Ambulatory blood pressure and heart rate responses to the stress of work and caregiving in older women.
BACKGROUND
Although the informal caregiving role is associated with a range of stressors that are both chronic and severe, little is known concerning the acute physical and psychological effects of caregiving in the natural setting. This study evaluated the hemodynamic and psychological responses of five women identified as family caregivers who also worked outside the home and five matched working noncaregivers.


METHODS
Subjects wore an ambulatory blood pressure monitor that recorded blood pressure and heart rate on an hourly basis throughout a one- to two-day period. They also completed hourly logs evaluating psychological, physical, and health-related variables through use of a preprogrammed pocket computer. Within- and between-group responses were compared in clinical, work, and postwork settings.


RESULTS
Caregivers and noncaregivers showed comparable ambulatory blood pressure levels in the clinic and work settings. However, in contrast to noncaregivers, who showed the expected decrease in blood pressure level upon leaving the work setting (p values < .03), caregivers demonstrated a significant increase in systolic blood pressure levels following work when they were in the presence of the care recipient (p < .0002). The differences observed in blood pressure responses between the two groups were similarly reflected in the patterns of affective response recorded in the work and postwork settings.


CONCLUSIONS
The results provide initial evidence of the acute iatrogenic effects of caregiving on physiological as well as psychological response systems.
Department of Health Research and Policy, Stanford University School of Medicine, Palo Alto, California.
A C
AC
King
R K
RK
Oka
D R
DR
Young
D000339:Affect / Q000502:physiology; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory / Q000295:instrumentation; D017028:Caregivers / Q000523:psychology; D016022:Case-Control Studies; D004644:Emotions; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008499:Medical Records; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000295:instrumentation; D009035:Mothers; D009043:Motor Activity / Q000502:physiology; D013312:Stress, Physiological / Q000503:physiopathology*; D013315:Stress, Psychological / Q000503:physiopathology*; D014937:Work / Q000502:physiology*