Caregiver Psychological Distress Research Articles

Effect of a Compassion Cultivation Training Program for Caregivers of People With Mental Illness in Denmark

Caregivers of people with mental illness are at increased risk of developing depression, anxiety, and stress. To investigate the effect of a compassion cultivation training (CCT) program on decreasing caregiver psychological distress. This waitlist-controlled randomized clinical trial was conducted in 2 different community settings in Denmark. Caregivers were excluded if they had a diagnosed and untreated mental illness, addiction, meditation practice, or current psychotherapeutic treatment. Enrollment occurred between May 2018 and March 2019. A repeated measurement model was used to examine the impact of the intervention. The primary analysis was based on the intention-to-treat principle. Data analysis was conducted from June 4 to July 7, 2020. Participants were randomized 1-to-1 to an 8-week CCT course or waitlist control. Block randomization was used with 40 participants in each block. The main outcome was reduction in psychological distress, as measured by the Depression, Anxiety, Stress Scale (DASS). Baseline, postintervention, and 3- and 6-month follow-up measurements were collected. Among 192 participants assessed for eligibility, 161 participants were included in the study (mean [SD] age, 52.6 [12.5] years; 142 [88.2%] women), with 79 participants randomized to the CCT intervention and 82 participants in the waitlist control group. At baseline, the mean (SD) DASS scores for the intervention vs control groups were 10.89 (8.66) vs 10.80 (8.38) for depression, 6.89 (6.48) vs 6.68 (5.33) for anxiety, and 14.96 (7.90) vs 15.77 (7.40) for stress. The CCT group experienced statistically significant improvement in the primary outcome in mean change from baseline vs the control group at postintervention (adjusted mean difference: depression, -4.16 [95% CI, -6.75 to -1.58]; P = .002; anxiety, -2.24 [95% CI, -3.99 to -0.48]; P = .01; stress, -4.20 [95% CI, -6.73 to -1.67]; P = .001), the 3-month follow-up (adjusted mean difference: depression, -3.78 [95% CI, -6.40 to -1.17]; P = .005; anxiety, -2.50 [95% CI, -4.27 to -0.73]; P = .006; stress, -3.76 [95% CI, -6.32 to -1.21]; P = .004), and the 6-month follow-up (adjusted mean difference: depression: -4.24 [95% CI, -6.97 to -1.52]; P = .002; anxiety, -2.12 [95% CI, -3.96 to -0.29]; P = .02; stress: -3.79 [95% CI, -6.44 to -1.13]; P = .005). These findings suggest that CCT was superior to the waitlist control in supporting caregivers' mental health. Statistically and clinically significant reductions in psychological distress were found and sustained at the 6-month follow-up. The improvements noted in this randomized clinical trial could serve to encourage implementation of future evidence-based programs for caregivers. ClinicalTrials.gov Identifier: NCT03730155.

Psychological Distress among Caregivers of Children with Neurodevelopmental Disorders in Nepal.

Parenting a child with neurodevelopmental disorder (NDD) is related to a higher rate of anxiety and depression, increased stress, and reduced quality of life. Although there is reason to believe that parenting children with NDD in low- and middle-income countries (LMIC) can be challenging, there is a lack of knowledge on the psychological distress among these caregivers, especially in rural areas. The aim of the study was to examine the psychological distress among caregivers having children with NDD in rural Nepal. Sixty-three caregivers were visited in their homes and interviewed by experienced mental health professionals. This study examined demographic information, severity of disability, perceived caregiver burden, and psychological distress, measured by the General Health Questionnaire-12 (GHQ-12). The study found a high level of psychological distress in the caregivers (M = 5.38, SD = 2.8). A majority (90.5%) scored two or higher, indicating the presence of a common mental disorder (CMD). Almost half (46%) scored six or higher, indicating a high level of distress. A majority of the caregivers reported that caring for their disabled child had a negative effect on the caregiver’s economy (70%), physical health (65%), social life (64%), and dreams and expectations for the future (81%). There was a significant relationship between the caregiver’s psychological distress (GHQ-12) and degree of disability in the child (Gross Motor Function Classification System), degree of caregiver burden, feeding problems, having health workers as a possible source of help, receiving incentive from the government, having somebody to confide in, and caregiver illiteracy. A forward regression analysis entering the significant factors indicated that caregiver burden, having someone to confide in, and having health workers as a possible source of help were significant related to psychological distress. The final step of the model explained 42.4% of the variance in psychological distress among the caregivers. The study indicates a high level of psychological distress and high overall burden in caregivers of children with NDD in rural Nepal. Further implications for research and service development are discussed.

