Role relationship quality and burden among caregivers for late stage cancer patients

Objective: The demands of caring for a loved one with late stage cancer can affect every dimension of a caregivers life, as caregivers grapple with both daily personal needs of the patient, and the intricacies and logistics of getting needed care. As most late stage cancer patients are over 60, most caregivers are themselves older or are adult children of elderly patients. Unlike most studies including only structural and demographic variables, this study considers the caregiver's perceived quality of relationships with those most intimately connected with their loved one's cancer care: family, physician, and the patient. “Relationship” is conceptualized as including communication, conflict, and support. Method: Cross-sectional data were collected as part of an ongoing study of cancer support and communication. Research assistants conducted structured telephone interviews with 419 family caregivers of advanced cancer patients receiving care at two urban tertiary care cancer clinics in the Midwest. Burden was measured using the five subscales of the Caregiver Reaction Assessment, 24 items scored 1-5, with reliability of each scale from .80 to.90. Results: Highly rated relationship quality with family and physician were associated with lower caregiver burden. Patient relationship was not significant, possibly due to measurement issues. Family and physician relationship were more strongly and consistently associated with four of five dimensions of burden than all demographic or structural variables measured. Conclusions: Looking beyond demographic characteristics of caregivers is essential in cancer care. Improving quality of relationships could be a useful target of intervention in reducing caregiver burden.