Hostname: page-component-669899f699-cf6xr Total loading time: 0 Render date: 2025-05-07T00:48:37.410Z Has data issue: false hasContentIssue false
  • English
  • Français

Predicting anxiety and depression among family carers of people with Chronic Obstructive Pulmonary Disease

Published online by Cambridge University Press:  13 March 2014

Cristina Jácome ,
Daniela Figueiredo ,
Raquel Gabriel ,
Joana Cruz  and
Alda Marques
Cristina Jácome
Affiliation:
School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal
Daniela Figueiredo*
Affiliation:
School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal Unidade de Investigação e Formação sobre Adultos e Idosos (UniFAI), Porto, Portugal
Raquel Gabriel
Affiliation:
School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal Unidade de Investigação e Formação sobre Adultos e Idosos (UniFAI), Porto, Portugal
Joana Cruz
Affiliation:
Department of Health Sciences (SACS), University of Aveiro, Aveiro, Portugal
Alda Marques
Affiliation:
School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal Unidade de Investigação e Formação sobre Adultos e Idosos (UniFAI), Porto, Portugal
*
Correspondence should be addressed to: Daniela Figueiredo, School of Health Sciences, University of Aveiro (ESSUA); Agras do Crasto—Campus Universitário de Santiago, Edifício 30, 3810–193 Aveiro, Portugal. Phone: +00351-234-372-462; Fax: +00351-234-401-597. Email: [email protected].
Get access

Abstract

Background:

Chronic Obstructive Pulmonary Disease (COPD) can be highly incapacitating, imposing a significant burden on family members, however, limited research has been conducted on psychological health of family carers. Thus, this study examined anxiety and depression symptoms in family carers of people with COPD and their predictors.

Methods:

A cross-sectional study was conducted with family carers and respective patients with COPD. The caregiving situation and the perceived burden, through the Carers’ Assessment of Difficulties Index, were collected from family carers. Patients’ COPD severity and activities limitation were assessed. The Hospital Anxiety and Depression Scale (HADS) was used to assess anxiety and depression symptoms in family carers and patients. Scores ≥8 were considered clinically significant.

Results:

A total of 203 family carers (58.2 ± 14.8 years old; 75.4% female) and respective patients with COPD (69.2 ± 11.5 years old; 36.5% female) were included. Clinically significant anxiety symptoms (HADS-anxiety ≥8) were present in 63.5% (n = 129) of family carers, depression symptoms (HADS-depression ≥8) were in 34% (n = 69) and both were in 27.1% (n = 55). Perceived burden [odds ratio (OR) 1.04, 95% confidence intervals (CI) = 1.01–1.06; 1.05, 95% CI = 1.03–1.07] and patients’ activities limitation (OR 1.32, 95% CI = 1.01–1.79; 1.41, 95% CI = 1.01–1.96) were significant predictors of anxiety and depression symptoms. Anxiety symptoms were also predicted by female gender (OR 0.33, 95% CI = 0.16–0.66) and depression symptoms by older age (OR 1.03, 95% CI = 1.01–1.06).

Conclusion:

Family carers of patients with COPD experience anxiety and depression symptoms. Perceived burden, female gender, older age, and patient's activities limitation were predictors of these distressing symptoms. These findings highlight the need to address family carers’ needs, namely by investigating the effectiveness of supportive interventions on family's psychological health.

