|Year : 2017 | Volume
| Issue : 4 | Page : 1085-1088
Depression and anxiety burden among families of patients with malignant disease
Hala M Shaheen1, Naser Abd El Bary2, Nagwa Nashat Hegazy1, Mohamed A Dawood1
1 Department of Family Medicine, Faculty of Medicine, Menoufia University, Menoufia, Egypt
2 Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, Menoufia University, Menoufia, Egypt
|Date of Submission||26-Feb-2017|
|Date of Acceptance||02-May-2017|
|Date of Web Publication||04-Apr-2018|
Mohamed A Dawood
Department of Family Medicine, Faculty of Medicine, Menoufia University, El Mahalla Kobra District, Gharbia Health Sector, Menoufia
Source of Support: None, Conflict of Interest: None
The aim of this work is to estimate the frequency of different malignant diseases among the families in Manshaat Sultan village, Menoufia Government, and also estimate the depression and anxiety burden among the families of the studied patients with malignant disease.
The prevalence of anxiety and depression was 47 and 18%, respectively, among family caregivers of patients with cancer. The psychological stress of caregiving has a negative effect not only on the health of the family caregivers but also on the health and well-being of the patients with cancer.
Patients and methods
The study was approved by the Ethical Committee of Faculty of Medicine, Menoufia University. In total, 356 families were identified as having one patient with cancer. There were 356 (1.424%) patients with cancer from 25 000 individuals registered in Manshaat Sultan village. Overall, 10 families were excluded for the pilot study. A total of 312 families accepted to complete the interview, with a response rate of 87.6%. Predesigned questionnaire included socioeconomic history and hospital anxiety depression scale to assess depression and anxiety burden among families of the studied patients with malignant disease.
The result found that 312 families accepted to complete the interview in Manshaat Sultan village. The results also showed that anxiety and depression were prevalent among the selected family caregivers in the study area at 47 and 18%, respectively. Depression and anxiety significantly increased among family caregivers with low socioeconomic level in Manshaat Sultan.
Anxiety and depression among family caregivers has been associated with sex, the patient's medical problem, and financial and social level of family caregivers.
Keywords: anxiety, burden, depression, family caregivers, malignant disease, patients
|How to cite this article:|
Shaheen HM, Abd El Bary N, Hegazy NN, Dawood MA. Depression and anxiety burden among families of patients with malignant disease. Menoufia Med J 2017;30:1085-8
|How to cite this URL:|
Shaheen HM, Abd El Bary N, Hegazy NN, Dawood MA. Depression and anxiety burden among families of patients with malignant disease. Menoufia Med J [serial online] 2017 [cited 2018 Oct 17];30:1085-8. Available from: http://www.mmj.eg.net/text.asp?2017/30/4/1085/229201
| Introduction|| |
The psychological stress of caregiving has a negative effect not only on the health of the family caregivers but also on the health and well-being of patients with cancer, so much so that the caregivers could be unable to provide care for the patients. There is a high prevalence of anxiety and depression burden among family caregivers. This finding indicates that more attention must be given to detecting changes in the psychological state of vulnerable family caregivers of patients with cancer. The mortality rate of caregivers who experience mental or emotional strain has been shown to be higher than that of noncaregivers. Low household income is associated with depression and anxiety among family caregivers. Given the high cost of cancer treatment and the poor health insurance coverage, families of low-income patients with cancer spend a large percentage of their household income on cancer treatment, resulting in catastrophic health expenditures. Women caregivers tend to report higher levels of depression, anxiety, and general psychiatric symptomology with lower level of life satisfaction compared with men caregivers.
| Patients and Methods|| |
The study was approved by the ethical committee of Faculty of Medicine, Menoufia University. The practical aspect of the study took 6 months (from the first August 2015 to the end of January 2017), through communication with the local health authority in Manshaat Sultan Village, Menoufia Governorate. The target families (those having patients with cancer) were known to health care workers in Manshaat Sultan Family Health Center. In total, 356 families were identified as having patients with cancer from the 5000 families registered in Manshaat Sultan village. Overall, 10 families were excluded for the pilot study. A total of 312 families accepted to complete the interview, with a response rate of 87.6%. The studied individuals were assessed using a predesigned questionnaire.
The study questionnaire involves two parts: first part assessed the participant's socioeconomic data according to the scoring system of Fahmy et al.. The total score was calculated, and the cut-off points to be used for SES classification were as follows: a high level was indicated as at least 70%, a medium level as 40% to less than 70%, and a low level as less than 40% of the total score. The second part assessed the depression and anxiety burden of cancer on families by using a translated valid reliable form of hospital anxiety depression (HAD) scale, with the use of two anxiety and depression subscales (HAD-A and HAD-D), which has seven domains for each subscale with a total score of 21 (total score range 0–21).
Data were collected, tabulated, and statistically analyzed by statistical package SPSS (SPSS Inc., Chicago, Illinois, USA) version 16. χ2-Test was used to compare two groups or more regarding one qualitative variable in 2 × 2 contingency table or r × c complex table. P value less than 0.05 was considered significant.
| Results|| |
The prevalence of anxiety was significantly higher among females as family caregivers (62.8%), nonworkers (55.6%), family size less than five members (64.5%), and low socioeconomic status of caregivers (77.8%) [Table 1] and [Figure 1], [Figure 2].
The depression was significantly more prevalent among males, those with secondary educational levels, those without work, and low socioeconomic status of family caregivers, with 42.8, 33.3, 37.7, and 55.5%, respectively [Table 2]. The prevalence of anxiety was significantly higher among family caregivers of patients with malignant diseases such as female breast cancer and hemolymphopoietic cancer, 75.0 and 65.7%, respectively [Table 3].
