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van den Berg R, Blok K, Tebayna N, van Dijk M, van Rosmalen J, de Beukelaar J. Reasons Patients With Primary Progressive Multiple Sclerosis Contact Their Specialist Nurses. Int J MS Care 2024; 26:30-35. [PMID: 38213677 PMCID: PMC10779713 DOI: 10.7224/1537-2073.2022-056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
BACKGROUND Questions asked by patients with primary progressive multiple sclerosis (PPMS) during patient-initiated MS nurse consultations may contain salient information that can help health care providers understand their needs, which, in turn, can help tailor counseling and treatment. METHODS Records of all patients with PPMS visiting the MS center of a large teaching hospital in the Netherlands between January 2007 and January 2021 were studied retrospectively. Number and type (scheduled or patient initiated) of MS nurse consultations, reasons for consultations (in prespecified categories), and frequency of subsequent referrals were registered. Association between factors (living with partner, Expanded Disability Status Scale score, comorbidities, age, sex) and number of patient-initiated consultations was studied using negative binomial regression analysis. RESULTS In total, 98 patients with PPMS were included, with 720 MS nurse consultations during follow-up (median duration, 8.1 years), of which 274 (38%) were patient initiated. Patients had a broad spectrum of reasons to contact MS nurses. The most common categories were treatment (36%) and micturition and defecation (31%). Patients living without a partner (incidence rate ratio, 2.340; 95% CI, 1.057-5.178) and male patients (incidence rate ratio, 1.890; 95% CI, 0.925-3.861) consulted MS nurses more frequently. The MS nurses made 146 referrals (20% of all contacts); 59 were after patient-initiated consultation (22%). The most frequent referrals were to neurologists, urologists, and rehabilitation specialists. CONCLUSIONS Multiple sclerosis nurses have a pivotal role in PPMS care, especially for patients living without a partner and male patients. Recurring questions about (new) treatment options illustrate the pressing need for highly effective treatment. Micturition and defecation problems are also a considerable concern and warrant close monitoring.
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Affiliation(s)
- Rosaline van den Berg
- From the Department of Neurology, Multiple Sclerosis Center (RvdB, KB, NT, JdB) and the Science Office (RvdB), Albert Schweitzer Hospital, Dordrecht, the Netherlands
| | - Katelijn Blok
- From the Department of Neurology, Multiple Sclerosis Center (RvdB, KB, NT, JdB) and the Science Office (RvdB), Albert Schweitzer Hospital, Dordrecht, the Netherlands
- Multiple Sclerosis Center ErasMS of the Department of Neurology (KB)
| | - Nura Tebayna
- From the Department of Neurology, Multiple Sclerosis Center (RvdB, KB, NT, JdB) and the Science Office (RvdB), Albert Schweitzer Hospital, Dordrecht, the Netherlands
| | - Monique van Dijk
- Nursing Science Section of the Department of Internal Medicine (MvD)
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Wang F, Irani E, Tian MC, Yi Lau MM. The Mediating Effect of Caregiving Relationship Quality on the Association Between Caregiving Stressors and Mental Health Problems Among Older Spousal Caregivers. Int J Aging Hum Dev 2023; 97:435-455. [PMID: 36518012 DOI: 10.1177/00914150221143959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
Providing care to a spouse can be especially challenging for older adults given their compounding stressors resulting from aging and caregiving. This cross-sectional study examines the relationships between caregiving stressors and caregiver mental health problems and the potential mediator (i.e., caregiving relationship quality) of these associations. A total of 431 Americans (≥65 years) were selected from the National Study of Caregiving. Path analysis shows that care assistance was positively associated with caregiver mental health problems, and this association was mediated by negative relationship quality (Indirect effect = .14, p = .016). Moreover, role overload was positively associated with caregiver mental health problems, which was mediated by negative relationship quality (indirect effect = .13, p = .002). Findings suggest that caregiving stressors can adversely affect mental health by exacerbating negative relationship quality. Interventions that limit negative exchanges and increase compassionate communications between older spousal caregivers and their care-receiving partners are needed.
