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Caregivers of Patients With Early-Stage Lung Cancer Face Anxiety, Moderate Burden


Health care providers can help alleviate caregiver burdens by teaching coping strategies, the authors said.

People with lung cancer not only rely on oncologists and other health care providers to manage their disease, but they also require help from family members, friends, and other caregivers.

Few previous studies have focused on the burdens faced by caregivers in cases where the cancers are caught early; most have looked at the burdens associated with caring for people with advanced lung cancer.

In a new report in Journal of Clinical Nursing, investigators from Central South University and the University of Hong Kong, both in China, explored the experiences of caregivers in cases of early-stage non–small cell lung cancer (NSCLC). The goal of the study was to better understand their burdens and to identify factors predictive of caregiver burden within this patient category.

The study involved the caregivers for 385 people with early-stage NSCLC and patients who had received surgical treatment for the cancer. Caregivers were interviewed using the Zarit Caregiver Burden assessment and were asked to complete questionnaires related to psychosocial characteristics.

Overall, the mean (SD) Zarit interview score was 29.1 (11.4), which the investigators said put the average caregiver into the mild to moderate burden category.

The authors said caregivers experience a high degree of uncertainty when a loved one receives a NSCLC diagnosis. They must adapt not only to the initial reality of a cancer diagnosis but to the changing burdens associated with the process of treatment and reassessment. Still, the authors said their findings suggest a lower caregiver burden than was reported in previous studies, likely because the caregivers in this study were specifically caring for people with early-stage disease.

“Demand for caregivers to assist their patients in meeting physical needs during early stages is low because such patients may experience few restrictions in their daily activities, thereby indicating that caregivers experience mild to moderate levels of burden,” they wrote, adding that the relatively low experience of burden could also reflect cultural norms in China, where caring for family members in need is considered by many to be a “spiritual duty and responsibility.”

Still, they said certain factors can increase the burden felt by caregivers, such as the length of time they must provide care. Caregiver anxiety can also increase the burden they feel. Such anxiety could be related to a difficulty confronting the diagnosis or uncertainty about how they will be able to meet the needs of the patient.

The study authors said it is important for health care professionals to help educate caregivers about coping strategies to decrease anxiety and that although previous research has suggested social support plays an important role in reducing caregiver burden, no similar correlation was found in this study of caregivers or early stage patients, “likely because medical staff members can provide professional care and support to hospitalized patients and their caregivers and potentially reduce caregiver burden.”

The authors concluded that this topic warrants more investigation, but they said it is important for health care providers to be vigilant, not only about the patient, but also about those surrounding the patients.

“Clinical health care professionals should develop comprehensive and continuous pre- and postoperative supportive care plans to meet caregiver needs while reducing caregiver burden,” they said.


Zhu S, Yang C, Mei W, et al. Caregiver burden for informal caregivers of patients after surgical treatment of early-stage lung cancer. J Clin Nurs. Published online July 22, 2022. doi:10.1111/jocn.16424

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