{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:10:46Z","timestamp":1787008246934,"version":"build-2736575974"},"reference-count":86,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2022,3,30]],"date-time":"2022-03-30T00:00:00Z","timestamp":1648598400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Palliative Medicine"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Anxiety, depression, and reduced quality of life (QOL) are common problems for hospice family caregivers, but it is unknown if disparities in these experiences exist among Black and White caregivers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To compare anxiety, depression, QOL, caregiver burden, and perceptions of caregiver-centered hospice team communication between Black and White hospice family caregivers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Secondary analysis of baseline data from two randomized clinical trials.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting\/Subjects:<\/jats:title>\n                    <jats:p>Seven hundred twenty-two Black and White hospice family caregivers ages 18+ from Midwestern and Northeastern United States.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements:<\/jats:title>\n                    <jats:p>Measures included the Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire (PHQ-9), Caregiver Quality-of-Life Index\u2013Revised (CQLI-R), Zarit Burden Interview (ZBI-7), and Caregiver-Centered Communication Questionnaire (CCCQ).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Black and White caregivers differed across demographic and socioeconomic variables. Nearly one-third of hospice family caregivers reported moderate-to-severe anxiety (32.1%) and moderate-to-severe depressive symptoms (32.0%). White caregivers reported lower QOL than Black caregivers (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.04), specifically in emotional (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.02) and social (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.0005) domains. In multiple regression analyses controlling for caregiver and patient factors, we found no racial differences in depression, anxiety, QOL, caregiver burden, or perceptions of caregiver-centered hospice communication.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Despite demographic and socioeconomic differences, Black and White hospice family caregivers experience similarly high levels of anxiety, depression, burden, and perceptions of hospice communication. Interventions to support hospice family caregivers across racial groups and research that identifies factors that mediate social determinants of health in this population are needed. The development and validation of culture-concordant mental health screening tools in racially diverse populations is recommended.<\/jats:p>\n                    <jats:p>\n                      Trial registration:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/ClinicalTrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                      NCT02929108 and\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/ClinicalTrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                      NCT01444027.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/jpm.2021.0302","type":"journal-article","created":{"date-parts":[[2021,11,18]],"date-time":"2021-11-18T12:15:55Z","timestamp":1637237755000},"page":"596-605","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":14,"title":["Anxiety, Depression, Quality of Life, Caregiver Burden, and Perceptions of Caregiver-Centered Communication among Black and White Hospice Family Caregivers"],"prefix":"10.1177","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0988-2401","authenticated-orcid":false,"given":"Lauren T.","family":"Starr","sequence":"first","affiliation":[{"name":"Department of Biobehavioral and Health Sciences, NewCourtland Center for Transitions and Health, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Bullock","sequence":"additional","affiliation":[{"name":"Department of Social Work, College of Humanities and Social Sciences, North Carolina State University, Raleigh, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karla","family":"Washington","sequence":"additional","affiliation":[{"name":"Division of Palliative Medicine, School of Medicine, Washington University in St. Louis, St. Louis, Missouri, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Subhash","family":"Aryal","sequence":"additional","affiliation":[{"name":"BECCA (Biostatistics * Evaluation * Collaboration * Consultation * Analysis) Lab, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debra","family":"Parker Oliver","sequence":"additional","affiliation":[{"name":"Division of Palliative Medicine, School of Medicine, Washington University in St. Louis, St. Louis, Missouri, USA."},{"name":"Barnes Jewish College, Goldfarb School of Nursing, St. Louis, Missouri, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Demiris","sequence":"additional","affiliation":[{"name":"Department of Biobehavioral and Health Sciences, NewCourtland Center for Transitions and Health, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA."