Bakas Caregiving Outcomes Scale Research Articles

The Burden and Quality of Life in Caregivers of Individuals With Stroke During the COVID-19 Pandemic in Turkey: A Cross-Sectional Study

This study investigated the caregiving burden, quality of life and life satisfaction of caregivers of individuals with stroke during the pandemic period. A descriptive a study was performed with a sample of caregivers (n = 80) of inpatient individuals with stroke in Kayseri, Turkey. The Bakas Caregiving Outcomes Scale, Short Form Health Survey-36, and Temporal Satisfaction with Life Scale were used as well as some open-ended questions. Using descriptive analysis and correlations, results showed that caregiving burden of the participants was correlated to quality of life and life satisfaction during the COVID-19 (p < 0.05). Specific types of burden include: stress, isolation, financial issues, disruption of therapy, patient-caregiver relationship, and kinship relations. These findings provide important information about the increased burden of caregivers during the pandemic. This study offers information to design a framework of interventions to reduce the physical, social, and psychological effects on caregivers in similar conditions.

Fibromyalgia syndrome in mothers of children with cerebral palsy and its relationship with caregiver burden: a cross-sectional study

Objectives: Fibromyalgia syndrome (FMS) is a stress-related disease. The birth of a child with cerebral palsy (CP) is an important stress factor for the mother. This study aims to investigate the incidence of FMS in mothers of children with CP by comparing it with the control group and determining the factors affecting the severity of FMS. Methods: The study included 112 children with CP (age: 38-216 months), their caregiver mother (age: 23-50 years) (Group 1) and 52 non-disabled children (age: 40-180 months), their caregiver mothers (age: 27-50 years) (Group 2). Children were evaluated with the Gross Motor Function Classification System (GMFCS) and the functional independence scale for children (WeeFIM). The mothers were evaluated according to the 2010 ACR FMS diagnostic criteria. The FMS Impact Questionnaire (FIQ), the Hospital Anxiety and Depression Scale (HADS), and the Bakas Caregiving Outcomes Scale (BCOS) were applied. Results: In Group 1, mothers had higher anxiety-depression scores and caregiving burden than Group 2 (p &amp;lt; 0.05). FMS rate was %31.3 in Group 1 and %5.7 in Group 2. Mothers' anxiety-depression scores, widespread pain index, symptom severity score, pain, and caregiver burden were higher in Group 1 than in Group 2 (p &amp;lt; 0.05). Factors affecting the severity of FMS are the number of siblings of children with CP, the number of siblings with CP, GMFCS, dependence level, anxiety-depression levels of mothers, and caregiver burden. The most influential factor is the caregiver burden. Conclusions: Long-term heavy caregiver burden in mothers of children with CP may be effective in developing FMS.

The care burden of mothers of children with disability: Association between family quality of life and fatigue

AimThis study was performed with the aim of investigating the correlation between care burden, family quality of life and fatigue of mothers of children with disability. Material and methodThe sample for this descriptive study comprised the mothers of 280 children with disabilities accepting participation in the study, meeting the inclusion criteria, and registered in special education and rehabilitation centers in Turkey. Data were collected with the Mother-Child Descriptive Information Form, Bakas Caregiving Outcomes Scale (BCOS), Beach Center Family Quality of Life Scale (BCFQOLS) and Fatigue Severity Scale (FSS). ResultsMothers, mean BCOS scores were 63.29 ± 17.47, mean BCFQOLS scores were 93.74 ± 14.63, and mean FSS scores were 3.84 ± 1.43. There was a statistically significant positive, moderate intensity correlation between the BCOS scores and BCFQOLS scores of mothers (r = 0.404, p < 0.001); a statistically significant negative weak correlation between BCOS scores and FSS scores (r = −0.346,p < 0.001); and a statistically significant negative weak correlation between BCFQOLS scores with FSS scores (r = −0.22,p < 0.001). According to regression analysis, the care burden of mothers was identified to be a significant determinant of family quality of life and fatigue severity (p < 0.05). ConclusionThe results of the study showed that as the care burden of mothers of children with disability increases, family quality of life reduces and fatigue levels increase. Practice implicationsIt is recommended to support the mother in the care process, to plan activities and trainings to reduce the burden and fatigue of care, to increase the quality of family life, and to provide psychological support.

