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.
