Exploring gender as a sociocultural construct among cancer caregivers enrolling in a dyadic resiliency trial.
Authors: Finkelstein-Fox Lucy , Cloutier Joanna G. , Goshe Brett M. , Horick Nora K. , Pintro Kedie , Miranda Isabelle L. , Farnam Emelia J. , Holmbeck Katherine E. , Barata Anna , Perez Giselle K. , El-Jawahri Areej , Park Elyse Richelle 
Published: September 2024

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Background:
Caregiving relations are essential for navigating cancer care among cancer curvivors (i.e., completed curative-intent treatment) and metavivors (i.e., living with incurable illness). Caregiving is associated with poor health outcomes, but little work explicates gender differences in specific sociocultural constructs that drive caregivers’ health outcomes. This study explores gender differences in caregiving relationship type (e.g., partner, friend) and psychosocial variables theorized to be impacted by caregiving stress, such as preventative health behaviors, self-compassion, depression/anxiety, informational/emotional social support and perceived caregiving relationship quality among caregivers of cancer curvivors and metavivors.
Methods:
47 survivor-caregiver dyads (64% metavivors) enrolled in a pilot clinical trial of simultaneous remotely-delivered dyadic stress management groups at a tertiary care academic center. Eligible caregivers were those supporting survivors who had completed initial treatment for cancer with curative intent 3 months- 5 years ago OR were diagnosed with metastatic illness at least 3 months before enrollment. Data were collected via brief self-report baseline surveys measuring depression (PHQ-2), anxiety (GAD-2), self-compassion (SCS-12), informational/emotional support (PROMIS short forms-4a), including assessments of sex-specific cancer screening behavior (i.e., recommended breast, cervical, prostate, and colorectal screening) and relationship quality created for this study. Bivariate statistics compared caregivers based on self-reported gender identity (two-tailed p < .05) with Cohen’s D used to characterize strength of between-group differences (0.2 = small, 0.5 = medium, 0.8 = large).
Results:
Most caregivers (
M
age = 56.9) were White (87%) women (64%) caring for men (53%). Women (79% partners, 17% family, 4% friends) and men (64% partners, 36% family) caregivers did not significantly differ in caregiving relationship type (
p
= .33). Most caregivers were up-to-date with sex-specific screening recommendations for breast (83%), cervical (80%), and prostate (85%) cancer, though women vs. men were significantly less adherent to colon cancer screening (60% vs. 100%,
p
= .003). Significant gender differences emerged in (anxiety D = -0.69,
p
=.03) but not depression (D = -0.47,
p
= .14 or self-compassion (D = .58,
p
= .07), such that women experienced great distress. Finally, women reported not significantly greater informational/emotional support (Ds = -0.30 and -0.25,
p
s > .40) and relationship quality (D = -0.63,
p
= .05).
Conclusions:
When comparing the experiences of women and men currently in caregiving roles, gendered traits such as anxious emotional expression, as well as gender norms around self-focused preventative health behaviors may place women at increased risk for poor health outcomes.

Clinical trial information:
NCT05702723

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