Needs, Aggravation, and Degree of Burnout in Informal Caregivers of Patients with Chronic Cardiovascular Disease
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Sample
2.3. Variables and Data Collection
2.4. Ethical Aspects
2.5. Data Analysis
3. Results
3.1. Sociodemographic Data of Caregivers
3.2. Assessment of the Level of Needs and Level of Emotional Exhaustion, Depersonalization, and Personal Accomplishment among Caregivers
3.3. Significant Correlations
Method of Logistic Regression
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
- Wojtyniak, B.; Gorynski, P.; Moskalewicz, B. Sytuacja zdrowotna ludności Polski i jej uwarunkowania. Nowotw. J. Oncol. 2013, 63, 269. [Google Scholar] [CrossRef] [Green Version]
- Nichols, M.; Townsend, N.; Scarborough, P.; Rayner, M. Cardiovascular disease in Europe 2014: Epidemiological update. Eur. Heart J. 2014, 35, 2950–2959. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Muszalik, M.; Kędziora-Kornatowska, K. Jakość życia przewlekle chorych pacjentów w starszym wieku. Gerontol. Pol. 2006, 14, 85–189. [Google Scholar]
- GUS. Sytuacja Demograficzna Osób Starszych i Konsekwencje Starzenia Się Ludności Polski w Świetle Prognozy na Lata 2014–2050. Available online: http://stat.gov.pl/obszary-tematyczne/ludnosc/ludnosc/sytuacja-demograficzna-osob-starszych-i-konsekwencje-starzenia-sie-ludnosci-polski-w-swietle-prognozy-na-lata-2014-2050,18,1.html (accessed on 22 June 2019).
- McNamara, B.; Rosenwax, L. Which caregivers of family members at the end of life need more support from health services and why? Soc. Sci. Med. 2010, 70, 1035–1041. [Google Scholar] [CrossRef] [PubMed]
- Galiatsatos, P.; Gurley, A.; Hale, W.D. Policy and advocacy for informal caregivers: How state policy influenced a community initiative. J. Public Health Policy 2017, 38, 503–508. [Google Scholar] [CrossRef]
- Morris, S.M.; King, C.; Turner, J.M.; Payne, S.A. Family carers providing support to a person dying in the home setting: A narrative literature review. Palliat. Med. 2015, 29, 487–495. [Google Scholar] [CrossRef] [Green Version]
- Rosochacka-Gmitrzak, M. Starzenie się w miejscu zamieszkania a zakłócony performance miejsca. Misc. Anthropol. Sociol. 2018, 19, 33–52. [Google Scholar]
- GUS. Zdrowie i Zachowanie Zdrowotne Mieszkańców Polski w Świetle Europejskiego Ankietowego Badania Zdrowia (EHIS) 2014 r. Warszawa 2015. Available online: https://stat.gov.pl/obszary-tematyczne/zdrowie/zdrowie/zdrowie-i-zachowania-zdrowotne-mieszkancow-polski-w-swietle-badania-ehis-2014,10,1.html (accessed on 20 June 2019).
- Ploeg, J.; Matthew-Maich, N.; Fraser, K.; Dufour, S.; McAiney, C.A.; Kaasalainen, S.; Markle-Reid, M.; Upshur, R.; Cleghorn, L.; Emili, A. Managing multiple chronic conditions in the community: A Canadian qualitative study of the experiences of older adults, family caregivers and healthcare providers. BMC Geriatr. 2017, 17, 40. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Duggleby, W.; Williams, A.; Ghosh, S.; Moquin, H.; Ploeg, J.; Markle-Reid, M.; Peacock, S. Factors influencing changes in health related quality of life of caregivers of persons with multiple chronic conditions. Health Qual. Life Outcomes 2016, 14, 81. [Google Scholar] [CrossRef] [Green Version]
- Siemiński, M.; Nitka-Siemińska, A.; Nyka, W.M. Zespół wypalenia. Forum. Med. Rodz. 2007, 1, 45–49. [Google Scholar]
- Marasinghe, K.M. Assistive technologies in reducing caregiver burden among informal caregivers of older adults: A systematic review. Disabil. Rehabil. Assist. Technol. 2015, 11, 353–360. [Google Scholar] [CrossRef] [PubMed]
- O’Brien, M.R.; Whitehead, B.; Jack, B.A.; Mitchell, J.D. The need for support services for family carers of people with motor neurone disease (MND): Views of current and former family caregivers a qualitative study. Disabil. Rehabil. 2011, 34, 247–256. [Google Scholar] [CrossRef] [PubMed]
- Morais, H.C.C.; Soares, A.M.D.G.; Oliveira, A.R.D.S.; Carvalho, C.M.D.L.; Da Silva, M.J.; De Araujo, T.L. Burden and modifications in life from the perspective of caregivers for patients after stroke. Rev. Lat. Am. Enferm. 2012, 20, 944–953. [Google Scholar] [CrossRef] [PubMed]
- Kurpas, D. Paradygmat Ppieki nad Chorymi Przewlekle w Ramach Podstawowej Ppieki Zdrowotnej; Uniwersytet Medyczny: Warsaw, Poland; pp. 61–62.
