scholarly journals Experiences of Black and White Family Hospice Caregivers: Anxiety, Depression, QOL, Burden, Hospice Communication

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 870-870
Author(s):  
Lauren Starr ◽  
Karla Washington ◽  
Subhash Aryal ◽  
Debra Parker Oliver ◽  
George Demiris

Abstract Although hospice care benefits seriously ill patients and their families, growing evidence suggests anxiety, depression, and altered quality of life are prevalent among family hospice caregivers. It is unknown if Black and white family hospice caregivers experience differences in mental health, quality of life, caregiver burden, or quality of hospice communication. In this secondary analysis of baseline data collected from 717 family hospice caregivers in two randomized clinical trials, we compared anxiety (GAD-7), depression (PHQ-9), quality of life (CQLI-R), caregiver burden (Zarit), and caregiver-reported quality of hospice team communication (CCCQ) between Black and white caregivers. Black and white caregivers differed demographically across multiple variables. In bivariate analysis, we found no differences in depression (P=0.3536), anxiety (P=0.0733), caregiver burden (P=0.6680), and perceptions of caregiver-centered hospice communication (P=0.4549). White caregivers reported lower quality of life than Blacks (P=0.0386), specifically in emotional (P=0.0321) and social (P=0.0002) domains. Financial and physical quality of life did not differ. In multivariate regression analyses controlling for caregiver and patient factors, we found no racial differences in depression (P= 0.5071), anxiety (P = 0.7288), quality of life (P=0.0584), caregiver burden (P=0.9465), or hospice communication (P=0.8779). Variables explained 7.7% to 20% of variability in outcomes, suggesting research is needed to understand which other factors contribute to hospice caregiver coping and communication experiences. Results suggest Black and white informal hospice caregivers experience similar levels of anxiety, depression, burden, and perceptions of hospice team communication quality. Interventions to support hospice caregivers across racial groups are needed.

2020 ◽  
Vol 33 (4) ◽  
pp. e100215
Author(s):  
Sneha Vadher ◽  
Rishi Desai ◽  
Bharat Panchal ◽  
Ashok Vala ◽  
Imran Jahangirali Ratnani ◽  
...  

BackgroundCaregivers play a pivotal role in providing care for mentally ill patients. Increase in caregiver burden can make them vulnerable to mental illness themselves.AimsWe assessed the severity of burden of care and its association with depression, anxiety and quality of life among caregivers of patients with alcohol use disorder (AUD) and schizophrenia.MethodsThis was an observational, cross-sectional, single-centred study of 50 consecutive caregivers of patients with AUD and schizophrenia. Participants were recruited from the psychiatry outpatient department of a tertiary care hospital between January and June 2017. The caregivers were further assessed by demographic details, Hospital Anxiety Depression Scale for assessment of depression and anxiety, Zarit Burden Interview for assessment of caregiver burden and WHO Quality Of Life-BREF for assessment of quality of life. Statistical data were analysed using GraphPad InStat V.3.06 (California). Multiple linear regression analysis was applied to identify the predictors of caregiver burden.ResultsBurden of care experienced by caregivers of patients with AUD is as high as that of caregivers of patients with schizophrenia (U=1142.5, p=0.46). Caregivers experiencing high burden of care are likely to have symptoms of anxiety (U=22, p<0.001), depression (U=32, p<0.001) and poor quality of life (U=84.5, p<0.001). Female caregivers are likely to experience higher burden of care (U=819.5, p=0.006). For caregivers of patients with schizophrenia, anxiety, environmental health, socioeconomic status and patients’ occupation can predict burden of care, while for caregivers of patients with AUD, depression and environmental health can predict burden of care.ConclusionOur study suggests that caregivers of patients with AUD experience burden of care as high as that of caregivers of patients with schizophrenia. Caregivers with high burden of care are more likely to have depression, anxiety and poor quality of life.Trial registration numberCTRI/2017/03/008224.


