Repetitive Negative Thinking: The Link Between Caregiver Burden and Depressive Symptoms.

PURPOSE/OBJECTIVES: To explore whether repetitive negative thinking (RNT) mediates the pathway between subscales of caregiver burden and depressive symptoms. 
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DESIGN: Cross-sectional pilot study. 
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SETTING: Bone marrow unit at the University of Louisville Hospital in Kentucky and caregiver support organizations in Louisville.
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SAMPLE: 49 current cancer caregivers who were primarily spouses or partners of individuals with lymphoma or leukemia and provided care for a median of 30 hours each week for 12 months.
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METHODS: Caregivers completed questionnaires assessing caregiver burden, RNT, and depressive symptoms.
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MAIN RESEARCH VARIABLES: Caregiver burden, RNT, and depressive symptoms.
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FINDINGS: Results showed that RNT mediated the relationship between burden (as a result of impact on schedule or finances) and depressive symptoms. Although burden from a lack of family support and impact on health was positively related to depressive symptoms, these relationships were not mediated by RNT. In addition, caregiver esteem was not associated with RNT or depressive symptoms. 
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CONCLUSIONS: RNT plays an important role in maintaining and potentially exacerbating caregiver distress. Assessment and intervention regarding RNT in cancer caregivers may reduce depressive symptoms prompted by burden from an impact on schedule or finances.
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IMPLICATIONS FOR NURSING: Nurses may be significant in connecting caregivers experiencing RNT to resources and professionals to enhance adaptive coping and potentially prevent depressive symptoms.