From Burden to Depressive Symptoms in Informal Caregivers during the COVID-19 Pandemic: A Path Analysis.

BACKGROUND: The objective of this study was to assess the complex relationship between the multiple determinants of the caregiving process, the caregiver burden, and depression during the COVID-19 pandemic in Serbia. METHODS: A cross-sectional study was conducted on a nationally representative sample (n = 798) during the COVID-19 pandemic in Serbia from March to September 2020. A nine-section questionnaire designed for this study included the characteristics of caregivers, characteristics of care and care recipients, COVID-19 related questions, and the following standardized instruments: 12-Item Short-Form Health Survey, Fatigue Severity Scale, Activities of Daily Living Scale and Instrumental Activities of Daily Living Scale, Zarit Caregiver Burden Scale, and Beck Depression Inventory. Path analysis was used for the simultaneous assessment of the direct and indirect relationships of all determinants. RESULTS: More than two thirds (71.9%) of informal caregivers experienced a burden, and more than one quarter (27.1%) had depression symptomatology. Self-rated physical health, need for psychosocial support, and caregiver burden were the main direct predictors of depression. Multiple determinants of the caregiving process had indirect effects on depressive symptomatology via the caregiver burden as a mediating factor. CONCLUSIONS: The subjective burden presented a significant risk factor for depressive symptoms in caregivers during the COVID-19 pandemic. The provision of psychosocial support was identified as an important opportunity to reduce depressive risk in informal caregivers.

Quality of Life of Informal Caregivers behind the Scene of the COVID-19 Epidemic in Serbia.

Background and objectives: The COVID-19 pandemic has had an unprecedented reliance on informal caregivers as one of the pillars of healthcare systems. The aim of this study was to assess the quality of life of informal caregivers during the COVID-19 epidemic in Serbia. Materials and Methods: A cross-sectional study was conducted among informal caregivers during the COVID-19 epidemic in Serbia. Physical and mental quality of life was measured by the 36-Item Short-Form Health Survey. Additional data included sociodemographic characteristics, caregiver and care recipient characteristics, and COVID-19 related concerns. The qualitative component was performed using focus groups and individual in-depth interviews. Results: Out of 112 informal caregivers enrolled, most were female (80%), and the average age was 51.1 ± 12.3 years. The majority was delivering care to one person, who was a family member, on a daily basis (86.4%, 92%, and 91.1%, respectively). In multiple regression models, significant predictors of caregivers' physical health were delivering care to a family member and a higher level of care complexity, while significant predictors of caregivers' mental health were a higher level of care complexity and increased concerns about self-health and the health of the person being cared for due to the COVID-19 epidemic. Conclusions: Informal caregivers are experiencing negative physical and mental health outcomes during the COVID-19 epidemic in Serbia.

Is Balint training associated with the reduced burnout among primary health care doctors?

The aim of our study was to examine whether the participation in Balint group is associated with the reducing burnout syndrome among primary health care doctors. This investigation was conducted on a population of 210 doctors employed in primary health centers in Belgrade. Out of 210 doctors, 70 have completed Balint training for a period of at least 1 year, whereas 140 doctors have never attended this training (the Non-Balint group). The level of burnout among physicians was assessed with the Serbian translation of the original 22-item version of the Maslach Burnout Inventory - Human Services Survey which defines burnout in relation to emotional exhaustion, depersonalization and personal accomplishment. We found that 45.0% of the Non-Balint participants and 7.1% of the Balint-trained participants responded with symptoms of high level of emotional exhaustion, with a statistically significant difference (p < 0.001). In relation to depersonalization, 20% of the Non-Balint subjects were highly depersonalized compared to 4.4% of the Balint-trained subjects, with a statistically significant difference (p < 0.001). Regarding the personal accomplishment, 21.4% of the Non-Balint subjects and 7.1% of the Balint-trained subjects had a perception of low personal accomplishment, with a statistical significance (p < 0.001). In the multiple ordinal logistic model, with emotional exhaustion as a dependent variable, statistically significant predictor was female gender (OR = 2.51; p = 0.021), while Balint training was obtained as a protective factor (OR = 0.12; p < 0.001). Non-specialists were detected as a risk factor for depersonalization (OR = 2.14; p = 0.026) while Balint group was found as a protective factor (OR = 0.10; p < 0.001), according to the multiple ordinal logistic regression analysis. Regarding the reduced personal accomplishment, our results indicated that nonspecialists were at risk for this subdimension (OR = 2.09; p = 0.025), whereas Balint participants were protected (OR = 0.18; p < 0.001). Participation in Balint groups is associated with the reduced burnout syndrome among primary health care doctors.

