Academic journal article East Asian Archives of Psychiatry

Psychosocial Condition of Family Caregivers of Patients with Chronic Obstructive Pulmonary Disease in Hong Kong

Academic journal article East Asian Archives of Psychiatry

Psychosocial Condition of Family Caregivers of Patients with Chronic Obstructive Pulmonary Disease in Hong Kong

Article excerpt

Introduction

Caregiving refers to the experiences and tasks about providing assistance to a family member who is no longer independent. (1) Burden of care indicates "the extent to which caregivers perceive their emotional or physical health, social life, and financial status suffering as a result of caring for their relative". (2) Objective burden of care reflects the disruptions in family life and the tasks and activities associated with providing care, whereas subjective burden of care focuses on perceived stress associated with providing care. (3) Subjective burden of care is related to many factors, such as the length of caregiving time entailed, the type of caregiving tasks, family stressors, and the physical condition of the care recipient. (4)

Severe and progressive dyspnoea is the most devastating and frequent complaint of patients with chronic obstructive pulmonary disease (COPD). (5) Pervasive dyspnoea is frightening to both the patient and caregiver, and can lead to stress. (6) Chronic obstructive pulmonary disease can result in physical disability, altered cognition, memory disturbances, and behavioural changes that may further increase the burden of care. (7)

Caregivers of COPD patients often have additional roles such as decision-maker and finance manager. (8) They have to deal with patient attitudes and irritability. (8) Sexton (9) reported that wives of COPD patients felt guilty about causing their husbands respiratory distress and thus limited the expression of strong feelings. The experience of a wife caregiver has been described as a mixture of anger, helplessness, guilt and isolation. (10) Wives of COPD patients were deemed to have lost freedom, because they had relinquished recreational and social activities. (8,10) Even their shopping trips were constrained, as they opted to stay at home as much as they could in order to avoid conflicts. (11) Persistent worry about the patients' health and symptoms was common, and wives frequently experienced fatigue and difficulty sleeping. (8,10)

Positive sides to caregiving were also described, which included the satisfaction from easing their husbands' suffering and helping them to stay at home as long as possible. This positive experience of caregiving was also related to the presence of family, children and grandchildren. (11) Ways of coping with the caregiving role reported by COPD wives included: finding personal satisfaction, successfully managing their husband's behaviour, finding meaning in the caregiving situation, managing their own distress, and finding support when expressing their feelings. (12)

Compared with wives of husbands without COPD, wives of COPD patients reported lower levels of life satisfaction. (8) Predictors of life satisfaction included the Subjective Stress Scale score, (13) satisfaction with money available, and the working status of the COPD wives. (8) Ross and Graydon (10) found that perceptions of their own health by COPD wives were correlated with their mood and social support. Wives of COPD patients found it hard to ask relatives for help, and needed increased support from the health care system. (11) Useful help might include: caregiving guidance and information delivery, (14) as well as counselling, and coaching in relaxation techniques. (8) Further support to carers could be provided via regular carers' group meetings and enhancement of informal support from family members and friends. (8,14) Respite care may provide relief to carers. (10,14) Patients with COPD need assistance from their significant others so as to cope with activities of daily living. (8) The presence of a significant person at home is the single most important factor facilitating the adjustment to COPD patients. This study aimed to examine the health-related quality of life (HRQOL) and burden of caregivers of patients with COPD, and to identify associated relevant factors.

Methods

Study Design

A clinically convenient sample of Hong Kong community-dwellers followed up in a university chest clinic and their caregivers were recruited. …

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