High Levels Of Caregiver Burden Research Articles

Factors Affecting Caregiver Burden in Caregivers of Patients with Parkinson's Disease

Purpose: Depression is a common sign of suffering among the patients with Parkinson’s disease (PD). Frequent and severe neuropsychiatric symptoms lead to high levels of distress in patients and their caregivers, which results in the high levels of caregiver burden. The aim of this study was to determine the predictors of caregiver burden in caregivers of the patients with Parkinson’s disease (PD). Methods: The study included 183 consecutive PD patients and their caregivers. Patients were assessed using the Hoehn and Yahr scale, Mini Mental State Examination (MMSE), Beck Depression Inventory (BDI), and Schwab and England Activities of Daily Living Scale. Caregivers’ depressive symptoms were evaluated using the Caregiver Burden Inventor (CBI), BDI, and World Health Organization Quality of Life Scale. Results: All of the patients reported one or more neuropsychiatric symptoms. Patients’ and caregivers' depressive symptoms, caregivers' age and education, time for caregiving, and quality of life were significantly associated with the increased caregiver burden. After controlling the level of education as a potential confounding variable, depression in both patients and caregivers, time for caregiving, and quality of life explained 45.6% of the variance in caregiver burden. Conclusion: Substantial attention needs to be given to the early identification of depression in PD patients and their caregivers to improve caregivers' quality of life and burden.

Prevalence and predictors of psychological problems among principal caregivers of children with cerebral palsy in Galle, Sri Lanka

Background Caregivers of children with disabilities are easy victims of psychological ill-health. Assessment of psychological problems and identification of factors predicting such outcomes are vital in identifying high-risk caregivers, to prevent them from becoming second order patients. Aim To describe the prevalence and predictors of psychological problems among principal caregivers of children with Cerebral Palsy (CP) in the Galle district Methods The study included 375 caregivers of children with CP, attending Teaching Hospital, Karapitiya, Galle. Prevalence of psychological problems of caregivers was assessed using the General Health Questionnaire (GHQ). Level of caregiver burden was assessed using Caregiver Difficulties Scale, developed and validated by the authors. An interviewer administered questionnaire was used to collect data on other study variables. Predictors of psychological problems in caregivers were determined using logistic regression analysis. Results Fifty six percent (95% Confidence Interval = 51.0% 61.0%) of caregivers had GHQ scores above the cut off threshold for psychological disorders. The strongest predictor for presence of psychological problems was high level of caregiver burden {Odds Ratio (OR)=19.99(5.54-72.13),p Conclusions Caregivers of children with CPshow a high prevalence of psychological problems. There are a number of factors predictive of caregiver psychological problems, particularly the level of caregiver burden, which need to be considered when developing long term care plans for children with CP. DOI: http://dx.doi.org/10.4038/jccpsl.v19i1.7621 Journal of the College of Community Physicians of Sri Lanka Vol.19(1) December 2013 8-17

P18.09 * STRESS INDUCED IMMUNE DYSFUNCTION IN NEURO-ONCOLOGY CAREGIVERS

Family caregivers are vital in the care of persons with a primary malignant brain tumor (PMBT) and also report high levels of psychological distress. The impact of psychological distress on caregivers' physical health has not been explored in neuro-oncology. The aims of the study were to determine profiles of proinflammatory cytokines (IL-6 and IL-1ra) over time in caregivers of persons with a PMBT and to identify the effect of caregivers' psychological distress on their cytokine levels. After institutional review board approval, sociodemographic data, measures of psychological distress (depressive symptoms, anxiety, caregiver burden) and blood samples were collected from 103 caregivers at baseline (time of patient diagnosis), 4, 8, and 12 months. Caregivers were >21, not a primary caregiver for anyone else, and caring for a person diagnosed with a PMBT verified via pathology (NIH R01CA117811). Plasma was batch analyzed using high sensitivity and regular ELISA. Trajectory analyses of log transformed cytokine levels were performed. Then, univariate analyses evaluated potential confounding variables; variables with p < .10 were included in model testing. Multiple logistic regression analyses used high versus low cytokine group membership as outcome variables to determine the impact of psychological distress on cytokine level. With IL-1ra, two groups of caregivers were identified (BIC= -235.28). One-third (34%) had high IL-1ra levels (M = 575.91pg/ml); two-thirds had low levels (M = 252.80pg/ml). With IL-6, two groups of caregivers were identified (BIC= -299.44); 59% had high IL-6 levels (M = 2.30pg/ml) and 41% had low levels (M = .90pg/ml). None of the groups significantly changed over time (baseline to 1 year). After controlling for confounding variables, all female caregivers and those male caregivers reporting increased anxiety were significantly (p = .02) more likely have high IL-1ra. Caregivers that reported higher levels of caregiver burden were significantly more likely to have both high IL-1ra (p = .01) and high IL-6 (p = .03) levels. Depressive symptoms did not significantly affect IL-1ra or IL-6 levels. Poor physical health in family caregivers has the potential to increase institutionalization rates for patients, affect the quality of care delivered in the home, and place a new burden on the healthcare system. These data provide support for mechanistic pathways of stress-induced immune dysfunction and are among the first of their kind to highlight the health risks for neuro-oncology family caregivers.

