Attachment insecurities, caregiver burden, and psychological distress among partners of patients with heart disease

Abstract

Caregiver psychological distress (i.e., depression and anxiety) is harmful to both caregiver and patient. Different affect-regulation strategies associated with attachment orientations may impact a caregiver’s perception of their caregiving role as a burden, thereby contributing to their psychological distress. The aim of the present investigation was to examine the links among attachment orientations, caregiver burden, and psychological distress in a cardiac context. Participants (N = 181, Mage = 61.79, SD = 10.49; males = 24.7%) were romantic partners of patients with heart disease (i.e., informal caregivers) who completed validated questionnaires. The majority of caregivers had partners with coronary artery disease (n = 127, 70. 2%). 66.3% of caregivers reported low burden, 87.6% reported low levels of depression and 89.9% reported low levels of anxiety. The mean anxious attachment score was 2.74 (SD = 1.37) and the mean avoidant attachment score was 2.95 (SD = 1.26). Four mediation analyses were run using PROCESS macro for IBM SPSS (version 26). Statistical models showed that the relationships between attachment anxiety and psychological distress were mediated by caregiver burden [abanxiety= 0.15, 95% C.I. (0.04, 0.29); abdepression = 0.15, 95% C.I. (0.05, 0.28)] and that attachment avoidance was not a significant covariate (cvanxiety = −0.02, p>0.05; cvdepression = 0.40, p>0.05). The relationships between attachment avoidance and psychological distress were also mediated by caregiver burden [abanxiety = 0.23, 95% C.I. (0.10, 0.42); abdepression = 0.21, 95% C.I. (0.09, 0.37]with attachment anxiety as a significant covariate (cvanxiety = 1.09, p<0.001; cvdepression = 1.09, p<0.001). Interventions for caregivers reporting attachment insecurity and burden should be explored to potentially lessen caregiver distress as they support their partners with heart disease.

Interventions for Caregivers of Heart Disease Patients in Rehabilitation: Scoping Review

“…For instance, caregivers commonly experience psychological distress and “caregiver burden,” described as the physical, social, economic, and emotional difficulties experienced by those who assume caregiving roles [ 42 ]. Informal caregivers can experience additional barriers related to the caregiving role, such as competing demands, limited time available for self-care, a lack of awareness of available support, and feelings of blame for seeking help for themselves instead of focusing on the person they are caring for, which can induce mental health problems [ 43 ]. Current practice generally excludes the integration of caregivers into formal programs, although there is greater concern for the health and well-being of caregivers of people in cardiac rehabilitation programs [ 44 , 45 ].…”

Affective Impact on Informal Caregivers over 70 Years of Age: A Qualitative Study

“…A large number of studies, mostly quantitative, have been conducted on the affective experiences of informal caregivers. Their results indicate that feelings and emotions can have a negative impact on the psychological health of the caregiver, with high levels of perceived stress, lower life satisfaction, and reduced quality of life, which can lead to problems of depression or anxiety [32][33][34][35][36][37][38]. Moreover, these effects produce an aggravation associated with the physical and cognitive ageing of caregivers over time, accentuated when they are older caregivers [39].…”