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Level of caregiving burden and affecting factors in family caregivers of patients with lung cancer: A cross-sectional study

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Abstract

Purpose

To determine the caregiving burden level and affecting factors of family members caring for patients with lung cancer (LC).

Methods

This study used a cross-sectional design and a convenience sampling method. The study was conducted between April 2023 and August 2023 with the LC patients (n = 448) and their caregivers (n = 448) who met the inclusion criteria and were followed up in seven clinics of a specialized hospital for pulmonary diseases in Turkey. Data were collected by using (1) a demographic questionnaire (for patient and caregiver), (2) the Zarit Burden Interview (ZBI), (3) the Beck Depression Inventory (BDI), and (4) the Caregiver Quality of Life Index-Cancer (CQoLC).

Results

The study included 448 caregivers, with a mean age of 45.09 ± 13.48 years, and 71.4% were female. The mean ZBI score of 31.45 ± 16.71 indicated mild to moderate burden. Pearson correlation analysis showed that caregivers’ depression levels increased and quality of life decreased significantly as the care burden increased. Multiple regression analysis indicated a significant relationship between the caregiver burden and the patient’s age (p < 0.05), caregiver’s chronic disease (p < 0.05), type of treatment given to the patient (p < 0.05), patient’s metastasis status (p < 0.05) and caregiver’s quality of life (p < 0.01).

Conclusion

The fact that most of the risk factors identified in this study are non-modifiable highlights the necessity of identifying caregiver burden early by nurses and initiating the appropriate support processes.

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Data availability

The data that support the findings of this study are available from the corresponding author, upon reasonable request.

References

  1. Siegel RL, Miller KD, Fuchs HE, Jemal A (2022) Cancer statistics, 2022. CA Cancer J Clin 72(1):7–33. https://doi.org/10.3322/caac.21708

    Article  PubMed  Google Scholar 

  2. Karimi Moghaddam Z, Rostami M, Zeraatchi A, Mohammadi Bytamar J, Saed O, Zenozian S (2023) Caregiving burden, depression, and anxiety among family caregivers of patients with cancer: An investigation of patient and caregiver factors. Front Psychol 14:1059605. https://doi.org/10.3389/fpsyg.2023.1059605

    Article  PubMed  PubMed Central  Google Scholar 

  3. Abbasi A, Mirhosseini S, Basirinezhad MH, Ebrahimi H (2020) Relationship between caring burden and quality of life in caregivers of cancer patients in Iran. Support Care Cancer 28(9):4123–4129. https://doi.org/10.1007/s00520-019-05240-y

    Article  PubMed  Google Scholar 

  4. Unsar S, Erol O, Ozdemir O (2021) Caregiving burden, depression, and anxiety in family caregivers of patients with cancer. Eur J Oncol Nurs 50:101882. https://doi.org/10.1016/j.ejon.2020.101882

    Article  PubMed  Google Scholar 

  5. Mosher CE, Bakas T, Champion VL (2013) Physical health, mental health, and life changes among family caregivers of patients with lung cancer. Oncol Nurs Forum 40(1):53–61. https://doi.org/10.1188/13.ONF.53-61

    Article  PubMed  Google Scholar 

  6. Oechsle K, Ullrich A, Marx G et al (2020) Prevalence and Predictors of Distress, Anxiety, Depression, and Quality of Life in Bereaved Family Caregivers of Patients With Advanced Cancer. Am J Hosp Palliat Care 37(3):201–213. https://doi.org/10.1177/1049909119872755

    Article  PubMed  Google Scholar 

  7. Given B, Wyatt G, Given C et al (2004) Burden and depression among caregivers of patients with cancer at the end of life. Oncol Nurs Forum 31(6):1105–1117. https://doi.org/10.1188/04.ONF.1105-1117

    Article  PubMed  PubMed Central  Google Scholar 

  8. Kuscu MK, Dural U, Onen P et al (2009) The association between individual attachment patterns, the perceived social support, and the psychological well-being of Turkish informal caregivers. Psychooncology 18(9):927–935. https://doi.org/10.1002/pon.1441

    Article  PubMed  Google Scholar 

  9. Turkoglu N, Kilic D (2012) Effects of care burdens of caregivers of cancer patients on their quality of life. Asian Pac J Cancer Prev 13(8):4141–4145. https://doi.org/10.7314/apjcp.2012.13.8.4141

    Article  PubMed  Google Scholar 

  10. Üzar-Özçeti NYS, Dursun Sİ (2020) Quality of life, caregiver burden, and resilience among the family caregivers of cancer survivors. Eur J Oncol Nurs 48:101832. https://doi.org/10.1016/j.ejon.2020.101832

