BackgroundThis study prospectively evaluated distress, depressive and anxiety symptoms as well as associated factors in family caregivers (FC) of advanced cancer patients at initiation of specialist inpatient palliative care.MethodsWithin 72 h after the patient’s first admission, FCs were asked to complete German versions of the Distress Thermometer, Generalized Anxiety Disorder 7-item scale (GAD-7), Patient Health Questionnaire depression module 9-item scale (PHQ-9) for outcome measure. Multivariate logistic regression analyses were used to identify associated factors.ResultsIn 232 FCs (62% spouses/partners), mean level of distress was 7.9 (SD 1.8; range, 2–10) with 95% presenting clinically relevant distress levels. Most frequent problems were sadness (91%), sorrows (90%), anxiety (78%), exhaustion (77%) and sleep disturbances (73%). Prevalence rates of moderate to severe anxiety and depressive symptoms were 47 and 39%, respectively. Only 25% of FCs had used at least one source of support previously. In multivariate regression analysis, being female (OR 2.525), spouse/partner (OR 2.714), exhaustion (OR 10.267), and worse palliative care outcome ratings (OR 1.084) increased the likelihood for moderate to severe anxiety symptom levels. Being female (OR 3.302), low socio-economic status (OR 6.772), prior patient care other than home-based care (OR 0.399), exhaustion (OR 3.068), sleep disturbances (OR 4.183), and worse palliative care outcome ratings (OR 1.100) were associated with moderate to severe depressive symptom levels.ConclusionsFCs of patients presenting with indication for specialist palliative care suffer from high distress and relevant depressive and anxiety symptoms, indicating the high need of psychological support not only for patients, but also their FCs. Several socio-demographic and care-related risk-factors influence mental burden of FCs and should be in professional caregivers’ focus in daily clinical practice.

Objective: To investigate prevalence and predictors of postloss distress, depressive and anxiety symptoms, and quality of life among bereaved family caregivers of patients with advanced cancer. Methods: Prospective multicenter study. Family caregivers (N = 160, mean age 56.8 years, 66% female) completed validated outcome measures (Distress Thermometer, Generalized Anxiety Disorder 7-item scale, Patient Health Questionnaire depression module 9-item scale, SF-8 Health Survey Questionnaire) 6 months after patient’s discharge or death at specialist inpatient palliative care ward. Results: Clinically relevant distress was observed in 82% with sadness (89%), exhaustion (74%), sleeping problems (68%), loneliness (53%), and sorrows (52%) being the most common distress-causing problems. Moderate/severe anxiety and depressive symptoms were observed in 27% and 35%, respectively. Compared to an adjusted norm sample, quality of life was significantly impaired with exception of “bodily pain” and physical component score. Preloss caregiving (odds ratio [OR] 2.195) and higher preloss distress (OR 1.345) predicted high postloss distress. Utilization of psychosocial support services (OR 2.936) and higher preloss anxiety symptoms (OR 1.292) predicted moderate/severe anxiety symptoms, lower preloss physical quality of life (OR 0.952), and higher preloss depressive symptoms (OR 1.115) predicted moderate/severe depressive symptoms. Conclusion: Preloss mental burden showed to be a consistent predictor for postloss burden and should be addressed during palliative care. Future research should examine specific caregiver-directed interventions during specialist palliative care.

Purpose This study aimed to investigate the supportive care needs of family caregivers (FCs) of advanced cancer patients and their support service use at the beginning of specialist inpatient palliative care (SIPC), near the patient’s death, and during bereavement. Methods FCs reported their needs using the Family Inventory of Needs (FIN), along with their utilization of psychosocial and bereavement support services at the beginning (N = 232) and 6–9 months after SIPC (N = 160). Results At the beginning of SIPC, mean of 16.9 of 20 needs were reported to be highly important, and 12.2 were reported to be met. At the time of the patient’s death, 16.8 needs were highly important, and 13.8 were met. At both time points, the highest ranked need was related to information about changes in the patient’s condition (100% vs. 99%), and the most frequently unmet need was related to feeling hope (73% vs. 71%). Multivariate linear regression analysis revealed a low education level to be consistently related to a greater number of highly important needs. Higher satisfaction with care and better social support was related to a greater number of met needs. Twenty-five percent of FCs had accessed at least one psychosocial support service prior to SIPC, and 30% had done so during bereavement. Among non-users of support services, > 75% indicated sufficient informal support as a barrier to service use. Conclusions The findings offer a useful guide for adequately addressing FCs’ needs in an effort to optimize FC support. However, only a subgroup of the FCs used support services. Better information and provision of tailored services might improve FCs’ situations in the future.

Este estudo investigou relações entre exposição à violência direta (VD) e violência indireta (VI), Bem-Estar Subjetivo (BES) e sintomas de depressão, ansiedade e estresse em 426 adolescentes de 12 a 18 anos (M=14,91; DP=1,66). Foram utilizados os instrumentos Triagem da Exposição de Crianças à Violência na Comunidade, Escala de Depressão, Ansiedade e Estresse para Adolescentes (EDAE-A), Escala de Afetos Positivos (AP) e Afetos Negativos (AN) e Escala Multidimensional de Satisfação de Vida para Adolescentes (EMSVA). A Regressão Linear Múltipla indicou um modelo em que ser exposto à VD e VI, ser do sexo feminino, ter maior nível de AN e menores níveis de SVA explicaram 47% da variação nos escores da EDAE-A. Depressão e VD explicaram 39% na variação nos escores do BES. A exposição à VD e VI foi associada a sintomas de ansiedade, depressão e estresse, demonstrando que se constitui num fator de risco ao desenvolvimento emocional.

Estudos prévios indicam que ser vítima de maus-tratos na infância e testemunhar a violência conjugal dos pais são preditores da violência no namoro na adolescência. A influência do grupo de pares, o uso de álcool e ser do sexo feminino igualmente aumentam o risco para a violência no namoro, embora ainda sejam variáveis pouco investigadas. Dessa forma, este estudo transversal descritivo investigou variáveis pessoais e contextuais associadas à perpetração de violência no namoro em 403 adolescentes, de 14 a 19 anos, de escolas públicas e privadas da Região Metropolitana de Porto Alegre, Brasil. Uma análise de regressão logística multivariada indicou que ter sofrido maus-tratos psicológicos na infância aumenta em 5,37 (IC 95 % = 2,30-12,57) a probabilidade de um adolescente ser perpetrador de violência verbal ou emocional no namoro. Demais variáveis preditoras (testemunhar violência parental, influência do grupo de pares, uso de álcool e ser do sexo feminino) não se mostraram significativas. Este estudo reúne evidências de aspectos intergeracionais da violência no namoro e indica a necessidade de programas de prevenção com adolescentes.