Caregivers Of Hemodialysis Patients Research Articles

The Effect of Hope Therapy on the Management of Hemodialysis Outcomes: A Review Article.

Hemodialysis can have specific adverse effects, so it's critical to minimize them by employing non-pharmacological techniques. This review's primary goal was to assess how hope therapy affected the treatment of hemodialysis patients.This review was conducted by analyzing the results of previous studies published between1996and 2023. We chose sixteen studies in consideration of the inclusion and exclusion criteria and by employing Medical Subject Headings (MeSH) terms to the literature discussed in international databases. The findings of the current study revealed that hope therapy can significantly reduce anxiety, stress, and depression and also considerably increase happiness, quality of life, and adherence to treatment in hemodialysis patients. In addition, effective interventions for improving hope in hemodialysis patients included spiritual counseling, spiritual therapy, stress management training, intervention based on disease perception, positive thinking training, and other similar methods.Based on the findings, we concluded that the caregivers of hemodialysis patients and their families must use other non-pharmacological methods, especially hope therapy, to reduce the adverse outcomes of hemodialysis.

Reliability and Validity of the COPE Index among Caregivers of Hemodialysis Patients in Pakistan

Objective: To assess the reliability and validity of the COPE (Carers of Older People in Europe) index tool among the caregivers of dialysis-dependent patients in Pakistan.Study Design: Cross-sectional study.Place and Duration of Study: The study was conducted at the Dialysis Unit of Pakistan Kidney Patients Association Rawalpindi, Bahria International Hospital Rawalpindi and Fauji Foundation Hospital Rawalpindi, Pakistan, from December 2018 to January 2019. Methods: A 15-item COPE index questionnaire was administered, and data were collected from 124 caregivers of patients undergoing regular hemodialysis. A Principal Component Analysis (PCA) was performed on all items of the COPE index to retain the underlying components. Further, Cronbach's alpha was used to assess the internal consistency of the retained component structure and loadings obtained from the PCA and the entire instrument separately.Results: The PCA analysis revealed that, with the context of this study, the COPE index had good internal consistency for the negative aspects of caregiving and social support (Cronbach's alpha scores were 0.864 and 0.781, respectively). For the positive impact items, a Cronbach's alpha score of 0.655 indicated modest internal consistency. Cronbach's alpha of 0.714 for the entire 15 items indicated that the COPE index had good overall internal consistency in our study population.Conclusion: The COPE index was found to be a valid tool for use in Pakistan to assess the caregiver experience, including both positive and negative aspects of caregiving.
 How to cite this: Nasim S, Lowe NM, Moran VH, Dillon S, Zaheer S, Philp I. Reliability and Validity of the COPE Index among Caregivers of Hemodialysis Patients in Pakistan. Life and Science. 2023; 4(4): 393-400. doi: http://doi.org/10.37185/LnS.1.1.351

Knowledge, Attitude, and Perception Regarding Chronic Kidney Disease among Caregivers of Hemodialysis Patients in Puducherry: A Cross-sectional Study

Abstract Context: Chronic kidney disease (CKD) has emerged as one of the most prominent causes of death and suffering in the 21st century. Aims: This study aims to assess the knowledge, attitude, and perception regarding CKD among caregivers of patients with kidney disease. Settings and Design: A cross-sectional study was conducted at our institute with a well-equipped dialysis center. Subjects and Methods: The study was conducted for 3 months from August to October 2023. This study population mainly consists of caregivers of CKD patients based on inclusion and exclusion criteria. A simple random sampling method has been used with an estimated sample size of 375. Statistical Analysis Used: Continuous variables were presented in the form of frequency and proportion. The Chi-square test was used for determining association. Results: Out of the 375 participants, 59.2% had good knowledge about CKD and 40.8% had poor knowledge. 57.1% had good attitude and 161 had poor attitude. 52.3% had good perception and 179 had poor perception. The study showed a significant association between age and knowledge (P < 0.001). A significant association between occupation and knowledge (P = 0.000) toward the risk of CKD was observed. The socioeconomic status of the caregivers had good association with knowledge and attitude (P < 0.001). Conclusions: Through this research, the knowledge of kidney disease can be improved among the general population in the view of reducing morbidity and mortality.

