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      Burnout syndrome in informal caregivers of older adults with dementia: A systematic review Translated title: SÍNDROME DE BURNOUT EM CUIDADORES INFORMAIS DE IDOSOS COM DEMÊNCIA: UMA REVISÃO SISTEMÁTICA

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          ABSTRACT

          Dementia is a constant concern for the public health system. Also, it impacts family members who provide informal care, often culminating in overload due to the emotional stress and physical distress of caregivers.

          Objective:

          This systematic review aimed to identify the consequences of Burnout Syndrome in informal caregivers of older adults with dementia.

          Methods:

          The search was performed spanning the last 10 years, in English, Portuguese or Spanish. The databases used were PubMed, SciELO, Web of Science and LILACS. The descriptors were obtained from MeSH and DeCS, which were, “caregivers”, “burnout”, “aged”, “psychological stress” and “dementia”. The selected articles included studies conducted with informal caregivers of community-dwelling older adults diagnosed with any type of dementia. The excluded articles had the following characteristics: the participants were not informal caregivers, the older adults were not diagnosed with dementia, or the main theme was not related to the Burnout Syndrome.

          Results:

          Initially, 1,208 articles were found. One hundred and forty-six were eliminated because they were duplicates. A further 1,033 were excluded because they did not meet the inclusion criteria. Twenty-nine studies were selected for full reading and 22 were excluded, giving 7 studies for inclusion in this review.

          Conclusion:

          The results showed that the Burnout Syndrome negatively affected caregivers’ quality of life and was associated with patient depressive and anxious symptoms and abusive behavior by caregiver. There is a need for studies with interventions addressing this issue.

          RESUMO

          A demência é uma preocupação constante para o sistema público de saúde. Além disso, traz impactos para os familiares que oferecem cuidados informais, culminando frequentemente em sobrecarga, devido ao estresse emocional e desgaste físico dos cuidadores.

          Objetivo:

          Esta revisão sistemática objetivou identificar as consequências da Síndrome de Burnout em cuidadores informais de idosos com demência.

          Métodos:

          A busca foi feita considerando-se os últimos 10 anos, nos idiomas inglês, português ou espanhol. As bases de dados utilizadas foram PubMed, SciELO, Web of Science e LILACS. Os descritores foram obtidos no MeSH e DeCS, sendo “cuidadores”, “burnout”, “idoso”, “estresse psicológico” e “demência”. Os artigos selecionados incluíram estudos desenvolvidos com cuidadores informais de idosos que vivem na comunidade, diagnosticados com qualquer tipo de demência. Os artigos excluídos apresentaram as seguintes características: os participantes não eram cuidadores informais, os idosos não receberam diagnóstico de demência, ou o tema principal não estava relacionado à Síndrome de Burnout.

          Resultados:

          Inicialmente, foram encontrados 1.208 artigos. Destes, 146 foram removidos por serem duplicados. Após, 1.033 foram excluídos por não atenderem aos critérios de inclusão. Assim, 29 estudos foram selecionados para leitura na íntegra e 22 foram excluídos. Finalmente, 7 estudos foram selecionados para esta revisão.

          Conclusão:

          De acordo com os resultados, foi possível identificar que a Síndrome de Burnout afeta negativamente a qualidade de vida dos cuidadores e está associada a sintomas depressivos, ansiosos e comportamento abusivo. Há a necessidade de estudos com intervenções que abordem esta temática.

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          Most cited references28

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          Dementia Caregiver Burden: a Research Update and Critical Analysis

          Purpose of Review This article provides an updated review of the determinants of caregiver burden and depression, with a focus on care demands and especially the differential effects of various neuropsychiatric symptoms or symptom clusters. Moreover, studies on caregivers for frontotemporal and Lewy body dementias were referred to in order to identify differences and similarities with the mainstream literature based largely on Alzheimer caregivers. Recent Findings As a group, neuropsychiatric symptoms are most predictive of caregiver burden and depression regardless of dementia diagnosis, but the effects appear to be driven primarily by disruptive behaviors (e.g., agitation, aggression, disinhibition), followed by delusions and mood disturbance. Disruptive behaviors are more disturbing partly because of the adverse impact on the emotional connection between the caregiver and the care-recipient and partly because they exacerbate difficulties in other domains (e.g., caring for activities of daily living). In behavioral variant frontotemporal dementia, not only are these disruptive behaviors more prominent but they are also more disturbing due to the care-recipient’s insensitivity to others’ feelings. In Lewy body dementia, visual hallucinations also appear to be distressing. Summary The disturbing nature of disruptive behaviors cuts across dementia conditions, but the roles played by symptoms that are unique or particularly serious in a certain condition need to be explored further.
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            Challenges of Family Caregivers of Patients with Mental Disorders in Iran: A Narrative Review

