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Rajachandrakumar R, Finlayson M. Multiple sclerosis caregiving: A systematic scoping review to map current state of knowledge. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e874-e897. [PMID: 34935217 DOI: 10.1111/hsc.13687] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 11/07/2021] [Accepted: 12/06/2021] [Indexed: 06/14/2023]
Abstract
Unpaid caregivers, typically family and friends, provide significant amounts of support to people with multiple sclerosis (MS). Understanding their experiences, needs and challenges is necessary to ensure that caregivers receive the support that they require to continue in their role. Our aim was to map the current state of knowledge about unpaid caregivers of people with MS and identify gaps in knowledge to guide future research and practice. We used scoping review methodology with three major health-related databases (MEDLINE, CINAHL, APA Psychinfo), searching in September 2019, April and October 2020 and October 2021. We selected peer-reviewed scientific articles reporting on primary studies of unpaid caregivers of people with MS, regardless of topic or research design. We extracted information on study aim, participant characteristics, measures used and key findings to generate major themes and identify knowledge gaps. We identified 108 published studies between 1992 and 2021 that met our criteria. Studies of spousal caregivers were most common. Studies focused primarily on measurement of caregiver burden or other negative consequences of caregiving. Thirteen studies addressed positive consequences of caregiving. Sixteen studies reported actual tasks performed by caregivers and seven reported outcomes of caregiver support interventions. Attention to diversity issues that may influence caregiving experiences and outcomes was rare. Overall, knowledge of MS caregiving is limited, particularly with respect to tasks performed by caregivers that may contribute to negative outcomes, diversity issues and effective approaches to remediate caregiver burden. Without this knowledge, finding ways to better support MS caregivers will be difficult.
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Affiliation(s)
| | - Marcia Finlayson
- School of Rehabilitation Therapy, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada
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Cejalvo E, Martí-Vilar M, Merino-Soto C, Aguirre-Morales MT. Caregiving Role and Psychosocial and Individual Factors: A Systematic Review. Healthcare (Basel) 2021; 9:1690. [PMID: 34946416 PMCID: PMC8700856 DOI: 10.3390/healthcare9121690] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 10/30/2021] [Accepted: 11/01/2021] [Indexed: 11/24/2022] Open
Abstract
Taking care of a person with a physical disability can become a challenge for caregivers as they must combine the task of caring with their personal and daily needs. The aim of this study was to assess the impact that taking care of a person who needs support has on caregivers and to analyze certain characteristics they present, such as self-esteem and resilience. To that end, a bibliographic review was carried out from 1985, when the first article of taking care of a person who needs support was published, to 2020 (inclusive), in the databases of Web of Science (WoS), Scopus, Pubmed, Eric, Psycinfo, and Embase. The search yielded a total of (n = 37) articles subject to review, following the guidelines established in the PRISMA declaration. The results show that caregiving was highly overburdening and negatively affected the physical condition and the psychological and mental states of caregivers. In addition, certain psychological characteristics present in caregivers such as having high self-esteem and being resilient were found to act as protective factors against the caregiving burden.
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Affiliation(s)
- Elena Cejalvo
- Department of Basic Psychology, Faculty of Psychology and Speech Therapy, Universitat de València, 46010 Valencia, Spain;
| | - Manuel Martí-Vilar
- Department of Basic Psychology, Faculty of Psychology and Speech Therapy, Universitat de València, 46010 Valencia, Spain;
| | - César Merino-Soto
- Psychology Research Institute, Universidad de San Martín de Porres, Lima 34, Peru
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Takalu MTM, Hosseini SA, Khankeh HR, Pishyareh E, Ebrahimi HA, Bakhshi E. How primary caregivers of individuals with multiple sclerosis cope with social isolation: a grounded theory study in an Iranian context. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2020. [DOI: 10.12968/ijtr.2019.0034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background/aims Multiple sclerosis is a progressive neurological disease that can significantly impact the psychosocial aspects of primary caregivers of individuals with multiple sclerosis. This study explored the process of social isolation among primary caregivers of individuals with multiple sclerosis in Kerman, Iran. Methods A grounded theory approach was employed to explore the various aspects of social isolation. Data were collected through unstructured and semi-structured interviews with 15 primary caregivers of individuals with multiple sclerosis, 13 individuals with multiple sclerosis and five health care providers who were selected based on purposeful and theoretical sampling. The data were analysed via constant comparative analysis. Results The core variable identified from the interviews was social isolation. Other concepts that were connected with this were: insufficient knowledge and awareness, escaping stigma, occupational difficulties, marital challenges and management of restrictions. Conclusions Social isolation can affect the wellbeing of primary caregivers of individuals with multiple sclerosis. Recognition and awareness of the process of social isolation and factors influencing it can be beneficial in designing theory-driven evaluation and intervention methods. It is recommended that rehabilitation specialists pay close attention to the common needs and interests of both individuals with multiple sclerosis and their primary caregivers.
