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Caregiver Burden According to Certain Personal Characteristics


3.2.2.3. Caregiver burden according to some personal characteristics

Table 3.11: ZBI burden of care scores of primary caregivers according to some personal characteristics (n = 120).

Element

Quantity

Burden of care ZBI

p

SD

Gender of caregiver

Male

40 (33.3%)

29.65

14.33

0.918

Female

80 (66.7%)

29.13

13.28

Age of caregiver

< 45 years old

50

23.00

10.17


0.0003

45 - 54 years old

24

31.30

12.3

55 - 64 years old

16

32.13

13.85

≥ 65 years old

30

36.73

15.09

Labor situation of caregivers

Working

75

25.75

11,12

0.001

No labor

45

35.22

15.27

Caregiver-patient relationship

Couple

43

36.72

14.90


0.0002

Son

71

25.30

11.00

Siblings

6

23.50

10.46

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Caregiver Burden According to Certain Personal Characteristics


X : mean; SD: standard deviation

Comments: There was no difference in caregiver burden scores according to caregiver gender (p>0.05; Mann-Whitney test). Caregivers aged 65 years and older had significantly higher caregiver burden (p= 0.0003; Kruskal-Wallis test). Caregivers who were not working had significantly higher caregiver burden than those who were working (p= 0.001; Mann-Whitney test). Caregivers who were spouses of patients had significantly higher caregiver burden than caregivers who were children, siblings, or grandchildren (p= 0.0002; Kruskal-Wallis test).


3.2.2.4. Burden of care according to patient's level of cognitive impairment

Table 3.12: ZBI care burden by level of cognitive impairment

(MMSE) of patients (n = 120)


Level of cognitive impairment

of the patient

Burden of care

p


X

SD

Severe/MMSE ≤ 9 (n = 26)

38.61

10.51


0.0001

Average/MMSE from 10 – 19(n = 57)

27.35

12.18

Mild/MMSE ≥ 20 (n = 37)

25.76

14.84


X : mean; SD: standard deviation

Comments: Caregivers of patients with severe cognitive impairment had significantly higher caregiving burden than caregivers of patients with mild and moderate cognitive impairment (p= 0.0001; Kruskal-Wallis test).

3.2.2.5. Correlation between care burden and some behavioral and mental symptoms of patients

Table 3.13: Correlation between caregiver burden (ZBI)

(n=120) with some behavioral and psychiatric symptoms NPI


Features

Caregiver Burden Correlation Coefficient (ZBI)

Paranoia

0.29*

Illusion

0.29*

Aggressive or aggressive

0.42*

Depression or dysthymia

0.24*

Anxiety

0.17

Mania

0.27*

Apathetic or indifferent

0.29*

Disinhibition

0.17

Irritability/emotional instability

0.19*

Repeat action

0.24*

Sleep disordered behavior

0.33*

Eat and drink

0.04

Severity

0.49*

Level of influence

0.51*

*: p< 0.05; Spearman test


Comments: The severity and impact of behavioral and psychiatric symptoms were positively correlated with caregiving burden (ZBI) (correlation coefficients 0.49 and 0.51; p <0.005), in which agitation or aggression and sleep disturbance were more related than other symptoms.

3.2.2.6. Linear regression model for caregiver burden

Alzheimer's patient

The dependent variable is caregiver burden of Alzheimer's patients.

represented by the burden of care score (ZBI).

Table 3.14: Linear regression of factors associated with caregiver burden (n=120)

Independent variable

Coefficient

P>t

Patient's MMSE

-0.121

0.378

Patient quality of life

-0.596

0.005

Severity of psychiatric behavioral symptoms

god (NPI)


-0.147


0.567

The impact of behavioral symptoms

god(NPI)


0.553


0.009

Age of caregiver

-0.006

0.947

Gender of caregiver (male vs. female)

3,143

0.049

Caregiver's education

0.987

0.123

Marital status of caregiver

1,238

0.706

Caregiver employment status

0.712

0.754

Caregiver-patient relationship

-1,458

0.434

Patient care time (years)

-2,221

0.008

Care time per day (hours)

0.143

0.529

Time of patient's diagnosis (years)

1,454

0.032

Caregiver's physical health

-0.937

0.023

Caregiver mental health

-1,481

0.000

Coefficient

77,150

0.000

p = 0.000

R 2 = 0.7016


Comments: Factors that were statistically significantly associated with caregiver burden included:

- Positive correlation: factors on the level of influence of patient's behavioral and mental symptoms (NPI) with coefficient = 0.553 (p = 0.009); caregiver's gender with coefficient = 3.143 (p = 0.049); time of disease detection with coefficient = 1.454 (p = 0.032).

- Inversely related: factors that are inversely related to caregiver burden include patient care time with coefficient = - 2.221 (p=0.008); caregiver physical health with coefficient = - 0.937 (p=0.023); caregiver mental health with coefficient = - 1.481 (p=0.023).

The results from the model showed that the level of influence of behavioral and mental disorders of patients (according to the NPI scale), patient quality of life, time of disease detection, caregiver gender, physical health, and mental health of caregivers were important characteristics that were statistically significantly associated with caregiver burden of Alzheimer's patients, in which male gender and long-term patient care were the factors that most affected caregiver burden. Other factors including demographic factors and MMSE scores did not correlate with caregiver burden. The above model explained 70.16% of the variation in caregiver burden and was significant at p<0.05.