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Affiliation(s)
- Fei Wang
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Elliane Irani
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | | | - Mandy Man Yi Lau
- Department of Social Work, Chinese University of Hong Kong, Hong Kong, SAR, China
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Chu NY, Watson KE, Al Hamarneh YN, Yushko L, Tsuyuki RT, Smyth P. Evaluating the impact of patient-reported outcome measures on depression and anxiety levels in people with multiple sclerosis: a study protocol for a randomized controlled trial. BMC Neurol 2023; 23:53. [PMID: 36732694 PMCID: PMC9893570 DOI: 10.1186/s12883-023-03090-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 01/25/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Multiple sclerosis (MS) is a chronic disease affecting multiple functional aspects of patients' lives. Depression and anxiety are common amongst persons with MS (PwMS). There has been an interest in utilizing patient-reported outcome measures (PROMs) to capture and systematically assess patient's perceptions of their MS experience in addition to other clinical measures, but PROMs are not usually collected in routine clinical practice. Therefore, this study aims to systematically incorporate periodic electronically administered PROMs into the care of PwMS to evaluate its effects on depression and anxiety. METHODS A randomized controlled trial will be conducted with patients allocated 1:1 to either intervention or conservative treatment groups. Patients in the intervention group will complete PROMs at the start of the study and then every 6 months for 1 year, in addition to having their MS healthcare provider prompted to view their scores. The conservative treatment group will complete PROMs at the start of the study and again after 12 months, and their neurologist will not be able to view their scores. For both groups, pre-determined critical PROM scores will trigger an alert to the patient's MS provider. The difference in change in Hospital Anxiety and Depression Scale score between the intervention and conservative treatment groups at 12 months will be the primary outcome, along with difference in Consultation Satisfaction Questionnaire and CollaboRATE scores at 12 months, and proportion and type of healthcare provider intervention/alerts initiated by different PROMs as secondary outcomes. DISCUSSION This study will determine the feasibility of utilizing PROMs on an interval basis and its effects on the psychological well-being of PwMS. Findings of this study will provide evidence on use of PROMs in future MS clinical practice. TRIAL REGISTRATION This trial is registered at the National Institutes of Health United States National Library of Medicine, ClinicalTrials.gov NCT04979546 . Registered on July 28, 2021.
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Affiliation(s)
- Nathan Y. Chu
- grid.17089.370000 0001 2190 316XDepartment of Medicine, Division of Neurology, University of Alberta, 7-132B Clinical Sciences Building, 8440 112 Street NW, Edmonton, AB T6G 2B7 Canada
| | - Kaitlyn E. Watson
- grid.17089.370000 0001 2190 316XEPICORE (Epidemiology Coordinating and Research) Centre, Department of Medicine, University of Alberta, Edmonton, AB Canada
| | - Yazid N. Al Hamarneh
- grid.17089.370000 0001 2190 316XEPICORE (Epidemiology Coordinating and Research) Centre, Department of Medicine, University of Alberta, Edmonton, AB Canada ,grid.17089.370000 0001 2190 316XDepartment of Pharmacology, University of Alberta, Edmonton, AB Canada
| | - Lily Yushko
- grid.17089.370000 0001 2190 316XEPICORE (Epidemiology Coordinating and Research) Centre, Department of Medicine, University of Alberta, Edmonton, AB Canada
| | - Ross T. Tsuyuki
- grid.17089.370000 0001 2190 316XEPICORE (Epidemiology Coordinating and Research) Centre, Department of Medicine, University of Alberta, Edmonton, AB Canada ,grid.17089.370000 0001 2190 316XDepartment of Pharmacology, University of Alberta, Edmonton, AB Canada ,grid.17089.370000 0001 2190 316XDepartment of Medicine, University of Alberta, Edmonton, AB Canada