Does early or late discharge after total knee replacement affect the burden and stress of caregivers?

BackgroundSince patients may experience difficulties in their daily activities after total knee replacement surgery, the role of the caregiver is important in supporting the daily needs of the patients. Caregivers are involved in the day-to-day care activities of the patient during the recovery process, managing their symptoms and providing support. All these factors can affect the burden and stress of caregivers. MethodsIt was aimed to compare the caregiver burden and stress of caregivers of total knee replacement patients who were discharged on the same day of surgery and at a later point. Data were collected from 140 caregivers by using the Bakas Caregiving Outcomes Scale, Zarit Caregiving Burden Scale, and Stress Coping Styles Scale. ResultsThere was no significant difference between on the same day of surgery discharge and later discharge in terms of care burden and stress of caregivers (p > 0.05). While the burden of care was mild to moderate (22.15 ± 13.76) on the same day of surgery discharge group, the burden of care in the later discharge group was very low (19.03 ± 13.65). ConclusionIn order to reduce the care burden and stress levels of caregivers, it is important that nurses determine the problems related to caregiving and provide the necessary support.

Compassion Fatigue and Family Caregivers Caring in End-Stage Heart Failure.

Background: Compassion fatigue is a negative consequence impacting caregivers of chronic illness, such as heart failure. Reliance on family caregivers is expected to rise, placing importance on recognizing family caregiver characteristics that contribute to compassion fatigue. Purpose: This study specifically examined the associations of characteristics of family caregivers caring for end-stage heart failure, compassion satisfaction, social desirability, and the family caregiver-nursing provider relationship on compassion fatigue. Methods: An adapted interaction model of client health behavior guided this cross-sectional survey, which comprised a demographic questionnaire, the Professional Quality-of-Life Scale, the caregiver-provider relationship assessment, the Marlowe-Crowne Social Desirability Scale Short Form (Form C), and the Bakas Caregiving Outcomes Scale. Results: There were 127 family caregivers (FCGs), primarily those who have been a caregiver for longer than 1 year (78.4%), who completed the entire survey. Increased compassion satisfaction and positive caregiving effects were associated with decreased compassion fatigue (p < .001), while increased social desirability was associated with increased compassion fatigue (p < .001). A positive family caregiver-nursing provider relationship was related to decreased compassion fatigue (p < .001). More compassion fatigue was seen with lower spiritual status (p < .001). Implications: The chronic progression of heart failure presents opportunities for nursing providers to assess caregivers and offer frequent interventions. Family caregivers may not ask for help. Nursing providers must foster relationships with family caregivers to prevent negative consequences and mitigate compassion fatigue. Future research on the nursing provider relationship and FCGs is needed.

Greek Caregivers of Chronically Ill Patients Struggling in Everyday Life.

Caregivers of chronically ill geriatric patients face several problems throughout the disease progression of the patients under their care. This is a prospective crosssectional study conducted from September 2017 to September 2018, including 130 caregivers of geriatric patients from Attica, Greece. This study investigates caregivers' anxiety, perception of changes in their lives, and quality of life. The questionnaires administered were the revised Bakas Caregiving Outcomes Scale (rBCOS), the State-Trait Anxiety Inventory (STAI), and the Linear Analogue Scale Assessment (LASA). Influencing factors associated with rBCOS, STAI and LASA were care timespan and energy levels. Only the State Anxiety Scale and the Patient-caregiver Relationship rBCOS questionnaire seemed to be affected by a cancer diagnosis. Our findings revealed that anxiety, low quality of life, and perception of changes in the lives of caregivers are the underlying factors. Significant factors were time spent caring for the patient, the status of their relationship, the diagnosis, especially in life-threatening and life-limiting diseases, and the caregivers' energy levels. These results are important in order to comprehend the lives of caregivers and assess by what means could the healthcare system and society further assist them.

