Psychological Burden and Coping Strategies Among Caregivers of Patients With End-Stage Cancer

The present cross-sectional study investigated psychological burden and coping strategies among informal caregivers of patients with end-stage cancer, with emphasis on anxiety, depression, stress, and sociodemographic and caregiving-related factors associated with caregiver burden.

The sample consisted of 300 informal caregivers of patients with end-stage cancer who were enrolled between 2023 and 2025 and completed the study questionnaires at a single time point. Caregiver burden was assessed with the Zarit Burden Interview (ZBI), psychological distress with the Depression Anxiety Stress Scales (DASS-21), and coping strategies with the Ways of Coping Questionnaire. Statistical analysis included descriptive statistics and multiple linear regression analysis, with the ZBI total score as the dependent variable. A p-value of <0.05 was considered statistically significant.

Most caregivers experienced high psychological burden, with 292 participants (97.3%) classified in the high-burden category. Anxiety was particularly elevated, with 184 caregivers (61.3%) classified as having extremely severe anxiety, and emerged as a strong positive predictor of caregiver burden (B = 0.775, p < 0.001). The final regression model showed high predictive power (R² = 0.750, F(10, 289) = 86.638, p < 0.001). Coping strategies such as positive reappraisal (B = -5.284, p < 0.001), problem solving (B = -5.371, p < 0.001), and social support (B = -2.431, p < 0.001) were associated with lower burden.

The findings indicate substantial psychological burden among informal caregivers of patients with end-stage cancer, with anxiety playing a central predictive role. Adaptive coping strategies were associated with lower burden, highlighting the need for systematic psychosocial assessment and targeted caregiver-support interventions within palliative care services.