#5602 DEPRESSION AND ANXIETY IN FAMILY CAREGIVERS OF END STAGE KIDNEY DISEASE PATIENTS IN GREECE: A COMPARISON BETWEEN DIALYSIS AND KIDNEY TRANSPLANTATION

Abstract Background and Aims Chronic kidney disease (CKD) is considered a high-stress disease because of its chronicity, co-morbidity, and lifelong treatment. Family members are often the main caregivers of end stage kidney disease (ESKD) patients and they are involved in various roles. Caregivers of ESKD patients experience emotional stress, anxiety and depression as they support their family members throughout the disease and treatment. This cross-sectional study aimed to assess depression and anxiety in caregivers of ESKD patients and to compare these disorders between caregivers of hemodialysis (HD) patients’ and kidney transplant recipients (KTR), as well as to investigate potential social-demographic parameters associated with caregivers’ depression and anxiety. Method A total of 342 participants (171 couples of patients and caregivers) were recruited. Structured interviews and self-completed questionnaires were obtained from HD patients, KTR (138 HD patients and 33 KTR) and their caregivers. The Beck Depression Inventory and the Generalized Anxiety Disorder-2 scales were used as screening tools. Depression scores were classified into four levels based on the level of severity (low, mild, moderate, severe). The collected data were encoded and analyzed using ΙΒΜ SPSS version 25 and R Statistical Software. Results Mean age of caregivers was 58 years and the majority were females (67.2%). Total anxiety score was high (Mdn = 3) with a mildly increased score of depression (Mdn = 9.5). Caregivers’ anxiety and depressive symptoms were significantly associated with gender, duration of caregiving, educational level, financial status, and caregivers’ age (p<0.01 for all). Caregivers’ depression and anxiety were also, related to the type of patients’ treatment (Table 1). HD caregivers reported significantly higher anxiety scores (Mdn = 3(2-5)) in comparison to KTR caregivers (Mdn = 2(2-4)) (p = 0.048) (Table 2). Moreover, HD caregivers revealed higher (Mdn = 11(0-46)) levels of depression than the KTR group (Mdn = 6 (0-25)) (p = 0.049) (Table 3). Conclusion Based on the findings of this study, the type of ESKD treatment displayed an important role in caregivers’ anxiety and depression symptoms, with KTR caregivers having the best scores. In particular, KTR caregivers appeared to have lower levels of depression and anxiety than caregivers of HD patients.

Effect of Benson's relaxation technique on caregiver burden in caregivers of hemodialysis patients. A Randomized Controlled Trial

Methods. This is a randomized controlled trial study on 52 caregivers of hemodialysis patients referred an universitary hospital at Jahrom. The caregivers were randomly divided into intervention and control groups. In the intervention group, Benson's relaxation was performed twice a day for 15 minutes each time, and continued for one month. Data collection tools included demographic information questionnaire and standard Zarit Burden Interview questionnaire which was completed by all participants before the intervention and one month after it. Results. After the intervention, the mean caregiver burden of hemodialysis patients in the intervention group decreased significantly compared to the control group (p<0.001). The results of paired t-test showed that in the intervention group, the mean scores of caregiver burden after the intervention (14.46± 10.91) was significantly lower than before the intervention (38.33±16.94) (p=0.001). Conclusion. Benson's relaxation method can reduce caregiver burden in caregivers of hemodialysis patients.

Assessing Burden, Anxiety, Depression, and Quality of Life among Caregivers of Hemodialysis Patients in Indonesia: A Cross-Sectional Study.

