Predictors Of Caregiver Burden Research Articles

Psychometric properties of the Danish version of the Caregiver Burden Scale: Investigating predictors and severity of burden after stroke, spinal cord injury, or traumatic brain injury.

To investigate (i) psychometric properties of the Danish version of the Caregiver Burden Scale, (ii) predictors of burden in caregivers of persons with stroke, spinal cord injury, or traumatic brain injury, and (iii) severity of caregiver burden, and compare level of severity of burden in caregivers of persons with stroke, spinal cord injury, or traumatic brain injury. Cross-sectional study. Pooled sample of 122 caregivers. Psychometric properties including internal consistency, floor and ceiling effects, inter-item and item-total correlation were investigated using the Caregiver Burden Scale. Severity of burden was compared using Fisher's exact test and ANOVA, and predictors of burden were investigated using multiple linear regression models. The total burden score exhibited good internal consistency (α = 0.93), with no floor or ceiling effects. Longer time as a caregiver was a significant predictor of higher total score. The majority (52.2%) reported a low level of caregiver burden (below cut-off of 2.00). Mean scores on the Caregiver Burden Scale were not significantly different among caregivers across diagnostic groups. Differences were found when comparing spinal cord injury caregivers with brain injury caregivers (traumatic brain injury and stroke, collectively), χ2(2) = 6.38, p = 0.04, as spinal cord injury caregivers were more likely to report low levels of burden. Good psychometric properties were reported, and most caregivers reported a low level of burden, and longer time as a caregiver was associated with higher burden. Consequently, the Caregiver Burden Scale is a valid measure to use when measuring burden in caregivers of stroke, spinal cord injury, and traumatic brain injury patients.

Care Recipient Factors That Predict Caregiver Burden in Older Adult Dyads

As individuals age, changes in their health status and functional level may begin to require caregiving from family caregivers. The role of caregiver can be taxing, a well-established phenomenon known as caregiver burden. While many studies have examined the factors within the caregiver that can be predictive of caregiver burden (or burnout), relatively few have examined the factors of the care recipient that predict caregiver burden. Using a sample of individuals enrolled in the Department of Veteran’s Affairs Home Based Primary Care program, we collected data on demographic, psychological (i.e. mood and cognitive) and nursing (e.g. ADL/IADL, fall risk, etc.) factors. Using stepwise regression modeling, we discovered that only care recipient’s age, IADL impairment, and gender predicted caregiver burden. We discuss possible causes of the relationships and implications for nursing and homecare practice.

SOURCES OF BURDEN IN CAREGIVERS OF PERSONS WITH EARLY- AND LATE-ONSET ALZHEIMER’S DISEASE

Abstract Functional impairment and neuropsychiatric symptoms (NPS) are common in Alzheimer’s disease (AD) and contribute to caregiver burden. Persons with early-onset AD (EOAD) on average experience greater functional impairment and NPS compared to late-onset AD (LOAD), yet their contribution to caregiver burden have not been explored. Objectives were to: 1) compare functional impairment, NPS, and caregiving burden in EOAD and LOAD; 2) identify sources of caregiver burden including functional impairment and NPS in EOAD and LOAD. Caregivers of 85 persons with EOAD (n=63) and LOAD (n=22) completed questionnaires [Functional Activities Questionnaire, Neuropsychiatric Inventory, Zarit Burden Inventory]. T-tests compared group differences in function, NPS, and caregiver burden. Persons with EOAD had greater NPS frequency than LOAD (t= 2.275, p=0.026). There were no significant differences between groups in function or caregiver burden. Multivariate regression analyses were performed in AD groups, with function and NPS frequency as predictors of caregiver burden covarying for age, caregiver sex, and global cognitive function (MMSE). In the total AD sample, the model explained 12.6% of the variance in caregiver burden [F(5,52)=2.64, adjusted R2=0.126; p=0.033] and poor function was a significant predictor (standardized B=0.42, p=0.003) of caregiver burden. In EOAD, the model explained 17% of the variance in caregiver burden [F(5,35)=2.64, adjusted R2=0.17; p=0.04], and poor function was a significant (standardized B=0.42, p=0.015) predictor of caregiver burden; however this was not the case in LOAD. Results suggest poor function predicts caregiver burden in EOAD. Although NPS in EOAD are more frequent, this was not a predictor of caregiver burden.

