An Exploration of Gratitude on Well-Being in Hospice and Palliative Care Familial Caregivers

Familial caregivers (FCGs) play a critical role in health care by providing unpaid care to loved ones with serious illness. Although caregiving is often associated with emotional and physical burden, increasing attention has been directed toward potential sources of meaning and psychological growth, including gratitude.

To investigate the role of gratitude on the well-being of hospice and palliative care FCGs.

Cross-sectional, quantitative survey study.

FCGs were recruited from a single hospice and palliative care organization in New York State, United States. Participants completed in-person or online surveys at their residence.

Measures included demographics, perceived sources of gratitude, the Gratitude Questionnaire-6 (GQ-6), Positive Aspects of Caregiving Scale, Caregiver Strain Index-Expanded Positive Version, and Flourishing Scale.

Among 196 FCGs, participants reported relatively high levels of gratitude (GQ-6 mean = 36.30, SD = 5.43), with family, social relationships, and personal health identified as the most common sources of gratitude. Higher gratitude (GQ-6) was significantly associated with greater self-perceived flourishing (r = 0.426, p < 0.01), greater recognition of positive aspects of caregiving (r = 0.221-0.348, p < 0.01), and lower caregiver strain (r = -0.131, p < 0.05). In addition, caregiver strain was negatively associated with flourishing (r = -0.250, p < 0.01) and positive aspects of caregiving (r = -0.273, p < 0.01).

Higher levels of gratitude were associated with greater flourishing and recognition of positive caregiving experiences and were inversely associated with caregiver strain among FCGs of hospice and palliative care patients. Future longitudinal and intervention-based research is needed to determine whether gratitude-focused approaches can improve resilience, psychological well-being, and relational connection in end-of-life caregiving.