Skip to main content

Prevalence and predictors of anxiety and depression among family caregivers of cancer patients: a nationwide survey of patient–family caregiver dyads in Korea

Supportive Care in Cancer volume 21, pages 2799–2807 (2013)Cite this article

Abstract

Purpose

This study aimed to identify the prevalence and predictors of anxiety and depression among family caregivers of patients with cancer in Korea.

Methods

A national, multicenter, cross-sectional survey was conducted with 897 family caregivers. The Hospital Anxiety and Depression Scale was used to assess anxiety and depression in patient–family caregiver dyads.

Results

The prevalence of anxiety in family caregivers was 38.1 %:20.3 % reported mild anxiety, 13.3 % reported moderate anxiety, and 4.6 % reported severe anxiety. The prevalence of depression was 82.2 %:40.4 % reported mild depression, 25.5 % reported moderate depression, and 16.3 % reported severe depression. Family caregivers who were younger, were caring for male patients, or had a low quality of life (QOL) in relation to three of the variables measured in the Korean Caregiver Quality of Life Index-Cancer (CQOLC-K): burden, disturbance, and financial concerns reported increased anxiety. Becoming unemployed during caregiving, being the spouse of a patient and having low QOL in relation to three of the variables measured by the CQOLC-K: burden, disturbance, and positive adaptation were associated with depression among family caregivers. The predictive validity of the selected variables were 0.861 (95 % CI: 0.844–0.892) for anxiety and 0.794 (95 % CI: 0.751–0.828) for depression.

Conclusions

Family caregivers of patients with cancer experienced high levels of anxiety and depression. Socio-demographic factors and QOL were predictors of anxiety and depression in family caregivers.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

References

  1. Jung KW, Park S, Kong HJ, Won YJ, Lee JY, Seo HG, Lee JS (2012) Cancer statistics in Korea: incidence, mortality, survival, and prevalence in 2009. Cancer research and treatment. Official Journal of Korean Cancer Association 44(1):11–24. doi:10.4143/crt.2012.44.1.11

    Article  Google Scholar 

  2. Glajchen M (2004) The emerging role and needs of family caregivers in cancer care. J Support Oncol 2(2):145–155

    PubMed  Google Scholar 

  3. Given BA, Given CW, Kozachik S (2001) Family support in advanced cancer. CA: a cancer journal for clinicians 51(4):213–231

    Article  CAS  Google Scholar 

  4. Nijboer C, Tempelaar R, Sanderman R, Triemstra M, Spruijt RJ, van den Bos GA (1998) Cancer and caregiving: the impact on the caregiver's health. Psycho-Oncology 7(1):3–13. doi:10.1002/(sici)1099-1611(199801/02)7:1<3::aid-pon320>3.0.co;2-5

    Article  CAS  PubMed  Google Scholar 

  5. Kim Y, Spillers RL (2010) Quality of life of family caregivers at 2 years after a relative's cancer diagnosis. Psycho-Oncology 19(4):431–440. doi:10.1002/pon.1576

    Article  PubMed  Google Scholar 

  6. Beach SR, Schulz R, Yee JL, Jackson S (2000) Negative and positive health effects of caring for a disabled spouse: longitudinal findings from the caregiver health effects study. Psychology and Aging 15(2):259–271

    Article  CAS  PubMed  Google Scholar 

  7. Lee S, Colditz GA, Berkman LF, Kawachi I (2003) Caregiving and risk of coronary heart disease in U.S. women: a prospective study. American Journal of Preventive Medicine 24(2):113–119

    Article  PubMed  Google Scholar 

  8. Haley WE, Roth DL, Howard G, Safford MM (2010) Caregiving strain and estimated risk for stroke and coronary heart disease among spouse caregivers: differential effects by race and sex. Stroke; A Journal of cerebral circulation 41(2):331–336. doi:10.1161/strokeaha.109.568279

