Main Article Content

Abstract

Thalassemia, a prevalent autosomal recessive disorder in Iraq with an incidence of 35.7 per 100,000. Affected individuals rely heavily on family caregivers for medical management and psychosocial support, which often results in significant caregiver emotional, mental, physical, and economic burden. This study aimed to identify the types of family caregivers’ burdens of thalassemia patients and to find out the association between types of burden and among caregivers’ and some sociodemographic characteristics. A cross-sectional study was conducted in thalassemia and hemophilia center in Rania City. from September 22, 2024 to the end of April, 2025. This study employed a census approach, including all thalassemia clients' caregivers who were directly involved in patient care, which was 65 caregivers who have been providing care for thalassemia patient. The data were collected using a constructed questionnaire based on a review of relevant literature and standardized psychological assessment tools. A total of 65 caregivers, all of them were patients mainly (67.7%) were mothers. The overall caregiver burden for physical and financial problems was high and moderate burdens for psychosocial health problems. The study also showed an association between caregivers' socioeconomic factors (lower education, lower income, and specific marital statuses) and physical and financial burdens. Caregivers of thalassemia patients experience significant physical and financial hardships, as well as moderately impacted psychological and social aspects. The Kurdistan Regional Government (KRG) should subsidize thalassemia treatments and partner with NGOs to ease the financial burden. The Ranya Center needs integrated mental health services and peer support groups.

