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      Emotional disorders evidenced by family caregivers of older people with Alzheimer’s disease Translated title: TRANSTORNOS EMOCIONAIS EVIDENCIADOS POR CUIDADORES FAMILIARES DE IDOSOS COM DOENÇA DE ALZHEIMER

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          ABSTRACT

          The task of caring for a family member with dementia is associated with caregiver physical and emotional problems. The patient’s decline in health and specific needs contribute directly to this situation.

          Objective:

          To evaluate burden, stress, depression and anxiety symptoms in family caregivers of elderly with Alzheimer’s disease.

          Methods:

          A cross-sectional, descriptive, correlational and quantitative study was carried out. The sample consisted of 66 family caregivers of elderly with Alzheimer’s disease, whom attended the Cognitive and Behavioral Neurology Outpatient Clinic of the Federal University of São Carlos, in the city of São Carlos, SP, Brazil.

          Results:

          Of the caregivers evaluated in the severe AD subgroup, 47.3% had intense burden; 86, 4% exhibited significant stress levels; 57% presented severe anxiety levels and 36.9% presented mild depression symptoms.

          Conclusion:

          Caring for a family member with Alzheimer’s disease generates burden, stress, anxiety and depression. Support groups comprising a multiprofessional team can be set up to assist caregivers. These actions can help caregivers cope with the daily demands and challenges and ensure better care quality in an increasingly aging population.

          RESUMO

          A tarefa de cuidar de um familiar com demência está relacionada a problemas físicos e emocionais no cuidador. O declínio do paciente e suas demandas específicas contribuem diretamente para essa situação.

          Objetivo:

          Avaliar sintomas de sobrecarga, estresse, depressão e ansiedade em cuidadores familiares de idosos com doença de Alzheimer.

          Métodos:

          Estudo transversal, descritivo, correlacional e de caráter quantitativo. A amostra foi composta por 66 cuidadores familiares de idosos com doença de Alzheimer, atendidos no Ambulatório de Neurologia da Universidade Federal de São Carlos, na cidade de São Carlos, SP, Brasil.

          Resultados:

          Dos cuidadores alocados no subgrupo DA avançada, 47,3% foram avaliados com sobrecarga intensa; 86,4% apresentaram níveis de estresse significativo; 57% apresentaram níveis graves de ansiedade e 36,9% apresentaram sintomas de depressão leve.

          Conclusão:

          Cuidar de um familiar com doença crônica e degenerativa como a doença de Alzheimer gera sobrecarga, assim como estresse, ansiedade e depressão. Grupos de apoio compostos por uma equipe multiprofissional podem ser implantados no sentido de garantir o acompanhamento desses cuidadores. Tais ações podem auxiliar a lidar com as demandas e os enfrentamentos diários e ainda garantir uma melhor qualidade no cuidado prestado, considerando o avanço do envelhecimento populacional.

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          Most cited references24

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          Mental disorders in primary health care: a study of their frequency and diagnosis in four developing countries.

          1624 patients who were attending primary health facilities in 4 developing countries were examined to determine how many were suffering from mental disorder. Using stringent criteria to establish the presence of psychiatric morbidity, 225 cases were found, indicating an overall frequency of 13.9%. The great majority of cases were suffering from neurotic illnesses and for most the presenting complaint was of a physical symptom, such as headache, abdominal pain, cough or weakness. The health workers following their normal procedure correctly detected one third of the psychiatric cases.
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            The association between subjective caregiver burden and depressive symptoms in carers of older relatives: A systematic review and meta-analysis