Caregiver burden and satisfaction in families of individuals with schizophrenia.

Caring for relatives with schizophrenia is complicated and has been associated with burden. Caregivers may also experience satisfaction, but these outcomes have not been simultaneously studied in family caregivers of relatives with schizophrenia. The aim was to investigate the attributes of caregiver burden and satisfaction among individuals and families as well as the association of caregiver burden on caregiver satisfaction in the care of Taiwanese individuals with schizophrenia. A cross-sectional, descriptive, correlational design was used. A convenience sample of 140 families (243 individual family caregivers) was recruited from two psychiatric hospitals in Taiwan. Participants were interviewed individually to complete questionnaires regarding pileup of demands, sense of coherence, mutuality, caregiver burden, and caregiver satisfaction. Linear mixed modeling was used. Female caregivers, greater family demands, decreased sense of coherence, and lower mutuality were associated with higher levels of caregiver burden, whereas being siblings or close relatives and being friends of the affected individuals were associated with lesser self-reported burden. Satisfaction was positively associated with caregiver age, sense of coherence, and mutuality. Burden and satisfaction were not significantly related. Caring for family members with schizophrenia is burdensome but can also be a source of satisfaction. Correlates of caregiver burden appeared to be somewhat distinct from those of caregiver satisfaction. Further research on negative and positive aspects of caregiving is warranted to broaden the understanding of caregiving experiences and design therapeutic interventions to mitigate caregiver burden and enhance the sense of satisfaction with caregiving.

Parents’ Perceptions About Their Child’s Illness in Pediatric Cancer: Links with Caregiving Burden and Quality of Life

This study examined the direct and indirect links, via the caregiving burden, between parents’ perceptions about the severity of their child’s illness and its interference in his or her life and the parents’ quality of life (QoL). The participants were 277 parents of children with malignant cancer, divided into two clinical groups according to treatment status: 126 parents of children on-treatment and 151 parents of children off-treatment. Self-reported questionnaires assessed parents’ perceptions of illness severity and interference in the child’s life, caregiving burden and QoL. Pediatric oncologists provided information about diagnosis, treatment status and intensity. Parents of children on-treatment reported more negative perceptions about the illness (severity and interference), higher levels of caregiving burden and worse QoL, when compared to parents of children off-treatment. Furthermore, parents’ perceptions about their child’s illness (severity and interference) were negatively linked to parents’ QoL through caregiving burden. Additionally, the link between caregiving burden and parents’ QoL was moderated by child treatment status, with stronger associations found for parents of children on-treatment. This study’s findings are discussed in terms of their relevant implications for intervention with families in the pediatric cancer context.

Caregiver burden and sibling relationships in families raising children with disabilities and typically developing children.

