Caregiver Depressive Symptoms Research Articles

Moderator Role of Mutuality on the Association Between Depression and Quality of Life in Stroke Survivor-Caregiver Dyads.

Authors of previous research have not yet analyzed the role of potential moderators in the relationship between depressive symptoms and quality of life (QOL). The aim of this study was to examine the moderating effect of mutuality between depressive symptoms and QOL in stroke survivor and caregiver dyads. This study used a longitudinal design with 222 stroke survivor-caregiver dyads enrolled at survivor discharge from rehabilitation hospitals. Data collection was performed for 12 months. We examined survivor and caregiver QOL dimensions (physical, psychological, social, and environmental), depression, and mutuality at baseline and every 3 months. Hierarchical linear modeling was used to test 4 longitudinal dyadic moderation models (1 for each QOL domain). Survivors (50% male) and caregivers (65% female) were 70.8 (SD, 11.9) and 52.5 (SD, 13.1) years old, respectively. We observed no significant moderating effects of mutuality for survivors across the 4 dimensions of QOL over time. However, higher survivor mutuality was significantly associated with higher survivor psychological and social QOL at baseline. Regarding caregivers, caregiver mutuality significantly moderated the association between caregiver depressive symptoms and caregiver physical (B = 0.63, P < .05), psychological (B = 0.63, P < .01), and social (B = 0.95, P < .001) QOL at baseline, but not in environmental QOL. Higher caregiver mutuality was significantly associated with less improvement in caregiver physical QOL over time. Mutuality is a positive variable on the association between depression and QOL for both members of the dyad at discharge but may lead to declines in physical health for caregivers over time. Further work is needed to understand the role of mutuality on long-term outcomes and associations with increased care strain.

Piloting a Dementia Caregiver Intervention in a Primary Care Setting

ABSTRACT Objectives The purpose of this pilot study is to examine the efficacy of a theoretically based, 6-week dementia caregiver support group in a primary care setting. Methods Using a quasi-experimental design, 22 participants completed the caregiver support group. Participants were mostly in their mid-60 s (M = 63 years old), female (n = 19), Caucasian (n = 14), and identified as either the care recipient’s child or spouse (n = 19). At baseline and 6 weeks, participants completed self-report measures related to demographic information, caregiver preparedness, strain, and depressive symptoms, and care recipient’s neuropsychiatric symptoms. Participants also completed a satisfaction survey. Within-subjects t-tests were run to determine if participants’ scores changed over time. Results Results revealed that participants demonstrated a significant increase in mean caregiver preparedness scores. No significant effects were found for caregiver strain, depressive symptoms, and distress related to neuropsychiatric symptoms. Participants rated being largely satisfied with the program. Conclusions Results suggest that this 6-week caregiver support group may be a promising caregiver intervention in primary care clinics. Clinical implications Findings support the importance of caregiver support for persons with dementia in primary care.

Test of the stress process model of family caregivers of people living with schizophrenia in China.

Across the world, people living with schizophrenia (PLS) are often cared for by family caregivers. This is especially true in China where community-based systems of care for PLS are underdeveloped. Thus, family caregivers of PLS may experience emotional distress and burden in the absence of community-based services. Pearlin (1990) proposed a highly influential model for understanding the stress process and its relationship to health and wellbeing. Although the model has been examined worldwide, it has yet to be studied in China for caregivers of PLS. In the present study, we use Pearlin's stress process model to examine the mediating effect of perceived caregiver burden, family functioning, and caregivers' positive feelings about caregiving on PLS global functioning and caregiver depressive symptoms. We also examine whether the model differs for parent and spouse caregivers. A total of 327 primary family caregivers of PLS in Hunan province, China, were assessed cross-sectionally using culturally-validated measures. Bootstrap methods with Hayes's PROCESS Macro were used to test multiple mediation models of global functioning scores of PLS and caregiver depressive symptoms. In this first study of the stress process model of family caregivers of PLS in China, the results generally support the model. Caregiver perceived burden, family functioning, and positive caregiver feelings about caregiving all mediate the relationship between PLS global functioning and caregiver depression, with perceived caregiver burden having the strongest indirect effect. Analyses also show that the stress process differs between parent and spouse caregivers, with perceived caregiver burden a mediator for both groups but family functioning only a mediator for parent depressive symptoms. We discuss implications of these findings for extending the stress process model cross-culturally; suggest hypotheses for future research to examine parent and spouse differences; and discuss fruitful directions for intervention.

