Influence of financial toxicity on posttraumatic growth in primary caregivers of cancer patients undergoing chemotherapy: the chain mediating effect of benefit finding and self-disclosure.

IntroductionCancer is a primary and challenging health problem, has a significant impact on caregivers, and is a leading cause of emotional responses like depression. Depression is the most common and serious psychiatric disorder that has a considerable effect on the daily life of primary caregivers. Different articles reported that the magnitude of depression was prevalent among primary caregivers of patients with cancer. There is scarcity of published articles about the problem in Ethiopia. This study aimed to assess the prevalence of depression and associated factors among primary caregivers of adult cancer patients at Northwest Amhara Regional States Referrals Hospitals, oncology treatment units, Northwest Ethiopia, 2021.MethodsAn institutional-based cross-sectional study was conducted in Northwest Amhara Regional States Referrals Hospitals. A systematic random sampling technique was used to select 421 participants. The data were collected using interviewer-administered and chart review through structured, pretested Patient Health Questionarie-9 questionnaires. The data were entered into Epi. Data version 4.6 and analyzed using Stata version 14.0. Bivariable and multivariable logistic regression were carried out to identify factors associated with depression. Adjusted odds ratio with a 95% confidence interval and variables with a p-value < 0.05 were considered significantly associated with depression.ResultsThe prevalence of depression was 45.15%. Being female (AOR = 2.01, 95%, CI: 1.27–3.19), having an average monthly income of < 1000 Ethiopian birr (AOR = 3.54, 95% CI: 1.54–8.13), and primary caregivers of a cancer patient with mixed therapy (AOR = 4.54, 95%, CI: (1.5–13.48) were significantly associated with depression.ConclusionThe prevalence of depression among primary caregivers of adult patients with cancer was significant. It’s better, health care providers in oncology treatment facilities need to recognize and screen and give special attention to female primary caregivers, having an average monthly income of < 1000 Ethiopian birr, and primary caregivers of a cancer patient with mixed therapy to reduce the risk of developing depression.

BackgroundThe effect of cancer diagnosis affects the psychological well-being of the caregivers of cancer patients and results in a risk of psychiatric morbidity. This study aimed to determine the prevalence and associated factors of depression among primary caregivers of adult cancer patients.ObjectiveThis study aimed to assess the magnitude of depression and associated factors among primary caregivers of adult cancer patients.MethodologyHospital-based cross-sectional study was conducted among primary caregivers of adult cancer patients. The convenient sampling method used to recruit caregivers of cancer patients. The data was collected by using the Amharic version patient health questionnaire and analyzed by SPSS version 25. Descriptive statistics were used to describe the prevalence of depression and bivariable and multivariable regression models were used to determine the net effect of each independent variable on depression.ResultsThe overall prevalence of depression among adult cancer patient caregivers was 54.1% (95% CI 47.6, 60.6). Household size < 3; (AOR = 4.5, 95% CI: 1.1–13), Monthly income < 600 (AOR = 2.8, 95% CI:2.5–15.9), Caring hours ≥ 9 (AOR = 9, 95% CI:4–21), Burden level ≥ 20 ;(AOR = 10.7, 95% CI:9.3–11.6) were independent factors of depression among primary caregivers of cancer patients.ConclusionThe results of this study showed a higher prevalence of depressed symptoms among primary caregivers of cancer patients. Long caring hours, small household size, low-income level, and higher burden level were independent factors of caregiver depression, indicating the urgent necessity to investigate and deal with it through interdisciplinary approaches.

This study was conducted to identify the influence of the burden of care on the quality-of-life dimensions and examine the role of self-control as a mediator on the burden of care and the quality-of-life dimensions among primary caregivers of cancer patients who are in the terminal phase. This cross-sectional study involves 97 primary caregivers of terminal-phase cancer patients who were selected using purposeful sampling. The Adult Carer Quality of Life Questionnaire (AC-QoL), Zarit Burden Interview (J-ZBI-8), and Pearlin’s Sense of Mastery questionnaires were used in this study. Based on data analysis using Smart-PLS-Structural Equation Modeling (SEM) the direct analysis showed that subscale in care load, that is role strain had a significant negative influence on the quality of life in terms of support for caring, caring stress, personal growth, and the ability to care. Meanwhile, the subscale under the burden of care, that is personal strain, had a significant negative influence on the quality of life in terms of caring stress. Additionally, the analysis of indirect relationships revealed that self-control was found not to act as a mediator in the relationship between burden, caring stress and quality of life of the primary caregiver. This study has implications for the family of caregivers who experience the burden of care, especially in terms of role strain and personal strain, thus affecting several dimensions of their quality of life. Thus, in order to improve the quality of life among the primary caregivers of those cancer patients at the terminal stage, social workers in the helping profession field need to implement some appropriate approaches, methods, and techniques that will help to give sufficient mental, emotional, social and family support among the caregivers.

