Purpose: To examine the frequency and severity of unmet needs among family caregivers of cancer patients undergoing immunotherapy, focusing on subdomains such as physical and daily living needs, psychological and emotional needs, care and support needs, and health-system and informational needs, as well as related correlating factors.
Methods: This cross-sectional study assessed family caregivers of cancer patients receiving immunotherapy at a medical center in northern Taiwan. A set of questionnaires was administered to evaluate caregivers’ unmet care needs and potential correlating factors, including stressors experienced by both caregivers and patients—such as caregivers’ symptoms and patients’ symptoms and adverse events (assessed using CTCAE v5.0). Additionally, the effort family caregivers invested in the shared decision-making process was assessed. Data were analyzed using the Mann-Whitney U test, Kruskal–Wallis test, and Spearman's correlation.
Results: Among the 104 family caregivers, the highest frequency and severity of unmet needs were found in the domains of healthcare service needs and informational needs. Mild but significant correlations were observed between patients’ education levels, overall symptoms, anxiety, depression, and uncertainty, and family caregivers’ unmet care needs. No significant association was found with adverse events. Caregivers with higher education levels, greater fatigue, more severe sleep disturbances, anxiety, depression, and uncertainty reported higher unmet care needs. Additionally, caregivers with higher unmet care needs indicated they invested more effort in the immunotherapy shared decision-making process, particularly concerning psychological and emotional needs and work and social support.
Conclusion: This study highlights significant unmet needs among family caregivers of cancer patients receiving immunotherapy. Caregivers’ education levels, fatigue, sleep disturbances, and psychological distress, particularly the time spent understanding immunotherapy-related information, are correlated with these unmet needs. Additionally, patients’ education levels and symptoms also play a role. Targeted support and interventions are essential for improving outcomes for both caregivers and patients in cancer treatment.