COVID‐19 related life changes for family caregivers of persons with Lewy body disease

AbstractBackgroundCoronavirus disease 2019 (COVID‐19) affected individuals’ physical and mental health. Protective measures such as closures, social‐distancing, masking, and isolation resulted in increased feelings of loneliness and isolation. This study aimed to investigate life changes associated with COVID‐19 for family caregivers of persons with Lewy body disease (LBD).MethodData were analyzed from an existing LBD caregiver needs and concerns study that took place between January 2021 and February 2021. A mixed methods approach was used to describe how 20 caregivers’ lives changed as a result of the COVID‐19 pandemic. Items from the Bakas Caregiving Outcomes Scale (BCOS) were adapted for COVID‐19 and rated on a response scale ranging from 1 = changed for the worst to 7 = changed for the best, with 4 = did not change. Qualitative data were collected as participants expanded upon their responses to the scale itemsResultCaregivers experienced both positive and negative life changes as a result of COVID‐19. On average, positive changes included increased use of the internet to order items (Mean = 4.35), videoconferencing to connect with others (Mean = 4.55), and improved financial well‐being (Mean = 4.35). Negative changes included reduced social (Mean = 1.7) and family (Mean = 2.05) activities and decreased ability to cope with stress (Mean = 2.60). Most responses ranged from 1 to 4, with some items having wider ranges from 1 to 7 showing that individual caregivers were impacted differently by the COVID‐19 pandemic. Qualitative comments were consistent with quantitative responses. Some caregivers expressed concerns that limited family and social contact contributed to a more rapid decline in the person with LBD. Caregiver health and well‐being were negatively affected as well, with caregivers noting decreased level of energy and worsened physical health.ConclusionFamily caregivers of persons with LBD experienced both positive and negative life changes as a result of COVID‐19. Responses indicated that caregivers were affected in a variety of ways and an individualized approach is recommended in dealing with caregiver life changes resulting from the COVID‐19 pandemic.

Stroke Family Caregiver Life Changes From the COVID-19 Pandemic.

ABSTRACTBACKGROUND: Stroke family caregivers were already struggling with unmet needs and changes in their own lives from providing care. The COVID-19 pandemic added further stress and disruption to their lives. The purpose of this study was to describe life changes in 17 stroke family caregivers specifically resulting from the COVID-19 pandemic. METHODS: This study was conducted as a secondary data analysis from an ongoing randomized controlled clinical trial testing feasibility of the Telehealth Assessment and Skill-Building Kit (TASK III). Using a multimethod design, both quantitative and qualitative data were analyzed to determine caregiver life changes. Quantitative ratings regarding life changes were obtained using 17 items adapted specifically for COVID-19 from the Bakas Caregiving Outcomes Scale. Rigorous content analysis procedures for the qualitative data were guided by a start list of codes based on the 17 items, with additional themes possible. Representative quotes were selected based on author consensus. RESULTS: Findings revealed both negative and positive life changes from the COVID-19 pandemic. Negative life changes included such things as disrupted daily routines, limited access to healthcare providers and resources (eg, food, masks, hand sanitizers), reduced family and social contact and activities, decreased emotional well-being, and problems with performing caregiving activities for the survivor. Positive life changes were increased use of the Internet and videoconferencing, closer relationships with friends, and learning how to access needed resources in new ways. CONCLUSION: Stroke family caregivers experienced both negative and positive life changes specifically as a result of the COVID-19 pandemic. Responses further indicated that COVID-19 affected most caregivers in different ways and an individualized approach is needed in dealing with caregiver life changes.

Psychometric Properties of Persian Version of the Bakas Caregiving Outcomes Scale.

