Depression and anxiety among the caregivers of palliative cancer patients in Hospital Sultanah Bahiyah Alor Star, Kedah / Noor Melissa Nor Hadi

Background: Caregivers play important role in the management of palliative cancer patients at the terminal stage of illness. Various studies have shown that this group was at risk to develop mental health problems, due to various factors related to caregiving. This study intended to investigate the factors associated with depression and anxiety among this group of caregivers. Method: This was a cross-sectional study to determine the presence of depression and anxiety among palliative cancer patients’ caregivers in Hospital Sultanah Bahiyah, Alor Setar, Kedah. The participants were screened for anxiety and depression using Depression, Anxiety and Stress Scale-21 (DASS-21) and subsequently assessed with Mini International Neuropsychiatric Inventory (MINI) if their DASS-21 results were positive. The study examined possible contributing factors including caregivers’ sociodemographic factors, caregiving factors, coping mechanism, perceived social support, and the care-recipients’ factor. Results: 6.1 % were diagnosed with depressive disorder and 3.1 % anxiety disorder. Factors found to be associated with depressive disorder were the patient’s age (p-value 0.033), coping by behavioural disengagement (p-value 0.010), positive reframing (pvalue 0.003), religious (p-value 0.025) and self-blame (p-value 0.034), total perceived social support (p-value 0.034). Factors found to be associated with anxiety disorder were the patient’s age (p-value 0.033), the number of patient’s physical symptoms (pvalue 0.039) and coping by positive reframing (p-value 0.029) and self-blame (OR 0.375, p-value 0.001). Removal of confounding factors by logistic regression found that coping by behavioural disengagement (OR 1.838, p-value 0.040) and positive reframing (OR 0.375, p-value 0.034) were significantly associated with depressive disorder, while coping by self-blame (OR 3.527, p-value 0.027) was significantly associated with anxiety disorder. Conclusion: Coping mechanism had been found to be significantly associated with depression and anxiety among caregivers of palliatie cancer patients in this study. Focus on teaching useful and adaptive coping mechanism should be integrated in clinical practive to help caregivers to face the challenges of caregiving.