Abstract
BackgroundThe responsibility of caring for patients with advanced cancer in sub-Saharan Africa is mostly shouldered by family members because of paucity of institutional facilities. There is a growing concern that the number of women needing treatment for advanced breast cancer is rising at an unprecedented rate in Nigeria.AimTo assess the caregiver burden and its associated factors amongst family caregivers of women with advanced breast cancer.SettingThe study was conducted at the radiation oncology clinic of the University College Hospital, Ibadan, Nigeria.MethodsA cross-sectional descriptive study was conducted amongst 157 eligible family caregivers of women with advanced breast cancer. The family caregivers completed an interviewer-administered questionnaire, which included the socio-demographic data, the caregiving process and the Zarit Burden Interview (ZBI). Logistic regression was used to identify factors, and ethical approval was obtained.ResultsOver half (53%) of the respondents were males with spousal caregivers dominantly constituting 27.4% of all respondents, closely followed by daughters (25.5%) of the care recipients. The mean ZBI score was 29.84 ± 13.9. Most (72%) of the caregivers experienced burden. Factors associated with caregiver burden were previous hospitalisation of the care recipient (odds ratio [OR] = 3.74, confidence interval [CI]: 1.67 to 8.38) and perceived dysfunction in patients activities of daily living (OR = 2.57, CI: 1.14 to 5.78).ConclusionFamily caregivers of women with advanced breast cancer experience burden of care. Recognition of this vulnerable population and the care recipient as a dyad is a sine qua non in mitigating the burden associated with their caregiving role.
Highlights
Breast cancer is the commonest form of cancer in women globally with over two million cases in 2018.1 Breast cancer is common in most part of the world.[2]
This study established a mean caregiver burden of 29.84 ± 13.9. This was comparable with the mean score of 30.55 ± 19.18 documented by Vahidi et al who looked at caregiver burden amongst primary caregivers of women with breast cancer in Iran[18] and the mean Zarit burden interview (ZBI) score of 29.16 ± 12.8 reported by Yusuf et al who looked at caregiver burden amongst family caregivers of patients with various cancer diagnoses in north-western Nigeria.[6]
An observational cohort study of caregivers of patients with advanced chronic diseases reported that the level of caregiver burden was similar across different patient diagnoses[19] and comparable with the level of burden previously documented amongst caregivers of patients with dementia[20] and terminal cancer.[14]
Summary
Breast cancer is the commonest form of cancer in women globally with over two million cases in 2018.1 Breast cancer is common in most part of the world.[2] The widespread belief that breast and other cancers are rare in low-income regions such as Africa is a myth In these low-income settings, the case fatality rate is high (in comparison to high-resource countries) as women with breast cancer either present with large, advanced tumours or do not present until the disease is at an incurable stage.[3] Metastatic or advanced breast cancer is the presence of disease at distant sites such as bone, liver or lung.
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