ArticleBMC palliative care2025
Resilience and its determinants among family caregivers of palliative care patients in Nepal.
Article in BMC palliative care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe increasing incidence of patients requiring palliative care warrants holistic care approaches for patients where caregivers play vital roles. Understanding caregiver resilience and its determinants is crucial for developing targeted interventions to strengthen care for both patients and their caregivers.
objectiveTo assess resilience levels among caregivers of palliative care patients and identify associated factors using the Connor-Davidson Resilience Scale (CD-RISC).
methodsA cross-sectional study was conducted in five palliative care centers in Nepal from 2023 to 2024 including 422 family caregivers of palliative care patients identified using the Supportive and Palliative Care Indicator Tool for Low-Income Settings (SPICT-LIS). Data were collected via demographic questionnaires and the validated Nepalese version of the CD-RISC. Resilience scores were reported as median and interquartile range. Associations were examined using non-parametric tests (Mann-Whitney U and Kruskal-Wallis H), and effect sizes (epsilon-squared) were calculated for significant findings. Statistical significance was set at p-value < 0.05 and 95% confidence intervals and data analysis were performed in SPSS version 20 with effect size calculation in R-software.
resultsThe caregivers had a mean age of 38.03 years (SD ± 12.3), with 51.2% being male. The resilience scores ranged from 13 to 100 (median 70.5). Caregiver resilience was significantly associated with perceived health status (p < 0.001) and patient diagnosis (p = 0.002). Caregivers with "very good" or "good" perceived health demonstrated higher resilience scores (median 74 and 73, respectively). Those caring for patients with cardiopulmonary conditions presented the highest resilience (median 75), whereas chronic kidney disease caregivers presented the greatest variability in resilience scores.
conclusionsThe patient's diagnosis and the caregivers' perceived health status were important determinants of caregiver resilience in Nepal's palliative care context. These results emphasize that routine palliative treatment in Nepal and other low and middle income countries should incorporate routine caregiver health assesments and support. Educational initiatives and support groups tailored to a particular diagnosis can assist caregivers in overcoming the burden of care and build resilience. In addition to community based programs that honor cultural caregiving roles, training healthcare staff to recognize and support caregiver needs may reduce caregiver burden and improve the sustainability of care.
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