Is the risk of malnutrition among caretakers related to caregiver anxiety? (original) (raw)
Related papers
Journal of Natural Science, Biology and Medicine, 2019
Objective: Research focusing on anxiety and depression among caregivers of hospitalized geriatric patients is lacking. The objective of this study was to determine the prevalence of anxiety and depression among caregivers of hospitalized geriatric patients for 1 week. Subjects and Methods: A prospective cohort study of caregivers of geriatric patients who were hospitalized at Cipto Mangunkusumo Hospital was conducted from February to May of 2018; levels of anxiety and depression symptoms were assessed on the 1st day of hospitalization compared with those from the 7th day using the Hospital Anxiety and Depression Scale questionnaire. The analysis was conducted using SPSS Statistics for bivariate and multivariate logistic regression. Results: On the 1st day of hospitalization, 29.1% of the caregivers had mild anxiety symptoms, 5.1% had moderate anxiety symptoms, and 2.6% had mild depression symptoms. On the 7th day, 44.4% of the caregivers had mild anxiety symptoms, 23.1% had moderate anxiety symptoms, and 3.4% had severe anxiety symptoms, whereas 49.6% had mild and 12.8% had moderate depression symptoms. The duration of caregiving ≥8 h/ day (P = 0.041; odds ratio [OR]: 4.228; 95% confidence interval [CI]: 1.060–16.860 for anxiety and P = 0.008; OR: 8.392; 95% CI: 1.723–40.880 for depression) and ≥6 days/week (P = 0.019; OR: 2.500; 95% CI: 1.163–5.375 for anxiety and P < 0.001; OR: 4.184; 95% CI: 1.982–9.256 for depression) significantly increased symptoms of anxiety and depression. Conclusion: Caregiving for hospitalized geriatric patients can aggravate anxiety and depression, and the duration of caregiving ≥8 h/day and ≥6 days/week significantly increased both symptoms.
Differences between caregivers and non-caregivers in psychological health and physical health: a met
2003
Providing care for a frail older adult has been described as a stressful experience that may erode psychological well-being and physical health of caregivers. In this meta-analysis, the authors integrated findings from 84 articles on differences between caregivers and noncaregivers in perceived stress, depression, general subjective well-being, physical health, and self-efficacy. The largest differences were found with regard to depression (g ϭ .58), stress (g ϭ .55), self-efficacy (g ϭ .54), and general subjective well-being (g ϭ Ϫ.40). Differences in the levels of physical health in favor of noncaregivers were statistically significant, but small (g ϭ .18). However, larger differences were found between dementia caregivers and noncaregivers than between heterogeneous samples of caregivers and noncaregivers. Differences were also influenced by the quality of the study, relationship of caregiver to the care recipient, gender, and mean age of caregivers.
Identifying and Addressing Family Caregiver Anxiety
Journal of Hospice & Palliative Nursing, 2019
Family members providing care at home for a loved one with a serious illness are growing in number and diversity. 1 A typical caregiver is a 45-55-year-old female caring for her 65-75year-old female loved one who has a long-term physical illness, and the duration of that care has been approximately four years. 1 Caregivers are most likely high school graduates who work full time, with an average household income of $55,000. 1 The family caregiver (sometimes called an informal caregiver) is usually an unpaid individual (i.e., a spouse, partner, neighbor, friend, or other relative) involved in assisting another with activities of daily living and/or medical tasks. 2 These informal caregivers often provide countless hours of direct or indirect care and support for their care recipients with chronic physical conditions, mental illness, terminal illness, and/or disabilities. 1 The National Academies of Sciences, Engineering, and Medicine (NASEM) 2016 report, Families Caring for an Aging America, highlights the increasing numbers of older adults, shrinking families, and the personal impacts of family caregiving. 3 A diagnosis of cancer can profoundly impact the overall quality of life of the care recipient as well as the family caregiver; this includes physical, psychological, social, and spiritual well-being. 4 Family caregivers of persons with cancer experience high levels of anxiety. Along with demographic factors, care recipient quality of life is considered a predictor for anxiety among family caregivers. 5 Manifestations of anxiety are similar to those of depression; however, they are Author Contributions: Dr. Moss and Ms. Kurzawa contributed to all aspects of the paper from conception through development and initially developed the paper. Both Drs. Daly and Prince-Paul provided feedback on the product throughout its refinement. Each coauthor wrote and edited all components of the paper and has reviewed the final paper prior to submission.
