Association of caregiver’s burden and mental health status in caregivers of cancer patients from Central Rural India: A Mixed-Method Study

Introduction: Cancer remains a growing public health challenge in India, impacting not only patients but also their informal caregivers, often family members who bear the emotional, physical, and financial burdens of care. These caregivers face overwhelming stress, anxiety, and depression, particularly in rural areas with limited healthcare access. Cultural expectations often lead them to neglect their own well-being. Many are forced to reduce work or quit jobs, worsening financial strain. Despite their vital role, caregivers are largely overlooked in cancer care discourse. There is an urgent need for India-specific, empathetic research and policies that support caregiver health and recognize caregiving as a public health priority.

Methods and analysis: This study employs a sequential explanatory mixed-methods design to examine the association between caregiver burden and mental health status among informal caregivers of cancer patients in central rural India. In the quantitative phase, a cross-sectional survey will be conducted using purposive sampling. Data will be collected via a semi-structured questionnaire and standardized tools: the Copenhagen Burnout Inventory to assess burnout levels and the Depression, Anxiety, and Stress Scale-21 to evaluate psychological distress. Statistical analysis will include descriptive statistics and multivariable logistic regression.

The qualitative phase will involve In-Depth Interviews with a purposively selected subgroup of caregivers to explore lived experiences, coping mechanisms, and emotional challenges. Interviews will be transcribed and analyzed using thematic content analysis. Integration of quantitative and qualitative findings will provide a comprehensive understanding of caregiver burden and mental health, reflecting both measurable patterns and the human experience of caregiving in a rural oncology setting.