The Relationships Between Patients' Physical, Psychological Distress and the Family Caregiver Burden in Hospitalized Gastrointestinal Cancer Patients

Sunday, 27 July 2014

In Fun Li, MSN, RN
Department of Nursing, Mackay Memorial Hospital/ Department of Nursing, Mackay Medical College, Taipei, Taiwan


A cancer diagnosis impacts not only the patient but also the family. In Taiwan, the majority of caregivers report taking on the role of caring of the family responsibility. When family caregiver care patients of cancer, they experienced both physical and mental health due to patients multiple symptoms and treatments, than might decrease the quality of patient care and the patient’s emotional state can increase distress in the caregiver. For this reason, the caregiver burden for a cancer patient’s family is an important issue today.

The purpose of this was to explore the relationship of patient’ physical and psychological distress to family caregiving burden in hospitalized gastrointestinal cancer patients.


This was a cross-sectional study involving 136 dyads of patients and families were approached and completed questionnaires during hospitalization. The data collection instruments including : demographics of patient and family, disease characteristics of patients, the modified Symptom Distress Scale for patient’s symptom distress, The Hospital Anxiety and Depression for patient’s psychological distress, and the caregiver’s burden (measured with the Caregiver Reaction Assessment, CRA). Descriptive statistics for each variable were examined, and multivariate canonical correlation analysis was used to explore.


 The following results were revealed: 1) The severity of care burden on the primary caregiver was in the order: disrupted schedule, financial problem, health problem, and lack of family support.  2) The severity of patients’ symptom distress was between non to mild . 3) 31.3% patients demonstrated clinical relevant level of anxiety and 58.2% with depression. 4) Depression of patients was the major factor to effect family caregiving burden. 5) The first and second canonical correlation coefficients between "patient’s depression”, “patient’s anxiety”, and “patient’s symptom distress” and family caregiving burden are .748 and .358( p < .001). The canonical variables x1 and x2 were able to explain up to 36.01% of total variables of family caregiving burden.


These finding showed caregiver might experience caregiving burden, and they also felt positive emotion, such as elevated self-esteem and self-worth about their role. Patient's depression and symptom distress were significantly to the caregiving burden. This study suggest healthcare professionals should systematically assess patients’ and caregivers’ problems and provide timely supportive care clinically. This is not only for patients , may also assist caregiver provide better quality care and reduce to the caregiving burden.