Overload felt by main caregivers in a cohort of patients with multiple pathologies

maxbw Máximo Bernabeu Wittel last modified 30/09/2009 14:34

This new study outlines the key functions and roles of primary caregivers in a cohort of patients with multiple chronic conditions, and analyzes the main sources of overload for them.

L. Moreno-Gaviño, M. Bernabeu-Wittel, Margarita Álvarez-Tello, Manuel Rincón , Salvador García-Morillo, Manuel Cassani, Manuel Ollero. INFORMAL CAREGIVERS’ BURDEN OF CARE IN A COHORT OF POLYPATHOLOGICAL PATIENTS. Atención Primaria 2008; 40:193-198.



Objective. To determine the profile of the main  caregiver (MC) and the factors associated with her/his care burden, in a multi-centre cohort of patients with multiple pathologies (PMP).

Design. Multi-centre cross-sectional study.

Setting. Four health districts in the Virgen del Rocío University Hospitals Health Area, Seville, Spain.

Participants. The PMP cohort was created  by checking all the patients who satisfied the health department criteria for PMP (2002): patients suffering from chronic diseases in 2 or more of the 7 clinical categories defined.

Main measurements. The profile of PMP  caregiver was determined for all patients. The caregiver strain index (CSI) was determined by the index of care stress (ICS). Predictive factors were analysed by the Student t,  ANOVA, and Pearson’s tests. Multivariate analysis was performed by a forward stepwise linear regression model.

Results. The interview was attended by  461 (69%) out of 662 eligible PMP. Of these, 293 (63.6%) had an MC whose mean age was 62 (15) years; 80% of them were women. First-degree relatives made up 88% of caregivers, with spouses 49.7% of them (n=146). In 41.5%, the CSI was >7 points (mean CSI was 5.35 [3.5]). This was higher in those caring for PMP with neurological illnesses (7 [3.2 vs 4.5 [3.3]; P=.0001).The  CSI was compared directly with the medical vulnerability of the PMP (R=0.37; P=.001),  cognitive deterioration on the Pfeiffer scale (PS) (R=0.4; P=.0001), and inversely with  functional status on Barthel’s scale (BS) (R=–0.67; P=.0001). Patient’s age (P=.03),  his/her medical vulnerability (P=.016) and functional ( P<.0001) and cognitive (P=.019)  deterioration were independently associated with the CSI.

Conclusions. The profile of the MC of the  PMP cohort corresponded mainly to firstdegree female relatives around sixty years old. The burden of care was high in more than a third of them. Predictive factors were age, medical vulnerability, and the functional and cognitive deterioration of the PMP.

Key words: Caregivers. Burden. Comorbidity.  Patient with multiple pathologies. Caregiver strain index.

Atención Primaria 2008


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