Background:Caregivers of stroke patients have many problems due to caring for patients. This study aimed to evaluate the psychometric properties of the Persian Version of the Bakas Caregiving Outcomes Scale (BCOS) in caregivers of stroke patients.Materials and Methods:This methodological study was conducted in 2018 with 191 caregivers of stroke patients. In order to assess the scale validity and reliability, the face, content, internal consistency, stability of the scale, and construct validity (exploratory and confirmatory factor analysis) were done.Results:The scale face and content validity qualitatively were checked and confirmed by caregivers' and experts' opinions. In the reliability, Cronbach's alpha was obtained to be 0.93. The test-retest was conducted on 30 participants and showed good stability after 2 weeks. The Intraclass Correlation Coefficient (ICC) for the total scores was reported to be 0.94. The Kaiser-Meyer-Olkin p value was 0.90, Bartlett's sphericity test was significant (p < 0.001), in the exploratory factor analysis, 2 factors with 14 items were extracted. The confirmatory factor analysis confirmed the appropriate model with 14 items (removal of item 13) with two factors at the expected level.Conclusions:The Persian version of the 14 items of the BCOS indicates satisfactory reliability, and validity in the Iranian caregivers of stroke patients.

The Subjective Component of the Dutch Objective Burden Inventory: A Psychometric Analysis.

The reliability and validity of the subjective component of the Dutch Objective Burden Inventory (DOBI) are unknown. The validity and reliability of the subjective component of the DOBI were examined in caregivers of individuals with heart failure, using the original 38- and a 24-item version. In an online cross-sectional investigation, confirmatory factor analysis was used to examine factorial validity. In examining convergent validity, corrected item-dimension correlations assessed item performance and associations between subjective subscale scores and the Bakas Caregiving Outcomes Scale. Cronbach's α examined internal consistency. The original 4-factor solution was retained and both the original and shorter versions of the subjective component of the DOBI supported adequate construct validity and internal consistency. Both the 38- and 24-item forms of the subjective DOBI supported construct validity and reliability. Further studies examining the usefulness of both versions are needed in carers of individuals with more severe HF.

Abstract 10320: Feasibility of the Telehealth Assessment and Skill-Building Kit for Stroke Family Caregivers

Introduction: Existing stroke family caregiver interventions are limited in the use of technology and lack focus on caregiver health. The Telehealth Assessment and Skill-Building Kit (TASK III) was optimized based on caregiver preferences for technology and goal setting to improve caregiver health. The purpose of this study was to test feasibility of the TASK III program compared with an Information, Support, and Referral group (ISR) for improving caregiver depressive symptoms, life changes, and unhealthy days. Methods: Using randomized control trial design and an intent-to-treat analysis, 74 stroke family caregivers were randomized to TASK III (n=36) or ISR (n=38). The TASK III Resource Guide was provided by hard copy, website, eBook, and USB drive. TASK III and ISR groups received an American Stroke Association (ASA) pamphlet, access to the ASA website, and 8 weekly calls from a nurse (telephone/videoconferencing), with a booster call a month later. Data trends from baseline to 8 and 12 weeks were explored for depressive symptoms (PHQ-9), life changes (Bakas Caregiving Outcomes Scale), and unhealthy days. Minutes on calls with the nurse were controlled in analyses. Results: Among caregivers with mild to severe depressive symptoms at baseline (PHQ-9 &gt; 5) (n=31), TASK III showed a greater reduction in depressive symptoms relative to ISR from baseline to 8 and 12 weeks (Mean group difference in change scores -3.7, p=.02 at 8 weeks; -3.7, p=.04 at 12 weeks). Using the full sample (N=74), life changes improved for TASK III relative to ISR from baseline to 8 and 12 weeks (Mean 8.1, p=.03; 14.9, p&lt;.01), and for specific life changes of emotional well-being (Mean 0.8, p=.05; 1.4, p=.01) and physical health (0.7, p=.07; 1.2, p&lt;.01). No significant differences in rate ratios were found for unhealthy physical (Rate ratio 1.7, p=.17; 1.1, p=.74) and mental days (Rate ratio 1.4 p=.22; 1.4, p=.25). Conclusions: Data trends supported feasibility of TASK III relative to ISR for improving depressive symptoms and life changes, including changes in emotional well-being and physical health. Unhealthy days were highly skewed and not sensitive to change. Testing efficacy of TASK III relative to ISR is warranted in a future, well-powered trial.

