Burden, anxiety and depression in patient's caregivers with chronic pain and in palliative care
Main Article Content
Keywords
Caregivers, Depression, Anxiety, Intractable Pain, Chronic Disease
Abstract
Background: in Mexico there are few studies about the psychological characteristics of the person that voluntary and in a complete sense assumes the role of responsible of a patient. The purpose of this study was to assess and compare the levels of burden, anxiety and depression of 56 caregivers of patients with chronic pain with the ones of 35 caregivers of terminally ill patients.
Methods: the study was conduced at the Chronic Pain and Palliative Medicine Department of the Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”. We used the Spanish version of the Burden Interview and the Informal Primary Caregiver Health Survey.
Results: both groups went over the cut off point of the Burden Scale even though no significative differences between groups were found nor in burden or in anxiety. The caregivers of terminal patients had more depression symptoms and a greater perception of the impact of the care activity in their mood. Positive correlations between burden and depression, depression and anxiety and burden and anxiety were found.
Conclusions: All caregivers reported multiple depression symptoms —greater if they cared terminally ill patients— so, it may suggest that the patient’s illness directly influences the depression symptoms of their caregivers. This study can help to develop intervention programs directed to help this population that is the principal support of the patient’s treatment.
References
Muñoz-Cobos F, Espinosa-Almendro JM, Portillo-Strempel J, Rodríguez-González G. La familia en la enfermedad terminal. Med Fam 2002; 3(3):190-199.
World Health Organization. WHO Fact Sheet “Caregiving”. Geneva: WHO; 1999.
Deví J, Almazán I. Modelos de estrés y afrontamiento en el cuidador del enfermo con demencia. Rev Gerontol 2002; 12(1):31-37.
Gaugler JE, Anderson KA, Leach CD, Smith FA, Mendiondo M. The emotional ramifications of unmeet need in dementia caregiving. Am J Alzheimers Dis Other Demen 2004; 19:369-380.
Waelde LC, Thompson L, Gallagher-Thompson D. A pilot study of a yoga and meditation intervention for dementia caregiver stress. J Clin Psychol 2004; 60(6):677-87.
Tolson D, Swan I, Knussen C. Hearing disability: a source of distress for older people and carers. Br J Nurs 2002; 11(15):1021-102.
Tugrul M, Eren I, Ozcankaya R, Civi I, Ertuk J, Ozturk M. Psychologycal symptoms are greater in caregivers of patients on hemodialysis than those of peritoneal dialysis. Hemodial Int 2003; 7(4):332-337.
Bastianello D, Gavin P, Berto E, Beltrame L, Sainati L, Perilongo G, et al. A project to improve the collaboration between doctors and nurses in the care of terminal cancer paediatric patients. Assist Inferm Ric 2004; 23(3):149-152.
Hudson JI, Arnold LM, Keck PE, Auchenbach MB, Pope HG. Family study of fibromyalgia and affective spectrum disorder. Biol Psychiatry 2004; 56(11):884-891.
Lopes-Monteiro da Cruz DA, De Mattos-Pimenta CA, Kurita GP, De Oliveira AC. Caregivers of patients with chronic pain: responses to care. Int J Nurs Termil Classif 2004; 15(1):5-13.
Pinquart M, Sorensen S. Gender differences in caregiver stressors, social resources, and health: an updated meta-analysis. J Gerontol 2006; 61(1):33-45.
Jerrom B, Main I, Rukanyake NG. Stress on relative caregivers of dementia sufferers and predictors of the breakdown of community care. Intern J Geriatric Psychiatry 1993; 8:331-337.
Hyunsook Y. Factors associated with family caregivers’ burden and depression in Korea. J Aging Human Dev 2003; 57(4):291-311.
Grunfeld E, Coyle D, Whelan T, Clinch J, Reyno L, Earle CC, et al. Family caregiver burden: results of a longitudinal study of breast cancer patients and their principal caregivers. CMAJ 2004; 170(12):1795-1801.
Zarit M, Zarit T. Evaluación del medio y del cuidador del paciente con demencia. Barcelona, España: Prous; 1982.
Kausar R, Powell G. Coping and psychological distress in carers of patients with neurological disorders. Asia Paci Disab Rehab J 1999; 10:2-9.
McClendon MJ, Smyth KA, Neundorfer MM. Survival of persons with Alzheimer’s disease: caregiver coping matters. Gerontologist 2004; 44:508-519.
Cuijpers P, Stam H. Burnout among relatives of psychiatric patients attending psychoeducational support groups. Psychiatric Serv 2000; 51:375-379.
Perlick DA, Rosenheck RA, Clarkin JF, Maciejewski PK, Sirey J, Struening E, et al. Impact if family burden and affective response on clinical outcome among patients with bipolar disorder. Psychiatric Serv 2004; 55:1029-1035.
Juárez G, Ferrell BR. Family and caregiver involvement in pain management. Clin Geriatr Med 1996; 12:531-547.
Hudson PL, Aranda S, Kristjanson LJ. Meeting the supportive needs of family caregivers in palliative care: challenges for health professionals. J Palliat Med 2004; 7:19-24.
Diwan S, Hougham GW, Sachs GA. Strain experienced by caregivers of dementia patients palliative care: findings from the Palliative Excellence in Alzheimer Care Efforts (PEACE) Program. J Palliat Med 2004; 7:797-807.
Singer Y, Bachner Y, Shvartzman P, Carmel S. Home death. The caregiver’s experience. J Pain Symptom Manage 2005; 30:70-75.
World Health Organization. WHO definition of palliative care. Geneva: WHO; 2002.
Loeser J. Bonica, terapéutica del dolor. México: McGraw Hill; 2002.
Ramos-del Río B. Encuesta de salud del cuidador primario informal. México: Facultad de Estudios Superiores Zaragoza, Universidad Nacional Autónoma de México; 2005. (Perteneciente al proyecto PAPITT IN305406-2).
Lazarus A. Terapia multimodal. Nueva York, EUA: IPPEM; 1976.
Beck A y Steer R. BDI-II. Inventario de depresión de Beck. España: Paidós; 2002.
Ruiz-Sánchez JJ, Imberón-González J. Psicoterapia cognitiva de urgencia. Rev Mex Psicol Soc 2003; 22:3-7.
Zilbergeld B. Mind power: getting what you want through mental training. Boston: Little Brown; 1987.
Kertesz R. El enfoque multimodal y las escuelas de psicoterapia. Rev IIPSI 2005; 82:113-127.
Hebert R. Preparedness for the death of a loved one and metal health in bereaved caregivers of patients with dementia: findings from the reach study. J Palliat Med 2006; 9(3):683-693.