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Affiliation(s)
| | - Seyed Ali Hosseini
- Social Determinants of Health Research Center and Occupational Therapy Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Hamid Reza Khankeh
- Health in Emergency and Disaster Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Ebrahim Pishyareh
- Department of Occupational Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | | | - Enayatollah Bakhshi
- Department of Biostatistics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Bai X, Liu C, Baladon L, Rubio-Valera M. Multidimensional determinants of the caregiving burden among Chinese male caregivers of older family members in Hong Kong. Aging Ment Health 2018; 22:980-989. [PMID: 28541777 DOI: 10.1080/13607863.2017.1330872] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVES The objective of this study was to examine multidimensional determinants of the caregiving burden among Chinese male caregivers of older family members in Hong Kong. Based on a modified stress process model, this study explored how background and contextual factors (demographic characteristics and mental health status of caregivers, caregiving-related factors, and support and services), primary stressors (degree of care dependency and special care needs), and secondary stressors (self-efficacy and gender role conflict) might affect the caregiving burden among male caregivers. METHOD A questionnaire survey was completed by 204 male caregivers who considered themselves as primary caregivers for older family members with care needs aged 60 and over. Descriptive, bivariate, and multivariate analyses were conducted. RESULTS Being the son of the care receiver, the presence of depressive symptoms, a higher degree of gender role conflict, a lower degree of caregiving self-efficacy, and the use of support and services all predicted greater caregiving burden among male caregivers. CONCLUSION This study established a modified stress process model specifically for male caregivers. Gender role conflict and caregiving self-efficacy were introduced into the model as secondary stressors and found to be significantly associated with the degree of caregiving burden. The findings of this study could inform the development of services and interventions to reduce the caregiving burden among male caregivers.
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Affiliation(s)
- Xue Bai
- a Department of Applied Social Sciences , The Hong Kong Polytechnic University , Hong Kong.,b Personal Social Services Research Unit , London School of Economics and Political Science , UK
| | - Chang Liu
- a Department of Applied Social Sciences , The Hong Kong Polytechnic University , Hong Kong
| | - Luisa Baladon
- c Adults Mental Health Centre of Garraf , Parc Sanitari Sant Joan De Déu , Barcelona , Spain
| | - Maria Rubio-Valera
- d Research and Teaching Unit , Fundació Sant Joan de Déu , Spain.,e Centre For Biomedical Research in Epidemiology and Public Health, CIBERESP , Madrid , Spain.,f School of Pharmacy , Universitat de Barcelona , Barcelona , Spain
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Pucciarelli G, Ausili D, Galbussera AA, Rebora P, Savini S, Simeone S, Alvaro R, Vellone E. Quality of life, anxiety, depression and burden among stroke caregivers: A longitudinal, observational multicentre study. J Adv Nurs 2018; 74:1875-1887. [PMID: 29700840 DOI: 10.1111/jan.13695] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2018] [Indexed: 11/29/2022]
Abstract
AIM To longitudinally describe stroke caregivers' quality of life, anxiety, depression and burden and to identify predictors of stroke caregivers' quality of life, anxiety, depression and burden. BACKGROUND Caregivers have a key role in stroke survivor care and the first year of caregiving is the most challenging. To give tailored interventions, it is important to capture changes and identify predictors of caregiver quality of life, anxiety, depression and burden during the first year. DESIGN A 12-month longitudinal study. Data were collected between June 2013-May 2016. METHODS Changes in stroke caregiver quality of life, anxiety and depression and burden and their predictors were identified using linear mixed-effects models. RESULTS The caregivers (N = 244) were 53 years old and mostly female. Caregiver quality of life did not change significantly over the 12 months, anxiety and depression decreased up to 9 months and caregiver burden decreased from baseline to 3 months, then increased up to 9 months. Higher caregiver quality of life was predicted by caregiver younger age, higher education, living with a stroke survivor, survivor older age and higher physical functioning; higher anxiety and depression were predicted by older caregiver age and younger survivor age; higher burden was predicted by caregiver male gender, the caregiver not living with survivor and survivor lower physical functioning. CONCLUSION The first 9 months of caregiving are particularly problematic for caregivers. The trajectories of the above variables and their predictors may be useful for policy makers, clinicians, investigators and educators to give better care to stroke caregivers and their survivors.
