A Study on the Correlation Between Caregiver Burden,Psychological Resilience,and Quality of Life in Patients With Advanced Cancer Receiving Inpatient Palliative Care

Abstract

Objective

This study aimed to examine the correlations among caregiver burden, psychological resilience, and quality of life (QOL) in primary caregivers of hospitalized advanced cancer patients receiving palliative care, and to identify factors influencing these outcomes to inform interventions for caregiver well-being.

Methods

In this cross-sectional study, 203 primary caregivers were recruited via cluster sampling between January 2022 and June 2024. Caregiver burden, psychological resilience, and QOL were assessed using the Zarit Burden Inventory, Connor-Davidson Resilience Scale, and SF-12 Health Survey, respectively. Pearson correlation analysis, one-way ANOVA, and multivariable linear regression were performed to explore relationships among variables and identify independent predictors. Mediation analysis was conducted to examine the role of resilience in the burden-QOL relationship.

Results

The mean caregiver burden score was 45.63, with 29.56% experiencing severe burden. Mean resilience and total QOL scores were 26.74 and 40.53, respectively. Caregiver burden negatively correlated with resilience (r = −.47, P < .001) and QOL (r = −.53, P < .001), while resilience positively correlated with QOL (r = .62, P < .001). Female caregivers, longer care duration, and caring for wheelchair-bound or lung cancer patients were associated with higher burden and lower resilience/QOL. Mediation analysis indicated that psychological resilience partially mediated the relationship between caregiver burden and QOL, accounting for 42.3% of the total effect.

Conclusion

Caregiving for hospitalized advanced cancer patients is associated with high burden, reduced psychological resilience, and lower QOL. Psychological resilience is positively related to QOL and may partially explain the association between caregiver burden and QOL. These findings highlight the potential value of supporting resilience and addressing caregiver burden, particularly among high-risk caregivers such as females, those providing long-term care, and those caring for functionally dependent patients, within palliative care settings.