Abstract
Informal caregivers (IC) are key to enabling home deaths, where preferred, at the end-of-life. Significant morbidity from advanced cancer can make caregiving burdensome. However, knowledge about the nature of the caregiving burden for caregivers in Singapore is limited. Hence, the key objective in this study was to examine the impact of the caregiving burden on quality of life (QOL), mental health and work capacity among local ICs. Eligible English-speaking ICs of hospitalized advanced cancer patients were recruited through non-random sampling. The Zarit Burden Interview (ZBI), Caregiver Quality of Life Index—Cancer (CQOLC), Center for Epidemiologic Studies Depression Scale—Revised (CESD-R), and Work Productivity and Activity Impairment Questionnaire (WPAI) were interviewer-administered to eligible ICs. Altogether, 16 ICs were surveyed. The mean age of ICs was 43.8 years. Most were children of patients (43.8%), and eight ICs had high burden (ZBI > 17). Those with ZBI > 17 had lower QOL, higher depression scores as well as greater work and activity impairment. In conclusion, high caregiver burden has adverse effects on QOL, mental health and work productivity. Non-physical elements of caregiving (particularly financial and decision-making) and increased number of care roles undertaken by a single IC contribute to high burden. Future interventions for caregiving burden in Singapore should also address the financial and decision-making aspects of caregiving. Outsourcing selected aspects of the caregiving role to community services may reduce the number of caregiving aspects undertaken by a single IC and caregiver burden.
Highlights
Caregiver burden is the description of a negative reaction to the impact of care on an informal caregiver’s (IC’s) social, occupational and personal roles
The same study revealed that Informal caregivers (IC) in Singapore and Asia (Iran, South Korea, Turkey, Taiwan) had lower quality of life (QOL) as compared to their Western counterparts (United States, United Kingdom, Canada) and that QOL was worst among ICs who cared for advanced-stage cancer [22]
Our study further shows that QOL is considerably lower among ICs experiencing high burden
Summary
Caregiver burden is the description of a negative reaction to the impact of care on an informal caregiver’s (IC’s) social, occupational and personal roles. These reactions encompass the ICs’ response to physical, psychological, social and financial challenges and can be prolonged in chronic or mental illness [1]. Cancers 2016, 8, 105 previously reported to be associated with negative effects on physical, mental health and general well-being [2,3,4,5]. Most studies in cancer caregiving have focused either on burden alone or on selected caregiving outcomes. To the best of our knowledge, no study has examined burden and multiple caregiving outcomes in the same setting for advanced cancer in Singapore
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