麻豆传媒

Frequent medical visits contribute significantly to psychological burden and depressive symptoms among caregivers of blood cancer patients, according to new research that points to potential strategies for reducing caregiver stress.¹ The study found that a staggering 80% of informal caregivers for patients with blood cancers report high psychological burden, with half experiencing significant depressive symptoms.¹

The growing success in treating blood cancers has transformed many of these diseases from acute to chronic conditions, leading to prolonged treatment courses and increased reliance on outpatient care. This shift has placed a greater burden on informal caregivers, who must provide ongoing support while managing frequent medical visits.¹ While caregiver burden has been well-documented in solid tumor cancers, less is known about the specific challenges faced by caregivers of patients with hematological malignancies, who often undergo complex, long-term treatments with multiple relapses and numerous lines of therapy.¹ Understanding these challenges is crucial as blood cancers account for approximately 6.5% of all cancer cases worldwide, and the impact on caregivers can significantly affect both patient outcomes and caregiver wellbeing.¹

Study design, key findings

Researchers at Rambam Health Care Campus in Israel examined 185 participants (115 patients and 70 caregivers) at their hematology ambulatory clinic. Using validated questionnaires including the Center for Epidemiologic Studies Depression Scale and the Zarit Caregiver Burden Interview, they assessed caregiver burden and depression while analyzing various contributing factors. Among the patients studied, 42% had multiple myeloma and 36% had non-Hodgkin lymphoma. Nearly half (49%) had experienced disease relapse, and most visits were for anticancer therapy.¹

The analysis revealed several significant predictors of caregiver burden. 

• Most caregivers were spouses (78%) with an average age of 57 years.
•  Female caregivers experienced higher levels of burden, as did those caring for patients with lower education levels or poorer health status. 
• Patient self-rated health and emotional status significantly influenced caregiver burden, with poorer patient health correlating with increased caregiver stress. 
• However, the frequency of medical visits emerged as a crucial modifiable factor, predicting both caregiver burden and depressive symptoms. 
• The study found that caregiver burden fully mediated the relationship between medical visits and depressive symptoms.¹

Implications for clinical practice

Healthcare systems could potentially decrease burden by reducing the number and duration of medical visits through telemedicine and other technologies, while maintaining quality of care. For instance, routine follow-up appointments and symptom checks could be conducted virtually, reducing the need for in-person visits. When medical visits are required, such as for chemotherapy administration, clinics could streamline processes to minimize waiting times and implement strategies like switching from intravenous to subcutaneous therapy administration where appropriate.¹

The study highlights the benefits of a hospital-at-home program to reduce clinic visits while providing necessary care. Enhanced psychosocial support for patients and caregivers, including mental health screenings, support groups for blood cancer caregivers, and access to social workers and counseling, could address psychological burden and depressive symptoms. Encouraging multiple family members to share caregiving duties could help distribute the burden and prevent burnout.¹

Published: December 30, 2024