The Stressful Caregiving Adult Reactions to Experiences of Dying (SCARED) Scale: a measure for assessing caregiver exposure to distress in terminal care.
OBJECTIVE
The authors evaluated the performance of the Stressful Caregiving Adult Reactions to Experiences of Dying (SCARED) scale, a new tool to assess caregiver exposure to patient distress, and the fear and helplessness evoked by these experiences.


METHODS
The SCARED was administered to 76 hospice-patient caregivers (e.g., family members). Major depressive disorder (MDD) was diagnosed with the Structured Clinical Interview for the DSM-IV; complicated grief (CG) "caseness" was diagnosed with the Inventory of Complicated Grief-Caregiver items, and quality-of-life domains were assessed with the Medical Outcomes Survey Short Form-36.


RESULTS
Respondents endorsed frequent exposure to each SCARED experience-from 30.3% who mistakenly thought the patient had died, to 80.3% who witnessed the patient in severe pain. Adjusted analyses revealed that the odds of MDD increased by 3.08 for each standard-deviation increase in the SCARED event frequency score and that higher SCARED scores were positively associated (p <0.05) with social and role impairment, less energy, and more negative health perceptions.


CONCLUSIONS
The SCARED may be a clinically useful tool for identifying caregivers at risk for MDD and quality-of-life impairments, as well as potential aspects of caregiving to target for treatment.
Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519, USA. Holly.Prigerson@yale.edu
Holly G
HG
Prigerson
Emily
E
Cherlin
Joyce H
JH
Chen
Stanislav V
SV
Kasl
Rosemary
R
Hurzeler
Elizabeth H
EH
Bradley
D000328:Adult; D000368:Aged; D001293:Attitude to Death; D017028:Caregivers / Q000523:psychology*; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D013315:Stress, Psychological / Q000453:epidemiology / Q000209:etiology / Q000523:psychology*; D011795:Surveys and Questionnaires; D013727:Terminal Care