Family caregivers endure the burden of caring for patients receiving hemodialysis, which can affect their psychological status and may disrupt the care process. This study aims to assess the level of burden, anxiety, depression, and quality of life (QOL) among family caregivers, to investigate the influence of caregivers’ sociodemographic factors and patients’ clinical conditions on the level of burden, and investigate how burden affects anxiety/depression and QOL. A descriptive, cross-sectional study was conducted from September to October 2020. A total of 104 caregivers with a mean age of 44.4 ± 12.7 years (63.5% women) in the hemodialysis department of a hospital in Indonesia were examined. Zarit Burden Interview (ZBI), Hospital Anxiety and Depression Scale, and WHOQOL-BREF were used. Descriptive analysis was conducted to assess the level of psychological status, and multiple regression analysis and path analysis were performed to evaluate the association among all factors. As result, regarding burden, 10.2% had a moderate-to-severe burden, and in terms of anxiety and depression, 25% and 9.6% showed abnormal cases; the mean scores of 4 domains of QOL were about 60 points. Burden and anxiety/depression were significantly negatively associated with all domains of QOL (p < 0.001); however, sociodemographic and clinical factors were not associated with any of the QOL domains. The path analysis results showed that burden positively correlated with anxiety/depression and negatively correlated with QOL via anxiety/depression. In conclusion, family caregivers’ QOL was found to be indirectly influenced by burden through anxiety/depression. Further evaluation of clinical significance and implications for caregiver’s lifestyle regarding anxiety and depression, which result in caregiver burden, is warranted.

Caregiver burden in Iranian caregivers of patients undergoing hemodialysis: a qualitative study

ABSTRACT So far, limited studies have investigated the caregivers of hemodialysis patients and the concept of caregiver burden from their own perspective. The present study aimed to explore the issue of caregiver burden among family caregivers of patients undergoing hemodialysis. A total of 21 family caregivers, patients, and formal caregivers were enrolled using the purposive sampling method. In-depth, semi-structured interviews were conducted to collect the data. For data analysis, a directed qualitative content analysis method was applied. Finally, five dimensions of caregiver burden were extracted, including physical, psychological, emotional, spiritual, financial, social, and time-dependent burdens.

Investigating the relationship between quality of life and hope in family caregivers of hemodialysis patients and related factors

BackgroundFamily caregivers of hemodialysis patients are the first and most crucial source of care at home. They experience many problems in the care of hemodialysis patients, which can affect their quality of life and hope, affecting the quality of care provided to patients. This study aimed to determine the relationship between quality of life and hope in family caregivers of hemodialysis patients.MethodsA cross-sectional (descriptive-analytical) study performed on 300 family caregivers in the east of Mazandaran province in Iran. Data were collected using the Family Caregiver Quality of Life (FQOL), SF8 and adult hope scale. Data analysis was performed in SPSS version 16, and a P-value of below 0.05 was considered statistically significant.ResultsThe results showed that, there was a direct and significant relationship between hope and quality of life. However, the quality of life was significantly lower in suburban residents, the unemployed, spouses, people with lower education and income levels, caregivers who cannot leave their patients alone, those living with their patients in the same house, and those taking care of male patients, compared to other participants (P < 0.05). Suburban residents, the unemployed, people with an insufficient level of income, and those living with their patients in the same house had significantly lower hope, compared to other subjects.ConclusionSince an increase of hope and quality of life of caregivers can cause improved quality of patient care, it is recommended that hope-based educational programs and interventions be implemented for caregivers.

Components of quality of life in hemodialysis patients from family caregivers\u2019 perspective: a qualitative study

BackgroundPatients with end-stage kidney disease experience serious complications which affect their lives. Few studies have investigated the patients’ quality of life qualitatively from the perspective of family caregivers as the closest individuals to the patients. The family caregivers are directly involved in the patients’ disease progression and observe the changes, problems, and complications of disease and hemodialysis. This study aimed to explain the components of quality of life in hemodialysis patients from the family caregivers’ perspective.MethodsIn this qualitative inductive content analysis, 16 family caregivers of hemodialysis patients, presenting to the teaching hospitals of Tehran, Iran, were enrolled via maximum-variation purposive sampling; sampling continued until reaching data saturation. The data collection method included in-depth semi-structured interviews. Also, an inductive content analysis was carried out based on Elo and Kyngas’ method.ResultsA total of 311 codes, 19 subcategories, eight generic categories, and three main categories were extracted in this study. The main (and the generic categories) included mental and psychological problems (depressive mood, incompatibility and reduced tolerance, mental exhaustion, and deprivation of basic needs), social disruption (social isolation and social threats), and physical problems (general complications and disabilities and defects in the normal functioning of organs).ConclusionFamily caregivers can be valuable information sources for formal caregivers to plan treatment for chronically ill patients who are mainly cared for at home. The present results can help us increase the existing knowledge on the impact of end-stage kidney disease and hemodialysis on the patients’ quality of life. It seems that addressing the issues related to quality of life, mentioned by the caregivers, can positively affect the patients’ quality of life and even reduce the caregivers’ burden.

