Caregiver Quality of Life Index-Cancer (CQOLC) Scale for Iraqi Cancer Caregivers

Abstract

The present study was conducted between November 2024 and February 2025. An invited the caregivers of patients in the medical oncology clinic at the Al-Furatt Cancer Institute, in Al-Najaf Province, to participate in this study during their patients’ appointments at the clinic. Caregivers were included if they were aged 22 years or older.  Caregiver Quality of Life Index-Cancer (CQOLC) is a 35-item self-report measure of caregivers’ QOL measured on a five-point Likert-type scale from 1 (not at all) to 5 (very much). This score is obtained by summing the item scores; higher scores denote better QOL. The CQOLC takes about 20 minutes to complete.

A total of 300 questionnaires were distributed, and a complete 230 were returned and used for calculation. So, the sample size for the subsequent analyses was sufficient.

The demographics of patients and cancer caregivers were recorded. The overall QOL of the family caregivers of patients with cancer was shown. Out of 12 subscales of Burden factor, two have high scores represented by “I fear my loved one will die” and “It upsets me to see my loved one deteriorate”, one scale has a low score represented by “I feel guilty”.

Among 11 subscales of Positive adaptation factor, only one “Relationship with patient” attained “A little bit”, the other 6 belong “quite bit” and 4 belong “somewhat”.

The sixth subscale of the Disruptiveness factor has three scores: one “It bothers me that my daily routine is altered” of “A little bit”, also one “It bothers me that I need to be available to chauffeur my loved one to appointments” has “Quite a bit”, and the remaining 4 subscales have a “somewhat “score.

Financial concern factors had 6 subscales, three had “Somewhat” score, two “quite bit”, and only one “Satisfaction with sexual functioning” of “Not at all”.

The overall QOL of family caregivers has a moderate score; financial concern had a better score than the other factors, where the other three factors have a moderate QOL.

Explanatory Factor Analysis (EFA) analysis showed that all items of the study were loaded more than 0.4 and included within 8 factors. 24 items belong to factor 1, the remaining 11 items are distributed across 7 factors.   Bivariate correlations revealed that all were correlated to the total CQOLC score, r (.636–.849, all ps < .001. All factors were correlated with each other (ps < .001). Table 8 presents the descriptive statistics and correlations of the CQOLC. Many of the family caregivers reported a negative impact from the disease onset on the relationship among family members; good family relationships are associated with less distress than poorer family relationships.

The financial situation might be an important topic in Iraq, in that Iraq does not have a fully financed healthcare system and relies instead on insurance systems that are not available for all inhabitants. About one-third of the family caregivers stated somewhat financial concerns related to the disease (e.g., increased economic pressure and being forced to discontinue treatment because of financial difficulties).

Religion and spirituality are two dimensions important for Muslims and were among the most important areas for having QoL. In the present study, religion and spirituality were found to influence some of the family caregivers in a positive way. Although religion and spirituality in the Iraqi cultural context are important, other areas, for example, relationships and financial situation, were more important in the life of family caregivers to a person with any cancer.