Predictors of caregiver burden in caregivers of persons with epilepsy with physical disabilities in rural and urban communities in Maharashtra

Predictors of caregiver burden in caregivers of persons with epilepsy with physical disabilities in rural and urban communities in Maharashtra

Dementia Caregiver Burden associated with COVID‐19 quarantine: A South American Cohort Study

AbstractBackgroundIn December 2019, a new virus, Coronavirus disease (COVID‐19/SARS‐CoV‐2), burst into the world. Social distancing reduces its transmission and delays the spread peak. However, because of the late arrival of vaccines to our region, Argentina had a rigorous mandatory preventive social isolation (MPSI) policy that extended beyond global record. As a result, MPSI had a disruptive impact on the actions associated with the well‐being of dementia patients, and caregivers. In addition, MPSI added to the well‐known caregiver burden already present in many dementia patients’ caregivers. This study aims to investigate the impact of MPSI on dementia patients’ caregivers’ mental health and to identify predictors of caregivers’ burden.MethodA sample of 112 caregivers (75.89% female; age 58.65 ± 14.30) of patients with dementia answered a survey with the following questionnaires: Zarit Burden Interview (ZBI), Weekly hourly load dedicated to dementia care, time spent on leisure activities (activity diary provided by Argentine National Institute of Statistics and Census), the Caregiver Activities Survey (CAS) and the Depression, Anxiety and Stress Scale (DASS‐21). These questionnaires evaluate caregiving characteristics and their impact on the caregiver. Additionally, history of COVID‐19 was recorded for patients, caregivers and people living with either of them.ResultMost caregivers were women (75.89%). This difference hindered direct comparison between men and women. A regularized L2 regression was performed and the number of caregiving hours (β = 0.090), depression (β = 0.085), anxiety (β = 0.099), stress (β = 0.164), and fear of COVID‐19 (β = 0.141), were identified as predictors of caregiver burden. Finally, a mediation analysis was also performed, and hours of care (CAS; r = 0.254), being the primary caregiver, and fear of COVID‐19 (r = 0.335) were identified as mediators of the effect between anxiety, depression, stress (DASS) and burden (ZBI).ConclusionCaregivers of dementia patients show sequelaes of anxiety, stress, depression, and caregivers’ burden in the context of COVID‐19 spread and during MPSI. Being a primary caregiver, dedicating more hours to caregiving, and fear of COVID‐19 are factors that contribute significantly to caregiver burden and mediate between this burden and mood variables. Relief of caregivers' burden could be aided by the design of public health policies that specifically address the mediators identified in this study.

Explorations of Caregiver Health and Well‐Being

AbstractBackgroundRecent projections have found that the global prevalence of dementia is expected to grow rapidly through 2050, rising from an estimated 57.4 million cases in 2019 to an estimated 152.8 million cases by 2050. This has alarming public health consequences, as dementia takes a toll socially, emotionally, and financially, with a global societal cost of $1.3 trillion dollars in 2019. Caregivers are at the forefront of this crisis, with more than 11 million individuals in the US providing unpaid care for individuals with dementia, estimated at 16 billion dollars worth of care/year. Studies investigating the factors that impact caregiver burden are lacking. This study aims to 1) qualitatively examine caregiver burden and quality of life (QoL) 2) identify/highlight factors that might provide support and/or improve caregiver QoL.MethodThis is a qualitative, cross‐sectional study that will use a series of interviews and questionnaires to collect data. The studies will be created on, and deployed using, Qualtrics software, a commonly used platform for survey studies.ResultPrevious research suggests that factors impacting caregiver burden and QoL will be highly individualized across demographics such as socioeconomic status and race, and that QoL will be, on average, lower among caregivers as a group compared to the general population. We hypothesize that engagement in various lifestyle factors, particularly those that are self‐focused, regardless of amount of time spent on them, will correlate with higher QoL and lower caregiver burden scores.ConclusionThe factors that predict caregiver burden and quality of life are an important and often under‐examined part of dementia care. This study, expected to be completed in Spring 2023, will contribute to the current understanding of caregiver’s experiences, and provide practical ideas to help increase QoL and reduce burden.

