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  Table of Contents  
VIEWPOINT
Year : 2018  |  Volume : 55  |  Issue : 4  |  Page : 419-420
 

Cancer has almost a similar psychosocial impact on family caregivers as those of the patients; but are we doing enough for them?


Department of Community Medicine, MGIMS, Sevagram, Wardha, Maharashtra, India

Date of Web Publication28-Feb-2019

Correspondence Address:
Sourav Goswami
Department of Community Medicine, MGIMS, Sevagram, Wardha, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijc.IJC_628_18

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How to cite this article:
Goswami S, Gupta SS. Cancer has almost a similar psychosocial impact on family caregivers as those of the patients; but are we doing enough for them?. Indian J Cancer 2018;55:419-20

How to cite this URL:
Goswami S, Gupta SS. Cancer has almost a similar psychosocial impact on family caregivers as those of the patients; but are we doing enough for them?. Indian J Cancer [serial online] 2018 [cited 2019 Mar 20];55:419-20. Available from: http://www.indianjcancer.com/text.asp?2018/55/4/419/253300




The family is a primary unit in all societies. It is a group of biologically related individuals living together and eating from a common kitchen.[1] Family is important in providing the environment for adjustment for the cancer patient. As the number of cancer patients and survivors of all age groups are increasing, the role of caregivers is growing as well.

Caregiving activities are varied and numerous. According to Blanchard et al.,[2] apart from taking personal care of the patient, the caregiving activities include mobility, transportation, communication, housework, management and coordination of medical care, administration of timely medications and therapies, emotional support, assisting with personal care, organizing appointments, social services, assistance with social activities, incontinence care, shopping, housework, meal preparation, telephone calls, and managing finances.

According to the American Cancer Society,[3] caregiving also includes patient follow-up, diagnosis announcement, treatment decision, and side effects monitoring. Adler et al.[4] in their book on Cancer Care on the Patient mentioned that the caregivers sometimes try to hide the diagnosis from the patient to overprotect him/her, which is common in our culture.[3],[4],[5]

Blanchard et al.[2] and Glajchen [6] have documented that caregivers are mostly concerned regarding the following three things, as regards to their near and dear one, who is suffering from cancer. The first and major concern is fear of cancer and its spread.[7] Spouses worry about the extent of disease at the time of diagnosis and about the ultimate outcome.[8],[9] The second category of concern relates to helping the patient deal with the emotional ramifications of the disease. It has been documented that dealing with the patient's emotional needs is one of the most difficult areas for the spouse. Spouses often do not know how to help and may feel unprepared to meet the patient's demands. They may also deny their own feelings while trying to provide support for the patient. This can result in their heightened anxiety and depression. The last area of concern of the caregiver relating to managing the disruptions in family routines and daily living caused by the cancer.[7]

So, it is not only the patient, but also the family members who have to directly confront with the negative impact of cancer. Northouse et al.[10] found that 22.7% caregivers suffer from depression and 2.7% have severe depression. Depression was also associated with anxiety in 79% of the caregivers and 10% of them had to take anxiolytics. It was linked to the fear of losing their close ones in 57.3% of cases.[10],[11]

A person suffering from advanced oral cancer is in a debilitated state who is unable to take care of himself/herself. So, the family members of these patients have to take care of them. But, this transition from a close relative to a caregiver occurs so abruptly that many a time they are not well prepared for it. While providing care for a terminally ill patient, caregivers often neglect their own needs. This neglect over time takes a heavy toll on the overall well-being of the caregiver resulting in a negative psychosocial impact on them.[12]

Family caregivers need to devote more time in caregiving and often suffer from the strain of caregiving. Macmillon [13] found that continuous caregiving results in reducing their physical health, emotional health, and overall quality of life.

Financial stress was the other reason for increased mental stress among the caregivers as they are the ones who are responsible for arranging the finances for the treatment of the patient and also to run their families. Sharp et al.[11] found in their study that the cost of cancer treatment was huge.

In spite of all these negative impacts of caregiving for long periods of time, most of the caregivers generally cope up with the problems.[14] Acceptance of the disease was found to be the most important measure that helped in adjusting with the deteriorating health conditions of their relatives.[15] The majority of the Indian rural population stay in joint families, where the cancer patient lives with many of his close relatives in the same house. So, all the relatives can take part in taking care of the patient suffering from oral cancer. This helps in task sharing and task shifting of the job of caregiving, that was found to prevent the negative psychosocial impact of oral cancer on the caregivers.