Effects of Nutritional Knowledge of Informal Caregivers on Depression and Metabolic Outcomes of Hemodialysis Patients

ABSTRACT Chronic renal failure (CRF) makes significant changes in the life of patients and their families. A good family support has a positive effect on successful patients’ adaptation to the treatment and compliance with dietary regimen. This study aimed to examine the effects of nutritional knowledge of informal caregivers on depression and metabolic outcomes of hemodialysis patients. This was a cross-sectional study conducted at Baskent University Hemodialysis Center with 116 hemodialysis patients and their informal caregivers. Findings revealed that the caregivers who were the couple of the patients had the highest nutritional knowledge level than the other caregivers (p < .05). The postgraduate caregivers were more likely to have high nutritional knowledge level than the others (p < .05). The inflammation marker of the patients was significantly lower in the group of caregivers with higher level (T3 group) of nutritional knowledge than the others (p < .05). The mean CES-D scores were also more likely to be low in T3 group than in the others (p < .05). These findings highlight that the nutritional knowledge of caregivers of hemodialysis patients may have an additional benefit on patients’ nutritional management and metabolic outcomes.

Factors Influencing Scales of Burden, Coping Mechanisms, and Quality of Life in Caregivers of Hemodialysis Patients in Andhra Pradesh, India.

Background:Evaluation of factors influencing scales of burden, coping mechanisms, and quality of life (QOL) in caregivers of hemodialysis (HD) patients may lead to the revision of interventions aimed at the betterment of QOL of caregivers of HD patients. In this study, we investigated the influence of demographic, social, and clinical variables on burden, coping mechanisms, and QOL in caregivers of HD patients.Methods:In this prospective study, 150 caregivers of HD patients were recruited. Assessment of burden, coping strategies, and QOL were made by the Zarit Burden Interview, Revised Ways of Coping, and Short Form-36 QOL. The role of age, gender, and social and clinical variables on these constructs was investigated using multivariate analysis of variance.Results:The mean age was 43.86 ± 1.11 years. Males outnumbered females. Most were Hindu, married, primary school educated, unemployed, spouses, caring the patients, and suffering from chronic diseases for <5 years. In multivariate analysis of variance, effect of age on physical functioning (PF), general health (GH), and physical component summary (PCS) score (P < 0.01); gender on burden, distancing, seeking social support, role limitation due to emotional problem, and pain (P < 0.05); role limitations due to physical health, energy/fatigue (EF), emotional well-being, PCS, and mental component summary (MCS) score (P < 0.01); religion on PF (P < 0.05); marital status on burden and GH (P < 0.05); PF and PCS (P < 0.01); relationship of caregiver with the patient on PCS (P < 0.05); EF and MCS (P < 0.01); and presence of chronic diseases on GH and social functioning (P < 0.01) were observed.Conclusion:The role of demographic, social, and clinical variables should be taken into consideration while initiating therapies for reducing the burden and improving the QOL of caregivers.

Factors Affecting Anxiety and Depression in Caregivers of Hemodialysis Patients.

Anxiety and depression have high levels in caregivers of patients on hemodialysis and are strongly associated with demographic factors. The aim of this study was to evaluate the factors affecting anxiety and depression in caregivers of hemodialysis patients. Four hundred and fourteen (414) caregivers (98 males and 316 females) participated in this study. Depression and anxiety were assessed by the Hospital Anxiety and Depression Scale (HADS), the State-Trait Anxiety Inventory (STAI), and the Beck Depression Inventory (BDI). Multinomial logistic regression was performed to estimate the factors being independently associated with anxiety and depression levels. Multiple linear regression was performed to estimate the factors being independently associated with Beck Depression Inventory and State-Trait Anxiety Inventory. From a total of 414 participants, 125 (30.2%) had depression and 215 (52%) had anxiety. The median age of respondents was 54.34 (43.9-66.28) years, with half of the sample's age ranging from 43.9 to 66.28 (IQR). Depression and anxiety were significantly associated with parents or siblings, low level of education, increased caregivers' age, retirement, poor financial condition, having children, and comorbidities. In this study, a significant proportion of caregivers were found to have high levels of depression and anxiety. Thus, a formal screening can contribute to early diagnosis and treatment of depression and anxiety in caregivers of patients on hemodialysis.