Caregiving Preparedness and Caregiver Burden in Omani Family Caregivers for Patients with Acquired Brain Injury

Objectives: This study aimed to explore the caregiving preparedness and caregiver burden among Omani family caregivers (FCs) of patients with acquired brain injury (ABI). Methods: This prospective observational study was conducted at the neurology clinic at Khoula Hospital, Muscat, Oman, from April 2019 to December 2021. Data were collected from 119 FCs and their patients at the time of discharge from the hospital and 16 weeks post-discharge during follow-up care. The questionnaire comprised the Zarit Burden Index, the Preparedness for Caregiving Scale, the Short-Form-12 Health Survey, and a patient symptom scale. Results: The FCs were predominantly female (53.8%), and the mean age was 38.27 ± 9.11 years. Most patients had moderate to severe ABI (95.8%) due to stroke (56.3%) and trauma (30.3%). The most common patient symptoms were loss of muscle strength, speech problems, mood problems, memory loss, and change in behaviour. Most FCs were found to have low caregiving preparedness (58%) at discharge, and 19.1% were found to have a high level of caregiver burden at 16 weeks post-discharge. The length of time post-injury (P <0.01), symptom severity (P <0.01) and the FCs’ physical and mental health status (P <0.01 each) were found to be significant predictors of caregiving preparedness, whereas caregiver preparedness (P <0.01), symptom severity (P <0.01), and caregivers’ mental health (P = 0.028) were seen as the predictors of caregiver burden. Conclusion: Omani FCs of patients with ABI tend to commence the caregiver role with inadequate preparation, and shortly after, a significant number suffer high caregiver burden. Interventions focusing on the caregiver’s health and training in symptom management may improve the outcomes of FCs and patients. Keywords: Acquired Brain Injury; Caregiver Burden; Caregivers; Family; Rehabilitation; Traumatic Brain Injuries; Oman.

16 Relative Contributions of Motor and Non-Motor Symptoms to Caregiver Burden in Parkinson’s Disease Patients Being Evaluated for Deep Brain Stimulation

Objective:Parkinson’s disease (PD) is a neurodegenerative disorder affecting over 10 million people worldwide. PD is characterized by both motor (e.g., tremor, rigidity, and bradykinesia) and non-motor (including cognitive impairment and neuropsychiatric symptoms such as apathy, disinhibition, executive dysfunction) symptoms. Caregiver burden is prevalent in those providing care for patients with PD and can result in negative health complications. Past work shows associations between motor symptoms, cognitive impairment, neuropsychiatric symptoms, and caregiver burden in PD. However, their relative contributions are poorly understood. This study examined these relationships, hypothesizing that while motor symptoms, cognitive impairment, and neuropsychiatric symptoms would all affect caregiver burden, neuropsychiatric symptoms would predict burden above and beyond the contribution of the other factorsParticipants and Methods:Participants were 42 people living with PD who were assessed at a hospital-based tertiary movement disorders specialty clinic for deep brain stimulation (DBS) candidacy evaluation with their caregiver. Motor exam was assessed by a PD specialist using the Unified Parkinson’s Disease Rating Scale (UPDRS). The Mini Mental State Examination (MMSE) assessed global cognition. Frontal Systems Behavior Scale (FrSBe) Family Form captured caregiver ratings of neuropsychiatric symptoms under 3 subscales: apathy, disinhibition, and executive dysfunction. The Multidimensional Caregiver Strain Index (MCSI) captured caregiver burden. Linear regression analyses examined relationships between caregiver burden (MCSI) and motor symptoms (UPDRS), cognitive impairment (MMSE), and neuropsychiatric symptoms (FrSBe).Results:Using linear regression analyses, cognitive impairment (R2=0.08, F(1,41)=4.42, p=0.04) and neuropsychiatric symptoms (R2=0.35, F(1, 41)=21.0, p<0.01) predicted caregiver burden but motor symptoms did not (R2=0.03, F(1,41)=1.30, p=0.26). Hierarchical linear regression revealed that neuropsychiatric symptoms predicted caregiver burden above and beyond the contribution of cognitive impairment (AR2=0.28, AF(1)=12.7, p=0.001), accounting for an additional 28% of the variance in caregiver burden. Follow-up linear regression to examine the relationships between caregiver burden and the FrSBe subscales indicated that apathy (p<0.001), versus disinhibition (p=0.16) and dysexecutive behaviors (p=0.80), was the driver of the significant relationship.Conclusions:Consistent with our hypothesis, results revealed that cognitive impairment and neuropsychiatric symptoms (specifically apathy) were independent predictors of caregiver burden, with neuropsychiatric symptoms predicting caregiver burden above and beyond the contribution of cognitive impairment. Somewhat surprisingly, motor symptoms were not a predictor of caregiver burden contrary to some previous research, though findings are mixed. Results highlight the importance of assessing for neuropsychiatric symptoms in PD, which may be overlooked by care providers relative to motor or cognitive symptoms, but which appear stressful to caregivers. Future directions include reexamining results in a larger more heterogenous sample including people living with PD at different disease stages (i.e., everyone in the present sample had severe enough symptoms to be considering DBS). Cognitive measures of executive functioning (which are more specific to PD than measures of global cognition) should also be included in future works. Development of supportive caregiver interventions specifically targeting apathy in PD may be useful. Longitudinal designs would be helpful to reexamine relationships following DBS surgery, as there are some reports of increased neuropsychiatric symptoms following the procedure.

