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ANALYZING TRAJECTORIES OF CAREGIVER PSYCHOLOGICAL DISTRESS OVER TIME USING GROUP-BASED MODELING METHODS

Kuo, Chien-Wen Jean (2010) ANALYZING TRAJECTORIES OF CAREGIVER PSYCHOLOGICAL DISTRESS OVER TIME USING GROUP-BASED MODELING METHODS. Master's Thesis, University of Pittsburgh. (Unpublished)

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Abstract

Group-based trajectory analysis is an innovative statistical method to identify distinct populations over time. We used this approach to characterize patterns of change in distress using shortened scales (depressive symptoms (CESD), anxiety (POMS), and caregiver burden (CRA)) in caregivers (CG) of persons with primary malignant brain tumors. In an ongoing longitudinal study, 98 CGs were interviewed within a month of their care recipients' diagnosis and at 4, 8, and 12- months afterwards. We used SAS Proc Traj to select models based on clinical criteria and statistical judgment. We identified 2 trajectories for depressive symptoms, 2 for anxiety, and 3 for caregiver burden. An estimated 61.2% of CGs had low CESD (range: 0-30) scores at baseline (mean (M)=5.3, standard deviation (SD) = 3.6) and remained low (M=2.7, SD=2.8) at 12-months (p=0.06 for trajectory slope); the remaining CGs (38.8%) had high scores at baseline (M=14.4, SD=5.3) that significantly decreased by 12-months (M=9.1, SD=4.6; p=0.01). An estimated 20.4% of CGs had low POMS (range: 3-18) scores at baseline (M=6.0, SD=2.2) that decreased significantly (M=4.0, SD=1.1) at 12-months (p=0.002); the remaining CGs (79.6%) had high scores at baseline (M=10.2, SD=2.1) that decreased significantly by 12-months (M=7.8, SD=1.5; p=0.001). An estimated 20.4% of CGs had low CRA (range: 5-25) scores at baseline (M=10.5, SD=2.7) that decreased significantly (M=6.4, SD=1.3) at 12-months (p<0.001); the moderate trajectory included 26.5% of CGs with consistent scores at baseline (M=14.2, SD=2.0) and 12 months (M=11.0, SD=1.4; p=0.51); the majority of CGs (53.1%) had consistently high scores at baseline (M=19.7, SD=2.1) and (M=20.0, SD=2.4) at 12 months (p=0.85). Logistic and multinomial regression results revealed that CGs with low emotional stability were more likely to belong to the high depressive symptoms (p=0.007) and anxiety (p=0.002) trajectory groups. CGs were more likely to belong to the moderate to high caregiver burden trajectory group if their care recipients had more aggressive tumor types (p=0.004) or lower constructional ability (p=0.05). The public health significance of this work is that trajectory analysis provides a way to identify CGs at risk of increasing psychological distress so that suitable interventions can be developed and targeted.


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Details

Item Type: University of Pittsburgh ETD
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Kuo, Chien-Wen Jeancjkuo584@gmail.com
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairStone, Roslynroslyn@pitt.eduROSLYN
Committee MemberRen, Dianxudir8@pitt.eduDIR8
Committee MemberKim, Kevinkhkim@pitt.eduKHKIM
Committee MemberSherwood, Paulaprs11@pitt.eduPRS11
Date: 28 January 2010
Date Type: Completion
Defense Date: 14 December 2009
Approval Date: 28 January 2010
Submission Date: 4 December 2009
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Institution: University of Pittsburgh
Schools and Programs: Graduate School of Public Health > Biostatistics
Degree: MS - Master of Science
Thesis Type: Master's Thesis
Refereed: Yes
Uncontrolled Keywords: caregiver psychological distress; group-based modeling; trajectory analysis
Other ID: http://etd.library.pitt.edu/ETD/available/etd-12042009-010411/, etd-12042009-010411
Date Deposited: 10 Nov 2011 20:08
Last Modified: 15 Nov 2016 13:53
URI: http://d-scholarship.pitt.edu/id/eprint/10037

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