Research on global quality of life (GQOL) in primary caregivers (PCGs) of cancer patients is limited. This study measured significant domains of GQOL in PCGs and their association with the patients' disease trajectory and the PCGs' background and life situation. This study also explored differences in their GQOL compared to a normative sample from the general population (NORM). In a cross-sectional design, 71 PCGs (aged > or = 50 years) of cancer patients in palliative phase rated their GQOL by the Quality of Life Scale (QOLS) and provided information concerning demography, experienced social support, and caring situation. Associations between the QOLS scores and variables of the patients' medical history were assessed, and comparisons of QOLS scores were made between the PCGs and age- and gender-adjusted NORM. Long duration of the curative phase for patients and holding a job for PCGs were significantly associated with a favorable GQOL in PCGs. The mean total GQOL score did not differ significantly between the PCGs and NORM groups, though subanalyses revealed significantly more favorable mean score of the relational domain in PCGs compared to NORM. GQOL in PCGs of cancer patients in palliative phase staying at home was as good as that of the NORM. For PCGs not employed or caring for patients with a short curative phase, getting some recreation could be of importance for improvement of GQOL.

The association between episodic listening and the burden of primary informal caregivers of cancer patients - An explorative cross-sectional study.

The present study aims to investigate the course of psychological symptoms through chemotherapy in a sample of primary caregivers of patients with cancer and to examine all possible correlations between psychological distress and demographic characteristics. In this prospective study, 112 primary family caregivers of cancer patients were evaluated. Symptom checklist 90 revised (SCL-90-R) was administered to assess their pathological symptoms, the Hospital Anxiety and Depression Scale (HADS) to assess depression and anxiety. There was an evaluation at the beginning of chemotherapy and a second at the end of the patients' intravenous chemotherapy treatment (EOT). A total of 112 primary caregivers were initially enrolled in the study, and 99 (88.4%) completed it. Caregivers' psychopathology was low to moderate at both points of time (baseline and EOT). However, a considerable decrease in the Global Severity Index (GSI) emerged over time. At EOT, participants reported statistically significant decreases in five aspects of SCL 90, namely Depression, phobic anxiety, obsessive-compulsive symptoms, somatization, and psychoticism. A notable finding was that female caregivers were significantly more distressed, especially when providing care to a male recipient.

ObjectivesThis study aimed to evaluate the caregiving burden among primary caregivers of cancer patients, clarify the relationship between family resilience and caregiving burden, and explore the mediation and moderation effects.DesignA...

Context: Primary caregivers of cancer patients often suffer from impaired Health-Related Quality of Life (HRQOL) due to stress arising from the responsibility of caregiving. Most studies conducted in Western populations have shown that increased caregiving burden was related to decreased mental and physical health and premature mortality among family caregivers. Therefore, the findings of those studies may not be directly applicable to the Kenyan population, especially Western Kenya, which has a different socio-cultural and ethnic background.&#x0D; Aim: This study sought to determine socioeconomic and psychological factors predicting the health-related quality of life among primary caregivers of cancer patients in Kakamega County.&#x0D; Methods: This was an institutional-based cross-sectional analytical study design. Kakamega County Referral Hospital was purposively sampled as it has a hospital with a western region cancer center. The sampling unit was caregivers of cancer patients seen in the hospital. The caregivers were systematically and randomly sampled from a list drawn from the Cancer Centre register of cancer patients, where the caregivers are captured as their treatment supporters, and each cancer patient is expected to have a caregiver. The sample size was 422 primary caregivers after calculation. The data collection tool was contracted from a QOL questionnaire, such as WHOQoL-BREF, developed to measure both objective and subjective dimensions of QOL, Personal Wellbeing scale, Herth Hope Index, and PHQ9/GAD-7 to assess psychological-related factors, which are more sensitive and have wider applicability.&#x0D; Results: Socioeconomic factors such as gender (p=0.007), type of area of residence (p=0.004), income in KSh (p=0.01), and number of rooms (p=0.0005) are significantly associated with perceived quality of life. Psychological-related factors like depression (p=0.001) and anxiety (p=0.002) are significantly associated with perceived quality of life. &#x0D; Conclusion: The study concluded that socioeconomic and psychological factors of primary caregivers of cancer patients can predict the health-related quality of life of those caregivers. The study recommends that financial charges for cancer management be subsided as this could relieve caregivers' financial burden. Other family members should support primary caregivers financially and psychologically to ease the burden of the primary caregiver. Psychosocial support group networks should be established for caregivers through multiple communication channels, thereby reducing the mental and psychological burden experienced by caregivers.

