Mean Burden Score Research Articles

The effect of supportive nursing intervention on burden and coping strategies of cargivers of children with cancer

Background and objective: Cancer is a serious health problem. Children with cancer are in particular need of support and care due to its complications followed by chemotherapy. These children should be cared for at home by family caregivers, and this places great mental and physical burden on caregivers. Therefore, appropriate and effective nursing interventions are essential in order to decrease burden and improve their coping pattern. The aim of this study was to determine the effect of supportive nursing intervention on the burden of care and coping pattern in caregivers of children with cancer.Methods: Research design: A Quasi-study pre, immediately after, and 1 month after the intervention was used to test the study hypothesis and fulfill the aim of the study. Setting: The study was conducted at outpatient clinic in Specialized Pediatric Hospital at Benha City. Subjects: Sixty caregivers for children with cancer was chosen through convenient sampling method and divided by using table of random numbers into two groups, study and control group. Caregivers of the study group attended seven nursing intervention sessions. Tools: The tools used were (1) An inertviewing questionnaire which include two part; sociodemoghaphic date and medical history for child and thier caregivers (2) Zarit Burden Scale (3) Coping Health Inventory for caregivers parents (CHIP).Results: During the study period, burden decreased in the study group and increased in the control group. Mean burden of care score before, immediately after, and 1 month after the intervention was 42.2, 33.7, and 25.6, respectively, in the study group and 44.2, 46.1, and 48.5, respectively, in the control group. In addition, the mean burden score in the study group significantly decreased in comparison with the control group (p < .001). Also, coping strategies increased in the study group and decreased in the control group. Mean coping pattern score before, immediately after, and 1 month after the intervention was 32.8, 47.5, 53.6, respectively, in the study group and 34.7, 30.7 and 26.2, respectively, in the control group. In addition, the mean coping pattern score in the study group significantly improved in comparison with the control group (p < .001).Conclusions: The supportaive nursing intervention can decrease burden in caregivers of children with cancer and consequently improve their methods of coping.

The Effect of Family Psychoeducation on Burden of Care in Families with Type I Diabetic Children

Background: When controlling diabetes in children, families suffer from burden of care imposed by the disease. The aim of this study was to investigate the effect of family psychoeducation on the burden of care imposed on families of adolescents with type 1 diabetes referring to Golestan diabetes clinic in Ahvaz city. Methods: The present study was a clinical trial with before-after design. The study population included families with adolescents with type 1 diabetes aged 12 - 19 years. A total of 40 families of sick children and one parent who was more in touch with the patient were selected and randomly divided into experimental (20 families) and control groups (20 families). To measure family burden of care, burden of care Questionnaire (DFI-S) was used. Family psychoeducation was carried out for the experimental group twice a week for 8 sessions of 90 minutes. Independent and paired t-test and Mann-Whitney test were used to compare the mean score of family burden of care in both groups while Chi-square test was used to compare qualitative variables between the two groups. SPSS v. 20 was used for statistical analysis. Results: The most frequent age range of diabetic children was 12 - 14 years (55%) and 15 - 19 years in the experimental and control groups (65%), respectively. Most fathers and mothers were self-employed (60%) and homemakers (85%), respectively. The mean score of burden of care imposed on families before the intervention in the experimental and control groups was 26.6 and 30.15, respectively, that reduced to 21.6 and 30.35 three months after the intervention, respectively, showing no change. Conclusions: Family psychoeducation can reduce family burden of care imposed by adolescents suffering from type I diabetes and increase the period for families facing the disease. It also reduces medical treatment costs and length of stay in health centers and increases quality of home care.

A Randomized, Controlled Trial of the Effectiveness of a Psychoeducational Intervention on Family Caregivers of Patients with Mental Disorders.

The present study aimed to investigate the effectiveness of a psychoeducational intervention on caregivers of patients assisted by the Center for Psychosocial Health Care (CPHC) focusing on the patient's psychopathology. This was a randomized clinical trial with 130 caregivers with higher mean burden scores assessed using the Zarit Burden Interview Scale (ZBI) (66 caregivers in the intervention group and 64 in the control group). The intervention included six home visits of psychoeducational interventions according to each mental disorder identified in the CPHC records. The intervention group had a reduction of 4.8 points in ZBI mean score (p = 0.008) and in the control group, the reduction was 1.9 points, which was not significant (p = 0.305). It is possible to think that psychoeducation may have served to inform about the disease and how to deal with it, to give emotional support to caregivers and to implement coping strategies and stress management.

