![]() ![]() ![]() Based on this research, CBT has been designated as first-line treatment for anxiety in cancer patients by the American Society of Clinical Oncology ( Andersen et al., 2014). CBT is efficacious for anxiety in cancer patients ( Osborn et al., 2006 Moyer et al., 2009 Greer et al., 2012), including when telephone-delivered ( Brenes et al., 2015 Watson et al., 2017). Therefore, treating anxiety in informal caregivers is vital to improving caregiver quality of life and OAC anxiety.Ĭognitive-behavioral therapy (CBT) is a time-limited problem-focused ( Moorey and Greer, 2002 Osborn et al., 2006) psychological treatment that targets thoughts and behaviors that increase distress ( Moorey and Greer, 2002 Freeman, 2004). In addition, patients whose caregivers report elevated anxiety are at increased risk for clinically significant anxiety themselves ( Bambauer et al., 2006 Segrin et al., 2007 Gotze et al., 2014). Over one-third of cancer caregivers report clinically significant anxiety ( Rossi Ferrario et al., 2003 Gotze et al., 2014 Gotze et al., 2016) that can be more severe than patient anxiety ( Rossi Ferrario et al., 2003 Gotze et al., 2014). The physical and cognitive impact of cancer and aging and the burden of cancer treatment place notable stress on OACs’ caregivers ( National Alliance for Caregiving and AARP Public Policy Institute, 2015). ![]() cancer caregivers care for an older adult ( National Alliance for Caregiving, 2016). Almost two-thirds (62%) of the 2.8 million U.S. OACs often rely heavily on informal or unpaid caregivers. Thus, effective anxiety treatments for OACs have the potential to reduce distress, improve quality of life, and enhance treatment engagement and response. OAC anxiety is associated with worse physical symptoms ( Bruera et al., 2000 Brown and Kroenke, 2009 Delgado-Guay et al., 2009 Reddy et al., 2009 Salvo et al., 2012) poor quality of life ( Smith et al., 2003 Horney et al., 2011) and treatment adherence and response ( Fujii et al., 2001 Greer et al., 2008 Pedersen et al., 2010) difficulty communicating with the healthcare team ( Schag and Heinrich, 1989) longer hospitalizations ( Prieto et al., 2002) and higher risk for mortality ( Chan et al., 2015). Older adults with cancer (OACs) experience high rates of anxiety, with over 40% reporting clinically significant anxiety ( Teunissen et al., 2006 Kasparian et al., 2009 Nelson et al., 2010). Cancer symptoms and treatment effects such as fatigue and nausea can add to and exacerbate these age-related physical and cognitive changes ( Derks et al., 2016 Klepin et al., 2016 Dura-Ferrandis et al., 2017 Oh, 2017 van Abbema et al., 2017). For older adults, the threat of cancer is potentially magnified by threats that accompany aging ( Holland, 2016 Dura-Ferrandis et al., 2017) such as age-related cognitive ( Parpa et al., 2014 Bluethmann et al., 2016) and physical changes ( Zhang et al., 2018). The objective threat posed by cancer makes the high rates of anxiety in cancer patients and survivors unsurprising and understandable ( Deimling et al., 2017). Anxiety is a normal response to a perceived threat and is characterized by worry that is difficult to control, restlessness, difficulty concentrating and sleeping, fatigue, and muscle tension ( American Psychiatric Association, 2013). ![]()
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