Using family systems theory as a theoretical framework, we investigated direct and indirect associations between type of disability, caregiver burden, and sibling relationships with structural equation modeling. We recruited 172 families raising typically developing children or a child with a disability. Participants volunteered at meetings and workshops for families of children with disabilities and were also recruited through snowball sampling. Mothers and fathers independently completed self-report questionnaires on caregiver burden and perceptions of the sibling relationship. Mothers experienced higher levels of caregiver burden than fathers. Parents of children with autism reported higher levels of caregiver burden than parents of typically developing children. Mothers of children with Down syndrome and multiple disabilities reported more positive sibling relationships than mothers of typically developing children. Mothers' and fathers' perceptions of caregiver burden were negatively related to their perceptions of the sibling relationship. Caregiver burden mediated the relationship between having a child with autism and positive sibling relationships. Results indicate the benefits of using a systems framework in examining families raising children with disabilities. Future research should focus on interventions for families of children with disabilities that help alleviate parental burden and foster positive sibling relationships.

Burden and depressive symptoms associated with adult-child caregiving for individuals with heart failure.

Background. The primary purpose of this study was to investigate adult-child caregiver burden in heart failure (HF) patients. Secondary purpose of the study was to identify the possible influencing factors for caregiver burden and depressive symptoms in a young adult-child caregiver group. Methods. A total of 138 adult-child caregivers and 138 patients with HF participated in this study. Caregivers' burden, depressive symptoms, and anxiety levels were assessed by using Zarit Caregiver Burden Scale (ZCBS), Beck Depression Inventory, and State-Trait Anxiety Inventory, respectively. Results. The mean ZCBS scores of the female caregivers were significantly higher than male caregivers. Approximately one-third of the adult-child caregivers had at least mild depressive symptoms. Caregivers with higher depressive symptoms had higher levels of caregiver burden. There were positive correlations between caregiving time, severity of depressive symptoms, and perceived caregiver burden. There was a negative correlation between education level of caregivers and perceived caregiver burden. Age, socioeconomic level, and marital status of patients were affecting factors for depressive symptoms in caregivers. Among caregiver characteristics, gender, marital status, and ZCBS scores seem to influence the depression in caregivers. Conclusions. The study findings suggest significant levels of burden and depressive symptoms even in adult-child caregivers of HF patients.

Introduction and Overview

Often referred to as the ‘silent epidemic’, traumatic and other forms of acquired brain injury are now considered to represent a significant and growing public health problem worldwide. Beyond the direct impacts of acquired brain injury on injured persons, this disability likewise impacts families. While medical personnel and acute rehabilitation services deliver an incredible array of high quality and sophisticated techniques to treat acute injuries, a concomitant service delivery system to support the needs of families is lacking. This is especially unfortunate given the extensive array of instrumental and affective forms of care families provide to their injured family members, often resulting in high levels of caregiver burden, depression and anxiety.

Employment status, social function decline and caregiver burden among stroke survivors. A South Indian study

Stroke leaves at least 60% of the survivors with moderate to severe disability limiting their employment status and social functioning leading to high levels of caregiver burden. AimWe sought to study the employment status and level of change of social functioning of stroke survivors and their principal caregiver and correlate it with severity of stroke, functional disability, and anxiety and depression scores. MethodsOne hundred and fifty stroke survivors and principal caregivers (3months–2years post-stroke) were recruited for the study. The employment status pre- and post-stroke was assessed. The social function of the patient and caregiver was analyzed using a 6 item social function scale developed for the study, encompassing culturally relevant questions. A 20 point scale adapted from Burden assessment schedule was used to assess the caregiver burden. ResultsMean age of the study group was 54.37±12.072 (range 22–75years), with 116 males and 34 females. Spouse was the principal caregiver for 142/150 patients (94.6%). In the stroke survivors, compared to the pre-stroke employment status of 62.7%, only 20.7% were employed post-stroke with half having change of job. But the employment status of caregiver was not reduced post-stroke (34.7% vs 33.3%). Employment loss in stroke survivors had a statistically significant association with severity of functional disability, male gender and presence of limb weakness (p values 0.037, 0.0001 and 0.043 respectively). There was an overall decline in social functions among the 6 parameters assessed in both the stroke survivors and caregivers. Of the caregiver burden, financial burden was more among female and older caregivers. The functional status and motor weakness of the stroke survivors did not tend to worsen the overall caregiver burden. ConclusionsLoss of occupation among stroke survivors is high. The decline in social function among stroke survivors and caregivers was significant. Even though functional disability contributed to employment loss and social function decline among stroke survivors, it did not have a significant impact on caregiver burden.

