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Investigation of Anxiety, Depression, Sleep, and Family Function in Caregivers of Children With Epilepsy

ABSTRACT: Objective: Epilepsy is a chronic disease that places a heavy burden on caregivers. Previous studies have shown that caregivers of epilepsy patients often experience anxiety and depression; however, few comprehensive studies have assessed their sleep quality and family function. Based on the current understanding of the anxiety and depression state of caregivers in children with epilepsy, we further explored the caregivers' sleep and family function and evaluated the predictors of the depression state of caregivers. Methods: In this cross-sectional online anonymous survey, we sent an online questionnaire to the caregivers of children with epilepsy who visited our hospital. The QR code of the questionnaire was scanned at the follow-up course to conduct an online survey. The questionnaire contained questions about sociodemographic and clinical information, the Self-rating Anxiety Scale, Self-rating Depression Scale, Pittsburgh Sleep Quality Index, and the Family Assessment Device. Results: A total of 308 caregivers of children with epilepsy aged 0–12 years were included in this study. The mean age of children with epilepsy was 4.8 ± 3.18 years, and the average illness duration was 34.2 ± 29.18 months. Further, 47.1% of the children took three or more anti-seizure medications, and 43.2% were on ketogenic diet therapy. We found that in 77.9% of the cases, the subjects were the mothers, in 89% there was more than one co-caregiver, and in 51.9%, financial help was required. Further, 63.6% of the caregivers thought they could not get enough access to disease knowledge education, and 83.7% perceived epilepsy was a terrible disease. Our results also showed that 65.6% of the caregivers were in depression status, 41.9% were in anxiety status, and 49.0% had poor sleep quality. The proportion of unhealthy family functioning in each subscale was 45.1–96.1%, and the unhealthy behavior control function accounted for 96.1%. Binary logistic regression analysis of the data showed that without co-caregivers [odds ratio (OR), 5.193], free of anxiety status (OR, 0.063), good sleep quality (OR, 0.446), healthy family role dimension (OR, 0.344), and healthy family general functional dimension (OR, 0.259) were predictors of depression status in caregivers of children with epilepsy. Conclusion: Anxiety and depression status are common in caregivers of children with epilepsy, with depression status being more prominent. Moreover, a considerable proportion of caregivers had poor sleep quality and unhealthy family function. The caregivers' anxiety status, sleep quality, family role dimension, family general function dimension, and the number of co-caregivers were predictors of depression status in caregivers. In clinical practice, caregivers' anxiety and depression status, poor sleep quality, and unhealthy family functioning should be addressed along with the treatment of children with epilepsy.

SUBMITTER: Zhang M

PROVIDER: S-EPMC8575681 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:Family caregivers of dementia patients are at increased risk of developing depression or anxiety. A multi-component program designed to mobilize support of family networks demonstrated effectiveness in decreasing depressive symptoms in caregivers. However, the impact of an intervention consisting solely of family meetings on depression and anxiety has not yet been evaluated. This study examines the preventive effects of family meetings for primary caregivers of community-dwelling dementia patients.A randomized multicenter trial was conducted among 192 primary caregivers of community dwelling dementia patients. Caregivers did not meet the diagnostic criteria for depressive or anxiety disorder at baseline. Participants were randomized to the family meetings intervention (n?=?96) or usual care (n?=?96) condition. The intervention consisted of two individual sessions and four family meetings which occurred once every 2 to 3 months for a year. Outcome measures after 12 months were the incidence of a clinical depressive or anxiety disorder and change in depressive and anxiety symptoms (primary outcomes), caregiver burden and quality of life (secondary outcomes). Intention-to-treat as well as per protocol analyses were performed.A substantial number of caregivers (72/192) developed a depressive or anxiety disorder within 12 months. The intervention was not superior to usual care either in reducing the risk of disorder onset (adjusted IRR 0.98; 95% CI 0.69 to 1.38) or in reducing depressive (randomization-by-time interaction coefficient?=?-1.40; 95% CI -3.91 to 1.10) or anxiety symptoms (randomization-by-time interaction coefficient?=?-0.55; 95% CI -1.59 to 0.49). The intervention did not reduce caregiver burden or their health related quality of life.This study did not demonstrate preventive effects of family meetings on the mental health of family caregivers. Further research should determine whether this intervention might be more beneficial if provided in a more concentrated dose, when applied for therapeutic purposes or targeted towards subgroups of caregivers.Controlled-Trials.com ISRCTN90163486.