Keywords

Thalassemia caregivers’ burdens physical burdens psychosocial burdens

Article Details

References

  1. Kumar R, Sharma P. Psychosocial impact of thalassemia on family caregivers: A study from a tertiary care
  2. hospital. J Family Med Prim Care. 2018;7(5):1020-1025. doi:10.4103/jfmpc.jfmpc_267_18.
  3. Shah, Farrukh T., et al. Challenges of blood transfusions in β-thalassemia. Blood reviews, 2019, 37: 10058.
  4. doi.org/10.1016/j.blre.2019.100588
  5. Rao E, Chandraker SK, Singh MM, Kumar R. Global distribution of β-thalassemia mutations: An update. Gene.
  6. ;896:148022. https://doi.org/10.1016/j.gene.2023.148022
  7. Mutar MT, Majid M, Jaleel A, Saad A, Abdulmortafea A, Talib H. Awareness among parents of beta thalassemia
  8. major and intermedia patients in three centers in Baghdad and Al-Nasiriyah, Iraq, in 2017. Int J Med Students.
  9. ;7(1):6-10. doi.org/10.5195/ijms.2019.315
  10. Lafta RK. Burden of Thalassemia in Iraq. Public Health Open Access. 2023;7(1):1. https://doi.org/10.23880/phoa
  11. DOI: 10.23880/phoa-16000242
  12. Kadhim KA, Baldawi KH, Lami FH. Prevalence, Incidence, Trend, and Complications of Thalassemia in Iraq.
  13. Hemoglobin. 2017;41(3):164-168. doi:10.1080/03630269.2017.1354877.
  14. Khan F, Khan N. Burden on caregivers of children with thalassemia: A qualitative study. BMC Pediatr.
  15. ;19(1):1-8. doi:10.1186/s12887-019-1740-2.
  16. Mansoor M, Bhatia S. Understanding the challenges faced by caregivers of thalassemic patients: A systematic
  17. review. Thalassemia Rep. 2021;11(1):12-20. doi:10.4081/thr.2021.8876.
  18. Lovibond PF, Lovibond SH. The structure of negative emotional states: Comparison of the Depression Anxiety
  19. Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behav Res Ther. 1995;33(3):335-43.
  20. DOI: 10.1016/0005-7967(94)00075-u
  21. Veijola J, Jokelainen J, Läksy K, Kantojärvi L, Kokkonen P, Järvelin MR, Joukamaa M. The Hopkins Symptom
  22. Checklist-25 in screening DSM-III-R axis-I disorders. Nord J Psychiatry. 2003;57(2):119-23. DOI: 10.1080/08039480310000941
  23. Cappellini MD, Farmakis D, Porter J, Taher A. Guidelines for the Management of Transfusion Dependent
  24. Thalassaemia (TDT) Thalassaemia International Federation. Strovolos, Cyprus. 2021.
  25. Shah FT, Sayani F, Trompeter S, Drasar E, Piga A. Challenges of blood transfusions in beta-thalassemia. Blood
  26. Rev. 2019;37:100588. doi.org/10.1016/j.blre.2019.100588
  27. Al-Allawi N, Al Allawi S, Jalal SD. Genetic epidemiology of hemoglobinopathies among Iraqi Kurds. J
  28. Community Genet. 2021;12(1):5-14. doi:10.1007/s12687-020-00495-z.
  29. Maximiano-Barreto MA, Alves LC, Monteiro DQ, Matias M, Montayre J, Luchesi BM. Factors associated with
  30. low health literacy in unpaid caregivers of older people: a systematic review. Health Promotion International. 2024
  31. Oct;39(5):daae118. DOI: 10.1093/heapro/daae118
  32. Mashayekhi F, Rafati S, RAFATI F, Pilehvarzadeh M, Mohammadi SM. A study of caregiver burden in mothers
  33. with thalassemia children in Jiroft, 2013.
  34. Kosaryan M, Karami H, Darvishi-Khezri H, Akbarzadeh R, Aliasgharian A, Bromand K. Treatment status of
  35. patients with B-thalassemia major in northern Iran: Thalassemia registry system. Iran J Public Health.
  36. ;48:1335-1345. PMID: 31497556 PMCID: PMC6708530
  37. Beijing AngelMom Charity Foundation. Report on the prevention and treatment of thalassemia in China. 2021.
  38. Available at: http://files.angelmom.org/Doc/20180312/20180312111844_9237.pdf
  39. Varghese A, Ukande U. Impact of selected socio-demographic variables with selected clinical variables and growth
  40. parameters among transfusion-dependent thalassemia children. Int J Adv Res. 2017;3(3):38-44. Available at:
  41. https://www.allresearchjournal.com/archives/2017/vol3issue3/PartA/3-3-41-743.pdf
  42. Aziz RA, Mohammed SH, Aburaghif LF. Burden of caregivers care for children with thalassemia at Babylon Child
  43. and Maternity Teaching Hospital, Babylon Governorate, Iraq. J Nurs Health Sci. 2015;4(6):82-87. Corpus ID:
  44. Paramore, C., Levine, L., Bagshaw, E., Ouyang, C., Kudlac, A., & Larkin, M. (2021). Patient- and Caregiver
  45. Reported Burden of Transfusion-Dependent β-Thalassemia Measured Using a Digital Application. The patient,
  46. (2), 197–208. https://doi.org/10.1007/s40271-020-00473-0
  47. Platania S, Gruttadauria S, Citelli G, Giambrone L, Di Nuovo S. Associations of thalassemia major and satisfaction
  48. with quality of life: The mediating effect of social support. Health Psychol Open. 2017;4:278688282. DOI:
  49. 1177/2055102917742054
  50. Lu L, Wang L, Yang X, Feng Q. Zarit caregiver burden interview: development, reliability and validity of the
  51. Chinese version. Psychiatry Clin Neurosci. 2009;63:730-734. DOI: 10.1111/j.1440-1819.2009.02019.x
  52. Abedi H, Abbaszadeh A, Kazemi M, Pouraboli B. Silent screams: experiences of caregiver suffering by parents of
  53. children with thalassemia: a qualitative study. Journal of Qualitative Research in Health Sciences. 2014 Sep
  54. ;3(3):281-91
  55. Islam, F., Seemanta, S., Rezina, S., Mehrab, A., Raheem, E., & Hossain, M. S. (2025). Depression, anxiety, and
  56. stress among mothers of children with thalassemia in Bangladesh: a cross-sectional study. BMC women's health,
  57. (1), 221. https://doi.org/10.1186/s12905-025-03762-8
  58. Son KY, Lee CH, Park SM, Lee CH, Oh SI, Oh B, Tak SH, Cho B, Lee K, Lee SH. The factors associated with the
  59. quality of life of the spouse caregivers of patients with cancer: A cross-sectional study. J Palliat Med. 2012;15:216
  60. DOI: 10.1089/jpm.2011.030514
  61. Sahu, S., Agrawal, A., Shrivastava, J., & Tonk, S. (2023). Psychiatric disorders and caregiver burden in children
  62. with transfusion dependent β-thalassaemia and their caregivers. World journal of clinical pediatrics, 12(3), 125
  63. https://doi.org/10.5409/wjcp.v12.i3.125
  64. Inamdar S, Inamdar M, Gangrade A. Stress level among caregivers of thalassemia patients. Natl J Community
  65. Med. 2015;6(4):579-582. Available from: https://njcmindia.com/index.php/file/article/view/1283
  66. Al-Mahmoud L, Al-Harbi K. The emotional and financial burden on families of children with thalassemia: A cross
  67. sectional study. Pediatr Blood Cancer. 2022;69(3):e29310. doi:10.1002/pbc.29310.
  68. Wilson D, Wong DL, Hockenberry MJ, Wilson D. Wong's nursing care of infants and children. Mosby/Elsevier;
  69. Schnitzer S, Oedekoven M, Amin-Kotb K, Gellert P, Balke K, Kuhlmey A. Caregivers’ burden and education
  70. level: does subjective health mediate the association? Innov Aging. 2017;1(Suppl 1):447. PMCID: PMC6245041.
  71. doi.org/10.1093/geroni/igx004.1599
  72. Mudiyanse RM. Thalassemia treatment and prevention in Sri Lanka: A cost-effective model for low-income
  73. countries. Sri Lanka J Child Health. 2015;44(4):230-236. DOI: 10.1080/03630260600642633
  74. Barua T, Sultana K, Barua D, Karnain R, Chowdhury SB, Arzu MA. Expenditure to treat thalassemia-a major
  75. financial burden. European Journal of Medical and Health Sciences. 2022 Sep 29;4(5):52-6.
  76. DOI: 10.24018/ejmed.2022.4.5.1454

Similar Articles

You may also start an advanced similarity search for this article.

Most read articles by the same author(s)