Factors associated with psychological burden among informal caregivers in outpatient palliative care: a prospective observational study of patient-caregiver dyads in Germany.

Authors

Leopold Hentschel, Beate Hornemann, Ulrich Schuler, André Wellesen, Charis Haering, Birgit Helbig, Maria Janisch, Katharina Schütte, Pauline Langguth

Published in

BMJ open. Volume 16. Issue 6. Pages e107141. Jun 18, 2026. Epub Jun 18, 2026.

Abstract

Informal caregivers are of utmost importance in providing sufficient care for palliative outpatients, yet are at risk for psychological burden themselves which might limit their capability to maintain their support.
This project aims to identify structural and psychological factors that are associated with the psychological burden of informal caregivers.
The prospective observational study recorded illness-related and structural data. Multiple logistic regressions were performed to identify relevant factors for increased psychological burden.
This monocentric study recruited 250 adult patients of a specialised outpatient palliative care team and 152 caregivers between April 2021 and August 2022.
Of 250 patients screened for participation, 152 caregiver-patient dyads were included in this study. Above-threshold depressivity was reported by 31%, anxiety by 33% and an elaborated psychological distress was stated by 82% of informal caregivers. Multivariate analyses revealed a significant association of above-threshold depressivity with higher daily caregiving time (OR: 3.215; p=0.026) and being highly burdened by COVID-19 (OR: 1.142; p=0.048). Perceived higher burden from COVID-19 seemed to be protective concerning elevated anxiety (OR: 0.859; p=0.024). High distress was non-significantly associated with higher education (p=0.056) and support by a professional nursing service (p=0.069). The statistical models explain 19% (anxiety, depressivity) and 21% (distress) of the total variance.
As the psychological burden of informal caregivers in an outpatient setting remains high, it tends to be slightly below those strains reported by informal caregivers in inpatient or curative settings. This project adds to the scarce knowledge about associated factors. Further research could address how to implement these results into daily clinical practice, for example, accounting for risk-factors in discharge routine.
NCT05082389.

PMID:
42315265
Bibliographic data and abstract were imported from PubMed on 19 Jun 2026.

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