1970 ◽  
Vol 4 (2) ◽  
Author(s):  
Aan Nuraeni ◽  
Ristina Mirwanti ◽  
Anastasia Anna ◽  
Ayu Prawesti ◽  
Etika Emaliyawati

Prevalensi Penyakit Jantung Koroner (PJK) terus mengalami peningkatan setiap tahunnya dan menjadi masalah kesehatan utama di masyarakat saat ini. PJK berdampak terhadap berbagai aspek kehidupan penderitanya baik fisik, psikososial maupun spiritual yang berpengaruh terhadap kualitas hidup pasien. Isu kualitas hidup dan faktor-faktor yang berhubungan didalamnya belum tergambar jelas di Indonesia. Tujuan dari penelitian ini adalah mengidentifikasi faktor yang memengaruhi kualitas hidup pada pasien PJK yang sedang menjalani rawat jalan. Faktor-faktor yang diteliti dalam penelitian ini meliputi jenis kelamin, tingkat penghasilan, revaskularisasi jantung, rehabilitasi jantung, kecemasan, depresi dan kesejahteraan spiritual. Kecemasan diukur dengan Zung Self-rating Anxiety Scale, depresi diukur dengan Beck Depression Inventory II, kesejahteraan spiritual diukur dengan kuesioner Spirituality Index of Well-Beingdan kualitas hidup diukur menggunakan Seattle Angina Questionnaire. Penelitian ini menggunakan rancangan kuantitatif deskriptif dan analitik multivariatedengan regresi logistic. Diteliti pada 100 responden yang diambil secara randomdalam kurun waktu 1 bulan di Poli Jantung. Hasil penelitian menunjukkan faktor yang memengaruhi kualitas hidup pada pasien PJK adalah cemas (p) 0,002; Odd Ratio(OR) 4,736 (95% confidence interval(CI), 1,749 – 12,827); depresi (p) 0,003; OR 5,450 ( 95% CI, 1,794 – 16,562); dan revaskularisasi (p) 0,033; OR 3,232 (95% CI, 1,096 – 9,528). Depresi menjadi faktor yang paling berpengaruh terhadap kualitas hidup pasien PJK. Faktor yang memengaruhi kualitas hidup pada pasien PJK meliputi depresi, cemas dan revaskularisasi. Dari ketiga variabel tersebut depresi merupakan variabel yang paling signifikan berpengaruh, sehingga manajemen untuk mencegah depresi perlu mendapatkan perhatian lebih baik lagi dalam discharge planningataupun rehabilitasi jantung.Kata kunci: Cemas, depresi, faktor yang memengaruhi, kualitas hidup, spiritual.Factors Influenced the Quality of Life among Patients Diagnosed with Coronary Heart Disease AbstractCoronary Heart Disease (CHD) has affected multidimensional aspects of human live nowadays. Yet, quality of life and factors associated with quality of life among people who live with heart disease has not been explored in Indonesia. This study aimed to identify factors influenced the quality of life among people with CHD received outpatient services. Those factors are gender, income, revascularization, cardiac rehabilitation, anxiety, depression and spiritual well-being. Zung Self-rating Anxiety Scale was used to measure anxiety where depression level measured using Beck Depression Inventory II. Spirituality index was used to measure spiritual well-being. The quality of life level was measured using the Seattle Angina Questionnaire. This study used quantitative descriptive with multivariate analysis using logistic regression. 100 respondents were randomly selected from the Cardiac Outpatient Unit. Findings indicated factors influenced the quality of life of CHD patients using a significance of ƿ-value < 0.005 were: anxiety (ƿ=0,002, OR = 4,736, 95% CI, 1,749 – 12,827); depression (ƿ=0,003; OR=5,450, 95% CI, 1,794 – 16,562); and revascularizations (ƿ=0,033; OR=3,232, 95% CI, 1,096 – 9,528). Depression was considered as the most significant factor; therefore, managing depression is a priority in the discharge planning or cardiac rehabilitation programme. Keywords: Anxiety, depression, quality of life, spiritual, well-being.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhongyi Chen ◽  
Zhaosheng Ding ◽  
Caixia Chen ◽  
Yangfan Sun ◽  
Yuyu Jiang ◽  
...  

Abstract Background Comprehensive geriatric assessment (CGA) interventions can improve functional ability and reduce mortality in older adults, but the effectiveness of CGA intervention on the quality of life, caregiver burden, and length of hospital stay remains unclear. The study aimed to determine the effectiveness of CGA intervention on the quality of life, length of hospital stay, and caregiver burden in older adults by conducting meta-analyses of randomised controlled trials (RCTs). Methods A literature search in PubMed, Embase, and Cochrane Library was conducted for papers published before February 29, 2020, based on inclusion criteria. Standardised mean difference (SMD) or mean difference (MD) with 95% confidence intervals (CIs) was calculated using the random-effects model. Subgroup analyses, sensitivity analyses, and publication bias analyses were also conducted. Results A total of 28 RCTs were included. Overall, the intervention components common in different CGA intervention models were interdisciplinary assessments and team meetings. Meta-analyses showed that CGA interventions improved the quality of life of older people (SMD = 0.12; 95% CI = 0.03 to 0.21; P = 0.009) compared to usual care, and subgroup analyses showed that CGA interventions improved the quality of life only in participants’ age > 80 years and at follow-up ≤3 months. The change value of quality of life in the CGA intervention group was better than that in the usual care group on six dimensions of the 36-Item Short-Form Health Survey questionnaire (SF-36). Also, compared to usual care, the CGA intervention reduced the caregiver burden (SMD = − 0.56; 95% CI = − 0.97 to − 0.15, P = 0.007), but had no significant effect on the length of hospital stay. Conclusions CGA intervention was effective in improving the quality of life and reducing caregiver burden, but did not affect the length of hospital stay. It is recommended that future studies apply the SF-36 to evaluate the impact of CGA interventions on the quality of life and provide supportive strategies for caregivers as an essential part of the CGA intervention, to find additional benefits of CGA interventions.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 275-276
Author(s):  
Jose Aravena ◽  
Jean Gajardo ◽  
Laura Gitlin

