Burden, stress and depression in caregivers of cirrhosis patients before and after liver transplantation.

BACKGROUND

Family caregivers of cirrhosis patients (CPs) often experience burden, stress, and depression. Investigating whether these conditions improve following the patient undergoing liver transplantation (LT) is crucial, as it would elucidate the comprehensive benefits of the procedure and demonstrate the positive impacts not only on the patients but also on their caregivers and society.

AIM

To compare the levels of burden, stress and depression among family caregivers of cirrhotic and liver transplant patients.

METHODS

This cross-sectional observational study evaluated caregivers of CPs and LT recipients at a quaternary Brazilian hospital. Instruments included identification cards, interview scripts, the caregiver burden scale Inventory, Lipp's Stress Symptom Inventory, and the Beck Depression Inventory-Second Edition. Psychometric analyses involved confirmatory factor analysis and calculation of McDonald's omega and composite reliability. Factor scores were compared with the Mann-Whitney test, with effect size as the rank-biserial correlation coefficient (). Statistical analysis was performed with R software ( < 0.05).

RESULTS

Seventy-seven CP caregivers and 65 LT recipient caregivers were included. Most were female (CP: 85.7% LT: 84.6%) and the patients' spouses (76.6% 63.1%). The median age and caregiving duration were 55.4 (23.3-76.3) 54.6 (25.7-82.1) and 3.9 (1-20) 8 (1.5-24) years, respectively ( = 0.001). LT caregivers were less likely to be at risk of overload (21.5% 49.4%), to be under stress (33.8% 36.4%) and to show symptoms of depression (15.4% 35.1%). Compared with LT caregivers, CP caregivers had greater median factor scores for burden (general tension, = 0.012; isolation, = 0.014; disappointment, = 0.004), depression ( = 0.008), and stress ( = 0.047), with small to moderate effect sizes. The disappointment ( = 0.240) and depression ( = 0.225) dimensions had the largest effect sizes.

CONCLUSION

Family caregivers of LT recipients are less likely to exhibit symptoms of burden, stress, and depression, suggesting that the benefits of LT extend to the patients' family members.