The relationship between the spiritual attitude of the family caregivers of older patients with stroke and their burden.

IntroductionStroke is a chronic condition that necessitates multidimensional and overwhelming care. The caregivers of stroke patients are faced with various stressors that can threaten different aspects of their health, especially their mental health. Spiritual attitude and being spiritually oriented contribute significantly to mental health and can be used as a strategy for adapting to the stressful events that are part of the role of caregiving. This study was therefore conducted to investigate the relationship between the spiritual attitude of the family caregivers of older patients with stroke and their burden.MethodsThis descriptive cross-sectional study was conducted in 2016. The study population consisted of all the family caregivers of older patients with stroke presenting to health care centers and nursing service companies of Gilan Province in Iran. The participants were selected through convenience sampling and consisted of 407 participants. Data were collected using the Spiritual Attitude Scale and the Caregiver Burden Inventory and were then analyzed in SPSS-18 using Pearson’s correlation coefficient at a significance level of 0.05.ResultsThe results showed that 88.9% of the caregivers were females. The mean age of the participants was 38.3±8.8 years. The duration of caregiving was <5 years in 84.4% of the participants, while its mean was 4.2±2.5 years. The mean score of spiritual attitude was 108.77±6.20. The majority of the participants (49.3%) had moderate and relatively favorable spiritual attitude (a score of 72–120), 27.8% had high or favorable spiritual attitude; 8.7% had mild burden, 54.4% had moderate burden and 37% had favorable burden. The mean score of burden was 28±12.75. A statistically significant positive relationship was observed in this study between the mean score of spiritual attitude and the total score of burden in all its dimensions, namely, time dependence, as well as the developmental, physical, social and emotional dimensions.ConclusionProviding strategies for improving spirituality, such as teaching spiritual self-care, can improve their burden. Given that such strategies are psychologically approved and pose no side effects, they can be used as an effective, low-cost and risk-free approach for all caregivers, so that they can acquire the necessary spiritual support for overcoming the stress caused by caring for family members through the reinforcement of their spiritual beliefs in the ultimate effort to provide effective care to older patients while maintaining their own health and quality of life.

Study of disease burden of chronic hepatitis B and C patients in Shanghai based on Bronfenbrenner' s ecological systems theory: a community-based survey

Objective: To systemically analyze family burden, quality of life of chronic hepatitis B and C patients in Shanghai and related influencing factors. Methods: A representative sample of chronic hepatitis patients (n=1 478) and their family members (n=1 478) was randomly selected through a multi-stage cluster sampling from 30 communities in 10 districts of Shanghai. One patient and one family member of each family were interviewed using different questionnaires to collect related information. Based on Bronfenbrenner' s ecological systems, psychological measurement, two-level random intercept model and multivariable structural equation model were applied to determine the effects and directions of the factors between life quality of chronic hepatitis patients and family burden. Results: The mean score of quality of life of chronic hepatitis patients in Shanghai was 78.70 ± 13.25, the score of " specific module" was highest and the score of " social function" was lowest. Additionally, the mean score of burden reported by the family members was 12.62±10.74, the score of " financial burden" was highest, and the score of " effect on family member' s health" was lowest. Multivariable structural equation model indicated that eight factors were related with life quality and family burden of patients with chronic hepatitis. Among them, HCV infection, elevated serum alanine aminotransferase level, average monthly cost for patient >3 000 yuan (RMB) and poor health of family members were the direct risk factors for the life quality of the patients as well as family burden. The factor of drinking more than once a week influenced the patients' life quality directly and family burden indirectly. On the contrary, the factors of local household registration, hospitalization and family member's indifferent attitude to hepatitis B vaccination influenced the family burden of the chronic hepatitis patients directly and the life quality of the patients indirectly. Conclusion: The findings could be used in the development of community based management and intervention of chronic hepatitis patients in Shanghai.

