FAMILY CAREGIVER BURDEN IN HOME PALLIATIVE CARE: A SAUDI CULTURAL PERSPECTIVE

Abstract

Background: Home-based palliative care places intensive and sustained demands on family caregivers; yet in Saudi Arabia, caregiver burden remains inadequately characterized, particularly with respect to its cultural and Islamic determinants.

Objectives: To examine the prevalence, severity, dimensions, and cultural predictors of family caregiver burden in home palliative care in Saudi Arabia, integrating Islamic religious coping as a culturally specific moderating resource within an adapted Stress-Process Model framework.

Methods: A descriptive cross-sectional design was employed with 100 purposively sampled family caregivers enrolled in Saudi home palliative care programs. Data were collected using the Arabic Zarit Burden Interview (ZBI-22), the Brief Religious Coping Scale (Brief RCOPE), and the Hospital Anxiety and Depression Scale (HADS). Hierarchical multiple linear regression identified independent predictors of burden.

Results: Mean ZBI-22 total score was 42.8 (SD = 15.4); 95.0% of caregivers reported clinically meaningful burden. Female caregivers reported significantly higher burden (M = 46.2 vs. 33.7; t(98) = 3.92, p < .001, d = 0.84). Positive religious coping was the strongest protective predictor (β = −.29, p = .001), while negative religious coping amplified burden (β = .22, p = .008). Clinically significant anxiety and depression were documented in 49.0% and 40.0% of participants. The final regression model explained 48.3% of variance (R² = .483, F(10,89) = 8.31, p < .001).

Conclusions: Family caregiver burden in Saudi home palliative care is pervasive and severe, shaped by gender inequalities, caregiving intensity, socioeconomic vulnerability, and the dual moderating function of Islamic religious coping. Routine screening, gender-sensitive support programs, and integration of Islamic spiritual care are urgently indicated.