Depression was significantly less prevalent among family caregivers of patients with malignant diseases such as respiratory tract (73.3%), female breast (69.4%), and urinary tract (69.3%) cancers [Table 4].
| Discussion|| |
The result showed higher prevalence of anxiety among females than males caregivers [Table 1]. This in agreement with a study conducted in the US by Hutchison et al., among caregivers of patients with lung cancer, where female caregivers had anxiety more than male caregivers. However, these findings are in contrast to those of a study conducted in Spain among caregivers of patients with urinary cancer by Mahoney et al., where male family caregivers had more anxiety than females.
The study showed more prevalence of anxiety among family caregivers having low socioeconomic level [Table 1]. This finding goes with a study conducted in south Korea by Dumont et al. that showed increased prevalence of anxiety among family caregivers having low financial level and against that conducted by Chochinov et al. who reported no relation between prevalence of anxiety and socioeconomic level of family caregivers.
The result shows more prevalence of depression among male than female caregivers [Table 2]. This finding agrees with a study conducted in India by Iconomou et al. that reported increased positive depression cases among male family caregivers, whereas disagrees with the study conducted by Raveis et al..
The study showed more prevalence of depression among family caregivers having low socioeconomic level [Table 1]. This goes with the result from the study conducted by Dumont et al. in South Korea that showed increased prevalence of depression patients among family caregivers with low financial level, whereas against the study conducted by Chochinov et al. that reported no relation between prevalence of depression and socioeconomic level of family caregivers.
This study showed higher prevalence of anxiety among family caregivers of patients with female breast cancer [Table 3]. This is in agreement with the findings of Rossi et al. that showed more prevalence of anxiety among family caregivers having patients with breast cancer than those with ovarian cancer, whereas it is in contrast with Oberst et al., which reported that more anxiety was prevalent among family caregivers having patients with respiratory tract cancer.
This study showed higher prevalence of depression among family caregivers having patients with skin cancer [Table 4]. This is in agreement with the findings of Hagedoorn et al. that showed more prevalence of depression among family caregivers having patients with skin cancer owing to bad cosmetics appearance and long expensive plastic therapy. This disagreed with the study by Mystakidou et al. that showed increase prevalence of depression among family caregivers having patients with hemolymphopoietic cancer.
| Conclusion|| |
From the presented results, one can conclude that certain psychosocial variables like anxiety and depression among family caregivers have been associated with sex, the patient's medical problem, and financial and social levels of family caregivers.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Holah NS, El-Azab DS, Aiad HA, Sweed DM. Hepatocellular carcinoma in Egypt: epidemiological and histopathological properties. Menoufia Med J 2015; 28
Vehling S, Mehnert A. Symptom burden, loss of dignity, and demoralization in patients with cancer: a mediation model. Psychooncology 2014; 23
Grov EK, Fossa SD, Sørebø O, Dahl AA. Primary caregivers of cancer patients in the palliative phase: a path analysis of variables influencing their burden. Soc Sci Med2006; 63
McPherson CJ, Wilson KG, Murray MA. Feeling like a burden to others: a systematic review focusing on the end of life. Palliat Med 2007; 21
Robinson JA, Crawford GB. Do palliative patients and careers agree about patients' psychological functioning? Palliat Support Care 2010; 8
Fahmy SI, Nofal LM, Shehata SF, El Kady HM, Ibrahim HK. Updating indicators for scaling the socioeconomic level of families for health research. J Egypt Public Health Assoc 2015; 90
Perrig-Chiello P, Hutchison S. Family caregivers of elderly persons: a differential perspective on stressors, resources, and well-being. GeroPsych 2010; 23
Mahoney R, Regan C, Katona C, Livingston G. Anxiety and depression in family caregivers of people with Alzheimer disease: the LASER-AD study. Am J Geriatr Psychiatry 2005; 13
Dumont S, Turgeon J, Allard P, Gagnon P, Charbonneau C. Caring for a loved one with advanced cancer: determinants of psychological distress in family caregivers. J Palliat Med 2006; 9
Chochinov HM, Hassard T, McClement S. The landscape of distress in the terminally ill. J Pain Symptom 2009; 38
Iconomou G, Vagenakis AG, Kalofonos HP. The informational needs, satisfaction with communication, and psychological status of primary caregivers of cancer patients receiving chemotherapy. Support Care Cancer 2001; 9
Raveis VH, Karus D, Pretter S. Correlates of anxiety among adult daughter caregivers to a parent with cancer. J Psychosom Oncol 1999; 17
Rossi FS, Zotti AM, Massara G, Nuvolone G. A comparative assessment of psychological and psychosocial characteristics of cancer patients and their caregivers. Psychooncology2003; 12
Oberst MT, Thomas SE, Gass KA, Ward SE. Caregiving demands and appraisal of stress among family caregivers. Cancer Nurs 1989; 12
Hagedoorn M, Buunk BP, Kuijer RG, Wobbes T, Sanderman R. Couples dealing with cancer: role and gender differences regarding psychological distress and quality of life. Psychooncology 2000; 9
Mystakidou K, Tsilika E, Parpa E, Galanos A, Vlahos L. Caregivers of advanced cancer patients: feelings of hopelessness and depression. Cancer Nurs 2007; 30
[Figure 1], [Figure 2]
[Table 1], [Table 2], [Table 3], [Table 4]