The influence of patient and caregiver depression on patient self‐care and caregiver contribution to self‐care in ostomy: A dyadic analysis
Paolo Iovino, Maddalena De Maria, Francesco Corvese, Vittoria Giordano, Rosaria Alvaro, Ercole Vellone, Giulia Villa
Abstract
AIMS AND OBJECTIVES: To explore the association between patient and caregiver depression and patient self-care and caregiver contribution to self-care in the context of ostomy care. BACKGROUND: Self-care is essential for ostomy patients and their caregivers. The ostomy self-care process can be considered a dyadic phenomenon in which the patient and the caregiver interact together and work as a team. The presence of depressive symptoms may limit the patient's ability to perform self-care and caregivers' abilities to engage in caregiving tasks. Research into the dyadic influence of depression on self-care behaviours from the perspective of ostomates and their caregivers is still in its infancy. DESIGN: Secondary analysis of a multicentre, cross-sectional study. The STROBE checklist was used to report the present study. METHODS: Patient-caregiver dyads were recruited from eight ostomy outpatient clinics from February 2017 to May 2018. Depression was assessed with the nine-item Patient Health Questionnaire in both patients and caregivers. Patient self-care was evaluated with the Ostomy Self-Care Index, and caregiver contribution to self-care was assessed with the Caregiver Contribution to Ostomy Self-Care Index. Both instruments measure the dimensions of maintenance, monitoring and management. The actor-partner interdependence model was performed for the dyadic analysis. RESULTS: In total, 252 patient-caregiver dyads (patients: 69.8% male, mean age 70.05; caregivers: 80.6% female, mean age 58.7) were enrolled. Patient depression was positively associated with caregiver contribution to self-care maintenance. Caregiver depression was negatively associated with self-care management. RELEVANCE TO CLINICAL PRACTICE: These findings add a better understanding of the reciprocal influence of dyadic depression on patient and caregiver contributions to self-care in ostomy contexts was found. Patient and caregiver depression influence patient self-care and caregiver contribution to self-care. Therefore, clinicians should assess and treat depression in both members of the dyad to improve self-care.