Keywords

family carersCOPDanxietydepressionpsychological health
Type
Research Article
Information
International Psychogeriatrics , Volume 26 , Issue 7 , July 2014 , pp. 1191 - 1199
Copyright
Copyright © International Psychogeriatric Association 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Altemus, M. (2006). Sex differences in depression and anxiety disorders: potential biological determinants. Hormones and Behavior, 50, 534–538.CrossRefGoogle ScholarPubMed
Berg, A., Palomäki, H., Lönnqvist, J., Lehtihalmes, M. and Kaste, M. (2005). Depression among caregivers of stroke survivors. Stroke, 36, 639–643.Google Scholar
Bergs, D. (2002). ‘The Hidden Client’– women caring for husbands with COPD: their experience of quality of life. Journal of Clinical Nursing, 11, 613–621.Google Scholar
Boyle, A. H. (2009). An integrative review of the impact of COPD on families. Southern Online Journal of Nursing Research, 9, 1–12.Google Scholar
Brito, L. (2002). A Saúde Mental dos Prestadores de Cuidados a Familiares Idosos. Coimbra: Quarteto Editora.Google Scholar
Brody, E. M. (1981). “Women in the Middle” and family help to older people. The Gerontologist, 21, 471–480.CrossRefGoogle ScholarPubMed
Carretero, S., Garcés, J., Ródenas, F. and Sanjosé, V. (2009). The informal caregiver's burden of dependent people: theory and empirical review. Archives of Gerontology and Geriatrics, 49, 74–79.Google Scholar
Covinsky, K. E., Newcomer, R., Fox, P., Wood, J., Sands, L., Dane, K. et al. (2003). Patient and caregiver characteristics associated with depression in caregivers of patients with dementia. Journal of General Internal Medicine, 18, 1006–1014.CrossRefGoogle ScholarPubMed
Drageset, S. and Lindstrom, T. C. (2005). Coping with a possible breast cancer diagnosis: demographic factors and social support. Journal of Advanced Nursing, 51, 217–226.Google Scholar
Dupuis, S. L., Epp, T. and Smale, B. (2004). Caregivers of Persons with Dementia: Roles, Experiences, Supports, and Coping. Ontario: University of Waterloo.Google Scholar
Gaugler, J. E., Jarrott, S. E., Zarit, S. H., Stephens, M. A., Townsend, A. and Greene, R. (2003). Adult day service use and reductions in caregiving hours: effects on stress and psychological well-being for dementia caregivers. International Journal of Geriatric Psychiatry, 18, 55–62.CrossRefGoogle ScholarPubMed
Grant, M., Cavanagh, A. and Yorke, J. (2012). The impact of caring for those with chronic obstructive pulmonary disease (COPD) on carers’ psychological well-being: a narrative review. International Journal of Nursing Studies, 49, 1459–1471.Google Scholar
Greenwood, N. and Mackenzie, A. (2010). An exploratory study of anxiety in carers of stroke survivors. Journal of Clinical Nursing, 19, 2032–2038.Google Scholar
Grov, E. K., Dahl, A. A., Moum, T. and Fosså, S. D. (2005). Anxiety, depression, and quality of life in caregivers of patients with cancer in late palliative phase. Annals of Oncology, 16, 1185–1191.CrossRefGoogle ScholarPubMed
Huang, C. Y., Sousa, V. D., Perng, S. J., Hwang, M. Y., Tsai, C. C., Huang, M. H. et al. (2009). Stressors, social support, depressive symptoms and general health status of Taiwanese caregivers of persons with stroke or Alzheimer's disease. Journal of Clinical Nursing, 18, 502–511.Google Scholar
Kim, Y., Baker, F. and Spillers, R. L. (2007). Cancer caregivers’ quality of life: effects of gender, relationship, and appraisal. The Journal of Pain and Symptom Management, 34, 294–304.CrossRefGoogle ScholarPubMed
Kim, Y. and Schulz, R. (2008). Family caregivers’ strains: comparative analysis of cancer caregiving with dementia, diabetes, and frail elderly caregiving. Journal of Aging and Health, 20, 483–503.CrossRefGoogle ScholarPubMed
Mathers, C. D. and Loncar, D. (2006). Projections of global mortality and burden of disease from 2002 to 2030. PLoS Medicine, 3, 2011–2030.CrossRefGoogle ScholarPubMed
Matud, M. P. (2004). Gender differences in stress and coping styles. Personality and Individual Differences, 37, 1401–1415.CrossRefGoogle Scholar
Miller, M. R., Hankinson, J., Brusasco, V., Burgos, F., Casaburi, R., Coates, A. et al. (2005). Standardisation of spirometry. European Respiratory Journal, 26, 319–338.CrossRefGoogle ScholarPubMed
Mitchell, A. J., Ferguson, D. W., Gill, J., Paul, J. and Symonds, P. (2013). Depression and anxiety in long-term cancer survivors compared with spouses and healthy controls: a systematic review and meta-analysis. The Lancet Oncology, 14, 721–732.CrossRefGoogle ScholarPubMed
Molloy, G. J., Johnston, D. W. and Witham, M. D. (2005). Family caregiving and congestive heart failure. Review and analysis. European Journal of Heart Failure, 7, 592–603.CrossRefGoogle Scholar
Ng, T. P., Niti, M., Fones, C., Yap, K. B. and Tan, W. C. (2009). Co-morbid association of depression and COPD: a population-based study. Respiratory Medicine, 103, 895–901.Google Scholar
Nici, L., Donner, C., Wouters, E., Zuwallack, R., Ambrosino, N., Bourbeau, J. et al. (2006). American thoracic society/European respiratory society statement on pulmonary rehabilitation. American Journal of Respiratory and Critical Care Medicine, 173, 1390–1413.CrossRefGoogle ScholarPubMed
Pais-Ribeiro, J., Silva, I., Ferreira, T., Martins, A., Meneses, R. and Baltar, M. (2007). Validation study of a Portuguese version of the hospital anxiety and depression scale. Psychology Health and Medicine, 12, 225–237.Google Scholar
Pearlin, L. I., Mullan, J. T., Semple, S. J. and Skaff, M. M. (1990). Caregiving and the stress process: an overview of concepts and their measures. The Gerontologist, 30, 583–94.Google Scholar
Perz, J., Ussher, J. M., Butow, P. and Wain, G. (2011). Gender differences in cancer carer psychological distress: an analysis of moderators and mediators. European Journal of Cancer Care, 20, 610–619.Google Scholar
Qian, J., Simoni-Wastila, L., Rattinger, G. B., Zuckerman, I. H., Lehmann, S., Wei, Y. J. et al. (2013). Association between depression and maintenance medication adherence among Medicare beneficiaries with chronic obstructive pulmonary disease. International Journal of Geriatric Psychiatry, 29, 49–57.Google Scholar
Savundranayagam, M. Y., Montgomery, R. J. V. and Kosloski, K. (2011). A Dimensional analysis of caregiver burden among spouses and adult children. The Gerontologist, 51, 321–331.Google Scholar
Selwood, A., Johnston, K., Katona, C., Lyketsos, C. and Livingston, G. (2007). Systematic review of the effect of psychological interventions on family caregivers of people with dementia. Journal of Affective Disorders, 101, 75–89.Google Scholar
Snaith, R. P. (2003). The hospital anxiety and depression scale. Health and Quality of Life Outcomes, 29, 1–4.Google Scholar
Sorensen, S., Duberstein, P., Gill, D. and Pinquart, M. (2006). Dementia care: mental health effects, intervention strategies, and clinical implications. The Lancet Neurology, 5, 961–73.Google Scholar
Vestbo, J., Hurd, S. S., Agustí, A. G., Jones, P. W., Vogelmeier, C., Anzueto, A. et al. (2013). Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. American Journal of Respiratory and Critical Care Medicine, 187, 347–365.Google Scholar