The Relationship between Cancer Caregiver Burden and Psychological Outcomes: The Moderating Role of Social Connectedness

The present study: (a) examined the extent of caregiver burden and psychological wellbeing and (b) tested whether social connectedness moderated the association between caregiver burden and psychological symptoms in caregivers of people with cancer. The cross-sectional survey study included 189 cancer caregivers (mean age = 36.19 years, standard deviation = 11.78; 80.4% female). Data were collected on caregiver burden, social connectedness, and depression and anxiety. Moderation analysis was conducted to examine the effect of social connectedness on the relationship between caregiver burden and depression and anxiety. Caregiver burden was positively associated with depression and anxiety symptoms. Controlling for significant demographic and caregiver characteristics, the moderation model showed as perceived social connectedness increased, the relationship between caregiver burden and depression decreased (β = −0.007, se = 0.004, 95% CI: −0.014, 0.000, p = 0.05). By contrast, social connectedness did not moderate the association between caregiver burden and anxiety. Findings have implications for the management of depression in cancer caregivers. Social connectedness appears to provide a protective buffer from the negative impacts of caregiving, providing increased psychological resources to manage the burden associated with caregiving, resulting in lower depression. Research on strategies to improve caregiver wellbeing through enhancing engagement with social networks in ways that improve perceived sense of connectedness with others is warranted.

Exploring Spirituality, Loneliness and HRQoL In Hispanic Cancer Caregivers

Providing care to an aging society in the new normal requires increased attention to the informal caregivers who support the health and well-being of older adults with chronic conditions. Hispanic caregivers carry a high caregiver-associated burden. Health disparities experienced by Hispanics, coupled with the emotional, social and physical demands of caregiving, may set an unprecedented risk for lower health-related quality of life (HRQoL). In a quantitative analysis, we investigated the relationship between spirituality, loneliness and HRQoL in Hispanic cancer caregivers using baseline data from the Support for Latinas with Breast Cancer study (N= 234 Hispanic caregivers). Findings suggested an indirect effect of spirituality on HRQoL through reduced loneliness among more spiritual caregivers, effects that were independent of age. The second study was conducted using qualitative semi-structured interviews (N= 10) with Hispanic caregivers. Interviews evaluated spirituality and HRQoL in Hispanic cancer caregivers who reported variable levels of loneliness. Five themes emerged: caregiver experience, coping strategies, loneliness, religion to gain strength or support, and spirituality to gain strength or support. Results supported the role of spirituality in promoting higher HRQoL in Hispanic cancer caregivers and elucidated pathways to intervene on HRQoL through spirituality. With Hispanics often underutilizing formal services, having an improved understanding of caregiving experiences, particularly related to spirituality, will support the development of culturally-relevant strategies and programming to promote HRQoL for Hispanic caregivers.

Technology-Based Interventions for Cancer Caregivers: Concept Analysis

Background Cancer is a taxing chronic disease that demands substantial care, most of which is shouldered by informal caregivers. As a result, cancer caregivers often have to manage considerable challenges that could result in severe physical and psychological health consequences. Technology-based interventions have the potential to address many, if not all, of the obstacles caregivers encounter while caring for patients with cancer. However, although the application of technology-based interventions is on the rise, the term is seldom defined in research or practice. Considering that the lack of conceptual clarity of the term could compromise the effectiveness of technology-based interventions for cancer caregivers, timely research is needed to bridge this gap. Objective This study aims to clarify the meaning of technology-based interventions in the context of cancer caregiving and provide a definition that can be used by cancer caregivers, patients, clinicians, and researchers to facilitate evidence-based research and practice. Methods The 8-step concept analysis method by Walker and Avant was used to analyze the concept of technology-based interventions in the context of cancer caregiving. PubMed, PsycINFO, CINAHL, and Scopus were searched for studies that examined technology-based interventions for cancer caregivers. Results The defining attributes of technology-based interventions were recognized as being accessible, affordable, convenient, and user-friendly. On the basis of insights gained on the defining attributes, antecedents to, and consequences of technology-based interventions through the concept analysis process, technology-based interventions were defined as the use of technology to design, develop, and deliver health promotion contents and strategies aimed at inducing or improving positive physical or psychological health outcomes in cancer caregivers. Conclusions This study clarified the meaning of technology-based interventions in the context of cancer caregiving and provided a clear definition that can be used by caregivers, patients, clinicians, and researchers to facilitate evidence-based oncology practice. A clear conceptualization of technology-based interventions lays foundations for better intervention design and research outcomes, which in turn have the potential to help health care professionals address the needs and preferences of cancer caregivers more cost-effectively.

