1668P - Unaddressed distress in cancer patients and primary care giver: A cross-sectional comparative study at a Quaternary Government Institute

Background

There is scant attention given to the distress experienced by cancer patients or their caregivers in low-middle income countries like India. This study measures patient and caregiver distress in oncology and attempts to evaluate any correlation between the two.

Methods

All cancer patients ≥18 years and their primary caregiver were invited to participate in a survey which included demographic, disease, and therapy details, the NCCN distress scale for the patient and the Zarit Burden Interview (Short 12 items) questionnaire for the caregiver. An open-ended interview was used to record any additional problems.

Results

250 patients and corresponding caregivers completed the survey. 70.4% patients and 32.4% caregivers had moderate to severe distress burden. The average distress score for the patients and caregiver was 4.82 and 17.88 on the respective scales. Higher mean distress scores were seen in patients younger than 40 years, those from a rural background, having secondary or higher education and those on active or palliative treatment. Distress in patients was independent of gender, income group and hospital admission. Commonest care givers were sons (38.8%) and husbands (25.6%). Daughters as caregivers had the highest mean average burden (22.6). When scored individually, the question on enough time for oneself (Q1) and stress towards other responsibilities (Q2) had the highest mean scores (1.9) while the lowest average score (0.9) was found for the question regarding strain felt around patient. Open ended interview identified financial stress and sexual frustration as common causes cause of caregiver distress. On generating a scatter plot using linear regression, a definite trend was seen of rising patient distress with an increase in caregiver distress and Pearson’s Chi square test revealed a statistically significant association with the patient and caregiver distress scores (p <.0001).

Conclusions

There is significant unaddressed distress in both cancer patients and caregivers with a definite association between them. Open ended interviews also gave insight into causes of distress. Distress screening, co- counselling and early psycho-oncological interventions may help address these lacunae.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

N. Bisht.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.