BACKGROUND: Cancer not only affects patients but also their caregivers. The objective of the current study was to assess the unmet needs of cancer caregivers and to identify possible predictors of their supportive care needs. METHODS: In a cross-sectional survey, 188 dyads of patients diagnosed with lung, urological, or gastrointestinal cancer and their primary caregivers were recruited. Caregiv-ers were asked to complete the Supportive Care Needs Survey self-report questionnaire (for partners and caregivers); patients completed the corresponding questionnaire. Both groups provided information regarding their distress (National Comprehensive Cancer Network Distress Thermometer), anxiety, and depression (Patient Health Questionnaire-4). Clinical characteristics were obtained from medical records. RESULTS: The mean age of the caregivers was 57.8 years. Approximately 72.3% were female. Patients had an average age of 62.5 years, with 33.0% being male. Caregivers were more distressed (P<.01) and exhibited higher anxiety scores (P<.01) compared with patients. Approximately 14.4% of caregivers reported no unmet need and 43.6% had at least 10 needs that were unmet. Main caregiver concerns were regarding health care service and information needs followed by emotional and psychological needs. To some degree, unmet needs in patients and caregivers' anxiety predicted unmet caregiver needs. Sociodemographic and clinical variables were not found to be significant predictors. CONCLUSIONS: A substantial percentage of caregivers have unmet needs for support, mainly with regard to fears concerning the patient's condition, receiving disease-related information, and emotional support for themselves. Prediction of unmet needs in caregivers from other clinical and psychological variables was rather poor. Therefore, by means of the frequency and disparity of caregivers unmet needs, they should be systematically assessed to direct specific
Objective: Caregiver research has relied on composite measures (eg, count) of unmet supportive care needs to determine relationships with anxiety and depression. Such composite measures assume that all unmet needs have a similar impact on outcomes. The purpose of this study is to identify individual unmet needs most associated with caregivers' anxiety and depression. Methods: Two hundred nineteen caregivers completed the 44‐item Supportive Care Needs Survey and the Hospital Anxiety and Depression Scale (minimal clinically important difference = 1.5) at 6 to 8 months and 1, 2, 3.5, and 5 years following the patients' cancer diagnosis. The list of needs was reduced using partial least square regression, and those with a variance importance in projection >1 were analyzed using Bayesian model averaging. Results: Across time, 8 items remained in the top 10 based on prevalence and were labelled " core. " Three additional ones were labelled " frequent, " as they remained in the top 10 from 1 year onwards. Bayesian model averaging identified a maximum of 3 significant unmet needs per time point—all leading to a difference greater than the minimal clinically important difference. For depression, none of the core unmet needs were significant, rather significance was noted for frequent needs and needs that were not prevalent. For anxiety, 3/8 core and 3/3 frequent unmet needs were significant. Conclusions: Those unmet needs that are most prevalent are not necessarily the most significant ones, and findings provide an evidence‐based framework to guide the development of caregiver interventions. A broader contribution is proposing a different approach to identify significant unmet needs.
Understanding the Impacts of Caregiver Stress
Professional case management, 2020
C aregiver stress, strain, or burden affects nearly 44 million caregivers in the United States and has become a public health issue (National Association of Chronic Disease Directors & Centers for Disease Control and Prevention, 2018; Shaji & Reddy, 2012). More than 16 million caregivers care for a person living with Alzheimer's disease or dementia (Alzheimer's Association, 2019). These caregivers are referred to as "informal" or "family" caregivers who are unpaid versus the more professional or paid caregivers who often work in home health or longterm care settings. One in 10 informal caregivers is 75 years and older, and this age group experiences higher rates of caregiver strain than its younger equivalent (National Alliance for Caregiving [NAC] and AARP, 2015). The number of older adult caregivers is expected to increase as our nation ages. The workload on these caregivers is immense, with nearly 31% of caregivers providing more than 20 hr of care a week. Of those high-hour caregivers, 53.8% have been providing care for more than 2 years and 24% have been providing care for more than 5 years (NAC & AARP, 2015). Caregiver stress is often underdiagnosed or overlooked in patients caring for older adults living with dementia due to it being perceived as a "normal part of aging" (Brodaty & Donkins, 2009). A caregiver is often "the invisible patient" who presents the in health care setting with significant physical and psychological issues that are negatively impacting his or her caregiving abilities (Adelman, Tmanova, Delgado, Dion, & Lachs, 2014, p. 1054). Emotional stress and financial strain are highly reported among caregivers (31%; NAC & AARP, 2015). Caring for those with a disabling health or mental health condition may negatively impact quality of life due to the development of chronic stress, which is highly associated with caregiving. Chronic stress, in turn, can lead to adverse physical, mental, and emotional health outcomes in both the caregiver and the care recipient (
Prevalences stress caregivers HQOL 2008
Background: Alzheimer's disease presents a social and public health problem affecting millions of Italians. Those affected receive home care from caregivers, subjected to risk of stress. The present investigation focuses on stress, anxiety and depression in caregivers. Methods: Data on 200 caregivers and their patients were collected using a specific form to assess cognitive, behavioural, functional patient (MMSE, and ADL-IAD) and caregiver stress (CBI). The relationship between stress, depression and disease has been assessed by means of a linear regression, logistic analysis which reveals the relationship between anxiety, stress and depression and cognitive problems, age, the patient's income. Results: The caregivers are usually female (64%), mean age of 56.1 years, daughters (70.5%), pensioners and housewives (30%), who care for the sick at home (79%). Of these, 53% had little time for themselves, 55% observed worsening of health, 56% are tired, 51% are not getting enough sleep. Overall, 55% have problems with the patient's family and/or their own family, 57% at work. Furthermore, 29% feel they are failing to cope with the situation as they wish to move away from home. The increase in the degree of anxiety and depression is directly proportional to the severity of the illness, affecting the patient (r = 0.3 stress and depression r = 0.4 related to CBI score). The memory disorders (OR = 8.4), engine problems (OR = 2.6), perception disorders (OR = 1.9) sick of the patient with Alzheimer's disease are predictive of caregiver stress, depression is associated with the presence of other disorders, mainly behavioural (OR = 5.2), low income (OR = 3.4), patients < 65 years of age (OR = 2.9). Conclusion: The quality of life of caregivers is correlated with the severity of behavioural disorders and duration of the Alzheimer's disease. The severity of the disease plays an important role in reorganization of the family environment in families caring for patients not institutionalised. It is important to promote measures to soften the impact that the patient has on the caregiver, and that, at the same time, improves the quality of life of the patient.