},{"name":"Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,3,30]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2012.0851"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2009.26.1818"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2009.26.3863"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.207624"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2016.0372"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2013.0196"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1080\/15524256.2013.846891"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/1049732312448543"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/1049909119842365"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.3109\/10401230009147083"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1478951513001193"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/1049909117703643"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.167.1.40"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.15123"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.12968\/ijpn.2004.10.2.12454"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1002\/pon.3033"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/inr.12000"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2019.08.012"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2007.11.008"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41416-018-0193-8"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1080\/10810730.2017.1324540"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1177\/0269216319852007"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1177\/1049909120935371"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.14639"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.1093\/hsw\/33.4.267"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.1080\/15524256.2011.548048"},{"key":"e_1_3_4_28_2","doi-asserted-by":"publisher","DOI":"10.1177\/1049909120985419"},{"key":"e_1_3_4_29_2","doi-asserted-by":"publisher","DOI":"10.1177\/1049909114565658"},{"key":"e_1_3_4_30_2","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.14263"},{"key":"e_1_3_4_31_2","doi-asserted-by":"publisher","DOI":"10.1177\/2333721420920414"},{"key":"e_1_3_4_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2018.01.007"},{"key":"e_1_3_4_33_2","doi-asserted-by":"publisher","DOI":"10.1177\/10499091211034383"},{"key":"e_1_3_4_34_2","first-page":"1","article-title":"Culture, caregiving, and health: Exploring the influence of culture on family caregiver experiences","volume":"2014","author":"Pharr JR","year":"2014","unstructured":"Pharr JR, , Francis CD, , Terry C, , Clark MC: Culture, caregiving, and health: Exploring the influence of culture on family caregiver experiences. Int Sch Res Notices, 2014; 2014:1\u20136.","journal-title":"Int Sch Res Notices"},{"key":"e_1_3_4_35_2","doi-asserted-by":"publisher","DOI":"10.1093\/geronb\/gbp096"},{"key":"e_1_3_4_36_2","doi-asserted-by":"publisher","DOI":"10.1177\/0898264316663576"},{"key":"e_1_3_4_37_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2007.06.004"},{"key":"e_1_3_4_38_2","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2012.0151"},{"key":"e_1_3_4_39_2","unstructured":"Centers for Disease Control and Prevention CDC: Vital Signs: African American Health\u2014creating equal opportunities for health. CDC: https:\/\/www.cdc.gov\/vitalsigns\/aahealth\/index.html. 2017. (Last accessed January 26 2021)."},{"key":"e_1_3_4_40_2","volume-title":"Health Disparities: Race and Hispanic Origin. Provisional Death Counts for Coronavirus Disease 2019 (COVID-19)","author":"Centers for Disease Control and Prevention CDC","year":"2021","unstructured":"Centers for Disease Control and Prevention CDC: Health Disparities: Race and Hispanic Origin. Provisional Death Counts for Coronavirus Disease 2019 (COVID-19). Washington, DC: CDC, 2021."},{"key":"e_1_3_4_41_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ssmph.2020.100561"},{"key":"e_1_3_4_42_2","first-page":"47","article-title":"Perceived needs of African-American caregivers of elders with dementia","volume":"93","author":"Lampley-Dallas VT","year":"2001","unstructured":"Lampley-Dallas VT, , Mold JW, , Flori DE: Perceived needs of African-American caregivers of elders with dementia. J Natl Med Assoc, 2001; 93:47\u201357.","journal-title":"J Natl Med Assoc"},{"key":"e_1_3_4_43_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1752-0606.2004.tb01253.x"},{"key":"e_1_3_4_44_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)30569-X"},{"key":"e_1_3_4_45_2","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.27.2.393"},{"key":"e_1_3_4_46_2","doi-asserted-by":"publisher","DOI":"10.1097\/NMD.0000000000000334"},{"key":"e_1_3_4_47_2","doi-asserted-by":"publisher","DOI":"10.1080\/01612840.2017.1423427"},{"key":"e_1_3_4_48_2","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2013.9468"},{"key":"e_1_3_4_49_2","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2021.0502"},{"key":"e_1_3_4_50_2","doi-asserted-by":"publisher","DOI":"10.1037\/a0031726"},{"key":"e_1_3_4_51_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2015.03.039"},{"key":"e_1_3_4_52_2","doi-asserted-by":"publisher","DOI":"10.1080\/13607860410001728998"},{"key":"e_1_3_4_53_2","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/45.1.90"},{"key":"e_1_3_4_54_2","doi-asserted-by":"publisher","DOI":"10.2190\/YH2B-8VVE-LA5A-02R2"},{"key":"e_1_3_4_55_2","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.15894"},{"key":"e_1_3_4_56_2","doi-asserted-by":"publisher","DOI":"10.1177\/1049909116661816"},{"key":"e_1_3_4_57_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.166.10.1092"},{"key":"e_1_3_4_58_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1497.2001.016009606.x"},{"key":"e_1_3_4_59_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1497.2006.00409.x"},{"key":"e_1_3_4_60_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-020-02885-6"},{"key":"e_1_3_4_61_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2354.2005.00612.x"},{"key":"e_1_3_4_62_2","first-page":"1189","volume":"21","author":"McMillan