Caregiver Burden in Caregivers of Acute Stroke Patients: From a Biopsychosocial Perspective in a Turkey Sample

Objective: This study aimed to evaluate caregiver burden among caregivers of acute stroke patients with a biopsychosocial perspective in a Turkey sample.&#x0D; Methods: 72 stroke patients and 72 their caregivers were included the study. The mean age of the stroke patients included in the study was 65±12.39. The mean age of caregivers was 44.5±14 and 66.7% of them were females. Modified Motor Assessment Scale (MMAS), Standardized Mini Mental State Examination (SMMSE) and The Barthel Index (BI) were used to assess the patients with stroke. The caregivers were evaluated by using the Bakas Caregiving Outcomes Scale, Family Sense of Coherence Scale-Short Form (FSOC-S), Hospital Anxiety and Depression Scale (HADS), WHOQOL-Bref-Short Form and Multidimensional Scale of Perceived Social Support (MSPSS).&#x0D; Results: There were significant positive correlation between the BCOS score and the SMMSE (r=0.36; p=0.002) and BI (r=0.22; p=0.05) scores. A significant positive correlation was found between the BCOS score and MSPSS’s family (r=0.31; p=0.007), friend (r=0.41; p

PREVALENCE OF DEPRESSION AND ANXIETY WITH CARE GIVER BURDEN IN PATIENTS UNDERGOING RADIOTHERAPY AT TERTIARY CARE CENTRE

Background: The aim of the present study was to investigate the factors associated with family caregivers’ anxiety and depression when caring for patients with advanced cancer. Methods: The sample consisted of 100 patients undergoing palliative radiotherapy and their respective caregivers. Patients completed the Hospital Anxiety and Depression Scale (HADS) and the MD Anderson Symptom Inventory. Their respective caregivers completed the Oberst Caregiving Burden Scale, the Bakas Caregiving Outcomes Scale, and the HADS. Correlational and multiple regression analyses were conducted to identify potential predictors of anxiety and depression. Results: Caregiving anxiety and depression were significantly higher in female as compare to male patients. (P < 0.05) Conclusion: The female caregivers experienced more anxiety and depression Key words: Advanced cancer, anxiety, burden, depression, family caregivers

The Effects of Patients' and Caregivers' Characteristics on the Burden of Families Caring for Stroke Survivors.

Background: Vascular strokes are the leading cause of long-term disability for adults. They impose high levels of burden on the patient, the family, and national healthcare systems worldwide. This study aimed to assess the effects of patients’ and caregivers’ characteristics on the perceptions of burden in families caring for a loved one living with stroke in Greece. Methods: Using purposive sampling, 109 dyads of patients and their respective caregivers were recruited from the Attica region. Patients completed a questionnaire that included personal characteristics and the Barthel Index, while caregivers completed a set of questionnaires—personal characteristics, revised Bakas Caregiving Outcomes Scale (BCOS), Personal Resource Questionnaire (PRQ 2000), and Center for Epidemiological Studies-Depression (CES-D). Results: Caregiving burden was linked to both patients’ and caregivers’ characteristics. A patient’s educational level, the number of family members living in the same house, the existence of equipment and facilities in the house, and the duration of provided care were associated with perception of greater burden. Regarding caregivers’ characteristics, those in good health had a significantly lower perception of burden. Higher PRQ 2000 scores were significantly associated with higher BCOS scores (less burden), and higher CES-D scores were significantly associated with lower BCOS scores (more burden). Conclusion: Caring for a loved one affected by stroke places a considerable burden on the caregiver. Systematic assessment and intervention strategies can help to identify caregivers at risk so that suitably targeted assistance may be provided.

