Prevalence and Associated Factors of Depressive Symptoms among Informal Caregivers of Patients with Advanced Cancer at the Apeksha Hospital Maharagama, Sri Lanka.

Abstract

Background: Informal caregivers (ICs) often have many caring responsibilities. They inevitably face unmet needs, neglect themselves, and mostly consider the needs of patients with advanced cancer. Subsequently, they are at greater risk of developing depression due to the heavy burden of caregiving responsibility. Objective: To determine the prevalence of depressive symptoms and its associated factors among ICs of patients with advanced cancer at the Apeksha Hospital Maharagama Methods: A convenient sample of 226 ICs was selected in this cross-sectional study. An interviewer-administered questionnaire which included socio-demographic and clinical characteristics was used to collect data. The validated 20-item Center for Epidemiological Studies Depression (CES-D) scale was used to assess depressive symptoms (DSs); higher scores indicate greater DSs. Descriptive statistics, Chi-square, Pearson correlation, and independent t-test were used for data analysis. Results: The mean±SD age of the ICs was 41.78±14.54 years. Most of the ICs were females (60%), married (72%), and educated up to secondary level (83%). Prevalence of DSs (≥16) was 49%. A significantly higher DSs was reported among females compared to males (20.52±9.65 vs 14.74±3.75) and currently unemployed vs employed ICs (19.69±9.14 vs 16.58±7.02). DSs were significantly associated with caregiver relationship with the patient (χ2=49.42, p<0.01) and caregiving hours/week (χ2=28.26, p<0.01). There was a significant positive relationship between DSs and caregiving period (r=0.16, p<0.01), sleeping hours/day (r=0.18, p<0.01), self-reported general health (r=0.34, p<0.01); negative relationship was found between DSs and emotional strain (r=-0.25, p<0.01), social support (r=-0.24, p<0.01), family/friends support (r=-0.183, p<0.01) of ICs. Further, younger age (r=0.108, p<0.01) and female gender (r=0.342, p<0.01) of cancer patients were significantly influenced. Conclusions: Nearly half of ICs reported higher levels of DSs. Caregiving-related variables such as caregiver relationship with the patient, caregiving hours/week, caregiving period and sleeping hours/day significantly impacted on DSs. Providing psychosocial support for caregivers is crucial. Support for caregiving-related activities is greatly needed for ICs. Hence, educational interventions for ICs to improve their knowledge and practice on caregiving are recommended.