Assessment of caretaker burden in patients with psychiatric illness

Background: There are approximately 450 million people across the world dealing with a mental illness. The burden perceived by caregivers of patients with psychiatric illness is a fundamental prognostic aspect in the history of the disease and the caregiver burden is reportedly a critical determinant for negative caregiving outcomes. Methods: A cross sectional study was conducted involving 100 caregivers of the patients attending a rural community based psychiatric centre. Results: A total of 100 subjects (caregivers) were recruited for the study. There were a total of 53 females and 47 males with the mean age of 38.9 years, among them 67% were financially able to take care of the patient. The mean burden score of 69.94 was the major finding in our study. 85% of the subjects accept being frustrated about the slow improvement of the patient. The mean burden score was found to be 69.94. Conclusions: From present study it was concluded that high amount of burden was present in the study population mostly in their physical, mental and financial condition.

The Effect of Barkley's Family-Oriented Program on the Burden of Care on Families of Children with Attention Deficit-Hyperactive Disorder.

Background:Attention deficit-hyperactive disorder (ADHD) is the most common behavioral disorders during childhood whose treatment is greatly dependent on families; therefore, families of such children should improve their relation with them so that they could enjoy their lives. Hence, this study was conducted to evaluate the effect of Barkley's family-oriented program on the burden of care on such families.Materials and Methods:This clinical trial was conducted among 64 family care givers for children with ADHD. By simple sampling, samples passing the inclusion criteria were selected and randomly allocated into two groups of control and intervention. The intervention group received Barkley's family education program through 9 sessions; the control group participated in 3 group sessions and expressed their problems and experiences. Data were collected and analyzed using the Zarit Burden Interview.Results:Burden of care was gradually reduced through the study in the intervention group, however, the mean score of burden of care did not have a significant reduction in the control group.Conclusions:Because Barkley's family-oriented program was able to reduce the burden of care in families of children with ADHD, it is recommended to develop similar programs and evaluate them through various studies.

A study on burden among caregivers of stroke patients

Introduction: Studies have shown that caregiving is associated with high burden that could affect caregivers’ mental and physical well-being. Unfortunately, caregivers are often overlooked even by healthcare professionals. With the rise of our elderly population and morbidity from stroke, there is a need to assess the burden among family caregivers in our society. This study was carried out to determine the level of burden among caregivers of stroke patients attending Hospital Universiti Sains Malaysia in Kelantan and to evaluate the possible risk factors associated with those with a burden. Methods: A total of 116 caregivers of stroke patients were interviewed. The participants were recruited from the Klinik Rawatan Keluarga in Hospital Universiti Sains Malaysia. Caregivers were assessed for the level of burden using the Zarit Burden Interview. Results: The mean burden score among the caregivers was 25.42 (SD 6.45). The minimum burden score is 11 and the maximum score is 49. This study significantly found that caregivers who look after bedbound patients have higher levels of burden. While the caregiver burden is lower with higher household income and among caregivers who have secondary or tertiary education level. Conclusions: Factors that affect caregiver burden such as the condition of the patient, caregiver’s education level and household income should be taken into account in the evaluation of caregivers of stroke patients.

Care Burden and Social Support Levels of Caregivers of Patients with Chronic Obstructive Pulmonary Disease.

This descriptive study was conducted to determine the care burden and social support levels of caregivers to patients with chronic obstructive pulmonary disease (COPD). The primary caregivers of 112 patients with COPD hospitalized in the chest diseases service of a university hospital were involved in the study. Data of the study were collected by using the Patient and Caregiver Information Form, which was prepared by reviewing the literature, Katz Index of Independence in Activities of Daily Living, Zarit Burden Interview, and Multidimensional Scale of Perceived Social Support. While the care burden mean score of caregivers of patients with COPD was 40.91 ± 20.58, the mean score of Multidimensional Scale of Perceived Social Support was 54.13 ± 18.84. In this study, it was determined that female caregivers, as well as individuals stating that their physical and psychological health was affected and those having difficulty giving care and needing help, had higher levels of care burden, whereas the spouses, as well as individuals with lower levels of income and those stating that their physical and psychological health was affected, had lower levels of social support.

Need for medication and stuffy nose predict the severity of allergic rhinitis.

Need for medication and stuffy nose predict the severity of allergic rhinitis.

