Psycho-Spiritual Well-Being and Stress Levels among Informal Caregivers of the Terminally Ill Within the Rwandan Households

Abstract

The increasing prevalence of non-communicable diseases and the global shift toward home-based palliative care have placed significant caregiving responsibilities on informal caregivers, particularly within family-centered societies such as Rwanda. Guided by the Integrated Spiritual Well-Being and Resilience-Coping Theory and the Caregiver Stress Process Model, this study examined psycho-spiritual well-being and stress levels among informal caregivers of terminally ill family members in Rwandan households. A descriptive cross-sectional design was employed, involving a purposive sample of 30 caregivers. Data were collected using the Kingston Caregiver Stress Scale (KCSS) and the Psycho-Spiritual Well-Being Scale (P-SWBS), and analysed using descriptive statistics and Spearman correlation. Findings revealed that caregivers reported high levels of psycho-spiritual well-being across domains such as compassion, connectedness, and meaningfulness. Despite this, caregivers experienced moderate to high levels of stress, particularly related to financial difficulties, family conflicts, and caregiving burden. Notably, no significant relationship was found between psycho-spiritual well-being and stress levels. These results suggest that while spiritual resources enhance resilience and meaning-making, they may not sufficiently mitigate stress in the presence of substantial structural and contextual challenges. The study concludes that caregivers in Rwanda demonstrate strong internal coping capacities but operate within environments characterized by limited external support. Therefore, strengthening formal support systems alongside psycho-spiritual resources is essential to effectively reduce caregiver stress and improve overall well-being.