The Psychosocial and Financial Challenges faced by Caregivers of Cancer Patients
DOI:
https://doi.org/10.51253/pafmj.v76iSUPPL-9.14194Keywords:
Cancer Caregivers, Caregiver Burden, Pakistan, Psychosocial Burden, Zarit Burden InterviewAbstract
Objective: To determine the psychosocial and economic burden of the caregivers of cancer patients.
Study Design: Cross-sectional study.
Place and Duration of Study: Department of Medical Oncology, PNS Shifa Hospital, Karachi Pakistan, from Jun to Dec 2025.
Methodology: A total of 150 caregivers of cancer patients were enrolled using the consecutive non-probability sampling method. For data collection the 22-items Zarit Burden Interview (ZBI-22), a validated tool for measurement of multidimensional caregiver burden was used. For demographic variables and ZBI scores, descriptive statistics were calculated. Chi-square test, with level of significance p-value <0.05 was used to determine the association between severity of burden and caregivers’ characteristics. Cronbach’s alpha was used to assess the internal consistency of the instrument.
Results: Average ZBI score was 37.89±12.80 signifies mild to moderate burden. Majority of caregivers reported variable amount of burden, no/mild 10.7%, mild/moderate 50.0%, moderate/severe burden 34.7% and severe burden was noted in 4.7% cases. Female caregivers reported higher burden scores than males. Around 40% participants reported financial and emotional stress.
Conclusion: The caregivers of cancer patients experienced substantial psychosocial and financial burden. It is paramount to formulate, implement and integrate caregivers’ focused screening and interventions into oncology settings to safeguard the wellbeing and outcomes for both caregivers and patients.
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References
1. Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin 2021; 71(3): 209-249. https://doi.org/10.3322/caac.21660
2. Bray F, Laversanne M, Weiderpass E, Soerjomataram I. The ever-increasing importance of cancer as a leading cause of premature death worldwide. Cancer 2021; 127(16): 3029-3054.
https://doi.org/10.1002/cncr.33587
3. Ali A, Manzoor MF, Ahmad N, Aadil RM, Qin H, Siddique R, et al. The Burden of Cancer, Government Strategic Policies, and Challenges in Pakistan: A Comprehensive Review. Front Nutr 2022; 9: 940514.
https://doi.org/10.3389/fnut.2022.940514
4. Arbani S, Bibi A, Hyder S, Javed S, Muhammad T, Abid S, et al. Assess the Burden of Caregivers of Cancer Patients at a Tertiary Care Hospital in Karachi, Pakistan: Burden of Caregivers of Cancer Patients. Pak Bio Med J 2023: 37-41.
https://doi.org/10.54393/pbmj.v6i12.986
5. Shahid N, Malik TA, Hussain A, Ahmed S. Unmet psycho-social needs, coping strategies and psychological distress among people with cancer: Evidence from Pakistan. J Pak Med Assoc 2021; 71(5): 1373-1378.
https://doi.org/10.47391/jpma.1117
6. Victor CR, Zubair M, Martin W. Families and caring in South Asian communities. InThe New Dynamics of Ageing: Volume 2. Bristol: Policy Press, 2018: 87-104.
https://doi.org/10.51952/9781447314813.ch006
7. Laryionava K, Pfeil TA, Dietrich M, Reiter-Theil S, Hiddemann W, Winkler EC. The second patient? Family members of cancer patients and their role in end-of-life decision making. BMC palliat Care 2018; 17(1): 29.
https://doi.org/10.1186/s12904-018-0288-2
8. Mishra S, Srivastava AK, Sharma R, Bhatnagar S. Caregiver burden and quality of life among family caregivers of cancer patients on chemotherapy: A cross-sectional study. Indian J Palliat Care 2021; 27(3): 397-404.
https://doi.org/10.4103/IJPC.IJPC_180_20
9. Onyeneho CA, Ilesanmi RE. Burden of care and perceived psycho-social outcomes among family caregivers of patients living with cancer. Asia Pac J Oncol Nurs 2021; 8(3): 330-336.
https://doi.org/10.4103/2347-5625.308678
10. Karimi Moghaddam Z, Rostami M, Zeraatchi A, Mohammadi Bytamar J, Saed O, Zenozian S. Caregiving burden, depression, and anxiety among family caregivers of patients with cancer: An investigation of patient and caregiver factors. Front Psychol 2023; 14: 1059605.