Family Caregiver Burden, Skills Preparedness, and Quality of Life in Non-Small Cell Lung Cancer

To describe burden, skills preparedness, and quality of life (QOL) for caregivers of patients with non-small cell lung cancer (NSCLC), and describe how the findings informed the development of a caregiver palliative care intervention that aims to reduce caregiver burden, improve caregiving skills, and promote self-care. Descriptive, longitudinal. A National Cancer Institute-designated comprehensive cancer center in southern California. 163 family members or friends aged 18 years or older and identified by patients as being a caregiver. All eligible caregivers were approached by advanced practice nurses during a regularly scheduled patient clinic visit. Informed consent was obtained prior to study participation. Outcome measures were completed at baseline and repeated at 7, 12, 18, and 24 weeks. Descriptive statistics were computed for all variables, and one-way repeated-measures analysis of variance was used to test for change over time for all predictor and outcome variables. Caregiver burden, skills preparedness, psychological distress, and QOL. Caregivers were highly functional. Caregiver burden related to subjective demands increased significantly over time. Perceived skills preparedness was high at baseline but decreased over time. Psychological distress was moderate but increased in the study period. Overall QOL was moderate at baseline and decreased significantly over time. Psychological well-being had the worst QOL score. Caregivers experienced high levels of caregiver burden and reported deteriorations in psychological well-being and overall QOL. Oncology nurses need to ensure that caregivers receive information that supports the caregiving role throughout the cancer trajectory. Although family caregivers are profoundly impacted by a loved one's lung cancer diagnosis, the literature about caregiver burden, skills preparedness, and QOL is limited. Current evidence suggests that family caregivers can be negatively impacted by a loved one's cancer diagnosis. Caregiver-specific support interventions are needed to eliminate the burden of caregiving in lung cancer.

Caregiver Burden and Preventive Dental Care Use for US Children with Special Health Care Needs: A Stratified Analysis Based on Functional Limitation

The objectives of this study were to evaluate the association between caregiver burden and preventive dental care use for children with special health care needs (CSHCN) and assess if caregiver burden explains the relationship between child- and family-level characteristics and preventive dental care use. Samples of US CSHCN ages 3-17 years with a functional limitation (n = 7,559) and those without (n = 26,345) were derived from the 2005-2006 National Survey of CSHCN. We generated structural equation models, stratified by functional limitation, to describe the relationships between caregiver burden and preventive dental utilization. We measured caregiver burden using six items on whether the child's health condition impacted work, time spent on health management, and finances. About 80.9 % of CSHCN used preventive dental care. Higher levels of caregiver burden were associated with significantly lower odds of preventive dental care use for CHSCN with a functional limitation (β = -0.06; P < 0.001) and those without (β = -0.07; P < 0.001). For CSHCN with a functional limitation, family poverty and being uninsured were significantly associated with greater caregiver burden and less preventive dental use. Findings were similar for CSHCN without a functional limitation, except that lower caregiver education was also associated with greater caregiver burden and less preventive dental care use. Caregiver burden is potential barrier to preventive dental care use for CSHCN and explains the relationship between child- and family-level characteristics and preventive dental care use. Interventions to improve the oral health of CSHCN should include strategies to reduce caregiver burden, especially within socioeconomically vulnerable families.

Predictive Role of Different Dimensions of Burden for Risk of Complicated Grief in Caregivers of Terminally Ill Patients

The aim of the study was to test whether high levels of caregiver burden, as other confirmed predictors, are associated with the risk of prolonged grief disorder in caregivers of terminally ill patients. A predictive study was carried out in order to test the hypothesis. A demographic schedule, the Prolonged Grief 12 (PG-12), the Toronto Alexithymia Scale, Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale, and Caregiver Burden Inventory were administered to 60 caregivers of 51 patients who were admitted in Hospice. In the regression analysis, difficulty in recognizing emotions, total burden, depression, and developmental burden dimension were significant predictors of PG-12 levels. Findings showed that feeling of deprivation of existential expectations represents the greater risk factor for the prolonged grief disorder, among the burden dimensions.

