Factors Affecting Caregiver Burden in Caregivers of Patients with Parkinson's Disease

Dong Won Kim; Eun Sook Bae

doi:10.7475/kjan.2015.27.3.283

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Factors Affecting Caregiver Burden in Caregivers of Patients with Parkinson's Disease

Dong Won Kim¹, Eun Sook Bae²

Korean Journal of Adult Nursing 2015;27(3):283-293.
Published online: June 30, 2015

DOI: https://doi.org/10.7475/kjan.2015.27.3.283

¹Department of Nursing Science, Dong-A University, Busan

²Department of Nursing Science, Dong-Eui University, Busan, Korea

Corresponding author: Bae, Eun Sook Department of Nursing Science, Dong-Eui University, 995 Eomgwang-ro, Busanjin-gu, Busan 614-714, Korea. Tel: +82-51-890-2861, Fax: +82-505-182-6876, E-mail: baesukkr3966@deu.ac.kr

• Received: February 24, 2015 • Accepted: June 5, 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Abstract
REFERENCES

Abstract

Purpose
Depression is a common sign of suffering among the patients with Parkinson's disease (PD). Frequent and severe neuropsychiatric symptoms lead to high levels of distress in patients and their caregivers, which results in the high levels of caregiver burden. The aim of this study was to determine the predictors of caregiver burden in caregivers of the patients with Parkinson's disease (PD).
Methods
The study included 183 consecutive PD patients and their caregivers. Patients were assessed using the Hoehn and Yahr scale, Mini Mental State Examination (MMSE), Beck Depression Inventory (BDI), and Schwab and England Activities of Daily Living Scale. Caregivers’ depressive symptoms were evaluated using the Caregiver Burden Inventor (CBI), BDI, and World Health Organization Quality of Life Scale.
Results
All of the patients reported one or more neuropsychiatric symptoms. Patients’ and caregivers' depressive symptoms, caregivers' age and education, time for caregiving, and quality of life were significantly associated with the increased caregiver burden. After controlling the level of education as a potential confounding variable, depression in both patients and caregivers, time for caregiving, and quality of life explained 45.6% of the variance in caregiver burden.
Conclusion
Substantial attention needs to be given to the early identification of depression in PD patients and their caregivers to improve caregivers' quality of life and burden.
Key Words: Parkinson's disease; Caregivers; Depression; Quality of life; Burden

Table 1.

The General Characteristics of the Participants

Characteristics	Categories	Patient (N=183)	Caregiver (N=183)
Characteristics	Categories	n (%) or M±SD	n (%) or M±SD
Gender	Female	120 (65.6)	86 (47.0)
Gender	Male	63 (34.4)	97 (53.0)
Age (year)	M±SD	66.1±12.97	50.2±24.99
	＜40	0 (0.0)	24 (13.1)
	40~49	2 (1.1)	26 (14.2)
	50~59	28 (15.3)	37 (20.2)
	60~69	69 (37.7)	45 (24.6)
	≥70	84 (45.9)	51 (27.9)
The level of education	No schooling	11 (6.0)	4 (2.2)
	Elementary school	53 (29.0)	25 (13.6)
	Middle school	54 (29.5)	24 (13.1)
	High school	40 (21.8)	62 (33.9)
	≥College	25 (13.7)	68 (37.2)
Average monthly income (10,000 won)	≤50	79 (43.2)	0 (0.0)
	51~100	26 (14.2)	39 (21.3)
	101~150	16 (8.7)	27 (14.8)
	151~200	13 (7.1)	26 (14.2)
	201~250	17 (9.3)	16 (8.7)
	≥251	32 (17.5)	75 (41.0)

Table 2.

