The psycho-social impact of cancer treatment on the caregivers of the patients
Authors: Shanmugam Subbiah , Jebasingh Arun Victor , Singodiya Suyash 
Published: November 2024

Objectives
The incidence of cancer cases shows an increasing trend over the past two decades owing to several factors, such as increased life expectancy, aging population, behavioral, environmental, and occupational risk factors, and more. Consequently, a greater number of people are expected to take the role of principal caregivers in the near future. Cancer treatment can have a multifaceted impact on the quality of life and psychological well-being of not only the patients but also their families. Caregivers are expected and required to provide complex care and support for which they are neither prepared nor trained. The reports of feeling overwhelmed and stressed are high when the demands placed on them exceed their resources, resulting in a negative effect on the overall well-being of the caregivers, including the patients themselves. The impact covers a wide spectrum of emotional, physical, financial, social, cognitive, spiritual, and work-related effects.

Material and Methods
This is a cross-sectional study conducted (for over three months from May to July 2023) among the caregivers accompanying cancer patients attending a tertiary care hospital in a South Indian metropolitan city. All the adult caregivers of patients diagnosed with cancer at least two to six months before the time of the study were considered as the study population. A systematic random sample was applied to recruit a convenient sample of 150 caregivers, maintaining the enrollment of only one caregiver per patient. Sociodemographic details of the patients and their caregivers were collected. The Zarit Burden Interview (ZBI) based on a Likert scale was implemented to collect relevant data related to both the cancer patient and the family caregiver.

Results
Of the total 150 cancer patients, the most common type of cancer among the patients was head and neck (63, 42%), followed by cancers of the female reproductive system (44, 29.3%) and breast (24, 16%). Nearly 47% of caregivers were children of cancer patients, while 35.3% were spouses. Significantly higher burden scores on the “emotional strain” and “financial/physical strain” domains were observed among female caregivers. Higher burden scores on the “self-criticism” domain were independently associated with a shorter caregiver-patient contact time. Significantly higher burden scores on the “self-criticism” and “time/dependence” domains were observed among employed caregivers. Higher levels of burden on the “financial/physical strain” domain were reported by unemployed caregivers. Significantly higher burden scores on the “uncertainty” domain were observed among older caregivers and caregivers who were parents or spouses of the patients.

Conclusion
Caregiving impacts the physical, emotional, financial, and social aspects of the caregiver’s life. They adopt active coping strategies to overcome the impacts of caregiving. A majority of the caregivers experienced mild to moderate burden, while most scored low on quality of life. Attention to concerns and the psychological well-being of caregivers may improve the overall scenario.