- Pasikowski, T. Polska adaptacja kwestionariusza Maslach Burnout Inventory. In Wypalenie Zawodowe. Przyczyny i Zapobieganie; Sęk, H., Ed.; Wydawnictwo Naukowe PWN: Warsaw, Poland, 2009; pp. 135–149. [Google Scholar]
- Nitka-Siemińska, A.; Myśliwiec, M.; Landowski, J.; Balcerska, A.; Wolnik, B. Zespół wypalenia u rodziców osób chorych na cukrzycę typu 1. Diabetol. Prakt. 2008, 9, 76–81. [Google Scholar]
- Temple, J.B.; Dow, B. The unmet support needs of caregivers of older Australians: Prevalence and mental health. Int. Psychogeriatr. 2018, 30, 1849–1860. [Google Scholar] [CrossRef]
- Kerpershoek, L.; de Vugt, M.; Wolfs, C.; Woods, W.; Jelley, H.; Orrell, M.M.; Stephan, A.; Bieber, A.; Meyer, G.; Selbaek, G.; et al. Needs and quality of life of people with middle-stage dementia and their family caregivers from the European Actifcare study. When informal care alone may not suffice. Aging Ment. Health 2018, 22, 897–902. [Google Scholar] [CrossRef]
- Gawlik, M.; Kurpas, D. Ocena poziomu wypalenia członków rodzin w opiece nad pacjentem z chorobą nowotworową objętych domową opieką paliatywną. Fam. Med. Prim. Care Rev. 2014, 16, 336–340. [Google Scholar]
- Siemiński, M.; Nitka-Siemińska, A.; Wichowicz, H.; Drzazga, E.; Meresta, M.; Pilarska, E.; Nyka, W.M. Zespół wypalenia wśród opiekunów dzieci chorujących na padaczkę. Psychiatria 2005, 2, 87–92. [Google Scholar]
- Czub, K.; Szpyrka, S.; Zareba, M. Obserwatorium Integracji Społecznej. Wielkopolskie Regionalne Obserwatorium Terytorialne. Departament Polityki Regionalnej UMWW. Pogłębione Studium Usług Opiekuńczych Skierowanych do Osób Starszych. Środowiskowa Opieka Formalna i Nieformalna. Raport z Badań. Poznań 2017. Available online: https://rops.poznan.pl/wp-content/uploads/2018/06/raport_Pogłębione-studium-usług-opiekuńczych-skierowanych-do-osób-starszych.-Środowiskowa-opieka-formalna-i-nieformalna_wersja-końcowa.pdf (accessed on 22 June 2019).
- Marzec, A.; Faleńczyk, F.; Pluta, A.; Kujawa, W.; Basińska-Drozd, H.; Budnik-Szymoniuk, M. Obciążenie opieką i depresyjność opiekuna osoby przewlekle chorej w domu, rodzaje problemów i czynniki wpływające na ich występowanie. Przeds Zarz. 2013, 14, 243–258. [Google Scholar]
- Ventura, A.D.; Burney, S.; Brooker, J.; Fletcher, J.; Ricciardelli, L. Home-based palliative care: A systematic literature review of the self-reported unmet needs of patients and caregivers. Palliat. Med. 2014, 28, 391–402. [Google Scholar] [CrossRef]
- Skrzypek-Czerko, M.; Kozera, G.; Chwojnicki, K.; Nyka, W.; Roszmann, A. Znaczenie wsparcia społecznego dla poziomu lęku i depresji oraz obciążenia opiekunów pacjentów po udarze mózgu–wyniki wstępne. Pielęg. Neurol. Neurochir. 2013, 2, 18–26. [Google Scholar]
- Zarit, S.H.; Reever, K.E.; Bach-Peterson, J. Relatives of the impaired elderly: Correlates of feelings of burden. Gerontologist 1980, 20, 649–655. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Rachel, W.; Datka, W.; Zyss, T.; Zięba, A. Obciążenie opiekunów pacjentów z otępieniem w chorobie Alzheimera. Gerontol. Pol. 2014, 22, 14–23. [Google Scholar]
