Impact of caregiver burden on caregiver mental health in patients with esophageal cancer: chain mediating effects of benefit finding and rumination, a cross-sectional study

Abstract

Background: Cancer caregivers are the main supporter for the tumor patients, they not only need to provide daily nursing to the patients, but also suffering the pressure from economy, emotion and even family members. The mental health of tumor patient is mostly noticed, while not caregivers. The mental health of caregiver greatly affected the nursing quality and even the treatment outcomes. In the current study, the mechanisms underlying the links between caregiver burden, benefit finding, mental health, and rumination in those caring for people with esophageal cancer were examined. Methods:The study was using a convenience sampling, 166 esophageal cancer patients in 2 general hospitals in Jiangsu Province, China, and caregivers of patients were included after excluded the nonconforming patients. Data were collected using investigator-developed questionnaires, the Benefit Finding Scale (BFS), the Event-Related Rumination Inventory (ERRI), the Zarit Burden Interview (ZBI), and the Hospital Anxiety and Depression Scale (HADS) during May 2020 to December 2020. The results were analyzed by SPSS, and the chain mediating effect was analyzed by the the SPSS PROCESS Macro Model. Results:The study comprised 166 caregivers with an average age of (59.96±11.48) years, most of them were female (85.5%). The ZBI was positive correlated with HADS (r=0.882, P<0.01), and negative correlated with BFS (r=−0.873, P<0.01). Intrusive rumination and deliberate rumination in caregivers were negatively correlated (r=−0.901, P<0.01) and positive correlated (r=0.904, P<0.01) with BFS scores, respectively. Furthermore, research have discovered a chain mediation impact of benefit finding and rumination between caregiver burden and psychological well-being among carers of esophageal cancer patients. Conclusions:The findings of this study imply that benefit finding and rumination are crucial components of the coping strategy used to buffer against negative emotion (such as anxiety and depression). Therefore, the mental health of caregivers should also be noticed, and health care professionals should provide targeted interventions to increase the caregiver's level of benefit finding and promote deliberate ruminative thinking.

The Interrelationship of Benefit Finding, Demoralization, and Stigma among Patients with Parkinson’s Disease and Their Caregivers

“…In a 2013 UK study with 842 breast cancer patient caregivers, BF was significantly negatively correlated with the psychological distress of caregivers [48]. Another 2022 Chinese study of 228 esophageal cancer patient caregivers suggested that the caregivers' BF played a mediating role in the anxiety-depression of the caregivers [12]. We suggested that a higher level of BF might lower the psychological distress of caregivers, which could lead to a lower prevalence of depression.…”

“…We found that lower BF level, higher demoralization severity, and higher stigma severity were associated with depression among PD caregivers. Several studies have shown a correlation between BF and depressive symptoms among caregivers [12,48]. In a 2013 UK study with 842 breast cancer patient caregivers, BF was significantly negatively correlated with the psychological distress of caregivers [48].…”

“…Benefit finding (BF) can be conceptualized as finding positive life changes or benefits from negative experiences such as trauma or chronic illness [11]. A 2022 cross-sectional study including 166 esophageal cancer patients showed that caregiver burden was negatively correlated with the Benefit Finding Scale (BFS) and positively correlated with the Hospital Anxiety and Depression Scale (HADS), which implied that BF may be crucial in buffering against anxiety and depression [12]. A 2014 cross-sectional study with 25 PD patient/spouse dyads showed that perceiving benefits from the experience of personally having or living with a spouse with PD was related to greater marital quality for both the patients and their spouses [13].…”

Emotional Coping Strategies for Informal Caregivers of Hospitalized Patients: A Study of Distress and Overload

“…Previous studies have reported the relationship between negative self-focus with anxiety, stress and depression. [46][47][48][49] Nevertheless, they have been detected only in non-caregivers' sample and caregivers of brain-injured and mentally ill patients. While these specific coping strategies may be more prevalent in certain groups (eg, non-caregivers and mental caregivers) we have proven that they are effective for caregivers, regardless of the specific situation.…”

The chain mediating effect of spiritual well‐being and anticipatory grief between benefit finding and meaning in life of patients with advanced lung cancer: Empirical research quantitative

“…Benefit finding assists patients in cultivating inner peace and acceptance, enabling them to better cope with the realities of the disease and approach their life journey with a positive mindset. This inner peace and acceptance help patients establish more solid internal support, leading to higher levels of satisfaction and tranquillity at a spiritual level (Wen et al., 2022 ). Carrico's research on HIV‐positive individuals found that benefit findings can influence spiritual well‐being to a greater extent, enabling individuals to more effectively manage the cumulative effects of HIV infection (Carrico et al., 2006 ).…”