Prevalence and coping strategies for psychological distress associated with caregiving among family caregivers of patients with cancer

Abstract Background: Family caregivers of patients with cancer undergo significant psychological trauma and stress in the process of caregiving. Care givers support is always very critical for patients with cancer due to the psychologically difficult process they undergo from cancer diagnosis, cancer treatment, to the end outcome, healing, or death from cancer. The aim of this paper was to describe the prevalence of psychological distress among family caregivers of cancers survivors, their demographic characteristics, and coping strategies they use to manage distress. Methods: The study used descriptive correlational study design. The target population were the caregivers who accompany patients with cancer seeking treatment in cancer treatment centers in Nairobi City County. Faraja Cancer Center and Kenyatta National Hospital were selected purposively seeking to capture 2 facilities, one representing the public centers and another representing the private centers. The total target population was 13,950. Hossan-Chowdhury formula for calculating sample size was applied on the target population yielding a sample size of 137 caregivers. Data collection was through 3 questionnaires, namely, the questionnaire for social demographic data which captured the sociodemographic information of caregivers and patients, while Hospital Anxiety and Depression Scale and Perceived Stress Scale were used to measure depression and stress, respectively. Key informant interview guidelines were used to measure coping strategies. Data analysis for quantitative information was through descriptive (percentages and frequencies) and inferential statistics (correlation and regression). The interviews were transcribed verbatim and coded. The data were analyzed using a reflective thematic analysis technique. Results: A total of 120 participants responded to the research instrument. This represented a response rate of 87.6% of total targeted respondents. It was established that women, as compared with men, were 2.8 times more likely to experience stress associated with cancer patients' caregiving ( P = 0.007). Education and employment status had a significantly high negative relationship with stress at r = −0.335 and −0.437 at P = 0.01, respectively. Majority of the caregivers (27.5%) felt that social support groups offered them support in alleviating psychological burden associated with caregiving. The social support systems came from family, friends, and engaging in social activities. Similarly, the study establishes that both meditation and group therapy was each used by 24.2% of the caregivers. Meditation as a coping strategy included the “me time” where the caregivers would take time praying, attending religious services and nature walks. Furthermore, the study found that using meditation was associated with 7.2 times increased odds ratio (OR) for managing or reducing psychological distress. Furthermore, using social support had nine times increased OR for getting help in managing psychological stress (OR = 9, P = 0.016, confidence interval = 95). This implied that professionals in the fields of mental health and health care can support caregivers in integrating meditation into their daily schedules. The findings coping mechanisms relate to previously conducted studies. For instance, Karabulutlu (2014) concur with this study, noting that healthcare workers need to focus on evidence-based coping mechanisms like group therapy and group counselling for the caregivers' families. Furthermore, the study also concurs with Teixeira et al. (2018), Louis et al. (2017), and Kohlsdorf and Costa Junior (2011) who had unanimous agreement that meditation for the caregivers who were at risk had a protective effect in reducing the likelihood of developing anxiety or depression. Conclusions: The study established that coping mechanisms and cancer patient's disease-related characteristics influenced the levels of psychological distress of the caregivers. It was concluded that meditation, social support, and group therapy were associated with reduction in psychological distress among caregivers, therefore; psychological support for the caregivers was highly recommended.