title: Rates and predictors of depression status among caregivers of patients with COPD hospitalized for acute exacerbations: a prospective study.
abstract: BACKGROUND
  Hospitalization is common for acute exacerbation of COPD, but little is known about its impact on the mental health of caregivers.
  
  
  OBJECTIVE
  The aim of this study was to determine the rates and predictors of depressive symptoms in caregivers at the time of hospitalization for acute exacerbation of COPD and to identify the probability and predictors of subsequent changes in depressive status 3 months after discharge.
  
  
  METHODS
  This was a prospective study. Depression symptoms were measured in 87 caregivers of patients hospitalized for exacerbation at hospitalization and 3 months after discharge. We measured factors from four domains: context of care, caregiving demands, caregiver resources, and patient characteristics. Univariate and multivariate multiple logistic regressions were used to determine the predictors of depression at hospitalization and subsequent changes at 3 months.
  
  
  RESULTS
  A total of 45 caregivers reported depression at the time of hospitalization. After multiple adjustments, spousal relationship, dyspnea, and severe airflow limitation were the strongest independent predictors of depression at hospitalization. Of these 45 caregivers, 40% had a remission of their depression 3 months after discharge. In contrast, 16.7% of caregivers who were not depressive at hospitalization became depressive at 3 months. Caregivers caring >20 hours per week for patients with dependencies had decreased odds of remission, and patients having dependencies after discharge increased the odds of caregivers becoming depressed.
  
  
  CONCLUSIONS
  Depressive symptoms are common among caregivers when patients are hospitalized for exacerbation of COPD. Although illness factors are determinants of depression at hospitalization, patient dependence determines fluctuations in the depressive status of caregivers.
authors.affiliation: Division of Pneumology, Hospital Morales Meseguer; Department of Physical Therapy, University of Murcia; Physiotherapy and Disability Research Group, Instituto Murciano de Investigación Biosanitaria Virgen de la Arrixaca (IMIB), Murcia, Spain.
authors.forename: Roberto
authors.initials: R
authors.lastname: Bernabeu-Mora
authors.affiliation: Department of Physical Therapy, University of Murcia.
authors.forename: Gloria
authors.initials: G
authors.lastname: García-Guillamón
authors.affiliation: Department of Physical Therapy, University of Murcia; Physiotherapy and Disability Research Group, Instituto Murciano de Investigación Biosanitaria Virgen de la Arrixaca (IMIB), Murcia, Spain.
authors.forename: Joaquina
authors.initials: J
authors.lastname: Montilla-Herrador
authors.affiliation: Department of Physical Therapy, University of Murcia; Physiotherapy and Disability Research Group, Instituto Murciano de Investigación Biosanitaria Virgen de la Arrixaca (IMIB), Murcia, Spain.
authors.forename: Pilar
authors.initials: P
authors.lastname: Escolar-Reina
authors.affiliation: Department of Physical Therapy, University of Murcia.
authors.forename: José Antonio
authors.initials: JA
authors.lastname: García-Vidal
authors.affiliation: Department of Physical Therapy, University of Murcia; Physiotherapy and Disability Research Group, Instituto Murciano de Investigación Biosanitaria Virgen de la Arrixaca (IMIB), Murcia, Spain.
authors.forename: Francesc
authors.initials: F
authors.lastname: Medina-Mirapeix
mesh_terms: D000368:Aged; D017028:Caregivers / Q000523:psychology*; D016009:Chi-Square Distribution; D017281:Cost of Illness; D003863:Depression / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology; D018450:Disease Progression; D005260:Female; D006304:Health Status; D006760:Hospitalization; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010351:Patient Discharge; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D012307:Risk Factors; D013997:Time Factors
keywords: COPD; acute care; caregivers; depression; family care