Depression, Anxiety and Caregiver Strain in Relatives of Inpatients with and without Pre-Admission Home Care: A Cross-Sectional Study in a Chest Diseases Ward

Hospitalization places demands on patients and on the relatives who provide their care. In this single-center, cross-sectional study, depression, anxiety, and caregiver strain were compared between relatives of inpatients with and without pre-admission home care in a chest diseases ward. Groups comprised 39 relatives in the home-care group and 97 in the no-home-care group. The Hospital Anxiety and Depression Scale (HADS), the Modified Caregiver Strain Index (MCSI), and the European Health Literacy Survey-16 were administered to all 136 caregivers. The prespecified primary outcome was probable depression (HADS-D ≥8); probable anxiety and caregiver strain were secondary. Probable depression was identified in 41.0% of the home-care group and in 17.5% of the no-home-care group, and probable anxiety in 51.3% and 17.5%, respectively. After adjustment for caregiver age and sex, membership of the home-care group was associated with probable depression (OR 3.01, 95% CI 1.28–7.06) and with probable anxiety (OR 4.62, 95% CI 2.00–10.68). In sensitivity analyses the estimate for depression was attenuated after adjustment for patient age (OR 2.31, 95% CI 0.94–5.67), and neither estimate was retained when mobility limitation, nutritional support, or all six patient characteristics were entered. Caregiver strain was greater in the home-care group, whereas health literacy did not differ between groups. Probable depression and anxiety were frequent among accompanying relatives in both groups and more frequent in the home-care group, although about half of the affected relatives were in the comparison group. These findings are exploratory.