# Associations of Critical Relationships With Distress and Burden in Caregivers of Patients With Brain Tumor

## TL;DR

This study explores how relationships with others affect the mental health and stress levels of caregivers for brain tumor patients.

## Contribution

It introduces a categorization of critical relationships and their impact on caregiver well-being in the context of brain tumor care.

## Key findings

- Most caregivers had positive or ambivalent critical relationships.
- Caregivers with negative or ambivalent relationships reported higher anxiety, depression, and burden.
- Stressful individuals in relationships can harm caregiver well-being even with a confidant.

## Abstract

Little data exists on critical relationships for caregivers of patients with brain tumors, or how their social context impacts caregiver well‐being.

Our goal was to describe and categorize the critical relationships reported by caregivers of patients with brain tumors, and to assess the association of categories of critical social relationships with caregiver reports of anxiety, depression, and burden.

We analyzed baseline self‐report data collected from neuro‐oncology caregivers enrolled in a supportive care trial. Data included demographics, presence of critical relationships—a confidante or person contributing stress, anxiety, depression, and burden. Critical relationships categories were operationalized as: positive (confidant, no stressful person), negative (no confidant, stressful person), neutral (no confidant nor stressful person), and ambivalent (confidant and stressful person). Descriptive statistics were calculated. One‐way ANOVAs assessed differences between relationship category groups on caregiver reports of anxiety, depression, and burden.

Data from 119 caregivers were analyzed. Caregivers had a mean age of 57 years (SD = 15), were mostly non‐Hispanic White (92%), female (70%), spouses (52%) of patients with grade 4 tumors (69%). Most caregivers were categorized as having positive (53%) or ambivalent (30%) critical relationships. Significant differences between relationship categories were seen in anxiety, depression, and burden (ps < 0.01).

Although most caregivers of people with brain tumors have confidants, many also identify people who contribute stress. The presence of stressful individuals can negatively impact caregiver well‐being in a way that is not counterbalanced by the co‐presence of a confidant. Future work should focus on helping caregivers manage stressful relationships.

The study was pre‐registered at ClinicalTrials.gov: NCT04268979.

The analysis plan for this manuscript was not formally pre‐registered.