Caregiver burden in owners of a sick companion animal: a cross‐sectional observational study

Abstract

Much recent work has focused on occupational stress in veterinary medicine, although little is known about the possible contribution of client-based factors. Clients providing care for a companion animal with protracted illness are likely to experience 'caregiver burden' and reduced psychosocial functioning, which may ultimately lead to increased veterinarian stress. This cross-sectional observational study assessed caregiver burden and psychosocial function in 238 owners of a dog or cat, comparing owners of an animal with chronic or terminal diseases (n=119) with healthy controls blindly matched for owner age/sex and animal species (n=119). Results showed greater burden, stress and symptoms of depression/anxiety, as well as poorer quality of life, in owners of companion animals with chronic or terminal disease (p<0.001 for all). Higher burden was correlated with reduced psychosocial function (p<0.001 for all). Owners of a sick companion animal exhibit elevated caregiver burden, which is linked to poorer psychosocial functioning. This knowledge may help veterinarians understand and more effectively handle client distress in the context of managing the challenges of sick companion animal caregiving. Future work is needed to determine whether clients with this presentation impact veterinarian stress and how burden in this population might be reduced.

Validation of an abbreviated instrument to assess veterinary client caregiver burden

“…Although significantly correlated in the expected directions with measures used to establish construct validity, correlations between the abbreviated adapted ZBI and constructs related to caregiver burden ranged in magnitude. Moderate to high correlations were observed for stress, which is consistent with past work . In contrast, a somewhat lower strength of relationship was noted for quality of life.…”

“…Additionally, these reference values provide the opportunity for researchers to determine if, as a secondary outcome measure, a patient treatment reduces caregiver burden to a reference range for the client. Of note, prior work in a smaller sample tentatively proposed a cut score of 18 for the full adapted ZBI; using a much larger normative sample, the current study similarly suggests a raw score of 18 as the lower end of increased caregiver burden for veterinary clients, and extends to suggest a raw score of 9 as the lower end of increased burden using the abbreviated measure. Continued examination of the full and abbreviated adapted ZBI in other samples and geographical regions might help determine if there are circumstances for which the proposed cutoffs do not apply.…”

“…The ZBI adapted for use with pet owners and small animal veterinary clients was the measure of focus for item reduction and creation of an abbreviated scale of pet caregiver burden. This 18‐item self‐report inventory assesses the client's experience of providing care for a sick companion animal on a 5‐point scale (“never” to “nearly always”), with items tapping into the practical impact of caregiving on the client's life (eg, “Do you feel that because of the time you spend with your pet that you don't have enough time for yourself?”) as well as affective experiences (eg, “Do you feel angry when you are around your pet?”).…”

“…Higher adapted ZBI scores suggest greater caregiver burden. Psychometric properties of the adapted ZBI include internal consistency (Cronbach's α = .90‐.92) and construct validity supported by correlation with a measure of companion animal treatment adherence that taps into difficulty providing care ( r = 0.51‐0.69), measures of the client's affective state including stress ( r = 0.51‐0.56), and a negative correlation with a quality of life measure ( r = −0.54 to −0.59) …”

“…Caregiver burden, a response of strain in the context of providing care for a loved one with an illness, is qualitatively reported by pet caregivers, with approximately half of owners providing care for seriously ill companion animals demonstrating quantitatively increased levels of burden . This caregiver burden is correlated with clinically meaningful clinical signs of depression and reduced quality of life in samples of social media‐recruited companion animal owners and small animal veterinary clinic clients, with owners of a chronically or terminally ill cat or dog being about twice as likely to describe increased clinical signs of depression and high stress levels compared to owners of a healthy pet.…”