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. 2024 Mar 15;24(1):817.
doi: 10.1186/s12889-024-18321-3.

The impact of caregiver burden on quality of life in family caregivers of patients with advanced cancer: a moderated mediation analysis of the role of psychological distress and family resilience

Panpan Cui  1   2 , Ming Yang  3 , Hengyu Hu  1 , Chunyan Cheng  4 , Xinyi Chen  5 , Jiaoxia Shi  6 , Shifeng Li  7 , Changying Chen  8   9 , Hongmei Zhang  10
Affiliations

The impact of caregiver burden on quality of life in family caregivers of patients with advanced cancer: a moderated mediation analysis of the role of psychological distress and family resilience

Panpan Cui et al. BMC Public Health. .

Abstract

Background: The caregiver burden frequently experienced by family members tending to advanced cancer patients significantly impacts their psychological well-being and quality of life (QoL). Although family resilience might function as a mitigating factor in this relationship, its specific role remains to be elucidated. This study aims to probe the mediating effect of psychological distress on the relationship between caregiver burden and QoL, as well as the moderating effect of family resilience.

Methods: A cross-sectional study was conducted between June 2020 and March 2021 in five tertiary hospitals in China. Data were collected on caregiver burden, family resilience, psychological distress (including anxiety and depression), and QoL. Moderated mediation analysis was performed.

Results: Data analysis included 290 caregivers. It confirmed the mediating role of psychological distress in the caregiver burden-QoL relationship (P < 0.001). Both overall family resilience and the specific dimension of family communication and problem-solving (FCPS) demonstrated significant moderating effects on the "psychological distress/anxiety-QoL" paths (P < 0.05). The utilization of social and economic resources (USER) significantly moderated the association between depression and QoL (P < 0.05).

Conclusions: The study corroborates psychological distress's mediation between caregiver burden and QoL and family resilience's moderation between psychological distress and QoL. It underscores the need for minimizing psychological distress and bolstering family resilience among caregivers of advanced cancer patients. Accordingly, interventions should be tailored, inclusive of psychological assistance and promotion of family resilience, particularly focusing on FCPS and USER, to augment the caregivers' well-being and QoL.

Keywords: Advanced cancer; Caregiver burden; Family resilience; Moderated mediation analysis; Psychological distress; Quality of life.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The hypothetical moderated mediation model. FCPS: Family communication and problem solving; USER: Utilization of social and economic resources; AMMA: Ability to make meaning of adversity; MPO: Maintaining a positive outlook; FC: Family connectedness; FS: Family spirituality
Fig. 2
Fig. 2
a Moderating effect of family resilience on the relationship between psychological distress-quality of life. PD: Psychological distress. b Moderating effect of FCPS on the relationship between psychological distress-quality of life. FCPS: Family communication and problem solving; PD: Psychological distress. c Moderating effect of USER on the relationship between depression-quality of life. USER: Utilization of social and economic resources. d Moderating effect of family resilience on the relationship between anxiety-quality of life. e Moderating effect of FCPS on the relationship between anxiety-quality of life. FCPS: Family communication and problem solving
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