Association between hope and burden reported by family caregivers of patients with advanced cancer

The aim of this study, in a sample of family caregivers (FCs) of patients with advanced cancer, was to describe the level of FC burden using the Caregiver Reaction Assessment (CRA). In addition, the effects of select FC and patient characteristics on each of the CRA subscales were evaluated. FCs and patients (n = 112) completed a demographic questionnaire, and Herth Hope Index, and the Hospital Anxiety and Depression Scale. FCs completed the CRA. Data were analyzed using multiple linear regression analyses. For three of the five CRA subscales (i.e., "impact on finances", "impact on daily schedule", and "impact on health"), the mean scores were comparable to a Norwegian sample of FCs caring for patients in the late palliative phase. The variance in each of the CRA subscales was explained by different factors. Total explained variance ranged from 5.5% ("lack of family support") to 31.8% ("impact on daily schedule"). FC characteristics, such as being female and lower educational level, distress regarding the patient's pain, anxiety, depression, and level of hope, as well as the patients' number of comorbidities, depression, and hope contributed to an increase in various domains of FC burden. FCs' level of hope was a significant predictor for three of the CRA subscales (i.e., "self-esteem", "lack of family support", and "impact on health"). Findings suggest that FCs' and patients' level of hope are important determinants of caregiver burden and that FCs with lower levels of hope represent a high-risk group for higher levels of caregiver burden.

Caregiver burden of Mexican dementia patients: The role of dysexecutive syndrome, sleep disorders, schooling and caregiver depression

As a result of the accelerated growth of the elderly population, reconfiguration of families and member roles, and the increase of mental disorders, it is necessary to investigate the effects of this set of factors on the caregivers of patients with dementia in Mexico. Mental disorders of individuals have a negative impact on their physical and emotional quality of life, leading to greater dependence and making the caring experience a heavy burden. Several studies (none in Mexico) have used either the characteristics of the patient or caregiver to determine the burden, but few studies have included both profiles within a single study. The objective of the present study was to analyze the characteristics of the patients and caregivers associated with caregiver burden. A multicenter study was carried out in six health institutions located in Mexico City, including 175 patients (and their caregivers) diagnosed with different types of dementia. We used the Spanish Caregiver Burden Screen. Descriptive analysis and logistic regressions were used to estimate the effect of the covariates on the caregiver burden. The results showed that patient variables have a greater impact on caregiver burden than caregiver-associated variables. Dysexecutive syndrome, sleep disorders, schooling and caregiver depression are associated with a higher level of caregiver burden. Caregiver burden is a complex phenomenon. The results of the present study showed the need to implement multifactorial interventions targeting the caregiver to reduce the burden, strengthen the skills for patient management to avoid depression, improve patient health, and diminish functional dependence and future hospitalization.

Apoyo con Carino: RCT of Patient Navigation to Improve Palliative Care Outcomes (FR417-C)

Objectives 1. Recognize the need to assess and address symptoms and quality of life even among early stage lung cancer patients. 2. Identify the need for continued interdisciplinary palliative care for late stage lung cancer patients as they face the final stage of their cancer. 3. Describe the importance of educating the patient’s caregiver along the lung cancer trajectory. Background. Palliative cancer care addresses multiple issues that cause suffering for patients and caregivers, greatly impacting their quality of life. Research Objectives. This paper describes how symptoms, distress, and quality of life (QOL) data from the usual care phase of a NCI supported Program Project informed the development of an interdisciplinary, tailored palliative care intervention for patients with early (I-IIIB, n 1⁄4 103) and late (IV, n 1⁄4 114) stage lung cancer, and their caregivers (n 1⁄4 163). Method. Patient-reported outcomes were completed at baseline, 6, 12, and 24 weeks with Early Stage completing an additional 36 and 52 weeks. Caregivers completed outcome measures at baseline, 7, 12, 18, and 24 weeks. Result. Earlyd 55% female, 78% former smokers. IADLs, KPS, and Timed Up and Go fluctuated longitudinally, p 1⁄4.012, .044 and p 1⁄4.008 respectively. QOL decreased (FACT physical well-being subscale, p 32 hours/week. Caregivers were highly functional, experienced high levels of emotional stress, increased caregiver burden, decrease in perceived skills preparedness, and reported deterioration in psychological well being and overall QOL. Conclusion. Patients continue to experience high symptom burden, diminished physical well-being, and decreased QOL. Caregivers experience high levels of caregiver burden and report decreased psychological well being and overall QOL over time. Implications for Research, Policy, or Practice. There is a vital need for interdisciplinary palliative care interventions for patients with lung cancer and family caregivers. Phase II of this study is currently testing such an intervention based on Phase I results.