Young- and Late-Onset Dementia: A Comparative Study of Quality of Life, Burden, and Depressive Symptoms in Caregivers.

To compare the quality of life, burden, and depressive symptoms of caregivers of individuals with young-onset dementia (YOD) and late-onset dementia (LOD). Using a cross-sectional design, a convenience sample of 110 dyads of individuals with dementia and their caregivers, all living in the community, was included. The care recipients completed assessments about cognition, quality of life, and awareness of disease. Caregivers' quality of life, resilience, depressive and anxiety symptoms, hopelessness, and burden of care were assessed. A significant difference was found in caregivers' burden and depressive symptoms according to the age of onset. However, there was no difference in caregivers' quality of life between YOD and LOD groups. In both groups, a linear regression analysis indicated that caregivers' perspective of quality of life of care recipient and caregivers' hopelessness were associated with their quality of life. In addition, in the LOD group, caregivers' burden was associated with their perspective of the quality of life of care recipient, type of kinship, and presence of emotional problems. In the YOD group, caregivers' burden was associated with duration of caregiving role, cohabitating with care recipient, and their anxiety symptoms. Caregivers' depressive symptoms were associated with anxiety symptoms in the YOD group, whereas hopelessness was associated with caregivers' depressive symptoms in both the groups. Our findings suggest that the factors that affect quality of life, burden, and depressive symptoms of caregivers of individuals with LOD differ from those that affect the caregivers of individuals with YOD.

Health of Vietnamese Older Adults and Caregiver’s Psychological Status in the United States: Result from the Vietnamese Aging and Care Survey

ABSTRACT Objective: We examined the association between care recipient’s physical, mental, and cognitive health conditions and caregivers’ psychological distress in Vietnamese older care recipients and their caregivers. Methods: The Vietnamese Aging and Care Survey was developed for care recipients, and adult-child and spousal caregivers, and inquired about their sociodemographics and health-related variables. Results: Data were collected on 58 caregiver-care recipient dyads. Adult-child and spousal caregivers were on average 43 and 70 years-old respectively. The vast majority were female (76%) and born in Vietnam (97%). Adult-child caregivers reported more caregiver burden than spousal caregivers. Care recipients were on average 75 years-old. Care recipients of adult-child caregivers reported more depressive symptoms than care recipients of spousal caregivers and were more likely to have mild dementia. Care recipients’ health had no effect on caregiver depressive symptoms but their educational attainment was associated with caregiver burden and depressive symptoms. Conclusions: This study showed care recipients and caregivers’ years of education were positively associated with caregivers’ psychological distress. Vietnamese families lived in ethnic enclaves and shared caregiving responsibilities within the family. However, using available outside resources may alleviate psychological distress of not only caregivers but also families as a whole. Clinical Implications: Healthcare professionals should encourage educated caregivers and educated care recipients to use outside resources to ease caregiving duties.

Multiple Caregivers, Many Minds: Family Discord and Caregiver Outcomes.

Family caregivers often have other family members helping to provide care. The purpose of our study was to examine relationships between care coordination quality among family members and the following caregiver outcomes: caregiver mental health (depressive symptoms, anxiety), social activity restrictions, and caregiver burden. Secondary analysis was conducted using data from the 2017 Pittsburgh Regional Caregivers' Survey. Six hundred and fifty-five caregivers who had other family members helping with care reported discordance in care coordination, depressive symptoms, anxiety, social activity restrictions, caregiving burden, and covariates such as demographics and known risk factors for negative caregiver outcomes. We used multiple logistic regression and negative binominal expansion models in the analysis. Discordant care coordination was associated with higher levels of caregiver depressive symptoms (p < .001), anxiety (p < .01), social activity restriction (p < .001), and caregiver burden (p < .001) after controlling for known risk factors. We found that lower quality of family care coordination was associated with negative caregiver outcomes. Future research should further investigate the dynamics of family care coordination and impacts on both caregivers and care recipients. The results suggest that caregiver interventions attempting to understand and decrease care coordination discord should be a priority.