3.2.3. Caregiver health-related quality of life

3.2.3.1. Health-related quality of life of primary caregivers

according to some personal characteristics

Table 3.15: Physical and mental health scores (SF-12) of primary caregivers according to some personal characteristics (n=120)

Characteristic

Physical health score

Mental health score


X

SD


X

SD

Total group (n = 120)

45.50

10.05

38.84

10.10

By caregiver gender

Male (n = 40)

45.15

10.01

39.40

9.80

Female (n = 80)

44.67

10.03

38.56

10.30

p

0.165

0.628

By caregiver age group

< 45 years old (n = 50)

52.02

5.63

41.35

8.39

45 - 54 years old (n = 24)

44.45

9.21

37.68

10.32

55 - 64 years old (n = 16)

45.38

8.72

37.31

12.76

≥ 65 years old (n = 30)

35.53

8.78

36.41

10.59

p

0.001

0.104

Caregiver's working status

Working (n = 75)

50.12

7.00

40.21

9.50

Not working (n = 45)

37.80

9.68

36.56

10.75

p

0.001

0.051

Caregiver-patient relationship

Spouse (n = 43)

36.68

9.25

36.11

11.49

Children (n = 71)

50.49

6.62

40.42

9.09

Siblings (n = 6)

49.63

5.30

39.75

7.96

p

0.001

0.066


X : mean; SD: standard deviation

Comments: The mean score of physical health of caregivers was 45.50±10.05; that of mental health was 38.84±10.10. There was no difference in health-related quality of life of caregivers.


male and female caregivers (p>0.05). Non-working caregivers had lower physical health-related quality of life scores than working caregivers (p = 0.001; Mann-Whitney test). Caregivers aged 65 years and older had significantly lower physical health-related quality of life scores than younger caregivers. Caregivers who were spouses of patients had significantly lower health-related quality of life scores than caregivers who were children or relatives of patients (p= 0.001; Kruskal-Wallis test).

3.2.3.2. Caregiver SF-12 health-related quality of life

according to the patient's cognitive status

Table 3.16: Physical health and mental health scores of caregivers

Primary care based on patient condition (n=120)



Patient condition

Health Points

physical

Health Points

mental


X

SD


X

SD

Severe (n = 26)

43.33

11.73

33.17

9.50

Average (n=57)

47.45

8.72

40.27

9.78

Mild (n = 37)

44.01

10.41

40.62

9.82

p

0.192

0.005


X : mean; SD: standard deviation


Comments: Caregivers of patients with severe cognitive impairment had significantly lower mental health-related quality of life than caregivers of patients with mild and moderate cognitive impairment. The difference was statistically significant (p= 0.005; Kruskal-Wallis test).


3.2.3.4. Caregiver health-related quality of life (SF-12)

anxiety and some behavioral and mental symptoms of the patient

Table 3.17: Correlation between primary caregiver's health-related quality of life and some behavioral and psychiatric symptoms of patients (n=120)


Features

Correlation coefficient with SF-12

Health

physical

Health

mental

Paranoia

-0.11

-0.12

Illusion

-0.10

-0.19*

Aggressive or aggressive

-0.07

-0.20 *

Depression or dysthymia

-0.07

-0.28 *

Anxiety

-0.06

-0.10

Mania

-0.01

-0.10

Apathetic or indifferent

- 0.00

-0.16

Disinhibition

-0.14

-0.03

Irritability/emotional instability

-0.16

- 0.10

Movement disorders

-0.09

-0.14

Patient behavior at night

-0.33*

-0.24*

Eat and drink

-0.13

-0.00

Overall severity of behavioral symptoms,

mental


-0.17


- 0.31 *

Overall impact of behavioral symptoms,

mental


-0.20*


- 0.32 *

*: p< 0.05; Spearman test

Comments: The quality of life related to mental health of caregivers was inversely correlated with the symptoms of agitation or aggression, depression or dysthymia, and sleep behavior disorders of patients, but all at low levels (correlation coefficients were -0.20, -0.24, and -0.28, respectively; p<0.05). The quality of life related to physical health of caregivers was inversely correlated with the symptoms of sleep behavior disorders of patients (correlation coefficient = -0.33; p<0.05).


3.2.3.5. Linear regression model of some health-related factors

physical condition of primary caregiver

The dependent variable was the physical health-related quality of life and mental health of caregivers of Alzheimer's patients as represented by the physical health score on the SF-12 scale.

Table 3.18: Linear regression of some factors related to caregiver health (n=120)


Variable

Health

physical

Health

mental

Coefficient

p

Coefficient

p

Patient's baseline cognitive status (MMSE)

-0.216

0.089

0.008

0.954

Patient quality of life according to caregiver

Squirrel reviews

-0.220

0.258

0.079

0.704

Severity of behavioral and psychological symptoms

god

-0.157

0.495

-0.028

0.907

The impact of behavioral and psychological symptoms

god

0.014

0.941

0.320

0.116

Age of caregiver

-0.231

0.007

0.019

0.830

Gender (male vs. female)

2,976

0.033

0.990

0.502

Education level (compared to secondary school)





High school

-2,127

0.333

-1,887

0.419

Secondary/college

1,010

0.652

-1,346

0.573

University/graduate

1,386

0.462

2,657

0.187

Marital status (married vs. single/divorced)

divorce, separation)

-1,416

0.638

-1,989

0.535

Employment status (yes vs. no)

3,325

0.146

0.998

0.681

Relationship with patient (vs. spouse)





Child

2,409

0.379

-2,116

0.467

Brothers, sisters/nephews

6,518

0.056

-2,847

0.430

Patient care time

-0.847

0.261

-0.888

0.268

Patient care time per day

-0.326

0.118

0.119

0.590

Patient's illness duration

1,107

0.080

-0.403

0.547

Burden of care ZBI

-0.227

0.001

-0.572

0.001

Constant

68,436

0.001

53,285

0.001

p

<0.001

<0.001

R 2

0.5656

0.5129

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