Caregiver Fatigue Research Articles

Symptom Experience of Family Caregivers of Patients With Cancer

To review the literature on depression, anxiety,sleep disturbance, fatigue, and pain in family caregivers of patients with cancer in the context of the Symptom Management Model (SMM)developed at the University of California, San Francisco (UCSF). Published research studies and systematic reviews from 1990-2007. Studies of depressive symptoms in caregivers of patients with cancer were the most numerous. A limited number of studies examined anxiety, fatigue, sleep disturbance, and pain. Most studies focused on the symptom experience dimension of the UCSF SMM. Based on the small sample sizes, cross-sectional nature of the studies, and lack of comparison groups, little is known about the prevalence and effects of symptoms in caregivers of patients with cancer. Additional research is needed to determine the prevalence, severity, and effects of symptoms on caregivers. Better descriptive, correlational studies will lead to the development of interventions to improve symptom management for this group of caregivers.

The impact of sleep interruptions on vital measurements and chronic fatigue of female caregivers providing home care in Japan

The purposes of this study were to examine the impact of sleep interruptions on diurnal changes in blood pressure and chronic fatigue in middle-aged and elderly caregivers by using a cross-sectional quantitative method. Thirty-five female caregivers who were not taking antihypertensive and/or sleeping drugs were recruited for this study. Blood pressure was monitored over a 24 h period. Sleeping or waking periods were monitored with an actigraph. Fatigue was determined from a self-administered questionnaire. Participants were classified into four groups by cause of sleep interruption. One-way analysis of variance showed no differences in blood pressure, but hypertension was prevalent (40%). Sleep duration differed significantly, with the longest duration for those scheduled to wake up for care. Substantial variations were identified in the eight subcategories of chronic fatigue, with those without sleep interruption having the worst profile. This suggests that multiple factors in addition to sleep interruption affect the care burden.

The effect of music therapy sessions on compassion fatigue and team building of professional hospice caregivers

The purpose of this study was to evaluate the effects of music therapy on compassion fatigue and team building of professional hospice workers. Participants were nurses, social workers, and chaplains and were employed for at least one year in hospice care. Seventeen participants engaged in one of two experimental music therapy groups. Experimental group 1 utilized an ecological music therapy approach with an open, free form without structure and encouraged participation in the live music experiences of instrumental improvisation as well as toning and chanting. Experimental group 2 utilized a didactic music therapy approach with a structured format wherein interventions were planned and facilitated by the music therapist a priori. Such interventions included guided meditation with live music, lyric analyses, and music and movement. To measure compassion fatigue, the Compassion Fatigue Scale (CFS) was used as a pre- and post-test measure in each group. To measure team building, the Team Building Questionnaire (TBQ) was used as a pre-and post-test measure in each group. Statistical analyses indicated a significant improvement in team building in both groups but no significant differences with regard to compassion fatigue. Further research studying the effects of music therapy on compassion fatigue and team building of professional hospice caregivers is recommended.

The Caregiver Balancing Act: Giving Too Much or Not Enough

Although there are many reasons why an individual becomes a caregiver, there are even more ways for a caregiver to suffer "burnout," which can endanger his or her well-being and limit the ability to provide adequate care to another. This article provides a summary of the manner in which an individual may approach caregiving, the reasons for becoming a caregiver, the causes of caregiver fatigue and burnout, and the liability that a caregiver may face if he or she does not provide adequate care. Additionally, this article will discuss federal and state programs to assist caregivers, as well as recommendations for public policies and programs to help caregivers and protect the individuals in need of care.

Cumulative fatigue symptoms among caregivers in Japan

To investigate the relationship of cumulative fatigue symptoms among caregivers in Japan with work environment issues and lifestyle behaviors. The subjects were 376 women (mean age, 54 years) attending professional seminars for caregivers held between 1999 and 2002. After obtaining informed consent, a survey was conducted to ascertain work environment issues, lifestyle behaviors and fatigue levels. Fatigue was quantitatively assessed using the Cumulative Fatigue Symptoms Index (CFSI) developed by Kosugoh et al. Factors related to caregiver fatigue were identified using Pearson's correlation coefficient, the Mann-Whitney U-test and multiple regression analysis. Caregivers who felt an xiety or concern regarding care techniques, care content, personal relationships, work conditions, and physical fitness showed higher CFSI scores, while caregivers who exercised regularly and had proper eating behavior displayed lower CFSI scores. Anxiety/concern regarding physical fitness and proper eating behaviors were identified as significant predictors for all CFSI category scores (P<0.001). Regular exercise behavior (P<0.001), age (P<0.001), and years of work experience (P<0.001) also represented significant independent variables for some CFSI categories. Our results suggest that upgrading the knowledge and skills of care and nursing and modifying lifestyle behaviors could reduce the level of fatigue experienced by caregivers.

Chronic renal failure: assessing the Fatigue Severity Scale for use among caregivers.

