Religious Coping as a Predictor of the Burden of Care in the Caregivers of End-stage Cancer Patients

Background & Aims: Advanced cancer is accompanied by physical, mental, and social complications in the patients. During the diagnosis and treatment processes, the necessary care is provided to the patient by formal caregivers for only a short period at the hospital; in other cases, the care is provided by informal caregivers. Informal caregivers are untrained individuals who are not paid for care provision, delivering care to their family members and close relatives. Under such circumstances, if the caregiver is not able to manage the caretaking time and their personal time, they will become prone to caregiver burden. Caregiver burden has a covert and personal nature, encompassing components such as time-related, evolutionary, physical, social, and emotional caregiver burden. The concept has external and internal dimensions; the external dimension of caregiver burden consists of the factors that are related to the patient, such as attention to the patients' needs, allocating time to the patients, and the provided services for the recovery of the patients. Internal caregiver burden involves personal beliefs, angers, internal emotions, and the individual's sense of importance toward the role of the caregiver. Meanwhile, coping strategies are the internal factors used by caregivers in the face of life tensions. In this regard, the role of religion as a strategy for coping with stress is considered as a form of defensive mechanism in a positive view (benevolent religious reappraisal, reappraisal of God's power, seeking spiritual support, collaborative religious coping, religious purification, religious redemption, religious helping, religious focus, spiritual connection, and seeking support from clergies) and a negative view (reappraisal of the punishing God, active/passive deference, self-directing religious coping, demonic reappraisal, spiritual discontent, and interpersonal religious discontent). Despite the importance of coping strategies and role of religion as an index that has been constantly emphasized in facing difficulties and adversities, it remains unclear in the literature whether religious coping could predict the caregiver burden of the caregivers of advanced cancer patients. Although extensive research has been conducted in this regard, further investigations should be focused on end-stage cancer patients and their caregivers. The present study aimed to predict the burden toleration among end-stage cancer patient caregivers based on their religious coping styles. Materials & Methods: This cross-sectional, correlational study was conducted on the caregivers of endstage cancer patients referring to the palliative care center of Firoozgar Hospital in Tehran, Iran during April-September 2017. In total, 154 individuals were selected via convenience sampling based on Tabachnick and Fidell sample size estimation method. The inclusion criteria were the minimum caregiving period of one month, disease course and treatment (end-stage patients requiring a main caregiver for fulltime care), basic literacy (ability to read and write), age of 15-75 years, Iranian nationality, and willingness to participate in the research. The exclusion criterion was the diagnosis of psychotic disorders in the patients affecting the interview process and validity of responses. Data were collected using the caregiver burden