Caregivers of long-term ventilator patients: physical and psychological outcomes.

STUDY OBJECTIVES

The physical and psychological effects of caregiving have been examined in several populations. To date, no one has examined the effects of caregiving on caregivers of patients receiving long-term mechanical ventilation (LTV) [patients who required > 4 days of continuous in-hospital mechanical ventilation] who reside in a home or institutional setting after hospital discharge. The purpose of this study was to describe the characteristics and examine depression, burden, overload, and physical health in this caregiver population over a 6-month period after hospital discharge.

DESIGN

This was a prospective longitudinal descriptive study of posthospital outcomes for patients receiving LTV and their caregivers.

SETTING AND PARTICIPANTS

Caregivers of 135 patients receiving LTV admitted to the ICUs of a university medical center, a Veterans Administration hospital, and small community hospital were enrolled.

MEASUREMENTS AND RESULTS

Interviews of caregivers were conducted at hospital discharge and 6 months later. Descriptive statistics, analysis of variance, and multiple regression analyses were used to analyze the data. Established tools were used to assess caregiver depression, burden, overload, and physical health. Caregivers reported a drop in physical health scores from hospital discharge to 6 months after discharge (p = 0.0001). Caregivers of patients residing in an institution reported higher depression (p = 0.039) and overload scores (p = 0.002) than did caregivers of patients residing at home 6 months after discharge; 51.2% of caregivers at discharge and 36.4% at 6 months after discharge reported symptoms consistent with some degree of depression. In addition, 12.2% of caregivers at hospital discharge and 15.6% at 6 months after discharge were classified as having symptoms consistent with severe depression. Caregiver physical health (p = 0.025) and overload (p = 0.006) made statistically significant contributions to explaining caregiver depression.

CONCLUSIONS

Caregivers of patients receiving LTV in our sample have similar characteristics to other caregiving populations. However, our sample had higher depression scores than those reported for many other caregiver groups.