    Article  PubMed  Google Scholar 

  9. Stenberg U, Ruland CM, Miaskowski C (2010) Review of the literature on the effects of caring for a patient with cancer. Psycho-Oncology 19(10):1013–1025. doi:10.1002/pon.1670

    Article  PubMed  Google Scholar 

  10. Edwards B, Clarke V (2004) The psychological impact of a cancer diagnosis on families: the influence of family functioning and patients' illness characteristics on depression and anxiety. Psycho-Oncology 13(8):562–576. doi:10.1002/pon.773

    Article  PubMed  Google Scholar 

  11. Grunfeld E, Coyle D, Whelan T, Clinch J, Reyno L, Earle CC, Willan A, Viola R, Coristine M, Janz T, Glossop R (2004) Family caregiver burden: results of a longitudinal study of breast cancer patients and their principal caregivers. CMAJ: Canadian Medical Association journal = journal de l'Association medicale Canadienne 170(12):1795–1801

    Article  Google Scholar 

  12. Schulz R, Beach SR (1999) Caregiving as a risk factor for mortality: the Caregiver Health Effects Study. JAMA: The Journal of the American Medical Association 282(23):2215–2219

    Article  CAS  Google Scholar 

  13. Grov EK, Dahl AA, Moum T, Fossa SD (2005) Anxiety, depression, and quality of life in caregivers of patients with cancer in late palliative phase. Annals of Oncology: Official Journal of the European Society for Medical Oncology / ESMO 16(7):1185–1191. doi:10.1093/annonc/mdi210

    Article  CAS  Google Scholar 

  14. Kurtz ME, Kurtz JC, Given CW, Given B (2005) A randomized, controlled trial of a patient/caregiver symptom control intervention: effects on depressive symptomatology of caregivers of cancer patients. Journal of Pain and Symptom Management 30(2):112–122. doi:10.1016/j.jpainsymman.2005.02.008

    Article  PubMed  Google Scholar 

  15. Price MA, Butow PN, Costa DS, King MT, Aldridge LJ, Fardell JE, DeFazio A, Webb PM (2010) Prevalence and predictors of anxiety and depression in women with invasive ovarian cancer and their caregivers. The Medical Journal of Australia 193(5 Suppl):S52–S57

    PubMed  Google Scholar 

  16. Yang X, Wang L, He J, Ge C, Chang Y, Fu J, Wei J, Pattaramongkolar E, Zhou Y (2011) Factors related to depressive symptoms among Chinese caregivers of cancer patients. Psycho-Oncology. doi:10.1002/pon.1999

    Google Scholar 

  17. Pitceathly C, Maguire P (2003) The psychological impact of cancer on patients' partners and other key relatives: a review. European Journal of Cancer (Oxford, England: 1990) 39(11):1517–1524

    Article  CAS  Google Scholar 

  18. Kim Y, Duberstein PR, Sorensen S, Larson MR (2005) Levels of depressive symptoms in spouses of people with lung cancer: effects of personality, social support, and caregiving burden. Psychosomatics 46(2):123–130. doi:10.1176/appi.psy.46.2.123

    Article  PubMed  Google Scholar 

  19. Rhee YS, Yun YH, Park S, Shin DO, Lee KM, Yoo HJ, Kim JH, Kim SO, Lee R, Lee YO, Kim NS (2008) Depression in family caregivers of cancer patients: the feeling of burden as a predictor of depression. Journal of Clinical Oncology: Official journal of the American Society of Clinical Oncology 26(36):5890–5895. doi:10.1200/jco.2007.15.3957

    Article  Google Scholar 

  20. Gaston-Johansson F, Lachica EM, Fall-Dickson JM, Kennedy MJ (2004) Psychological distress, fatigue, burden of care, and quality of life in primary caregivers of patients with breast cancer undergoing autologous bone marrow transplantation. Oncol Nurs Forum 31(6):1161–1169. doi:10.1188/04.onf.1161-1169

