The effect of caregiver mastery on the associations of depression, anxiety, caregiver burden, fear of disease progression with quality of life among children with solid tumors

Objectives Caring for children with solid tumors (STs) can impact caregiver's physical and mental health. Caregiver mastery, which influences psychological well-being, is vital in improving outcomes for both caregivers and children. The study aimed to investigate the relationship between caregiver mastery, anxiety, depression, fear of disease progression (FoP), caregiver burden, and the quality of life (QOL) of children with ST.Methods This cross-sectional study was conducted from June 2022 to April 2023 at a Grade A tertiary hospital in Shandong. Family caregivers of children with ST completed several validated measures, including the Pediatric Quality of Life Inventory (PedsQL) 3.0 Cancer Module, the Fear of Progression Questionnaire-parent version (FoP-Q-SF/PR), the Zarit Burden Interview Scale (ZBI), the hospital anxiety and depression scale (HADS), and the Caregiver Mastery Scale. Multiple linear regression analyses assessed the relationships between FoP, caregiver burden, anxiety, depression, caregiver mastery, and children's QOL. Results were expressed as beta and 95% confidence intervals (CIs).Results A total of 454 caregivers participated. Caregiver mastery was positively correlated with children's QOL (beta = 0.80, 95% CI: 0.20 to 1.39). Depression (beta = -0.64, 95% CI: -0.83 to -0.45), anxiety (beta = -0.67, 95% CI: -0.85 to -0.49), caregiver burden (beta = -1.20, 95% CI: -1.60 to -0.80), and FoP (beta = -0.04, 95% CI: -0.05 to -0.03) were negatively related to children's QOL. Caregiver mastery moderated the associations between depression, caregiver burden, FoP, and children's QOL, while also improving the effect of mild anxiety on QOL.Significance of results The study underscores the importance of fostering caregiver mastery to mitigate the negative impact of caregiver distress on children's QOL and improve outcomes for both caregivers and children with solid tumors.Conclusion Caregiver mastery moderates the effects of anxiety, depression, FoP, and caregiver burdenon children's QOL. Supporting caregiver mastery can alleviate caregiver burden and enhance both caregiver and child well-being.