Caregiver strain in the setting of caring for older patients with breast cancer was associated with advanced disease, caregiver employment, and patient depression, according to study findings published in Clinical Journal of Oncology Nursing.

Caring for a patient with cancer is associated with emotional and physical strains, especially when the patient has many needs. This study sought to evaluate patient and caregiver characteristics that may contribute to increased strain.

For this study, the researchers recruited 39 older women receiving any treatment for breast cancer at The Ohio State University between 2013 and 2018. Patients were evaluated by a geriatric nurse practitioner and caregivers self-administered the Modified Caregiver Strain Index (MCSI) instrument.

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The patients were mean age 77.9 years (range, 70 to 93), 30 had infiltrating ductal carcinoma, 23 underwent lumpectomy, and 9 had stage IV disease.

Caregiver MCSI scores correlated with Timed Up and Go test (r, 0.45; P =.006), Geriatric Depression Scale score (r, 0.41; P =.01), and caregiver age (r, −0.46; P =.02).

Stratified by cancer stage and caregiver employment status, more caregivers who worked had high MCSI scores when the patient had early-stage cancer (P =.04). Both employed and unemployed caregivers of a patient with advanced disease tended to have high MCSI scores.

This study may have been limited by not evaluating the relationship between patient and caregivers.

These data suggest that advanced disease, employment status, and patient depression were significant predictors for caregiver strain. These predictors may be useful for nurses to identify individuals more vulnerable to strain and to make a plan of care that may address the factors contributing to caregiver strain.


Overcash J, Johnston M, Sinnott LT, Williams N. Influence of patient functional status and depression on strain in caregivers. Clin J Oncol Nurs. 2022;26(4):406-412. doi:10.1188/22.CJON.406-412