    Article  Google Scholar 

  11. Gérain P, Zech E (2019) Informal Caregiver Burnout? Development of a Theoretical Framework to Understand the Impact of Caregiving. Front Psychol 2019(10):1748. https://doi.org/10.3389/fpsyg.2019.01748

    Article  Google Scholar 

  12. Thana K, Lehto R, Sikorskii A, Wyatt G (2021) Informal caregiver burden for solid tumour cancer patients: a review and future directions. Psychol Health 36(12):1514–1535. https://doi.org/10.1080/08870446.2020.1867136

    Article  PubMed  Google Scholar 

  13. Stephanou M (2023) Caregiver burden: Support needed for those who support others and the National Health Service. Patient Exp J 10(2):23–33. https://doi.org/10.35680/2372-0247.1796

    Article  Google Scholar 

  14. Grant M, Sun V, Fujinami R et al (2013) Family caregiver burden, skills preparedness, and quality of life in non-small cell lung cancer. Oncol Nurs Forum 40(4):337–346. https://doi.org/10.1188/13.ONF.337-346

    Article  PubMed  PubMed Central  Google Scholar 

  15. Senden C, Vandecasteele T, Vandenberghe E et al (2015) The interaction between lived experiences of older patients and their family caregivers confronted with a cancer diagnosis and treatment: a qualitative study. Int J Nurs Stud 52(1):197–206. https://doi.org/10.1016/j.ijnurstu.2014.07.012

    Article  PubMed  Google Scholar 

  16. Seo YJ, Park H (2019) Factors influencing caregiver burden in families of hospitalised patients with lung cancer. J Clin Nurs 28(9–10):1979–1989. https://doi.org/10.1111/jocn.14812

    Article  PubMed  Google Scholar 

  17. Ferrell B, Hanson J, Grant M (2013) An overview and evaluation of the oncology family caregiver project: improving quality of life and quality of care for oncology family caregivers. Psychooncology 22(7):1645–1652. https://doi.org/10.1002/pon.3198

    Article  PubMed  Google Scholar 

  18. Chen JE, Lou VW, Jian H et al (2018) Objective and subjective financial burden and its associations with health-related quality of life among lung cancer patients. Support Care Cancer 26(4):1265–1272. https://doi.org/10.1007/s00520-017-3949-4

    Article  PubMed  CAS  Google Scholar 

  19. Danacı E, Koç Z (2018) Caregiving Burden and Life Satisfaction Among Caregivers of Cancer Patients Admitted to the Emergency Department. Clin Nurs Res. 27(7):800–825. https://doi.org/10.1177/1054773817708083

    Article  PubMed  Google Scholar 

  20. Coolbrandt A, Sterckx W, Clement P et al (2015) Family Caregivers of Patients With a High-Grade Glioma: A Qualitative Study of Their Lived Experience and Needs Related to Professional Care. Cancer Nurs 38(5):406–413. https://doi.org/10.1097/NCC.0000000000000216

    Article  PubMed  Google Scholar 

  21. Girgis A, Lambert S, Johnson C, Waller A, Currow D (2013) Physical, psychosocial, relationship, and economic burden of caring for people with cancer: a review. J Oncol Pract 9(4):197–202. https://doi.org/10.1200/JOP.2012.000690

    Article  PubMed  Google Scholar 

  22. Geng HM, Chuang DM, Yang F et al (2018) Prevalence and determinants of depression in caregivers of cancer patients: A systematic review and meta-analysis. Medicine (Baltimore) 97(39):e11863. https://doi.org/10.1097/MD.0000000000011863

    Article  PubMed  Google Scholar 

  23. García-Torres F, Jabłoński MJ, Gómez Solís Á et al (2020) Caregiver Burden Domains and Their Relationship with Anxiety and Depression in the First Six Months of Cancer Diagnosis. Int J Environ Res Public Health 17(11):4101. https://doi.org/10.3390/ijerph17114101

    Article  PubMed  PubMed Central  Google Scholar 

  24. Lee Wong C, Choi KC, Lau MN, Lam KL, Wei So WK (2020) Caregiving burden and sleep quality amongst family caregivers of Chinese male patients with advanced cancer: A cross-sectional study. Eur J Oncol Nurs 46:101774. https://doi.org/10.1016/j.ejon.2020.101774

    Article  PubMed  Google Scholar 

  25. Karabekiroğlu A, Demir EY, Aker S, Kocamanoğlu B, Karabulut GS (2018) Predictors of depression and anxiety among caregivers of hospitalised advanced cancer patients. Singapore Med J 59(11):572–577. https://doi.org/10.11622/smedj.2018066

    Article  PubMed  PubMed Central  Google Scholar 

  26. Milbury K, Badr H, Fossella F, Pisters KM, Carmack CL (2013) Longitudinal associations between caregiver burden and patient and spouse distress in couples coping with lung cancer. Support Care Cancer 21(9):2371–2379. https://doi.org/10.1007/s00520-013-1795-6