A novel behavioral health program for family caregivers of children admitted to a transitional chronic ventilator unit.

The care of mechanically ventilated pediatric patients is complex and burdensome. It is essential to adequately support the family caregivers of these children to optimize outcomes; however, there is no literature describing interventions for caregivers in this population. This study described a novel behavioral health program and examined its impact on family caregiver engagement and psychological distress on a pediatric inpatient chronic ventilator unit. Electronic chart review was completed with retrospective and prospective participant enrollment for the purposes of longitudinal evaluation of caregiver engagement. For analytic purposes, participants were grouped into three categories: (1) preprogram, (2) postprogram, and (3) postprogram with completion of psychotherapy. The behavioral health program was associated with increased caregiver participation in rounds, t = 7.76, p = < .001. Parents who completed a course of psychotherapy within the behavioral health program demonstrated reduced time to training completion (F = 5.89; p < .01), higher staff-rated caregiver engagement (F = 3.69; p < .05), and significantly reduced levels of caregiver distress (t = 2.09; p < .05).

Experience of psychological distress and the level of resilience by adolescent as care giver in palliative care: A qualitative analysis in the context of hospitalisation

Summary Objective Most health providers are still focusing on the patients while caregivers are dying within them. This has made most of the caregivers to suffer from psychological problem such as distress. Distress without support will lead to mental illness in the future. The present work had an objective to analyse the factors of psychological distress in caregivers of hospitalized patients in palliative care while evaluating the level of resilience associated with it. Participants/Method The study was carried out on a sample of 09 adolescents. It was a qualitative and descriptive study with a diagnostic dimension conducted over a period of 10 months from June 2019 to April 2020. The evaluation was done by the use of an interview guide, three diagnostic scales K 6-Distress Scale, post-traumatic stress checklist scale, and Connor Davidson resilience scale questionnaires for participants to respond and also for a face-to-face interview. Result The analysis of the clinical interview allows the conception of caregivers sympathy toward the patients, the absence of support from the family members, and the experience of stressful events, initially was the origin of their distress. Most of the caregivers’ distress was associated proportionally to resilience due to the support from family members while those without support from the family members was vice visa. Conclusion The palliative caregiver had a source of resilience that is activated within them to deal with their distress. However, the health staff must give this caregiver a little more attention alongside with the patients in order to improve the level of resilience activation.

Factors associated with resilience in spousal caregivers of patients with cancer: An integrative review.

AimTo explore resilience and associated factors in spousal caregivers of patients with cancer.DesignAn integrative review.MethodsThis review used the standardized critical appraisal instruments developed by the Joanna Briggs Institute and was conducted by researching the electronic databases of Cochrane, CINAHL, ProQuest, Science Direct, PubMed, Scopus, EBSCO and Google Scholar. The articles were published in English with full text from January 2010 to January 2020.ResultsAccording to data retrieval, 26 articles were finally selected. From this review, resilience was typically measured by using exact resilience scales (i.e. Connor‐Davidson or Wagnild Resilience Scales) or using other variables to indicate either more positive psychological outcomes or less negative psychological outcomes. For factors associated with resilience, these were classified as individual internal and external factors. Internal factors included caregiver burden, psychological distress, coping strategies and other factors, whereas social support, couple interaction, patient health status and other parameters were considered external factors.ConclusionsResilience plays an important role in promoting positive adaptation in spite of adversity among the spousal caregivers of patients with cancer. Due to the uniqueness of resilience among spousal caregivers, ways to assess resilience and identify its associated factors deserve more attention and careful consideration.

