Stress Management in Primary Caregivers: A Health Challenge
Technology based advances in healthcare are leading to social changes that, in turn, will require innovative responses from health systems. Mainly due to these advances, life expectancy grows so, the aging of world population increases and with it the percentage of chronic patients. Because ofthese two factors: aging people and chronic patients, new needs are posed to the current health system. Together with these patients,a population of non-professional caregivers emerges playing a key role in the care process. However, the impact of the care burden on their health is usually underminedalthough an increasing number of studies report caregiver associated diseases. One of the challenges that arise from health systems: To acknowledgeand to take care this population of caregivers,to avoid the so-called burned caregiver syndrome as well as to reduce the risks of comorbidities associated with the caregiver's stress by setting up appropriate interventions.
Having in mind all these considerations, from the Clinic Hospital in Barcelona we are starting to work ona biofeedback program involvingdifferent populations of caregivers: 30 caregivers of oncological patients and 30 caregivers of geriatric patients and the corresponding control group. The project that is presented in this paper is aiming to determine if these therapies can become effective interventions to reduce the stress that represents the caregiver syndrome. The follow-up of the project willfocus on the possibility to indirectly demonstrate if the decrease of stress actually results in a decrease of the derived diseases and of the total cost that it entails.
(1) Mateo, I, Millán, A, García, M, Gutiérrez, P, Gonzalo, E. y López, L. A." Cuidadores familiares de personas con enfermedad neurodegenerativa: perfil, aportaciones e impacto familiar", Atención Primaria. 2000; 26; 25-34.
(2) Rodríguez, P., Sancho, T., Alvaro, M. y Justel, M.” Las personas mayores en España. Perfiles. Reciprocidad familiar. Madrid: Instituto Nacional de Servicios Sociales
(3) Pinquart M, Sörensen S. "Associations of stressors and uplifts of caregiving with caregiver burden and depressive mood: a meta-analysis". J Gerontol B Psychol Sci Soc Sci. 2003;58:P112-28.
(4) Oliva-Moreno J, Trapero-Bertran M, Peña-Longobardo LM, Del Pozo-Rubio R. "The Valuation of Informal Care in Cost-of-Illness Studies: A Systematic Review". Pharmacoeconomics. 2017; 35: 331-345..
(5) Pickard L, King D. Informal care supply and demand in Europe. In: Geerts. J, Willeme P, Mot E, editors. Long-term care use and supply in Europe: projections for Germany, the Netherlands, Spain and Poland.Brussels: European Network of Economic Policy Research Institutes (ENEPRI). 2012.Research Report 116:114–23.
(6) Lyons JG, Cauley JA, Fredman L. The Effect of transitions in caregiving status and intensivity on perceived stress among 992 female caregivers and noncaregivers. J Gerontol A Biol Sci Med Sci. 2015 Aug;70(8):1018-23.
(7) Susan K.Roepke, Matthew Allison, Roland Von Ka Nel, Brent T. Mausbach, et al. "Relationship between chronic stress and carotid intima-media thickness (IMT) in elderly Alzheimer’s disease caregivers". Stress, March 2012; 15(2): 121–129.
(8) Association of psychosocial risk factors with risk of acute myocardial infarction in 11119 cases and 13648 controls from 52 countries. (the INTERHEART study): case-control study. The Lancet; Sep 11-Sep 17, 2004; 364, 9438; Health & Medical Collection.
(9) Haug, M. R., Ford, A. B., Stange, K. C., Noelker, L. S., & Gaines, A. D. (1999). Effect of giving care on caregivers' health. Research on Aging, 21(4), 515-538.
(10) Janice K. Kiecolt-Glaser, Lymama Mc Guire, Theodore F Robles, Ronald Glaser. Psychoneuroimmunology: Psychological Influences on Immune Function and Health. Journal of Consulting and Clinical Psychology 2002; vol 70; 537-547.
(11) Ashi, S., Girona, G. y Ortuño, M. A. (1995). Sindrome del cuidador. Rehabilitación, 29, 465-468.
(12) M.J. Gómez-Ramos, F.M. Gonzáñez-Valverde. Caregivers of dementia patients: application of the Caregiver Burden Scale. Rev Esp Geriatr Gerontol 2004;39:154-9.
(13) Schulz R, Beach SR. Caregiving as a risk factor for mortality: the Caregiver Health Effects Study. JAMA. 1999;282:2215-9.
(14) Zarit SH, Reever KE, Bach-Peterson J. Relatives of the impaired elderly: correlates of feelings of burden. Gerontologist. 1980;20:649-55.
(16) Cheryl L. Kern-Buell, Angele Mc Grady, Philip B. Conran, Lois A. Nelson. Asthma severity, Psichophysiological indicators of arousal, and inmmune function in asthma patients undergoing biofeedback-assisted relaxation. Applied Psychophysiology and biofeedback. June 2000, vol 25. Issue 2, 79-91.
(17) Juan Manuel Vázquez Goñi et al, "Reducing the stress of food processing workers through respiratory biofeedback". Revista Cubana de salud y trabajo 2011; 12 (1): 39-44.
(18) Hernando A, Lazaro J, Gil E, Arza A, Garzón-Rey JM et al. Inclusion of respiratory frequency information in Heart Rate Variability for a better analysis of Stress.IEEE JBHI2016; 20 (4): 1016-1025
(19) Aguilo J, Ferrer-Salvans P, Garcia-Rozo A, et al. Project ES3: attempting to quantify and measure the level of stress. Rev Neurol. 2015;61(9):405-415.
(20) Dunn SA Bonner PN, Lewis SL, Meize-Grochowski R. Quality of life for spouses of CAPD patients. ANNA Journal. 1994;21:237–247.