Academic journal article Perspectives in Psychiatric Care

Distressing Emotions in Female Caregivers of People with AIDS, Age-Related Dementias, and Advanced-Stage Cancers

Academic journal article Perspectives in Psychiatric Care

Distressing Emotions in Female Caregivers of People with AIDS, Age-Related Dementias, and Advanced-Stage Cancers

Article excerpt

PURPOSE. To describe and compare the depressive mood, anxiety, anger, and sleep problems of informal female caregivers of people with AIDS, age-related dementias (ARD), and cancer (CA).

METHODS. Caregivers recruited from clinics serving people with AIDS, ARD, and CA were interviewed using structured instruments measuring depressive symptoms, anxiety, anger, and sleep problems. Data analysis compared these emotions in the caregivers and related aspects of the caregiving situation to these emotions within each group.

FINDINGS. Caregivers did not differ significantly in depressive mood, but did differ in anxiety and anger and sleep problems. Individual items on each scale were compared to provide more descriptive detail. In each group, distressing emotions were significantly related to each other and to sleep problems.

CONCLUSIONS. Caregivers of people with AIDS, ARD, and CA experience distressing emotions that may affect their mental and physical health. A comprehensive approach to mental health nursing therapy will best meet the needs of caregivers in relieving their distress.

Key words: Age-related dementia, AIDS, cancer, distressing emotions, informal caregivers, sleep problems

Caregivers frequently come to the attention of mental health nurses because of the need for supportive counseling, psychotherapy, and pharmacologic treatment for distressing emotions they are experiencing. Informal caregiving to people with chronic illnesses has been found consistently to have negative effects on the caregiver's health and well-being (Given & Given, 1998; Turner & Catania, 1997). Caregivers experience physical health problems; depression; disruption of interpersonal relationships, social life, and work life; and financial strain associated with caregiving.

This study describes the distress felt by female caregivers of people with AIDS, age-related dementias (ARD), and advanced-stage cancers (CA) together with the similarities and differences in these three groups, and discusses possible reasons for these differences. Finally, there are suggestions for therapeutic interventions by mental health nurses to support the health and well-being of caregivers.

Review of the Literature

Depression

Depressive mood is the distressing emotion most frequently reported in caregivers of people with AIDS, ARD, and CA (Bergman-Evans, 1994; Given & Given, 1998; Knop, Bergman-Evans, & McCae, 1998; Turner & Catania, 1997). There is gone evidence that suggests depressive mood might be considered a distressing but transient emotion that accompanies the process of caregiving. Schulz, Visintainer, and Williamson (1990) noted that although strong evidence exists of increased symptom reports of depressive mood among caregivers, it is important to keep in mind the distinction of "normal" distress from psychiatric illness. Periods of extreme distress, grief, despair, hopelessness, and helplessness may be common among caregivers, but they usually are transient and circumscribed to the period of caregiving. These findings explain the presence of depressive symptoms associated with caregiving in those without a prior psychiatric history. In this situation, depressive symptoms may be considered a transient dysphoric and distressing emotion occurring during the process of being exposed to an identifiable psychosocial stressor (caregiving). Even in studies where depressive mood was considered an outcome measure (Flaskerud & Tabora, 1998), the investigators also have found it to be a strong predictor of poorer physical, social, and role functioning, as well as perceived physical health. These findings again suggest that depressive mood accompanies the process of caregiving.

Anxiety, Anger, and Loneliness

Anxiety in AIDS, ARD, and CA caregivers has been associated with uncertainty about the care receiver's health status and prognosis, a sense of incompetence in providing care, the number and severity of care-receiver symptoms and functional dependencies, current and future financial problems, role conflicts (e. …

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