The relationship between the care burden and burnout levels of primary caregivers of patients undergoing liver transplantation

Burden, stress and depression in caregivers of cirrhosis patients before and after liver transplantation

BACKGROUND

Family caregivers of cirrhosis patients (CPs) often experience burden, stress, and depression. Investigating whether these conditions improve following the patient undergoing liver transplantation (LT) is crucial, as it would elucidate the comprehensive benefits of the procedure and demonstrate the positive impacts not only on the patients but also on their caregivers and society.

AIM

To compare the levels of burden, stress and depression among family caregivers of cirrhotic and liver transplant patients.

METHODS

This cross-sectional observational study evaluated caregivers of CPs and LT recipients at a quaternary Brazilian hospital. Instruments included identification cards, interview scripts, the caregiver burden scale Inventory, Lipp’s Stress Symptom Inventory, and the Beck Depression Inventory-Second Edition. Psychometric analyses involved confirmatory factor analysis and calculation of McDonald’s omega and composite reliability. Factor scores were compared with the Mann-Whitney U test, with effect size as the rank-biserial correlation coefficient (r). Statistical analysis was performed with R software (P < 0.05).

RESULTS

Seventy-seven CP caregivers and 65 LT recipient caregivers were included. Most were female (CP: 85.7% vs LT: 84.6%) and the patients’ spouses (76.6% vs 63.1%). The median age and caregiving duration were 55.4 (23.3-76.3) vs 54.6 (25.7-82.1) and 3.9 (1-20) vs 8 (1.5-24) years, respectively (P = 0.001). LT caregivers were less likely to be at risk of overload (21.5% vs 49.4%), to be under stress (33.8% vs 36.4%) and to show symptoms of depression (15.4% vs 35.1%). Compared with LT caregivers, CP caregivers had greater median factor scores for burden (general tension, P = 0.012; isolation, P = 0.014; disappointment, P = 0.004), depression (P = 0.008), and stress (P = 0.047), with small to moderate effect sizes. The disappointment (r = 0.240) and depression (r = 0.225) dimensions had the largest effect sizes.

CONCLUSION

Family caregivers of LT recipients are less likely to exhibit symptoms of burden, stress, and depression, suggesting that the benefits of LT extend to the patients’ family members.

Caregiver burden, perceived stress, and social support among parents of chronically Ill children in Saudi Arabia

BACKGROUND

Children with chronic illnesses pose a significant burden on parents who are directly involved in caregiving. Despite the high prevalence of chronic illnesses among children in Saudi Arabia, no study has examined caregiver burden and other related factors in the Saudi Population. Thus, this study determined the levels of caregiver burden, perceived social support, and perceived stress and their association among parents who provide care to their child with a chronic illness.

METHODS

A cross-sectional design was used for this study. Data were collected through an online survey using standardized scales from parents who had at least one child suffering from a chronic illness or disability for more than 12 months and requiring continuous medical treatment.

RESULTS

A total of 206 parents reported mild-to-moderate levels of caregiver burden, moderate levels of perceived stress, and high levels of perceived social support. Furthermore, perceived social support was significantly correlated with caregiver burden (rho = - 0.36, p < 0.01) and perceived stress (rho = - 0.45, p < 0.01), and caregiver burden was significantly associated with perceived stress (rho = 0.65, p < 0.01).

CONCLUSIONS

Study findings suggest that social support could play a pivotal role in designing intervention programs to mitigate the stress caused by the caregiver burden. This insight underscores the urgent need for policymakers to develop psychosocial interventions and targeted programs for caregivers of children with chronic illnesses.

Is Night Surgery a Nightmare for Lung Transplantation?