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Affiliation(s)
- Gianluca Pucciarelli
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Davide Ausili
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Alessia Antonella Galbussera
- Centre of Biostatistics for Clinical Epidemiology, Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Paola Rebora
- Centre of Biostatistics for Clinical Epidemiology, Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | | | - Silvio Simeone
- Department of Cardiology, Policlinico Federico II, Naples, Italy
| | - Rosaria Alvaro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
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6
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Opara J, Brola W. Quality of Life and Burden in caregivers of Multiple Sclerosis patients. ACTA ACUST UNITED AC 2018. [DOI: 10.1515/pha-2017-0002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
Multiple sclerosis (MS) is one of the most disabling disorders of the central nervous system. Caregivers of individuals with MS may experience unique caregiver strain due to the age at onset and progressive nature of the disease. Additionally, because MS is more prevalent in women, men often become spousal caregivers. This places women in the position of being care recipients rather than caregivers. Some results also supported hypothesis that female caregivers reported a higher need for emotional support than male caregivers. As with female caregivers, decreased emotional support predicted poorer QoL among male caregivers. Caring for a MS patient may negatively impact several objective and subjective aspects of caregiver's life, such as physical and emotional health, morale, work life, finances, social mobility, interpersonal relationships and sexual life. In studies assessing the psychological consequences of care a higher level of anxiety and depression in caregivers than in the general population has been reported. Caregivers who experience burden are more likely to have a higher risk of depression and a lower quality of life. Early recognition of caregiver burden is important in determining appropriate interventions. In this review report the current state of knowledge about the QoL of MS caregivers as well the burden of MS caregivers has been described.
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Affiliation(s)
- Józef Opara
- PhD, MD Jerzy Kukuczka Academy of Physical Education ul. Mikołowska 72b, 40-065 Katowice , Poland
| | - W. Brola
- Department of Neurology, Specialist Hospital in Końskie, Końskie , Poland
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7
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Rodrigues AM, Ferreira PL, Ferré-Grau C. Providing informal home care for pressure ulcer patients: how it affects carers' quality of life and burden. J Clin Nurs 2016; 25:3026-35. [PMID: 27577533 DOI: 10.1111/jocn.13356] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2016] [Indexed: 12/31/2022]
Abstract
AIMS AND OBJECTIVES To evaluate the quality of life of informal caregivers of patients with pressure ulcer; to assess their levels of burden; to analyse the variables influencing both their quality of life and burden. BACKGROUND Informal caregivers of pressure ulcer patients, besides coping with the natural dependency of these patients, deal with the specificity of caring these types of wounds. This situation has an impact on not only the quality of life and burden felt by informal caregivers but also on individual and familiar dynamics. DESIGN Descriptive and correlational study. METHODS This study focused on 145 informal caregivers providing home care. Measurement instruments were: SF-36v2 and the Burden Interview Scale. Descriptive analysis of the quantitative variables was carried out according to measures of central tendency, and the qualitative variables were described using absolute and relative frequencies. The relationships or associations between variables were explored through correlational analysis and, whenever the data allowed, multivariate techniques were used. RESULTS AND DISCUSSION Informal caregivers showed low levels of quality of life and, most of them, significant burden. Quality of life decreased with overload, with the increasing number of pressure ulcer and with less experience of informal caregivers, with lack of financial remuneration, with unemployment, with patient positioning and with the direct care of the wound. The burden increased with the number of pressure ulcer in each patient and with the lack of financial remuneration. CONCLUSION These informal caregivers have low quality of life and are overburdened. Both situations are positively and negatively influenced by factors related to the pressure ulcer and to the patients' sociodemographic data. RELEVANCE TO CLINICAL PRACTICE The results of this study allow more effective monitoring by health professionals of levels of burden and quality of life encountered in pressure ulcer informal caregivers, as well as direct interventions to inhibit the factors inducing burden and enhance those that improve quality of life.
