{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T17:16:24Z","timestamp":1779383784198,"version":"3.53.1"},"reference-count":22,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T00:00:00Z","timestamp":1778803200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: Family caregivers are essential partners in the outpatient care of older adults with cancer, yet the knowledge, skills, and confidence, collectively, of caregiver activation are not well characterized in Asian settings. Understanding activation can inform tailored support to sustain effective caregiving. Accordingly, this study assessed the overall activation levels among cancer caregivers in the three most common cancer diagnoses in Singapore by using the Caregiver-Patient Activation Measure (CG-PAM). Methods: A total of 103 informal caregivers of patients \u226560 years (lung, GI, or myeloma) at Singapore\u2019s largest public cancer hospitals completed the 13-item CG-PAM, scored 0\u2013100 and classified into four activation levels. Descriptive statistics summarized characteristics and CG-PAM responses, and logistic regression analyses assessed the degree of activation for individual demographic and other characteristics (p &lt; 0.05). Results: Caregivers showed moderate\u2013high activation (mean 65.9 \u00b1 16.1) and the following levels: L1, 4.9%; L2, 23.3%; L3, 38.8%; L4, 31.1%. They strongly endorsed personal responsibility and active engagement, reporting confidence in key self-management tasks, but struggled to sustain behaviors under stress. Activation was not significantly associated with demographic factors or any other measured characteristics. Conclusions: Caregivers of older adults with cancer in Singapore included in this study showed moderate\u2013high activation and strong self-management confidence but struggled to sustain behaviors under stress. Routine activation assessment and tailored support (education, coaching) could strengthen outpatient care. Longitudinal and interventional research, alongside follow-up interviews, is needed to identify unmet needs, existing support systems, and inform scalable, sustainable models.<\/jats:p>","DOI":"10.3390\/ijerph23050661","type":"journal-article","created":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T16:46:18Z","timestamp":1779381978000},"page":"661","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["From Willingness to Readiness: Caregiver Activation for Cancer Care in Singapore"],"prefix":"10.3390","volume":"23","author":[{"given":"Safora","family":"Johansen","sequence":"first","affiliation":[{"name":"Faculty of Health Sciences, Oslo Metropolitan University, 0167 Oslo, Norway"},{"name":"Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore 828608, Singapore"},{"name":"Cancer Clinic, Oslo University Hospital, 0318 Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7392-0655","authenticated-orcid":false,"given":"Melissa Gaik Ming","family":"Ooi","sequence":"additional","affiliation":[{"name":"Department of Medicine, Yong Loo Lin School of Medicine (YLLSOM), National University of Singapore, Singapore 119228, Singapore"},{"name":"National University Cancer Institute Singapore, National University Hospital, Singapore 117597, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0952-6610","authenticated-orcid":false,"given":"Alice F. S.","family":"Chua","sequence":"additional","affiliation":[{"name":"Department of Nursing Administration (DNA), National Cancer Centre Singapore, Singapore 168583, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1097\/SPC.0000000000000438","article-title":"Caring for informal cancer caregiver","volume":"13","author":"Sun","year":"2019","journal-title":"Curr. Opin. Support. Palliat. Care"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Schultz, R., and Eden, J. (2016, November 28). 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