Caregiver Burden as People With Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder Transition into Adolescence and Adulthood in the United Kingdom

There is increasing recognition that autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) are associated with significant costs and burdens. However, research on their impact has focused mostly on the caregivers of young children; few studies have examined caregiver burden as children transition into adolescence and young adulthood, and no one has compared the impact of ASD to other neurodevelopmental disorders (e.g., ADHD). We conducted an observational study of 192 families caring for a young person (aged 14 to 24 years) with a childhood diagnosis of ASD or ADHD (n = 101 and n = 91, respectively) in the United Kingdom. A modified stress-appraisal model was used to investigate the correlates of caregiver burden as a function of family background (parental education), primary stressors (symptoms), primary appraisal (need), and resources (use of services). Both disorders were associated with a high level of caregiver burden, but it was significantly greater in ASD. In both groups, caregiver burden was mainly explained by the affected young person's unmet need. Domains of unmet need most associated with caregiver burden in both groups included depression/anxiety and inappropriate behavior. Specific to ASD were significant associations between burden and unmet needs in domains such as social relationships and major mental health problems. Adolescence and young adulthood are associated with high levels of caregiver burden in both disorders; in ASD, the level is comparable to that reported by persons caring for individuals with a brain injury. Interventions are required to reduce caregiver burden in this population.

Examining the Interrelatedness of Patient and Spousal Stress in Heart Failure

Recent research has highlighted the positive influence that spouses can have on patient outcomes. It is not clear whether patients and spouses influence each other's well-being reciprocally or whether spousal well-being affects the success of patients' disease management. Our goals were 2-fold: (a) to propose a conceptual framework to examine the reciprocity between patient and spouses' well-being, especially as it relates to disease management, and (b) to begin to assess the validity of this model using pilot data. Twenty-three veterans with heart failure (HF) and their spouses were recruited into a pilot cross-sectional observational study. Participants completed psychosocial surveys to assess depressive symptoms, caregiver burden, relationship satisfaction, and disease management. Descriptive analyses and bivariate correlations between these measures were calculated. Using standard cutoffs, analyses suggested clinically significant depressive symptoms in patients (Center for Epidemiological Studies-Depression score >16; mean, 21.8 [SD, 13]) and a high level of caregiver burden among spouses (Zarit Burden Interview score >15; mean, 22.4 [SD, 15.4]). Both patients and spouses reported high relationship satisfaction levels (Dyadic Adjustment Scale score >100; mean, 112.6 [SD, 26.5] and 115.9 [SD, 14.4], respectively). On average, patients reported poor disease management (Self-care of Heart Failure Index subscale <70 across all subscales: confidence = 53.3 [SD, 28.2]; maintenance = 59.7 [SD, 17.3]; management = 54.0 [SD, 19.4]). Patient depressive symptoms were positively correlated with spouse depressive symptoms (r = 0.53) and caregiver burden (r = 0.64; all P's < .05). Spouses' depressive symptoms were additionally correlated with lower levels of perceived social support among patients (r = -0.47), poor patient relationship satisfaction (r = -0.51), and worse patient confidence in HF management (r = -0.48). Greater caregiver burden was associated with more patient disease complaints (r = 0.49), poorer patients' relationship satisfaction (r = -0.72), and poorer patients' perceived social support (r = -0.73). These results provide preliminary support to the proposed conceptual model. Further research is necessary to determine which spousal factors appear to be most relevant to disease management. Disease management interventions may benefit from engaging spouses in a way that enhances their role without adding to their burden.