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Affiliation(s)
- Alexandre M Rodrigues
- School of Health, University of Aveiro, Aveiro, Portugal. .,CEISUC - Centre for Health Studies and Research of the University of Coimbra, Coimbra, Portugal.
| | - Pedro L Ferreira
- CEISUC - Centre for Health Studies and Research of the University of Coimbra, Coimbra, Portugal.,Faculty of Economics, University of Coimbra, Coimbra, Portugal
| | - Carmen Ferré-Grau
- Nursing Department, University of Roviri i Virgili, Tarragona, Spain
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EVASEP: A Noninterventional Study Describing the Perception of Neurologists, Patients, and Caregivers on Caregivers' Role in the Support of Patients Suffering from Multiple Sclerosis Treated with Subcutaneous Interferon Beta 1a. Mult Scler Int 2016; 2016:4986073. [PMID: 27563466 PMCID: PMC4983666 DOI: 10.1155/2016/4986073] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 06/17/2016] [Accepted: 07/03/2016] [Indexed: 11/24/2022] Open
Abstract
Background. The perception of the role of caregivers for people with multiple sclerosis (MS) is important but poorly studied, particularly in patients with low levels of disability. Objectives. To describe the perceptions of the role of caregivers from the perspective of the caregiver, the patient, and neurologists. Methods. This observational study was conducted in France on patients with relapsing remitting MS treated with subcutaneous (SC) interferon-β-1a (IFN-β-1a) for more than 24 months. Results. Caregiver, patients, and neurologists all considered providing moral support and fighting against the disease as the most important role of the care provider. Moral support was considered significantly more important by caregivers than the patients and neurologists (p = 0.002) and caregivers considered their role in helping patients to fight disease more important than did the neurologists (p = 0.006). Knowledge of disease and available treatments were less important among support providers than patients (p = 0.007 and p = 0.001). Conclusion. There are many unmet needs in the perception of the role of caregivers for people with MS which need to be addressed to deliver the most effective care package for patients and to support the needs of the support provider.
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9
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Rollero C. The Experience of Men Caring for a Partner With Multiple Sclerosis. J Nurs Scholarsh 2016; 48:482-9. [DOI: 10.1111/jnu.12231] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Chiara Rollero
- Assistant Professor; Faculty of Psychology; University eCampus; Italy
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10
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Giordano A, Cimino V, Campanella A, Morone G, Fusco A, Farinotti M, Palmisano L, Confalonieri P, Lugaresi A, Grasso MG, Ponzio M, Veronese S, Patti F, Solari A. Low quality of life and psychological wellbeing contrast with moderate perceived burden in carers of people with severe multiple sclerosis. J Neurol Sci 2016; 366:139-145. [PMID: 27288793 DOI: 10.1016/j.jns.2016.05.016] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 05/10/2016] [Accepted: 05/10/2016] [Indexed: 11/24/2022]
Affiliation(s)
- Andrea Giordano
- Unit of Neuroepidemiology, Foundation IRCCS Neurological Institute C. Besta, via Celoria 11, 20133 Milan, Italy.
| | - Vincenzo Cimino
- MS Centre, Neurology Clinic, University Hospital Policlinico Vittorio Emanuele, via S. Sofia, 78, 95123 Catania, Italy.
| | - Angela Campanella
- Scientific Direction, Foundation IRCCS Neurological Institute C. Besta, via Celoria 11, 20133 Milan, Italy.
| | - Giovanni Morone
- Multiple Sclerosis Unit, IRCCS S. Lucia Foundation, Via Ardeatina 306, 00142 Rome, Italy.
| | - Augusto Fusco
- Multiple Sclerosis Unit, IRCCS S. Lucia Foundation, Via Ardeatina 306, 00142 Rome, Italy.
| | - Mariangela Farinotti
- Unit of Neuroepidemiology, Foundation IRCCS Neurological Institute C. Besta, via Celoria 11, 20133 Milan, Italy.
| | - Lucia Palmisano
- Department of Therapeutic Research and Medicine Evaluation, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy.
| | - Paolo Confalonieri
- Unit of Neuroimmunology, and Neuromuscular Diseases, Foundation IRCCS Neurological Institute C. Besta, via Celoria 11, 20133 Milan, Italy.
| | - Alessandra Lugaresi
- Department of Neuroscience, Imaging and Clinical Sciences, G. d'Annunzio University of Chieti-Pescara, Via dei Vestini 31, 66013 Chieti, Italy.
| | - Maria Grazia Grasso
- Multiple Sclerosis Unit, IRCCS S. Lucia Foundation, Via Ardeatina 306, 00142 Rome, Italy.
| | - Michela Ponzio
- Department of Research, Fondazione Italiana Sclerosi Multipla (FISM), Via Operai 40, 16149 Genoa, Italy.
| | - Simone Veronese
- FARO Charitable Foundation, Via Oddino Morgari 12, 10125 Turin, Italy.
| | - Francesco Patti
- MS Centre, Neurology Clinic, University Hospital Policlinico Vittorio Emanuele, via S. Sofia, 78, 95123 Catania, Italy.
| | - Alessandra Solari
- Unit of Neuroepidemiology, Foundation IRCCS Neurological Institute C. Besta, via Celoria 11, 20133 Milan, Italy.