| | - Penelope Smyth
- grid.17089.370000 0001 2190 316XDepartment of Medicine, Division of Neurology, University of Alberta, 7-132B Clinical Sciences Building, 8440 112 Street NW, Edmonton, AB T6G 2B7 Canada
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Smyth P, Watson KE, Al Hamarneh YN, Tsuyuki RT. The effect of nurse practitioner (NP-led) care on health-related quality of life in people with multiple sclerosis - a randomized trial. BMC Neurol 2022; 22:275. [PMID: 35879701 PMCID: PMC9310450 DOI: 10.1186/s12883-022-02809-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 07/19/2022] [Indexed: 11/10/2022] Open
Abstract
Background Care for People with Multiple Sclerosis (PwMS) is increasingly complex, requiring innovations in care. Canada has high rates of MS; it is challenging for general neurologists to optimally care for PwMS with busy office practices. The aim of this study was to evaluate the effects of add-on Nurse Practitioner (NP)-led care for PwMS on depression and anxiety (Hospital Anxiety and Depression Scale, HADS), compared to usual care (community neurologist, family physician). Methods PwMS followed by community neurologists were randomized to add-on NP-led or Usual care for 6 months. Primary outcome was the change in HADS at 3 months. Secondary outcomes were HADS (6 months), EQ5D, MSIF, CAREQOL-MS, at 3 and 6 months, and Consultant Satisfaction Survey (6 months). Results We recruited 248 participants; 228 completed the trial (NP-led care arm n = 120, Usual care arm n = 108). There were no significant baseline differences between groups. Study subjects were highly educated (71.05%), working full-time (41.23%), living independently (68.86%), with mean age of 47.32 (11.09), mean EDSS 2.53 (SD 2.06), mean duration since MS diagnosis 12.18 years (SD 8.82) and 85% had relapsing remitting MS. Mean change in HADS depression (3 months) was: -0.41 (SD 2.81) NP-led care group vs 1.11 (2.98) Usual care group p = 0.001, sustained at 6 months; for anxiety, − 0.32 (2.73) NP-led care group vs 0.42 (2.82) Usual care group, p = 0.059. Other secondary outcomes were not significantly different. There was no difference in satisfaction of care in the NP-led care arm (63.83 (5.63)) vs Usual care (62.82 (5.45)), p = 0.194). Conclusion Add-on NP-led care improved depression compared to usual neurologist care and 3 and 6 months in PwMS, and there was no difference in satisfaction with care. Further research is needed to explore how NPs could enrich care provided for PwMS in healthcare settings. Trial registration Retrospectively registered on clinicaltrials.gov (ClinicalTrials.gov Identifier: NCT04388592, 14/05/2020). Supplementary Information The online version contains supplementary material available at 10.1186/s12883-022-02809-9.
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Affiliation(s)
- Penelope Smyth
- Division of Neurology, Department of Medicine, University of Alberta, Edmonton, Canada.
| | - Kaitlyn E Watson
- EPICORE Centre, Department of Medicine, University of Alberta, Edmonton, Canada
| | - Yazid N Al Hamarneh
- EPICORE Centre, Department of Medicine, University of Alberta, Edmonton, Canada
| | - Ross T Tsuyuki
- EPICORE Centre, Department of Medicine, University of Alberta, Edmonton, Canada
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Morrison EH, Sorkin D, Mosqueda L, Ayutyanont N. Validity and Reliability of the Scale to Report Emotional Stress Signs–Multiple Sclerosis (STRESS-MS) in Assessing Abuse and Neglect of Adults With Multiple Sclerosis. Int J MS Care 2021; 24:18-24. [DOI: 10.7224/1537-2073.2020-016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Abstract
Background:
Approximately 30% of people with multiple sclerosis (MS) require caregiving, with unknown prevalence of abuse and neglect. To explore these issues, we created the Scale to Report Emotional Stress Signs–Multiple Sclerosis (STRESS-MS). The objective was to develop, validate, and field-test a self-report questionnaire for screening people with MS for mistreatment.
