Investigators looked into the toll that caregiving for adult patients with cancer may take on the mental health of caregivers, according to a recent study published by Klekovkina et al in Archives of Gerontology and Geriatrics Plus.
Background
Millions of family members and friends provide care for loved ones undergoing cancer treatment per year, often at great emotional cost.
“Caregivers remain largely overlooked in psychosocial oncology care, leaving many without the support they need,” said lead study author Elizaveta Klekovkina, HBSc, MSW, a social worker in the Department of Supportive Care at Princess Margaret Cancer Centre in Toronto.
Study Methods and Results
In a comprehensive literature review, investigators identified 23 studies that examined the relationship between traumatic stress and caregivers of adult patients with cancer. However, the majority of published studies were cross-sectional with small sample sizes and a lack of racial and gender diversity.
The investigators found that over 15% of those who cared for patients with cancer experienced post-traumatic stress disorder (PTSD). They revealed that caregivers with preexisting mental health issues, lower social support, and a higher caregiver burden were at greater risk of PTSD. Additionally, patient-related factors such as disease severity, symptom burden, and perceived likelihood of mortality also contributed to caregiver distress.
“Identifying these risk factors is important for developing targeted interventions to prevent and alleviate traumatic stress in caregivers,” emphasized co–study author Maya Stern, MPH, MSW, RSW, a social worker in the Department of Supportive Care at Princess Margaret Cancer Centre.
In addition, the investigators noted that caregivers of patients with head and neck cancer or acute leukemia were among the most distressed, with up to 37% of them meeting PTSD criteria. The most commonly reported PTSD symptoms were intrusive thoughts and hypervigilance. Unlike with other forms of trauma, avoidance was not an option, since the caregivers remained deeply involved in their loved one’s cancer care.
Conclusions
“We were surprised to find so few studies on traumatic stress among caregivers of adult [patients with] cancer,” underlined co–study author Carmine Malfitano, PhD, MSW, RSW, Director of Research and Education at the Centre for Psychology and Emotional Health as well as a clinical social work specialist at the Princess Margaret Cancer Centre. “There is an urgent need for further research to reduce this gap in the literature and to develop proactive, evidence-based interventions to better integrate caregiver support in oncology care,” he continued.
The investigators indicated that improving support could require more proactive screenings.
“If left unaddressed, traumatic stress in caregivers can have long-term impacts on their mental and physical health,” suggested senior study author Esme Fuller-Thomson, PhD, Director of the Institute for Life Course & Aging at the University of Toronto. “The high prevalence of PTSD among adult cancer caregivers underscores the need to ensure they receive early support, especially at key points such as diagnosis, recurrence, or treatment transitions,” she concluded.
Disclosure: For full disclosures of the study authors, visit sciencedirect.com.