The Disease-related Characteristics of the Patients (N=183)

Characteristics	Categories	n (%) or M±SD
Duration of having the illness (month)	＜12	15 (8..2)
	13~36	44 (24.0)
	37~72	53 (29.0)
	73~108	25 (13.7)
	109~144	28 (15.3)
	≥145	18 (9.8)
Age of onset (year)	40~49	18 (9.8)
	50~59	56 (30.6)
	60~69	58 (31.7)
	≥70	51 (27.9)
Caregiving time per day (hour)	＜3	107 (58.5)
	3~6	29 (15.9)
	7~10	6 (3.2)
	≥11	41 (22.4)
Living together with	Spouse	103 (56.3)
	Son or daughter	26 (14.2)
	No one	23 (12.5)
	Spouse and children	31 (17.0)
Hoehn & Yahr stage	M±SD	2.41±0.50
	1	4 (2.2)
	1.5	2 (1.1)
	2	70 (38.3)
	2.5	61 (33.3)
	3	46 (25.1)
SE-ADL (%)	M±SD	76.33±16.32
	≤60	31 (16.9)
	70	26 (14.2)
	80	71 (38.8)
	90	50 (27.3)
	100	5 (2.7)

SE-ADL=Schwab & England activities of daily living.

Table 3.

The Descriptive Statistics of the Study Variables (N=183)

Variables	M±SD	Range
Patient's depression	16.52±9.90	0~63
Caregiver's depression	9.04±7.91	0~63
Caregiver's quality of life	79.57±13.42	1~130
Caregiver burden	61.32±15.93	1~125

Table 4.

Differences in Depression, Quality of Life and Burden by Caregiver's Characteristics (N=183)

Variables	Categories	Caregiver's depression		Caregiver's quality of life		Caregiver burden
Variables	Categories	M±SD	t or F (p)	M±SD	t or F (p)	M±SD	t or F (p)
Caregiver gender	Female	50.07±10.09	1.57	77.86±13.76	-1.62	51.76±17.67	0.34
Caregiver gender	Male	47.53±11.77	(.011)	81.09±13.00	(.106)	50.93±14.30	(.730)
Age (year)	＜40	5.43±7.13^a	6.04	87.13±10.29^a	3.74	43.71±12.82^a	5.96
	40~49	6.42±6.73^b	(＜.001)	82.46±10.11^b	(.006)	44.96±13.31^a	(＜.001)
	50~59	6.68±6.08^b	a＜b	79.84±13.88^b	a＞b	48.08±13.76^b	a＜b
	60~69	12.11±7.97^b		75.18±12.12^b		58.24±16.44^b
	≥70	11.14±8.45^b		78.24±12.59^b		54.37±16.63^b
Education level	Elementary school	13.48±8.98^b	15.45	74.34±10.64^b	11.92	58.00±14.78^c	7.78
	Middle school	15.83±8.47^b	(＜.001)	68.79±12.51^b	(＜.001)	60.88±17.05^c	(＜.001)
	High school	7.48±5.37^a	a＜b	80.50±12.00^a	a＞b	50.05±15.22^b	a＜b, a＜c
	College	6.22±7.09^a		84.76±13.25^a		46.25±14.43^a
Caregiving time (hrs/day)	＜3	7.08±7.18^a	10.57	82.57±12.34	5.90	46.53±14.26^a	11.24
	3~6	8.03±5.64^b	(＜.001)	79.03±12.58	(.001)	53.66±13.84^b	(＜.001)
	7~10	11.17±7.02^b	a＜b	74.17±10.18		52.00±9.75^b	a＜b
	≥11	14.56±8.76^b		72.93±14.79		67.05±16.95^b
H & Y stage	1	4.75±2.63	0.57	87.75±9.97	1.06	38.75±7.18	1.19
	1.5	6.50±2.12	(.679)	94.50±30.40	(.376)	57.50±30.40	(.315)
	2	8.66±6.89		79.71±13.27		51.50±16.79
	2.5	9.93±9.28		79.03±13.74		49.69±14.20
	3	8.93±7.84		78.72±12.76		54.02±16.58
SE-ADL	≤60	10.03±8.07	0.26	77.48±12.01	1.02	59.45±19.62	2.59
	70	8.50±8.44	(.897)	83.58±15.08	(.397)	49.85±10.36	(.038)
	80	9.23±7.62		78.59±12.54		50.28±14.44
	90	8.66±8.31		79.70±14.52		48.64±15.91
	100	7.00±5.74		84.40±13.37		50.00±24.60

H & Y stage=Hoehn & Yahr stage; SE-ADL=Schwab & England activities of daily living.

Table 5.