Caregiver burden among poor caregivers of patients with cancer in an urban African setting

The nature and magnitude of the problems facing caregivers remain largely unknown in developing countries of the world. This study addresses these issues in a group of caregivers of patients with cancer in Zaria, Nigeria. One hundred and three patients attending an oncology outpatient clinic at the Ahmadu Bello University Teaching Hospital were enrolled in the study with their caregivers. The caregivers were interviewed using the Socio-demographic data sheet, General Health Questionnaire-30 (GHQ-30) and Zarith Burden Interview (ZBI). A score of 4 or more in GHQ and scores above the median score of the sample in ZBI were considered a clinically significant level of psychological morbidity and a high level of burden, respectively. Data obtained were analyzed using the Statistical Package for Social Sciences Version 13 for Windows. All statistical tests of significance were carried out at 5% level of probability. The patients were 60 women whose mean age was 57. Of the 103 caregivers, 60 (58%) were men and 43 (42%) were women. Their mean age was 37. Their mean ZBI and GHQ-30 scores were 29.16±12.8 (median = 25) and 3.67±3.01, respectively. A high level of burden was found in 49.5% (95% CI 39.9-59.1%) and psychological morbidity was found in 46.6% (95% CI 37.0-56.2%) of the caregivers. High levels of burden and psychological morbidity were significantly associated with absence of financial support. The study demonstrated a high level of caregiver burden, psychological morbidity and financial strain in family caregivers coming to the clinic with a relative who has cancer in an urban Nigerian setting.

Effects of Gender on Burden Among Caregivers of Alzheimer's Patients

This study was conducted to determine the effects of gender on caregiver burden among caregivers of persons with Alzheimer's disease. Comparative descriptive study. Factors affecting the burden of female and male caregivers (age, total duration of caregiving, mean duration of daily caregiving, education, income, employment status, age of the patients cared for, and Mini-Mental State Examination [MMSE] and Neuropsychiatric Inventory [NPI] scores) were similar (p > .05). The sample consisted of 120 female and 72 male caregivers of patients with Alzheimer's disease. Data were collected from patients by means of the MMSE and demographic variables, and data from the Caregiver Burden Inventory [CBI] and NPI were obtained from caregivers, as well as from face-to-face interviews using a questionnaire. Descriptive statistics and t-tests were used to describe and analyze data. Female caregivers had significantly higher scores for caregiver burden than their male counterparts (p= .002). Subscale analysis on the CSI revealed that female caregivers had significantly higher scores for caregiver burden than male caregivers on time dependence (p= .040), developmental (p= .002), physical (p= .001), and social burdens (p= .045). No difference was found with respect to emotional burden (p= .718). Results of this study suggest that female caregivers are subjected to a higher level of caregiver burden than male caregivers in Turkey. In subscales, female caregivers experienced more burden than male caregivers in the time dependence, developmental, physical, and social burdens. Emotional burden was similar in both genders. Although caregiver burden has been a much debated issue for many years, it is a relatively new topic in Turkey. In order to provide appropriate care for the patient's and family's cultural values and needs, more studies are needed to be conducted on family members giving care to Alzheimer's patients. It is thought that the findings of the present study will facilitate cross-cultural comparisons and culture-oriented care planning.

Goal adjustment capacities, coping, and subjective well-being: The sample case of caregiving for a family member with mental illness.

This study examined the associations between goal adjustment capacities, coping, and indicators of subjective well-being in 2 waves of data from individuals who provide care for a family member with mental illness. We hypothesized that goal adjustment capacities would predict higher levels of subjective well-being by facilitating coping with caregiving stress. Results showed that goal disengagement was associated with effective care-specific coping (e.g., less self-blame and substance use). Goal reengagement was also associated with effective care-specific coping (e.g., positive reframing), but at the same time it predicted the use of less effective strategies (e.g., venting and self-distraction). Moreover, goal disengagement predicted lower levels of caregiver burden and depressive symptoms and buffered the longitudinal effect of caregiver burden on increases in depressive symptoms. Goal reengagement, by contrast, predicted higher levels of caregiver burden and purpose in life and buffered the cross-sectional association between caregiver burden and depressive symptoms. Finally, effective (and less useful) care-specific coping statistically explained the adaptive (and maladaptive) effects of goal adjustment capacities on participants' well-being.