Sunday, April 30, 2023

Quality of life, anxiety and depression in caregivers and relatives

Psychological feelings of medical caregivers:

a series of psychological affections that some caregivers or relatives of people in critical health conditions may present are explained, considering that in the hospital setting, people present a wide range of emotions and cognitions as a consequence of exposure to situations and circumstances.
that are highly stressful, such as complex congenital malformations, which are pathologies that affect the quality and rhythm of life not only of patients, but also of their families and/or caregivers.

Psychological changes:

However, not all people who carry out care activities will suffer psychological alterations, so it is important to avoid self-diagnosis and distinguish between normal reactions to critical events and pathological reactions.

Some of the normal expected reactions and other recommendations to detect alarm signals and act in time can be seen in the following images:

Quality of life:

The term quality of life has to do with emotional, material and physical well-being, and with the conditions that allow personal development, relationships with others and social inclusion.

In relation to health, quality of life is associated with both internal elements of the individual and external elements, which interact with him in a bidirectional dynamic and can modify his state of health.

This is why the quality of life of caregivers is conceived as a multidimensional process characterized by physical, psychological, social and spiritual well-being (Montalvo, Romero and Flórez, 2011).

In a systematic review carried out by Gregory, Prouhet and Pfannenstiel (2018) whose main objective was to identify how the quality of life of parents or caregivers of children with complex congenital heart disease is affected and what the associated risk factors, it was found that having a child with this pathology significantly affects the quality of life of the parents.

This affectation depends on the severity of the disease, the minor's age, the perception of support, the availability of economic resources, the caregiver's gender and family functionality.
This was done based on the analysis of 33 scientific research articles.

Depression and anxiety:

Depression as a clinical disease presents as a set of affective, cognitive, volitional and somatic symptoms, being especially characteristic for the alteration at the affective level, whose clinical symptoms are pathological sadness, anhedonia (inability to experience pleasure or feel interest in activities that were previously pleasurable), decay, subjective perception of psychological discomfort and feeling of not being able to cope with life situations. Generally, depression has serious repercussions in the different areas of the individual's functioning, such as social, work and/or academic, becoming a disabling condition that substantially diminishes the quality of life, which constitutes a global psychic and physical affectation (Ministry of Health and Consumption, 2018).

According to the Government of Spain, Quality Plan for the National Health System and Laín Entralgo Agency, 2008, anxiety is defined as a state of anticipation before a future event that can cause harm, accompanied by an unpleasant sensation and somatic manifestations of strain.

This can be adaptive or pathological. In this way, anxiety as a normal emotional state constitutes a way of responding to the demands of the environment.

pathological anxiety:

However, it becomes pathological anxiety when it exceeds certain limits and increases in intensity, surpassing the person's ability to respond, which generates physical, psychological and behavioral symptoms.

Pathological anxiety constitutes a group of diseases in which there is worry, fear or excessive fear, as well as tension or activation in the face of different environmental stimuli, which generates clinically significant repercussions in the different areas of activity of the person.

The causes are unknown, but it is generally explained from a model in which biological, environmental and psychosocial factors interact (Government of Spain, Quality Plan for the National Health System and Laín Entralgo Agency, 2008).

describe the mental health of parents:

In a review study carried out with 24 scientific research articles whose purpose was to describe the mental health of parents with children with complex congenital heart disease during different stressful periods of the child's disease, it was found that having a child with this pathology can be very stressful for caregivers, who face not only this unexpected event, but also other emotional, physical, or financial changes.

Especially mothers show a high risk of stress, anxiety, depression, somatization, hopelessness and symptoms of post-traumatic stress disorder.

In the long term, most parents successfully adapt to the situation, but approximately 40% report the need for support and psychological help (Kolaitis, Meentken, & Utens, 2017).