Differences in COPD Patient Care by Primary Family Caregivers: An Age-Based Study

Abstract

BackgroundBecause Taiwan has the fastest aging rate among developed countries, care for the elderly is becoming more prominent in the country. Primary family caregivers play an important role in patient health and health promotion behavior. Chronic obstructive pulmonary disease (COPD), an age-related disease, is a major public health problem with high morbidity and mortality and can be a long-term burden for family members; however, little attention has been given to the differences in COPD care between elder caregivers and other caregivers. This study aimed to investigate the differences between elder family caregivers and non-elder family caregivers caring for COPD patients in Taiwan, including caring behavior, caregiver response, and caring knowledge.MethodsThis cross-sectional study was conducted between March 2007 and January 2008; 406 primary family caregivers of COPD patients from the thoracic outpatient departments of 6 hospitals in north-central Taiwan were recruited to answer questionnaires measuring COPD characteristics, care behavior, caregiver response, and COPD knowledge. All questionnaires, which addressed caregiver knowledge, care behaviors, and care reactions, were shown to have acceptable validity and reliability, and the data were analyzed using univariate and generalized linear model techniques.ResultsThe elder caregivers group had 79 participants, and the non-elder caregivers comprised 327 participants. The COPD-related knowledge scale results were positively correlated with the family caregiver caring behavior scale, suggesting that better COPD-related knowledge among family caregivers may result in improved caring behavior. After adjusting for all possible confounding factors, the elder caregivers had significantly lower COPD-related knowledge than the non-elder caregivers (P<0.001). However, there were no significant differences in the family caregiver caring behavior scale or the caregiver reaction assessment scale between the two groups.ConclusionsElder family caregivers require increased education regarding medications and preventive care in COPD patient care.

Informal caregiving in COPD: A systematic review of instruments and their measurement properties

“…These findings are related to the life domains identified in this review. Most instruments explored the negative impacts of caregiving with only two addressing both the positive and negative impacts of caring for a person with COPD, the Caregiver Reaction Assessment [25,47,61,62] and the Family Appraisal of Caregiving Questionnaire for Palliative Care [23,63]).…”

“…Studies assessing the measurement properties of instruments were of low quality possibly because they were not specifically designed for this purpose. Only one study assessed the content validity of an instrument (Caregiver Reaction Assessment) [61]. Assessment of content validity is a fundamental step when testing an existing instrument in a population that differs from the original population for which it was developed [17].…”

“…Only one study assessed the content validity of an instrument, the Caregiver Reaction Assessment [61]. The study was rated as 'poor' mainly because it did not assess the relevance of items in the study population but only considered the professionals' views through the content validity index (CVI) [66].…”

“…Other domains, assessed in the studies, comprised both the negative and positive aspects of caregiving (Caregiver Reaction Assessment [25,47,61,62]; Family Appraisal of Caregiving Questionnaire for Palliative Care [23,63]), disability due to the partner's disease (COPD Disability Index [50], which was a modified version of the Pain Disability Index), objective and subjective health status (Health Perceptions Questionnaire Form II e only the Current Health subscale was used [48]), low back pain prevalence and impact (Nordic low back pain questionnaire [60]), psychosocial impact of the illness (Psychosocial Adjustment to Illness Scale e Self-Report [32,33]), loneliness (revised UCLA Loneliness scale [43,64]), spiritual wellbeing (Functional Assessment of Chronic Illness Therapy 12-item Spiritual Well-Being Scale [47]) and life satisfaction (Life Satisfaction Index-A [65]).…”

“…Informal caregivers included in these studies were mostly female and patients' spouses [26,33,36,38e41,43,48e50,52,64]. Sample sizes ranged from 25 [48] to 406 [61]. Caregivers' mean age ranged from 48 to 67 years.…”