Family caregivers of persons with spinal cord injury: Predicting caregivers at risk for probable depression.

Abstract

Objective-To determine the percentage of family caregivers of persons with spinal cord injury (SCI) with probable depression and to test the hypothesis that dysfunctional problem-solving abilities would be significantly predictive of risk status after taking into account important demographic characteristics and caregiver health.Design-Correlational and logistic regression analyses of data collected in a cross-sectional design.Participants-Eighteen men and 103 women caregivers (mean age of caregivers = 45.66 years, SD = 12.88) of individuals with SCI. Main Outcome Measure-The Inventory to Diagnose Depression.Results-Nineteen caregivers (15.7%) met criteria on the Inventory to Diagnose Depression for a major depressive disorder. A dysfunctional problem-solving style was significantly predictive of caregiver depression, regardless of the severity of physical impairment of the care recipient or the physical health of the caregiver and caregiver demographic variables.Conclusions-The percentage of caregivers with probable depressive disorder may parallel that observed among persons with SCI, using a more conservative self-report measure designed to assess symptoms associated with a depressive syndrome. Family caregivers with a dysfunctional problemsolving style and assisting individuals with more severe injuries may have probable depression. As a result of recent advances in medical technology, persons surviving a spinal cord injury (SCI) are living longer lives and often require varied degrees of assistance over their life span (DeVivo & Stover, 1995;Eisenberg & Saltz, 1991;Lasfargues, Custis, Carswell, & Nguyen, 1995). In response, family members often become the primary sources of assistance for various activities of daily living, such as feeding, dressing, transfers, and bowel and bladder care (Robinson-Whelen & Rintala, 2003;Weitzenkamp, Gerhart, Charlifue, Whiteneck, & Savic, 1997). However, caregivers enter into this new role without formal preparation or training . As a result, family caregivers of persons with severe disabilities encounter a host of problems, including role overload, lack of information, financial strain, impaired quality of life, changes in health status, and emotional problems Vitaliano, Zhang, & Scanlan, 2003). Caregiver depression has been consistently associated with poor quality of life and other adverse outcomes (Covinsky, Fortinsky, Palmer, Kresevic, & Landefeld, 1997;Han & Haley, 1999;Schulz & Beach, 1999).For many individuals, the traumatic onset of a severe physical disability may be experienced as an "off time," nonnormative life event (Neugarten, 1979) that abruptly interferes with the routine pursuit of normative personal, social, and vocational roles (Moen, Robison, & Dempster-McClain, 1995). Family caregivers of persons with SCI may experience a wide range of lifestyle and quality of life changes after assuming the role as primary caregiver (Boschen, Tonack, & Gargaro, 2005;Kolakowsky-Hayner & Kishore, 1999;Unalan et al., 2001). Although descriptive studies have found...

Psychological impact and the burden of caregiving for persons with spinal cord injury (SCI) living in the community in Fiji

“…2,21 This study did not find any significant relationship between the level of injury and the caregiver burden, and is similar to the findings reported in other nonWestern countries. 7,22 This could be because of the fact that the majority of the paraplegic persons, who were expected to be independent in self-care and mobility, suffered from moderate-to-severe disability requiring assistance in many ADL.…”

Personal and familial predictors of depressive feelings in people with orthopedic disability

“…However, family caregivers of individuals with orthopedic disability also undergo various dif ficulties themselves; they experience financial strain (Sav et al, 2013), health problems resulting from caregiving such as pain and disruptions in the func tioning of the cardiovascular and immune systems (Donelan et al, 2002;Vitaliano, Zhang, & Scanlan, 2003), elevated levels of distress (Chan, Lee, & Lieh Mak, 2000), anxiety, and a lower quality of life (Elliott & Berry, 2009). Family caregivers who report a great er caregiving burden have a greater tendency to feel decreased life satisfaction and high levels of depres sion (Dreer, Elliott, Shewchuk, Berry, & Rivera, 2007;Unalan et al, 2001). They are also more likely to have negative attitudes towards their family member with disability (Elliott & Pezent, 2008), which disrupts the positive family environment.…”

“…Therefore, there is usually a family caregiver who lives with people with orthopedic disabilities and interacts with them on a daily basis (Dreer, Elliott, Shewchuk, Berry, & Rivera, 2007). Due to such a living arrangement that requires continual interaction between the indi vidual with disability and his/her relative, the char acteristics and functioning of the caregiving family member might be among the factors affecting the emotional wellbeing of individuals with disabilities.…”

Effects of Adult Romantic Attachment and Social Support on Resilience and Depression in Patients With Acquired Disabilities

“…Armstrong goes on to state that the spouse's mourning, difficulty of assuming a providing role, as well as possible changes in sexual relationships are often not acknowledged by the caregiver or patient. Dreer et al (2007) reported that depression was higher in caregivers of patients with SCI than in a non-SCI population. They suggest that role overload, lack of information, financial strain, impaired quality of life, change in health status, and emotional problems all contribute to the caregiver's increased vulnerability to depression.…”

“…Depression is examined in relation to adult attachment anxiety and avoidance, perceived social support, and proposed as a measurement of the absence of resilience. Specifically, the acquisition of a disability can negatively impact social support, increase the likelihood of experiencing depression, and activate the attachment system (Armstrong, 1991;Dreer, Elliott, Shewchuk, & Berry, 2007;Gan & Schuller, 2002). The possible relationships between sustaining a disability and attachment strategies, social support, resilience, and depression are integrated throughout the chapter.…”