Attachment to Peers and School: Longitudinal Moderators of the Relation Between Caregiver Psychological Distress and Adolescent Hopelessness.

Research has yet to determine how relationships outside of the family system may buffer negative outcomes associated with hopelessness among racial minority youth. In a sample of Black American youth (N = 512; 49% females) and their parents or caregivers, this study used longitudinal growth models to explore whether youth relationships (attachment to peers and attachment to school) moderated the association between caregiver distress (depressive symptoms and traumatic stress), and youth hopelessness. Adolescents' gender was examined to determine if there were gender differences present in these associations. Four linear growth models showed a significant change in levels of hopelessness over time for youth and a significant positive relation between caregiver distress and youth level of hopelessness. Attachment to peers and attachment to school did not equally moderate the relation between caregiver psychological distress and youth hopelessness. The type of caregiver distress had a differential effect on youth hopelessness in the context of the moderation models and based on gender. The type of caregiver distress had a differential effect on youth hopelessness in the context of the moderation models and based on gender. Implications for the importance of non-familial attachments among Black American youth with distressed parents are discussed.

Neuropsychiatric Symptoms in Patients with Dementia Associated with Increased Psychological Distress in Caregivers During the COVID-19 Pandemic.

The social isolation imposed by COVID-19 pandemic can have a major impact on the mental health of dementia patients and their caregivers. We aim to evaluate the neurological decline of patients with dementia and the caregivers' burden during the pandemic. We performed a cross-sectional study. Caregivers of dementia patients following in the outpatient clinic were included. A structured telephone interview composed of the Neuropsychiatric Inventory Questionnaire (NPI-Q), Zarit Burden Interview (ZBI), Beck Depression (BDI) and Anxiety (BAI) Inventories to address cognitive, behavioral, and functional changes associated with social distancing during the Sars-Cov-2 outbreak. Patients were divided in two groups according to caregivers' report: with perceived Altered Cognition (AC) and Stable Cognition (SC). A total of 58 patients (median age: 57 years [21-87], 58.6%females) and caregivers (median age: 76.5 years [55-89], 79.3%females) were included. Cognitive decline was shown by most patients (53.4%), as well as behavioral symptoms (48.3%), especially apathy/depression (24.1%), and functional decline (34.5%). The AC group (n = 31) presented increased behavioral (67.7%versus 25.9%, p = 0.002) and functional (61.3%versus 3.7%, p < 0.001) changes when compared to the SC group. In the AC group, ZBI, BDI, NPI-Q caregiver distress, and NPI-Q patient's severity of symptoms scores were worse than the SC group (p < 0.005 for all). Patients' neuropsychiatric worsening and caregiver burden were frequent during the pandemic. Worsening of cognition was associated with increased caregivers' psychological distress.

Protective and risk factors predicting caregiver psychological distress in people with advanced Parkinson's disease

Neurological diseases are one of the main contemporary challenges in advanced societies. Parkinson's disease (PD) is one of the most common neurological diseases causing disability. It is a health problem associated with a decrease in personal autonomy. It causes an imbalance in family functioning, with a negative impact on quality of life. The objective was to identify risk factors associated with the psychological burden of the caregiver. Prospective ex post facto research conducted with a sample of 106 caregivers of persons with PD, who were administered a socio-demographic questionnaire, the NEO-FFI (personality) and COPE-28 (coping strategies) inventories, and an adaptation of the Katz index to assess involvement in care. A structured diagnostic instrument (CORE-OM) was used as a dependent variable. Multiple regression analysis identified high neuroticism; poor caregiver perception of health; poor caregiver perception of health; non-adaptive coping strategies; and PD disability as risk factors. In turn, adaptive coping strategies and caregiver time may act as protective factors. The resulting model explains 57.1% of the variance in caregiver psychological distress. These results help explain why some people adapt better than others to the burden of care. The findings highlight the importance of identifying the variables that influence the quality of care for people with this disease.