Abstract In a scenario of increasing longevity and social inequalities, Latin-America is an important contributor to the worldwide dementia burden. Caregivers’ health is fundamental to maintain the person with dementia quality of life. However, caregiving is a culturally sensible role that requires tailored solutions. The aim is to synthesize the evidence about non-pharmacologic interventions targeted to caregivers of people with dementia in Latin-American contexts. A comprehensive review of interventions in caregivers and persons with dementia in Latin-American countries was conducted using MEDLINE, Embase, PsycINFO, and Scopus with studies published until January 27th, 2020. Randomized clinical trials of non-pharmacologic interventions targeted to caregivers of people with dementia or dyads where included. Qualitative synthesis of the evidence was presented and analyzed. Overall, 9 pilot RCT were included for the final analysis (6 Brazil, 1 Colombia, 1 Mexico, 1 Perú). The biggest study recruited 69 caregivers and the smallest 13 dyads, with follow-up range of 3-6 months. 5 control groups received at least some other non-standard care type of intervention. 8 were targeted exclusively to caregivers (4 group intervention, 3 individual, and 1 combined) and 1 multicomponent intervention. Most frequent measured outcomes were caregiver’s burden, anxiety, depressive symptoms, and quality of life, and person with dementia neuropsychiatric symptoms. Individual interventions report better results in caregiver parameters such as burden and depressive symptoms and person with dementia neuropsychiatric symptoms. Group interventions presented mixed results. Nevertheless, the quality of evidence was low. There is a critical need to study interventions for caregivers in Latin-American contexts.


2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii40-ii41
Author(s):  
Joshua Palmer ◽  
Brett Klamer ◽  
Karla Ballman ◽  
Paul Brown ◽  
Jane Cerhan ◽  
...  

Abstract PURPOSE We investigated the long term impact of SRS and WBRT in two large prospective phase III trials. METHODS Patients with 1–4 BMs +/- resection were randomized to SRS or WBRT. Cognitive deterioration was a drop of &gt;1 standard deviation from baseline in &gt;2/6 cognitive measures (CM). Quality of life (QOL) scores were scored 0–100 point scale. CM and QOL scores were modeled using baseline adjusted Linear Mixed Models (LMM) with uncorrelated random intercept for subject and random slopes for time. Differences over time between groups and the effect of &gt;2 cognitive scores with &gt;2 SD change from baseline were assessed. RESULTS 88 patients were included with median follow up of 24 months. We observed decreasing CM over time (SRS: 4/6; WBRT: 5/6). Mean CM was significantly higher in SRS for Total recall and Delayed Recall at 3, 6, 9, 12 months. More patients in WBRT arm declined 1 SD in &gt;1 and &gt;2 CM at the 3, 6, 9, and 12 months. A 1 SD decline in &gt;3 CM at 1 year was 21% SRS vs 47% WBRT (p=0.02). SRS had fewer patients with a 2 SD decline in &gt;1 CM at every time point. SRS had fewer patients with a 2 SD decline at &gt;2 and &gt;3 CM. WBRT had lower QOL at 3 months, but switched to SRS having lower QOL at 24 months for PWB, EWB, FWB, FactG, BR, and FactBR (p&lt; 0.05). A 2 SD decline in cognition decreased mean FWB by 6.4 units (95% CI: -11, -1.75; p=0.007) and decreased QOL by 5.1 units (95% CI: -7.7, -2.5; p&lt; 0.001). CONCLUSIONS We report the first pooled prospective study demonstrating the long term outcomes of patients with BMs after cranial radiation. WBRT was associated with worse cognitive outcomes. Impaired cognition is associated with worse QOL.


Sign in / Sign up

Export Citation Format

Share Document