Psychological Distress, Caregiver Burden and Quality of Life Among Informal Carers of First Nations Australians Diagnosed With Cancer: A Cross-Sectional Study.

IntroductionInformal carers provide essential support for people diagnosed with cancer, however, the demands of caregiving can negatively impact their psychological wellbeing. There is a need to examine psychological wellbeing among carers of First Nations cancer patients to understand the impacts of caregiving within cultural contexts. Therefore, this study aims to quantify carer psychological distress, burden, and quality of life (QoL) among carers of First Nations Australian cancer patients - key indicators of carer wellbeing that may have implications for both carers and patients.MethodsThis prospective cross-sectional study recruited adult (≥18 years) carers of First Nations Australians diagnosed with cancer across six Queensland hospitals (July 2021-December 2024). Of 221 eligible carers, 172 (78%) participated in the study. Logistic regression models assessed association between carer characteristics with high psychological distress (Distress Thermometer, score≥4) and significant carer burden (six-item Zarit Burden Interview, score≥6); linear models assessed associations with QoL (CarerQoL-7D).Results165 (96%) carers approached were included in the analysis, of which 67% (n=111) identified as First Nations. High distress was reported by 43% (95% CI:36%-51%), 44% reported significant carer burden (95%CI:37%-52%), and mean CarerQoL-7D score was 9.7 (95%CI:9.3-10.1). Only prevalence of high distress differed between First Nations and non-Indigenous carers. For all carers as well as First Nations carers, clinical diagnosis of anxiety and/or depression was associated with high distress, significant carer burden and lower QoL.ConclusionTo our knowledge, this study is the first to quantify the psychological wellbeing of carers of First Nations cancer patients in Australia. We observed no associations typically expected for wellbeing and distress among carers, except for with clinical anxiety/depression, suggesting that existing measures may not fully capture carer's experiences in this population. These findings highlight the need for culturally appropriate measures co-designed with Indigenous communities to better assess and support carer wellbeing.