Pathways to Mental Health–Related Treatment Among Caregiving Spouses

Spouses of cancer survivors are 33% less likely to receive guideline-concordant depression treatment than other married adults. However, depression is only one of many manifestations of psychological distress for caregivers. This exploratory study sought to assess the paths by which caregivers access mental health-related treatment. Using nationally representative data from the Medical Expenditures Panel Survey, we assessed the proportion of caregivers who received a mental health-related prescription or psychotherapy visit across care settings (office based versus outpatient hospital, emergency room, or inpatient visit), provider type (psychiatric, primary care, other specialty, or other), and visit purpose (regular checkup, diagnosis and treatment, follow-up, psychotherapy, other). In addition, we assessed the health condition(s) associated with the treatment. The findings indicate that a plurality of caregivers accessed mental health-related treatment through an office-based visit (90%) with a primary care provider (47%). A minority accessed this care through a psychologist or psychiatrist (11%) or a physician with another specialty (12%) or other provider types. Nearly a third accessed treatment as part of a regular check-up (32%). These patterns did not differ from the general population after controlling for sociodemographic characteristics. Interestingly, mental health-related treatments were associated with a mental health diagnosis in only a minority of caregivers. The findings confirm the importance of regular primary care as a door way to mental healthcare, and highlight the range of potential paths to care. Future research will examine the correlates of accessing care across path types.

Determinants of caregiver burden in early onset dementia

AbstractBackgroundCaregivers of patients with early onset dementia (EOD) experience high levels of burden, which is known to be affected by financial and social variables, as well as by psychological features of the caregiver and patient’s symptoms. However, it is not known how all these factors reciprocally interact in determining the burden of caregivers of EOD patients. We investigated multiple determinants of burden in a comprehensive model.MethodConsecutive eligible patients with EOD and their caregivers were recruited from the Cognitive Neurology Clinic of the Modena University Hospital, Italy. Patients underwent extended clinical, imaging and neuropsychological assessment. Caregivers were interviewed and asked to fill in questionnaires to gain information on patients’ symptoms, caregiver burden (Zarit Burden Interview), caregiver psychological distress (Relative Stress Scale). Patient/caregiver demographics, social and clinical variables were entered in linear multiple regression models and mediation models to explore if the effect on burden is mediated by stress.ResultData from 89 EOD patient‐caregiver dyads were examined. Caregiver burden was positively related to female caregiver sex (b=0.44,p=0.0002), severity of patient’s behavioral symptoms (b=0.32,p=0.0004), diagnostic delay (b=0.18,p=0.017) and financial distress of the family (b=0.28, p=0.0008). Significant factors reducing the burden were caregiver perception of patient’s quality of life (b=‐0.20, p=0.005), disease duration (b=‐0.27,p=0.0003), caregiver age (b=‐0.31,p=0.0017), offspring number (b=‐0.25,p=0.0004), patient’s education (b=‐0.15,p=0.022), region of birth (b=‐0.17,p=0.025) and number of days off work (b=‐0.15, p&lt;0.0001) (adjusted‐R2=0.64). While the effect of financial distress, number of caregiver’s days off‐work, patient’s disease duration, and caregiver sex was entirely mediated by the level of caregiver stress, the effect of diagnostic delay and of proxies of family or social network on burden was direct.ConclusionMost of the effect of the known determinants of the burden of caregivers is mediated by caregivers’ level of stress, in particular for female caregivers. In particular, the number of days off‐work that the caregiver can take is a variable on which action can be taken to reduce the caregivers’ stress, hence their burden. However, as some determinants are independent from stress, direct actions should be aimed at increasing social networks and shortening diagnostic delay to reduce caregiver burden.

