Exploring the other side of cancer care: The informal caregiver Evridiki Papastavrou a, * ,1 , Andreas Charalambous a, * , Haritini Tsangari b a School of Health Sciences, Department of Nursing, Cyprus University of Technology, 215, Dromos Lemesou, 2252 Latsia, Nicosia, Nicosia 2252, Cyprus b University of Nicosia, Cyprus Keywords: Caregiving Burden Cancer Coping Informal caregiver Depression abstract Objectives: To identify the caregiver outcomes among relatives caring for patients with cancer and to examine the patient and family caregiver variables that predicted for caregiver burden and depression. Methods: One hundred and thirty caregivers completed the Greek versions of the Burden Interview (BI), the Center of Epidemiology – Depression Scale (CES-D) and the Ways of Coping Questionnaire. Principal component analysis was performed to examine the underlying dimensions of caregiver outcome measures. One-way ANOVA and independent sample t-tests were used to test for differences in burden and depression in relation to demographic variables of interest. One-way ANOVA was used for examining differences in coping strategies. Findings: One-way ANOVA showed that there are significant differences among the various educational levels (p < 0.001) and the income (p < 0.005) of the caregiver in terms of overall burden. 66.4% of caregivers had a depression above the usual cutoff point for depression. An independent samples t-test for possible gender differences, showed that there is a significant difference between males and females (p ¼ 0.29). In regression analysis it was found that only caregiver’s income and patient’s age are statis- tically significant in predicting burden and depression. When considering high-burdened caregivers results showed that there are significant differences in the use of coping strategies (p < 0.001). Conclusions: Caregivers reported high levels of burden and depression. These outcomes of caregiving are related to several variables, but the caregiver’s income and patient’s age are predictive. Intervention strategies are needed to the vulnerable caregivers to help reduce burden and depression associated with caregiving. Ó 2009 Elsevier Ltd. All rights reserved. Introduction Cancer remains a major cause of morbidity and mortality within Cyprus affecting one in four of the population (Cyprus Statistical Services, 2003). Based on the ‘‘2003 Yearly Report’’ launched by the Cyprus Ministry of Health, cancer is considered as one of the ‘‘new epidemics’’ of our time along with heart diseases. Cancer claims 10% of the total number of deaths, and is considered one of the biggest killers (Charalambous et al., 2008). Alongside the nature of cancer has changed dramatically in recent years, including shorter inpatients’ stays, an increasing older cancer population and significant improvements in treatments’ outcomes and effective- ness. The shift from inpatient to outpatient treatment has emphasized the importance of informal caregivers [Throughout the article, ‘caregiver’ is used to denote a family caregiver, rather than a professional caregiver], increasing their responsibilities in rela- tion to the care (Glajchen, 2004; Hudson et al., 2004). In Cyprus, the role and magnitude of family caregivers in the care of people with cancer is similar to the ones reported interna- tionally (Haley, 2003). The reason for this lays perhaps in the strong relationships between the family members as well as the tradi- tional norms which drive in many cases the people’s actions. Several organizations which are based on private initiatives offer care to patients with cancer at their homes. Even though some evidence and research studies have been performed in Cyprus in relation to cancer care, these remain scarce stressing for more studies in this area and particularly the provision of cancer care, a need which echoes the aim of the current study. Caregiving has emerged as a dominant focus of research in recent years (Van Pelt et al., 2007; Cain et al., 2004). The literature review focused on those studies that investigated primarily the domains of caregiver burden, the assessment of psychiatric * Corresponding authors. Tel.: þ357 99545021. E-mail addresses: epapastavrou@cut.ac.cy (E. Papastavrou), andreas.charalambous@ cut.ac.cy (A. Charalambous). 1 Tel.: þ357 22001605. Contents lists available at ScienceDirect European Journal of Oncology Nursing journal homepage: www.elsevier.com/locate/ejon 1462-3889/$ – see front matter Ó 2009 Elsevier Ltd. All rights reserved. doi:10.1016/j.ejon.2009.02.003 European Journal of Oncology Nursing 13 (2009) 128–136