Caregiver burden in the veterinary dermatology client: comparison to healthy controls and relationship to quality of life

Abstract

Background Skin disease in companion animals often requires long‐term management which may contribute to caregiver burden in the dermatology client. Hypotheses/Objectives We expected greater caregiver burden in dermatology clients relative to healthy control veterinary clients and that no difference would be present between healthy controls and dermatology clients reporting good skin disease control. Within the dermatology sample, we hypothesized that greater caregiver burden would correlate with client perception of the animal's severity of disease (ASD), animal skin disease quality of life (ASD‐QoL), and client general quality of life (CG‐QoL) and skin disease‐related quality of life (CSD‐QoL). Participants Participants were 358 dog owners, including veterinary dermatology clients (n = 152) and healthy general veterinary control clients (n = 206). Methods and materials Cross‐sectional online assessments were completed for client caregiver burden (both samples) and CG‐QoL, CSD‐QoL, ASD‐QoL and ASD (dermatology sample only). Results Caregiver burden was greater in dermatology clients overall relative to healthy controls (P < 0.001); it was comparable for those reporting good skin disease control (P > 0.05). Within the dermatology group, correlations between caregiver burden and CSD‐QoL were high (r = 0.58; P < 0.001). CG‐QoL was predicted by caregiver burden (P < 0.001) but not significantly by CSD‐QoL (P > 0.05). Conclusions and clinical importance In the presence of good skin disease control, caregiver burden in dermatology clients is as low as general veterinary clients with a healthy dog. Understanding client experiences of companion animal skin disease may be optimized by assessing caregiver burden.

Validation of an abbreviated instrument to assess veterinary client caregiver burden

“…Finally, regarding reference values, because caregiver burden is conceptually due to the burden of providing care during illness, it could be argued that veterinary clients with a healthy companion animal are a suboptimal reference point. However, the present study and prior work demonstrate that when examining self‐reported caregiver burden, a summed total of “0” is actually not typical for owners of a healthy companion animal . In the same way that it is necessary to know the range of values greater than “0” that could be still be considered negative for a given bloodwork titer, it is essential to establish reference values for “normal” burden associated with owning a healthy companion animal.…”

“…geographical regions of the United States with median household income in the range of $62-68 000. 17 Participants were fairly homogeneous in terms of race and sex, with overrepresentation of females and Caucasians relative to the census data for these locations.17 Similar to prior work,4,5,8,16,18 the overrepresentation of Caucasian females could lead to bias in that these individuals might experience burden differently from other groups. Although this is possible, it is also likely that the demographic make-up of our sample is representative of the target population, that is, veterinary clients who choose caregiving over euthanasia when faced with significant illness in a companion animal.…”

“…These “high overlap” items may drive stronger correlations with quality of life when using the full adapted ZBI. If this is the case, the abbreviated adapted ZBI could actually represent a more pure reflection of the construct of caregiver burden, as research demonstrates that caregiver burden and quality of life are separate, though typically strongly linked constructs . Continued work is needed to examine the theoretical underpinnings of caregiver burden in this population in order to further investigate this question.…”

“…Additionally, although a strength of this study is the inclu- giver burden, a summed total of "0" is actually not typical for owners of a healthy companion animal. 4,5,8,16 In the same way that it is necessary to know the range of values greater than "0" that could be still be considered negative for a given bloodwork titer, it is essential to establish reference values for "normal" burden associated with owning a healthy companion animal. Work to examine if a still further abbreviated (ie, "screener") version of the measure might also be of benefit.…”

“You can be blind because of loving them so much”: The impact on owners in the United Kingdom of living with a dog with osteoarthritis

“…Those owners describe adapting multiple aspects of their own lifestyles to accommodate the reduced exercise capacity, requirements for time-specific medication dosing and frequent veterinary visits required by their dogs. In a series of recent cross-sectional studies, Spitznagel et al [14,[21][22] demonstrated, using scales designed for human patients and carers as well as for pet owners, that owners of pets with a range of chronic illnesses report greater "caregiver burden", psychological distress and a lower quality of life than owners of healthy pets. Where research subjects, in this instance pet owners, are not involved in research design there is a risk that important topics may not be included in tools for their completion leading to poor face validity, a problem common also in human healthcare [23].…”