https://doi.org/10.3389/fpsyg.2023.1059605
11. Ugalde A, Gaskin CJ, Rankin NM, Schofield P, Boltong A, Aranda S, et al. A systematic review of cancer caregiver interventions: appraising the potential for implementation of evidence into practice. Psychooncology 2019; 28(4): 687-701.
https://doi.org/10.1002/pon.5018
12. Psihogios AM, Strachan L, Melch M, Ahmed AM, McKelvey ER, Sproch A, et al. Activating Adolescent and Young Adult Involvement with Cancer Care Responsibilities: A Dyadic Qualitative Study with Caregivers. J Adolesc Young Adult Oncol 2024; 13(4): 683-692.
https://doi.org/10.1089/jayao.2023.0139
13. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018. CA Cancer J Clin 2018; 68(1): 7-30.
https://doi.org/10.3322/caac.21442
14. Akter J, Konlan KD, Nesa M, Ispriantari A. Factors influencing cancer patients’ caregivers’ burden and quality of life: An integrative review. Heliyon 2023; 9(11).
https://doi.org/10.1016/j.heliyon.2023.e21243
15. Mahmood S, Khawaja SN, Yusuf MA. Cancer care in times of conflict: Treatment of patients from Afghanistan, in Pakistan. Front Oncol 2023; 13: 1110709.
https://doi.org/10.3389/fonc.2023.1110709
16. Nguyen OT, Donato U, McCormick R, Reblin M, Kim L, Hume E, Otto AK, Alishahi Tabriz A, Islam JY, Hong YR, Turner K. Financial toxicity among head and neck cancer patients and their caregivers: A cross‐sectional pilot study.Laryngoscope Investig Otolaryngol 2023; 8(2): 450-457.
https://doi.org/10.1002/lio2.1038
17. Mathew M, Rao AP, Pai A, Sumit K, Lewis S. Assessment of financial toxicity and coping strategies associated with cancer treatment among caregivers of patients with cancer from a lower-middle–income country. JCO Glob Oncol 2024; 10: e2300397. https://doi.org/10.1200/GO.23.00397
18. Kitaw TA, Tilahun BD, Zemariam AB, Getie A, Bizuayehu MA, Haile RN. The financial toxicity of cancer: unveiling global burden and risk factors–a systematic review and meta-analysis. BMJ Glob Health 2025: 10(2): e017133.
https://doi.org/10.1136/bmjgh-2024-017133
19. Gupta S, Rohilla KK, Bachheti Y, Kalyani VC, Gupta A, Sundriyal D, et al. Challenges faced by caregivers of patients with cancer in the sub-Himalayan region: An exploratory survey. Cancer Res Stat Treat 2022; 5(2): 220-225.
https://doi.org/10.4103/crst.crst_319_21
20. Rexhaj S, Nguyen A, Favrod J, Coloni-Terrapon C, Buisson L, Drainville AL, et al. Women involvement in the informal caregiving field: A perspective review. Front Psychiatry 2023; 14: 1113587. https://doi.org/10.3389/fpsyt.2023.1113587
21. Ng JHY, Luk BHK, Lee NPM. Gender differences in cancer spousal caregiving: A systematic review. Palliat Support Care 2023; 21(5): 880–889. http://doi.org/10.1017/S147895152300073
22. Yuen EY, Wilson CJ. The relationship between cancer caregiver burden and psychological outcomes: the moderating role of social connectedness. Curr Oncol 2021; 29(1): 14-26.
https://doi.org/10.3390/curroncol29010002
23. Kalyani CV, Rohilla KK, Gupta P, Gupta A, Gupta S. Effect of Psychosocial Interventions on Cancer's Caregiver Quality of Life: Meta-analysis. Clin Pract Epidemiol Ment Health 2023; 19: e174501792308240.
http://dx.doi.org/10.2174/17450179-v19-e230927-2022-HT14-4336-1
24. Geng HM, Chuang DM, Yang F, Yang Y, Liu WM, Liu LH,et al. Prevalence and determinants of depression in caregivers of cancer patients: A systematic review and meta-analysis. Medicine 2018; 97(39): e11863.
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