    Article  PubMed  PubMed Central  Google Scholar 

  27. Northouse L, Williams AL, Given B, McCorkle R (2012) Psychosocial care for family caregivers of patients with cancer. J Clin Oncol 30(11):1227–1234. https://doi.org/10.1200/JCO.2011.39.5798

    Article  PubMed  Google Scholar 

  28. Ellis J (2012) The impact of lung cancer on patients and carers. Chron Respir Dis 9(1):39–47. https://doi.org/10.1177/1479972311433577

    Article  PubMed  Google Scholar 

  29. Zabora J, BrintzenhofeSzoc K, Curbow B, Hooker C, Piantadosi S (2001) The prevalence of psychological distress by cancer site. Psychooncology 10(1):19–28. https://doi.org/10.1002/1099-1611(200101/02)10:1%3c19::aid-pon501%3e3.0.co;2-6

    Article  PubMed  CAS  Google Scholar 

  30. Morrison EJ, Novotny PJ, Sloan JA et al (2017) Emotional Problems, Quality of Life, and Symptom Burden in Patients With Lung Cancer. Clin Lung Cancer 18(5):497–503. https://doi.org/10.1016/j.cllc.2017.02.008

    Article  PubMed  PubMed Central  Google Scholar 

  31. Mirhosseini S, Ameri M, Baraniak A, Grimwood S, Basirinezhad MH, Ebrahimi H (2023) Unexpected changes and associated factors of care burden among caregivers of cancer patients one year after COVID-19 outbreak. Heliyon 9(10):e20504. https://doi.org/10.1016/j.heliyon.2023.e20504

    Article  PubMed  PubMed Central  Google Scholar 

  32. Hu X, Peng X, Su Y, Huang W (2018) Caregiver burden among Chinese family caregivers of patients with lung cancer: A cross-sectional survey. Eur J Oncol Nurs 37:74–80. https://doi.org/10.1016/j.ejon.2018.11.003

    Article  PubMed  Google Scholar 

  33. Zhu S, Yang C, Mei W et al (2023) Caregiver burden for informal caregivers of patients after surgical treatment of early-stage lung cancer. J Clin Nurs 32(5–6):859–871. https://doi.org/10.1111/jocn.16424

    Article  PubMed  Google Scholar 

  34. Zarit SH, Reever KE, Bach-Peterson J (1980) Relatives of the impaired elderly: correlates of feelings of burden. Gerontologist 20(6):649–655. https://doi.org/10.1093/geront/20.6.649

    Article  PubMed  CAS  Google Scholar 

  35. İnci F, Erdem M (2008) Validity and Reliability of The Burden Interview and Its Adaptation to Turkish. Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi 11(4):85–95

    Google Scholar 

  36. Schreiner AS, Morimoto T, Arai Y, Zarit S (2006) Assessing family caregiver’s mental health using a statistically derived cut-off score for the Zarit Burden Interview. Aging Ment Health 10(2):107–111. https://doi.org/10.1080/13607860500312142

    Article  PubMed  CAS  Google Scholar 

  37. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J (1961) An inventory for measuring depression. Arch Gen Psychiatry 4:561–571. https://doi.org/10.1001/archpsyc.1961.01710120031004

    Article  PubMed  CAS  Google Scholar 

  38. Hisli N (1989) Use of the beck depression inventory with Turkish university students: reliability, validity and factor analysis. Turkish Journal of Psycholoy 7:3–13

    Google Scholar 

  39. Weitzner MA, Jacobsen PB, Wagner H Jr, Friedland J, Cox C (1999) The Caregiver Quality of Life Index-Cancer (CQOLC) scale: development and validation of an instrument to measure quality of life of the family caregiver of patients with cancer. Qual Life Res 8(1–2):55–63. https://doi.org/10.1023/a:1026407010614

    Article  PubMed  CAS  Google Scholar 

  40. Bektas HA, Ozer ZC (2009) Reliability and validity of the caregiver quality of life index-cancer (CQOLC) scale in Turkish cancer caregivers. J Clin Nurs 18(21):3003–3012. https://doi.org/10.1111/j.1365-2702.2009.02915.x

    Article  PubMed  Google Scholar 

  41. Hacialioglu N, Ozer N, Yilmaz Karabulutlu E, Erdem N, Erci B (2010) The quality of life of family caregivers of cancer patients in the east of Turkey. Eur J Oncol Nurs 14(3):211–217. https://doi.org/10.1016/j.ejon.2010.01.017

    Article  PubMed  Google Scholar 

  42. Degner LF, Sloan JA (1995) Symptom distress in newly diagnosed ambulatory cancer patients and as a predictor of survival in lung cancer. J Pain Symptom Manage 10(6):423–431. https://doi.org/10.1016/0885-3924(95)00056-5

