 This study examined the role of psychological factors in caregiver burden among caregivers of stage 4 cancer patients using data from 328 caregivers. Males, spouses, and caregivers of patients with a PEG or tracheostomy or those diagnosed with pancreatic biliary cancer had a significantly higher risk of caregiver burden. Age, sex, caregiver patient relationship, caregiving duration, patients catheter status, cancer types, depression and stress severity, rumination, dysfunctional attitudes, and dysfunctional coping strategies explained 69.7% of the variants in Xeric care burden scale scores. Moderation analysis revealed significant interactions of emotional coping with depression and dysfunctional coping with stress on caregiver burden. Rumination mediated the relationships between caregiver burden, stress, and depression. The study highlights the intricate relationships among caregiver burden, mental health, and coping strategies, suggesting tailored interventions to support caregiver health and quality of care. This article was authored by IPEC Ozonder-Unil and Chetan Ordu. We are article.tv, links in the description below.