Hidden face of chronic obstructive pulmonary disease: effects of patients’ psychiatric symptoms on caregivers’ burden and quality of life

Year 2023, Volume: 9 Issue: 5 - September 2023, 874 - 883, 04.09.2023

Zeynep Karagün , Deniz Çelik , Mehmet Sinan Aydın , İbrahim Gündoğmuş , Yusuf Tuğrul Şipit

https://doi.org/10.18621/eurj.1143986

Abstract

Objectives: Chronic Obstructive Pulmonary Disease (COPD) faces functional and physical limitations and often needs the help of others at certain times in their lives. Patients and caregivers can affect each other psychologically, physically, and socially. This study aims to examine the relationship between the demographic and clinical characteristics of COPD patients and the quality of life and burden of care of caregivers.

Methods: The study was carried out with 250 COPD patients who applied to the chest diseases hospital and their caregivers. Hospital Anxiety-Depression Scale (HADS), The Zarit Burden Interview (ZBI), and World Health Organization Quality of Life Scale Short Form (WHOQOL-BREF) scales were applied to the patients.

Results: The patients’ gender, age, regular drug use, non-invasive mechanical ventilator use, emergency room admissions, number of hospitalizations, number of intensive care admissions, presence of comorbidities were found to be associated with HADS anxiety and depression scores, ZBI, and WHOQOL-BREF. According to the results of multiple linear regression analysis; it is seen that the patient's gender, NIV use, regular device use, presence of comorbidity, HADS anxiety score, and HADS depression score is an independent predictor of the caregiver's burden (ZBI score); and the patient's NIV use, regular device use, HADS anxiety score and HADS depression score is an independent predictor of the caregiver's WHOQOL-BREF score.

Conclusions: It is important to evaluate patients and caregivers in a holistic approach and to realize the factors that may negatively affect them in the early period to take the necessary therapeutic measures.

