Stress among the Family Caregivers of Liver Transplant Recipients

Cohen, Miri; Katz, Dafna; Baruch, Yaacov

doi:10.1177/152692480701700107

Cited by 37 publications

(39 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Similar to previous studies in dementia and spinal cord injury, our study found a relatively scant social support in caregivers, which was in turn correlated with depression in these individuals (33,34). Both burden questionnaires, in turn were related to depression and social support, which replicate findings in other chronic diseases (26–28). Our study also confirmed findings noted in other diseases, such as mild cognitive impairment in Alzheimer's disease, major depression, Parkinson's disease, and stroke, that the degree of caregiver burden is highly correlated with the patient's cognitive impairment (35–38).…”

Section: Discussionsupporting

confidence: 80%

The Multi-Dimensional Burden of Cirrhosis and Hepatic Encephalopathy on Patients and Caregivers

Bajaj

Wade²,

Gibson³

et al. 2011

American Journal of Gastroenterology

311

287

View full text Add to dashboard Cite

Objectives Cirrhosis and hepatic encephalopathy (HE) can adversely affect survival, but their effect on socioeconomic and emotional burden on the family is not clear. The aim was to study the emotional and socioeconomic burden of cirrhosis and HE on patients and informal caregivers. Methods A cross-sectional study in two transplant centers (Veterans and University) of cirrhotic patients and their informal caregivers was performed. Demographics for patient/caregivers, model-for-end-stage liver disease (MELD) score, and cirrhosis complications were recorded. Patients underwent a cognitive battery, sociodemographic, and financial questionnaires. Caregivers were given the perceived caregiver burden (PCB; maximum = 155) and Zarit Burden Interview (ZBI)-Short Form (maximum = 48) and questionnaires for depression, anxiety, and social support. Results A total of 104 cirrhotics (70% men, 44% previous HE, median MELD 12, 49% veterans) and their caregivers (66% women, 77% married, relationship duration 32 ± 14 years) were included. Cirrhosis severely impacted the family unit with respect to work (only 56% employed), finances, and adherence. Those with previous HE had worse unemployment (87.5 vs. 19%, P = 0.0001) and financial status (85 vs. 61%, P = 0.019) and posed a higher caregiver burden; PCB (75 vs. 65, P = 0.019) and ZBI (16 vs. 11, P = 0.015) compared with others. Cognitive performance and MELD score were significantly correlated with employment and caregiver burden. Veterans and non-veterans were equally affected. On regression, depression score, MELD, and cognitive tests predicted both PCB and ZBI score. Conclusions Previous HE and cognitive dysfunction are associated with worse employment, financial status, and caregiver burden. Cirrhosis-related expenses impact the family unit's daily functioning and medical adherence. A multidisciplinary approach to address this burden is required.

show abstract

Section: Discussionsupporting

confidence: 80%

The Multi-Dimensional Burden of Cirrhosis and Hepatic Encephalopathy on Patients and Caregivers

Bajaj

Wade²,

Gibson³

et al. 2011

American Journal of Gastroenterology

311

287

View full text Add to dashboard Cite

show abstract

“…The study by Cohen et al . was the first study in this area and took the form of a cross‐sectional survey, using the Caregiver Stress Questionnaire, of 24 care‐givers carried out from 1 to 15 years following LT. Their objective was to determine psychological distress amongst caregivers following LT and hypothesized there may be differences between the sexes.…”

Section: Resultsmentioning

confidence: 99%

The effect of Liver Transplantation on the quality of life of the recipient's main caregiver – a systematic review

Young

Rowe

Absolom

et al. 2016

Liver International

View full text Add to dashboard Cite

show abstract

“…48 Caregiver strain and burden, too, may reduce the quality and effectiveness of the support provided and, indirectly, may increase rates of medication nonadherence. 49,50 …”

Section: Discussionmentioning

confidence: 99%

Patient-Reported Immunosuppression Nonadherence 6 to 24 Months after Liver Transplant: Association with Pretransplant Psychosocial Factors and Perceptions of Health Status Change

et al. 2013

View full text Add to dashboard Cite

Context Knowing the prevalence and risk factors of immunosuppression nonadherence after liver transplant may help guide intervention development. Objective To examine whether sociodemographic and psychosocial variables before liver transplant are predictive of nonadherence after liver transplant. Design Structured telephone interviews were used to collect self-report immunosuppression adherence and health status information. Medical record reviews were then completed to retrospectively examine the relationship between immunosuppression adherence and pretransplant variables, including sociodemographic and medical characteristics and the presence or absence of 6 hypothesized psychosocial risk factors. Setting and Participants A nonprobability sample of 236 adults 6 to 24 months after liver transplant at 2 centers completed structured telephone interviews. Main Outcome Measure Immunosuppressant medication nonadherence, categorized as missed-dose and altered-dose “adherent” or “nonadherent” during the past 6 months; immunosuppression medication holidays. Results Eighty-two patients (35%) were missed-dose nonadherent and 34 patients (14%) were altered-dose nonadherent. Seventy-one patients (30%) reported 1 or more 24-hour immunosuppression holidays in the past 6 months. Missed-dose nonadherence was predicted by male sex (odds ratio, 2.46; P = .01), longer time since liver transplant (odds ratio, 1.08; P = .01), pretransplant mood disorder (odds ratio, 2.52; P = .004), and pretransplant social support instability (odds ratio, 2.25; P = .03). Altered-dose nonadherence was predicted by pretransplant mood disorder (odds ratio, 2.15; P = .04) and pretransplant social support instability (odds ratio, 1.89; P = .03). Conclusion Rates of immunosuppressant nonadherence and drug holidays in the first 2 years after liver transplant are unacceptably high. Pretransplant mood disorder and social support instability increase the risk of nonadherence, and interventions should target these modifiable risk factors.

show abstract

Stress among the Family Caregivers of Liver Transplant Recipients

Abstract: Caregiving stress endures after transplantation. Professional intervention is needed to improve caregivers' quality of life and, consequently, that of transplant recipients as well.

Cited by 37 publications

References 44 publications

The Multi-Dimensional Burden of Cirrhosis and Hepatic Encephalopathy on Patients and Caregivers

The Multi-Dimensional Burden of Cirrhosis and Hepatic Encephalopathy on Patients and Caregivers

The effect of Liver Transplantation on the quality of life of the recipient's main caregiver – a systematic review

Patient-Reported Immunosuppression Nonadherence 6 to 24 Months after Liver Transplant: Association with Pretransplant Psychosocial Factors and Perceptions of Health Status Change

Contact Info

Product

Resources

About