Objective: Previous studies on caregivers of patients with disorders of consciousness (DOCs) have highlighted that their overall burden is not related to disease duration or diagnosis, but mainly to their personal characteristics. The aim of this study was to investigate the impact of attachment style and hopelessness on overall burden in caregivers of patients in both vegetative state and minimally conscious state.Methods and procedure: Nineteen caregivers of patients with DOCs, hosted in a long-term care facility, were assessed using the Caregiver Burden Inventory, the Attachment Style Questionnaire, and the Beck Hopelessness Scale. Socio-demographic information was also collected. Data were analysed through descriptive statistics, correlations, one sample t-test and a multiple regression analysis using SPSS.Outcomes and results: Burden was not associated with duration of caregiving and gender had no effect on overall burden. Multiple regression analysis indicated that preoccupied attachment sty...

Anxious attachment style and hopelessness as predictors of burden in caregivers of patients with disorders of consciousness: a pilot study.

Providing care to hospitalized patients may be associated with stress, reduced quality of life, and even psychiatric disorders. This case-control study aimed to compare the level of stress (using the 14-question perceived stress scale (PSS-14), potential risk factors, and stress-coping strategies (using the 28-item brief coping scale (BCS-28) between two convenient samples of patients’ companions (56) and administrative employees (98) working in a tertiary care hospital in Saudi Arabia. The average PSS-14 was slightly higher in companions than administrative employees (27.4 ± 9.9 vs. 25.1 ± 10.1, p=0.179). After stratifying by gender, the difference in males (but not females) was marginally significant in the unadjusted comparison and significant in the adjusted comparison. Companions had similar scores of adaptive stress-coping strategies but higher scores of maladaptive stress-coping strategies compared with administrative employees. This was especially apparent in the denial and self-distraction strategies. PSS-14 in all participants had a moderate significant positive correlation with maladaptive stress-coping strategies. Companions exhibited a gender-specific slight increase in the level of stress and adopted more maladaptive stresscoping strategies compared with administrative employees. There were no group differences in blood lipids, serum glucose, or cortisol levels.

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Work-Related Stress and Stress-Coping Strategies among Patients Companions at a Tertiary Care Hospital in Saudi Arabia

BACKGROUND The role of the caregiver has received increasing attention in recent years. This is due in part to today's longer life expectancy, which has resulted in a larger population affected by chronic pathologies. But it is also due to the lack of suitable solutions provided by the social and health structures. This research aims to investigate in depth the characteristics and the needs of caregivers involved with adult and paediatric patients who are receiving treatment for acute pathologies in hospitals. Study Design. Questionnaire. METHODS A questionnaire was used that was validated in a previous study. It was administered in the period from March 2014 to January 2015 at the Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano in six wards. The questionnaire was anonymous. RESULTS We administered 364 questionnaires which enabled us to identify the characteristics of adult and paediatric patients' caregivers. Those in hospitals are prevalently women. Adult patients' caregivers tend to be from 40 to 79 years of age, those of paediatric patients from 20 to 59. Adult patients' caregivers may often be the husband/wife (35%), or a son/daughter (32%). Paediatric patients' caregivers for paediatric patients are almost always parents (97%). The states of mind and the sensations felt by caregivers are anxiety and tension. CONCLUSION The increasing number and severity of the conditions of people needing care, the changing family composition and the economic crisis have compelled caregivers to perform tasks requiring technical skills that should not be expected from them, but which the circumstances do not allow them to evade. It emerges from an analysis of the data provided by this research that a more complete use could be made of caregivers' potentials by involving them to a greater extent in the care process by the healthcare providers.

The characteristics of caregivers attending adult and paediatric patients in a Milan hospital.

RIASSUNTO. Introduzione: l’obiettivo e di indagare e descrivere il carico soggettivo dei familiari di anziani con polipatologia ricoverati in un reparto ospedaliero per acuti e valutare le necessita di intervento e l’analisi del bisogno di sostegno psicologico. Metodi: intervista a 100 caregiver di pazienti ricoverati in un reparto di Geriatria, utilizzando due strumenti per misurare il carico assistenziale: il Family Strain Questionnaire - Short Form (FSQ-SF) e la Anxiety and Depression Short Scale (AD-R). Risultati: il FSQ-SF ha evidenziato che il 7% dei caregiver mostra adeguate abilita di coping per fronteggiare lo stress legato alla malattia; il 21% potrebbe necessitare di un counselling psicologico; per il 48% e consigliato un intervento di valutazione e sostegno psicologici; nel 24% l’intervento psicologico assume caratteristiche di urgenza. I risultati della AD-R hanno mostrato che il 36% e il 10.5% degli intervistati mostrano livelli clinicamente significativi di ansia e di depressione. Sebbene il bisogno di sostegno psicologico sia diffuso (93%), solo il 35% dei soggetti vorrebbe parlarne con un esperto e il 18% vorrebbe maggiori informazioni per usufruire di sostegno psicologico per se. Conclusioni: i risultati mostrano un paradosso definibile come bisogno non espresso da parte dei familiari: l’esigenza di avere maggior sostegno non si traduce in una richiesta di intervento. Il dato meriterebbe di essere indagato: capire le ragioni di tale atteggiamento di chiusura verso la possibilita di rivolgersi a figure professionali specializzate nel sostegno psicologico ed individuare quali servizi possano essere migliorati o istituiti per rispondere alle esigenze dei familiari. Parole chiave: burden, caregiver, comorbilita.

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Burden del caregiver di anziani ricoverati in una unità operativa ospedaliera per acuti e ruolo dello psicologo nella gestione del caregiver "fragile"

INTRODUCTION the purpose was to investigate and describe the subjective burden perceived by caregivers of elderly patients affected by multiple pathologies admitted to an acute ward and to consider the necessity of intervention with special reference to the analysis of psychological support need. METHODS a sample of 100 caregivers of elderly patients admitted to Geriatrics ward was interviewed using two instruments assessing care burden: the Family Strain Questionnaire--Short Form (FSQ-SF) and the Anxiety and Depression Short Scale (AD-R). RESULTS the FSQ-SF highlighted that 7% of caregivers showed adequate coping abilities to face the stress related to illness; 21% of caregivers could require psychological counselling intervention; for 48% an intervention of psychological evaluation and support was recommended; for 24% the psychological intervention became urgent. Results from the AD-R showed that 36% and 10.5% of interviewed caregivers felt clinically significant levels of anxiety and depression. Despite psychological support need was widely spread (93%), only 35% of caregivers would like to go to a specialist, 18% would like to have more information about how to receive individual psychological support. CONCLUSIONS results from caregiver burden analysis highlight a paradox which can be defined as an unexpressed need by family members: needing more support from health care services doesn't turn into a tangible demand for intervention. This remark raises some questions: understanding the reasons of such refusing behaviour towards the opportunity of applying specialists in psychological support and identifying which health services could be improved in order to satisfy caregivers needs.

Antonio Lorido

Papers

Burden del caregiver di anziani ricoverati in una unità operativa ospedaliera per acuti e ruolo dello psicologo nella gestione del caregiver "fragile"

[Burden of caregivers of aged patients at a hospital acute care unit and role of the psychologist in the management of the "fragile" caregiver].