Variables | Coding | |
---|---|---|
x1 | Gender | 1—Women |
2—Men | ||
x2 | Age (in years) | Number of years |
x3 | Marital status | 1—Single |
2—Married | ||
3—Widowed | ||
4—Divorced | ||
x4 | Place of residence | 1—Big city <100 thousand inhabitants |
2—Middle town from 20–100 thousand inhabitants | ||
3—Town small >20 thousand inhabitants | ||
4—Village | ||
x5 | Education | 1—Primary |
2—Vocational | ||
3—Secondary without Matura Exam | ||
4—Secondary with Matura Exam | ||
5—Post-secondary | ||
6—BA | ||
7—MA | ||
x6 | Family-related caregiver | 1—Wife/husband |
2—Brother/sister | ||
3—Mother/father | ||
4—Uncle/aunt | ||
5—Cousin | ||
6—Other | ||
x7 | Non-family caregiver | 1—Neighbour |
2—Informal partner | ||
3—Other | ||
x8 | Employment | 1—Full time |
2—Part-time | ||
3—Sick leave-child care | ||
4 – Sick leave | ||
5—Unemployment benefit | ||
6—Unemployment | ||
x9 | Period of homecare | Number of years |
Variable (n = 161) | n | % | |
---|---|---|---|
Gender | women | 113 | 70.2 |
men | 48 | 29.8 | |
Age (in years) | n = 159 | ||
median | 55 | ||
Q.25%–Q.50%–Q.75% | 42.50–55–64 | ||
min.–max. | 17–95 | ||
Education | primary | 16 | 9.9 |
vocational | 37 | 23 | |
secondary without Matura Exam | 7 | 4.3 | |
secondary with Matura Exam | 38 | 23.6 | |
post-secondary | 11 | 6.8 | |
BA | 6 | 3.7 | |
MA | 46 | 28.6 | |
total | 161 | 100 | |
Place of residence | urban | 94 | 58.4 |
rural | 67 | 41.6 | |
total | 161 | 100 | |
Marital status | single | 31 | 19.4 |
married | 105 | 65.6 | |
widowed | 15 | 9.4 | |
divorced | 9 | 5.6 | |
total | 160 | 100 | |
Family-related caregiver | wife/husband | 42 | 28.2 |
brother/sister | 6 | 4 | |
mother/father | 63 | 42.3 | |
uncle/aunt | 5 | 3.4 | |
cousin | 6 | 4 | |
other | 27 | 18.1 | |
total | 149 | 100 | |
Non-family caregiver | neighbour | 9 | 60 |
informal partner | 4 | 26.7 | |
other | 2 | 13.3 | |
total | 15 | 100 | |
Employment | full time | 76 | 48.4 |
part-time | 10 | 6.4 | |
sick leave-child care | 6 | 3.8 | |
sick leave | 1 | 0.6 | |
unemployment benefit | 6 | 3.8 | |
unemployed | 58 | 36.9 | |
total | 157 | 100 | |
Period of homecare (in years) | n = 131 | ||
median | 4 | ||
Q.25%–Q.50%–Q.75% | 2–4–10 | ||
min.–max. | 1–51 |
Variable | n | M | SD | Q.25% | Me | Q.75% | Min. | Max. | SW Test p |
---|---|---|---|---|---|---|---|---|---|
Camberwell Index | 161 | 0.83 | 0.13 | 0.76 | 0.88 | 0.94 | 0.44 | 1 | <0.001 |
Emotional exhaustion | 154 * | 20.28 | 12.52 | 10 | 20 | 28 | 0 | 50 | 0.002 |
Depersonalization | 155 * | 7.22 | 6 | 2 | 6 | 11.50 | 0 | 24 | <0.001 |
Personal Accomplishment | 147 * | 29.07 | 8.43 | 23 | 29 | 35 | 8 | 48 | 0.322 |
Variable | MBI Emotional Exhaustion | MBI Depersonalization | MBI Personal Accomplishment | |||
---|---|---|---|---|---|---|
r | p | r | p | r | p | |
Gender | −0.04 | 0.640 | 0 | 0.969 | −0.04 | 0.647 |
Age (in years) | 0.21 | 0.010 | 0.21 | 0.009 | −0.08 | 0.336 |
Marital status | 0.19 | 0.020 | 0.24 | 0.003 | −0.09 | 0.303 |
Education | −0.11 | 0.164 | −0.18 | 0.028 | 0.12 | 0.136 |
Family-related caregiver | −0.12 | 0.148 | −0.06 | 0.492 | −0.09 | 0.321 |
