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Published in: BMC Palliative Care 1/2016

Open Access 01-12-2016 | Research article

Caregiving in ALS – a mixed methods approach to the study of Burden

Authors: Miriam Galvin, Bernie Corr, Caoifa Madden, Iain Mays, Regina McQuillan, Virpi Timonen, Anthony Staines, Orla Hardiman

Published in: BMC Palliative Care | Issue 1/2016

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Abstract

Background

Caregiver burden affects the physical, psychological and emotional well-being of the caregiver. The purpose of this analysis was to describe an informal caregiver cohort (n = 81), their subjective assessment of burden and difficulties experienced as a result of providing care to people with Amyotrophic Lateral Sclerosis (ALS).

Methods

Using mixed methods of data collection and analysis, we undertook a comprehensive assessment of burden and difficulties associated with informal caregiving in ALS. As part of a semi-structured interview a series of standardised measures were used to assess quality of life, psychological distress and subjective burden, and in an open-ended question caregivers were asked to identify difficult aspects of their caregiving experience.

Results

The quantitative data show that psychological distress, hours of care provided and lower quality of life, were significant predictors of caregiver burden. From the qualitative data, the caregiving difficulties were thematised around managing the practicalities of the ALS condition, the emotional and psychosocial impact; limitation and restriction, and impact on relationships.

