The Relationship between the Unmet Needs of Chinese Family Caregivers and the Quality of Life of Childhood Cancer Patients Undergoing Inpatient Treatment: A Mediation Model through Caregiver Depression

Abstract

A large proportion of the global burden of childhood cancer arises in China. These patients have a poor quality of life (QoL) and their family caregivers have high unmet needs. This paper examined the association between the unmet needs of family caregivers and the care recipient’s QoL. A total of 286 childhood cancer caregivers were included in this cross-sectional study. Unmet needs and depression among caregivers were assessed by the Comprehensive Needs Assessment Tool for Cancer Caregivers (CNAT-C) and the Patient Health Questionnaire (PHQ-9), respectively. The patient’s QoL was proxy-reported by the Pediatric Quality of Life Inventory Measurement Models (PedsQL 3.0 scale Cancer Module). Descriptive analyses, independent Student’s t-tests, one-way ANOVA, and mediation analyses were performed. The mean scores (standard deviations) for unmet needs, depression, and QoL were 65.47 (26.24), 9.87 (7.26), and 60.13 (22.12), respectively. A caregiver’s unmet needs (r = −0.272, p < 0.001) and depression (r = −0.279, p < 0.001) were negatively related to a care recipient’s QoL. Depression among caregivers played a mediating role in the relationship between a caregiver’s unmet needs and a care recipient’s QoL. As nursing interventions address depression among caregivers, it is important to standardize the programs that offer psychological support to caregivers.

Psychological Distress Among Parents of Children With Chronic Health Conditions and Its Association With Unmet Supportive Care Needs and Children’s Quality of Life

“…The current study examined these relationships across a range of common childhood CHCs and explored how unmet needs and child QoL directly influence parent distress levels. However, due to the inherent limitations of cross-sectional designs employed by our own research and the study conducted by Wang et al (2022) and Aziza et al (2019) , it is not possible to draw causal inferences about whether child functioning influences parent functioning or vice versa in families of children with CHCs. Longitudinal studies are needed to address such limitations and to evaluate the directionality of the observed effects.…”

“…Few studies to date have explored unmet needs in families of children with various CHCs ( Thomas et al, 2023 ). Moreover, few studies have examined links between unmet needs and parental distress in this population, with most work in this area to date focusing on parents of children with cancer ( Aziza et al, 2019 ; Wang et al, 2022 ). The current study examined these relationships across a range of common childhood CHCs and explored how unmet needs and child QoL directly influence parent distress levels.…”

“…A study of parents of children with cancer ( N = 100) looked at the association between anxiety and depression and unmet needs and found that unmet needs were higher in parents with clinical levels of anxiety but were not associated with clinical levels of depression ( Aziza et al, 2019 ). In another study involving 286 parents of children with cancer, higher parental depression symptoms mediated the association between the level of unmet needs reported by parents and children’s QoL ( Wang et al, 2022 ).…”

Effect of gastrointestinal symptoms and skipping breakfast on anxiety and depression in quarantined Chinese college students during the COVID-19 pandemic: A cross sectional survey

“…GAD-7 has been proved to be an effective method to measure the severity of anxiety among Chinese population [36][37][38]. Depressive symptoms were assessed by PHQ-9 [39], which is composed of 9 items and has been widely performed to assess the depression level of Chinese people [40][41][42].…”