Night work is frequently associated with sleep deprivation and is associated with greater surgical and medical complications. Lung transplantation (LT) is carried out both at night and during the day and involves many medical healthcare workers. The goal of the study was to compare morbidity and mortality between LT recipients according to LT operative time. We performed a retrospective, observational, single-center study. When the procedure started between 6 AM and 6 PM, the patient was allocated to the Daytime group. If the procedure started between 6 PM and 6 AM, the patient was allocated to the Nighttime group. Between January 2015 and December 2020, 253 patients were included. A total of 168 (66%) patients were classified into the Day group, and 85 (34%) patients were classified into the Night group. Lung Donors' general characteristics were similar between the groups. The 90-day and one-year mortality rates were similar between the groups (90-days: n = 13 (15%) vs. n = 26 (15%), p = 0.970; 1 year: n = 18 (21%) vs. n = 42 (25%), p = 0.499). Daytime LT was associated with more one-year airway dehiscence (n = 36 (21%) vs. n = 6 (7.1%), p = 0.004). In conclusion, among patients who underwent LT, there was no significant association between operative time and survival.

The mediating effect of sense of coherence on the caregiver ability-caregiver burden relationship for caregivers of children with liver transplantation in China

BACKGROUND

Caregivers of children who have had liver transplantation often experience chronic care stress. Previous studies have focused on caregivers' negative feelings (e.g., caregiver burden), but few studies have focused on caregivers' positive feelings (e.g., sense of coherence) and caregiver ability.

OBJECTIVES

The study purpose was to investigate the status of the burden of caregivers of children with liver transplantation, and to explore the mediating role of sense of coherence between caregiver ability and caregiver burden.

METHODS

There were 461 questionnaires collected from a tertiary-level hospital from caregivers of children who had liver transplantation from April to June 2022. Demographic data, Family Caregiver Task Inventory, Sense of Coherence Scale-13, and Zarit Burden Interview were used. The STROBE checklist was monitored.

RESULTS

The average caregiver burden score was 32.19 ± 16.71. The distribution of caregiver burden levels was mild (42.52%), none (26.25%), moderate (24.95%), and severe (6.29%). Caregiver ability score was negatively correlated with caregiver burden score; however, sense of coherence score was negatively correlated with caregiver burden score. Caregiver ability partially mediated caregiver burden through sense of coherence (38.51%).

CONCLUSION

The caregiver burden level was not heavy in general. Both positive and negative feelings were present in caregivers. Caregiver ability also reduced the caregiver burden through sense of coherence.

Caregiver Burden in Adult Solid Organ Transplantation

The informal caregiver plays a critical role in supporting patients with various end-stage diseases throughout the solid organ transplantation journey. Caregiver responsibilities include assistance with activities of daily living, medication management, implementation of highly specialized treatments, transportation to appointments and treatments, and health care coordination and navigation. The demanding nature of these tasks has profound impacts across multiple domains of the caregiver's life: physical, psychological, financial, logistical, and social. Few interventions targeting caregiver burden have been empirically evaluated, with the majority focused on education or mindfulness-based stress reduction techniques. Further research is urgently needed to develop and evaluate interventions to improve caregiver burden and outcomes for the patient-caregiver dyad.

Social support and transplantation

PURPOSE OF REVIEW

Social support has many benefits for patients undergoing organ transplantation, though inclusion of it as criteria for transplant listing has been debated. This review highlights recent developments in the research regarding social support and organ transplantation, including the impact of social support on transplantation and caregivers, interventions, COVID-19, and ethical perspectives.

RECENT FINDINGS

Social support and perceived social support have benefits for transplant patients, including increased quality of life and adherence. The providers of social support may also be impacted and the impact may vary based on patient and caregiver characteristics, including organ group and caregiver ethnicity. Debates regarding COVID-19 vaccine requirements for caregivers and ethical concerns about the inclusion of social support as criteria for transplant listing are also explored.

SUMMARY

Transplant patients benefit from social support, though additional research is needed on the impact of social support on transplant outcomes and the utility of the use of social support as criteria for transplant listing. There is also a need for more robust research on diverse caregiver populations, including the identification and use of supportive interventions for caregivers.