homes most of the times. When I did this study before, I drove anywhere within the eastern Iowa area and a couple places just over the Mississippi in the Illinois area. A couple hours driving distance between here and their home would be best. I've gone as far as Des Moines, though.
How long will the study last?
I want to collect data until I've collected data on 24--I'm looking for 24 caregivers. Their participation in the study, from the beginning to the end, is no more than five weeks because they finish out the post-tests on the 30 th and 31 st days after the last writing session. They don't need to devote much time to the study because the writing sessions themselves--and there are six of them all together--are only 20 minutes long.
What will the study be looking at in these participants?
We know that caregivers are stressed and have a lot of what we call caregiver burden. The measurement tools that are the pre-test and post-test tools, measures stress and caregiver burden.
One of the tools is called the "finding meaning tool". The reason the writing works is because it helps people make sense of their experience. I want to see if their sense of meaning has changed because of their writing. There are a couple tools to measures of stress, and one to measure their emotional state.
The other critical measure is that I'm actually measuring saliva cortisol, which is really easy to collect. I provide all the vials and there's a little piece of cotton in each vial. They put that piece of cotton in their mouth for a minute or two, they drop it in the vial, put it in the refrigerator. They collect those at four times during the day, and when they're done collecting them for two days, they mail those back to me. What's great about collecting cortisol--not only is it easy to collect--but it's a hormone that's a measure of stress and it's very specific to the kinds of stress that caregivers experience.
Has this type of writing or journaling been effective with other types of caregivers?
Actually, this is my third study and I'm using the same design I used before. The people in the study before really enjoyed it.
The first study focused on caregivers of persons with Alzheimer's disease, and in that study the cortisol was significant and the other measures showed that the writing made a difference. The writing promoted health and reduced stress and those differences were significant.
This work with writing has been done in more than 50 studies for the last 25 years. In almost all those studies of different populations, it's clear that the writing makes a real difference and does promote health.
If someone would like to learn more about the study, who should they contact?
Contact me at 319-335-7039 or e-mail me at howard-butcher@uiowa.edu . |
