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Predictors of quality of life in caregivers to cardiothoracic transplant recipients
Myaskovsky L, McNulty M, Kormos R, Dew MA. Predictors of quality of life in caregivers to cardiothoracic transplant recipients. Paper presented at: European Society for Organ Transplantation Annual Meeting; 2010 Apr 19; Rotterdam, Netherlands.
Current trends in medical treatment and healthcare economics have resulted in shortened hospital stays, and extended life expectancies for chronically ill adults, thus placing increased responsibility for their care on the family. As hospitals rely more heavily on family caregivers (CGs) to assist with patient recovery, it is imperative to determine the effects that such burden may have on CGs. Previous research has focused on the burden of caregiving to adults whose health deteriorates over time. However, little attention has been paid to CGs of patients who undergo procedures to improve their health. We therefore examined such a population, CGs of transplant (TX) recipients, in order to determine the nature of change in CG quality of life (QOL) and psychosocial factors that may predict their QOL post-TX.
Adult (aged 18+) caregivers of 218 cardiothoracic TX recipients (lung, n = 120; heart, n = 98) participated in semi-structured interviews that included measures of demographics, social support, self image (optimism and mastery), coping, caregiver burden, and QOL (SF-36) at 2, 7 and 12 months post-TX. Mixed-model hierarchical analysis of variance (ANOVA) showed that QOL in CGs was high and remained so across the first year post-TX in emotional and social functioning. However, CG physical functioning [F(2,305) = 5.8, p < .01] and bodily pain [F(2,336) = 3.1, p < .05] worsened over the year. Linear regression analysis indicated that optimism was the most consistently important predictor of CG QOL across all domains. Greater caregiver burden predicted poorer QOL in physical and psychological domains. Higher family support predicted better QOL in social and psychological domains (adjusted R2 range = 0.12 to 0.28, all ps < .001). There were no differences by type of TX recipients received. TX teams should identify CGs who may be at risk for QOL declines in order to maximize positive outcomes for the entire family after transplant.