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Leibach GG, Stern M, Arelis AA, Islas MAM, Barajas BVR. Mental Health and Health-Related Quality of Life in Multiple Sclerosis Caregivers in Mexico. Int J MS Care 2016; 18:19-26. [PMID: 26917994 DOI: 10.7224/1537-2073.2014-094] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Multiple sclerosis (MS) rates are increasing in Latin America, and caregiving for an individual with MS is associated with poorer mental and physical health outcomes. No existing research has examined the relation between mental health and health-related quality of life (HRQOL) in MS caregivers in Latin America. METHODS The present study examined the association between mental health (Patient Health Questionnaire-9, Satisfaction with Life Scale, Rosenberg Self-esteem Scale, State-Trait Anxiety Inventory) and HRQOL (36-item Short Form Health Status Survey) in 81 Mexican MS caregivers. RESULTS A canonical correlation analysis uncovered a large, significant overall association between mental health and HRQOL, with 52.7% of the variance shared between the two sets of constructs. When individual canonical loadings were examined in this analysis, the most substantial pattern that emerged was between depression and general health. Four regressions controlling for demographic variables found that HRQOL uniquely accounted for 19.0% of the variance in caregiver anxiety, 32.5% in depression, 13.5% in satisfaction with life, and 14.3% in self-esteem. CONCLUSIONS These findings demonstrated a strong association between HRQOL and mental health, which points to directions for future studies on interventions for MS caregivers, particularly in Mexican and other Latino populations.
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Affiliation(s)
- Gillian G Leibach
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA (GGL); Department of Child & Family Studies, Rehabilitation & Mental Health Counseling Program, University of South Florida, Tampa, FL, USA (MS); Department of Neuroscience, University of Guadalajara, Guadalajara, Mexico (MAMI); Department of Research, Universidad Enrique Diaz de Leon, Guadalajara, Mexico (AAA); and Department of Psychology, Universidad Enrique Diaz de Leon, Guadalajara, Mexico (BVRB)
| | - Marilyn Stern
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA (GGL); Department of Child & Family Studies, Rehabilitation & Mental Health Counseling Program, University of South Florida, Tampa, FL, USA (MS); Department of Neuroscience, University of Guadalajara, Guadalajara, Mexico (MAMI); Department of Research, Universidad Enrique Diaz de Leon, Guadalajara, Mexico (AAA); and Department of Psychology, Universidad Enrique Diaz de Leon, Guadalajara, Mexico (BVRB)
| | - Adriana Aguayo Arelis
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA (GGL); Department of Child & Family Studies, Rehabilitation & Mental Health Counseling Program, University of South Florida, Tampa, FL, USA (MS); Department of Neuroscience, University of Guadalajara, Guadalajara, Mexico (MAMI); Department of Research, Universidad Enrique Diaz de Leon, Guadalajara, Mexico (AAA); and Department of Psychology, Universidad Enrique Diaz de Leon, Guadalajara, Mexico (BVRB)
| | - Miguel Angel Macias Islas
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA (GGL); Department of Child & Family Studies, Rehabilitation & Mental Health Counseling Program, University of South Florida, Tampa, FL, USA (MS); Department of Neuroscience, University of Guadalajara, Guadalajara, Mexico (MAMI); Department of Research, Universidad Enrique Diaz de Leon, Guadalajara, Mexico (AAA); and Department of Psychology, Universidad Enrique Diaz de Leon, Guadalajara, Mexico (BVRB)
| | - Brenda Viridiana Rábago Barajas
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA (GGL); Department of Child & Family Studies, Rehabilitation & Mental Health Counseling Program, University of South Florida, Tampa, FL, USA (MS); Department of Neuroscience, University of Guadalajara, Guadalajara, Mexico (MAMI); Department of Research, Universidad Enrique Diaz de Leon, Guadalajara, Mexico (AAA); and Department of Psychology, Universidad Enrique Diaz de Leon, Guadalajara, Mexico (BVRB)
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McKenzie T, Quig ME, Tyry T, Marrie RA, Cutter G, Shearin E, Johnson K, Simsarian J. Care Partners and Multiple Sclerosis: Differential Effect on Men and Women. Int J MS Care 2015; 17:253-60. [PMID: 26664330 PMCID: PMC4673917 DOI: 10.7224/1537-2073.2014-083] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Caring for someone with multiple sclerosis (MS) can be a stressful experience that requires clinical attention. We investigated the impact of caregiver stress on the emotional well-being and physical health of the MS care partner using the North American Research Committee on Multiple Sclerosis (NARCOMS) Registry. METHODS Care partners of NARCOMS participants were invited to complete an online questionnaire that captured demographic characteristics, health status, caregiver burden as measured by the Zarit Caregiver Burden Interview, and impact of caregiving on employment. RESULTS Of 1446 care partners who agreed to participate, 1333 had complete data. Most were men (n = 825, 61.9%), with a mean (SD) age of 51.1 (11.2) years. The mean (SD) Zarit total score was 24.6 (15.1), placing the overall group in the mild caregiver burden range. Compared with male care partners, female care partners reported higher levels of burden and stress and more medication use for stress/anxiety and mood disorders. Male care partners were more likely to report physical concerns. Care partners of people with primary progressive MS reported greater perceived burden than did partners of people with secondary progressive MS and relapsing-remitting MS. More than 40% of care partners (559 of 1288) had missed work during the past year owing to caregiving responsibilities. CONCLUSIONS Care partners of people with MS have substantial physical and psychological health concerns and experience an adverse impact on employment. Future research should evaluate how to mitigate the adverse effects of caregiving and evaluate positive aspects of the role.