    Article  PubMed  CAS  Google Scholar 

  43. Williams AL, Tisch AJ, Dixon J, McCorkle R (2013) Factors associated with depressive symptoms in cancer family caregivers of patients receiving chemotherapy. Support Care Cancer 21(9):2387–2394. https://doi.org/10.1007/s00520-013-1802-y

    Article  PubMed  Google Scholar 

  44. Hodges LJ, Humphris GM, Macfarlane G (2005) A meta-analytic investigation of the relationship between the psychological distress of cancer patients and their carers. Soc Sci Med 60(1):1–12. https://doi.org/10.1016/j.socscimed.2004.04.018

    Article  PubMed  CAS  Google Scholar 

  45. Mellon S, Northouse LL, Weiss LK (2006) A population-based study of the quality of life of cancer survivors and their family caregivers. Cancer Nurs 29(2):120–133

    Article  PubMed  Google Scholar 

  46. Hsu T, Loscalzo M, Ramani R et al (2014) Factors associated with high burden in caregivers of older adults with cancer. Cancer 120(18):2927–2935. https://doi.org/10.1097/00002820-200603000-00007

    Article  PubMed  Google Scholar 

  47. Kaynar OG, Vural F (2018) Assessment of the caregiver burden of caregivers of colorectal patients with cancer. Turkish Journal of Colorectal Disease 28:164–171. https://doi.org/10.4274/tjcd.26121

    Article  Google Scholar 

  48. Verma V, Simone CB 2nd, Werner-Wasik M (2017) Acute and Late Toxicities of Concurrent Chemoradiotherapy for Locally-Advanced Non-Small Cell Lung Cancer. Cancers (Basel) 9(9):120. https://doi.org/10.3390/cancers9090120

    Article  PubMed  CAS  Google Scholar 

  49. Rucińska M (2022) Combined radiotherapy and chemotherapy. Nowotwory Journal of Oncology 72(5):319–325. https://doi.org/10.5603/NJO.2022.0051

    Article  Google Scholar 

  50. Yu H, Li H, Zuo T et al (2022) Financial toxicity and psychological distress in adults with cancer: A treatment-based analysis. Asia Pac J Oncol Nurs 9(9):100069. https://doi.org/10.1016/j.apjon.2022.04.008

    Article  PubMed  PubMed Central  Google Scholar 

  51. Hendriksen E, Williams E, Sporn N, Greer J, DeGrange A, Koopman C (2015) Worried together: a qualitative study of shared anxiety in patients with metastatic non-small cell lung cancer and their family caregivers. Support Care Cancer 23(4):1035–1041. https://doi.org/10.1007/s00520-014-2431-9

    Article  PubMed  Google Scholar 

  52. Willis K, Lewis S, Ng F, Wilson L (2015) The experience of living with metastatic breast cancer–a review of the literature. Health Care Women Int 36(5):514–542. https://doi.org/10.1080/07399332.2014.896364

    Article  PubMed  Google Scholar 

  53. Rotter J, Spencer JC, Wheeler SB (2019) Financial Toxicity in Advanced and Metastatic Cancer: Overburdened and Underprepared. J Oncol Pract 15(4):e300–e307. https://doi.org/10.1200/JOP.18.00518

    Article  PubMed  PubMed Central  Google Scholar 

  54. Rodriguez-Gonzalez A, Velasco-Durantez V, Martin-Abreu C et al (2022) Fatigue, Emotional Distress, and Illness Uncertainty in Patients with Metastatic Cancer: Results from the Prospective NEOETIC_SEOM Study. Curr Oncol 29(12):9722–9732. https://doi.org/10.3390/curroncol29120763

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

The authors thank the patients and caregivers who agreed to participate in this study.

Funding

No funds, grants, or other support was received.

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Contributions

All authors contributed to the study conception and design. Material preparation and data collection were performed by HB. The full manuscript was written by ÖED & HB and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Öznur Erbay Dalli.

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Ethics approval and consent to participate

The study was conducted according to the Declaration of Helsinki. Required permissions were obtained from the Health Sciences Research and Publication Ethics Committee at Bursa Uludağ University (Decision no: 2023-02/06) and the administration of the hospital where the study was conducted. Caregivers and patients who were eligible to participate in the study were informed about the purpose and procedure of the study, their written and verbal consent was obtained, and they were informed that they had the right to withdraw from the study at any time.

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Erbay Dalli, Ö., Bulut, H. Level of caregiving burden and affecting factors in family caregivers of patients with lung cancer: A cross-sectional study. Support Care Cancer 32, 60 (2024). https://doi.org/10.1007/s00520-023-08259-4

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