CoChat
Sign Up
Cited by 33Nursing care and researchPalliative Care and End-of-Life IssuesIntergenerational Family Dynamics and Caregiving

Caregiving burden of informal caregivers of older adults with advanced cancer: The effects of rurality and education

Open access
Xu, Huiwen, Kadambi, Sindhuja, Mohile, Supriya G., Yang, Shuhan, Kehoe, Lee A., Wells, Megan, Culakova, Eva, Kamen, Charles +12 more·2021·Journal of Geriatric Oncology
DOI 10.1016/j.jgo.2021.04.002PMC PMC8429077
Open this paper in CoChat — free account

Abstract

Objectives Rural-urban disparities in the experiences of caregivers of older adults with advanced cancer may exist. This study examined factors associated with caregiver mastery and burden and explored whether rural-urban disparities in caregiver outcomes differed by education. Materials and methods Longitudinal data (baseline, 4-6 weeks, and 3 months) on caregivers of older adults (≥ 70) with advanced cancer were obtained from a multicenter geriatric assessment (GA) trial (ClinicalTrials.gov: NCT02107443). Rurality was determined based on 2010 Rural-Urban Commuting Area codes. Caregivers' education was categorized as ≥ some college vs ≤ high school. Caregiver outcomes included Ryff Environmental Mastery (scored 7-35) and Caregiver Reaction Assessment (including self-esteem, disrupted schedules, financial problems, lack of social support, and health problems; each scored 1-5). Separate linear mixed models with interaction term of education and rurality were performed. Results Of 414 caregivers, 64 (15.5%) were from rural areas and 263 (63.5%) completed ≥ some college. Rurality was significantly associated with more disrupted schedules (β = 0.21), financial problems (β = 0.17), and lack of social support (β = 0.11). A significant interaction between education and rurality was found, with rurality associated with lower mastery (β = -1.27) and more disrupted schedule (β = 0.25), financial problems (β = 0.33), and lack of social support (β = 0.32) among caregivers with education ≤ high school. Conclusion Our study identifies subgroups of caregivers who are vulnerable to caregiving burden, specifically those from rural areas and with lower education. Multifaceted interventions are needed to improve caregivers' competency and reduce caregiving burden.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1016/j.jgo.2021.04.002

Cites

45 of 45 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • African American and rural caregivers have historically had limited access to formal resources and supportive services.

    “In addition, African American and rural caregivers have historically had limited access to formal resources and supportive services.”

    From Palliative Care Coaching for Family Caregivers of Patients With Advanced Cancer (2026) · cites this paper as [6]

    The Discussion (page not provided) reports that rural caregivers have less social support and fewer workplace benefits, including employee assistance programs. This supports the rural-caregiver portion, but the paper does not establish a historical pattern of limited access to formal services or make that claim about African American caregivers. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

  • Barriers such as geographic isolation, socioeconomic disadvantage, limited broadband access, and systemic inequities in access to palliative and psychosocial care can contribute to unmet needs for information, skills training, and emotional support.

    “Barriers such as geographic isolation, socioeconomic disadvantage, limited broadband access, and systemic inequities in access to palliative and psychosocial care can contribute to unmet needs for information, skills training, and emotional support.6,7,8,9,10”

    From Palliative Care Coaching for Family Caregivers of Patients With Advanced Cancer (2026) · cites this paper as [6]

    The Discussion (page not specified) links rural caregivers’ geographic isolation and lower education to lack of social support, and calls for caregiving training and psychosocial interventions. The Results (page not specified) also report greater lack of social support among rural caregivers, particularly those with less education. The paper does not establish limited broadband access, systemic inequities in access to palliative or psychosocial care, or unmet information needs as contributors. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 1

  1. [24]Onega T, Duell EJ, Shi X, Wang D, Demidenko E, Goodman D. Geographic access to cancer care in the US. Cancer. 2008; 112(4): 909– 918. 18189295

Cited by

Sorted by citations

Related

Authors
Xu, H., Kadambi, S., Mohile, S. G., Yang, S., Kehoe, L. A., Wells, M., Culakova, E., Kamen, C., Obrecht, S., Mohamed, M., Gilmore, N. J., Magnuson, A., Grossman, V. A., Hopkins, J. O., Geer, J., Berenberg, J., Mustian, K., Cupertino, A., Mohile, N., & Loh, K. P.
Affiliations
  • University of Rochester Medicine (US)
  • Southeast Clinical Oncology Research Consortium (US)
Corresponding author
  • Xu, Huiwen
  • Kadambi, Sindhuja
  • Mohile, Supriya G.
  • Yang, Shuhan
  • Kehoe, Lee A.
  • Wells, Megan
  • Culakova, Eva
  • Kamen, Charles
  • Obrecht, Spencer
  • Mohamed, Mostafa
  • Gilmore, Nikesha J.
  • Magnuson, Allison
  • Hopkins, Judith O.
  • Geer, Jodi
  • Berenberg, Jeffrey
  • Mustian, Karen
  • Mohile, Nimish
  • Loh, Kah Poh
ORCID
Venue
Journal of Geriatric Oncology
Publisher
Elsevier BV
Published
2021-09
Volume
12
Issue
7
Pages
1015-1021
ISSN
1879-4068 (ISSN-L)
DOI
10.1016/j.jgo.2021.04.002
PMC
PMC8429077
OpenAlex
W3156046115
Cited by
33
References
45
Citations by year
2026: 9 · 2025: 7 · 2024: 5 · 2023: 6 · 2022: 5 · 2021: 1
FWCI
6.63
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Geriatric Oncology (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • Patient-Centered Outcomes Research Institute (4634)
  • Wilmot Cancer Institute, University of Rochester Medical Center
  • National Institutes of Health (KL2TR001999)
  • National Cancer Institute (K99CA237744, UG1 CA189961)
  • National Institute on Aging (K24 AG056589, R33 AG059206)
Topics
  • Health Sciences › Health Professions › Pharmacy › Nursing care and research
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
  • Social Sciences › Sociology and Political Science › Intergenerational Family Dynamics and Caregiving
Keywords
caregiver burden, informal caregivers, older adults, advanced cancer, rurality, urban-rural differences, caregiver education, caregiver mastery, environmental mastery, caregiver reactions, social support, financial problems, geriatric assessment
MeSH terms
Caregiver Burden, Aged, Humans, Neoplasms, Rural Population, Social Support, Caregivers

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review