            Background: Family caregivers of patients with mental disorders play the most important role in the care of psychiatric patients (PPs) and preventing their readmission. These caregivers face different challenges in different cultures. We conducted this study to determine the challenges of caregivers of patients with mental disorders in Iran. Materials and Methods: This study is a narrative review with a matrix approach conducted by searching electronic databases, SID, IRANMEDEX, MAGIRAN, PUBMED, SCOPUS, Web of Sciences, from February 2000 to 2017. Searched keywords include challenges, family caregivers of psychiatric patient, family caregivers and psychiatric patient, mental illness, families of psychiatric patient, and Iran. One thousand two hundred articles were found in English and Farsi, and considering inclusion and exclusion criteria, 39 articles were examined. Results: The results of the studies show that not meeting the needs of caregivers, burnout and high burden of care, high social stigma, low social support for caregivers, and low quality of life of caregivers were among the most important challenges faced by caregivers. Conclusions: Despite the efforts of authorities in Iran, family caregivers of patients with mental disorders still face challenges. Therefore, the need for all-inclusive support for family caregivers of patients with mental health problems is necessary.
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              The experience of burnout among home caregivers of patients with dementia: relations to depression and quality of life.

              Caregivers of patients with dementia often experience chronic and emotional strains, which may lead to emotional exhaustion and burnout. The objective of this study was to examine the relationships between burnout, depression, and quality of life in home caregivers of patients with dementia. The participants were 84 home caregivers (39 male; 45 female), and they were asked to complete three questionnaires: the Beck Depression Inventory Second Edition (BDI-II), the WHO Quality of Life 26 (WHO-QOL26), and the Pines Burnout Measure (BM). Results from a bivariate correlation showed that BM scores significantly correlated with the scores on BDI-II and WHO-QOL26. Results from ANOVA comparing the level of burnout with the scores on BDI-II and WHO-QOL26 revealed that there were differences between the burnout groups and the scores on BDI-II and WHO-QOL26. The higher levels of burnout were found to correspond to higher levels of depressive symptoms and lower QOL. These findings suggest that caregiver intervention to reduce burnout might benefit from strategies to reduce depression and increase QOL.
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                Author and article information

                Journal
                Dement Neuropsychol
                Dement Neuropsychol
                dn
                Dementia & Neuropsychologia
                Associação de Neurologia Cognitiva e do Comportamento
                1980-5764
                Oct-Dec 2019
                Oct-Dec 2019
                : 13
                : 4
                : 415-421
                Affiliations
                [1 ]Master’s student in Health Sciences, Graduate Program in Nursing, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil.
                [2 ]PhD. Student in Health Sciences, Graduate Program in Nursing, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil.
                [3 ]Nurse, São Carlos, SP, Brazil.
                [4 ]PhD. Student in Sciences, Graduate Program in Fundamental Nursing, University of São Paulo (USP), Ribeirão Preto, SP, Brazil.
                [5 ]Associate Professor, Department of Medicine, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil.
                Author notes
                Ludmyla Caroline de Souza Alves. Federal University of Sao Carlos (UFSCar). Center for Biological and Health Sciences (CCBS). Department of Gerontology (DGero) - Rod. Washington Luís, Km 235, SP-310 - 13565-905 São Carlos SP - Brazil. E-mail: luud.souza@ 123456hotmail.com

                Disclosure: The authors report no conflicts of interest.

                Author contributions. Ludmyla Caroline de Souza Alves: design, intellectual contribution to the writing of the manuscript. Diana Quirino Monteiro: design, intellectual contribution to the writing of the manuscript. Sirlei Ricarte Bento: analysis of data, intellectual contribution to the writing of the manuscript. Vânia Diniz Hayashi: analysis of data, intellectual contribution to the writing of the manuscript. Lucas Nogueira de Carva lho Pelegrini: analysis of data, intellectual contribution to the writing of the manuscript. Francisco Assis Carvalho Vale: design, intellectual contribution to the writing of the manuscript.

                Author information
                http://orcid.org/0000-0001-5507-702X
                Article
                10.1590/1980-57642018dn13-040008
                6907708
                31844495
                0e20f410-3836-4633-ac10-113a543b3eec

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 20 February 2019
                : 12 August 2019
                Categories
                Original Article

                caregivers,burnout,aged,dementia,stress,cuidadores,idoso,demência,estresse,sobrecarga

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