Clinical study of preoperative psychological distress and its related factors in the primary caregivers of patients with glioma

ObjectiveTo investigate the preoperative psychological distress in the primary caregivers of glioma patients and its influencing factors and to determine the relationship between preoperative psychological states of glioma patients and their caregivers. MethodsUsing a mixed methods design, the caregivers of patients with malignant glioma were interviewed and completed questionnaires about anxiety/depression and family function during preoperative period. ResultsCaregivers of glioma patients had different types of psychological distress before surgery. A total of 46 caregivers (36.5 %) had preoperative psychological depression or anxiety symptom; 30 caregivers (23.8 %) had depression symptoms, 39 caregivers (31.0 %) had anxiety symptoms, and 23 (18.3 %) had both preoperative anxiety and depression symptoms. Female gender was an influential factor for both preoperative depression and anxiety symptoms in caregivers, surgical information was a risk factor for caregivers' preoperative depression symptoms and residence was a risk factor for caregivers' preoperative anxiety symptoms. The preoperative psychological states of patients was positively correlated with the preoperative anxiety and depression symptoms of caregivers. ConclusionThe rural female caregivers are more likely to experience psychological distress before surgery, and the preoperative psychological states of patients was positively correlated with the psychological distress in caregivers.

Association of fatty acid ethyl esters in meconium with behavior during childhood

ObjectiveTo examine associations between amounts of fatty acid ethyl esters (FAEEs) in meconium and behavior in school aged children exposed to alcohol and drugs in utero. MethodsA secondary analysis of a prospective cohort of cocaine, polydrug exposed children, primarily African-American, low socioeconomic status, recruited at birth into a longitudinal study. FAEEs were quantified with gas chromatography via a flame ionization detector. Meconium was analyzed for FAEEs for 216 newborns of whom 194 were assessed with the Child Behavior Checklist (CBCL) at ages 4, 6, 9, 10, 11, and 12. Generalized estimating equation analyses were used to assess the relationship of quantity of FAEEs to outcomes, controlling for maternal psychological distress. ResultsHigher concentrations of FAEEs (ethyl myristate, ethyl palmitate, ethyl oleate, ethyl linoleate, and ethyl linolenate) were associated with caregiver reported aggressive and/or delinquent behavior at ages 10 and 12. After control for caregiver psychological distress, and age, significant (p < 0.05) FAEE by age interactions were found for ethyl myristate for aggression and for ethyl oleate, ethyl linoleate and ethyl linolenate for delinquency. Thus, higher concentrations of FAEE were related to more caregiver reported aggressive and delinquent behaviors of clinical significance at ages 10 and 12. ConclusionHigher concentrations of FAEEs in meconium are potential markers for children at risk for aggressive and delinquent behaviors related to the effects of prenatal alcohol exposure.

Exploring the caregiver's experience in an innovative homebound hematopoietic stem cell transplantation program.

Home care for hematopoietic stem cell transplants (HSCTs), an alternative to traditional inpatient or outpatient recovery programs, is safe and feasible but may place greater demand on full-time caregivers. The goal of this study was to characterize the experiences of caregivers in a newly piloted homebound HSCT program as a means of identifying unmet needs and ensuring adequate support. A qualitative approach was utilized. Participants created self-recorded video diaries guided by open-ended prompts at designated time points throughout recovery and participated in a single follow-up interview within four weeks post-discharge. Diaries and interviews were transcribed, analyzed, and coded to identify recurrent ideas and themes. Data were collected from 12 caregivers of homebound HSCT patients. Thematic content analysis yielded four themes: facilitators (external support, sense of normalcy, and patient wellness), challenges (difficulties with transplant care instructions, managing the patient's physical and emotional health, and caregiver psychological distress), roles in recovery (caregiving responsibilities), and analysis of homebound experience (positive outcomes and suggestions for improvement). Caregivers perceived the homebound program as offering high-quality medical care in a setting that provided a sense of normalcy, privacy, and greater level of oversight. Unmet needs included lacking preparedness in completing nursing responsibilities and handling caregiver and patient distress. While the homebound program was preferred to routine hospital care, psychotherapeutic support and programming to improve caregiver preparedness in a homebound HSCT recovery program is indicated.