Non-family caregiver | −0.11 | 0.708 | −0.08 | 0.775 | −0.15 | 0.596 |
Employment | 0.19 | 0.018 | 0.23 | 0.005 | −0.09 | 0.264 |
Place of residence (urban/rural) | −0.22 | 0.006 | −0.11 | 0.184 | 0.15 | 0.062 |
Variable | Unmet Needs | |
---|---|---|
r | p | |
MBI—Emotional Exhaustion | −0.47 | p < 0.001 |
MBI—Depersonalization | −0.34 | p < 0.001 |
MBI—Personal Accomplishment | 0.32 | p < 0.001 |
Explanatory Variables | bi | SEi | zi | pi = Pr (> |zi|) | ||||
---|---|---|---|---|---|---|---|---|
Models with two explanatory variables | ||||||||
Model 1 (n = 161) | ||||||||
Chi2 = 9.66, df = 2, p = 0.008, pseudo R2 =0.04 | ||||||||
Intercept | – | – | – | – | ||||
X1 | Gender | 0.919 | 0.320 | 2.874 | 0.004 | |||
X2 | Age | −0.023 | 0.008 | −2.980 | 0.003 | |||
Model 2 (n = 161) | ||||||||
Chi2 = 4.97, df = 2, p = 0.083, pseudo R2 = 0.02 | ||||||||
Intercept | – | – | – | – | ||||
X1 | Gender | 0.506 | 0.242 | 2.085 | 0.037 | |||
X3 | Marital status | −0.335 | 0.157 | −2.134 | 0.033 | |||
Models with three explanatory variables | ||||||||
Model 3 (n = 161) | ||||||||
Chi2 = 11.15, df = 3, p = 0.011, pseudo R2 = 0.05 | ||||||||
Intercept | – | – | – | – | ||||
X4 | Place of residence | 0.340 | 0.115 | 2.955 | 0.003 | |||
X5 | Education | −0.117 | 0.059 | −1.978 | 0.048 | |||
X8 | Employment | −0.161 | 0.063 | −2.559 | 0.011 | |||
OR | Per Unit | Per Range | ||||||
OR | 95% CI | 1/OR | OR | 95% CI | 1/OR | range | ||
From Model 1 | ||||||||
X1 | Gender (1–2) | 2.51 | 1.36–4.81 | 1.77 | 2.51 | 1.36–4.81 | 0.40 | 1 |
X2 | Age (17–95) | 0.98 | 0.96–0.99 | 0.99 | 0.16 | 0.05–0.52 | 6.07 | 78 |
From Model 2 | ||||||||
X3 | Marital status (1–4) | 0.72 | 0.52–0.98 | 1.40 | 0.37 | 0.14–0.90 | 2.73 | 3 |
From Model 3 | ||||||||
X4 | Place of residence (1–4) | 1.40 | 0.52–1.77 | 0.71 | 2.77 | 1.43–5.56 | 0.36 | 3 |
X5 | Education (1–7) | 0.89 | 0.52–0.99 | 1.12 | 0.50 | 0.24–0.98 | 2.02 | 6 |
X8 | Employment (1–6) | 0.85 | 0.52–0.96 | 1.17 | 0.45 | 0.24–0.82 | 2.24 | 5 |
Explanatory Variables | bi | SEi | zi | pi = Pr (> |zi|) | ||||
---|---|---|---|---|---|---|---|---|
Models with two explanatory variables | ||||||||
Model 1 (n = 154) | ||||||||
Chi2 = 8.51, df = 2, p = 0.014, pseudo R2 = 0.04 | ||||||||
Intercept | – | – | – | – | ||||
X2 | Age | 0.015 | 0.006 | 2.607 | 0.009 | |||
X4 | Place of residence | −0.313 | 0.111 | −2.818 | 0.005 | |||
Model 2 (n = 154) | ||||||||
Chi2 = 5.29, df = 2, p = 0.071, pseudo R2 = 0.03 | ||||||||
Intercept | – | – | – | – | ||||
X5 | Education | −0.087 | 0.044 | −1.996 | 0.046 | |||
X8 | Employment | 0.106 | 0.052 | 2.045 | 0.041 | |||
OR | Per Unit | Per Range | ||||||
OR | 95% CI | 1/OR | OR | 95% CI | 1/OR | range | ||
from Model 1 | ||||||||
X2 | Age (17–95) | 1.02 | 1.00–1.03 | 0.98 | 3.32 | 1.37–8.41 | 0.30 | 78 |
X4 | Place of residence (1–4) | 0.73 | 0.58–0.91 | 1.37 | 0.39 | 0.20–0.74 | 2.56 | 3 |
from Model 2 | ||||||||
X5 | Education (1−7) | 0.92 | 0.84–0.99 | 1.09 | 0.59 | 0.35–0.98 | 1.69 | 6 |
X8 | Employment (1−6) | 1.11 | 1.01–1.23 | 0.90 | 1.70 | 1.03–2.86 | 0.59 | 5 |
