Psychosocial Distress in Caregivers of Patients with a Metastatic Solid Tumor in Routine Care: A Survey in a Community Based Oncology Group Practice in Germany

Abstract

Introduction: Psychosocial distress in caregivers of cancer patients is highly prevalent, particularly in advanced stages. Little data is available concerning extent and main issues of caregivers’ distress from patients who receive their treatment in an oncology group practice. Methods: Standardized cross-sectional survey was administered to caregivers and patients with a metastatic solid tumor who were treated in a community based oncology group practice. Patients provided information concerning their caregivers and level of distress. Caregivers assessed level and main issues of distress. The extent of distress was evaluated using the Distress Thermometer (DT), main issues of distress were evaluated by the Hospital Anxiety and Depression Scale (HADS-D). Results: 200 patients (35% male) with a median age of 68 (38 – 93) were interviewed. DT mean score was 4.7, with 35% scoring above cut-off (> 5). 90% named one or more caregiver, 1.3 were named in mean (0 – 4). 137 caregivers (42% male) with a median age of 61.5 (25 – 86) were interviewed. DT mean score was 5.4, with 48% scoring above cut-off (> 5). According to HADS-D 20% were anxious (cut-off >= 11) and 15% depressed (cut-off >= 9) in a clinical sense. With regard to the distress level of caregivers and patients, gender was not found to be a confounding variable although female patients showed higher distress levels than male patients. Conclusion: Caregivers are screened as highly distressed, sometimes even more than the patients themselves. A significant proportion seems to be anxious and depressed and therefore should be offered help.