Caregivers of Children with Fetal Alcohol Spectrum Disorder: Psychosocial Factors and Evidence for Self-compassion as a Potential Intervention Target

Fetal alcohol spectrum disorder (FASD) is a common neurodevelopmental condition involving lifelong challenges for both children and their families. The aim of the current study was to explore experiences of caregivers of children, adolescents and young adults diagnosed with FASD. More specifically, we examined the relationship between shame, guilt, pride, self-compassion and caregiver psychological distress. It was hypothesised that shame, guilt, pride and self-compassion would be uniquely associated with caregiver psychological distress. We also examined differences between biological and non-biological caregivers on these variables. It was hypothesised that relative to non-biological caregivers, biological parents would (i) report significantly higher levels of psychological distress, guilt and shame and (ii) report significantly lower self-compassion scores. The current study included 175 caregivers of children and young people diagnosed with FASD. Caregivers completed an online survey that included a range of standardised self-report measures that assessed psychological distress, shame, guilt, pride and self-compassion. Caregiver self-compassion was negatively correlated with psychological distress, shame and guilt, and positively correlated with pride. Hierarchical multiple regression controlling for significant caregiver demographics revealed that shame, pride, guilt and self-compassion accounted for 68.1% of the variance in caregiver psychological distress. Shame and self-compassion were both unique significant factors in the final model. Some preliminary differences between caregiver groups were also found; specifically, biological parents reported higher levels of guilt compared with non-biological caregivers. The current findings revealed shame, pride, guilt and self-compassion were associated with caregiver psychological distress. Self-compassion and shame were identified as unique contributors to caregiver psychological distress. Future longitudinal research is required to establish if these associations may be casual, which will provide a useful starting point for further investigation into the efficacy of interventions that target self-compassion for promoting better psychological outcomes in this population.

Neighbourhood relationships moderate the positive association between family caregiver burden and psychological distress in Japanese adults: a cross-sectional study

ObjectivesFamily caregiver burden is associated with higher psychological distress. However, little is known about the impact of neighbourhood relationships on caregivers’ psychological distress. We examined whether neighbourhood relationships of caregivers moderate the association between family caregiver burden and psychological distress. Study designThis was a cross-sectional study. MethodsWe recruited 5321 Japanese adults who participated in the Japan Multi-Institutional Collaborative Cohort Study in the Okazaki area between 2013 and 2017. Participants completed self-reported questionnaires to measure psychological distress (Kessler 6: K6), subjective caregiver burden, and neighbourhood relationships. We performed a multivariable linear regression analysis in which caregiver burden was designated as an independent variable and the K6 score as a dependent variable, adjusting for demographics. The interaction term between caregiver burden and neighbourhood relationships was also included in the analysis. ResultsData from a total of 5069 participants were included (mean age [standard deviation]: 63.1 years [10.3 years]; 2226 [43.9%] female). Caregiver burden was significantly and positively associated with psychological distress (compared with no burden, mild burden: β = 0.24, P = 0.197; severe burden: β = 0.60, P < 0.01; P for trend < 0.01). There was a significant negative interaction effect of caregiver burden × neighbourhood relationship on psychological distress (severe burden × good neighbourhood relationship: β = −3.29, P < 0.01). ConclusionsA higher caregiver burden was associated with higher psychological distress, and neighbourhood relationships moderated this association. Our findings suggest that good neighbourhood relationships can buffer caregiving-associated psychological distress.

Implementation of e-mental health interventions for informal caregivers of adults with chronic diseases: a protocol for a mixed-methods systematic review with a qualitative comparative analysis

IntroductionInformal caregivers provide the majority of care to individuals with chronic health conditions, benefiting the care recipient and reducing use of formal care services. However, providing informal care negatively impacts...

