Hope, cancer-related goal interference, and quality of life among caregivers of people receiving treatment for metastatic cancer

Background: Caregivers of people with metastatic cancer often experience strain that interferes with personal goals, potentially affecting their mental health and quality of life. Hope interventions, which support goal-directed thinking and action, may be a promising approach to support caregivers’ goals, mental health, and quality of life. This study examined the relation between caregiver hope, goal interference, and mental health and quality of life outcomes, characterized caregiver goals, and determined interest in hope interventions. Methods: Caregivers of people undergoing treatment for stage IV (metastatic) cancer (N = 60) completed a cross-sectional survey, including open-ended questions regarding caregiver goals. Open-ended responses were analyzed using hybrid deductive–inductive content analysis to identify themes in caregiver goals. Descriptive statistics characterized caregiver interest and preferences for a hope intervention. Mediation analyses examined relations between hope, goal interference, and mental health. Results: Many caregivers (31.7%) reported elevated depression symptoms, over half (53.3%) elevated anxiety, and 58.3% low positive affect. The most-reported goals were family/social connections outside caregiving (24.8%), caregiver health (22.9%), and caregiving-related goals (18.1%). Caregivers reported moderate goal interference (M = 14.12; SD = 5.45). Mediation models showed hope related negatively with goal interference (β = −0.30, p <.001), had direct effects on depression (β = −0.38, p =.001), anxiety (β = −0.29, p =.005), quality of life (β = 0.67, p <.001), and positive affect (β = 0.44, p <.001), and that goal interference accounted for 37-48% of the variance between hope and anxiety and quality of life outcomes. Most caregivers (81.7%) expressed interest in a hope-enhancing intervention, preferring flexible delivery formats (e.g. online or phone-based). Conclusions: Hope interventions, which equip people with cognitive behavioral skills to pursue goals, may be a promising approach to support caregivers’ goals, mental health, and quality of life during caregiving for metastatic cancer.