Predictors of caregiver burden among primary caregivers of cancer patients at Hawassa oncology center Northern, Ethiopia, 2022: institution-based cross-sectional study

BackgroundApproximately 60,960 people are diagnosed with cancer each year, and more than 44,000 people die from it. Family caregivers face a range of difficulties because cancer affects many facets of life, such as nursing care, communication, financial issues, and emotional conflicts. Consequently, family caregivers are more susceptible to developing demanding physical and mental conditions. Despite these problems, cancer remains the most neglected and underfunded health problem in Ethiopia. Therefore, this study aimed to assess the caregiver burden experienced by family caregivers of patients with cancer; as well as its associated factors.MethodsAn institutional-based cross-sectional study was employed among 347 family caregivers of cancer patients who attended Hawassa University Comprehensive Specialized Hospital Oncology Center from May 30 to July 30, 2022. The data were checked for completeness and consistency and then coded. The coded data were entered into Epi-data version 4.6 and then exported into Statistical Package for Social Science (SPSS) version 25 for analysis. The caregiver’s burden was assessed by a short form of Zarit burden Interview. The explanatory variables, like clinical and care-related factors, were assessed by a structured questionnaire. Family caregivers’ perceptions of social support were assessed by the multidimensional scale of perceived social support. Binary logistic regression was used to assess the strength of the association between outcome and explanatory variables. Each explanatory variable was entered separately in the bivariate analysis, and a variable with a p-value less than 0.25 goes further for multivariate analysis to control the possible confounding. The statistical significance of the factors influencing the outcome variable was declared in multivariate logistic regression analysis using an adjusted odds ratio at a 95% confidence interval when a p-value < 0.05.ResultsThe response rate of the caregiver was 100%. This study reported that 66.6% (95% CI 61.5–71.5) of the caregivers had a high caregiver burden. Being female, caring hours, previous history of hospitalization, and sleeping hours were significantly associated with the caregiver’s burden.ConclusionIn this finding, more than two-thirds of the caregivers had a higher caregiver burden. This suggested that there is a need to focus on and give more attention to caregivers to decrease their burden by including caregiver burden in routine nursing activities by the oncology unit, and further study should be done at the national level using other study designs.

Direct and Indirect Predictors of Burden in Arab-Bedouin and Jewish-Israeli Mothers Caring for a Child with Epilepsy.