The effect of education and group interaction on the family burden and support in the mothers of intellectually disabled children

Objective: This study was conducted to determine the effect of interactive education with group interaction on the family burden and support in the mothers of intellectually disabled children by using pre-post test with control group experimental design. Methods: The study was conducted with 62 mothers have intellectually disabled children between 15th September 2010 and 30th May 2011. An education about difficulties and coping strategies was given to the study group mothers as 6 sessions (every session is for 35-45 minutes) by using interactive methods. Before and after the study, Family Burden Evaluation Scale for Families of Child with Intellectual Disabilities and Family Support Scale were practiced with mothers in the study and control groups. Results: It is determined that family burden mean score was decreased, family support median score was increased in the study group mothers after the education. Also, there was a negative and poor level meaningful relation between total family support and total family burden scores in the study group mothers after the education. Conclusions: The education given by the nurses was effective on decreasing family burden and increasing family support in mothers have intellectually disabled children. It is suggested that education should be given regularly and constantly and mothers who live same problems should be supported by being together.

Şizofreni hastalarının bakımıyla ilgilenenlerde yük ve ilişkili özellikler

Burden and burden-related features in caregivers of schizophrenia patients Objective: Burden, social support and coping methods in caregivers of patients and the relationship between these variables were cross-sectionally evaluated in this study. Method: Demographic form, Zarit Caregiver Burden Scale, Multidimensional Scale of Perceived Social Support and Ways of Coping Inventory were administered to the caregivers. The correlation of specified load levels with respect to the disease and characteristics of the caregivers were investigated. Results: The mean burden score of caregivers participated in the study was 60.45 points. By gender, burden in female caregivers was higher than men. The burden of employed caregivers was higher than unemployed. Statistically significant negative correlation between monthly income and burden was found. Helplessness and fatalistic attitudes were statistically correlated with burden. Conclusion: Caregivers who are not able to use effective coping styles have heavier burdens. Caregivers using nonfunctional coping styles, should be helped to change their attitudes.

End-of-life care research with bereaved informal caregivers--analysis of recruitment strategy and participation rate from a multi-centre validation study.

BackgroundOne essential element of research is the successful recruitment of participants. However, concerns are obvious regarding the ethical implications of involving terminally ill and even dying patients and their informal caregivers as research participants. This study aims to illustrate central issues encountered when recruiting bereaved informal caregivers for a questionnaire validation study on the quality of dying and death.MethodsBetween July 2012 and November 2013, informal caregivers of deceased inpatients who were treated at two palliative care units in Germany were invited to participate in a questionnaire validation study. Informal caregivers were called by a trained researcher at the end of the fourth week after death at the earliest and by the sixteenth week after death at the latest and asked to participate in a face-to-face interview in their private home.ResultsThe overall participation rate of all eligible informal caregivers was 76.1% (226/297). The mean burden score was 2.5 (NRS from 0 = no burden to 10 = maximum burden; n = 221). Higher burden scores (≥4) were associated with emotional and burdensome memories (n = 34) being invoked throughout the interview. Severe or maximum burden scores (≥7) were stated by 13.2% of participants. The average time between the associated patient’s death and the informal caregiver’s interview was 57.3 days (range 26–176 days, median 49.5 days). 5.3% of all 226 interviews were not completed due to different reasons. Participants’ comments on the way in which the study was conducted gave insight into their motivation to take part in the study and their evaluation of the interview situation.ConclusionsThe recruitment strategy can be recommended to other researchers developing research with bereaved carers. The burden caused by study participation was acceptable to the researchers carrying out this research, although a small group of participants experienced high levels of burden which should be anticipated and appropriate support services offered. Family caregivers are willing to support end-of-life care research, have different motivations for participation and even reported benefits from participation. Nevertheless, study designs have to take into account and ease the potential burden of interviews for caregivers experiencing grief.

The effect of group psycho-education program on the burden of family caregivers with multiple sclerosis patients in Isfahan in 2013-2014.

