Caregiving and Its Resulting Effects—The Care Study to Evaluate the Effects of Caregiving on Caregivers of Patients with Advanced Cancer in Singapore

Abstract

Informal caregivers (IC) are key to enabling home deaths, where preferred, at the end-of-life. Significant morbidity from advanced cancer can make caregiving burdensome. However, knowledge about the nature of the caregiving burden for caregivers in Singapore is limited. Hence, the key objective in this study was to examine the impact of the caregiving burden on quality of life (QOL), mental health and work capacity among local ICs. Eligible English-speaking ICs of hospitalized advanced cancer patients were recruited through non-random sampling. The Zarit Burden Interview (ZBI), Caregiver Quality of Life Index—Cancer (CQOLC), Center for Epidemiologic Studies Depression Scale—Revised (CESD-R), and Work Productivity and Activity Impairment Questionnaire (WPAI) were interviewer-administered to eligible ICs. Altogether, 16 ICs were surveyed. The mean age of ICs was 43.8 years. Most were children of patients (43.8%), and eight ICs had high burden (ZBI > 17). Those with ZBI > 17 had lower QOL, higher depression scores as well as greater work and activity impairment. In conclusion, high caregiver burden has adverse effects on QOL, mental health and work productivity. Non-physical elements of caregiving (particularly financial and decision-making) and increased number of care roles undertaken by a single IC contribute to high burden. Future interventions for caregiving burden in Singapore should also address the financial and decision-making aspects of caregiving. Outsourcing selected aspects of the caregiving role to community services may reduce the number of caregiving aspects undertaken by a single IC and caregiver burden.

Family caregivers of advanced cancer patients: self-perceived competency and meaning-making

“…We also examined the main and moderating effects of caregiver-reported self-competency and sense of meaning on the relationship between time spent caregiving and caregiver psychological outcomes. The scores indicative of anxiety and depression for our sample were consistent with other studies among informal caregivers of patients with cancer in Singapore27 and other countries 28 29. Caregiving esteem scores in our sample were also comparable with estimates from a national survey of primary informal caregivers of older community dwelling Singaporeans with functional limitations 22…”

“…We note that the average time spent caregiving in our sample was only around 17.4 hours per week (approximately 2.5 hours/day); this figure is relatively low compared with estimates of caregiving hours in the literature, perhaps because the patients being cared for were required to be independent in self-care and ambulatory (ECOG status ≤1) and a majority of our sample reported receiving caregiving help, including from domestic workers. A recent study among caregivers of patients with advanced cancer in Singapore27 reported a majority of caregivers to spend 84 hours or more per week providing care. Similarly, caregivers of terminally ill cancer patients in Taiwan also reported higher estimates of caregiving hours (46% reported 56 hours or more per week)35 relative to our sample.…”

Validation of a German version of the Caregiver Quality of Life Index-Cancer (CQOLC) in a sample of significant others of breast and gynaecologic cancer patients

“…This effect on caregivers' HRQoL could not have been shown in global HRQoL (Lapid et al, 2016). The correlation with psychological health is higher than with physical health, which is congruent with the original publication (Weitzner et al, 1997) and other studies assessing the association between mental health (Chua et al, 2016;Gorji et al, 2012;Wadhwa et al, 2013) and caregiver HRQoL. Rhee et al (2005) also suggested that the Korean version of the CQOLC reflects the mental health issues better than physical ones.…”

“…This is comprehensible because the construct HRQoL is composed differently and focuses on a holistic everyday health experience, while the CQOLC involves specific aspects impacting on one's health while being involved in the care of a family member affected with cancer. Most of all, caregiver burden is an influential factor for caregivers' HRQoL (Bahrami & Farzi, 2014;Chua et al, 2016;Rha, Park, Song, Lee, & Lee, 2015;Turkoglu & Kılıc, 2012;Yun et al, 2005). It is therefore likely that measuring caregivers' HRQoL with the CQOLC offers a certain added value compared to existing translations of global HRQoL instruments.…”

Health condition of patient caregiver on oncological palliative care / Condição de saúde do cuidador do paciente em cuidados paliativos oncológicos / Condición de salud del cuidador del paciente en cuidado paliativo oncológico

“…O tempo como cuidador nesta pesquisa, foi majoritariamente, acima de 12 meses, com dados corroborados por estudos em Singapura e Irã com cuidadores de paciente em cuidados paliativos, onde foi identificado que a maioria dos cuidadores realizam cuidados por um período acima de 12 meses, variando de 62,5% a 100% dos cuidadores (6,17) .…”