The primary caregivers of a cancer patient are essential in the recovery and fight against cancer, which is why there is a high risk that they present deterioration in their physical and mental health due to the innumerable amount of activities focused clearly on the patient that as a consequence put aside self-care to drastically change your daily activities. Objective: To determine coping strategies and quality of life in primary caregivers of cancer patients. Methodology: Corresponds to the quantitative, descriptive, correlational cross-sectional approach to establish the dimension of quality of life in primary caregivers of cancer patients through a descriptive survey of the quality of life test that addresses the physical, emotional, cognitive and social dimensions that influence the daily performance of the primary caregiver. Results: From the application of the Quality of Life Test, it was obtained in the sociodemographic characteristics that women with 58% in an age range of 28 to 37 years are mostly the primary caregivers of cancer patients, in terms of health status. In general, 70% of the caregivers consider themselves to be in good physical and mental condition, however, with the passage of time, considerable deterioration was observed in the caregivers of patients with a longer fight against cancer. Conclusions: Informal caregivers also require medical attention and psychological evaluation because they are the ones who face all the requirements of a cancer patient.

Background: False beliefs and myths about cancer prevail among the general population which gravely affect cancer care. The study aims to explore and address these misconceptions for improving treatment outcomes. Methods: This cross-sectional observational study was done among primary caregivers of cancer patients attending a tertiary cancer care hospital from eastern India which involved a face-to-face interview with a pretested validated questionnaire assessing perceptions related to cancer namely cultural beliefs, contagiousness, diet, screening, hazard of biopsy and surgery, alternate medication use, chemotherapy-induced pain, hair fall, and curability of disease. Myth score and myth index (MI) were calculated for each subject (MI ≥30% considered high). Results: Between August and December 2023, 356 caregivers were interviewed. The median age was 38 years, with 52% being females and 88% from a rural background. The median myth score was 7 (interquartile range: 4–10), and 85 (23.9%) caregivers had MI ≥30%. Univariate logistic regression analysis revealed female gender (odds ratio [OR]: 2.206], illiteracy (OR: 2.273), and not residing with a patient (OR: 1.819) to be significant predictors of high MI whereas multivariate logistic regression revealed only female gender (OR: 1.791) being a significant predictor. Conclusion: This study found numerous misconceptions among primary caregivers of cancer patients. Illiteracy, female gender as well as not residing with the patient were significant predictors of high MI. Various social stigmata that ostracize the cancer patient were identified. We hope our study will help to develop health policy to enhance cancer awareness by targeting specific perceptions.

This paper deeply studied the phenomenon of anticipatory grief among primary caregivers of cancer patients and explored its concept, influencing factors and effective intervention measures. Anticipatory grief, as a complex psychological experience, is often accompanied by the responsibility of cancer patients' caregivers and the challenge of pre-perceiving grief. We found that factors such as patient health status, care burden, and social support play a key role in the gen-eration of anticipatory grief. By deeply analyzing the concept and measurement tools of anticipatory grief, we revealed the multi-level characteristics of this psychological phenomenon. The discussion of influencing factors highlights the mental health needs of caregivers and emphasizes the importance of personalized support. In terms of proposed intervention measures, various strategies such as psychological support, educational information sharing, emotional expression and social support are considered to be key factors that are beneficial to alleviating anticipatory grief. Future research and practice should continue to deepen the understanding of anticipatory grief, continuously innovate and tailor support strategies to better meet the personalized needs of primary caregivers of cancer patients. Through joint efforts, we look forward to providing this special group with more warm and comprehensive support in the journey of care, so that they can find strength and hope in difficult situations.

