Supportive Care in Cancer

, Volume 25, Issue 4, pp 1247–1256 | Cite as

Cognitive dysfunction in patients with brain metastases: influences on caregiver resilience and coping

  • Marlon Garzo SariaEmail author
  • Natasia Courchesne
  • Lorraine Evangelista
  • Joshua Carter
  • Daniel A. MacManus
  • Mary Kay Gorman
  • Adeline M. Nyamathi
  • Linda R. Phillips
  • David Piccioni
  • Santosh Kesari
  • Sally Maliski
Original Article



Neurologic deficits that may be manifested as cognitive impairment contribute to the challenges faced by caregivers of patients with brain metastases. To better address their needs, we examined how caregivers respond to these challenges and explore the relationship between the patient’s cognitive impairment and caregiver resilience and coping.


We conducted a descriptive, cross-sectional study using self-reported data from 56 caregivers of patients with brain metastases. Study participants from a comprehensive cancer center were asked to complete a series of instruments that measured their perception of the patient’s cognitive dysfunction (revised memory and behavior problems checklist, RMBC), their own personal resilience (Resilience Scale, RS), and their utilization of a broad range of coping responses (COPE inventory and Emotional-Approach Coping scale).


Caregivers reported that memory-related problems occurred more frequently in the patients they cared for compared to depression and disruptive behavior (mean scores 3.52 vs 2.34 vs. 1.32, respectively). Coping strategies most frequently used by caregivers were acceptance (3.28), planning (3.08), and positive reinterpretation and growth (2.95). Most caregivers scored moderate to high on the RS (77%). The coping strategy acceptance correlated significantly with the memory and disruptive behavior subscales of the RMBC.


Given the protective effect of problem-focused coping and the high rate of caregivers utilizing less effective coping strategies in instances of worsening cognitive dysfunction, healthcare professionals need to systematically assess the coping strategies of caregivers and deliver a more personalized approach to enhance effective coping among caregivers of patients with brain metastases.


Brain metastases Caregiver burden Cognitive dysfunction Coping Resilience 



Dr. Marlon Garzo Saria would like to thank Dr. Annette Stanton for her assistance in reviewing the research proposal and the manuscript as a member of his dissertation committee.

Compliance with ethical standards

Conflict of interest

Dr. Marlon Garzo Saria has received academic scholarship grants from the American Cancer Society and the Oncology Nursing Society Foundation while completing this study as part of his doctoral work. In addition, the study was supported by a research grant from The Daisy Foundation. None of the organizations had a role in the study design, data collection and analysis, report writing, and decision for manuscript submission for publication. The authors have full access to all of the data in this study and take complete responsibility for the integrity of the data and the accuracy of the data analysis.


American Cancer Society Doctoral Degree Scholarships in Cancer Nursing

Oncology Nursing Society Doctoral Scholarship

The DAISY Foundation Research Grant


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Marlon Garzo Saria
    • 1
    • 2
    Email author
  • Natasia Courchesne
    • 3
  • Lorraine Evangelista
    • 4
  • Joshua Carter
    • 5
  • Daniel A. MacManus
    • 3
  • Mary Kay Gorman
    • 3
  • Adeline M. Nyamathi
    • 1
  • Linda R. Phillips
    • 1
  • David Piccioni
    • 6
  • Santosh Kesari
    • 2
  • Sally Maliski
    • 1
    • 7
  1. 1.School of NursingUniversity of California, Los AngelesLos AngelesUSA
  2. 2.John Wayne Cancer Institute and Pacific Neuroscience Institute at Providence Saint John’s Health CenterSanta MonicaUSA
  3. 3.Moores Cancer CenterUniversity of California San DiegoLa JollaUSA
  4. 4.Nursing ScienceUniversity of California, IrvineIrvineUSA
  5. 5.QuintilesParsippanyUSA
  6. 6.School of MedicineUniversity of California San DiegoLa JollaUSA
  7. 7.School of NursingUniversity of Kansas Medical CenterKansas CityUSA

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