Introduction:
Continuous Ambulatory Peritoneal Dialysis (CAPD) is a widely utilised home-based renal replacement therapy, offering patients the flexibility to manage their treatment outside of clinical settings. However, while CAPD provides significant benefits, it can also place substantial mental and emotional burdens on caregivers. This study examines the levels of caregiver burden, as well as associated mental health challenges such as depression and anxiety, among caregivers of CAPD patients in a tertiary care centre in southern India
Methods:
This cross-sectional study involved 58 caregivers of patients undergoing Continuous Ambulatory Peritoneal Dialysis (CAPD) at a tertiary care center. All caregivers were of patients who had completed at least one year of CAPD treatment and were followed up in the hospital. The Zarit Burden Interview (ZBI) was administered to evaluate the level of caregiver burden, while the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7) were utilized to assess depression and anxiety levels among caregivers. The study also explored correlations between these mental health outcomes and various demographic and clinical variables, providing insights into the factors that contribute to caregiver burden, depression, and anxiety.
Results:
This study involved 58 caregivers with a mean age of 46.59 years (SD = 6.13), focusing on factors influencing psychological stress in caregivers of peritoneal dialysis (PD) patients. The mean Zarit Burden Interview (ZBI) score was 20.19 (SD = 12.06), the PHQ-9 score was 5.03 (SD = 3.58), and the GAD-7 score was 4.48 (SD = 3.14), indicating moderate levels of caregiver burden, depression, and anxiety. Caregivers who were employed showed strong positive correlations with all three outcomes (ZBI: r = 0.57, p < 0.001; PHQ-9: r = 0.51, p < 0.001; GAD-7: r = 0.46, p < 0.001), suggesting that having a job is associated with higher stress levels. Similarly, fear of PD peritonitis and a history of PD peritonitis were significantly correlated with increased caregiver burden (Fear of PD peritonitis: ZBI: r = 0.42, p < 0.001; History of PD peritonitis: ZBI: r = 0.46, p < 0.001), depression (Fear of PD peritonitis: PHQ-9: r = 0.51, p < 0.001; History of PD peritonitis: PHQ-9: r = 0.39, p < 0.001), and anxiety (Fear of PD peritonitis: GAD-7: r = 0.39, p < 0.001; History of PD peritonitis: GAD-7: r = 0.42, p < 0.001). Difficulties in obtaining PD fluid (ZBI: r = 0.55, p < 0.001) and disposing of the drain bag (ZBI: r = 0.66, p < 0.001) were also significantly correlated with increased psychological stress. Conversely, higher monthly income was moderately negatively correlated with both caregiver burden (ZBI: r = -0.30, p = 0.02) and depression (PHQ-9: r = -0.30, p = 0.02), suggesting that financial stability may reduce stress levels. Additionally, receiving government financial benefits was strongly negatively correlated with burden (ZBI: r = -0.81, p < 0.001), depression (PHQ-9: r = -0.85, p < 0.001), and anxiety (GAD-7: r = -0.84, p < 0.001), highlighting the protective role of financial support in mitigating psychological stress. Other factors, such as age, sex, education, and caregiving duration, showed weak correlations with psychological outcomes and were not statistically significant, suggesting minimal impact on caregiver stress levels. Overall, logistical challenges in managing PD and financial difficulties appear to be key contributors to caregiver stress, while financial support serves as a significant mitigating factor.
Conclusions:
This study highlights that mental health issues and caregiver burdens are significant concerns among CAPD patients. The strong correlations between caregiver burden and mental healthindices underscore the need for comprehensive mental health support and caregiver assistance programs. Proactive mental health screening and targeted interventions should be integral components of CAPD management to improve overall patient and caregiver well-being and to reduce the impact of these challenges on treatment outcomes
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.