Family caregiver fatigue, social roles, and mental health-related quality of life after pancreatic resection for pancreatic cancer: a cross-sectional study

Abstract Family caregivers of patients recovering from pancreatic resection for pancreatic cancer may experience substantial burden, yet correlates of health-related quality of life (HRQoL) remain understudied. This two-center cross-sectional study examined whether fatigue was indirectly associated with HRQoL through social roles and whether this association varied by spousal status. Complete-case analyses included 105 of 122 caregivers assessed four weeks after surgery. Fatigue and social roles were assessed using PROMIS-29 v2.1 and HRQoL using SF-12 v2. PROCESS models with 5,000 percentile bootstrap samples adjusted for caregiver age and care burden. Higher fatigue was associated with lower scores for social roles and lower mental HRQoL. The 95% bootstrap interval for the indirect association through social roles excluded zero for mental but not physical HRQoL. Conditional indirect estimates had bootstrap intervals excluding zero in both groups, with a more negative point estimate among spousal caregivers. Although the bootstrap interval for the index of moderated mediation excluded zero, the fatigue × spousal status interaction was nonsignificant, providing only modest, exploratory evidence of moderation. Concurrent self-report data cannot establish temporal ordering or causal mediation; reverse or reciprocal relationships remain possible. Social roles may be a relevant correlate of mental HRQoL warranting longitudinal confirmation.