Burden, quality of life, anxiety, and depressive symptoms among caregivers of hemodialysis patients: The role of social support.

OBJECTIVE: The purpose of this study was to determine how burden and quality of life predict anxiety and depressive symptoms among caregivers of hemodialysis patients. Social support was included in the model as a proposed moderator in the above relationships. METHODS: This cross-sectional study involved 340 caregivers of chronic kidney patients undergoing hemodialysis. The setting was in Terengganu, Malaysia. The caregivers completed the measures of caregiving burden, quality of life, social support, and symptoms of anxiety and depression. RESULTS: About 28.8% and 52.4% of caregivers showed clinically moderate levels of anxiety and depressive symptoms, respectively. Furthermore, 35.9% and 3.8% of them showed clinically high levels of anxiety and depressive symptoms, respectively. Analyses showed that general quality of life was a significant predictor of both anxiety and depressive symptoms. Burden and psychological domains of quality of life significantly predicted anxiety. In addition, a lack of social support was a determinant of depressive symptoms. Evidence suggested that social support moderated the burden-anxiety relationship. Specifically, caregivers with low levels of social support showed more elevated levels of anxiety symptoms when their burden was higher. CONCLUSION: There is an urgent need for early detection to initiate prompt treatment in this population. The study provides some important insights into offering comprehensive intervention to help caregivers cope more effectively through the provision of sufficient social support to buffer the effects of caregiving burden and improve mental health.

Child and Adolescent Mental Health Service (CAMHS), Terengganu, Malaysia: milestones so far and the paths to the future.

This study aims to provide an overview of mental health problems of children and adolescents in Malaysia in general and the state of Terengganu in particular. It also highlights the challenges and the opportunities in the establishment of child and adolescent mental health services (CAMHS). CAMHS in Malaysia are developing slowly but have not reached the standards found in developed countries. Significant improvements are needed to ensure that the service can provide optimal help to children and adolescent as well as their families. Constraining factors such as a lack of trained workers, limited financial resources for training and inadequate facilities are among the challenges. Despite all these challenges, specific strategies are required to optimally utilise the potential existing resources. The Ministry of Health initiatives in creating and implementing the national mental health policy and increasing mental health awareness campaigns for children and adolescents are of paramount importance. To overcome the lack of resources in the implementation of CAMH services, in-service education and training, integration of mental health services with the existing primary health care facilities and cultivation of cooperative and communicative networks between primary care professionals, mental health workers and other relevant agencies are crucial steps.