Assessing an evidence-based intervention for spouse caregivers of persons with Alzheimer’s disease: results of a community implementation of the NYUCI in Israel

Objectives Alzheimer’s disease (AD) affects not only the person with the illness, but family caregivers as well. The NYU Caregiver Intervention (NYUCI), a psychosocial intervention which has demonstrated both short and long-term benefits for caregivers, has been used widely in the United States and in Australia and England. The Israeli study was a hybrid between a community implementation study and a randomized controlled trial (RCT) of the NYUCI in a non-English speaking country. Method A sample of 100 spouse caregivers participated in trial comparing the NYUCI provided by ten Israeli clinicians (enhanced care), to support group participation (usual care). The major outcome of interest was caregiver depressive symptoms, measured with the Geriatric Depression Scale. A linear random effects regression model controlling for factors associated with depressive symptoms was used to plot the longitudinal trajectories of depressive symptoms over the two-year study period and compare outcomes for the enhanced care and control groups. Results One hundred spouse caregivers enrolled, of whom 81 provided data at baseline and at one or more post intervention assessments. The Israeli adaptation of the NYUCI was effective in reducing depressive symptoms reported by caregivers compared to their counterparts in the control group, b= −1.29 [95%CI (−2.43, −0.15)], p= .0265. Conclusion While implementing a randomized controlled trial of an intervention developed and tested in traditional research settings using community providers in Israel, posed unique challenges, the study demonstrated benefits to caregivers. As a result, 30 municipalities in Israel are currently implementing an ongoing adaptation of the NYUCI.

Caregivers’ depressive symptoms and social–emotional development of left-behind children under 3 years old in poor rural China: The mediating role of home environment

We explored the influence of caregivers’ depressive symptoms on the social–emotional development of left-behind children in rural China through a cross-sectional study in five counties from five provinces in middle-western China. We visited 847 left-behind children aged under 3 years and their primary caregivers at home, collecting demographic and anthropometric data of children and caregivers through face-to-face interviews. Depressive symptoms of caregivers were measured using the Zung Self-rating Depression Scale (ZSDS). Home environment was assessed using the Infant-Toddler Home Observation for Measurement of the Environment inventory (IT-HOME). Children’s social–emotional development was evaluated using the Chinese version of Ages & Stages Questionnaires: Social–Emotional (ASQ:SE-C). Of the left-behind children, 37.19% had social–emotional problems, and 40.02% of caregivers reported depressive symptoms. Caregivers’ depressive symptoms were positively correlated with social–emotional problems in left-behind children. This association was mediated by home environment, which explained 15.62% of the total effect. Among the six domains of the IT-HOME, responsivity, acceptance, involvement, and variety mediated the relationship between caregivers’ depressive symptoms and children’s social–emotional problems. The social–emotional development of left-behind children under 3 years old in the surveyed area of rural China was poor, especially in children whose caregivers exhibited depressive symptoms. Comprehensive intervention addressing caregivers’ mental health and the home environment could benefit left-behind children and their families.

834-P: Understanding Risks for Depressive Symptoms among Caregivers of Young Children Newly Diagnosed with T1D: The Role of Social Support and Social Problem-Solving

Introduction: Elevated depressive symptoms are common in caregivers following their children’s T1D diagnoses. In the general population, strong social support and social problem-solving abilities buffer depressive symptoms during stressful life events. To evaluate whether these constructs apply to diagnosis-related distress, we examined the associations among caregiver social support, social problem solving, and depressive symptoms after their children’s T1D diagnoses. We hypothesized that higher social support and higher social problem solving would be related to lower caregiver depressive symptoms. Methods: Participants included 157 young children (M age=4.46±1.64 years) newly diagnosed with T1D (M days diagnosed = 28.78±15.10) and their primary caregivers (70% Caucasian, 74% married, 90% female) assessed at baseline of an ongoing behavioral RCT. Caregivers self-reported their social support (Protective Factors Survey (PFS)-Social Support), social problem solving abilities (Social Problem Solving Inventory- R:SF; SPSI), and depressive symptoms (Center for Epidemiological Studies-Depression Scale; CES-D). Results: Overall, 46.5% of caregivers exceeded the clinical cut-off on the CES-D (M=16.60 (11.58)). Further, higher social support (B=-.235,-p=.004) and higher social problem solving abilities (B=-.317,-p&amp;lt;.001) were related to lower caregiver depressive symptoms, controlling for child age/sex, and presence of other caregivers (all p&amp;gt;.05). Higher negative (not positive) problem orientation was related to higher depressive symptoms (B=.373,-p&amp;lt;.001); problem solving styles were unrelated to depressive symptoms (p&amp;gt;.05). Conclusions: Behavioral interventions focused on promoting positive social support and social problem solving abilities may decrease caregivers depressive symptoms after their children’s initial T1D diagnosis. Replication using longitudinal data is needed. Disclosure C.H. Wang: None. M. Sinisterra: None. N. Herrera: None. C. Tully: None. L. Clary: None. M. Monaghan: Research Support; Self; American Diabetes Association. M.E. Hilliard: None. R. Streisand: None. Funding National Institute of Diabetes and Digestive and Kidney Diseases (R01DK102561)