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Affiliation(s)
- Tamara McKenzie
- American School of Professional Psychology, Argosy University, Washington, DC, USA (TM, ES, KJ); Neuropsychology Associates of Fairfax, Fairfax, VA, USA (MEQ); Department of Neurology, Georgetown University Medical Center, Washington, DC, USA (MEQ); Dignity Health, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA (TT); Departments of Medicine and Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada (RAM); Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA (GC); and Neurology Center of Fairfax, Fairfax, VA, USA (JS)
| | - Mary Elizabeth Quig
- American School of Professional Psychology, Argosy University, Washington, DC, USA (TM, ES, KJ); Neuropsychology Associates of Fairfax, Fairfax, VA, USA (MEQ); Department of Neurology, Georgetown University Medical Center, Washington, DC, USA (MEQ); Dignity Health, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA (TT); Departments of Medicine and Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada (RAM); Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA (GC); and Neurology Center of Fairfax, Fairfax, VA, USA (JS)
| | - Tuula Tyry
- American School of Professional Psychology, Argosy University, Washington, DC, USA (TM, ES, KJ); Neuropsychology Associates of Fairfax, Fairfax, VA, USA (MEQ); Department of Neurology, Georgetown University Medical Center, Washington, DC, USA (MEQ); Dignity Health, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA (TT); Departments of Medicine and Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada (RAM); Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA (GC); and Neurology Center of Fairfax, Fairfax, VA, USA (JS)
| | - Ruth Ann Marrie
- American School of Professional Psychology, Argosy University, Washington, DC, USA (TM, ES, KJ); Neuropsychology Associates of Fairfax, Fairfax, VA, USA (MEQ); Department of Neurology, Georgetown University Medical Center, Washington, DC, USA (MEQ); Dignity Health, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA (TT); Departments of Medicine and Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada (RAM); Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA (GC); and Neurology Center of Fairfax, Fairfax, VA, USA (JS)
| | - Gary Cutter
- American School of Professional Psychology, Argosy University, Washington, DC, USA (TM, ES, KJ); Neuropsychology Associates of Fairfax, Fairfax, VA, USA (MEQ); Department of Neurology, Georgetown University Medical Center, Washington, DC, USA (MEQ); Dignity Health, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA (TT); Departments of Medicine and Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada (RAM); Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA (GC); and Neurology Center of Fairfax, Fairfax, VA, USA (JS)
| | - Edward Shearin
- American School of Professional Psychology, Argosy University, Washington, DC, USA (TM, ES, KJ); Neuropsychology Associates of Fairfax, Fairfax, VA, USA (MEQ); Department of Neurology, Georgetown University Medical Center, Washington, DC, USA (MEQ); Dignity Health, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA (TT); Departments of Medicine and Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada (RAM); Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA (GC); and Neurology Center of Fairfax, Fairfax, VA, USA (JS)
| | - Kamau Johnson
- American School of Professional Psychology, Argosy University, Washington, DC, USA (TM, ES, KJ); Neuropsychology Associates of Fairfax, Fairfax, VA, USA (MEQ); Department of Neurology, Georgetown University Medical Center, Washington, DC, USA (MEQ); Dignity Health, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA (TT); Departments of Medicine and Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada (RAM); Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA (GC); and Neurology Center of Fairfax, Fairfax, VA, USA (JS)
| | - James Simsarian
- American School of Professional Psychology, Argosy University, Washington, DC, USA (TM, ES, KJ); Neuropsychology Associates of Fairfax, Fairfax, VA, USA (MEQ); Department of Neurology, Georgetown University Medical Center, Washington, DC, USA (MEQ); Dignity Health, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA (TT); Departments of Medicine and Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada (RAM); Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA (GC); and Neurology Center of Fairfax, Fairfax, VA, USA (JS)