Background:Lack of adequate training and support of primary caregivers of multiple sclerosis (MS) patients is the major factor in causing stress, anxiety, and increase of burden. Therefore, the treatment team members such as psychiatric nurses can help these vulnerable people overcome psychiatric pressures effectively not only through their care and referral role but also through their supportive characteristic, which helps the patients improve their clinical status, together with their social, familial, and work adaptation. Therefore, the researcher tried to identify the effect of a group psycho-education program on the burden family caregivers with MS patients.Materials and Methods:This is a two-group three-stage clinical trial. The researcher referred to the heads of neurology clinics to present the purpose of the study and to start the sampling. The neurology clinics of AL Zahra University Hospital, and also a Private Neurology Clinic were selected to collect the data of the study. The subjects were randomly selected, and then, assigned to two groups of study and control.Results:Independent t-test showed a significant reduction in family caregivers’ burden immediately after and 1-month after intervention in the study group, compared to control. Repeated measure ANOVA showed a significant reduction in caregivers’ burden mean score in the study group (P < 0.001).Conclusions:As group psycho-education reduced family caregivers’ burden, it is recommended to develop and design other programs for the family caregivers of the patients with MS.

A composite measure of personal financial burden among patients with stage III colorectal cancer.

Despite improved survival with chemotherapy for stage III colorectal cancer (CRC), patients may suffer substantial economic hardship during treatment. Methods for quantifying financial burden in CRC patients are lacking. To derive and validate a novel patient-reported measure of personal financial burden during CRC treatment. Within a population-based survey of patients in the Detroit and Georgia Surveillance, Epidemiology and End Results regions diagnosed with stage III CRC between 2011 and 2013, we asked 7 binary questions assessing effects of disease and treatment on personal finances. We used factor analysis to compute a composite measure of financial burden. We used χ tests to evaluate relationships between individual components of financial burden and chemotherapy use with χ analyses. We used Mantel-Haenszel χ trend tests to examine relationships between the composite financial burden metric and chemotherapy use. Among 956 patient surveys (66% response rate), factor analysis of 7 burden items yielded a single-factor solution. Factor loadings of 6 items were >0.4; these were included in the composite score. Internal consistency was high (Cronbach α=0.79). The mean financial burden score among all respondents was 1.72 (range, 0-6). The 812 (85%) who reported chemotherapy use had significantly higher financial burden scores than those who did not (mean burden score 1.88 vs. 0.88, P<0.001). Financial burden is high among CRC patients, particularly those who use adjuvant chemotherapy. We encourage use of our instrument to validate our measure in the identification of patients in need of additional financial support during treatment.

Anticholinergic medications: an additional contributor to cognitive impairment in the heart failure population?

Patients with congestive heart failure (CHF) have a high prevalence of cognitive impairment and the association is multifactorial. In general, the burden of anticholinergic drugs has consistently been shown to be a risk factor for cognitive impairment in the elderly. The aim of this study was to assess the cognitive burden of medications in patients with CHF. This was a cross-sectional, retrospective, single-center study. The study was conducted in an outpatient setting. Patients who presented to a comprehensive heart failure clinic during a 1-month period were included. The primary outcomes of interest were mean anticholinergic cognitive burden (ACB) score of all medications and CHF medications (ACB-CHF), calculated based on the ACB Scoring Scale (ACB-SS). The ACB-CHF score was further dichotomized as 0 or 1 (low anticholinergic burden) versus 2 or 3 (high anticholinergic burden). A total of 182 patients were included. The mean ACB and ACB-CHF scores were 2.4 (range 0-13) and 1.0 (range 0-4), respectively, while 25.8 % of patients had an ACB-CHF score of 2 or 3. There was no association found between ejection fraction in patients with systolic heart failure and the ACB (p = 0.28) or ACB-CHF (p = 0.62) score. We conclude that patients with CHF have a substantial exposure to anticholinergic medications with adverse cognitive effects. This may be another important contributor to the increased prevalence of cognitive impairment in these patients.

Burden and coping strategies among caregivers of patients with mood disorders

The study aimed to investigate burden and coping strategies among caregivers of patients with mood disorder and examine the relationship between them. A descriptive correlational design was utilized. The study was carried out at inpatient unit at neuropsychiatry and neurosurgical hospital at Assiut University. A convenient sample comprised of 100 caregivers of patients with mood disorder. Tools of study comprised of personal data questionnaire, mood disorder burden index and ways of coping questionnaire. Results: The highest mean scores of burden of exhibited specific behaviors by patients were related to sleeping too much, there were too many thoughts running through patients' head and they were more talkative than usual. The highest mean scores of coping strategies were related to self-controlling, positive reappraisal and seeking social support respectively. Self-controlling, planful problem solving and positive reappraisal were positively and significantly correlated with frequency of exhibited specific behaviors by patients. Conclusion: Caregivers experienced high mean scores of burden related to the frequency of symptoms exhibited by patients. The highest mean scores of coping strategies utilized by them were related to self-controlling, positive reappraisal and seeking social support. Self-controlling, planful problem solving and positive reappraisal were positively and significantly correlated with some of exhibited specific behaviors by patients. Recommendations: Designing and implementing psychoeducational programs are essential for caregivers of patients with mood disorders.

