RHEUMATOID ARTHRITIS – CLINICAL ASPECTS

Abstract

Objectives: To study the burden as experienced by informal caregivers for people with Rheumatoid Arthritis (RA) in Egypt and the Netherlands and to determine which factors are related to this burden. Methods: A total of 99 Dutch and 30 Egyptian females with RA and their caregivers participated in the study. Data were collected by means of questionnaires including the amount of help provided, mental health and subjective burden as experienced by the caregiver, patient demographic and health status, social support, self-efficacy expectations and caregiver characteristics. Differences between Egypt and the Netherlands were analysed with ANCOVA, controlled for age and disease duration. Variables related to subjective burden and mental health were analyzed by multiple regression. Results: The objective burden as measured in the hours spent on helping the patients was less in Egypt (24 hours) compared to the Netherlands (35 hours). But the number of ADL tasks performed by the caregiver was higher in Egypt (4.3 vs 2.4). Subjective burden of the Egyptian caregivers was higher (32.4 vs 14.2) and their mental health was worse (61.5 vs 78.6) than those of the Dutch caregivers. In Egypt 34% of the subjective burden of caregivers could be explained by negative attitude towards help (β = −0.47), worse affect (β = 0.31), and the fact that the caregivers felt that the patients were heavily dependent upon them (β = 0.26). Whereas, in the Netherlands 27% could be explained by negative attitude towards help (β = −0.45), the fact that the caregivers felt that the patients were heavily dependant upon them (β = 0.30), and higher patient income (β = 0.27). Poor mental health among Egyptian caregivers could for 33% be explained by higher level of education (β = −0.47), and more pain (β = −0.47) of patients. Among the Dutch caregivers 45% could be explained by positive attitude towards help (β = −0.53), less negative social support for patients (β = −0.34), high self efficacy of caregivers for giving help (β = 0.27), and good physical health of the caregivers (β = 0.19). Conclusion: Egyptian caregivers for RA patients have higher subjective burden than the Dutch and worse mental health. In both countries negative attitude towards help and high caregiver estimation of dependency of their care-receivers were consistent variables for predicting subjective burden. In Egypt patient variables are the most important variables in predicting poor mental health of the caregivers whereas in the Netherlands caregiver variables are.