Supportive Care in Cancer

, Volume 21, Issue 9, pp 2527–2535

Association between hope and burden reported by family caregivers of patients with advanced cancer

  • Inger Utne
  • Christine Miaskowski
  • Steven M. Paul
  • Tone Rustøen
Original Article

DOI: 10.1007/s00520-013-1824-5

Cite this article as:
Utne, I., Miaskowski, C., Paul, S.M. et al. Support Care Cancer (2013) 21: 2527. doi:10.1007/s00520-013-1824-5



The aim of this study, in a sample of family caregivers (FCs) of patients with advanced cancer, was to describe the level of FC burden using the Caregiver Reaction Assessment (CRA). In addition, the effects of select FC and patient characteristics on each of the CRA subscales were evaluated.


FCs and patients (n = 112) completed a demographic questionnaire, and Herth Hope Index, and the Hospital Anxiety and Depression Scale. FCs completed the CRA. Data were analyzed using multiple linear regression analyses.


For three of the five CRA subscales (i.e., “impact on finances”, “impact on daily schedule”, and “impact on health”), the mean scores were comparable to a Norwegian sample of FCs caring for patients in the late palliative phase. The variance in each of the CRA subscales was explained by different factors. Total explained variance ranged from 5.5 % (“lack of family support”) to 31.8 % (“impact on daily schedule”). FC characteristics, such as being female and lower educational level, distress regarding the patient’s pain, anxiety, depression, and level of hope, as well as the patients’ number of comorbidities, depression, and hope contributed to an increase in various domains of FC burden. FCs’ level of hope was a significant predictor for three of the CRA subscales (i.e., “self-esteem”, “lack of family support”, and “impact on health”).


Findings suggest that FCs’ and patients’ level of hope are important determinants of caregiver burden and that FCs with lower levels of hope represent a high-risk group for higher levels of caregiver burden.


OncologyFamily caregiverBurdenHopeCancer pain

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Inger Utne
    • 1
  • Christine Miaskowski
    • 2
  • Steven M. Paul
    • 2
  • Tone Rustøen
    • 3
    • 4
  1. 1.Faculty of Health ScienceOslo and Akershus University College of Applied ScienceOsloNorway
  2. 2.Department of Physiological NursingUniversity of CaliforniaSan FranciscoUSA
  3. 3.Division of Emergencies and Critical Care, Department of Research and Development, UllevålOslo University HospitalOsloNorway
  4. 4.Lovisenberg Diaconal University CollegeOsloNorway