Caring for a child with epilepsy poses various psychological, physical and medical challenges; these can lead to caregiver burden. The aim of this study was to identify predictors of burden with mothers caring for a child with epilepsy. Our analyses included sociodemographic (e.g., ethnicity), mental health (e.g., symptoms of anxiety, depression) and physiological factors (e.g., extent of pharmacotherapy). A total of 168 mothers caring for a child with epilepsy were recruited while attending the Pediatric Neurology Clinic at Soroka Medical Center, Be'er Sheva, Israel. This cross-sectional sample included 130 Jewish-Israeli and 38 Arab-Bedouin mothers who completed parallel questionnaire batteries that included the Zarit Burden Interview and other scales translated and validated in Hebrew and Arabic. We computed path analyses to identify both direct and indirect predictors of caregiver burden. Burden was directly predicted by emotional exhaustion, symptoms of anxiety and (Bedouin) ethnicity. Indirect effects on burden included illness severity (via emotional exhaustion), ethnicity and emotional exhaustion (both via anxiety). That is, both ethnicity and emotional exhaustion directly and indirectly predicted caregiver burden via greater anxiety. Illness severity indirectly predicted symptoms of depression, anxiety and caregiver burden. We found that 55% of epilepsy care burden was predicted by this path model. Bedouin mothers reported greater illness severity, symptoms of depression, anxiety and caregiver burden. Differences between groups in epilepsy severity suggest that less severe cases in the Bedouin community do not come to clinical attention (e.g., are concealed due to stigma). These findings underscore the need for health promotion strategies and interventions for caregivers tailored to account for ethnic and cultural differences.

Exploring factors contributing to caregiver burden in family caregivers of congolese adults with suspected dementia.

Predicting caregiver burden in individuals with suspected dementia - is critical due to the debilitating nature of these disorders and need for caregiver support. While some examination of the factors affecting burden has been undertaken in Sub-Saharan Africa, each country presents with its own unique challenges and obstacles. This pilot study investigates predictors of caregiver burden in family caregivers of individuals with suspected dementia living in the Democratic Republic of the Congo (DRC). Linear and multiple regression analyses were conducted to explore factors associated with caregiver burden in 30 patient-caregiver dyads with the Zarit Burden Interview (ZBI) for caregiver burden evaluation. Cognitive impairments of patients were assessed using the Community Screening Instrument for Dementia, Alzheimer's Questionnaire (AQ), the African Neuropsychology Battery, and the Neuropsychiatric Symptoms Inventory (NPI). Average caregiver burden on the ZBI was 36.1 (SD=14.6; range=12-58). Greater impairments in patient cognition (orientation, visuospatial, memory, executive functioning), fragility, and neuropsychiatric symptoms (delirium, agitation, depression) were predictive of caregiver burden. After controlling for AQ scores and caregiver gender, greater symptoms of depression, and worse performances on verbal memory and problem solving were associated with greater caregiver burden. Worsening patient fragility, cognition, functioning, and neuropsychiatric symptoms influenced caregiver burden in caregivers of individuals with suspected cognitive impairment in the DRC. These findings are consistent with the prior literature. Future studies may wish to explore supportive factors and caregiver specific characteristics that buffer against perceived burden.

Caregiver Preparedness: A Therapeutic Mechanism and Moderating Factor on Outcomes for the Savvy Caregiver Program

ABSTRACT Objectives Evidence-based interventions for dementia caregivers, such as the Savvy Caregiver Program (SC), seek to address skills and knowledge deficits, caregiver burden, depressive symptoms, and grief. Little research has examined mechanisms by which these interventions accomplish their goals. Caregiver preparedness may be a possible mechanism by which caregiver interventions may confer benefits. Methods The sample included 76 dementia caregivers who completed the 6-session SC. Participants completed the Anticipatory Grief Scale, Center for Epidemiological Studies-Depression Scale, the Preparedness for Caregiving Scale, and the Zarit Burden Interview-Short Form. Results A repeated measures ANOVA was utilized to determine the interaction between baseline scores and pre-post change in caregiver preparedness. Analysis significantly predicted caregiver burden, (F (1) = 6.68, p=.012, partial η 2 =.10), depressive symptom endorsement, (F (1) = 6.41, p=.014, partial η 2 =.09, and anticipatory grief, (F (1) = 6.22, p=.02, partial η 2 =.1), post-treatment. Conclusions Pre-post change in caregiver preparedness significantly predicted pre-post change across measures of caregiver burden, depressive symptom endorsement, and anticipatory grief. Findings suggest that caregiver preparedness may be one mechanism by which the SC confers positive outcomes. These findings provide an empirical and theoretical basis for tailoring future dementia caregiver interventions. Clinical Implications Clinical Interventions may seek to improve caregiver preparedness and subsequent outcomes through utilization of programs like SC.