Methods:
We developed the STRESS-MS questionnaire and administered it to 102 adults with advanced MS-related disability and 97 primary informal caregivers, correlating responses with direct observation of mistreatment, conducting an item analysis, and evaluating validity using a Longitudinal, Expert, All Data (LEAD) panel.
Results:
Most STRESS-MS subscales correlated highly with criterion-standard LEAD panel evaluations of mistreatment, with strong concurrent and discriminant validity. Nearly 53% of participants with MS reported experiencing psychological abuse; 9.8%, financial exploitation; 6.9%, physical abuse; 4.9%, neglect; and 3.9%, sexual abuse. Protective factors for people with MS included social support and older age; risk factors included depression and aggressiveness. The greatest risk factor was an informal caregiver who spent 20 or more hours per week caring for the person with MS.
Conclusions:
The STRESS-MS questionnaire is reasonably reliable and valid for detecting caregiver mistreatment in adults with MS. Although most informal caregivers are not abusive, this study highlights an underrecognized need to detect and prevent abuse and neglect of people with MS.
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Affiliation(s)
- Elizabeth H. Morrison
- From the Department of Psychiatry and Neuroscience, University of California, Riverside School of Medicine, Riverside, CA, USA (EHM)
| | - Dara Sorkin
- Departments of Medicine, Public Health, and Psychology and Social Behavior, University of California, Irvine School of Medicine, Irvine, CA, USA (DS)
| | - Laura Mosqueda
- Department of Family Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA (LM)
| | - Napatkamon Ayutyanont
- Graduate Medical Education–Far West Division, Hospital Corporation of America, Las Vegas, NV, USA (NA)
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Knobloch LK, Nichols LO, Martindale-Adams J. Applying Relational Turbulence Theory to Adult Caregiving Relationships. THE GERONTOLOGIST 2020; 60:598-606. [PMID: 31228192 DOI: 10.1093/geront/gnz090] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Indexed: 01/06/2023] Open
Abstract
Although the quality of the relationship between caregivers and care recipients predicts the well-being of both people, gaps exist in understanding the interpersonal dynamics of adult caregiving. We introduce relational turbulence theory as a conceptual framework for understanding how caregivers and care recipients relate to each other. We searched for research on relational turbulence theory as well as research on the relationships of adult care partners. Then, we integrated the two bodies of work. Our review suggests initial support for the theory's three central tenets: (a) transitions, including the transition to caregiving, are key periods within relationships; (b) relational uncertainty and interdependence are relationship parameters that complicate relating during transitions; and (c) relational turbulence predicts outcomes. Recommendations for practice include (a) helping care partners focus on relationship continuity, (b) gearing clinical services toward both people, (c) educating them about relational uncertainty and interdependence, and (d) teaching them communication strategies for diminishing relational turbulence. Making care partners aware of interpersonal challenges may bolster relationship satisfaction.
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Affiliation(s)
| | - Linda O Nichols
- Veterans Affairs Medical Center Memphis and Departments of Preventive Medicine and Internal Medicine, University of Tennessee Health Science Center, Memphis
| | - Jennifer Martindale-Adams
- Department of Preventive Medicine, University of Tennessee Health Science Center and Veterans Affairs Medical Center Memphis, Memphis
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Tehranineshat B, Yektatalab S, Momennasab M, Bijani M, Mohammadi F. The Experiences of Multiple Sclerosis Patients' Family Caregivers at the First Hospitalization of Their Patients: A Qualitative Study. Patient Prefer Adherence 2020; 14:1159-1172. [PMID: 32764889 PMCID: PMC7367720 DOI: 10.2147/ppa.s257746] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 06/23/2020] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND AND AIM Being diagnosed with multiple sclerosis is usually accompanied by emotional trauma for patients and their families. The chronic, progressive, and unpredictable nature of the disease spells the patients' long-term need for care from their families. As soon as a diagnosis is made, family caregivers are faced with many challenges. The present study aims to identify family caregivers' experiences at the first hospitalization of their patients. MATERIALS AND METHODS The present study is a work of qualitative research and uses the conventional content analysis approach. It lasted from July 2019 to March 2020. The subjects were selected via purposeful sampling. To collect data, the researchers conducted in-depth, semi-structured interviews with 18 family caregivers of patients with multiple sclerosis. The collected data were analyzed using MAXQDA 2007. RESULTS Analysis of the data yielded three themes: peaceful environment, need for continuing full support, and religion-based coping strategies. CONCLUSION The findings of the present study can be used to develop support programs that address family caregivers' problems and needs to assist them in accepting and coping with the conditions of their patients, thereby increasing the quality of care provided to patients with multiple sclerosis.
