The greatest threat to the health of family caregivers looking after cancer patients is not the actual burden of treatment costs but the "psychological stress" over economic difficulties, according to a new study. The severing of social ties caused by caregiving was also identified as a major factor raising caregivers' depression and anxiety.
A joint research team led by Professor Cho Be-long of the Department of Family Medicine at Seoul National University Hospital, Professor Yoo Shin-hye of the Palliative Medicine and Clinical Ethics Center, and Professor Shim Jin-ah of the Catholic University of Korea announced the findings Sunday. The study analyzed the impact of economic burden and social networks on the quality of life and mental health of 200 family caregivers of patients with advanced cancer. The results were published in the latest issue of the international journal Journal of the National Comprehensive Cancer Network (JNCCN).
The research team divided caregivers' economic burden into "material burden," such as actual medical and living expenses, and "psychological stress" arising from financial difficulties. The analysis found that psychological stress over financial hardship had a far greater impact on caregivers' health than the actual scale of spending.
Caregivers with high economic-related psychological stress faced an 8.35 times higher risk of declining quality of life than those without. Their risk of anxiety was 7.44 times higher, the risk of deteriorating subjective health 3.77 times higher, and the risk of depression 2.81 times higher. By contrast, material burden, meaning the actual burden of medical and living expenses, only raised the risk of depression by 2.67 times.
Social isolation was also identified as an independent risk factor worsening caregivers' mental health. Caregivers who did not participate in social activities had a 3.77 times higher risk of depression, a 3.32 times higher risk of deteriorating subjective health, and a 2.49 times higher risk of anxiety than those who did. Caregivers with little interaction with friends had a 2.36 times higher risk of declining quality of life.
Conversely, caregivers who maintained social relationships had relatively lower levels of psychological stress from economic difficulties, confirming that social networks partly buffered the impact of financial burden.
The research team explained that while advances in cancer treatment technology have extended patient survival times and increased the caregiving burden on family members, research and policy to date have been patient-centered, leaving caregivers' health issues relatively neglected.
"The economic burden on the families of cancer patients should be approached not simply as a medical cost issue but in terms of psychological stress and mental health," Professor Shim Jin-ah of the Catholic University of Korea stressed. "An integrated cancer treatment and support policy that includes not only patients but also their families is needed."
