Psychological burden in family caregivers of patients with advanced cancer at initiation of specialist inpatient palliative care.
Adult
Aged
Aged, 80 and over
Anxiety
/ epidemiology
Caregivers
/ psychology
Depression
/ epidemiology
Female
Germany
Humans
Inpatients
Male
Mental Health
Middle Aged
Palliative Care
/ psychology
Prospective Studies
Risk Factors
Sadness
Socioeconomic Factors
Stress, Psychological
/ epidemiology
Young Adult
Anxiety
Cancer
Depression
Distress
Family caregiver
Palliative care
Regression analysis
Journal
BMC palliative care
ISSN: 1472-684X
Titre abrégé: BMC Palliat Care
Pays: England
ID NLM: 101088685
Informations de publication
Date de publication:
18 Nov 2019
18 Nov 2019
Historique:
received:
02
07
2019
accepted:
20
09
2019
entrez:
20
11
2019
pubmed:
20
11
2019
medline:
14
4
2020
Statut:
epublish
Résumé
This study prospectively evaluated distress, depressive and anxiety symptoms as well as associated factors in family caregivers (FC) of advanced cancer patients at initiation of specialist inpatient palliative care. Within 72 h after the patient's first admission, FCs were asked to complete German versions of the Distress Thermometer, Generalized Anxiety Disorder 7-item scale (GAD-7), Patient Health Questionnaire depression module 9-item scale (PHQ-9) for outcome measure. Multivariate logistic regression analyses were used to identify associated factors. In 232 FCs (62% spouses/partners), mean level of distress was 7.9 (SD 1.8; range, 2-10) with 95% presenting clinically relevant distress levels. Most frequent problems were sadness (91%), sorrows (90%), anxiety (78%), exhaustion (77%) and sleep disturbances (73%). Prevalence rates of moderate to severe anxiety and depressive symptoms were 47 and 39%, respectively. Only 25% of FCs had used at least one source of support previously. In multivariate regression analysis, being female (OR 2.525), spouse/partner (OR 2.714), exhaustion (OR 10.267), and worse palliative care outcome ratings (OR 1.084) increased the likelihood for moderate to severe anxiety symptom levels. Being female (OR 3.302), low socio-economic status (OR 6.772), prior patient care other than home-based care (OR 0.399), exhaustion (OR 3.068), sleep disturbances (OR 4.183), and worse palliative care outcome ratings (OR 1.100) were associated with moderate to severe depressive symptom levels. FCs of patients presenting with indication for specialist palliative care suffer from high distress and relevant depressive and anxiety symptoms, indicating the high need of psychological support not only for patients, but also their FCs. Several socio-demographic and care-related risk-factors influence mental burden of FCs and should be in professional caregivers' focus in daily clinical practice.
Sections du résumé
BACKGROUND
BACKGROUND
This study prospectively evaluated distress, depressive and anxiety symptoms as well as associated factors in family caregivers (FC) of advanced cancer patients at initiation of specialist inpatient palliative care.
METHODS
METHODS
Within 72 h after the patient's first admission, FCs were asked to complete German versions of the Distress Thermometer, Generalized Anxiety Disorder 7-item scale (GAD-7), Patient Health Questionnaire depression module 9-item scale (PHQ-9) for outcome measure. Multivariate logistic regression analyses were used to identify associated factors.
RESULTS
RESULTS
In 232 FCs (62% spouses/partners), mean level of distress was 7.9 (SD 1.8; range, 2-10) with 95% presenting clinically relevant distress levels. Most frequent problems were sadness (91%), sorrows (90%), anxiety (78%), exhaustion (77%) and sleep disturbances (73%). Prevalence rates of moderate to severe anxiety and depressive symptoms were 47 and 39%, respectively. Only 25% of FCs had used at least one source of support previously. In multivariate regression analysis, being female (OR 2.525), spouse/partner (OR 2.714), exhaustion (OR 10.267), and worse palliative care outcome ratings (OR 1.084) increased the likelihood for moderate to severe anxiety symptom levels. Being female (OR 3.302), low socio-economic status (OR 6.772), prior patient care other than home-based care (OR 0.399), exhaustion (OR 3.068), sleep disturbances (OR 4.183), and worse palliative care outcome ratings (OR 1.100) were associated with moderate to severe depressive symptom levels.
CONCLUSIONS
CONCLUSIONS
FCs of patients presenting with indication for specialist palliative care suffer from high distress and relevant depressive and anxiety symptoms, indicating the high need of psychological support not only for patients, but also their FCs. Several socio-demographic and care-related risk-factors influence mental burden of FCs and should be in professional caregivers' focus in daily clinical practice.