Educational intervention on knowledge and attitude regarding postdialysis home care among caregivers of hemodialysis patients: An institutional study

Educational intervention on knowledge and attitude regarding postdialysis home care among caregivers of hemodialysis patients: An institutional study

The effect of group logo therapy on the burden of hemodialysis patients’ caregivers

Introduction: The relationship between caregivers and patients plays a vital role in providing effective care. Objectives: The aim of this study was to investigate the effect of group logo therapy on the burden of hemodialysis patients’ caregivers. Patients and Methods: The present research was a quasi-experimental study with pretest-posttest design. The study population was all caregivers of hemodialysis patients in Qazvin. The sample of this study consisted of 100 caregivers (50 participants in the intervention group and 50 participants in the control group) who were selected according to the inclusion criteria and then randomly allocated in two groups. After the initial evaluation of burden in both groups, 10 sessions, (90 minutes for each session) logo therapy was conducted for intervention group. Immediately after the end of the course and one month later, the intensity of caregiver burden in both groups was measured. The data collection tools were demographic questionnaires for the patient and caregiver and the Zarit Burden Interview. Results: In this study we found, the intervention group with a mean score of 44.6±7.4 and the control group with a mean score of 44.8±5.38 experienced severe burden. Regarding the effect of logo therapy on caregiver burden, the results showed that the mean score of burden before the intervention was 44.6±7.4 and immediately after the intervention and one month later were 37.2±12.6 and 2.14±6.34, respectively (P&lt;0.001). Conclusion: The findings showed the positive effect of group logo therapy on reducing the burden of hemodialysis patients’ caregivers. Considering the high level of caregiver burden, it appears that the application of logo therapy in educational programs for dialysis centers is necessary to reduce the caregiver burden and improve the quality of life.

Burden, quality of life, anxiety, and depressive symptoms among caregivers of hemodialysis patients: The role of social support

The purpose of this study was to determine how burden and quality of life predict anxiety and depressive symptoms among caregivers of hemodialysis patients. Social support was included in the model as a proposed moderator in the above relationships. This cross-sectional study involved 340 caregivers of chronic kidney patients undergoing hemodialysis. The setting was in Terengganu, Malaysia. The caregivers completed the measures of caregiving burden, quality of life, social support, and symptoms of anxiety and depression. About 28.8% and 52.4% of caregivers showed clinically moderate levels of anxiety and depressive symptoms, respectively. Furthermore, 35.9% and 3.8% of them showed clinically high levels of anxiety and depressive symptoms, respectively. Analyses showed that general quality of life was a significant predictor of both anxiety and depressive symptoms. Burden and psychological domains of quality of life significantly predicted anxiety. In addition, a lack of social support was a determinant of depressive symptoms. Evidence suggested that social support moderated the burden-anxiety relationship. Specifically, caregivers with low levels of social support showed more elevated levels of anxiety symptoms when their burden was higher. There is an urgent need for early detection to initiate prompt treatment in this population. The study provides some important insights into offering comprehensive intervention to help caregivers cope more effectively through the provision of sufficient social support to buffer the effects of caregiving burden and improve mental health.

The Relationship Between Care Burden and Coping Strategies in Caregivers of Hemodialysis Patients in Kermanshah, Iran.

