The Indirect Effect of the Frailty of Dependent Elderly People Needing Hospitalization on Their Informal Caregivers' Anxiety

Abstract

Background A high prevalence of anxiety symptoms has been identified among the caregivers of disabled older people. The aim of the study was to explore the relationships between objective burden (intensity of care and burdensome characteristics of the care recipient, like frailty status), caregiver characteristics, subjective burden, and anxiety in a sample of informal caregivers caring for hospitalized elderly patients. Methods In this cross-sectional study, patients' and their informal caregivers' characteristics were recorded for 311 patient-caregiver dyads. Subjective caregiver burden and caregivers' anxiety were assessed by using the Zarit Burden Interview and the Hospital Anxiety and Depression Scale (HADS), respectively. Correlation coefficients and path analysis were used to examine the relationship between variables. Caregivers' anxiety was considered as the outcome variable. Caregivers' subjective burden was entered as a mediator between caregiver characteristics-objective burden and anxiety. An objective burden was measured based on the care needs of the dependent elderly (frailty status, cognitive impairment, comorbidity, independence in activities of daily living, behavioral problems, hours spent on caregiving, and duration of caregiving). Results Abnormal anxiety symptoms (HADS score 11-21) were reported by 92 caregivers (29.6%). Borderline cases (HADS score 8-10) were 66 caregivers (21.2%). A mild, moderate, or severe subjective burden was recorded for 113 (36.3%), 100 (32.2%), and 26 (8.4%) caregivers, respectively. The female gender of the caregiver, the spousal relationship with the patient, and the subjective burden were directly related to higher levels of caregivers' anxiety. A subjective burden was found to be a significant mediator in the relationship between duration of caregiving, patients' frailty status, caregiver gender, patients' comorbidity, and caregivers' anxiety. Conclusion Among the risk factors for caregivers' anxiety, the frailty status of the patient is probably the only modifiable factor via interventions targeting frailty reversion or reduction.

Serial Multiple Mediation of Mastery and Sleep Quality in the Relationship between Caregiving Burden and Anxiety among Parental Caregivers of Children with Leukemia in China

“…For the direct efects, this study shows that caregiving burden signifcantly elevated caregiver anxiety symptoms. Tis is consistent with the theoretical hypothesis of the stress process model [11,12], and it is also consistent with previous empirical evidence [8,10]. Generally, the responsibility to care for a child with leukemia is a primary stressor for parents and has an adverse efect on their mental health.…”

“…Despite the growing research in caregivers' anxiety [8,9], there is a lack of attention to the psychological well-being of parental caregivers of children with leukemia in China. Moreover, the relationship between caregiving subjective burden and anxiety among those caregivers needs further exploration [10]. Caregiving burden is a multidimensional concept and is often treated as the primary stressor for the general caregivers in the stress process model [11,12].…”

Factors associated with health‐related quality of life of informal caregivers of older patients and the mediating role of subjective caregivers' burden

“…This study is part of a larger project evaluating informal caregiving for dependent older patients. Other findings from this project have been presented elsewhere 32 …”

The role of frailty among the predictors of depression on informal caregivers of older adults: a mediation analysis

“…This study is part of a research project dealing with informal caregiving for dependent, older care‐recipients. Other research results from this project have already been published 25,26 …”

“…Other research results from this project have already been published. 25,26 Definitions Older adults were considered those aged >65 years old. 27 Informal caregivers were considered those who provided unpaid care for a dependent older adult in at least two categories of the following: activities related to self-care and mobility, activities related to health or medical care, interactions with the healthcare system and providers, household tasks and transportation.…”