Conclusions

The collection and analysis of quantitative and qualitative data better explores the complexity of caregiver burden in ALS. Understanding the components of burden and the difficulties experienced as a result of caring for someone with ALS allows for better supporting the caregiver, and assessing the impact of burden on the care recipient.
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Literature
1.
go back to reference Rooney J, Byrne S, Heverin M, Corr B, Elamin M, Staines A, et al. Survival analysis of Irish amyotrophic lateral sclerosis patients diagnosed from 1995–2010. Plos One. 2013;8(9). doi: 10.1371/journal.pone.0074733 Rooney J, Byrne S, Heverin M, Corr B, Elamin M, Staines A, et al. Survival analysis of Irish amyotrophic lateral sclerosis patients diagnosed from 1995–2010. Plos One. 2013;8(9). doi: 10.​1371/​journal.​pone.​0074733
3.
go back to reference Aoun SM, Connors SL, Priddis L, Breen LJ, Colyer S. Motor Neurone Disease family carers’ experiences of caring, palliative care and bereavement: an exploratory qualitative study. Palliat Med. 2012;26(6):842–50. doi:10.1177/0269216311416036.CrossRefPubMed Aoun SM, Connors SL, Priddis L, Breen LJ, Colyer S. Motor Neurone Disease family carers’ experiences of caring, palliative care and bereavement: an exploratory qualitative study. Palliat Med. 2012;26(6):842–50. doi:10.​1177/​0269216311416036​.CrossRefPubMed
5.
go back to reference O’Brien MR, Whitehead B, Jack BA, Mitchell JD. From symptom onset to a diagnosis of amyotrophic lateral sclerosis/motor neuron disease (ALS/MND): experiences of people with ALS/MND and family carers - a qualitative study. Amyotroph Lateral Scler. 2011;12(2):97–104. doi:10.3109/17482968.2010.546414.CrossRefPubMed O’Brien MR, Whitehead B, Jack BA, Mitchell JD. From symptom onset to a diagnosis of amyotrophic lateral sclerosis/motor neuron disease (ALS/MND): experiences of people with ALS/MND and family carers - a qualitative study. Amyotroph Lateral Scler. 2011;12(2):97–104. doi:10.​3109/​17482968.​2010.​546414.CrossRefPubMed
8.
go back to reference Kaub-Wittemer D, von Steinbuchel N, Wasner M, Laier-Groeneveld G, Borasio GD. Quality of life and psychosocial issues in ventilated patients with amyotrophic lateral sclerosis and their caregivers. J Pain Symptom Manag. 2003;26(4):890–6. doi:10.1016/s0885-3924(03)00323-3.CrossRef Kaub-Wittemer D, von Steinbuchel N, Wasner M, Laier-Groeneveld G, Borasio GD. Quality of life and psychosocial issues in ventilated patients with amyotrophic lateral sclerosis and their caregivers. J Pain Symptom Manag. 2003;26(4):890–6. doi:10.​1016/​s0885-3924(03)00323-3.CrossRef
9.
go back to reference Trail M, Nelson ND, Van JN, Appel SH, Lai EC. A study comparing patients with amyotrophic lateral sclerosis and their caregivers on measures of quality of life, depression, and their attitudes toward treatment options. J Neurol Sci. 2003;209(1–2):79–85. doi:10.1016/s0022-510x(03)00003-0.CrossRefPubMed Trail M, Nelson ND, Van JN, Appel SH, Lai EC. A study comparing patients with amyotrophic lateral sclerosis and their caregivers on measures of quality of life, depression, and their attitudes toward treatment options. J Neurol Sci. 2003;209(1–2):79–85. doi:10.​1016/​s0022-510x(03)00003-0.CrossRefPubMed
10.
16.
go back to reference Morgan DL. Integrating qualitative and quantitative methods: a pragmatic approach. 1st ed. Sage Publications Inc; 2014 Morgan DL. Integrating qualitative and quantitative methods: a pragmatic approach. 1st ed. Sage Publications Inc; 2014
17.
go back to reference Zarit SH, Reever KE, Bachpeterson J. Relatives of the impaired elderly–correlates of feelings of burden. Gerontologist. 1980;20(6):649–55.CrossRefPubMed Zarit SH, Reever KE, Bachpeterson J. Relatives of the impaired elderly–correlates of feelings of burden. Gerontologist. 1980;20(6):649–55.CrossRefPubMed
19.
go back to reference Cohen SR, Mount BM, Strobel MG, Bui F. The McGill Quality-of-Life Questionnaire–a measure of quality-of-life appropriate for people with advanced disease–a preliminary-study of validity and acceptability. Palliat Med. 1995;9(3):207–19. doi:10.1177/026921639500900306.CrossRefPubMed Cohen SR, Mount BM, Strobel MG, Bui F. The McGill Quality-of-Life Questionnaire–a measure of quality-of-life appropriate for people with advanced disease–a preliminary-study of validity and acceptability. Palliat Med. 1995;9(3):207–19. doi:10.​1177/​0269216395009003​06.CrossRefPubMed
20.
go back to reference IBM Corp. IBM SPSS statistics for Windows, Version 22.0. Armonk: IBM Corp; Released 2013 IBM Corp. IBM SPSS statistics for Windows, Version 22.0. Armonk: IBM Corp; Released 2013
21.
go back to reference QSR International, NVivo qualitative data analysis software; QSR International Pty Ltd. Version 10, 2012 QSR International, NVivo qualitative data analysis software; QSR International Pty Ltd. Version 10, 2012
22.
go back to reference Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101.CrossRef Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101.CrossRef
24.
