Psychological Distress among Family Members of Inpatients in General Medicine Wards at a Tertiary Care Hospital: A Cross-sectional Study

Abstract

Introduction: It is now being increasingly recognised that even family members of the patients face emotional and cognitive challenges. Several studies have studied the distress experienced by family members of patients admitted in the Intensive Care Unit (ICU) setting and have identified anxiety and depression, stress, confusion, uncertainty among the family members. There is however, sparse literature available on the psychological distress experienced by family members of inpatients in general wards, globally as well as in India. Aim: To estimate psychological distress among the family members of inpatients in General Medicine wards at a tertiary care hospital. Materials and Methods: A cross-sectional study was conducted in General Medicine wards at a tertiary care hospital in Goa, India. Family member caregivers of the patients admitted in these wards constituted the study sample. The data was collected in predesigned format. The psychological distress was studied by using the Hospital Anxiety and Depression Scale (HADS) questionnaire and the Caregiver Self-Assessment Questionnaire (CSAQ). Statistical analysis was conducted using Statistical Package for the Social Sciences version 24.0. Chi-square was the test of significance used. Odds ratios and 95% Confidence Interval (CI) were calculated wherever the association between the variable of interest and outcome variable was statistically significant with p-value ≤0.05. Results: Out of 150 family member caregivers, 84 were males and 66 were females with mean age of 38.87±13.08 years. Majority (43.3%) were children of the admitted patients. The most common ailments were cardiovascular (24%) followed by infectious diseases (17.3%) and neurological (16.6%) problems. The prevalence of anxiety was 42% among the family members whereas that of depression was 23.3%, on HADS scoring system. Relationship of the family member with the inpatient and marital status of the patient were the factors significantly associated with anxiety in the family member. Around 66% of the family members were experiencing high degree of distress, as measured by the CSAQ. Relationship of family member with the inpatient and the gender of the caregiver were the only factors significantly associated with psychological distress, measured by CSAQ. Conclusion: Since family members of patients experience significant psychological distress even in general ward setting there may be a need to more actively involve family members in the hospital care of the admitted patients. This departure from the traditional patient centered care wherein a family member’s role was minimal may lead to a more holistic healthcare benefiting both the patient and his family.

Keywords

• anxiety
• caregivers
• depression
• prevalence