Protective factors supporting caregiver well-being in glioblastoma.

Abstract

12095 Background: Caregiving in glioblastoma (GBM) means dealing with cancer symptoms, plus the neurological decline that comes with this disease. Becoming a caregiver is rarely straightforward. Caregivers often become essential to the patient’s daily life and well-being, though this may result in neglecting their own health. Most caregivers develop coping strategies (protective factors such as caregiver mastery or spiritual beliefs) to manage the responsibility of caring for a terminally ill loved one. This study looked at how caregiver protective factors shifted across the disease trajectory and whether these factors were connected. Methods: This was a secondary analysis of data from a three-group randomized clinical trial testing a needs-based intervention for neuro-oncology caregivers (NINR # R01 NR013170). Caregivers were included if they were 21 or older, identified by the patient as their unpaid primary caregiver, spoke English, had phone access, were not caring for anyone else (except children under 21), and scored above 6 on the CES-D. Recruitment occurred from March 2014 to July 2016 at the University of Pittsburgh Medical Center, the University of Pittsburgh Cancer Institute, and the MD Anderson Cancer Center. Patients and caregivers gave informed consent prior to participation in the primary study. We conducted an a priori power analysis to determine the sample size required for detecting minimal differences in quality of life (QOL). The final sample included 60 caregivers. We measured outcomes at baseline, two, four, six, and ten months. Analysis used paired samples t-test, bivariate correlations, and linear mixed models. Results: Caregiver QOL changed significantly over time, particularly from baseline to four months ( p = 0.02) and four to six months ( p = 0.01). Protective factors correlated with one another at varying strengths (weak, moderate, and strong). At each time point, religion and spirituality were related to other protective factors. Spirituality had significant positive correlations with caregiver mastery ( r = 0.32-0.65, p = < .001-0.01) and QOL ( r = 0.44-0.70, p = < .001-0.01) throughout the study. After factoring in optimism, we found significant associations for caregiver mastery, positive aspects of caregiving, social support, and religion. Conclusions: Spirituality emerged as a key protective factor, yet most caregiver interventions ignore it. Providers should recognize and support spiritual coping mechanisms throughout GBM care, offering resources that match caregiver values and beliefs. Monitoring caregiver QOL is equally critical as tracking patient outcomes. When QOL declines, early interventions can prevent caregiver burnout and improve care quality for both members of the dyad.