Family caregiver fatigue, social roles, and mental health-related quality of life after pancreatic resection for pancreatic cancer: a cross-sectional study

Family caregivers of patients recovering from pancreatic resection for pancreatic cancer may experience substantial burden, yet correlates of health-related quality of life (HRQoL) remain understudied. This two-center cross-sectional study examined whether fatigue was indirectly associated with HRQoL through social roles and whether this association varied by spousal status. Complete-case analyses included 105 of 122 caregivers assessed four weeks after surgery.

Fatigue and social roles were assessed using PROMIS-29 v2.1 and HRQoL using SF-12 v2. PROCESS models with 5,000 percentile bootstrap samples adjusted for caregiver age and care burden. Higher fatigue was associated with lower scores for social roles and lower mental HRQoL.

The 95% bootstrap interval for the indirect association through social roles excluded zero for mental but not physical HRQoL. Conditional indirect estimates had bootstrap intervals excluding zero in both groups, with a more negative point estimate among spousal caregivers. Although the bootstrap interval for the index of moderated mediation excluded zero, the fatigue × spousal status interaction was nonsignificant, providing only modest, exploratory evidence of moderation.

Concurrent self-report data cannot establish temporal ordering or causal mediation; reverse or reciprocal relationships remain possible. Social roles may be a relevant correlate of mental HRQoL warranting longitudinal confirmation. This work was supported by the Dongguk University Research Fund of 2024 to YK.

College of Nursing, Dongguk University WISE, Gyeongju, South Korea Division of HBP Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea Pancreatobiliary Cancer Center, Yonsei Cancer Center, Severance Hospital, Seoul, South Korea The authors declare no competing interests. This study was approved by the Institutional Review Boards of Yonsei University Severance Hospital and Gangnam Severance Hospital in Seoul, South Korea (Approval numbers: 4-2021-0436 and 3-2021-0055). All procedures were performed in accordance with relevant guidelines and regulations.

Written informed consent was obtained from all participants prior to data collection. Participants were informed about the study’s purpose, confidentiality, voluntary participation, and their right to withdraw at any time. Anonymity and confidentiality were strictly maintained.