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A Disproportionate Burden of Care: Gender Differences in Mental Health, Health-Related Quality of Life, and Social Support in Mexican Multiple Sclerosis Caregivers. Behav Neurol 2015; 2015:283958. [PMID: 26538818 PMCID: PMC4619924 DOI: 10.1155/2015/283958] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Revised: 05/29/2015] [Accepted: 06/04/2015] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Multiple sclerosis (MS) rates in Latin America are increasing, and caregivers there experience reduced mental and physical health. Based on rigid gender roles in Latin America, women more often assume caregiving duties, yet the differential impact on women of these duties is unknown. METHODS This study examined gender differences in mental health (Patient Health Questionnaire-9, Satisfaction with Life Scale, Rosenberg Self-Esteem Scale, State-Trait Anxiety Inventory, and Zarit Burden Inventory), health-related quality of life (HRQOL; Short Form-36), and social support (Interpersonal Support Evaluation List-12) in 81 (66.7% women) Mexican MS caregivers. RESULTS As compared to men caregivers, women had lower mental health (p = 0.006), HRQOL (p < 0.001), and social support (p < 0.001). This was partially explained by women caregivers providing care for nearly twice as many hours/week as men (79.28 versus 48.48, p = 0.018) and for nearly three times as many months (66.31 versus 24.30, p = 0.002). CONCLUSIONS Because gender roles in Latin America influence women to assume more substantial caregiving duties, MS caregiver interventions in Latin America-particularly for women caregivers-should address the influence of gender-role conformity on care and psychosocial functioning.
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Patterns of Objective and Subjective Burden of Informal Caregivers in Multiple Sclerosis. Behav Neurol 2015; 2015:648415. [PMID: 26078487 PMCID: PMC4452831 DOI: 10.1155/2015/648415] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Accepted: 04/30/2015] [Indexed: 01/24/2023] Open
Abstract
Background. Home
care for patients with Multiple Sclerosis (MS)
relies largely on informal caregivers (ICs).
Methods. We assessed ICs
objective burden (Resource Utilization in
Dementia measuring informal care time (ICT)) and
ICs subjective burden (Zarit Burden Inventory (ZBI)). Results. ICs
(N = 99)
were spouses (70%), mean age 52 years,
assisting disabled patients with a mean EDSS
(Expanded Disability Status Scale) of 5.5, with
executive dysfunction (mean DEX (Dysexecutive questionnaire) of 25) and a duration of MS
ranging from 1 to 44 years. Objective burden was
high (mean ICT = 6.5 hours/day), mostly
consisting of supervision time. Subjective
burden was moderate (mean ZBI = 27.3).
Multivariate analyses showed that both burdens
were positively correlated with higher levels of
EDSS and DEX, whereas coresidency and IC's
female gender correlated with objective burden
only and IC's poor mental health status with
subjective burden only. When considering MS
aggressiveness, it appeared that both burdens
were not correlated with a higher duration of MS
but rather increased for patients with severe
and early dysexecutive function and for patients
classified as fast progressors according to the
Multiple Sclerosis Severity Score.
Conclusion. Evaluation of MS
disability course and IC's personal
situation is crucial to understand the burden
process and to implement adequate interventions
in MS.
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du Plooy DR, Pretorius C. The caregiver experience: a South African perspective on caring for people with multiple sclerosis. JOURNAL OF PSYCHOLOGY IN AFRICA 2014. [DOI: 10.1080/14330237.2014.980623] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Abstract
Thirty percent of persons with multiple sclerosis (pwMS) require caregiving owing to their disability, and 80% of care to pwMS is provided by informal unpaid caregivers. The average caregiver is male, in a spousal/partner relationship with the pwMS, and provides more than 4 hours per day of care for many years. The physical, emotional, and time-intensive nature of caregiving for pwMS frequently impairs the caregiver's own physical and emotional health. Rehabilitation medicine professionals should be aware of the high risk of caregiver burden. Assessment of caregiver needs and appropriate intervention will help minimize the burden on caregivers.
