Correlation Between Chronic Heart Failure Patients' Depression And Caregivers' Burden, Quality Of Life And Depression

BackgroundChronic heart failure(CHF)is a debilitating chronic disease characterized by high incidence rate,many complications and poor prognosis.Owing to restricted social life and impaired QOL,patients are prone to depression.Caregivers have made great contributions to patients' disease treatment,life care and psychological support.However,owing to providing support for patients,caregivers bore heavy burden,and their physical,mental health and QOL were negatively affected.Managing patients'emotion and providing emotional support may bring more difficulties,challenges and negative effects to caregivers.However,so far,there are few studies focused on the impact of CHF patients' depression on caregivers' outcome.Objectives1.To analyze the influencing factors of CHF patients' depression and provide basis for clinical intervention.2.To identify the relationship between depression in CHF patients with caregivers'burden,QOL,and depression and provide a reference for improving the physical and mental health of caregivers,caregiving quality and patients' outcome.3.To analyze the real care experience of caregivers of CHF patients with depression.Combined with qualitative results,it is intended to provide more comprehensive research support for management of CHF patients and caregivers.MethodsThe first section,the study used a convenient sampling method.110 CHF patients with NYHA class ?-? and their caregivers were enrolled at the department of cardiology in a first class tertiary hospital in Guangzhou from October 2016 through January 2017.To collect data on patients and caregivers' demographic data and patients'disease information.Patients were investigated using a patient demographic questionnaire and the Beck Depression Inventory-II(BDI-II)scale.Caregivers were investigated using a caregiver characteristic questionnaire,the Zarit Burden Interview(ZBI),the Family Caregiver Quality of Life(FAMQOL)and the BDI-II scales.The second section,qualitative research method was used.12 CHF patients with depression and their caregivers were enrolled at the department of cardiology from a first class tertiary hospital in Guangzhou from June 2017 through August 2017.The semi-structured interviews were conducted using Colaizzi 7 step analysis method for data analysis to determine the theme and know about caregivers' real care experience of caregiving for CHF patient with depression.Results1.The incidence of depression in CHF patients was 43.6%.The risk factor were duration?5 years(OR=16.706)as well as 1?2 and?3 complications(OR1=3.474,OR2=20.761).And monthly family income in 2000-5000 yuan and 5001-10000 yuan (OR1=0.139,OR2=0.109,P<0.05)were the protective factor of depression in CHF patients.2.Caregivers of CHF patients with depression had a higher level of burden(41.00±10.72vs.28.11±10.74 on the ZBI;P<0.001),reported worse overall QOL(45.05±7.76 vs.55.14 ± 10.36 on the FAMQOL;P<0.001),and had a higher level of depression(14.00 ± 3.82 vs.6.86±4.34 on the BD?-?;P<0.001)than those of CHF patients without depression.3.Patients' depression was associated with burden(r=0.611,P<0.001),QOL(r=-0.525,P<0.001)and depression(r=0.741,P<0.001)in caregivers.4.Totally 6 subjects about care experience were extracted,which were maladjustment to caregiving life,lack of caregiving knowledge of depression,strong willingness to understand depression,coexistence of positive and negative coping styles,desire for recognization for caregiving work,and lack of social support.ConclusionsDepression is common in CHF patients,and the influencing factors of depression in CHF patients are duration,complications,monthly family income.Depression of patients increased burden and lowered QOL of caregivers,caregivers of depressed patients were more likely to develop negative emotion especially depression.In addition,physical health,daily and social life of caregivers would be negatively affected.Clinical staff should pay attention to the impact of depression of CHF patients on caregivers and consider to take interventions to improve patients'depression and then alleviate the adverse impact on caregivers and promote the health of patients and caregivers.