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Affiliation(s)
- Banafsheh Tehranineshat
- Community-Based Psychiatric Care Research Center, Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shahrzad Yektatalab
- Community-Based Psychiatric Care Research Center, Department of Mental Health and Psychiatric Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
- Correspondence: Shahrzad Yektatalab Community-Based Psychiatric Care Research Center,Department of Mental Health and Psychiatric Nursing,School of Nursing and Midwifery,Shiraz University of Medical Sciences,Zand St., Nemazee Sq.,7193613119, Shiraz, Iran Email
| | - Marzieh Momennasab
- Community-Based Psychiatric Care Research Center, Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mostafa Bijani
- Department of Medical Surgical Nursing, Fasa University of Medical Sciences, Fasa, Iran
| | - Fateme Mohammadi
- Chronic Diseases (Home Care) Research Center, Autism Spectrum Disorders Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
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O’Mahony J, Marrie RA, Laporte A, Bar-Or A, Yeh EA, Brown A, Dilenge ME, Banwell B. Pediatric-onset multiple sclerosis is associated with reduced parental health–related quality of life and family functioning. Mult Scler 2018; 25:1661-1672. [DOI: 10.1177/1352458518796676] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Diagnosis of multiple sclerosis (MS) during childhood has the potential to impact the affected child’s self-perception and the health-related quality of life (HRQoL) of the family. Objective: To evaluate the impact of chronic disease, in children ascertained as having MS and their families, when compared to those with monophasic acquired demyelinating syndrome (monoADS). Methods: In a national prospective cohort study of pediatric acquired demyelinating syndromes (ADS), the HRQoL of children and their families was captured using the Pediatric Quality of Life Inventory (PedsQL™) Modules. Results: Participants (58 MS; 178 monoADS) provided cross-sectional HRQoL data a median (interquartile range (IQR)) of 4.1 (2.0–6.0) years after disease onset. The HRQoL of parents of children with MS and their family functioning was lower when compared to that of parents and families of children with monoADS (both p < 0.001); parents of children with MS reported greater emotional dysfunction, worry, worse communication, and lower family functioning irrespective of clinical disease activity. Self-reports of the MS and monoADS participants did not suggest a difference in overall HRQoL or fatigue after adjusting for age of the child at the time of assessment. Conclusion: While children with MS did not self-report lower HRQoL compared to children who experienced monoADS, the diagnosis of MS during childhood was negatively associated with parental HRQoL and family functioning.
