Quality of Life among Caregivers of Lower-Income Cancer Patients: A Single-Institutional Experience in India and Comprehensive Literature Review

Abstract

Objectives: Quality of life (QOL) among caregivers of cancer patients is often diminished. For lower-income caregivers, the deterioration in QOL may be of greater impact. We aimed to evaluate QOL among lower-income cancer caregivers in Delhi, India and to comprehensively review similar investigations conducted internationally.Methods: A Hindi-version of the Caregiver Quality of Life Cancer (CQOLC) index was administered to 89 caregivers of lung cancer patients. Bivariate analyses were employed to evaluate associations between baseline demographics and CQOLC index scores. A systematic review of PubMed, EMBASE, and PsychInfo was undertaken.Results: Reduced QOL was observed for caregivers residing in homes earning less than our center’s median annual income per capita (p < 0.01) and for caregivers providing aid for 4 months or longer (p < 0.01). The burden of caregiving contributed most to summative index scores (p < 0.01). Eleven studies were selected by systematic review. Lower-income caregivers in Asia and the Middle East experience reduced QOL and increased burden. Available evidence does not suggest that lower-income caregivers in Europe and North America share worse QOL.Conclusion: Lower-income caregivers suffer loss in QOL, particularly in the developing world. Resourceful interventions are warranted to mitigate burden for this underappreciated population.

Psychosocial Issues Among Primary Caregivers of Patients with Advanced Head and Neck Cancer - A Mixed-method Study

“…Another study from Delhi using CQOLC stated that caregivers with lower socioeconomic status in developing countries are at risk of lower QOL. [ 26 ] Likewise, Nayak et al . in their study also found that caregivers of advanced cancer patients attributed financial burden to negatively influence their QOL, [ 27 ] being a charitable cancer hospital, all our patients too were from lower socioeconomic group.…”

Quality of Life of Primary Caregivers Attending a Rural Cancer Centre in Western Maharashtra: A Cross-Sectional Study

“…7 The studies conducted in South East Asia and Middle Eastern countries which do share somewhat similar social norms and have reported higher CQOL-C score than the present study. [16][17][18][19][20][21][22][23] Other studies conducted in the West revealed much higher CQOL-C as compared with the South East Asian and Middle Eastern studies. [24][25][26][27] This reflects the role of societal norms and coping attitudes of caregivers of our region in providing the appropriate care along with handling their QOL.…”

Out-of-Pocket, Catastrophic Health Expenditure and Distress Financing on Non-Communicable Diseases in India: A Systematic Review with Meta-Analysis

“…Out-of-Pocket, Catastrophic Health Expenditure and Distress Financing on Non-Communicable Diseases in India: A Systematic Review with Meta-Analysis distress compelling a household to resort to alternative ways of financing, which pushes the household in a deeper financial debt (WHO, 2010). Owing to lack of finances, knowledge and technological assistance, cancer patients and their caregivers, especially those who belong to the lower socioeconomic group, face significant financial and emotional struggle (Vashistha et al, 2019).…”

“…Mahal et al, (2010) published a comprehensive discussion paper on economic implication of NCDs including cancer in India. In another review conducted by Vashistha et al, (2019), it was observed that the quality of life of caregivers of cancer patients reduces significantly. Quality of life was further lowered with increase in duration of care, especially for lower income households.…”