NPCDCS (National Program For Prevention and Control of Cancer, Diabetes, Cardiovascular Disease and Stroke) program [16] is concerned with the preventive, curative, and palliative aspect of the cancer patients, but there is still not a single initiative from the part of the state to look into the problems of the caregivers in our country, where due to several reasons, keeping a nursing staff for taking care of the cancer patients at home is not always feasible. So, the family caregivers, mostly the females who are actively involved in the process of caregiving, are the worst sufferers. So, it is high time for the government to understand the matter thoroughly and launch a new program that will focus on increasing the knowledge and skill of the family caregivers along with proper counseling sessions.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Park K. Park's Textbook of Preventive and Social Medicine. 23rd ed. Jabalpur: Bhanot Publications; 2015. p. 381-90.  Back to cited text no. 1
    
2.
Blanchard CG. The crisis of cancer: Psychological impact on family caregivers. Oncol J [Internet] 1997;11:189-94.  Back to cited text no. 2
    
3.
American Cancer Society. Global Cancer Facts & Figures [Internet]. American Cancer Society. 2015. p. 1-57. Available from: https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/global-cancer-facts-and-figures/global-cancer-facts-and-figures-3rd-edition.pdf. [Last accessed on 2018 Jan 15].  Back to cited text no. 3
    
4.
Adler N, Page A. Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs. Washington: National Academies Press (US); 2008. p. 11-12.  Back to cited text no. 4
    
5.
Hewitt M, Rowland JH, Yancik R. Cancer survivors in the United States: Age, health and disability. J Gerontol 2003;58:82-91.  Back to cited text no. 5
    
6.
Glajchen M. The emerging role and needs of family caregivers in cancer care. J Support Oncol 2004;2:145-55.  Back to cited text no. 6
    
7.
PDQ Supportive and Palliative Care Editorial Board. Family caregivers in cancer: Roles and challenges (PDQ®): Health professional version. 2017 Mar 15. In: PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002. Available from: https://www.ncbi.nlm.nih.gov/books/NBK65845/. [Last accessed on 2018 Oct 15].  Back to cited text no. 7
    
8.
Morgan MA, Small BJ, Donovan KA, Overcash J, McMillan S. Cancer patients with pain: The spouse/partner relationship and quality of life. Cancer Nurs 2011;34:13-23.  Back to cited text no. 8
    
9.
Fletcher KA, Lewis FM, Haberman MR. Cancer-related concerns of spouses of women with breast cancer. Psychooncology 2010;19:1094-101.  Back to cited text no. 9
    
10.
Northouse LL, Peters-Golden H. Cancer and the family: Strategies to assist spouses. Semin Oncol Nurs 1993;9:74-82.  Back to cited text no. 10
    
11.
Sharp L, Timmons A. The financial impact of a cancer diagnosis. National Cancer Registry Ireland; 2010.  Back to cited text no. 11
    
12.
Schulz R, Sherwood PR. Physical and mental health effects of family caregiving. Am J Nurs 2008;108 Suppl 9:23-7.  Back to cited text no. 12
    
13.
McMillan SC. Quality of life of primary caregivers of hospice patients with cancer. Cancer Pract 1996;4:191-8.  Back to cited text no. 13
    
14.
Karabulutlu EY. Coping with stress of family caregivers of cancer patients in Turkey. Asia Pac J Oncol Nurs 2014;1:55-60.  Back to cited text no. 14
  [Full text]  
15.
Rodríguez-Pérez M, Abreu-Sánchez A, Rojas-Ocaña MJ, Del-Pino-Casado R. Coping strategies and quality of life in caregivers of dependent elderly relatives. Health Qual Life Outcomes 2017;15:71.  Back to cited text no. 15
    
16.
Ministry of Health and Family Welfare G of I. National Programme For Prevention and Control of Cancer, Diabetes, Cardiovascular Disease and Stroke (NPCDCS) [Internet]. 2017. p. 1–2. Available from: https://mohfw.gov.in/about-us/departments/departments -health-and-family-welfare/national-programme-prevention-and-control-cancer-diabetes- cardiovascular-disease. [Last accessed on 2018 Dec 06].  Back to cited text no. 16
    




 

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