go back to reference Pallant JF, Tennant A. An introduction to the Rasch measurement model: an example using the Hospital Anxiety and Depression Scale (HADS). Br J Clin Psychol. 2007;46:1–18.CrossRefPubMed Pallant JF, Tennant A. An introduction to the Rasch measurement model: an example using the Hospital Anxiety and Depression Scale (HADS). Br J Clin Psychol. 2007;46:1–18.CrossRefPubMed
25.
go back to reference Springate BA, Tremont G. Dimensions of caregiver burden in dementia: impact of demographic, mood, and care recipient variables. Am J Geriatr Psychiatr. 2014;22(3):294–300.CrossRef Springate BA, Tremont G. Dimensions of caregiver burden in dementia: impact of demographic, mood, and care recipient variables. Am J Geriatr Psychiatr. 2014;22(3):294–300.CrossRef
26.
go back to reference Schreiner AS, Morimoto T, Arai Y, Zarit S. Assessing family caregiver’s mental health using a statistically derived cut-off score for the Zarit Burden Interview. Aging Ment Health. 2006;10(2):107–11.CrossRefPubMed Schreiner AS, Morimoto T, Arai Y, Zarit S. Assessing family caregiver’s mental health using a statistically derived cut-off score for the Zarit Burden Interview. Aging Ment Health. 2006;10(2):107–11.CrossRefPubMed
28.
go back to reference Lillo P, Mioshi E, Hodges JR. Caregiver burden in amyotrophic lateral sclerosis is more dependent on patients’ behavioral changes than physical disability: a comparative study. BMC Neurology. 2012;12. doi: 10.1186/1471-2377-12-156 Lillo P, Mioshi E, Hodges JR. Caregiver burden in amyotrophic lateral sclerosis is more dependent on patients’ behavioral changes than physical disability: a comparative study. BMC Neurology. 2012;12. doi: 10.​1186/​1471-2377-12-156
29.
go back to reference Savundranayagam MY. Receiving while giving: the differential roles of receiving help and satisfaction with help on caregiver rewards among spouses and adult-children. Int J Geriatr Psychiatry. 2014;29(1):41–8. doi:10.1002/gps.3967.CrossRefPubMed Savundranayagam MY. Receiving while giving: the differential roles of receiving help and satisfaction with help on caregiver rewards among spouses and adult-children. Int J Geriatr Psychiatry. 2014;29(1):41–8. doi:10.​1002/​gps.​3967.CrossRefPubMed
31.
go back to reference Siegert RJ, Jackson DM, Tennant A, Turner-Stokes L. Factor analysis and Rasch analysis of the Zarit Burden Interview for acquired brain injury carer research. J Rehabil Med. 2010;42(4):302–9.CrossRefPubMed Siegert RJ, Jackson DM, Tennant A, Turner-Stokes L. Factor analysis and Rasch analysis of the Zarit Burden Interview for acquired brain injury carer research. J Rehabil Med. 2010;42(4):302–9.CrossRefPubMed
32.
go back to reference Ankri J, Andrieu S, Beaufils B, Grand A, Henrard JC. Beyond the global score of the Zarit Burden Interview: useful dimensions for clinicians. Int J Geriatr Psychiatry. 2005;20(3):254–60.CrossRefPubMed Ankri J, Andrieu S, Beaufils B, Grand A, Henrard JC. Beyond the global score of the Zarit Burden Interview: useful dimensions for clinicians. Int J Geriatr Psychiatry. 2005;20(3):254–60.CrossRefPubMed
33.
go back to reference Aoun SM, Bentley B, Funk L, Toye C, Grande G, Stajduhar KJ. A 10-year literature review of family caregiving for motor neurone disease: moving from caregiver burden studies to palliative care interventions. Palliat Med. 2013;27(5):437–46. doi:10.1177/0269216312455729.CrossRefPubMed Aoun SM, Bentley B, Funk L, Toye C, Grande G, Stajduhar KJ. A 10-year literature review of family caregiving for motor neurone disease: moving from caregiver burden studies to palliative care interventions. Palliat Med. 2013;27(5):437–46. doi:10.​1177/​0269216312455729​.CrossRefPubMed
34.
go back to reference Montgomery RJV, Kosloski K. Caregiving as a process of changing identity: implications for caregiver support. Generations-Journal of the American Society on Aging. 2009;33(1):47–52. Montgomery RJV, Kosloski K. Caregiving as a process of changing identity: implications for caregiver support. Generations-Journal of the American Society on Aging. 2009;33(1):47–52.
35.
go back to reference Foley G, Timonen V, Hardiman O. Exerting control and adapting to loss in amyotrophic lateral sclerosis. Soc Sci Med. 2014;101:113–9.CrossRefPubMed Foley G, Timonen V, Hardiman O. Exerting control and adapting to loss in amyotrophic lateral sclerosis. Soc Sci Med. 2014;101:113–9.CrossRefPubMed
36.
go back to reference Oyebode JR, Smith H-J, Morrison K. The personal experience of partners of individuals with motor neuron disease. Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration. 2013;14(1):39–43.CrossRefPubMed Oyebode JR, Smith H-J, Morrison K. The personal experience of partners of individuals with motor neuron disease. Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration. 2013;14(1):39–43.CrossRefPubMed
Metadata
Title
Caregiving in ALS – a mixed methods approach to the study of Burden
Authors
Miriam Galvin
Bernie Corr
Caoifa Madden
Iain Mays
Regina McQuillan
Virpi Timonen
Anthony Staines
Orla Hardiman
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Palliative Care / Issue 1/2016
Electronic ISSN: 1472-684X
DOI
https://doi.org/10.1186/s12904-016-0153-0

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