Factors Affecting Caregiver Burden by Multiple Regression Analysis (N=183

Variables	B	SE	β	t	p
Caregiver's age	0.67	0.76	.05	0.87	.385
Caregiver's education level	0.40	1.01	.03	0.39	.694
Patient's depression	0.32	0.10	.20	3.05	.003
Time for caregiving	1.35	0.85	.11	1.56	.019
Caregiver's depression	0.66	0.15	.34	4.36	＜.001
Caregiver's quality of life	-0.27	0.08	-.23	-3.21	.002

R²=.486, Adjusted R²=.459, F=18.16, p＜.001

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Factors Affecting Caregiver Burden in Caregivers of Patients with Parkinson's Disease

Korean J Adult Nurs. 2015;27(3):283-293. Published online June 30, 2015

DOI: https://doi.org/10.7475/kjan.2015.27.3.283

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Factors Affecting Caregiver Burden in Caregivers of Patients with Parkinson's Disease

Korean J Adult Nurs. 2015;27(3):283-293. Published online June 30, 2015

DOI: https://doi.org/10.7475/kjan.2015.27.3.283

Factors Affecting Caregiver Burden in Caregivers of Patients with Parkinson's Disease

Table 1.

The General Characteristics of the Participants

Characteristics	Categories	Patient (N=183)	Caregiver (N=183)
Characteristics	Categories	n (%) or M±SD	n (%) or M±SD
Gender	Female	120 (65.6)	86 (47.0)
Gender	Male	63 (34.4)	97 (53.0)
Age (year)	M±SD	66.1±12.97	50.2±24.99
	＜40	0 (0.0)	24 (13.1)
	40~49	2 (1.1)	26 (14.2)
	50~59	28 (15.3)	37 (20.2)
	60~69	69 (37.7)	45 (24.6)
	≥70	84 (45.9)	51 (27.9)
The level of education	No schooling	11 (6.0)	4 (2.2)
	Elementary school	53 (29.0)	25 (13.6)
	Middle school	54 (29.5)	24 (13.1)
	High school	40 (21.8)	62 (33.9)
	≥College	25 (13.7)	68 (37.2)
Average monthly income (10,000 won)	≤50	79 (43.2)	0 (0.0)
	51~100	26 (14.2)	39 (21.3)
	101~150	16 (8.7)	27 (14.8)
	151~200	13 (7.1)	26 (14.2)
	201~250	17 (9.3)	16 (8.7)
	≥251	32 (17.5)	75 (41.0)

Table 2.

The Disease-related Characteristics of the Patients (N=183)

Characteristics	Categories	n (%) or M±SD
Duration of having the illness (month)	＜12	15 (8..2)
	13~36	44 (24.0)
	37~72	53 (29.0)
	73~108	25 (13.7)
	109~144	28 (15.3)
	≥145	18 (9.8)
Age of onset (year)	40~49	18 (9.8)
	50~59	56 (30.6)
	60~69	58 (31.7)
	≥70	51 (27.9)
Caregiving time per day (hour)	＜3	107 (58.5)
	3~6	29 (15.9)
	7~10	6 (3.2)
	≥11	41 (22.4)
Living together with	Spouse	103 (56.3)
	Son or daughter	26 (14.2)
	No one	23 (12.5)
	Spouse and children	31 (17.0)
Hoehn & Yahr stage	M±SD	2.41±0.50
	1	4 (2.2)
	1.5	2 (1.1)
	2	70 (38.3)
	2.5	61 (33.3)
	3	46 (25.1)
SE-ADL (%)	M±SD	76.33±16.32
	≤60	31 (16.9)
	70	26 (14.2)
	80	71 (38.8)
	90	50 (27.3)
	100	5 (2.7)

SE-ADL=Schwab & England activities of daily living.

Table 3.

The Descriptive Statistics of the Study Variables (N=183)

Variables	M±SD	Range
Patient's depression	16.52±9.90	0~63
Caregiver's depression	9.04±7.91	0~63
Caregiver's quality of life	79.57±13.42	1~130
Caregiver burden	61.32±15.93	1~125

Table 4.