Quality of life for caregivers of end-stage renal disease patients has not been well addressed yet the physical and psychological status of this overlooked group can be important in the recovery or adaptation of patients with chronic renal failure, not to mention the caregivers themselves. One particular feature of the overall quality of life of such caregivers is that of fatigue. The purpose of the study was to test the Fatigue Severity Scale for potential usefulness in assessing fatigue among a non-medical population, caregivers of end-stage renal disease patients. Subjects completed a short battery of measures at either a dialysis centre or at home. The Short Form-12 of the Short Form-36 and the Center for Epidemiologic Studies Depression Scale accounted for 56% of the variance on the Fatigue Severity Scale. The results suggest that physical fatigue may be more prominent than mental fatigue as a feature of caregiver quality of life. The Fatigue Severity Scale which has been used for multiple sclerosis patients may prove to be useful as a short assessment of fatigue among the non-medical population of end-stage renal disease caregivers. This may result in improved interventions for the population of caregivers. Physicians, nurses and allied health professionals will be called on more frequently to assess and intervene with fatigued and overburdened caregivers in addition to patients themselves. A more thorough understanding of the nature of caregiver fatigue may drive changes or innovations with caregivers who are too often overlooked in the current era of scarce resources. Accordingly results of the study suggest that the direction in intervention may focus more on rest and respite as opposed to a need for psychosocial support or counselling. While there are various modes for assessing end-stage renal disease caregivers' fatigue, a simple measure like the Fatigue Severity Scale is brief enough to be administered without undue demand on practitioners or caregivers.

Sleep EEG patterns and fatigue of middle-aged and older female family caregivers providing routine nighttime care for elderly persons at home.

The sleep EEGs and fatigue of 9 female family caregivers (age M=65 yr.) and 9 female noncaregivers (age M=67 yr.) were measured during two successive nights at their houses. Perceived quality of sleep was measured by the Sleep Evaluation Questionnaire. Fatigue was measured by a self-rated questionnaire, the Perceived Symptoms of Fatigue, and by critical flicker fusion (CFF) frequency. The caregivers had a significantly higher percentage of Stage 1 and a lower percentage of Stage 2 during the 2nd cycle and a higher percentage of Stages 3+4 during the 3rd cycle than those of the noncaregivers. Caregivers had significantly higher percentages of EEG waves of 7-9 Hz in the 1st cycle and 6-9 Hz in the 2nd cycle and significantly lower percentages of 2-3 Hz in the 1st cycle than those of the noncaregivers. The caregivers reported a lower quality of sleep and higher perceived fatigue symptoms and also lower CFF frequency (increased physiological fatigue) than noncaregivers. The caregivers' sleep EEGs were associated with their higher sleep needs and fatigue.

Effects of individual and family hardiness on caregiver depression and fatigue.

Hardiness is defined as commitment to life, viewing change as challenge, and having control over one's life. Previous research suggests that hardiness is related to better outcomes in stressful situations. The effects of individual and family hardiness on depression and fatigue of caregivers of disabled older adults (DA) were examined using a descriptive, cross-sectional design. The sample was 67 caregivers of DA with high functional impairment. One-third of caregivers reported moderate to high fatigue, and 40% had scores indicating possible clinical depression. Memory and behavior problems of the DA were positively correlated with caregiver depression and fatigue. Family hardiness was negatively related to memory and behavior problems of the DA. Controlling for covariates, individual hardiness was negatively associated with depression and fatigue; coping strategies did not mediate the relationship. Caregivers with low individual and family hardiness had more depression than those high in both resources. Additional research is needed to determine the relevance of hardiness theory in caregiving research.

Behavioral Interventions and Families: A Medical Rehabilitation Perspective

Behavioral interventions are pertinent to many issues faced by medical rehabilitation patients and their families in late adulthood. Despite their utility in managing chronic illnesses and reducing problematic behaviors related to cognitive impairment, behavioral interventions can be difficult to implement and maintain in a family setting. Problems resulting from countercontrol, caregiver fatigue, conflicting priorities, and impact on family relationships must be anticipated and addressed. These issues are illustrated through references to pertinent research and case examples. Recommendations are offered to reduce caregiver stress and to minimize shifts in relationships when family caregivers act to alter a member's behavior.

Fatigue in mothers of infants discharged to the home on apnea monitors

A comparative study was done to determine differences in caregiver fatigue between two groups of mothers of preterm infants at baseline, in the hospital (Time 1), 1 week postdischarge (Time 2), and 1 month postdischarge (Time 3). Group 1 infants were discharged home on apnea monitors (AM) (n = 28), and Group 2 infants were not on apnea monitors (nonAM)(n = 46). Measured by the Multidimensional Assessment of Fatigue (MAF) scale, mean fatigue scores from Time 1 to Time 3 markedly increased for the monitor group and decreased for the nonmonitor group. The scores were significantly different between the two groups at Times 2 and 3 but not at baseline. Two-way analysis of variance (ANOVA) with repeated measures showed group by time interaction effects on fatigue. Monitoring and alleviation of fatigue in home caregivers of preterm infants on apnea monitors are necessary.

Changes in and factors related to fatigue of in-home caregivers who utilize temporary nursing home assistance

In order to understand the fatigue of in-home caregivers of the elderly and the remedical effects of temporary nursing home assistance (i.e., "respite care service"), pre- and post-service surveys were conducted on the Cumulative Fatigue Symptoms Index (CFSI) of 34 in-home caregivers who use the respite care service offered by a nursing home in Shizuoka, Japan. The results of these two surveys are as follows: 1) The physical fatigue of caregivers before using the respite service is higher, and caregiver's free time is related to their feelings of fatigue. 2) According to CFSI figures, chronic fatigue, general fatigue, anxiety, depression (p < 0.01), and irritability caused by excessive workload and reduced vitality (p < 0.05) were significantly reduced by the services given. 3) Twenty-seven caregivers, or 79% of the sample, showed some improvement, while the remaining 7 caregivers (21%) showed none. 4) Factors which may have affected the degree of fatigue recovery were shown, including reasons and days for using the respite service.