Effects of general change mechanisms on outcome in telephone-based cognitive-behavioral therapy for distressed family caregivers.

The study investigated the influence of general change mechanisms (GCMs) on outcome in telephone-based cognitive-behavioral therapy (CBT) for family caregivers. In a stepped-care intervention approach, highly distressed family caregivers received telephone-based CBT after completing a care counseling intervention. Sixty-sixtherapist-caregiver dyads rated emotional bond, agreement on collaboration, problem actuation, resource activation, clarification of meaning, and mastery after each of 12 therapy sessions. Outcomes were caregiver burden (SCQ-AV) and depression (CES-D) after therapy. Associations of GCMs with outcome were examined in multilevel regression models. Caregiver burden was significantly predicted by caregiver-rated emotional bond (β = -0.18) as well as therapist-rated resource activation (β = -0.26), problem actuation (β = -0.22), clarification of meaning (β = -0.18), and mastery (β = -0.18). None of the GCMs predicted depression from any perspective. The findings suggest that GCMs are relevant for reducing caregiver burden in CBT for family caregivers and should be fostered in treatment manuals, in particular therapist-rated GCMs. Since therapist and caregiver perspectives differed in predicting caregiver burden, future research should investigate perspective congruence and its effect on therapy outcome.

Caregiver burden according to ageing and type of care activity in caregivers of individuals with spinal cord injury.

To describe caregiver burden according to the caregivers' general characteristics, especially with ageing, and type of care activities provided by caregivers of individuals with spinal cord injury. A cross-sectional study was conducted utilizing a structured questionnaire that included general characteristics, health conditions, and caregiver burden. A single center study in Seoul, Korea. Participants were recruited from 87 individuals with spinal cord injuries and 87 caregivers. The Caregiver Burden Inventory was used to assess caregiver burden. Caregiver burden was significantly different by age (p = 0.001), relationship (p = 0.025), sleep hours (p = <0.001), underlying disease (p = 0.018), pain (p = <0.001), and daily activities of individuals with spinal cord injury (p = 0.001). Caregiver's age (B = 0.339, p = 0.049), sleep duration (B = -2.896, p = 0.012) and pain (B = 2.558, p < 0.001) predicted caregiver burden. Toileting assistance was the most challenging and time-consuming for caregivers, while patient transfer was associated with the greatest concerns for body injury. Caregiver education should be targeted according to caregiver's age and type of assistance. Social policies need to be developed to distribute devices and care-robots to reduce caregiver burden and thereby assist caregivers.

Burden of Family Caregivers of Patients with Oral Cancer in Home Care in Taiwan.

Oral cancer is currently the fourth leading cause of cancer-related death in Taiwan. The complications and side effects of oral cancer treatment cause a tremendous burden on patients' family caregivers. This study explored the burden on primary family caregivers of patients with oral cancer and its related factors. One hundred and seven patients with oral cancer and their primary family caregivers were included through convenience sampling. The Caregiver Reaction Assessment (CRA) scale was employed as the primary research instrument. The primary factors of caregiver burden, in descending order, were disrupted schedules (M = 3.19, SD = 0.84), a lack of family support (M = 2.82, SD = 0.85), health problems (M = 2.67, SD = 0.68), and financial problems (M = 2.59, SD = 0.84). The CRA scores of the caregivers differed significantly in terms of education level (t = 2.57, p < 0.05) and household income (F = 4.62, p < 0.05), which significantly predicted caregiver burden (R2 = 0.11, F = 4.32, p = 0.007). The study results provide a reference for healthcare professionals to identify the factors for family caregiver burden, as well as the characteristics of patients and family caregivers particularly vulnerable to caregiver burden, thus improving family-centred care.

