title: Caregiving and Its Resulting Effects-The Care Study to Evaluate the Effects of Caregiving on Caregivers of Patients with Advanced Cancer in Singapore.
abstract: Informal caregivers (IC) are key to enabling home deaths, where preferred, at the end-of-life. Significant morbidity from advanced cancer can make caregiving burdensome. However, knowledge about the nature of the caregiving burden for caregivers in Singapore is limited. Hence, the key objective in this study was to examine the impact of the caregiving burden on quality of life (QOL), mental health and work capacity among local ICs. Eligible English-speaking ICs of hospitalized advanced cancer patients were recruited through non-random sampling. The Zarit Burden Interview (ZBI), Caregiver Quality of Life Index-Cancer (CQOLC), Center for Epidemiologic Studies Depression Scale-Revised (CESD-R), and Work Productivity and Activity Impairment Questionnaire (WPAI) were interviewer-administered to eligible ICs. Altogether, 16 ICs were surveyed. The mean age of ICs was 43.8 years. Most were children of patients (43.8%), and eight ICs had high burden (ZBI > 17). Those with ZBI > 17 had lower QOL, higher depression scores as well as greater work and activity impairment. In conclusion, high caregiver burden has adverse effects on QOL, mental health and work productivity. Non-physical elements of caregiving (particularly financial and decision-making) and increased number of care roles undertaken by a single IC contribute to high burden. Future interventions for caregiving burden in Singapore should also address the financial and decision-making aspects of caregiving. Outsourcing selected aspects of the caregiving role to community services may reduce the number of caregiving aspects undertaken by a single IC and caregiver burden.
authors.affiliation: National University Health System, Singapore 119228, Singapore. cheryl_chua@nuhs.edu.sg.
authors.forename: Cheryl Kai Ting
authors.initials: CK
authors.lastname: Chua
authors.affiliation: Health Services Research Unit, Division of Research, Singapore General Hospital, Singapore 169608, Singapore. wu.jun.tian@sgh.com.sg.
authors.forename: Jun Tian
authors.initials: JT
authors.lastname: Wu
authors.affiliation: Clinical Quality Department, Assisi Hospice, Singapore 574623, Singapore. wong.yin.yee@assisihospice.org.sg.
authors.forename: Yin Yee
authors.initials: YY
authors.lastname: Wong
authors.affiliation: Department of Palliative Care, National Cancer Centre Singapore, Singapore 169610, Singapore. qu.l.m@nccs.com.sg.
authors.forename: Limin
authors.initials: L
authors.lastname: Qu
authors.affiliation: Department of Palliative Care, National Cancer Centre Singapore, Singapore 169610, Singapore. tan.yung.ying@nccs.com.sg.
authors.forename: Yung Ying
authors.initials: YY
authors.lastname: Tan
authors.affiliation: Department of Palliative Care, National Cancer Centre Singapore, Singapore 169610, Singapore. patricia.neo.s.h@singhealth.com.sg.
authors.forename: Patricia Soek Hui
authors.initials: PS
authors.lastname: Neo
authors.affiliation: Care Integration Division, Agency for Integrated Care, Singapore 069110, Singapore. grace.pang@aic.sg.
authors.forename: Grace Suyin
authors.initials: GS
authors.lastname: Pang
keywords: advanced cancer; burden; caregiving; depression; quality of life; work impairment