Caregiver Burden in Head and Neck Cancer: The Combined Impact of Clinical Complexity and Psychological Distress

Background/Objectives: Caregiver burden represents a critical yet under-integrated dimension of clinical care in head and neck cancer, where complex treatments and functional impairments impose substantial demands on informal caregivers. This study aimed to evaluate caregiver burden and to identify its clinical and psychological correlates among caregivers of patients with head and neck cancer. Methods: This prospective cross-sectional study included 132 caregivers. Caregiver burden was assessed using the Zarit Burden Interview, and psychological distress was evaluated using the Hamilton Depression (HAM-D) and Anxiety (HAM-A) Rating Scales. Clinical variables, including tracheostomy status, radiotherapy, disease stage, chemotherapy, reconstructive surgery, and disease recurrence, were analyzed. Univariate and multivariate analyses were performed to identify factors associated with caregiver burden. Statistical significance was defined as p < 0.05. Results: Caregiver burden was highly prevalent, with a substantial proportion of participants experiencing moderate to severe levels. In the univariate analyses, caregiver burden was significantly higher among caregivers of patients who underwent tracheostomy (p = 0.003), radiotherapy (p < 0.001), chemotherapy (p < 0.001), reconstructive surgery (p = 0.024), and those with advanced-stage disease (p < 0.001). Higher levels of depression and anxiety were significantly associated with increased caregiver burden (both p < 0.001) in the univariate analyses. In the adjusted analysis, anxiety and cohabitation status remained independently associated with caregiver burden, whereas disease stage, tracheostomy, radiotherapy, chemotherapy, reconstructive surgery, disease recurrence, and depression did not retain statistical significance. Educational level, professional caregiving support, and relationship to the patient were also not significantly associated with caregiver burden. Conclusions: Caregiver burden in head and neck cancer is primarily associated with caregiver psychological status and certain social characteristics, while clinical factors play a less prominent role after adjustment. These findings suggest the need for systematic identification of high-risk caregivers based on psychological vulnerability and caregiving demands. Integrating caregiver-focused assessment and targeted psychosocial interventions into multidisciplinary care could improve caregiver well-being and patient-related outcomes.