ObjectiveThe purpose of this study was to investigate the relationship between care burden and coping strategies in caregivers of hemodialysis patients.MethodsThis cross-sectional survey was conducted from September to December 2018 in Kermanshah, Iran. A total of 130 caregivers of patients admitted to the hemodialysis wards of Imam Reza and Imam Khomeini hospitals of Kermanshah, Iran were selected via convenience sampling. Data-collection tools included a demographic information form, caregiver-burden inventory, and coping inventory for stressful situations. Data were analyzed using descriptive and analytical tests.ResultsThe mean age of the caregivers was 35.8±13.7 years, and 71 (54.6%) were patients’ children. The mean caregiver-burden score was 58.5±20.5 out of 96. Mean scores of time-dependent, evolutionary, physical, social, and emotion-dependent care burdens were 17.5±5.3, 12.2±6.3, 9.1±4.7, 8.2±4.0, and 11.4±5.1, respectively. Mean scores of problem-focused, emotion-focused, and avoidance-oriented coping strategies were 46.0±80.8, 43.1±9.0, and 48.9±9.5, respectively. Among the strategies, only the avoidance-oriented one had a significant positive relationship with total care burden and all its subscales.ConclusionCaregivers of hemodialysis patients experienced a relatively high care burden. However, they did not use appropriate coping strategies; therefore, they should be trained to select an effective coping strategy.

Testing the Caregiver Stress Model with the Caregivers of Hemodialysis Patients

<div><!--block-->Chronic renal failure (CRF) is a long, progressive, and chronic condition that requires care. In hemodialysis treatment, which is the most preferred treatment method in CRF, caregivers (informal caregivers) and health teams (formal caregivers) have difficulties as much as patients during the period of illness, and treatment. The aim of this study is to investigate the caregiving process of hemodialysis patients’ informal and formal caregivers within the frame of the “Caregiver Stress Model”. Informal (N = 50, mean of age: 48.5, 92% of which were woman), and formal (N = 63, mean of age: 33.4, 84%of which were woman) caregivers from various dialysis units in Istanbul participated in the study. The Resilience Scale for Adults, The Caregiver Well-Being Scale, The Multidimensional Scale of Perceived Social Support, The Ways of Coping Inventory, and the Maslach Burnout Inventory were used. The results showed that the unconfident coping factor of The Ways of Coping Inventory was a moderator of the relationship between the vital activities and personal success which is sub-dimension of Maslach Burnout Inventory was revealed. Also, the findings suggested that resilience, self-confident and unconfident coping factors were significant mediators of the relationships between the vital activities and personal success. The importance of this study is that the caregiver stress model being tested on caregivers of hemodialysis patients has never appeared in the literature before. In the literature, psychological resilience, coping and social support variables, whose formative effects are frequently discussed, contributed to the mediator effects that partially supported the model. Our findings are discussed in light of other published studies in the field.</div>

Caregiver Burden and Spiritual Well-being in Caregivers of Hemodialysis Patients.

The number of hemodialysis patients is increasing worldwide, and the caregivers of these patients experience a great burden. This study was conducted to examine the relationship between caregiver burden and spiritual well-being in caregivers of hemodialysis patients in Kerman, Iran. This correlational study was conducted on 382 caregivers of hemodialysis patients. Data were collected using the Caregiver Burden Inventory (24 items) and Ellison and Paloutzian 20-Item Spiritual Well-being Questionnaire. Data were analyzed by descriptive and inferential statistics (t test, ANOVA, Spearman correlation, and linear regression analysis) in SPSS 20 software. The findings showed that 45 (11.8%) caregivers had mild, 214 (56%) moderate, and 123 (32.2%) high caregiver burden. Furthermore, 1 (0.3%) caregiver had mild, 349 (92.4%) moderate, and 32 (8.4%) high spiritual well-being. Also, Spearman correlation test showed a significant reveres relationship between caregiver burden and spiritual well-being scores (p < 0.001, r = - 0.41). Moreover, the results of the regression analysis showed that the patient's income, frequency of patient dialysis per week, and patient's need to receive care and spiritual well-being were predictors of caregiver burden, which explained 41% of the burden in caregivers. The results of this study revealed that spiritual well-being was negatively related to caregiver burden and was one of its predictors. Therefore, spirituality can be used as a low-cost and effective intervention to reduce the caregiver's burden.

Predictive Factors of Death Anxiety in Caregivers of Hemodialysis Patients

Predictive Factors of Death Anxiety in Caregivers of Hemodialysis Patients

The Effect of Psycho-educational Intervention on the Caregiver burden among Caregivers of Hemodialysis Patients

The Effect of Psycho-educational Intervention on the Caregiver burden among Caregivers of Hemodialysis Patients