Differences in Depression, Quality of Life and Burden by Caregiver's Characteristics (N=183)

Variables	Categories	Caregiver's depression		Caregiver's quality of life		Caregiver burden
Variables	Categories	M±SD	t or F (p)	M±SD	t or F (p)	M±SD	t or F (p)
Caregiver gender	Female	50.07±10.09	1.57	77.86±13.76	-1.62	51.76±17.67	0.34
Caregiver gender	Male	47.53±11.77	(.011)	81.09±13.00	(.106)	50.93±14.30	(.730)
Age (year)	＜40	5.43±7.13^a	6.04	87.13±10.29^a	3.74	43.71±12.82^a	5.96
	40~49	6.42±6.73^b	(＜.001)	82.46±10.11^b	(.006)	44.96±13.31^a	(＜.001)
	50~59	6.68±6.08^b	a＜b	79.84±13.88^b	a＞b	48.08±13.76^b	a＜b
	60~69	12.11±7.97^b		75.18±12.12^b		58.24±16.44^b
	≥70	11.14±8.45^b		78.24±12.59^b		54.37±16.63^b
Education level	Elementary school	13.48±8.98^b	15.45	74.34±10.64^b	11.92	58.00±14.78^c	7.78
	Middle school	15.83±8.47^b	(＜.001)	68.79±12.51^b	(＜.001)	60.88±17.05^c	(＜.001)
	High school	7.48±5.37^a	a＜b	80.50±12.00^a	a＞b	50.05±15.22^b	a＜b, a＜c
	College	6.22±7.09^a		84.76±13.25^a		46.25±14.43^a
Caregiving time (hrs/day)	＜3	7.08±7.18^a	10.57	82.57±12.34	5.90	46.53±14.26^a	11.24
	3~6	8.03±5.64^b	(＜.001)	79.03±12.58	(.001)	53.66±13.84^b	(＜.001)
	7~10	11.17±7.02^b	a＜b	74.17±10.18		52.00±9.75^b	a＜b
	≥11	14.56±8.76^b		72.93±14.79		67.05±16.95^b
H & Y stage	1	4.75±2.63	0.57	87.75±9.97	1.06	38.75±7.18	1.19
	1.5	6.50±2.12	(.679)	94.50±30.40	(.376)	57.50±30.40	(.315)
	2	8.66±6.89		79.71±13.27		51.50±16.79
	2.5	9.93±9.28		79.03±13.74		49.69±14.20
	3	8.93±7.84		78.72±12.76		54.02±16.58
SE-ADL	≤60	10.03±8.07	0.26	77.48±12.01	1.02	59.45±19.62	2.59
	70	8.50±8.44	(.897)	83.58±15.08	(.397)	49.85±10.36	(.038)
	80	9.23±7.62		78.59±12.54		50.28±14.44
	90	8.66±8.31		79.70±14.52		48.64±15.91
	100	7.00±5.74		84.40±13.37		50.00±24.60

H & Y stage=Hoehn & Yahr stage; SE-ADL=Schwab & England activities of daily living.

Table 5.

Factors Affecting Caregiver Burden by Multiple Regression Analysis (N=183

Variables	B	SE	β	t	p
Caregiver's age	0.67	0.76	.05	0.87	.385
Caregiver's education level	0.40	1.01	.03	0.39	.694
Patient's depression	0.32	0.10	.20	3.05	.003
Time for caregiving	1.35	0.85	.11	1.56	.019
Caregiver's depression	0.66	0.15	.34	4.36	＜.001
Caregiver's quality of life	-0.27	0.08	-.23	-3.21	.002

R²=.486, Adjusted R²=.459, F=18.16, p＜.001

Table 1. The General Characteristics of the Participants

Table 2. The Disease-related Characteristics of the Patients (N=183)

SE-ADL=Schwab & England activities of daily living.

Table 3. The Descriptive Statistics of the Study Variables (N=183)

Table 4. Differences in Depression, Quality of Life and Burden by Caregiver's Characteristics (N=183)

H & Y stage=Hoehn & Yahr stage; SE-ADL=Schwab & England activities of daily living.

Table 5. Factors Affecting Caregiver Burden by Multiple Regression Analysis (N=183

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Table 5.

ABOUT

BROWSE ARTICLES

EDITORIAL POLICY

FOR CONTRIBUTORS