# The Impact of Caregiving Intensity and Financial Burden on the Health-Related Quality of Life Among Informal Caregivers for Patients With Advanced Lung Cancer: A Multicenter Cross-Sectional Study

## TL;DR

This study examines how caregiving intensity and financial burden affect the health of informal caregivers for advanced lung cancer patients in China.

## Contribution

The study identifies financial burden and caregiving intensity as key factors negatively impacting caregivers' health-related quality of life.

## Key findings

- Caregiving intensity and financial burden are significantly linked to lower health-related quality of life in informal caregivers.
- Financial burden partially mediates the negative impact of caregiving intensity on caregivers' health.
- Caregiver occupation and financial burden are strong predictors of health outcomes for informal caregivers.

## Abstract

To determine the relationship between caregiving burden (including caregiving intensity and financial burden) and health-related quality of life (HRQoL) of informal caregivers, as well as to explore their association with the HRQoL of patients with advanced lung cancer.

Against the backdrop of aging and high prevalence of tumor disease, caregiving support for cancer patients is mostly provided by informal caregivers. The caregiving burden resulting from this support may have adverse effects on the health of informal caregivers. Few studies have examined these effects simultaneously in relation to caregiving burden.

This hospital-based cross-sectional study collected questionnaire data through face-to-face interviews at 13 centers in China. A total of 540 pairs of patients with advanced NSCLC and their informal caregivers were recruited. The HRQoL of patients and informal caregivers was measured using the EORTC QLQ-C30 and the EQ-5D-5L scale, respectively. The structural equation modeling method was used to assess the pathways and potential mediating effects.

The average EQ-5D-5L score of informal caregivers was 0.92 ± 0.14. Caregiver occupation (β = −0.011, p=0.002), caregiving intensity (β = −0.013, p=0.017) and financial burden (β = −0.039, p < 0.001) were negatively associated with the HRQoL of informal caregivers. Overall, caregiving intensity was positively associated with financial burden (β = 0.242, p < 0.001) and health problems (β = 0.130, p < 0.001) among informal caregivers. Mediation analysis showed that financial burden (β = 0.021, p=0.016) and patient's HRQoL (β = 0.113, p < 0.001) were significant mediators in the association between caregiving intensity and caregivers' HRQoL.

More efforts are required to reduce financial burden to diminish the negative impact of patient care needs on informal caregiver health. It is imperative to explore initiatives for enhancing support to informal caregivers.