Caregiver burden and health-related quality of life among family caregivers of oesophageal cancer patients: a prospective nationwide cohort study

Abstract

Background

Oesophageal cancer surgery is extensive with high risk of long-term health-related quality of life (HRQL) reductions. After hospital discharge, the family members often carry great responsibility for the rehabilitation of the patient, which may negatively influence their wellbeing. The purpose was to clarify whether a higher caregiver burden was associated with psychological problems and reduced HRQL for family caregivers of oesophageal cancer survivors.

Material and methods

This was a nationwide prospective cohort study enrolling family members of all patients who underwent surgical resection for oesophageal cancer in Sweden between 2013 and 2020. The family caregivers reported caregiver burden, symptoms of anxiety, depression, post-traumatic stress, and HRQL 1 year after the patient’s surgery. Associations were analysed with multivariable logistic regression and presented as odds ratios (OR) with 95% confidence intervals (CI). Differences between groups were presented as mean score differences (MSD).

Results

Among 319 family caregivers, 101 (32%) reported a high to moderate caregiver burden. Younger family caregivers were more likely to experience a higher caregiver burden. High-moderate caregiver burden was associated with an increased risk of symptoms of anxiety (OR 5.53, 95%CI: 3.18–9.62), depression (OR 8.56, 95%CI: 3.80–19.29), and/or posttraumatic stress (OR 5.39, 95%CI: 3.17–9.17). A high-moderate caregiver burden was also associated with reduced HRQL, especially for social function (MSD 23.0, 95% CI: 18.5 to 27.6) and role emotional (MSD 27.8, 95%CI: 19.9 to 35.7).

Conclusions

The study indicates that a high caregiver burden is associated with worse health effects for the family caregiver of oesophageal cancer survivors.

Keywords:

• Oesophageal neoplasm
• psychological distress
• cancer survivorship

Acknowledgment

We would like to thank all participants of the study for sharing their experiences and the members of the Surgical Care Science patient research partnership group for comments throughout the development of the publication.

Author contributions

Conception and design: Anna Schandl, Cecilia Ringborg, and Pernilla Lagergren; Collection and assembly of data: Kalle Mälberg and Pernilla Lagergren; Data analysis: Asif Johar; Interpretation of results and manuscript writing: All authors; Final approval of manuscript: All authors.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data that support the findings of this study are available upon request by the corresponding author [AS].

Additional information

Funding

This work was supported by funding from the Swedish Cancer Society [Grant no. 15 0803; 08 0685], the Swedish Research Council [Grant no. 521-2012-2824], and the Cancer Research Foundations of Radiumhemmet [Grant no. 141223; 171103; 201173]. Pernilla Lagergren is supported by the NIHR Imperial Biomedical Research Centre (BRC) for her Imperial College London affiliation. The study sponsors had no role in the design of the study, data collection, analysis, or interpretation of the results, the writing of the manuscript or the decision to submit the manuscript for publication.