The burden of care experienced by carers of cancer patients during the patient's lengthy medical treatment seriously affects their mental health and quality of life. Although social support may play a moderating role in this relationship, its specific role remains to be elucidated. This study aimed to investigate the mediating role of care burden in the relationship between psychological resilience and quality of life, as well as the moderating role of social support. 329 primary caregivers of cancer patients were chosen for the study from a tertiary hospital in Jinzhou, Liaoning, China, using a convenience selection technique. Data were collected using the Psychological Resilience Scale (CD-RISC), Carer Burden Inventory (CBI), Quality of Life Scale (SF-12), and Social Support Scale (SSRS). Additionally, descriptive statistics were utilized to study the sample. Significant correlations were found between psychological resilience, burden of care, social support, and quality of life of primary caregivers of cancer patients (P < 0.01). Mediation analyses showed that psychological resilience was a significant predictor of quality of life and that the effect of psychological resilience on quality of life was mediated to some extent by the caregiving burden. Care burden mediates the relationship between psychological resilience and quality of life, and social support moderates the relationship between care burden and quality of life. A high level of social support can reduce the level of caregiver burden and enable caregivers to maintain a high level of living standards. Primary carers of cancer patients are physiologically and psychologically vulnerable during the long process of treatment and care of cancer patients, and their overall level of quality of life should also be taken seriously, with clinical practitioners paying timely attention to their overall health status and providing appropriate and timely interventions and tools.

Primary caregivers of cancer patients in the palliative phase: A path analysis of variables influencing their burden

A large proportion of cancer deaths occur in the developing world, with limited resources for palliative care. Many patients dying at home experience difficult symptoms. The objective of this study was to assess the feasibility of a structured training program on symptom management along with an acute symptom management kit for primary caregivers of cancer patients receiving home care. Descriptive design was used. Thirty primary caregivers of cancer patients attending the palliative care clinic in Vellore, South India, were provided training on the administration of drugs for acute symptoms. A plastic box with partitions for drugs specific to symptom was provided. On follow-up visits, the usage of the kit, drugs used, and routes of administration were noted. A structured questionnaire with a 4-point scale was used to assess primary caregiver views and satisfaction. Of primary caregivers, 96.7% used a kit. The common medications used were morphine, metoclopramide, dexamethasone, and benzodiazepines. Seventy-three percent of primary caregivers administered subcutaneous injections at home. Hospital visits for acute symptoms reduced by 80%; 90% were satisfied with the training received; 73% stated it was not a burden to treat the patient at home. The training program and acute symptom management kit were favorably received and appropriately used by caregivers of diverse backgrounds. Rural backgrounds and illiteracy were not barriers to acceptance. Healthcare professionals should train caregivers during hospital visits, empowering them to manage acute symptoms and provide simple nursing care. This is doubly important in countries where resources are limited and palliative care facilities scarce.

The vital role played by primary caregivers in caring for cancer patients is well-recognized, but the caregiver burden and impact on family functioning to caregivers' mental health is poorly understood. This study examined the prospective and reciprocal relationships between family functioning, caregiver burden, and mental health. We aimed to determine whether inferior family functioning and heavy caregiver burden act as risk factors for mental health, as consequences of mental health, or both. Participants were 187 primary caregivers of cancer patients. They completed questionnaires with standardized measures assessing family functioning, caregiver burden, and mental health. A quantitative longitudinal design and a cross-lag model were used to test the reciprocal relationships between variables at three time points with 6-month intervals during the first year of early-stage cancer diagnosis and treatment. Family functioning did not predict participants' future mental health, but their mental health state predicted future caregiver burden and family functioning. Caregiver burden also predicted participants' future mental health. There was a dynamic reciprocal relationship between caregiver burden and mental health over time. The findings of this study emphasize the adverse effects of caregiver burden and may contribute to shedding light on the distinct mechanisms that underlie the relationships between caregiver burden, family functioning, and mental health. Our findings indicate the necessity of developing interventions to reduce the burden of caregiving and to facilitate family functioning. They will provide direction for family-centered nursing to meet primary caregivers' mental health needs in the care of cancer patients.