Religious Involvement, Depressive Symptoms, and Burden in Caregivers of Terminally Ill Patients

Abstract

Caring for terminally ill patients can be emotionally burdensome. Previous research has demonstrated that caregiving is associated with anxiety and depression. Research on caregivers of terminally ill patients is limited by retrospective studies with small samples. This study aimed to (1) describe religiosity, religious coping, and depressive symptoms in caregivers of persons with amyotrophic lateral sclerosis or advanced cancer; (2) examine the relationship between religiosity and depressive symptoms in caregivers of persons with amyotrophic lateral sclerosis or advanced cancer; (3) examine the relationship between religious coping and depressive symptoms in caregivers of persons with amyotrophic lateral sclerosis or advanced cancer. A descriptive exploratory design was used to analyze data from a larger 5-year National Institutes of Health-funded multisite randomized controlled trial (the TAILORED study). Nearly half of the caregivers screened positive for depressive symptoms, and negative religious coping was associated with higher depressive symptoms (P < .001). Spouse caregivers reported higher depressive symptoms than nonspouse caregivers. Many caregivers experienced depression, which was mitigated by positive religious coping. KEY WORDScaregiver burden, end of life, religious coping, terminally ill BackgroundCaring for patients with terminal illness can be emotionally difficult and burdensome. Caregiving has been associated with anxiety and depression, 1 and regardless of sex, age, or ethnicity, caregivers are at risk of major stress, anxiety, and depression and are vulnerable to physical and financial repercussions. 2 Previous studies highlighted that approximately 70% of family caregivers of patients receiving palliative care suffer from clinically relevant signs of anxiety and depression, 3 and 26% to 57% of caregivers reported depression. 4 A recent study found denial and self-blame predict high levels of anxiety and depression. 5 Caregiver burden is associated with caregiver stress and depression 6 and is particularly common among caregivers of patients with cancer, chronic obstructive pulmonary disease, and heart failure. 7 Informal caregivers, often spouses, relatives, or friends, frequently experience caregiver burden associated with mental, physical, emotional, social, or financial negative outcomes. 8 Recent research shows that patients with amyotrophic lateral sclerosis (ALS) and their caregivers become socially marginalized as the disease progresses and patients become more dependent on caregivers. 9 Moreover, caregivers reported feelings of guilt related to caregiver burden, as well as social isolation and loneliness. 9 Previous study of caregivers of patients who had experienced a stroke found the main caregivers experienced high burden and endured an equal to or greater than the occurrence of mental illness than did the patients. 6 Often, up to 64% of caregivers of persons after stoke experience anxiety and symptoms of depression. 6 Additionally, long-term caregiving is affected by financial...

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