Project description:BackgroundThe prevalence rates of depression and anxiety are unforeseen among primary caregivers of patients with epilepsy. Little attention is being given to the problem in Ethiopia.ObjectivesThis study aimed to assess the prevalence and associated factors of depression and anxiety among caregivers of children and adolescents with epilepsy in three selected hospitals in Amhara region, Ethiopia.MethodsInstitution-based cross-sectional study was conducted in Ethiopia from January 1-30/2021. Systematic sampling technique was used. The Public Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder (GAD-7) questionnaires were used to measure depression and anxiety respectively. Binary logistic regression model was employed independently for both depression and anxiety. Variables with P-values <0.2 were taken to multivariate analyses. Variables with P-value <0.05 in the multivariate analyses were considered to have a statistical association with depression and anxiety.ResultA total of 383 participants involved yielding a response rate of 90.5%. The prevalence of depression and anxiety were found to be 13.7% and 10.4% respectively. Being female (Adjusted Odds Ratio (AOR) = 1.21: 95% Confidence Interval (CI): 1.00, 3.82), being unmarried (AOR = 1.31; 95%CI: 0.32, 5.023), having history of chronic medical illness (AOR = 1.46; 95%CI: 1.07, 1.98), current seizure attack (AOR = 4.19; 95%CI: 1.36, 12.97), duration of care 6-11years (AOR = 1.80; 95%CI: 1.11, 7.58), duration of care > 11years (AOR = 6.90; 95%CI: 1.56, 30.49), moderate social support (AOR = 0.37; 95%CI: 0.13, 0.81), strong social support (AOR = 0.61; 95%CI: 0.22, 1.67) and currently use substance (AOR = 2.01;95%CI: 1.63, 6.46) were factors associated with depression. On the other hand, being unmarried (AOR = 1.47; 95%CI: 1.12, 1.93), current seizure attack (AOR = 1.81 with 95% CI = 1.28-2.54), able to read and write (AOR = 0.33; 95%CI: 0.14, 0.77), completed primary and secondary education (AOR = 0.54; 95%CI: 0.39, 0.76), current substance use (AOR = 1.466; 95%CI: 1.12, 1.93), being parent (AOR = 2.55; 95%CI: 1.31, 4.96), rural (AOR = 3.75; 95%CI: 1.40, 10.04) and grand mal type (AOR = 2.21; 95%CI: 1.68, 2.91) were factors associated with anxiety.ConclusionsIn our study, approximately one in fifteen and more than one in ten caregivers had depression and anxiety respectively. The result of this study suggested that healthcare providers need to pay more attention to the psychological well-being of all caregivers of children and adolescents with epilepsy.

Project description:Many of the same sleep problems seen in typically developing (TD) children are frequently experienced by children with epilepsy (CWE). Behavioural sleep interventions (BSIs) are commonly and successfully used to treat these sleep problems in TD children and in some neurodevelopmental disorder populations. Therefore, BSIs should be effective in CWE, however, there are special seizure-related considerations for CWE and their parents which may be salient to consider in any future BSI development for this group. The current study sought to identify, from parents, if there were special considerations for the content and delivery of an online BSI for parents of CWE. Semi-structured interviews were conducted with nine mothers of CWE and thematic analysis was conducted on the interview data. Ten themes were apparent which represented what parents wanted from any online BSI for CWE. Parents wanted (i) other parents' views and real-life experiences to be included, (ii) recognition of how changes over time may influence the appropriateness of using various sleep-management options, (iii) to be presented with a range of sleep management options from which they could select, (iv) personalised information and suggestions for behaviour-change options, (v) help to address child anxiety around sleep, (vi) for the advice and behaviour-change options to be practical, (vii) general educational information about sleep and the relationship between sleep and epilepsy, (viii) for parental worries and concerns to be acknowledged, (ix) to receive help, support, and reassurance around children's sleep; and (x) to include the child in the intervention. It was clear that any online BSI would require specific adaptations and additions (to content and delivery format) to best meet the needs of parents of CWE. It is hoped that having identified what parents want from on online BSI for CWE will allow these factors to be acknowledged in future intervention development, with the intention to optimise parental engagement and intervention effectiveness. Practical suggestions for how these aspects could be integrated into any online BSI are suggested.

Project description:PURPOSE:Given the complexities and risks of allogeneic HCT, patients and their family caregivers may experience elevated psychological distress, including symptoms of anxiety and depression, in anticipation of the procedure. Patients and caregivers also bring with them their pre-HCT experiences of diagnosis, prior treatment, and associated burdens, thus potentially compounding their acute distress. Identification of clinical, psychosocial, and sociodemographic factors related to pre-HCT distress would allow targeting of patients and caregivers who may require assistance during the HCT process. METHODS:Consecutive patients (n?=?111) and their caregivers (n?=?110) completed measures of anxiety, depression, cancer distress, perceived threat, perceived control, self-efficacy, relationship quality, and physical quality of life in the week before HCT. Multivariate linear regression analysis was used to identify factors associated with patient and caregiver anxiety or depression, including disease type, donor type, and patient and caregiver sociodemographic, health-related, and psychosocial factors. RESULTS:Family caregivers had higher levels of anxiety and depression symptoms than patients. Thirty percent of caregivers vs. 17% of patients met criteria for clinically significant anxiety and a lesser amount (5% for both) met criteria for clinically significant depression. Patient anxiety was related to younger age (b?=?-?0.22, p?=?0.005) and greater cancer-related distress (b?=?0.59, p?<?0.001), while caregiver anxiety was related to lower self-efficacy (b?=?-?0.19, p?=?0.011) and greater cancer-related distress (b?=?0.58, p?<?0.001). Similarly, patient depression was related to lower perceived control (b?=?-?0.17, p?=?0.050), greater cancer-related distress (b?=?0.34, p?=?0.005), and lower physical functioning (b?=?-?0.26, p?=?0.008), while caregiver depression was related to greater cancer-related distress (b?=?0.46, p?<?0.001). CONCLUSIONS:Family caregivers may be more emotionally vulnerable than patients before HCT and in need of additional assistance. Cancer-related distress was the strongest correlate of anxiety and depression in both patients and caregivers, suggesting that distress related to their cancer experience and its consequences plays a major role in their emotional functioning prior to HCT.

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Investigation of Anxiety, Depression, Sleep, and Family Function in Caregivers of Children With Epilepsy

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