Caregiver Burden and Its Relationship to Health-Related Quality of Life in Craniopharyngioma Survivors

Abstract

Context Craniopharyngioma (CP) is a rare brain tumor associated with severe comorbidities that reduce survivor health-related quality of life (HRQOL). However, CP impact on caregivers is unknown. Objective To measure caregiver burden and examine its relationship to survivor HRQOL and other determinants in CP. Methods Eighty-two participants who self-identified as caregivers of CP survivors responded to an online survey including caregiver-reported Pediatric Quality of Life Inventory (PedsQL), and the Zarit Burden Interview (ZBI). Results Caregivers reported an average of 13 out of 29 health conditions in survivors following tumor treatment including excess weight, hypopituitarism, fatigue, mood, cognition, social issues, temperature dysregulation, visual impairment, and sleep problems. Strikingly, 70% of survivors who experienced obesity also experienced hyperphagia. ZBI scores were moderate with a median of 37. PedsQL total scores were poor with a median of 46.2. ZBI scores were independent of caregiver level of education and care duration. Both scores were independent of income, survivor age, gender, age at diagnosis, or tumor recurrence. In contrast, both scores depended on the number (p < 0.001) and the type of survivor health problems with significantly worse scores for caregivers or survivors with symptoms of hypothalamic dysfunction (p < 0.001) including hyperphagia but not obesity. PedsQL total scores significantly predicted ZBI scores (p < 0.001). Conclusion Survivor poly-symptomatology predicted and incurred significant caregiver burden. Our study separated hyperphagia and obesity and identified hyperphagia and other hypothalamic-dysfunction symptoms as understudied issues. Altogether, these findings draw particular attention to the unmet needs of CP survivors and their caregivers.