Palliative medicine family conferences and caregiver psychological distress during prolonged mechanical ventilation

ObjectivesLittle is known about the experience of family caregivers of patients who require prolonged mechanical ventilation (PMV). We examined the perspectives of caregivers of patients who died after PMV to...

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

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

M225. EXPRESSED EMOTIONS AND PSYCHOLOGICAL DISTRESS AMONG CAREGIVERS OF PATIENTS WITH CHRONIC MENTAL ILLNESS ATTENDING PSYCHIATRIC DEPARTMENT OF BPKIHS

BackgroundFamily expressed emotions had been shown to be predictive of outcome in mental illnesses in variety of cultural settings. Distressed caregivers who provide care to mentally ill relatives are at risk for developing mental health disorders.MethodsA hospital based cross sectional study was conducted among 85 caregivers of chronic mental illness using purposive sampling technique. Caregivers were interviewed using Family Questionnaire (FQ) and Kessler Psychological Distress Scale (K10) to assess expressed emotions and psychological distress of caregivers respectively.ResultsMore than half (55.3%) of the caregivers had low expressed emotions while 44.7% had high expressed emotions. More than half (55.3%) of the caregivers had low psychological distress, followed by medium risk (31.8%) and high risk (12.9%).Study revealed significant association between caregiver’s expressed emotion with caregiver’s relationship to patient, area of residence, socioeconomic status, age and gender of patients. Caregiver’s psychological distress had a significant association with their relationships with patient and educational qualification of patient. There was positive correlation between caregiver’s expressed emotions and psychological distress.DiscussionThis study illustrated that more than half (55.3%) of the caregivers had low expressed emotions and 44.7% had high expressed emotions while caring their patients with chronic mental illness. This finding is contradictory to the findings of a study conducted in India which depicts that most of the caregivers were designated as high EE (56%) as compared to low EE (44%). Another study conducted in Thailand indicated that large number of caregivers have high expressed emotion (87.5%).Another descriptive quantitative exploratory study done in Saudi Arabia had shown that majority of caregivers had low EE (85%). This differences in the results related to expressed emotions could be possibly due to variations in the sample size and tools used for data collection among these studies.

A cross-sectional study on spouse and parent differences in caregiving experiences of people living with schizophrenia in rural China

BackgroundConflicting evidence exists on whether parent or spouse caregivers experience better outcomes when caring for family members with schizophrenia. The current study aims to examine relative caregiving experiences and impacts of spouse and parent caregivers for people living with schizophrenia (PLS) in China.MethodsA cross-sectional study was conducted in a sample of 264 community-dwelling primary family caregivers of PLS. Face-to-face interviews were conducted to collect information on family caregiving activities; negative caregiving impacts including objective and subjective burden, and caregiver psychological distress such as depression and anxiety; positive caregiving impacts including caregiving rewarding feelings, and family functioning for spouse and parent caregivers.ResultsBoth types of caregivers report engaging in similar caregiving activities and report comparable levels of objective burden. However, parent caregivers report significantly higher subjective burden than spouse caregivers (b = 7.94, 95%CI:2.08, 13.80, P < 0.01), which is also reflected in significantly higher depression (b = 3.88, 95%CI:1.35, 6.41, P < 0.01) and anxiety (b = 2.53, 95%CI: 0.22, 4.84, P < 0.05), and lower family functioning (b = − 1.71, 95%CI: − 2.73, − 0.49, P < 0.01). Despite these differences, both groups of caregivers report comparable rewarding feelings about caregiving.ConclusionsOur findings have implications for family caregivers globally, but especially for countries that adhere to Confucian cultural values and provide guidance for future family intervention programs. Such programs may do well to incorporate cultural values and beliefs in understanding caregiving and kinship family dynamics so as to support family caregivers, and in particular, the specific vulnerabilities of parent caregivers.