Race Difference in Psychological Outcome Among Heart Failure Family Caregivers

Abstract

Background Family caregivers (FCGs) of persons with heart failure (HF) experience negative psychological outcomes due to chronic caregiving stress. Culture may play a role in how FCGs experience and cope with caregiving demands and stress. Purpose To examine differences in caregiver burden and the psychological outcome of depressive symptoms based on caregiver race. Method Participants were FCGs of persons with HF from a family caregiver intervention study (N=127, mean age=55.3 ± 1.5years, 92% women, 58% African American (AA), 42% White). Variables measured included demographic characteristics, depressive symptoms (CES-D), caregiver stress (Perceived Stress Scale; PSS), life changes resulting from caregiving (Bakas Caregiving Outcome Scale; BCOS) and sleep quality (Pittsburgh Sleep Quality Index; PSQI). Descriptive statistics, t-tests, Chi square, and regression were used for analysis. Results AA FCGs were younger in age (n=74, mean age=53 ± 11 years) compared with white FCGs (n=53, mean age=59 ± 11years), (p=.006), and less reported their overall health as good or excellent (n=61, 82.5% vs n=47, 88.7%; χ2=6.69, p=.035). AA FCGs reported slightly lower but non-significantly different levels of CES-D scores (14.9 ± 11) compared to the white FCGs (15.6 ± 9). Multiple linear regression to predict CES-D scores accounted for 60% of the variance (Adjusted R 2 =.60, F(7,119)=28.4, p Conclusions Race moderated the relationship between depressive symptoms and both perceived stress and life changes from caregiving. AA FCGs were less likely to experience higher depressive symptoms from stress and caregiving life changes than white FCGS. Implications These results suggest that greater understanding of the impact of family caregiving based on cultural norms and expectations may guide clinical assessments and interventions. Culturally sensitive interventions have potential to benefit FCG outcomes.