ABSTRACT
Background A high prevalence of anxiety symptoms has been identified among the caregivers of disabled older people. The aim of the study was to explore the relationships between objective burden (intensity of care and burdensome characteristics of the care recipient, like frailty status), caregiver characteristics, subjective burden, and anxiety in a sample of informal caregivers caring for hospitalized elderly patients. Methods In this cross-sectional study, patients' and their informal caregivers' characteristics were recorded for 311 patient-caregiver dyads. Subjective caregiver burden and caregivers' anxiety were assessed by using the Zarit Burden Interview and the Hospital Anxiety and Depression Scale (HADS), respectively. Correlation coefficients and path analysis were used to examine the relationship between variables. Caregivers' anxiety was considered as the outcome variable. Caregivers' subjective burden was entered as a mediator between caregiver characteristics-objective burden and anxiety. An objective burden was measured based on the care needs of the dependent elderly (frailty status, cognitive impairment, comorbidity, independence in activities of daily living, behavioral problems, hours spent on caregiving, and duration of caregiving). Results Abnormal anxiety symptoms (HADS score 11-21) were reported by 92 caregivers (29.6%). Borderline cases (HADS score 8-10) were 66 caregivers (21.2%). A mild, moderate, or severe subjective burden was recorded for 113 (36.3%), 100 (32.2%), and 26 (8.4%) caregivers, respectively. The female gender of the caregiver, the spousal relationship with the patient, and the subjective burden were directly related to higher levels of caregivers' anxiety. A subjective burden was found to be a significant mediator in the relationship between duration of caregiving, patients' frailty status, caregiver gender, patients' comorbidity, and caregivers' anxiety. Conclusion Among the risk factors for caregivers' anxiety, the frailty status of the patient is probably the only modifiable factor via interventions targeting frailty reversion or reduction.
ABSTRACT
Although hemoglobin levels beneath 6.5 g/dl are considered to be life-threatening and the patients theoretically suffer from a cluster of symptoms, few cases of patients who seek medical assistance when their hemoglobin levels had fallen beneath 3 g/dl have been reported in the literature. Here, we describe the case of a 97-year-old patient who was transferred to the emergency department with dyspnea and the initial screening tests showed a hemoglobin level of 1.7 g/dl, due to iron deficiency. The patient was hemodynamically stable, and no ischemic lesions were seen on the electrocardiogram. His dyspnea was due to a lower respiratory tract infection and bilateral pleural effusion. He was bedridden for two years. His absence of physical activity in combination with the slow onset of anemia and the absence of severe underlying pulmonary and cardiovascular diseases could hide the symptoms until additional stressful events, such as the respiratory tract infection and the deterioration of heart function, occurred. So, we must keep in mind that in elderly patients with reduced physical activity and without severe pulmonary and cardiovascular comorbidities, the symptoms of severe anemia may go unnoticed until hemoglobin reaches life-threatening levels.
ABSTRACT
AIM: The aim of this study was the evaluation of health-related quality of life (HRQoL) of HIV-infected patients and the effect of their illness in their living costs. MATERIAL AND METHOD: This is a cross-sectional study and the study sample, which was a sample of convenience, included 98 HIV-infected patients from March to May 2019 at the General Oncology hospital "Oi Agioi Anargyroi" in Greece. The main tools of the survey were the Greek version of the MOS-HIV and a questionnaire used for measuring rehabilitation costs in trauma patients adjusted for the needs of the this study. RESULTS: A total of 98 patients were inducted in our study aged 49.3 ± 11.3 years, most of them males (68.3%). HRQoL was assessed in 11 individual dimensions. The highest score was found in the dimensions of role functioning (73.47 ± 36.93), physical functioning (72.53 ± 26.65), and social functioning (71.63 ± 32.3). Regarding the patients' living costs over the last month due to their illness, the highest burden comes from other expenses (152.4 ± 179.5), services provided by a psychologist (142.8 ± 170.6) and medical visits (142.8 ± 170.6). CONCLUSIONS: As the HIV infection is characterized as a chronic disease, the economic cost due to the illness needs to be studied as it affects the extent to which an HIV-infected patient can access medical care and meet emerging needs. Therefore, future research should focus in the economic dimension of the illness in relation with the quality of life of these patients and their relatives, so that new health policies may arise.