Explanatory Variables | bi | SEi | zi | pi = Pr (> |zi|) | ||||
---|---|---|---|---|---|---|---|---|
Models with two explanatory variables | ||||||||
Model 1 (n = 155) | ||||||||
Chi2 = 8.20, df = 2, p = 0.017, pseudo R2 = 0.05 | ||||||||
Intercept | – | – | – | – | ||||
X4 | Place of residence | −0.190 | 0.071 | −2.664 | 0.008 | |||
X9 | Period of homecare | 0.041 | 0.021 | 1.965 | 0.049 | |||
Model 2 (n = 155) | ||||||||
Chi2 = 8.58, df =2, p = 0.014, pseudo R2 = 0.05 | ||||||||
Intercept | – | – | – | – | ||||
X5 | Education | −0.127 | 0.047 | −2.701 | 0.007 | |||
X9 | Period of homecare | 0.043 | 0.022 | 1.982 | 0.047 | |||
OR | Per Unit | Per Range | ||||||
OR | 95% CI | 1/OR | OR | 95% CI | 1/OR | range | ||
From Model 1 | ||||||||
X4 | Place of residence (1–4) | 0.83 | 0.72–0.95 | 1.21 | 0.57 | 0.37–0.85 | 1.77 | 3 |
X9 | Period of homecare (1–51) | 1.04 | 1.00–1.09 | 0.96 | 7.84 | 1.19–79.55 | 0.13 | 50 |
From Model 2 | ||||||||
X5 | Education (1–7) | 0.88 | 0.80–0.96 | 1.14 | 0.47 | 0.26–0.80 | 2.15 | 6 |
Explanatory Variables | bi | SEi | zi | pi = Pr (> |zi|) | ||||
---|---|---|---|---|---|---|---|---|
Models with two explanatory variables | ||||||||
Model 1 (n = 147) | ||||||||
Chi2 = 6.05, df = 2, p = 0.049, pseudo R2 = 0.03 | ||||||||
Intercept | – | – | – | – | ||||
X1 | Gender | 0.616 | 0.258 | 2.390 | 0.017 | |||
X4 | Place of residence | −0.246 | 0.116 | −2.113 | 0.035 | |||
OR | Per Unit | Per Range | ||||||
OR | 95% CI | 1/OR | OR | 95% CI | 1/OR | range | ||
From Model 1 | ||||||||
X1 | Gender (1–2) | 1.85 | 1.13–3.12 | 0.54 | 1.85 | 1.13–3.12 | 0.54 | 1 |
X4 | Place of residence (1–4) | 0.78 | 0.62–0.98 | 1.28 | 0.48 | 0.24–0.94 | 2.09 | 3 |
© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
Szlenk-Czyczerska, E.; Guzek, M.; Bielska, D.E.; Ławnik, A.; Polański, P.; Kurpas, D. Needs, Aggravation, and Degree of Burnout in Informal Caregivers of Patients with Chronic Cardiovascular Disease. Int. J. Environ. Res. Public Health 2020, 17, 6427. https://doi.org/10.3390/ijerph17176427
Szlenk-Czyczerska E, Guzek M, Bielska DE, Ławnik A, Polański P, Kurpas D. Needs, Aggravation, and Degree of Burnout in Informal Caregivers of Patients with Chronic Cardiovascular Disease. International Journal of Environmental Research and Public Health. 2020; 17(17):6427. https://doi.org/10.3390/ijerph17176427
Chicago/Turabian StyleSzlenk-Czyczerska, Elżbieta, Marika Guzek, Dorota Emilia Bielska, Anna Ławnik, Piotr Polański, and Donata Kurpas. 2020. "Needs, Aggravation, and Degree of Burnout in Informal Caregivers of Patients with Chronic Cardiovascular Disease" International Journal of Environmental Research and Public Health 17, no. 17: 6427. https://doi.org/10.3390/ijerph17176427
APA StyleSzlenk-Czyczerska, E., Guzek, M., Bielska, D. E., Ławnik, A., Polański, P., & Kurpas, D. (2020). Needs, Aggravation, and Degree of Burnout in Informal Caregivers of Patients with Chronic Cardiovascular Disease. International Journal of Environmental Research and Public Health, 17(17), 6427. https://doi.org/10.3390/ijerph17176427