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. 2025 Sep 26;24(1):1202.
doi: 10.1186/s12912-025-03807-1.

The trajectory of caregiver burden and the predictive role of sense of coherence among primary caregivers of colorectal cancer patients: a longitudinal study

Wangjie Xia #  1   2 , Tingting Liu #  3 , Mengru Wu  2 , Zhen Luo  2 , Daoxia Guo  2 , Li Tian  4   5
Affiliations

The trajectory of caregiver burden and the predictive role of sense of coherence among primary caregivers of colorectal cancer patients: a longitudinal study

Wangjie Xia et al. BMC Nurs. .

Abstract

Background: Patients undergoing postoperative chemotherapy for colorectal cancer often have long-term and complex care needs, which places a significant physical and psychological burden on their primary caregivers. Sense of coherence (SOC) may help alleviate this burden by fostering correct perceptions and a positive mindset. This study aimed to analyze the trajectory of caregiver burden and the predictive role of SOC among primary caregivers of CRC patients.

Methods: A longitudinal survey was conducted from November 2021 to November 2022 in the oncology departments of three Class A tertiary hospitals in Suzhou. The survey was collected at four time points: before the first chemotherapy, after the first chemotherapy, in the middle of the chemotherapy, and after the last chemotherapy. The Sense of Coherence scale and the Zarit Caregiver Burden Interview were used. Growth Mixture Modeling classified potential trajectories of caregiver burden, and logistic regression assessed the influence of SOC on these.

Results: 204 primary caregivers of CRC patients completed the survey. The overall caregiver burden showed an initial increase and subsequent decrease, being most severe at T2 and least severe at T4. Caregiver burden trajectories were categorized into low and high caregiving burden groups (P < 0.01). SOC was moderate (65.52 ± 14.75) and was negatively associated with the trajectory of caregiver burden (OR = 0.955, 95% CI: 0.927-0.985). Factors significantly linked to the high-burden group included having one child, low education, being the patient's child, having other family members to care for, lacking alternative caregivers, and caregiving ≥ 12 h daily (all P < 0.01).

Conclusion: A lower SOC can exacerbate the primary caregiver burden. Healthcare professionals should pay special attention to primary caregivers who have low education, have one child, are the children of patients, are responsible for caring for other family members, and lack alternative caregivers. Timely interventions should be initiated to provide appropriate support, such as mental health education, SOC training, cognitive therapy, and other interventions. These efforts aim to enhance SOC levels and reduce the caregiver burden, thereby promoting the overall well-being of primary caregivers.

Clinical trial number: Not applicable.

Keywords: Caregiver burden; Caregivers; Colorectal cancer; Sense of coherence.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was approved by the Medical Ethics Committee of Soochow University (SUDA20220103H03), Suzhou, China. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Written informed consent was obtained from each participant in this study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Change trajectory diagram of caregiver burden levels among primary caregivers of CRC patients
See this image and copyright information in PMC

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