Impact of a Training Program for Caregivers of Neurological Patients on Depression, Prostration, and Subjective Burden

The aim of our study was to examine whether a training program for family caregivers of neurological patients has effects on the relatives' depression, prostration, and subjective burden. Fourteen caregivers who participated in a special training program in a German regional neurological rehabilitation hospital and 14 caregivers in the control group were assessed with the Geriatric Depression Scale, the prostration scale of the Giessen Discomfort Questionnaire, and the Caregiver Burden Scale after admission, before discharge, and 1 month after discharge in a telephone interview. Mean depression, prostration, and burden scores were relatively low in both groups. There were no significant variations of depression scores over time within both groups. We found a significant reduction of prostration scores over the three measurement points in the control group. The decrease of the total burden score within the intervention group had a high effect size. Patients in both groups improved remarkably in their Barthel indices. The low psychological complaints in both groups might be associated with a cohort effect. In elderly caregivers, self-disclosure is regarded more negatively compared with younger people. The remarkable improvement of patients in both groups might have been supported by the presence of their caregivers during rehabilitation.

The relationship of coping style with depression, burden, and life dissatisfaction in caregivers of patients with subarachnoid haemorrhage

To assess the relationship of coping style with depression, burden and life satisfaction in caregivers of patients with subarachnoid haemorrhage. Cross-sectional study. Forty-one primary caregivers of patients with subarachnoid haemorrhage. Caregivers completed several questionnaires within the first year after subarachnoid haemorrhage. Coping style was assessed using the Utrecht Coping List, depression with the Goldberg Depression Scale (GDS), burden with the Sense of Competence Questionnaire, and life satisfaction with the Life Satisfaction Questionnaire. Caregivers had a mean burden score of 37.8 (standard deviation (SD) = 7.4) and a life satisfaction score of 5.0 (SD = 0.6). Nine caregivers (23%) had depressive symptoms (GDS ≥ 2). A palliative coping style was positively associated with the presence of depressive symptoms (odds ratio (OR) = 1.45, p = 0.016). A passive coping style was positively related to burden (ß = 1.61, p = 0.024), adjusted for morbidity of the caregiver (ß = 11.90, p = 0.013), and inversely related to life satisfaction (ß = -0.10, p = 0.025). In caregivers of patients with subarachnoid haemorrhage palliative or passive coping styles are related to depressive symptoms, higher burden and life dissatisfaction. This implies that rehabilitation programmes for patients with subarachnoid haemorrhage should also include caregiver support programmes that focus on coping style.

Burden and psychological challenges in caregivers of children with intellectual disabilities in a child neurology clinic in Lagos, Nigeria

Background:Informal caregivers play an important role but may be strained while providing support for children with Intellectual Disabilities (ID), especially in resource poor nations.Aim:The study aimed to determine the severity of caregiving burden among care givers of children with ID and factors associated with such burden.Methodology:The study was cross-sectional and descriptive in nature and participants (study group) were caregivers of children with ID attending the clinic at the Lagos University Teaching Hospital (LUTH) while the control group were caregivers of children with acute medical illness. Instruments: included a sociodemographic questionnaire, a questionnaire on mothers attitude to mental retardation, the Zarit burden interview (ZBI) and the Zung self-rating depression scale (ZDS).Results:The majority of the caregivers were mothers, 90·6% in the study group and 88·2% in the control group. There were significant differences about the understanding of the illnesses among both cases and controls (P = 0·011). The caregivers in the study group (chronic cases) had higher mean scores than the caregivers in the control group (acute cases) on the Burden Scale. The difference in mean burden scores between the two groups was statistically significant (P = 0·016).Conclusion:There is a significant burden experienced by Caregivers of children with intellectual disabilities in the study location and this should be a focus of attention for health service providers that may be attending to these children.