Keywords

COPD, caregiver, quality of life, caregivers’ burden, psychiatry, inpatient

References

• 1. Markou NK, Myrianthefs PM, Baltopoulos GJ. Respiratory failure: an overview. Crit Care Nursing Q 2004;27:353-79.
• 2. Montagnani A, Mathieu G, Pomero F, Bertu L, Manfellotto D, Campanini M, et al; FADOI-Epidemiological Study Group. Hospitalization and mortality for acute exacerbation of chronic obstructive pulmonary disease (COPD): an Italian population-based study. Eur Rev Med Pharmacol Sci 2020;24:6899-907.
• 3. Tödt K, Skargren E, Jakobsson P, Theander K, Unosson M. Factors associated with low physical activity in patients with chronic obstructive pulmonary disease: a cross-sectional study. Scand J Caring Sci 2015;29:697-707.
• 4. Jafari H, Ebrahimi A, Aghaei A, Khatony A. The relationship between care burden and quality of life in caregivers of hemodialysis patients. BMC Nephrol 2018;19:321.
• 5. Sajadi SA, Ebadi A, Moradian ST. Quality of life among family caregivers of patients on hemodialysis and its relevant factors: a systematic review. Int J Community Based Nurs Midwifery 2017;5:206-18.
• 6. Duran Parra M, Torres CC, Arboleda LB, Rivera Carvajal R, Franco S, Santos J. Effectiveness of an educational nursing intervention on caring ability and burden in family caregivers of patients with chronic non-communicable diseases. A preventive randomized controlled clinical trial. Invest Educ Enferm 2019;37:e04.
• 7. Riffin C, Van Ness PH, Wolff JL, Fried T. Multifactorial examination of caregiver burden in a national sample of family and unpaid caregivers. J Am Geriatr Soc 2019;67:277-83.
• 8. Caro CC, Costa JD, Da Cruz DMC. Burden and quality of life of family caregivers of stroke patients. Occup Ther Health Care 2018;32:154-71.
• 9. Al-Gamal E. Quality of life, anxiety and depression among patients with chronic obstructive pulmonary disease and their spouses. Issues Ment Health Nurs 2014;35:761-7.
• 10. de Wit J, Bakker LA, van Groenestijn AC, van den Berg LH, Schröder CD, Visser-Meily JMA, et al. Caregiver burden in amyotrophic lateral sclerosis: a systematic review. Palliat Med 2018;32:231-45.
• 11. Quittner AL, Goldbeck L, Abbott J, Duff A, Lambrecht P, Sole A, et al. Prevalence of depression and anxiety in patients with cystic fibrosis and parent caregivers: results of the International Depression Epidemiological Study across nine countries. Thorax 2014;69:1090-7.
• 12. Griva K, Goh C, Kang W, Yu ZL, Chan MC, Wu SY, et al. Quality of life and emotional distress in patients and burden in caregivers: a comparison between assisted peritoneal dialysis and self-care peritoneal dialysis. Qual Life Res 2016;25:373-84.
• 13. Beach SR, Schulz R. Family caregiver factors associated with unmet needs for care of older adults. J Am Geriatr Soc 2017;65:560-6.
• 14. Pearlin LI, Mullan JT, Semple SJ, Skaff MM. Caregiving and the stress process: an overview of concepts and their measures. Gerontologist 1990;30:583-94.
• 15. Jácome C, Figueiredo D, Gabriel R, Cruz J, Marques A. Predicting anxiety and depression among family carers of people with chronic obstructive pulmonary disease. Int Psychogeriatr 2014;26:1191-9.
• 16. Chu H-H, Lee K-S, Ho Lee K, Chung JH, Shin K-C, Hwang T-Y. Association of physical and psychological health status between chronic obstructive pulmonary disease patients and their family caregivers. Health Care Women Int 2019;40:1019-30.
• 17. Huang C-Y, Sousa VD, Perng S-J, Hwang M-Y, Tsai C-C, Huang M-H, et al. Stressors, social support, depressive symptoms and general health status of Taiwanese caregivers of persons with stroke or Alzheimer’s disease. J Clin Nurs 2009;18:502-11.
• 18. Kim Y, Baker F, Spillers RL. Cancer caregivers' quality of life: effects of gender, relationship, and appraisal. J Pain Symptom Manage 2007;34:294-304.
• 19. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983;67:361-70.
• 20. Aydemir Ö, Güvenir T, Küey L, Kultur S. [Validity and reliability of Turkish version of Hospital Anxiety and Depression Scale] Türk Psikiyatri Dergisi 1997;8:280-7. [Article in Turkish]
• 21. Eser E, Fidaner H, Fidaner C, Eser SY, Elbi H, Göker E. [Psychometric properties of tlte WHOQOL-100 and WHOOOL-BREF]. Psikiyatri Psikoloji Psikofarmakoloji (3P) Dergisi 1999;7:23-40. [Article in Turkish]
• 22. Zarit SH, Reever KE, Bach-Peterson J. Relatives of the impaired elderly: correlates of feelings of burden. Gerontologist 1980;20:649-55.
• 23. Özlü A, Yıldız M, Aker T. [Validity and reliability study of Zarit Caregiver Burden Scale in relatives of Schizophrenia patients]. Noropsikiatri Arşivi 2009;46:38-42. [Article in Turkish]
• 24. Cedano S, Bettencourt ARdC, Traldi F, Machado MCLO, Belasco AGS. Quality of life and burden in carers for persons with chronic obstructive pulmonary disease receiving oxygen therapy. Rev Lat Am Enfermagem 2013;21:860-7.
• 25. Ivziku D, Clari M, Piredda M, De Marinis MG, Matarese M. Anxiety, depression and quality of life in chronic obstructive pulmonary disease patients and caregivers: an actor-partner interdependence model analysis. Qual Life Res 2019;28:461-72.
• 26. Mikkelsen RL, Middelboe T, Pisinger C, Stage KB. Anxiety and depression in patients with chronic obstructive pulmonary disease (COPD). A review. Nordic J Psychiatry 2004;58:65-70.
• 27. Shah R, Collard H, Morisset J. Burden, resilience and coping in caregivers of patients with interstitial lung disease. Heart Lung 2018;47:264-8.
• 28. Levant RF, Hall RJ, Williams CM, Hasan NT. Gender differences in alexithymia. Psychol Men Masc 2009;10:190-203.
• 29. Baha A, Köktürk N, Öztürk B, Özarı Yıldırım E, Özmen İ, Gürgün A, et al. The evaluation of disease awareness, caregiver burden and workday loss in caregivers of COPD patients. Turk J Med Sci 2022;52:346-53.
• 30. Baykal H., Bulcun E. Relationship of clinical parameters and inflammation markers with pulmonary hypertension in patients with stable chronic obstructive pulmonary disease. Sağlık Bil Değer 2022;12:6-14.
• 31. Şahan E, Bulut S. Relationship between disease severity and atrial fibrillation in chronic obstructive pulmonary disease. Turk Kardiyol Dern Ars. 2021;49:517-21.