Family caregiver related factors contributing to role strain among adult patients with cancer at a National Referral Hospital in Kenya: cross-sectional study.

Abstract

Introduction: cancer care involves a long-term treatment plan with a demand for continuous care which currently is largely being offered as an outpatient service and worldwide family caregiving is becoming the backbone for long-term care delivery. There is a paucity of information regarding family caregivers of patients with cancer in Africa. Therefore, this study aimed to determine family caregiver-related factors contributing to role strain among family caregivers of adult patients with cancer, this being a first step in designing the best strategies to mitigate the role strain.

Methods: the study adopted an analytical cross-sectional design involving 255 systematically sampled family caregivers of adult patients attending Kenyatta National Hospital outpatient cancer treatment clinic between February and March 2020. Both quantitative and qualitative data were collected. Quantitative data from a structured questionnaire and Modified Caregiver Strain Index (MCSI) tool was analyzed by deriving descriptive statistics and ordinal logistic regression was performed to derive the relationship between the independent variables and the dependent variable. Quantitative data was presented by use of tables and charts. SPSS software version 25 was utilized in data analysis. Qualitative data from focused group discussion interviews was analyzed thematically.

Results: from the study findings, the family caregiver-related factors associated with role strain include being married (AOR=0.49, 95% CI 0.252-0.960, p=0.038); unemployed (AOR=3.29, 95% CI 1.833-5.894, p=0.001); providing care for <5 hours (AOR 0.40, 95% CI 0.227-0.715, p=0.002); lack of perception of strain related to social isolation (AOR=0.20, 95% CI 0.075-0.541, p=0.001), disturbed sleep cycle (AOR=0.30, 95% CI 0.141-0.641, p=0.002), social support (AOR=0.13, 95% CI 0.051-0.391, p=0.001) and costly transport costs (AOR=0.32, 95% CI 0.121-0.816, p=0.017).

Conclusion: there are various family caregiver-related factors associated with the role strain. This therefore calls for healthcare practitioners to pro-actively consider FCGs for psychological counseling, social support groups, health education, and provision of literature materials on self-care and self-financial empowerment, spiritual support and referral for financial support if available.