Relationship between caregiver burden and psychological distress among stem cell transplant (SCT) recipients prior to transplant.

12120 Background: SCT is a potentially curative therapy for patients with hematologic malignancies that involves prolonged hospitalization, intensive follow-up, and a considerable risk of morbidity and mortality. Family and friends caring for SCT recipients experience substantial caregiving burden as they prepare for SCT. Previous research demonstrates caregiver distress is highest pre-transplant and is comparable to or higher than patient-reported distress. However, the extent of this distress and its relationship to certain domains of quality of life (QOL) and caregiving burden is currently unknown. Methods: We conducted a secondary analysis of cross-sectional data from two supportive care studies focused on caregivers of SCT recipients. Caregivers completed the Hospital Anxiety and Depression Scale (HADS) and the CareGiver Oncology QOL questionnaire to assess their psychological distress and QOL prior to SCT. Scores &gt;8 on the HADS anxiety and depression subscales indicated clinically significant symptoms. We selected eight domains from the CareGiver Oncology QOL questionnaire including social support, physical wellbeing, self-efficacy, coping, leisure time, financial stability, private life concerns, and caregiving burden. Multivariate regression models adjusted for age, sex, caregiver relationship, and SCT type were used to examine associations between these domains and caregivers’ anxiety and depression symptoms. Results: A total of 193 caregivers (age M= 57 years, 70% female, 52% allogeneic transplant) were enrolled with a majority caring for their spouse (80%), parent (8%) or child (5%). Overall 47% and 16% of caregivers reported clinically significant anxiety and depression symptoms, respectively. Low social support, physical well-being, coping and leisure time as well as high caregiver burden, private life concerns and financial distress were associated with both caregiver anxiety and depression symptoms (p &lt; .05). Low self-efficacy was associated with higher anxiety symptoms (p &lt; .05). Conclusions: Caregivers of SCT recipients experience substantial anxiety and depression symptoms prior to SCT. Impairments across multiple QOL domains are associated with caregiver’s psychological distress. Psychosocial interventions designed to improve coping, reduce caregiving burden, and enhance QOL are needed for caregivers prior to transplant.

Psychosocial screening and mental health in pediatric cancer: A randomized controlled trial.

Diagnosis and treatment of childhood cancer can impact the mental health of the family. Early psychosocial risk screening may help guide interventions. The primary aim of this study was to evaluate if an intervention (providing psychosocial risk information to the patient's treating team) would result in decreased depression symptoms in caregivers, in general, and relative to initial psychosocial risk. A secondary aim was to examine intervention effects in a small sample of patient and sibling self-reported outcomes. We randomly allocated families to the intervention group (IG, treating team received PAT summary) or control group (CG, no summary). One hundred and twenty-two caregivers of children newly diagnosed with cancer completed measures of depression and anxiety and psychosocial risk 2-4 weeks from diagnosis (T1) and 6 months later (T2). Patients and siblings completed self-report measures of depression and anxiety. There was no significant difference in caregiver depression symptoms between the IG and CG at T2. However, in the context of psychosocial risk, caregivers in the IG showed improvement in depression scores compared to CG when risk was high near diagnosis (Ms = 6.68 vs. 9.76, respectively, d = .60). Similar results were found in anxiety scores. Intervention effects with patients and siblings were inconclusive. Sharing psychosocial risk information with the treating team had measurable impact on mental health outcomes only if caregivers had initial high psychosocial risk. This study contributes to our understanding of mapping psychosocial screening and resources to improve outcomes in families managing childhood cancer. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Caregiver depression is associated with hair cortisol in a low-income sample of preschool-aged children

