Depression and anxiety symptoms in bereaved caregivers of patients with advanced cancer.

Abstract

11623 Background: Caregivers of patients with advanced cancer experience substantial caregiving burden and psychological distress during the illness course. However, data on depression and anxiety symptoms in bereaved caregivers and factors associated with their psychological distress are lacking. Methods: We conducted a secondary analysis of 168 caregivers enrolled in a randomized trial of early palliative care integrated with oncology care versus oncology care alone for patients newly-diagnosed with incurable lung and non-colorectal gastrointestinal cancers and their caregivers who completed bereavement assessments at 3 months after their loved one’s death. We used the Hospital Anxiety and Depression Scale (HADS) to assess patients’ and caregivers’ depression and anxiety symptoms at baseline within 8 weeks of diagnosis, and at 3-4 months after the patient’s death (for caregivers). We asked caregivers to rate patient’s physical and psychological distress in the last week of life on a 10-point scale. We used linear regression adjusting for randomization and cancer type to explore associations between patient and caregiver factors and bereaved caregivers’ depression and anxiety. Results: 30.4% (51/168) and 43.4% (73/168) of bereaved caregivers reported clinically significant depression and anxiety symptoms, respectively. Younger patient age (B = -0.06, P = 0.041), higher patient baseline anxiety (B = 0.28, P = 0.002), and caregiver rating of worse physical (B = 0.28, P = 0.035) and psychological (B = 0.41, P < 0.001) distress experienced by the patient at the end of life (EOL) were associated with worse depression symptoms in bereaved caregivers. Only caregiver factors, including age (B = -0.07, P = 0.004), female sex (B = 1.60, P = 0.024), and rating of worse psychological distress experienced by the patient at the EOL (B = 0.42, P < 0.001) were associated with worse bereaved caregivers’ anxiety symptoms. Conclusions: Bereaved caregivers of patients with advanced cancer experience substantial psychological distress which is associated with their perceptions of their loved one’s distress at the EOL. Interventions to optimize EOL care for patients and reduce bereaved caregivers’ psychological distress are needed.