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17
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Costs of formal and informal home care and quality of life for patients with multiple sclerosis in sweden. Mult Scler Int 2014; 2014:529878. [PMID: 24729875 PMCID: PMC3960744 DOI: 10.1155/2014/529878] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Accepted: 11/19/2013] [Indexed: 11/22/2022] Open
Abstract
Disease progression in multiple sclerosis leads to dramatic changes in a person's ability to perform daily activities and increases reliance on external help. This study aims to describe and to estimate costs of formal/informal home care and quality of life related to multiple sclerosis. A mailed survey to a random sample of MS sufferers (n = 1500) collected data on the number of hours of home care received, type of help, productivity losses, quality of life, and disease characteristics. Costs for home care were estimated in 2012 € and factors that may influence the likelihood of getting home care were also evaluated. Formal care was given to 27% of the respondents (n = 839) at an average of 238.7 hrs/month at a mean monthly cost of €2873/person with MS. Informal care was received by 49% of the respondents at an average of 47.3 hrs/month at a mean monthly cost of €389/person with MS. Utilities across disease severity are as follows: mild MS = 0.709 (sd = 0.233), moderate MS = 0.562 (sd = 0.232), and severe MS = 0.284 (sd = 0.283). Total home care costs increased with increasing disease severity. Informal caregiving contributes significantly to MS home care in Sweden.
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18
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Sonder JM, Holman R, Knol DL, Bosma LVAE, Polman CH, Uitdehaag BMJ. Analyzing differences between patient and proxy on Patient Reported Outcomes in multiple sclerosis. J Neurol Sci 2013; 334:143-7. [PMID: 24018128 DOI: 10.1016/j.jns.2013.08.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Revised: 07/23/2013] [Accepted: 08/11/2013] [Indexed: 01/22/2023]
Abstract
BACKGROUND Proxy respondents, partners of multiple sclerosis (MS) patients, can provide valuable information on the MS patients' disease. In an earlier publication we found relatively good agreement on patient reported outcomes (PROs) measuring physical impact and functioning, but we found large differences on (neuro)psychological scales. OBJECTIVE We aim to identify patient and proxy related variables explaining differences between patients' and proxies' ratings on five PROs. METHODS We report on data from 175 MS patients and proxy respondents. Regression analyses were performed, using as dependent variable the mean differences on five scales: Physical and Psychological scale of the Multiple Sclerosis Impact Scale (MSIS-29), the Multiple Sclerosis Walking Scale (MSWS), Guy's Neurological Disability Scale (GNDS) and the Multiple Sclerosis Neuropsychological Screening Questionnaire (MSNQ). The independent variables were patient, proxy and disease related variables. RESULTS Caregiver strain was significantly related to differences between patient and proxy scores for all five PROs. A higher level of patient anxiety on the HADS was linked to larger differences on all PROs except the GNDS. In addition, cognitive functioning, proxy depression, walking ability, proxy gender and MS related disability were contributing to the discrepancies. CONCLUSION We found several patient and proxy factors that may contribute to discrepancies between patient and proxy scores on MS PROs. The most important factor is caregiver burden.
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Affiliation(s)
- Judith M Sonder
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands; Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands.
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Conceptions of daily life in men living with a woman suffering from chronic obstructive pulmonary disease. Prim Health Care Res Dev 2012; 14:140-50. [PMID: 23026500 DOI: 10.1017/s1463423612000394] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
AIM To describe conceptions of daily life in men living with a woman suffering from chronic obstructive pulmonary disease (COPD) in different stages of the disease. BACKGROUND A chronic disease like COPD affects not only the person living with the illness, but also the spouse. Significant tasks and demands are placed on husbands. COPD has for a long time been considered more a man's disease than a woman's disease, but according to new evidence COPD is a vast problem in women, which requires support from their spouses. The literature review did not reveal any previous studies concerning conceptions of daily life in men living with women suffering from COPD in different stages. METHODS A phenomenographic study was conducted. Data were collected from October 2008 to October 2009 through semi-structured interviews with 19 men living with a woman suffering from COPD. FINDINGS Two main descriptive categories were found: (1) unchanged life situation where no support was needed; (2) changed life situation related to severity of COPD, where support was needed. The categories were described from the perspective 'ME and my spouse'. Even in their caregiving situation, the men continued with their own life and activities and did not put themselves in second place. No support was needed from healthcare or municipality when the women had mild COPD, but this changed when the COPD progressed. The men felt that daily life was burdened, restricted and the partner relationship was affected, even if the disease had not reached the final stage. The COPD forced them gradually into a caregiving role, and their daily life changed. They become more of a caregiver than a spouse. The men experienced lack of knowledge and support, and they felt that health professionals and municipality did not care about them.
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