Health behaviors of caregivers of childhood cancer survivors: a cross-sectional study

Abstract

Background: Caregiving for childhood cancer survivors may be burdensome for caregivers and affect their physical health and health behaviors. However, studies examining health behaviors in caregivers of childhood cancer survivors are scarce. This study aimed to examine health behaviors of caregivers of childhood cancer survivors by comparing them with those of the general population, and analyze associated factors. Methods: This study included 326 caregivers of childhood cancer survivors recruited from 3 major hospitals in South Korea and 1304 controls from the Korean National Health and Nutritional Examination Survey matched for age, sex, and education level. We compared health behaviors between the two groups by using conditional logistic regression analyses, and investigated factors associated with unhealthy behaviors in caregivers by using multiple logistic regression analyses. Results: Caregivers were less likely to be physically inactive (aOR: 0.69, 95% CI: 0.51, 0.92) compared to controls, and this was more evident in women (aOR: 0.65, 95% CI: 0.45, 0.94). However, caregivers were more likely to be binge drinkers (aOR: 2.26, 95% CI: 1.73, 2.97), especially if they were men (aOR: 13.59, 95% CI: 8.09, 22.82). Factors associated with unhealthy behaviors in caregivers differed by the type of behavior. Current smoking risk was lower in female caregivers and in those with more comorbidities. Increasing age, female sex, higher education level, and lower household income were associated with lower risk of binge drinking. Higher household income and anxiety were associated with lower risk of physical inactivity, while depression was associated with higher risk of physical inactivity. Conclusions: Caregivers of childhood cancer survivors were more likely to engage in binge drinking, but less likely to be physically inactive. Strategies to promote adherence to desirable health behaviors in caregivers are needed with consideration of their socioeconomic and clinical factors, such as number of comorbidities.

Patterns of health‐promoting behaviors and associated factors in family caregivers of people receiving cancer treatment: A latent class profile analysis

“…Although evidence found in cancer caregivers is still lacking, our findings align with the literature explaining that: males, higher levels of burden, stress perceived by caregivers, and lower self‐efficacy were associated with decreased HPBs 9,35,36 . The finding about gender difference is consistent with research on caregivers of childhood cancer survivors, 37 indicating male sex was associated with a higher risk of engaging in unhealthy behaviors, including physical inactivity, cigarette smoking, and alcohol consumption. The findings may be explained by socialized gender roles and gender differences in stress‐coping strategies 37 .…”

“…The findings may be explained by socialized gender roles and gender differences in stress-coping strategies. 37 This study also confirmed the findings of other caregiving studies, 9,38,39 that self-efficacy was associated with participation in HPBs. In line with Akpinar et al, 40…”

“…The finding about gender difference is consistent with research on caregivers of childhood cancer survivors, 37 indicating male sex was associated with a higher risk of engaging in unhealthy behaviors, including physical inactivity, cigarette smoking, and alcohol consumption. The findings may be explained by socialized gender roles and gender differences in stress‐coping strategies 37 . This study also confirmed the findings of other caregiving studies, 9,38,39 that self‐efficacy was associated with participation in HPBs.…”

Understanding and Supporting Informal Cancer Caregivers

“…High levels of unmet need can exacerbate caregivers’ burden of cancer caregiving and jeopardize their psychophysiological function [ 37 ] and quality of life [ 28 , 38 , 39 ]. Heavy caregiver burden may foster unhealthy behaviors such as alcohol [ 40 , 41 ] and drug [ 40 ] use, which can increase the risk of developing metabolic syndrome including high levels of nonfasting glucose and triglycerides, low level of high-density lipoprotein, high blood pressure, and abdominal girth [ 42 ]. Caregiver burden and the depressive symptoms associated with caregiving can negatively affect the physical and mental health as well as quality of life of those they care for [ 43 , 44 ].…”

“…However, male partners or husbands of female cancer patients who hold the norms of masculinity and face the dilemma of expressing emotional distress are also likely to develop high levels of caregiver burden and depressive symptoms [ 34 , 64 ]. The negative side of masculinity in the context of cancer caregiving may lead to a higher risk of unhealthy behaviors, such as smoking and binge drinking, in male caregivers [ 41 ].…”