BackgroundCaregiver depression and child temperamental characteristics such as effortful control have been associated with child dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis. Hair cortisol concentrations (HCC) has been increasingly adopted as an integrated marker of HPA axis activity. This study examined the associations between caregiver depressive symptoms, caregiver social support, child effortful control, and child HCC in a sample of a high-risk, low-income preschool-aged children. Methods154 caregivers comprised mostly of mothers and their children (2-to-5 years) who were enrolled in a birth cohort study conducted in poor urban neighborhoods of São Paulo, Brazil. Through personal interviews at their homes, caregivers provided ratings of their psychosocial experiences and of their child’s behavior. Hair was sampled from children with at least a 3-cm hair length. ResultsIn a multivariable regression analysis, an unadjusted model showed child age to be negatively associated with HCC (β = -0.32, p < .001). The adjusted model, which accounted for child age and sex, showed a positive relationship between caregiver depressive symptoms and HCC (β = 0.22, p < .01). Caregiver social support and child effortful control were not associated with HCC. ConclusionsThe elevated HCC among children with caregivers reporting greater depression risk is consistent with prior findings showing elevated HCC among children exposed to persistent stress. Stabilization of child HCC may be occurring within preschool children given the negative association between HCC and age. Greater research is needed to determine whether the effects of caregiver social support and effortful control can be captured through HCC.

Resourcefulness as a Mediator of the Effects of Dementia Symptoms and Caregiver Reactions on Caregiver Mental Health

In this secondary analysis of 138 community-dwelling women caregivers of persons with dementia, we examined whether caregiver resourcefulness mediated the effects of both the frequency of and reactions to their care recipients’ memory-related, depressive, and disruptive symptoms of dementia on caregiver depressive symptoms. Caregiver resourcefulness mediated the effects of care recipient depressive symptoms on caregiver depressive symptoms, and the effects of caregiver actions to depressive and disruptive symptoms on caregiver depressive symptoms. The findings suggest the potential benefit of teaching resourcefulness skills to reduce depressive symptoms of caregivers whose care recipients frequently exhibited depressive or disruptive symptoms associated with dementia.

Characteristics and Prevalence of Depression Symptoms in Caregivers of Patients Undergoing Palliative Care

Family role in taking care of patients undergoing palliative care leads to complex, multidimensional responsibility which may have consequences to the mental health of primary caregivers. Studies have shown that 40 to 70 percent of caregivers experience symptoms of depression. The general objective of this study was to determine the characteristics and prevalence of depressive symptoms among caregivers of patients in palliative care. The population comprised of caregivers of patients undergoing palliative care at the Kenyatta National Hospital. A cross-sectional study was used where questionnaires were administered using Beck‘s Depression Inventory and a researcher designed socio-demographic characteristics questionnaire for the caregivers. The results showed that 62.7% of the caregivers presented with symptoms of depression. This is four times higher as compared to the general population. The severity of the depressive symptoms ranged from mild to severe with the majority experiencing symptoms of severe depression. Spousal caregivers had the highest prevalence of depressive symptoms followed by those who were taking care of their children. The recommendations include having healthcare providers do routine screening for depression in family caregivers and not just on patients alone.

Perceived Stress and Depressive Symptoms as Predictors of Decisional Conflict in Dyads Considering a Left Ventricular Assist Device