The effectiveness of telehealth for a caregiver wellness program

Introduction This study compared outcomes of a telehealth and in-person delivered caregiver wellness program called Powerful Tools for Caregivers (PTC). Methods A total of 11 pairs of PTC class leaders delivered in-person and telehealth PTC classes. Caregiver participants completed a health-related questionnaire one week before, one week after, and six months after completing the program. A split-plot, mixed-design analysis of variance (ANOVA) and t tests were used to examine attendance and health-related outcome measures: depression as measured by the Center for Epidemiological Studies Depression Scale-Revised (CESD-R), caregiver experience as measured by the Bakas Caregiving Outcomes scale (BCOS), caregiver self-efficacy, and number of negative self-care behaviors. Results A total of 72 caregivers attended PTC in-person and 42 attended via telehealth. Mean attendance was 4.97 ± 1.21 for the in-person group and 5.21 ± 0.071 for the telehealth group, with no significant difference between delivery formats t(112) = 1.074, p = 0.285; 23 caregivers completed all three assessment periods for ANOVA. Interaction of group and time was non-significant for all outcome measures and the main effect of group was only significant for CESD-R scores at pre-PTC assessment, indicating that there were no differences between the two delivery formats for outcomes at post test or six months. The effect of time was significant for all outcome measures, indicating both in-person and telehealth participants improved on health-related outcomes over time. Discussion Telehealth is an effective delivery format for PTC – a traditionally in-person caregiver wellness program. This trial was registered [ClinicalTrials.gov identifier: NCT03800238].

The Relationship Between Caregiver Workload and Stress Levels with Clinical Symptom Severity in Cerebral Palsy

The aim of this study is to compare the functional status, spasticity, motor function status of children with cerebral palsy and their caregivers' workload and stress levels. A single-center prospective cross-sectional study was carried out with 30 children with Cerebral Palsy (CP) and their 30 caregivers. The clinical status of the children was assessed with the Modified Ashworth Scale (MAS), Gross Motor Function Classification System (GMFCS), The Functional Independence Measure for Children (WeeFIM). The caregivers' workload and stress levels were evaluated with Bakas Caregiving Outcomes Scale (BCOS) and Perceived Stress Scale (PSS), respectively. The mean age of the children was 11.46±7.45 years. In correlation analysis, the caregivers' BCOS score was related to the children's MAS score (p&amp;lt;0.05). On the other hand, there was a significant relationship between BCOS and PSS scores of the caregivers (p&amp;lt;0.05). Greater levels of spasticity in the children were associated with greater levels of workload. Stress level is higher in caregivers with a high workload.

Burden and Depression among Jordanian Caregivers of Hemodialysis Patients: A Cross-sectional Study

Introduction: Caring for patients receiving hemodialysis places a burden on caregivers. Objectives: To examine caregiving burden and depression in the family caregivers of patients receiving hemodialysis and associated factors. Methods: A cross-sectional design was used. Participants were 204 adult caregivers of patients receiving hemodialysis. Questionnaires included sociodemographic characteristics, the Oberst Caregiving Burden Scale-Difficulty (OCBS-D) subscale, Bakas Caregiving Outcomes Scale (BCOS), and the Patient Health Questionnaire-9 to measure the burden and depression of caregivers. Descriptive statistics, two linear regression analyses, and multinomial logistic regression were used in data analysis. Results: The majority (59.0%, n = 120) of caregivers had a moderate level of depression with scores ranging from 11 to 16. The analysis showed that the mean score of OCBS-D was 42.0 (SD = 4.7) with scores ranging from 26.9 to 58.9 (range = 32.0), while the caregivers' mean score of BCOS was 52.1 (SD = 9.3) with scores ranging from 38.0 to 82.5 (range = 44.5). Given that the expected score of OCBS-D and BCOS ranged from 15 to 75 and 15 to 105, respectively, the analysis indicated a moderate to a high level of burden among caregivers. Age and travel time were associated with a higher likelihood of negative outcomes in the family caregivers, while higher patient age was associated with a greater caregiver burden. Relevance to Clinical Practice: It is important to assess and address the practical issues that caregivers experience, such as employment-related responsibilities, financial difficulties, and the need to learn specific skills related to patients’ chronic illnesses. Conclusion: Caregivers of patients receiving hemodialysis are likely to experience moderate depression and burden. Caregiver burden increases with patient age and travel time to the hemodialysis units.

