title: Sleep Problems, Anxiety, and Global Self-Rated Health Among Hospice Family Caregivers.
abstract: BACKGROUND
  Although research has linked sleep problems, anxiety, and poor health outcomes among patients' family members in nonhospice settings, little is known about these often interrelated issues among hospice family caregivers.
  
  
  OBJECTIVE
  We sought to examine the relationships between sleep problems, anxiety, and global self-rated health among hospice family caregivers. Methods, Setting, and Patients: We conducted a secondary analysis of quantitative data from 395 family caregivers of hospice patients in the Midwest and Southeastern United States.
  
  
  RESULTS
  Nearly one-third of the hospice family caregivers who participated in this study experienced clinically noteworthy levels of sleep problems and/or anxiety. Caregivers' symptoms of anxiety and sleep problems were strongly correlated. Caregivers who reported more frequent sleep problems and higher levels of anxiety reported poorer overall health.
  
  
  CONCLUSIONS
  Hospice providers, who are charged with attending to the needs of both patients and their family caregivers, may improve their practice by regularly assessing for sleep problems and anxiety among family caregivers and providing appropriate interventions or referrals.
authors.affiliation: 1 School of Medicine, University of Missouri, Columbia, MO, USA.
authors.forename: Karla T
authors.initials: KT
authors.lastname: Washington
authors.affiliation: 1 School of Medicine, University of Missouri, Columbia, MO, USA.
authors.forename: Debra
authors.initials: D
authors.lastname: Parker Oliver
authors.affiliation: 1 School of Medicine, University of Missouri, Columbia, MO, USA.
authors.forename: Jamie B
authors.initials: JB
authors.lastname: Smith
authors.affiliation: 2 School of Health Professions, University of Missouri, Columbia, MO, USA.
authors.forename: Christina S
authors.initials: CS
authors.lastname: McCrae
authors.affiliation: 2 School of Health Professions, University of Missouri, Columbia, MO, USA.
authors.forename: Shanky M
authors.initials: SM
authors.lastname: Balchandani
authors.affiliation: 3 School of Medicine, University of Washington, Seattle, WA, USA.|4 School of Nursing, University of Washington, Seattle, WA, USA.
authors.forename: George
authors.initials: G
authors.lastname: Demiris
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000453:epidemiology*; D017028:Caregivers / Q000523:psychology*; D005190:Family / Q000523:psychology*; D005260:Female; D006304:Health Status; D017051:Hospice Care / Q000523:psychology*; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D012893:Sleep Wake Disorders / Q000453:epidemiology*
keywords: anxiety; caregivers; end-of-life care; health; hospice; sleep