Factors associated with symptoms of depression among informal caregivers of people with systemic sclerosis: a cross-sectional study

The role of frailty among the predictors of depression on informal caregivers of older adults: a mediation analysis

BACKGROUND

Providing care for older adults has been associated with the presence of depressive symptoms among their informal caregivers. Numerous caregivers and older adults' characteristics have been mentioned as predictors of caregivers' depression. However, studies dealing with the impact of older adults' frailty status on caregivers' depression are scarce. This study was conducted to clarify the precise relationship between caregivers' depression, caregivers' burden, caregivers' characteristics and patients' characteristics, including frailty, among the variables that may have an impact on caregivers' depression.

METHODS

In this cross-sectional study, patients and caregivers' characteristics were recorded for 311 patient-caregiver dyads, when the patient was admitted to the hospital. For the purpose of the study, a mediation analysis was used with patients and caregiver characteristics considered to be predictors, subjective caregivers' burden as the mediator, and caregivers' depression as the outcome variable.

RESULTS

Only patients' frailty and caregivers' subjective burden had a direct effect on caregivers' depression. Moreover, caregivers' gender, patients' frailty status and comorbidity, duration of caregiving, and the relationship with the patient, had an indirect effect through caregivers' burden that acted as mediator. Regarding total effects, caregivers burden followed by patients' frailty status had the greater impact on caregivers' depression.

CONCLUSIONS

By organising interventions to reduce caregivers' depression, patients' frailty status could be among the targets of those interventions considering that frailty might be delayed or reversed.

Needs of informal caregivers of people with a rare disease: a rapid review of the literature

OBJECTIVES

Many people living with a rare disease (RD) are cared for by a family member. Due to a frequent lack of individual RD knowledge from healthcare professionals, the patient and their informal caregiver are frequently obliged to become 'experts' in their specific condition. This puts a huge strain on family life and results in caregivers juggling multiple roles in addition to unique caring roles including as advocate, case manager and medical navigator. We conducted a rapid review of literature reporting on the unmet needs of informal caregivers for people living with an RD. All searches were conducted on 14 September 2021, followed by a manual searches of reference lists on 21 September 2021.

SETTING

Searches were conducted in Medline, Embase, Web of Science, GreyLit and OpenGrey.

RESULTS

Thirty-five papers were included in the final review and data extracted. This rapid review presents several unmet needs identified by informal caregivers of persons with an RD. The related literature was organised thematically: caregiver burden, support through the diagnosis process, social needs, financial needs, psychological needs, information and communication needs and acknowledgement from healthcare professionals.

CONCLUSIONS

This review provides evidence that increased meaningful support is required for caregivers. Active engagement should be encouraged from this cohort in future research and awareness raised of the support available to improve the quality of life for families living with an RD. The unmet needs identified through this review will benefit people living with an RD, caregivers, healthcare professionals and policy makers.

Carer reported experiences: Supporting someone with a rare disease

This exploratory study aimed to gain an understanding of carer reported experiences derived specifically from persons caring for someone with a rare disease. The survey took place online on the SmartSurvey platform from November 2019 to January 2020. The facilitated workshop took place in Bangor Carnegie Library, Northern Ireland. To be eligible to participate in the online survey respondents had to be adults caring for someone with a rare disease. Fifty-seven respondents took part, 15.8% male, 84.2% female. Thirty-two attendees were part of the facilitated workshop. While carers reported several positive aspects of their caring role, the majority of comments highlighted challenges such as sub-optimal interactions with healthcare professionals, insufficient (or absent) emotional, psychological and social support, lack of financial support and lack of awareness of existing support services. It is important that strategies are put in place to ensure that carers are given the time they need to care for themselves, and that awareness is raised of what support options are available for carers of people with a rare disease(s) from health and social care providers, charities or support groups.

Spousal Care Intensity, Socioeconomic Status, and Depression among the Older Caregivers in China: A Study on 2011–2018 CHARLS Panel Data

Using the stress process model and data from the 2011–2018 China Health and Retirement Longitudinal Study (CHARLS), this study examined the effect of spousal caregiving intensity on the depression level of older caregivers in China. The moderating role that socioeconomic status plays in the relationship between spouses was explored by constructing multilevel growth models (MGMs). The care intensity for a spouse was found to relate to significantly increased depression levels in older caregivers, while the degree of disability of the spouse being cared for (B = 0.200, p < 0.001) having a greater effect on depression than the duration of care (B = 0.007, p < 0.01). There was a threshold effect where the provision of more than 10 h of care per week for a spouse (B = 0.931, p < 0.001; B = 0.970; p < 0.01) or caring for a disabled spouse with limited ADLs (B = 0.709, p < 0.01; B = 1.326; p < 0.001; B = 1.469, p < 0.01) increased depression in older caregivers. There were moderating influences, including higher professional prestige before retirement (B = −0.006, p < 0.05) and higher annual family income (B = −0.037, p < 0.10), that increased depression related to the spouse’s degree of disability. It was considered that active familism measures should be formulated for older spousal caregivers, especially those with lower socioeconomic status.