The decision to pursue a left ventricular assist device (LVAD) commits loved ones to major caregiving responsibilities and, often, medical decision-making. How emotional domains overlap within patients and their caregivers and contribute to conflict around the decision to pursue LVAD remains largely unexplored. The associations within and between individuals in patient-caregiver dyads considering LVAD were estimated in a specific type of structural equation model known as the Actor-Partner Interdependence Model. This model tested whether each person's depression and stress predicted their own decisional conflict (actor effects), as well as their partner's decisional conflict (partner effects). At the time of study enrollment when a formal LVAD evaluation was initiated, 162 patient-caregiver dyads completed assessments of decisional conflict using the Decisional Conflict Scale, depressive symptoms using the Patient Health Questionnaire-2, and stress using the Perceived Stress Scale. Across both models, decisional conflict was significantly correlated within patient-caregiver dyads (β=0.47 and 0.44, for depression and perceived stress models, respectively, P<0.001). Greater perceived stress in both the patient (β=0.18; P<0.05) and caregiver (β=0.28; P<0.001) was significantly related to greater decisional conflict (both actor effects). Greater patient depressive symptoms were related to greater patient decisional conflict (β=0.16; P<0.05), whereas caregiver depression symptoms was not related to their own decisional conflict (β=0.07; P=0.37). There were no partner effects identified between decisional conflict and perceived stress or depressive symptoms. Patient and caregiver conflict over the decision to pursue an LVAD was highly correlated in this sample, with greater perceived stress significantly predicting greater decisional conflict in both patients and caregivers. Depressive symptoms in patients also predicted greater patient decisional conflict. No partner effects were identified in predicting decisional conflict. These results contribute to a larger body of work acknowledging the importance of patient-caregiver well-being in serious illness. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT02344576.

Identifying treatment effects of an informal caregiver education intervention to increase days in the community and decrease caregiver distress: a machine-learning secondary analysis of subgroup effects in the HI-FIVES randomized clinical trial

BackgroundInformal caregivers report substantial burden and depressive symptoms which predict higher rates of patient institutionalization. While caregiver education interventions may reduce caregiver distress and decrease the use of long-term institutional care, evidence is mixed. Inconsistent findings across studies may be the result of reporting average treatment effects which do not account for how effects differ by participant characteristics. We apply a machine-learning approach to randomized clinical trial (RCT) data of the Helping Invested Family Members Improve Veteran’s Experiences Study (HI-FIVES) intervention to explore how intervention effects vary by caregiver and patient characteristics.MethodsWe used model-based recursive partitioning models. Caregivers of community-residing older adult US veterans with functional or cognitive impairment at a single VA Medical Center site were randomized to receive HI-FIVES (n = 118) vs. usual care (n = 123). The outcomes included cumulative days not in the community and caregiver depressive symptoms assessed at 12 months post intervention. Potential moderating characteristics were: veteran age, caregiver age, caregiver ethnicity and race, relationship satisfaction, caregiver burden, perceived financial strain, caregiver depressive symptoms, and patient risk score.ResultsThe effect of HI-FIVES on days not at home was moderated by caregiver burden (p < 0.001); treatment effects were higher for caregivers with a Zarit Burden Scale score ≤ 28. Caregivers with lower baseline Center for Epidemiologic Studies Depression Scale (CESD-10) scores (≤ 8) had slightly lower CESD-10 scores at follow-up (p < 0.001).ConclusionsFamily caregiver education interventions may be less beneficial for highly burdened and distressed caregivers; these caregivers may require a more tailored approach that involves assessing caregiver needs and developing personalized approaches.Trial registrationClinicalTrials.gov, ID:NCT01777490. Registered on 28 January 2013.

Psychological mindedness as a mediator in the relationship between dysfunctional coping styles and depressive symptoms in caregivers of children with autism spectrum disorder.

Psychological mindedness (PM) can partly explain depressive symptoms in caregivers of autism spectrum disorder (ASD). This cross-sectional study examines PM in mediating the relationship between dysfunctional coping styles and depressive symptoms. One hundred fifty-five adult ASD caregivers completed the Malay version of Brief COPE, the Patient Health Questionnaire-9, and the Balanced Index of PM. Direct paths between dysfunctional coping style and depressive symptoms, between insight and depressive symptoms, and between dysfunctional coping style and all PM variables (insight and interest) were obtained. Multiple regression analyses revealed that insight, but not interest, significantly mediates the relationship between dysfunctional coping and depressive symptoms. PM can be enhanced via psychological interventions.