Factors Influencing Caregiver Burden among Family Caregivers of Post-Stroke Persons in Wenzhou, China

Providing care to post-stroke persons who are dependent at home may lead to a burden for the family caregivers and there are various factors influencing the burden. This predictive correlational study aimed to examine the caregiver burden at three months after providing care for post-stroke persons and examine whether caregiver health status, caregiver amount of caregiving activities, and caregiver mutuality can predict caregiver burden at three months after providing care for the post-stroke persons in Wenzhou, China. A simple random sampling was used to recruit 101 family caregivers who took the patients to follow-up at the outpatient department of the First Affiliated Hospital of Wenzhou Medical University in China. Data were collected using questionnaires including the demographic questionnaire, The SF-12 Health Survey Version 2, The Caregiving Activities Scale, The Mutuality Scale, and The 12-item Zarit Burden Interview. Data were analyzed using descriptive statistics and standard multiple regression. The results showed that the family caregiver burden was at a mild to moderate level with a mean score of 18.29 (SD = 4.9). Standard multiple regression revealed health status (β = -.30, p &lt; .001), caregiver amount of caregiving activities (β = .24, p &lt; .001), caregiver mutuality (β = -.38, p &lt; .001) as the predictor of caregiver burden. The findings provided information for developing an appropriate nursing intervention to prevent progressive caregiver burden, and, in turn, will enable post-stroke persons to receive effective care by targeting caregiver health status, caregiver amount of caregiving activities, and caregiver mutuality.

Predictors of caregiver burden before starting family-based treatment for adolescent anorexia nervosa and associations with weight gain during treatment

PurposeCaregivers play a pivotal role in the success of family-based treatment (FBT) for anorexia nervosa (AN). Caregiver burden is frequently demonstrated in eating disorders (EDs) and may impact FBT outcomes. This study examined factors associated with caregiver burden before starting FBT and whether pre-treatment caregiver burden was associated with weight gain during FBT.MethodsParticipants included 114 adolescents with AN or atypical AN (mean age = 15.6 years, SD = 1.4) and a primary caregiver (87.6% mothers) who received FBT in the United States. Before starting treatment, participants completed self-report measures of caregiver burden (via the Eating Disorder Symptom Impact Scale), caregiver anxiety, caregiver depression, and ED symptoms. Clinical characteristics and percentage of target goal weight (%TGW) at FBT session 1 and 3 and 6 months after starting treatment were obtained via retrospective chart review. Hierarchical regressions examined predictors of caregiver burden before FBT initiation. Associations between pre-treatment caregiver burden and %TGW gain at 3 and 6 months after starting FBT were assessed with hierarchical regressions.ResultsCaregiver anxiety (p < 0.001), family history of EDs (p = 0.028), adolescent mental health treatment history (p = 0.024), and ED symptoms (p = 0.042) predicted caregiver burden before starting FBT. Pre-treatment caregiver burden was not associated with %TGW gain at 3 or 6 months. Males demonstrated less %TGW gain than females at 3 months (p = 0.010) and 6 months (p = 0.012).ConclusionProactively evaluating caregiver burden before starting FBT is suggested. Providing recommendations and/or referrals for identified caregiver vulnerabilities could indirectly impact FBT progress. Males in FBT could require longer courses of treatment and extra vigilance to this demographic is suggested.Level of evidence: Level III, case–control analytic study.

Caregiver Burden in Informal Caregivers of Patients in Saudi Arabia Receiving Hemodialysis: A Mixed-Methods Study.