Being a caregiver of a Behçet's syndrome patient: challenges and perspectives during a complex journey

Background

As often seen in many chronic diseases, the disease impact on patients also induces a significant impact on the quality of life (QoL) of caregivers. Caregivers are the ones who are really willing to offer care in the general approach of many aspects of the disease, including the awareness of the diseases itself, the daily management of therapy, and all the potential challenges that living with a chronic disease can include. The main objectives of the study were to explore the perspectives and views of caregivers of Behçet’s syndrome (BS) patients, to study their level of awareness on the disease and the impact that BS may have on their lives by means of a survey co-designed with caregivers and patients with this purpose. A survey was entirely co-designed with a panel of caregivers of patients living with BS patients.

Results

Results show that BS caregivers organise their life according to the needs of the patient, that they (79%) considered themselves as helpful for the patient and 53% of them replied that they can freely express their emotions. Notably, 70% and 68% of the respondents reported they renounced with a variable frequency to sexual relationships due to concerns regarding the health of the partner or to the partner’s illness, respectively. The majority (79%) of respondents indicated that they are familiar with the treatment taken by the patients and that 68% deal with the administration of some medicines. In terms of awareness, a good percentage (64%) of respondents reported to understand the illness and, in terms of education, 68% of participants are willing to take part in training programmes dedicated to BS.

Conclusions

The results of this survey contribute to provide new information on BS caregivers and on their important role, and to identify areas in which new initiatives could provide BS caregivers (and therefore patients) with tools and knowledge that can empower them in reducing the burden of the disease on their lives, on families, and on the patient.

Intensity of care and perceived burden among informal caregivers to persons with chronic medical conditions: a systematic review and meta-analysis

PURPOSE

Informal caregivers provide ongoing assistance to a loved one with a health condition. No studies have compared caregiving intensity and perception of burden across chronic medical conditions.

MATERIALS AND METHODS

Databases were searched from inception through 11 September 2020 to identify studies that included the Level of Care Index or the Zarit Burden Inventory (ZBI) among caregivers for people with chronic diseases. Pooled mean ZBI scores and 95% confidence intervals by medical condition were calculated using a random effects model and heterogeneity with I².

RESULTS

Ninety-seven included articles reported on 98 unique samples across 21 chronic diseases. No study used the Level of Care Index. Among 12 disease groups with more than one study, heterogeneity was too high (I² range: 0-99.6%, ≥76.5% in 11 groups) to confidently estimate burden. The percent of studies rated high risk of bias ranged from 0% to 98%, but all external validity items were rated as high-risk in >50% of studies.

CONCLUSIONS

Findings highlight the need for studies on caregiver burden to improve sampling techniques; better report sampling procedures and caregiver and care recipient characteristics; and develop a standard set of outcomes, including a measure of caregiving intensity. Systematic Review Registration: CRD42017080962IMPLICATIONS FOR REHABILITATIONThe amount of burden reported by caregivers to loved ones is associated with reduced physical and mental health.We found considerable heterogeneity in perceived burden reported by informal caregivers across different studies within disease groups, which is likely related to methodological issues, including sampling techniques.Health care providers who use research on caregiver burden should assess how representative study samples may be and exercise caution in drawing conclusions.

Burden, Positive Aspects, and Predictive Variables of Caregiving: A Study of Caregivers of Patients with Pediatric Glaucoma

Purpose

To determine the presence of burden and positive aspects among caregivers of patients with pediatric glaucoma (PG) and to establish whether they were influenced by the characteristics of the caregivers and the patients.

Method

This study was designed to be cross-sectional and descriptive. The Chinese version of the Caregiver Burden Inventory (CBI) and the Positive Aspects of Caregiving (PAC) questionnaires were used to evaluate the caregivers. The demographic data of the enrolled participants were also collected. The CBI and the PAC scores were analyzed in relation to each other and different characteristics of the patients with PG and their caregivers through a generalized linear regression model.

Result

Most of enrolled 57 caregivers were found to act with a moderate level of burden and benefits. The emotional subscale score of the CBI is negatively related to the aggregate score of the PAC and to that of outlook on life. Moreover, patients with a longer duration of disease and caregivers who were female, had jobs, had lower education levels, and had lower household incomes have qualities that are positively related to the summary score of the CBI. However, no factors we collected were significantly related to the PAC score.

Conclusion

The results suggest that caregivers perceive positive and negative experiences in the care and support of patients suffering from PG. In addition, we should pay more attention to the caregivers with a high risk of experiencing caregiver burden, especially females with jobs and also with lower incomes and lower levels of education.