    Article  PubMed  Google Scholar 

  21. Miaskowski C, Kragness L, Dibble S, Wallhagen M (1997) Differences in mood states, health status, and caregiver strain between family caregivers of oncology outpatients with and without cancer-related pain. J of Pain and Symptom Manage 13(3):138–147

    Article  CAS  Google Scholar 

  22. Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67(6):361–370

    Article  CAS  PubMed  Google Scholar 

  23. Oh SM, Min KJ, Park DB (1999) A study on the standardization of the Hospital Anxiety and Depression Scale for Koreans: a comparison of normal, depressed and anxious groups. J Korean Neuropsychiatr Assoc 38(2):289–296

    Google Scholar 

  24. Rhee YS, Shin DO, Lee KM, Yu HJ, Kim JW, Kim SO, Lee R, Lee YO, Kim NS, Yun YH (2005) Korean version of the caregiver quality of life index-cancer (CQOLC-K). Quality of life research: an international journal of quality of life aspects of treatment, care and rehabilitation 14(3):899–904

    Article  Google Scholar 

  25. Yun YH, Park YS, Lee ES, Bang SM, Heo DS, Park SY, You CH, West K (2004) Validation of the Korean version of the EORTC QLQ-C30. Quality of life research: an international journal of quality of life aspects of treatment, care and rehabilitation 13(4):863–868

    Article  CAS  Google Scholar 

  26. Breslow N (1982) Design and analysis of case–control studies. Annual Review of Public Health 3:29–54. doi:10.1146/annurev.pu.03.050182.000333

    Article  CAS  PubMed  Google Scholar 

  27. Zou KH, Tuncali K, Silverman SG (2003) Correlation and simple linear regression. Radiology 227(3):617–622. doi:10.1148/radiol.2273011499

    Article  PubMed  Google Scholar 

  28. Swore Fletcher BA, Dodd MJ, Schumacher KL, Miaskowski C (2008) Symptom experience of family caregivers of patients with cancer. Oncol Nurs Forum 35(2):E23–E44. doi:10.1188/08.onf.e23-e44

    Article  PubMed  Google Scholar 

  29. Braun M, Mikulincer M, Rydall A, Walsh A, Rodin G (2007) Hidden morbidity in cancer: spouse caregivers. Journal of clinical oncology: official journal of the American Society of Clinical Oncology 25(30):4829–4834. doi:10.1200/jco.2006.10.0909

    Article  Google Scholar 

  30. Lee EE, Farran CJ (2004) Depression among Korean, Korean American, and Caucasian American family caregivers. Journal of transcultural nursing: official journal of the Transcultural Nursing Society / Transcultural Nursing Society 15(1):18–25. doi:10.1177/1043659603260010

    Article  Google Scholar 

  31. Youn G, Knight BG, Jeong HS, Benton D (1999) Differences in familism values and caregiving outcomes among Korean, Korean American, and White American dementia caregivers. Psychol and Aging 14(3):355–364

    Article  CAS  Google Scholar 

  32. Kurtz ME, Kurtz JC, Given CW, Given BA (2004) Depression and physical health among family caregivers of geriatric patients with cancer—a longitudinal view. Medical science monitor: international medical journal of experimental and clinical research 10(8):CR447–CR456

    Google Scholar 

  33. Iconomou G, Viha A, Kalofonos HP, Kardamakis D (2001) Impact of cancer on primary caregivers of patients receiving radiation therapy. Acta Oncologica (Stockholm, Sweden) 40(6):766–771

    Article  CAS  Google Scholar 

  34. Kurtz ME, Kurtz JC, Given CW, Given B (1982) Relationship of caregiver reactions and depression to cancer patients' symptoms, functional states and depression—a longitudinal view. Soc Sci & Med 40(6):837–846

