The Relationship Of Cancer Caregiver Burden, Quality Of Life And Depression

IntroductionSince the middle of the century, the rank of cancer in the disease spectrum and death spectrum increased dramaticly year by year no matter in developed or developing country. In recent years, malignant tumor has tended to be the most primary cause of death. Cancer has become the first health killer since the year 2005 in China. Cancer is a disease with high mortality and also is a systemic wasting disease. Patients suffer from both physical torture and the destruction of spirit in a relative long period. Cancer is not only a major life event to patients themselves but also has a great affect on their caregivers, often resulting in tension and pressure, declining of well-being and quality of life in caregivers. Meanwhile caregivers have to bear the burden and pressure in a long period of time because of the long-term and heavy caring work, thus their physical and mental health are seriously affected.Cancer patients and their families have to face not only cancer diagnosis and treatment process but also the impact of their family system. Especially core-type family type is the major type of current China's family type, that family members'life must be affected when there is a cancer patient in their family. In addition, China has entered the aging society which has a great number of older population. Under such circumstance, caregivers usually have heavy family burden to family members including supporting the elderly, raising children and taking care of cancer patients.Due to aging and the one child policy, the caregiving problem has become prominent in China. Since long-term care has not established in China, as well as the shortage of official nurses and caregivers, family members usually take the responsibility of taking care of patients and older people, their quality of life should not be underestimated.In recent years, domestic scholars have carried out a large number of researches on the psychological stress and quality of life of cancer patients, but few scholars care for the burden of caregivers of cancer patients. Therefore, we carry out this survey in order to evaluate the burden of care and quality of life of caregivers of cancer patients and to study the related factor. In this study, we provide the evidence through the evaluation of caregivers of cancer patients about the burden of care, quality of life and depression levels to explore effective predictor to improve the coping capacity of caregivers of cancer patients, to reduce their stress and to improve their health status, as well as to further improve the quality of life and life satisfaction of cancer patients.This study aims to assess caregiver burden, quality of life and depression among the cancer patients, and explore the relatinship of caregiver burden, quality of life and depression and to find out predictors of caregiver burden on depression. Finally, establish theoretical model of caregiver burden, provide evidence and new ideas about long-term care for the government, and give effective interventions in order to improve the care situationsMethodA cross-sectional study was conducted through the convince sampling, composed of 400 caregivers of cancer patients from 3 departments in the Second Affiliated Hospital of China Medical University. A face-to-face interview was explored to assess caregivers' burden, depression, and quality of life.The questionnaire consisted of question on demographic variables, the Chinese edition of Zarit caregiver burden interview (ZBI), quality of life (QOL), Center for Epidemiologic Studies Depression Scale (CES-D), Caregiver reaction assessment (CRA), Sence of coherence scale (SOC). Multivariate linear regression analyses were performed to study the factors related to cargiver burden and depression. Statistical analysis was performed using Statistical Package for the Social Sciences Version,11.5 (SPSS Inc.,Chicago,IL,USA),and apply structural equation (SEM) AMOS6.0 to ResultStructural equation model analysis showed that cargiver burden had a significantly main effect on depression, the heavier cargiver burden is, the prevalence of depression is higher, and the QOL is lower. Caregiver reaction was the mediator of burden on depression. Sence of coherence was the moderator, which could moderate depression. Additionally Caring workload has a remarkable effect on cargiver burden, and the help mode has a positive correlation with caregiver burden, while demographic variables has not notable influence on caregiver burden.ConclusionCaring workload results in the prevalence of caregiver burden, it is necessary to establish compensation mechanism for alternating nursing care,in order to decrease caregivers burden. Caregiver reaction was the mediator of burden on depression. Sence of coherence was the moderator, which could moderate depression.Therefore, guidance training should be provided in order to enhance the levels of coping capacity and psychological control, so as to improve the ability to deal with nursing burden, and improve their quality of life. Supportive environment should be created which contributes to releasing pressure, including improve medical level and service level of hospitals, optimize patients'therapeutic environment, establish rational doctor-patient relationship, strive volunteers'support and social helping.