SC","unstructured":"McMillan SC, , Mahon M The impact of hospice services on the quality of life of primary caregivers. Oncol Nurs Forum 1994;21:1189\u20131195.","journal-title":"Oncol Nurs Forum"},{"key":"e_1_3_4_63_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-019-05288-w"},{"key":"e_1_3_4_64_2","doi-asserted-by":"publisher","DOI":"10.1177\/0825859719887239"},{"key":"e_1_3_4_65_2","doi-asserted-by":"publisher","DOI":"10.1080\/15524250903081566"},{"key":"e_1_3_4_66_2","doi-asserted-by":"publisher","DOI":"10.1002\/pon.1179"},{"key":"e_1_3_4_67_2","unstructured":"National Institute of Mental Health N: Generalized Anxiety Disorder. NIH. Mental Health Information Statistics Website: https:\/\/www.nimh.nih.gov\/health\/statistics\/generalized-anxiety-disorder.shtml#:~:text=Prevalence%20of%20Generalized%20Anxiety%20Disorder%20Among%20Adults -Based%20on%20diagnostic&text=An%20estimated%202.7%25%20of%20U.S. than%20for%20males%20(1.9%25). 2021. (Last accessed 2021)."},{"key":"e_1_3_4_68_2","first-page":"1","article-title":"Prevalence of depression among adults aged 20 and over: United States, 2013\u20132016","author":"Brody D","year":"2018","unstructured":"Brody D, , Pratt LA, , Hughes J: Prevalence of depression among adults aged 20 and over: United States, 2013\u20132016. NCHS Data Brief, 2018:1\u20138.","journal-title":"NCHS Data Brief"},{"key":"e_1_3_4_69_2","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.15896"},{"key":"e_1_3_4_70_2","first-page":"19","article-title":"The lived experience of African-American informal caregivers of family members with Alzheimer's disease and related dementias","volume":"28","author":"Mars D","year":"2017","unstructured":"Mars D, , Davis BL, , Montgomery AJ, et al.: The lived experience of African-American informal caregivers of family members with Alzheimer's disease and related dementias. J Natl Black Nurses Assoc, 2017; 28:19\u201325.","journal-title":"J Natl Black Nurses Assoc"},{"key":"e_1_3_4_71_2","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2020.0324"},{"key":"e_1_3_4_72_2","doi-asserted-by":"publisher","DOI":"10.1177\/1049909114529013"},{"key":"e_1_3_4_73_2","doi-asserted-by":"publisher","DOI":"10.1177\/0733464807302669"},{"key":"e_1_3_4_74_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.gerinurse.2013.11.003"},{"key":"e_1_3_4_75_2","doi-asserted-by":"publisher","DOI":"10.1097\/NJH.0b013e31819974f9"},{"key":"e_1_3_4_76_2","doi-asserted-by":"publisher","DOI":"10.1037\/pas0000550"},{"key":"e_1_3_4_77_2","doi-asserted-by":"publisher","DOI":"10.1002\/da.22940"},{"key":"e_1_3_4_78_2","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/gnr011"},{"key":"e_1_3_4_79_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.janxdis.2015.01.005"},{"key":"e_1_3_4_80_2","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/42.2.237"},{"key":"e_1_3_4_81_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2010.322"},{"key":"e_1_3_4_82_2","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/45.5.634"},{"key":"e_1_3_4_83_2","doi-asserted-by":"publisher","DOI":"10.1177\/0269216314531313"},{"key":"e_1_3_4_84_2","first-page":"1532","article-title":"Effects of perceived racism, cultural mistrust and trust in providers on satisfaction with care","volume":"98","author":"Benkert R","year":"2006","unstructured":"Benkert R, , Peters RM, , Clark R, , Keves-Foster K: Effects of perceived racism, cultural mistrust and trust in providers on satisfaction with care. J Natl Med Assoc, 2006; 98:1532\u20131540.","journal-title":"J Natl Med Assoc"},{"key":"e_1_3_4_85_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40615-017-0350-4"},{"key":"e_1_3_4_86_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-020-06557-9"},{"key":"e_1_3_4_87_2","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2017.0151"}],"container-title":["Journal of Palliative Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/jpm.2021.0302","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/jpm.2021.0302","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/jpm.2021.0302","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T17:12:56Z","timestamp":1777655576000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/jpm.2021.0302"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,30]]},"references-count":86,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2022,4]]}},"alternative-id":["10.1089\/jpm.2021.0302"],"URL":"https:\/\/doi.org\/10.1089\/jpm.2021.0302","relation":{},"ISSN":["1096-6218","1557-7740"],"issn-type":[{"value":"1096-6218","type":"print"},{"value":"1557-7740","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,30]]}}}