Need for greater COPD carer support
medwireNews: Research shows that family carers of patients with advanced chronic obstructive pulmonary disease (COPD) cope differently to those of patients in the earlier stages of disease.
In particular, the relatively poor subjective mental health among this group of carers indicated that their coping strategies and the support they receive may be inadequate.
“Early interventions in COPD care-giving, including practical information about the disease and education on problem-solving and other alternative coping strategies…seem to be crucial for preventing burden and promoting opportunities for carers to continue in their care-giving role without becoming ill themselves,” comment Daniela Figueiredo (University of Aveiro, Portugal) and colleagues.
Their study involved 109 family carers of patients with early COPD and 49 carers of people with advanced disease. The majority had been caregiving for more than 4 years, and most were women looking after a male spouse.
Using the Carers’ Assessment of Managing Index, the authors found that, in comparison to carers of patients with early disease, carers of patients with advanced COPD relied more heavily on all three types of coping strategies assessed: problem-solving strategies, emotional–cognitive strategies, and strategies dealing with the consequences of stress.
And, while carers in the advanced COPD group tended to rate the various coping strategies as more helpful than did carers in the early COPD group, both groups considered problem-solving mechanisms to be the most useful type of coping strategy overall.
Carers of patients with early COPD were less likely to use emotional coping, with more than 50% of participants not applying 10 of the 15 emotional coping strategies assessed.
Dealing with the consequences of stress was the least-used type of coping strategy among both groups of carers; however, carers of those with advanced disease were more likely to report that taking their mind off things or maintaining interests outside of caring was helpful.
Notably, the authors report that perceived self-rated mental health was significantly worse in carers of those with advanced COPD compared with early COPD carers, something which was associated with increasing use of emotional–cognitive and dealing with the consequences of stress mechanisms.
Writing in the Journal of Clinical Nursing, Figueiredo et al describe their results as “not surprising,” given the progressive nature of COPD. However, they say that their results should be useful for planning targeted interventions for each stage of the disease process.
“The fact that carers of people with advance COPD presented poorer subjective mental health suggests the limitations of individual coping strategies and the need for adequate formal support,” they conclude.
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By Kirsty Oswald, medwireNews Reporter