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Affiliation(s)
- Julia O’Mahony
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada/The Hospital for Sick Children, Toronto, ON, Canada/Canadian Centre for Health Economics, Toronto, ON, Canada
| | - Ruth Ann Marrie
- Departments of Internal Medicine and Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Audrey Laporte
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada/Canadian Centre for Health Economics, Toronto, ON, Canada
| | - Amit Bar-Or
- Center for Neuroinflammation and Experimental Therapeutics and Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - E Ann Yeh
- Department of Pediatrics, University of Toronto, Canada; Division of Neurology, The Hospital for Sick Children, Neurosciences and Mental Health, SickKids Research Institute, Toronto, Ontario, Canada
| | - Adalsteinn Brown
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | | | - Brenda Banwell
- Division of Child Neurology, The Children’s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Mediational Model of Multiple Sclerosis Impairments, Family Needs, and Caregiver Mental Health in Guadalajara, Mexico. Behav Neurol 2018; 2018:8929735. [PMID: 29593840 PMCID: PMC5822770 DOI: 10.1155/2018/8929735] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 08/24/2017] [Accepted: 09/27/2017] [Indexed: 01/02/2023] Open
Abstract
Individuals with multiple sclerosis (MS), especially those living in Latin America, often require assistance from family caregivers throughout the duration of the disease. Previous research suggests that family caregivers may experience positive and negative outcomes from providing care to individuals with MS, but few studies have examined the unmet needs of individuals providing care to family members with MS and how these unmet needs may mediate the relationship between MS symptoms and caregiver mental health. The current study examined the relationships among MS impairments (functional, neurological, cognitive, behavioral, and emotional), unmet family needs (household, informational, financial, social support, and health), and caregiver mental health (satisfaction with life, anxiety, burden, and depression) in a sample of 81 MS caregivers from Guadalajara, Mexico. A structural equation model demonstrated the mediational effect of unmet family needs on the relationship between MS impairments and caregiver mental health. These findings suggest that intervention research on MS caregivers in Latin America may consider focusing on caregiver mental health problems by addressing unmet family needs and teaching caregivers ways to manage the impairments of the individual with MS.
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Pooyania S, Lobchuk M, Chernomas W, Marrie RA. Examining the Relationship Between Family Caregivers' Emotional States and Ability to Empathize with Patients with Multiple Sclerosis: A Pilot Study. Int J MS Care 2016; 18:122-8. [PMID: 27252599 DOI: 10.7224/1537-2073.2015-023] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Multiple sclerosis (MS) is the most common nontraumatic cause of disability affecting young adults in Canada. Caregivers of patients with MS are highly psychologically burdened. Empathy and helping behaviors are hallmarks of quality care, but when they are challenged, suboptimal patient care can result. We aimed to evaluate the prevalence of negative emotional states among primary caregivers of people with MS; the association between the caregiver's empathy-related behavior and the physical and cognitive impairment of the person with MS; and the association between the caregiver's emotional status and his or her empathy-related behaviors. METHODS We conducted a descriptive, cross-sectional pilot study with family caregivers of noninstitutionalized individuals living with MS. We used univariate linear regression models for each potential predictor. The Kruskal-Wallis test was conducted to compare differences in caregiver empathic responses depending on Profile of Mood States subscale scores. RESULTS Thirty percent of caregivers had elevated or very elevated mood scores, and such elevated scores were associated with greater functional impact of MS on the person with MS. Patient severity of cognitive impairment was not associated with caregiver mood scores. Caregiver mood state was not associated with empathy-related behaviors. Empathy-related behaviors were less frequent when levels of anger and hostility were higher, but this association did not reach statistical significance. CONCLUSIONS Given the elevated levels of fatigue, depression, and anger observed among caregivers in this study, clinicians need to be aware of the potential impact of caregiving and to assess the needs of caregivers.
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Affiliation(s)
- Sepideh Pooyania
- Department of Internal Medicine (SP, RAM) and Department of Community Health Sciences (RAM), College of Medicine; and College of Nursing (ML, WC), Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Michelle Lobchuk
- Department of Internal Medicine (SP, RAM) and Department of Community Health Sciences (RAM), College of Medicine; and College of Nursing (ML, WC), Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Wanda Chernomas
- Department of Internal Medicine (SP, RAM) and Department of Community Health Sciences (RAM), College of Medicine; and College of Nursing (ML, WC), Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Ruth Ann Marrie
- Department of Internal Medicine (SP, RAM) and Department of Community Health Sciences (RAM), College of Medicine; and College of Nursing (ML, WC), Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
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