The Correlation Between Family Functioning and Caregiver Burden Among Family Caregivers of Breast Cancer Patients

Background. Breast cancer is common chronic disease among Indonesian woman. When a family deal with breast cancer disease, they will face many negative and positive impact for their family functioning. In a family, diagnosis of cancer is a new experience toward family members and patients who are diagnosed, which often face various problems when dealing with the disease (Wozniak & Izycki, 2014). One of problems faced is like anger and a sense of denial with cancer, thus allowing communication disturbances within the family. In addition, the positive impact for family is the opportunity to provide care and support for patient. In Indonesia, family become a key element in caring for sick family members (Effendy et al., 2015). In contrast with western countries, caregiving for sick family member is a culture for Indonesians. Therefore, there is a change in family functioning that makes one of family member becomes a family caregiver and it will become a daily multiple role. Time spent during caregiving for patient will increase the prevalence of caregiver burden perceived by family caregiver. For understanding that matter needed further research on family caregiver breast cancer patients for situation related with value and role in Indonesian culture.

Methods. This study is a quantitative research using self-report questionnaire. Due to issues related with research variables, information from participant also gathered through interview and observation. There are two instruments used in this study, Family Functioning Device (FAD) and Zarit Burden Interview (ZBI). FAD is a instrument developed by Epstein, Baldwin and Bishop in (1983) that assessed dimensions of Mc-Master Model according to the perceptions of each family member. Tuliskan ke enam dimensinya  ZBI is a instrument that aims to see the subjective burden perceived by family caregiver. In this study there are 35 family caregivers of breast cancer patients with range between 18 years old to 65 years old.

Result. Result of this study there are negative significant correlations between family functioning and caregiver burden (r=-0,597, p<0,05). The higher score of family functioning then related with lower score of caregiver burden perceived by family caregiver of breast cancer patient. It means, if a family could maintain an effective family functioning, it could decreased caregiver burden in give caregiving for the patient. More specifically, decreased in caregiver burden was associated with dimension role functioning. Base on analysis of six dimensions of family functioning, it shows that  roles dimensions has the negative significant correlation with caregiver burden (r(35)= -0,523, p<0,01).

Conclusions. When family member becomes family caregiver of breast cancer patient, the  major change in family functioning is the role of each family member. Related with family values in Indonesian culture, family member feel obligation to taking care of their family member. As a caregiver, most of the times, their family become a priority and they are not focus in their jobs or social activity. In this study most of family caregiver were primary caregiver and live together with patients. In this situation interaction between caregiver and patient were intense and give stresses for both of them. More specifically, in this study, due to their medical treatment, most patients and family caregivers who are not live in Jakarta, stay in shelter homes for a long time. No other family member involved either taking care patient or helping family caregiver. They need to find a way to keep the effectiveness in their family functioning and keep support each other throughout the medical process.

Add-Values. This study give data of family situation related with living with cancer and provide more information about family caregiver of breast cancer patient in Indonesia. These findings suggest to include a family involvement in medical intervention, also a caregiver interventions in reducing burden in assisting and supporting their family. With those data, it could inform and advise the hospital or shelter homes  about the importance to the attention of mental health of family with breast cancer patient, not only focusing with the treatment for the patients. It could provide some idea or insight in adaptation process of family with breast cancer patients.

Keywords: family functioning, caregiver burden, family caregiver

Word count: 672 words.