Caregiver Anxiety Due to Interstage Feeding Concerns
Congenital Heart Disease, 2015
Introduction. Improved weight gain during the interstage (IS) period has been shown to improve overall outcomes in patients with single ventricle physiology (SVP). This emphasis on nutrition may have untoward effects, such as increasing anxiety/stress levels in caregivers, who are already known to be at risk for increased anxiety/stress levels. The goal of this study was to evaluate anxiety/stress levels of caregivers as it pertains to feeding during the IS period and to determine if certain characteristics were associated with higher anxiety/stress scores. Methods. Caregivers of children with SVP who completed the IS period, defined as the time between the first and second cardiac surgeries, were recruited. Baseline demographics were obtained. Anxiety/stress levels were measured via eight questions using a 0-to 10-point scale. Correlations were performed between demographic variables and anxiety/stress level scores. Results. Fifty-six surveys were completed (39 males, 27 females) on 43 children. Fourteen children required tube feeds during the IS period. There were significant correlations between anxiety/stress scores and caregiver's gender, caregiver's age, caregiver's level of education, percent of time a caregiver spent feeding the child, if caregivers were taking medications for anxiety, and if the child was seen in the emergency room during the IS period. There were no correlation of anxiety/stress scores with caregiver's race, child's underlying cardiac diagnosis, age of child, route of feeding during the IS period, birth order of the child or number of children in the family, relationship status, or distance from the hospital. Conclusion. In general, caregivers of children with SVP experience anxiety/stress during the IS period specifically due to feeding concerns. Certain intrinsic and extrinsic characteristics were associated with higher anxiety/stress levels. Future studies are needed to determine how to minimize anxiety/stress levels during this stressful time period.
Cureus, 2022
Background A high prevalence of anxiety symptoms has been identified among the caregivers of disabled older people. The aim of the study was to explore the relationships between objective burden (intensity of care and burdensome characteristics of the care recipient, like frailty status), caregiver characteristics, subjective burden, and anxiety in a sample of informal caregivers caring for hospitalized elderly patients. Methods In this cross-sectional study, patients' and their informal caregivers' characteristics were recorded for 311 patient-caregiver dyads. Subjective caregiver burden and caregivers' anxiety were assessed by using the Zarit Burden Interview and the Hospital Anxiety and Depression Scale (HADS), respectively. Correlation coefficients and path analysis were used to examine the relationship between variables. Caregivers' anxiety was considered as the outcome variable. Caregivers' subjective burden was entered as a mediator between caregiver characteristics-objective burden and anxiety. An objective burden was measured based on the care needs of the dependent elderly (frailty status, cognitive impairment, comorbidity, independence in activities of daily living, behavioral problems, hours spent on caregiving, and duration of caregiving). Results Abnormal anxiety symptoms (HADS score 11-21) were reported by 92 caregivers (29.6%). Borderline cases (HADS score 8-10) were 66 caregivers (21.2%). A mild, moderate, or severe subjective burden was recorded for 113 (36.3%), 100 (32.2%), and 26 (8.4%) caregivers, respectively. The female gender of the caregiver, the spousal relationship with the patient, and the subjective burden were directly related to higher levels of caregivers' anxiety. A subjective burden was found to be a significant mediator in the relationship between duration of caregiving, patients' frailty status, caregiver gender, patients' comorbidity, and caregivers' anxiety. Conclusion Among the risk factors for caregivers' anxiety, the frailty status of the patient is probably the only modifiable factor via interventions targeting frailty reversion or reduction.
PLOS ONE, 2021
There is increasing evidence that subjective caregiver burden is an important determinant of clinically significant anxiety in family carers. This meta-analysis aims to synthesise this evidence and investigate the relationship between subjective caregiver burden and anxiety symptoms in informal caregivers. We searched PubMed, CINAHL and PsycINFO up to January 2020. Combined estimates were obtained using a random-effects model. After screening of 4,312 articles, 74 studies (with 75 independent samples) were included. There was a large, positive association between subjective caregiver burden and anxiety symptoms (r = 0.51; 95% CI = 0.47, 0.54; I2 = 0.0%). No differences were found in subgroup analyses by type of study design (cross-sectional vs. longitudinal), sampling, control of confounders or care-recipient characteristics. Subjective caregiver burden is an important risk factor for anxiety in informal caregivers. Targeting subjective caregiver burden could be beneficial in preven...