Abstract WP463: Moderator Role of Preparedness on the Association Between Depression and Quality of Life in Stroke Survivor-Caregiver Dyads

Background: Although several studies have clearly shown that depressive symptoms in stroke survivors and caregivers decreases their quality of life (QOL), previous research has not yet analyzed the role of potential moderators in the relationship between the above two variables. Aims: To examine the moderating effect of caregiver preparedness between depressive symptoms and QOL in stroke survivor and caregiver dyads. Methods: Longitudinal design with 222 stroke survivor-caregiver dyads enrolled at survivor discharge from rehabilitation hospitals. Data collection was performed over 12 months. We measured survivor and caregiver QOL dimensions (physical, psychological, social and environmental), depression and preparedness. Hierarchical Linear Modeling was used to test four longitudinal dyadic moderation models (one for each QOL domain). Results: Survivors (50% males) and caregivers (65% females) were 70.8 (SD=11.9) and 52.5 (SD=13.1) years old, respectively. Controlling for baseline covariates, caregiver preparedness significantly moderated the association between survivor depressive symptoms and survivor psychological (B = 0.56, p &lt; .01) and environmental (B = 0.58, p &lt; .01) QOL at baseline and social QOL over time (B = 0.24, p &lt; .05). In each case, higher levels of caregiver preparedness were protective and buffered the influence of survivor depressive symptoms on survivor QOL. Similarly, caregiver preparedness significantly moderated the association between caregiver depressive symptoms and caregiver physical (B = 0.25, p &lt; .01) and environmental (B = 0.18, p &lt; .05) QOL over time. Conclusions: Caregiver preparedness is a positive variable for both members of the dyad and the paper highlights the importance of implementing tailored intervention which could improve caregivers’ preparedness already during the rehabilitation period.

Caregiver Quality of Life Before and After Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy

Cytoreductive surgery plus intraperitoneal hyperthermic chemotherapy (CRS+HIPEC) is a formidable procedure, often affecting the quality of life (QOL) of the caregiver as well as the patient. We explored the impact of quality of life and depressive symptom burdens of CRS+HIPEC caregivers prospectively. Patient and caregiver dyads were both consented per IRB-approved protocol; CRS ± HIPEC was performed. The impact on QOL and depressive symptom burdens was assessed on patient-caregiver dyads via the Caregiver Quality of Life (CG QOL-C), CES-D (Center for Epidemiological Studies - Depression) instruments; pre-CS+HIPEC (T1), postoperative (T2), 6 (T3), and 12 (T4) months. Seventy-seven dyads were approached, with 73 participating. Both caregiver and patient depressive symptom trajectories changed significantly. CES-D means for caregivers were (T1-4): 15.1 (SE [standard error] 1.7), 15.0 (1.4), 10.3 (1.4), 13.1 (2.1), p= 0.0008; for patients were: 10.3 (SE 1.1), 13.7 (1.4), 9.0 (1.2), and 10.3 (1.5), p= 0.0002. Preoperatively, caregivers scored 4.8 points (SD 13.4) (p= 0.026) higher than patients. Patients experienced an increase in depression scores at the postoperative visit. At T3, both groups dropped to less concerning levels; yet caregiver CES-D scores increased again at T4 4.7 points (SD 12.5) higher than the patients, and financial well-being became worse from T1 to T3. Possible, probable, and "cases" of depression were higher for caregivers were at all measured time points. Significant numbers of caregivers endured high depressive symptom burdens and financial concerns. Different caregiver-patient trajectories reflect the need for differential timing of supportive interventions. Evaluation of quality of life and impact of CRS+HIPEC procedures must move beyond assessment of only the patient.

Anxiety and depression in informal caregivers of dependent elderly people: an analytical study.

To analyze the symptoms of anxiety and depression in informal caregivers of dependent elderly at home. Analytical, cross-sectional study conducted in the city of Teresina (PI), with informal caregivers of dependent elderly people. Data collection took place from November 2017 to February 2018, using a characterization form for the dependent elderly and their caregiver, Beck's Anxiety Inventory (BAI) and Beck's Depression Inventory (BDI). The forward linear regression model was used to identify the predictive variables of anxiety and depression. It was found that 18.4% of caregivers had symptoms of depression; and 14%, moderate to severe anxiety. There was a correlation between anxiety and depression (p = 0.000). The findings of this study make it possible to assess anxiety and depression in caregivers of dependent elderly people, making it possible, through these parameters, to view the profile and care demands of this population.