    Article  Google Scholar 

  35. Shin JY, Kim SY, Lee KS, Lee SI, Ko Y, Choi YS, Seo HG, Lee JH, Park JH (2012) Costs during the first five years following cancer diagnosis in Korea. Asian Pacific journal of cancer prevention: APJCP 13(8):3767–3772

    Article  PubMed  Google Scholar 

  36. Moon TJ (2012) Light and shadows of the Korean healthcare system. J of Korean Med Sci 27(Suppl):S3–S6. doi:10.3346/jkms.2012.27.S.S3

    Article  Google Scholar 

  37. Choi KS, Kim HS, Kwon SU, Kim JS (2005) Factors affecting the burden on caregivers of stroke survivors in South Korea. Arch of Phys Med and Rehabil 86(5):1043–1048. doi:10.1016/j.apmr.2004.09.013

    Article  Google Scholar 

  38. Cannuscio CC, Colditz GA, Rimm EB, Berkman LF, Jones CP, Kawachi I (2004) Employment status, social ties, and caregivers' mental health. Soc Sci & Med 58(7):1247–1256. doi:10.1016/s0277-9536(03)00317-4

    Article  Google Scholar 

  39. Dumont S, Turgeon J, Allard P, Gagnon P, Charbonneau C, Vezina L (2006) Caring for a loved one with advanced cancer: determinants of psychological distress in family caregivers. J of Palliat Med 9(4):912–921. doi:10.1089/jpm.2006.9.912

    Article  Google Scholar 

  40. Hillner BE, Smith TJ, Desch CE (2000) Hospital and physician volume or specialization and outcomes in cancer treatment: importance in quality of cancer care. J Clin Oncol 18(11):2327–2340

    CAS  PubMed  Google Scholar 

  41. Swets JA (1988) Measuring the accuracy of diagnostic systems. Science (New York, NY) 240(4857):1285–1293

    Article  CAS  Google Scholar 

  42. Northouse L, Williams AL, Given B, McCorkle R (2012) Psychosocial care for family caregivers of patients with cancer. J of Clin Oncol: official journal of the American Society of Clinical Oncology 30(11):1227–1234. doi:10.1200/jco.2011.39.5798

    Article  Google Scholar 

Download references

Acknowledgments

This study was supported from the National Cancer Center, Korea (Grant No. 1210150–1), a grant of the National R&D Program for Cancer Control (Grant No. 1020010), and the Ministry of Health and Welfare, Korea (administrative support)

Declaration of conflicting interests

The author(s) declared no conflicts of interest with respect to authorship and/or publication of this article.

Author information

Affiliations

  1. National Cancer Control Institute, National Cancer Center, Goyang, South Korea

    Boyoung Park, So Young Kim, Ji-Yeon Shin & Jong-Hyock Park

  2. Priority Research Centre for Health Behaviour, University of Newcastle & Hunter Medical Research Institute, New South Wales, Australia

    Robert W. Sanson-Fisher

  3. Seoul National University Hospital and Seoul National University Cancer Hospital, Seoul, South Korea

    Dong Wook Shin

  4. Department of Health Science and Technology, School of Medicine & SAHIST, Sungkyunkwan University, Seoul, South Korea

    Juhee Cho

  5. Division of Cancer Policy and Management, National Cancer Control Research Institute, National Cancer Center, 111 Jungbalsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-769, South Korea

    Jong-Hyock Park

Authors
  1. Boyoung Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. So Young Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ji-Yeon Shin
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Robert W. Sanson-Fisher
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Dong Wook Shin
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Juhee Cho
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Jong-Hyock Park
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jong-Hyock Park.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Park, B., Kim, S.Y., Shin, JY. et al. Prevalence and predictors of anxiety and depression among family caregivers of cancer patients: a nationwide survey of patient–family caregiver dyads in Korea. Support Care Cancer 21, 2799–2807 (2013). https://doi.org/10.1007/s00520-013-1852-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-013-1852-1

Keywords

  • Family caregivers
  • Anxiety
  • Depression
  • Cancer
  • Oncology