Burden, Stress, and Depression in Informal Caregivers of Patients Pre and Post Liver Transplant.

BACKGROUND: Caring for a patient with chronic liver disease involves exposure to factors that increase family caregivers' vulnerability to developing mental disorders. This study reassessed the scores of burden, stress, and depression in informal (family) caregivers of patients with liver disease after liver transplant. METHODS: In this observational and descriptive study, the caregivers were reassessed for the same outcomes 4 to 10 years following the initial assessment pre-transplant. The data were obtained from the identification card, the interview script, the Brazilian version of the Caregiver Burden Scale, the Lipp Inventory of Stress Symptoms for Adults, and the Beck Depression Inventory. Descriptive statistics of pre- and post-liver transplant phases were calculated, and the Wilcoxon signed rank test was used to compare the burden scores. RESULTS: The 5 caregivers were women, with a mean age of 51.6 (SD, 8.38) years. All of the caregivers' (100%) burden score increased, 2 caregivers needed to seek some form of help, and 3 caregivers showed an indication of burden risk. Regarding stress symptoms, 3 caregivers (60%) maintained a score indicating no stress, 2 caregivers (40%) presented increased scores, and the predominant symptoms changed from psychological to physical. Regarding depression, 3 caregivers (60%) maintained the minimum level of symptoms for depression, and 2 caregivers (40%) presented increased scores. CONCLUSION: After liver transplant, caregivers' burden scores increased, and levels of stress and depression increased for caregivers who already showed symptoms in the pre-transplant phase.

Randomized controlled trial of a therapeutic intervention group in patients with fibromyalgia syndrome.

OBJECTIVE: To evaluate the efficacy of a weekly interdisciplinary program (WIP) consisted of educational activities, physical therapy, stretching, ergonomics, posture guidance combined with cognitive behavioral strategies and approaches to psychosocial and occupational factors in order to determine whether this intervention would be effective to short and medium-term improvement of symptoms in these patients. METHODS: This was a single-center study, randomized single blind controlled trial with a sample test group (T), with a diagnosis of FMS (n = 12), and a control group (C) subjected to Pain Clinic referral (n = 15). The instruments used at two different times were the Fibromyalgia Impact Questionnaire (FIQ), Visual Analogue Scale (VAS) and Post-Sleep Protocol (PSI). To assess quality of life, we used the SF-12. RESULTS: In samples, both groups were predominantly female, mean age of 42.5 ± 9.8 years, 43% married, average schooling of 8.3 ± 4.5 years. It was reported a mean of 4.2 years pain and an average of two years for the diagnosis of SFM from the group T. There was statistical difference between the groups in terms of efficacy post intervention WIP, in almost all outcome measures. CONCLUSION: It was found that weekly interdisciplinary program (WIP) has contributed to improving the quality of life of patients with fibromyalgia.