Levels and predictors of distress in home hemodialysis caregivers

Alison E. Blogg*, Denise V. O'Shaughnessy, David R. Cairns

*Corresponding author for this work

    Research output: Contribution to journalReview articlepeer-review

    4 Citations (Scopus)


    The principal objective of this study was to understand the level of distress in the home hemodialysis caregiver community. A literature review revealed that relatively little attention had been given to this group. Seventy-two caregivers of the Sydney Dialysis Center's home hemodialysis population were approached to complete a self-reported questionnaire, with 64 caregivers responding (89% response rate). This analysis includes 61 caregivers of a patient of the opposite sex. The questionnaire included a global measure of distress (General Health Questionnaire) and a specific measure of distress (Relatives' Stress Scale). The Relatives' Stress Scale included subscales for Personal Distress, Life Upsets, and Negative Feelings. Other variables included were demographic and medical. Descriptive statistics revealed that the specific distress scales were more sensitive measures of caregiver distress than the global distress score. Segmentation modeling (SPSS CHAID decision-tree analysis) was performed to identify caregiver subgroups which reported high distress. Separate segmentation analyses were performed for Personal Distress, Life Upsets, and Negative Feelings. The main predictors of high Personal Distress were younger age of the caregiver combined with low levels of involvement with the patient. The main predictors of high Life Upsets were a perception of the patient's health as 'fair,' combined with a younger caregiver. For caregivers who perceived their patient to be in 'fair' health, females were also high on Life Upsets. The main predictor of high Negative Feelings was level of involvement, with high Negative Feelings associated with both low and high involvement. Two caregiver subgroups - rural-based caregivers with high involvement; and caregivers, able to take a break from caring responsibilities, with low involvement - were particularly at risk of reporting high Negative Feelings. Interestingly, the age of the caregiver was not associated with Negative Feelings. Overall, complete segmentation decision-tree analysis assists in the identification of caregiver subgroups with specific forms of distress that may not be identified with global distress measures.

    Original languageEnglish
    Pages (from-to)507-517
    Number of pages11
    JournalDialysis and Transplantation
    Issue number9
    Publication statusPublished - Sept 1999


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