Burnout of Formal Caregivers of Children with Cerebral Palsy.

BACKGROUND: Burnout syndrome is under-researched within caregivers (CGs) of children with cerebral palsy. The primary aim was to determine the burnout level of formal CGs of children with cerebral palsy (G1) and to compare it with a control group (G2) of professional pediatric nurses, and second, to correlate the level of depression and anxiety with the burnout level. METHOD: In a total sample of 60 CGs, the Maslach Burnout Inventory Human Services Survey (MBI-HSS), consisting of three structural units - emotional exhaustion (MBIEE) subscale, depersonalization (MBI-DP) subscale and personal accomplishment (MBI-PA) subscale - was used to measure burnout. The Beck Anxiety Inventory (BAI) was used for the assessment of anxiety, and the Beck Depression Inventory (BDI) for depression. RESULTS: A significant difference was shown on the MBI-EE subscale and on the BDI test (p<0.05), in both cases higher scores were obtained by G1. High burnout was observed in all subscales, on the MBI-EE subscale registered 50% of CGs in G1, and 17% in control G2. Correlation of the MBI-EE subscale with BDI and BAI tests was highly significant (p<0.01). CONCLUSIONS: These findings indicate the need for future research aimed at formulating preventive strategies for caregivers' mental health. Better care for caregivers would provide them with better professional satisfaction, and consequently would lead to better care for patients.

[Dysfunctionality of the primary family as a supportive factor for the development of polytoxicomany in young people].

INTRODUCTION: Dependent behaviour represents a strong homeostasis of the family of an addict. OBJECTIVE: The aim of our research is to record and explore irregularities during the addicts' growth, as well as the specific type of family relations in the addicts' family. METHODS: For research purposes a general questionnaire was used on growth and development, and GRADIR questionnaire on the assessment of family relationships. RESULTS: Our results indicate that delinquent behaviour is often found with the addicts before the occurrence of abuse. A significant dysfunctional family of addicts was detected. Families with an addict were not substantially damaged or altered in terms of emotional exchange, but in their structure that enhanced dysfunction leading to addictive behaviour. CONCLUSION: Emotional investments without control, prohibitions and penalties, contribute to a lack of consciousness that disturbs the process of socialization. Due to the apparent control and the apparent support, the addicts do not have structured organization and socialization. Emotional stimuli without obligation for polytoxicomanes to maintain a reciprocal relationship with their parents influence the parental support of egoistic style of behaviour.

Development of polytoxicomania in function of defence from psychoticism.

INTRODUCTION: Polytoxicomanic proportions in subpopulations of youth have been growing steadily in recent decades, and this trend is pan-continental. Psychoticism is a psychological construct that assumes special basic dimensions of personality disintegration and cognitive functions. Psychoticism may, in general, be the basis of pathological functioning of youth and influence the patterns of thought, feelings and actions that cause dysfunction. OBJECTIVE: The aim of this study was to determine the distribution of basic dimensions of psychoticism for commitment of youth to abuse psychoactive substances (PAS) in order to reduce disturbing intrapsychic experiences or manifestation of psychotic symptoms. METHODS: For the purpose of this study, two groups of respondents were formed, balanced by age, gender and family structure of origin (at least one parent alive). The study applied a DELTA-9 instrument for assessment of cognitive disintegration in function of establishing psychoticism and its operationalization. The obtained results were statistically analyzed. From the parameters of descriptive statistics, the arithmetic mean was calculated with measures of dispersion. A cross-tabular analysis of variables tested was performed, as well as statistical significance with Pearson's chi2-test, and analysis of variance. RESULTS: Age structure and gender are approximately represented in the group of polytoximaniacs and the control group. Testing did not confirm the statistically significant difference (p > 0.5). Statistical methodology established that they significantly differed in most variables of psychoticism, polytoxicomaniacs compared with a control group of respondents. Testing confirmed a high statistical significance of differences of variables of psychoticism in the group of respondents for p < 0.001 to p < 0.01. CONCLUSION: A statistically significant representation of the dimension of psychoticism in the polytoxicomaniac group was established. The presence of factors concerning common executive dysfunction was emphasized.