Psychometric Examination of the Dutch Objective Burden Inventory in Heart Failure Caregivers.

Psychometric properties of the 38-item version of the Dutch Objective Burden Inventory (DOBI) have been evaluated primarily in older female caregivers, with no published studies that vary by a different gender and age distribution. The aim of this study was to test the construct validity and reliability of the DOBI in caregivers of individuals with heart failure from the United States and other countries. This secondary analysis from a cross-sectional study used an online survey. Factorial validity was tested with confirmatory factor analysis, item performance was examined with ordinal item response analysis, and convergent validity was tested correlating DOBI subscale scores with Bakas Caregiving Outcomes Scale scores. Internal consistency reliability was assessed with Cronbach α. Item response analysis removed 14 items. Confirmatory factor analysis retained the original 4-factor solution. Original and reduced instruments demonstrated good internal consistency. Validity was supported by meaningful associations with the Bakas Caregiving Outcomes Scale. Both the original 38-item DOBI and the reduced 24-item DOBI had support for their construct validity and internal consistency. The 24-item DOBI may be a useful alternative to the 38-item version, because it maintains psychometric properties of the original instrument while decreasing data collection burden. However, more research is needed to assess whether the shorter version is useful in assessing objective caregiving burden.

Predictors of the burden on family carers of patients on haemodialysis in Jordan.

Family caregivers of patients on haemodialysis can experience life changes and depression. This study assessed the self-perceived burden on their family caregivers of haemodialysis patients in Jordan, and the caregivers' perceived burden of caregiving and depression. The predictors of caregiver outcomes were determined. This cross-sectional study included 190 patients on haemodialysis and their caregivers in Jordan. Patients' self-perceived burden on their caregivers was assessed using the self-perceived burden scale. For caregivers, burden was assessed using the Oberst caregiving burden scale and Bakas caregiving outcomes scale - difficulty subscale. Caregivers' depression was assessed using the patient health questionnaire-9. Mean scores and standard deviations (SD) were calculated. Multiple regression analysis was done to determine the predictors of caregiver outcomes. Patients thought that they were a moderate to severe burden on their caregivers (mean score 36.31, SD 3.48). Caregivers perceived themselves as moderately burdened, and thought that their lives had changed for the worse because of caregiving (mean score 2.82, SD = 0.98). Caregivers were moderately depressed (mean score 1.80, SD 0.42). Multiple regression analysis showed that the perceived difficulty of caregiving tasks and patients' self-perceived burden predicted the caregiver outcomes. The difficulty of caregiver tasks explained 38% of the overall variance in the caregiver outcomes. Patient's self-perceived burden on their caregivers explained 16.4% of the variance. Factors that affect the burden on caregivers of dialysis patients should be identified and interventions considered to support caregivers and reduce this burden.

Caregiver Strain and Heart Failure Patient Clinical Event Risk: An Extension of Previous Work.

In a study of Italian heart failure patient-caregiver dyads, greater caregiver strain significantly predicted lower patient clinical event risk. The purpose of this secondary analysis was to examine this relationship in a sample from the United States. Data came from 92 dyads who participated in a self-care intervention. Logistic regression was used to test the relationship between baseline strain (Bakas Caregiving Outcomes Scale, divided into tertiles) and patient likelihood of events (heart failure hospitalization/emergency visit or all-cause mortality) over 8 months. Nearly half of patients (n = 40, 43.5%) had an event. High (vs low) caregiver strain was associated with a 92.7% event-risk reduction, but with substantial variability around the effect (odds ratio, 0.07; 95% confidence interval, 0.01-0.63; P = .02). Although findings were similar to the Italian study, the high degree of variability and contrasting findings to other studies signal a level of complexity that warrants further investigation.