Published online Dec 24, 2020. doi: 10.5306/wjco.v11.i12.1045
Peer-review started: May 29, 2020
First decision: September 18, 2020
Revised: September 29, 2020
Accepted: November 11, 2020
Article in press: November 11, 2020
Published online: December 24, 2020
Processing time: 202 Days and 18.6 Hours
Nigeria is known to have the highest cancer mortality rate in Africa with an annual death toll of 10000 persons; with a cancer incidence of 100000, 300000 and 500000 in 1990, 2010 and 2013, respectively, and 41000 cancer-related deaths were recorded in 2014 alone. The upsurge in the incidence of cancer may pose serious challenges in caregiving with its attendant burden on the patients and caregivers. The physical, psychological, social, spiritual and financial impact of caregiving is considerable and often negative. Ample evidence has shown that caring for an advanced cancer patient may be associated with physical problems such as weight loss, sleeplessness, fatigue and exhaustion. Also, psychological symptoms such as depression, anxiety, feeling of isolation and reduced self-esteem may be experienced. They often cause a social burden resulting in restriction of time, disturbances in routines, diminished opportunities for leisure activities and loss of income. Recent descriptive surveys and qualitative studies of caregivers’ cancer care experiences in India and Nigeria show that 38.9% of caregivers of cancer patients reported symptoms of depression. 41% to 62% of caregivers of advanced cancer patients experienced a high level of psychological burden compared to 19.2% of the general population.
Cancer is a devastating and debilitating chronic disease that affects both the patient and family members. Available evidence has confirmed that the care of chronically ill relatives by family members can be very challenging. This is because caregiving of cancer patients often presents a high level of burden on the caregivers. Consequently, this requires the adoption of coping mechanisms to cushion the effect of the burden experienced during caregiving.
To determine the burden experienced and coping strategies among caregivers of advanced cancer patients attending University of Calabar Teaching Hospital (UCTH), Cross River State, Nigeria.
The study adopted a descriptive cross-sectional study design and the study population consisted of informal family caregivers providing services to histologically diagnosed advanced cancer patients receiving treatment at the UCTH as at the time of the survey. A researcher-developed structured questionnaire, a 22-item standardized validated Zarit Burden Interview (ZBI) and a modified 17-item Coping Orientation to Problems Experienced (COPE) Inventory were used to collect data from 250 eligible informal caregivers who were selected with regard to caregiver’s characteristics, caregivers’ level of burden and caregivers’ coping strategies, respectively. Data gathered from the respondents were collated, coded and analyzed using Statistical Package for Social Sciences (SPSS version 20.0) software and Predictive Analytical Software (PAS version 19.0). Chi-square was used to test for associations between categorical variables at the 0.05 level of significance. Results are presented in tables and charts.
Assessment of burden level revealed that a reasonable proportion of the caregivers [97 (46.19%)] experienced severe burden, and 37 (17.62%) experienced trivial or no burden, while 76 (36.2%) perceived moderate burden. The results showed that the coping strategies used by caregivers to ease the level of burden experienced during caregiving included; acceptance, reprioritization, appreciation, family, positive self-view and empathy. It was also found that there was a strong association between caregivers’ level of burden and coping strategies (P = 0.030).
There was a strong association between socio-demographic characteristics (age, education, functional ability, desire to continue caregiving, types of cancer) and caregivers’ coping strategies
Further studies on caregiver’s burden level and coping strategies in patients with comorbidities should also be carried out.