An Evaluation of Natural Environment Interventions for Informal Cancer Caregivers in the Community

Home-based informal caregiving by friends and family members of patients with cancer is becoming increasingly common globally with rates continuing to rise. Such caregiving is often emotionally and cognitively demanding, resulting in mental exhaustion and high perceived burden. Support for caregivers may be fostered by engagement with the natural environment. Interaction with nature is associated with mental health benefits such as stress reduction and improved wellbeing. The purpose of this paper was to evaluate the state of the science regarding the use of natural environment interventions to support caregivers of cancer patients in the community. A comprehensive scoping review using the Arksey and O’Malley framework and the Preferred Reporting Items for Systematic Reviews and Meta-analyses assessed natural environment therapies and mental health outcomes among cancer caregivers. Databases searched included CINAHL, PubMed, Scopus, Cochrane, and Alt HealthWatch. Findings recovered a total of five studies over a 10-year period that met criteria, demonstrating a lack of empirical evidence addressing this potential resource to support caregivers. Often, study appraisal was not on nature exposure, but rather other aspects of the projects such as program evaluation, exercise, or complementary therapies. Both qualitative and quantitative designs were used but sample sizes were small. Caregivers experienced beneficial results across the various studies and future work could enhance these findings.

Cancer Caregiver Quality of Life: Meta-Analysis

People living with cancer benefit greatly from informal caregivers. There has never been a previous meta-analysis on the quality of life of cancer caregivers or the efficacy of caregiver intervention programmes. The goal of this meta-analysis was to look at the quality of life of cancer caregivers and the impact of various initiatives aimed at improving it. From January 2006 to April 2021, a comprehensive literature search was conducted using PubMed, PubMed Central, Clinical Key, Google Scholar and Cochrane database. The effect of caregiver interventional programs on quality of life was evaluated using a mean difference between experimental and control groups. A random-effect model was used to measure the risk ratio (RR) for calculating the quality of life of cancer caregivers. The final report comprised eight trials with a total of 1142 participants. The caregiver intervention programme was found to improve the quality of life of cancer caregivers, but not statistically significantly (mean difference=0.10; p<0.00001). A caregiver interventional program had a positive effect on the quality of life of cancer caregivers, according to this meta-analysis. To prove that caregiver interventional programs are successful strategies for improving the quality of life of cancer caregivers, further randomised controlled trials are required.

The Supportive Care Needs of Regional and Remote Cancer Caregivers

Objective: As cancer survival rates continue to increase, so will the demand for care from family and friends, particularly in more isolated settings. This study aims to examine the needs of cancer caregivers in regional and remote Australia. Methods: A total of 239 informal (i.e., non-professional) cancer caregivers (e.g., family/friends) from regional and remote Queensland, Australia, completed the Comprehensive Needs Assessment Tool for Cancer Caregivers (CNAT-C). The frequencies of individuals reporting specific needs were calculated. Logistic regression analyses assessed the association between unmet needs and demographic characteristics and cancer type. Results: The most frequently endorsed needs were lodging near hospital (77%), information about the disease (74%), and tests and treatment (74%). The most frequent unmet needs were treatment near home (37%), help with economic burden (32%), and concerns about the person being cared for (32%). Younger and female caregivers were significantly more likely to report unmet needs overall (OR = 2.12; OR = 0.58), and unmet healthcare staff needs (OR = 0.35; OR = 1.99, respectively). Unmet family and social support needs were also significantly more likely among younger caregivers (OR = 0.35). Caregivers of breast cancer patients (OR = 0.43) and older caregivers (OR = 0.53) were significantly less likely to report unmet health and psychology needs. Proportions of participants reporting needs were largely similar across demographic groups and cancer type with some exceptions. Conclusions: Caregiver health, practical issues associated with travel, and emotional strain are all areas where regional and remote caregivers require more support. Caregivers’ age and gender, time since diagnosis and patient cancer type should be considered when determining the most appropriate supportive care.