(1) Background: Long-term caregiving for patients receiving hemodialysis (HD), is associated with physical and psychological stress, which may impact on the well-being and quality of life of caregivers. Due to a lack of understanding of the experiences of informal caregivers of patients receiving HD, especially in Saudi Arabia, this study aimed to measure burden in informal caregivers of patients receiving HD, examine the factors that predict caregiver burden (CB), and explore the experience of burden in caregivers of patients receiving HD. (2) Methods: This study used a mixed-methods, sequential, explanatory design, which consisted of two phases. Phase 1 involved a cross-sectional study design, with a convenience sample of 61 caregivers of patients on maintenance HD for at least 3 months. All caregivers in the study completed the Arabic version of the Zarit Burden Interview to identify caregiver burden. Phase 2 of the study involved a qualitative descriptive design involving semi-structured interviews with nine caregivers. (3) Results: Study findings indicate that caregivers did not experience severe burden. Being older, a female caregiver and having comorbidities was positively associated with increased levels of caregiver burden. In the qualitative phase of the study, a number of important factors emerged that may contribute to a reduction in caregiver burden, including social support, cultural acceptance, and religious influences. (4) Conclusion and impact: CB was found to be low when a comparison was made with other studies using similar populations. Understanding the factors that influence caregiver burden will contribute to the accurate assessment of caregiver burden and help reduce burden in informal caregivers, patients with renal failure, and others with chronic illnesses worldwide.

Predictors of female caregivers’ burden: An estimated conceptual model in low income settings

Globally, there has been increasing interest in the study of caregiving. Female caregiver predictors or mediators and a multidimensional female caregiver burden (FCG burden) model that incorporates environmental hygiene factors such as toilet hygiene and kitchen are lacking, particularly in low- and middle-income countries. This study evaluates caregiver burden predictors and provides a multidimensional model of unremunerated care burden for family practice and policy in two different population group communities in Cape Town, South Africa. A systematic random sampling (SRS) procedure was employed, and 100 black or African and 100 mixed race female caregivers in two different cultural communities were selected for a reliable cross-section. A questionnaire was used to solicit caregiver burden information. The average age of the female caregivers was 47.9 years (standard deviation [SD] = 11.7 years). About 49.0% of the selected participants were older than 50 years. There was a significant relationship between environmental health (kitchen hygiene and toilet hygiene). Social grant receipt and physical health status of care recipients were predictors of caregiver burden. The overall model explained the largest variation (43.4%) in caregiver burden. This study recommends an increase in the social grants given to caregivers. National health policies should reflect female caregivers’ circumstances.Transdisciplinarity Contribution: This article contributes to the improvement in community health.

Burden in primary informal caregivers of children and adolescents with type 1 diabetes: Is it associated with depression, family dysfunction, and glycemic control?

The requirement of a chronic treatment and the increase in life expectancy in children with type 1 diabetes (T1D) leads to the possibility of caregiver burden. The aim of our study was to evaluate the burden in primary informal caregivers (PIC) of children and adolescents with type 1 diabetes and its association with depression, family dysfunction, and glycemic control. A retrospective study was performed in PIC of children and adolescents with T1D. Zarit Burden Interview Scale (ZBIS) was used to evaluate caregiver burden. Beck Depression Inventory (BDI-II) was used to evaluate depression in PIC, and the Family APGAR questionnaire was used to evaluate the family functionality. A total of 100 PIC of children and adolescents with T1D were included. Caregiver burden was found in 33% of caregivers. The total score of the Zarit scale was 41 (34-49); 19% had mild caregiver burden, and 14% had severe caregiver burden. According to the BDI-II, 82% had minimal depression, 11% mild depression, 5% moderate depression, and 2% severe depression. Family function was good in 69%; 13% had moderate dysfunction, and 18% had severe dysfunction. A positive correlation between caregiver burden and BDI-II score (r = 0.84; p = 0.001) and the grade of depression (r = 0.87; p = 0.001) was found. A logistic regression model showed that BDI-II score was associated with caregiver burden (OR 1.14; 95% CI 1.061-1.23; p = 0.001). A BDI-II cut off of 9 or more had a sensibility and specificity of 58% and 28%, respectively, for caregiver burden [AUC 0.751 (0.64-0.85); p = 0.001]. A BDI-II score ≥9 was a predictor of caregiver burden (OR 3.4; 95% CI 1.4-8.1; p = 0.008). Caregiver burden is present in more than one third of the PIC of patients with T1D and is associated with depression. A BDI-II score ≥9 is a predictor of caregiver burden which may be a point to take into account in the integral approach to the patient with T1D and his or her family nucleus.