The Role of Family Caregiver in Head and Neck Cancer

Abstract

Objective: The family caregiver’s role (FCG) is largely un-investigated among head and neck cancer patients. 1) To better detail the role of FCG. 2) To evaluate quality of life (QoL) and psychological distress of FCGs and patients. 3) To investigate relationships between FCG’s well being and patient’s QoL and emotional pattern. Method: Sixty patients and their caregivers were enrolled in this observational cross-sectional study between 2008 and 2011 at the ENT Division of the University of Turin. Inclusion criteria: diagnosis of HNSCC, stage III-IV, completion of curative treatment and NED at the enrollment. Psycho-oncological tests: Distress Thermometer, STAI-Y1/Y2, Beck Depression Inventory (BDI) and Montgomery-Asberg Depression Rating Scale (MDRS), EORTC-QLQ-C30+H&N35 module and Caregiver Quality of Life Index-Cancer. Results: Patients: state and trait anxiety are 46.7% (STAI-Y1 mean value 40.2 ± 10.2; cutoff 40) and 36.7% (STAI-Y2 mean value 36.7 ± 8.2; cutoff 40) respectively; self-reported and clinician-rated depression are 31.6% (BDI mean value 8.2 ± 5.3; cutoff 9) and 48.3% (MDRS mean value 7.9 ± 5.9; cutoff 6), respectively. CGs: state and trait anxiety are 50% (STAI-Y1 mean value 42.5 ± 9.9; cutoff 40) and 41.7% (STAI-Y2 mean value 39.1 ± 8.7; cutoff 40), respectively; self-reported and clinician-rated depression are 28.3% (BDI mean value 7.3 ± 4.7; cutoff 9) and 41.7% (MDRS mean value 7.6 ± 5.8; cutoff 6), respectively. Positive association among emotional scales of patients and caregivers was observed. Patients’ psychological aspects are negatively associated with CGs’ QoL and vice versa. Conclusion: Anxiety and depression are often present in FCGs and cured HNC patients. Long-term patients’ QoL is the result of a frail balance between FCG and patient emotional and psychological distress. A psychological support for FCG could improve patient well-being.