Identifiants
pubmed: 31739802
doi: 10.1186/s12904-019-0469-7
pii: 10.1186/s12904-019-0469-7
pmc: PMC6862724
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
102Subventions
Organisme : Cancer Society of Hamburg, Germany ("Hamburger Krebsgesellschaft e.V.")
ID : no assigned reference number
Organisme : Cancer Society of Hamburg, Germany ("Hamburger Krebsgesellschaft e.V.")
ID : no assigned reference number
Références
Psychooncology. 2016 Dec;25(12):1400-1407
pubmed: 26360934
Psychooncology. 2013 Sep;22(9):1987-93
pubmed: 23335153
Arch Intern Med. 2006 May 22;166(10):1092-7
pubmed: 16717171
Support Care Cancer. 2016 May;24(5):1975-1982
pubmed: 26476628
Cancer. 2015 Jan 1;121(1):150-8
pubmed: 25209975
Support Care Cancer. 2017 Aug;25(8):2437-2444
pubmed: 28247128
Psychooncology. 2008 Oct;17(10):959-66
pubmed: 18203146
J Clin Oncol. 2010 Sep 1;28(25):4013-7
pubmed: 20660825
Br J Psychiatry. 1995 Jan;166(1):29-34
pubmed: 7894872
Psychother Psychosom Med Psychol. 2015 Feb;65(2):66-72
pubmed: 25405873
Death Stud. 2017 May-Jun;41(5):276-283
pubmed: 27982741
Palliat Support Care. 2016 Feb;14(1):5-12
pubmed: 25881585
Psychooncology. 2016 Jul;25(7):795-802
pubmed: 26449934
J Clin Oncol. 2015 May 1;33(13):1446-52
pubmed: 25800762
Palliat Med. 2018 Dec;32(10):1605-1614
pubmed: 30130458
Palliat Support Care. 2014 Apr;12(2):139-48
pubmed: 23919966
J Palliat Med. 2013 Sep;16(9):1095-101
pubmed: 23909373
J Natl Compr Canc Netw. 2003 Jul;1(3):344-74
pubmed: 19761069
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2006 Sep;49(9):853-60
pubmed: 16927038
Palliat Med. 2015 Jul;29(7):605-32
pubmed: 25802323
J Psychosom Res. 2017 Dec;103:127-132
pubmed: 29167039
Psychooncology. 2011 Apr;20(4):394-403
pubmed: 20878839
Ann Behav Med. 2017 Aug;51(4):519-531
pubmed: 28097515
Psychooncology. 2015 Jan;24(1):19-24
pubmed: 25044819
Med Care. 2008 Mar;46(3):266-74
pubmed: 18388841
Psychooncology. 2018 Mar;27(3):969-976
pubmed: 29226997
J Palliat Med. 2018 Sep;21(9):1234-1241
pubmed: 29727256
Ann Oncol. 2016 Aug;27(8):1607-12
pubmed: 27177859
Am J Hosp Palliat Care. 2018 Apr;35(4):677-683
pubmed: 29141459
Palliat Support Care. 2011 Sep;9(3):315-25
pubmed: 21838952
Eur J Cancer Care (Engl). 2018 Mar;27(2):e12833
pubmed: 29461649
Support Care Cancer. 2016 Jul;24(7):3057-67
pubmed: 26887588
J Palliat Med. 2011 Jul;14(7):864-9
pubmed: 21599532
Palliat Med. 2019 Sep;33(8):1045-1057
pubmed: 31185804
Gen Hosp Psychiatry. 2013 Sep-Oct;35(5):551-5
pubmed: 23664569
Support Care Cancer. 2017 Mar;25(3):887-893
pubmed: 27841006
Cochrane Database Syst Rev. 2011 Jun 15;(6):CD007617
pubmed: 21678368
Qual Health Care. 1999 Dec;8(4):219-27
pubmed: 10847883
BMC Palliat Care. 2017 May 10;16(1):31
pubmed: 28486962
J Pain Symptom Manage. 2005 Jul;30(1):51-62
pubmed: 16043007
Palliat Med. 2010 Oct;24(7):674-81
pubmed: 20621947
Eur J Cancer Care (Engl). 2018 Mar;27(2):e12606
pubmed: 27859889
J Gen Intern Med. 2001 Sep;16(9):606-13
pubmed: 11556941
Psychooncology. 2015 Jan;24(1):54-62
pubmed: 24789500
Gesundheitswesen. 1999 Dec;61 Spec No:S178-83
pubmed: 10726418
Psychother Psychosom Med Psychol. 2012 May;62(5):185-94
pubmed: 22565336
Cancer. 2006 Jan 1;106(1):214-22
pubmed: 16329131
Palliat Support Care. 2019 Jun;17(3):286-293
pubmed: 29478419
Ann Palliat Med. 2018 Oct;7(4):420-426
pubmed: 29860851