Abstract

Millions of family members deliver informal care and support to patients with heart failure (HF). Accumulating evidence suggests that caregivers of patients with HF suffer from depressive symptoms, but factors associated with depressive symptoms are unknown. Identification of such factors could provide targets for intervention. Three possible factors that are amenable to intervention are caregivers’ functional status, their sense of caregiving burden, and perceived control. (1) To examine differences in functional status, perceived control, and caregiving experiences (time, difficulty, and burden) between depressed and non-depressed caregivers; (2) To examine whether these factors predict caregivers’ depressive symptoms. A total of 92 caregivers (mean age of 57 years; female 75%; spousal caregiver 80%) of patients with HF were recruited from outpatient clinics at two community hospitals and an academic medical center in central Kentucky. Their depressive symptoms were assessed using the Beck Depression Inventory-II (BDI-II). Functional status was assessed using the Duke Activity Status Index. Perceived control was assessed using the Control Attitudes Scale-Revised. Caregiving difficulty, time, and burden were assessed using the Bakas Caregiving Inventory and the Zarit Caregiver Burden Scale. Caregivers were grouped using the standard cut point of 13 on the BDI-II score. The 27% of caregivers with depressive symptoms had poorer functional status (21± 20 vs. 34 ± 19; p =.007), lower perceived control (22 ± 4 vs. 25 ± 4; p = .005), and higher caregiving burden (26 ± 14 vs. 13 ± 10; p< .001) than caregivers without depressive symptoms. Controlling for age and gender in a multiple regression, functional disability (sβ= −.298, p<.001), perceived control (sβ= −.298, p<.001), and caregiver burden (sβ= .328, p=.002) explained 45% of the variance in caregivers’ depressive symptoms. Caregivers’ functional disability, poor controllability, and burden related to caregiving were associated with depressive symptoms. These findings suggest that depressed caregivers of patients with HF may benefit from interventions that improve perceived control, address caregiving burden and functional status.

Full Text
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