            Background Family carers are an important source of care for older people. Although several studies have reported that subjective caregiver burden is related to depressive symptoms there are no systematic reviews quantifying this association. Objective To establish the extent to which subjective caregiver burden is associated with depressive symptoms and whether this association would vary by study or care characteristics. Methods We searched major databases such as PubMed, CINAHL, PsycINFO, Scopus and ISI Proceedings up to March 2018, and conducted a meta-analysis of included studies. Summary estimates of the association were obtained using a random-effects model to improve generalisation of findings. Results After screening of 4,688 articles, 55 studies were included providing a total of 56 independent comparisons with a total of 9,847 carers from data across 20 countries. There was a large, positive association between subjective caregiver burden and depressive symptoms ( r ¯ = 0.514; 95% CI = 0.486, 0.541), with very low heterogeneity amongst individual studies (I2 = 8.6%). Sensitivity analyses showed no differences between cross-sectional or repeated measures ( r ¯ = 0.521; 95% CI = 0.491, 0.550; 51 samples) and longitudinal studies ( r ¯ = 0.454; 95% CI = 0.398, 0.508; 6 samples). We found a higher effect size for those caring for people living with dementia compared to those caring for frail older people, and stroke survivors. Carer sex, age and kinship did not change the estimate of the effect. Conclusions Subjective caregiver burden is a significant risk factor for depressive symptoms in carers of older people and may precipitate clinical depression. Those caring for people with dementia experience greater burden. There is a need for longitudinal evaluations examining the effects of potential mediators of the association of subjective burden and depressive symptoms. Future interventions should test whether minimizing subjective burden may modify the risk of developing depression in carers of older relatives.
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              Caregiver burden and coping strategies in caregivers of patients with Alzheimer’s disease

              Background Alzheimer’s disease (AD) causes considerable distress in caregivers who are continuously required to deal with requests from patients. Coping strategies play a fundamental role in modulating the psychologic impact of the disease, although their role is still debated. The present study aims to evaluate the burden and anxiety experienced by caregivers, the effectiveness of adopted coping strategies, and their relationships with burden and anxiety. Methods Eighty-six caregivers received the Caregiver Burden Inventory (CBI) and the State-Trait Anxiety Inventory (STAI Y-1 and Y-2). The coping strategies were assessed by means of the Coping Inventory for Stressful Situations (CISS), according to the model proposed by Endler and Parker in 1990. Results The CBI scores (overall and single sections) were extremely high and correlated with dementia severity. Women, as well as older caregivers, showed higher scores. The trait anxiety (STAI-Y-2) correlated with the CBI overall score. The CISS showed that caregivers mainly adopted task-focused strategies. Women mainly adopted emotion-focused strategies and this style was related to a higher level of distress. Conclusion AD is associated with high distress among caregivers. The burden strongly correlates with dementia severity and is higher in women and in elderly subjects. Chronic anxiety affects caregivers who mainly rely on emotion-oriented coping strategies. The findings suggest providing support to families of patients with AD through tailored strategies aimed to reshape the dysfunctional coping styles.
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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
                1980-5764
                Jan-Mar 2020
                Jan-Mar 2020
                : 14
                : 1
                : 56-61
                Affiliations
                [1 ]Universidade Federal de São Carlos Ringgold standard institution – Enfermagem – Avenida Rio de Janeiro, Araraquara, SP Brazil.
                [2 ]Universidade Federal de São Carlos Ringgold standard institution – Medicina Sao Carlos – São Paulo, SP, Brazil.
                Author notes
                Carlene Souza Silva Manzini. Universidade Federal de São Carlos Ringgold standard institution – Enfermagem – Avenida Rio de Janeiro – 14811-11 Araraquara SP – Brazil. E-mail: carlotamanzi@ 123456hotmail.com

                Author contributions. The authors conceptualized and drafted this article, and critically revised the manuscript.

                Disclosure: The authors report no conflicts of interest.

                Author information
                http://orcid.org/0000-0001-6195-4252
                Article
                10.1590/1980-57642020dn14-010009
                7077868
                32206199
                f584511c-9376-4dcc-a470-47a3c81df60b

                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
                : 04 October 2019
                : 23 November 2019
                Categories
                Original Article

                alzheimer’s disease,aged,caregivers,family,dementia,geriatric nursing,doença de alzheimer,idoso,cuidadores,família,demência,enfermagem geriátrica

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