vices in their caregiving than lightly burdened caregivers. Heavily burdened caregivers were more likely to rent wheelchairs, to consult a staff of a support center ...
International Medical Journal Vol. 19, No. 3, pp. 221 - 223 , Septetnber 2012
221
HEALTH & ENVIRONMENT
Burden among Family Caregivers of Patients on Chronic Hemodialysis in Northern Japan Masakazu Washio' ^', Hídeakí Yoshida^', Nobuyuki Ura'', Hirofumi OhnishF', Nobuhiko TogashP, Fumio Sakauchi^', Yumiko Arai"', Mitsuru Kazuaki Sbimamoto^' ABSTRACT Purpose: To investigate factors related to burden among family caregivers of regular hemodialysis patients. Design: Cross sectional study. Subjects: 108 pairs of family caregivers and regular hemodialysis patients in Hokkaido Prefecture, Japan. Subjects and Methods: Caregivers answered a self-administered questionnaire about various factors that may affect their care-burden and also completed the Japanese version of the Zarit careburden interview (J-ZBI). They were divided into two groups according to their ZBI score. . Results: Compared with lightly burdened caregivers, those heavily burdened were more likely to be spouses and to have chronic diseases under medical treatment. Patients cared for by heavily burdened caregivers were more likely to be males, have dementia, and be disabled than their counterparts. Heavily burdened caregivers spent a longer time with their charges as well as in providing for their physical care than lightly burdened caregivers. In addition, they spent more money to use social services in their caregiving than lightly burdened caregivers. Heavily burdened caregivers were more likely to rent wheelchairs, to consult a staff of a support center for the frail elderly, to consult a home doctor, to use home renovation services, to apply to the insurer for the assessment of need for care, and to make a care plan than their counterparts. Compared with lightly burdened caregivers, more of those heavily burdened wanted regular assistance for care and facilities for regular day-time respite care. Conclusion: These findings suggest that looking after patients for a long time as well as paying a lot of money seems to be an important factor related to caregiver's developing psychological feelings of heavy burden.
KEY WORDS caregiver, burden, hemodialysis patients
INTRODUCTION Improvements of public health and advances in medicine after World War II have given Japan one of the highest life expectancies in the world, i.e., 79.6 years for men and 86.4 years for women in 2009". On the other hand, the live birth rate (per 1000 Japanese population) decreased from 34.3 in 1947" to 8.5 in 2009". As the birth rate dropped sharply after the postwar baby boom, population aging is proceeding more rapidly than any other industrialized nation". The dramatic increase in the number of older people in Japan, which is now well documented", has led to a concurrent increase in the number of the frail elderly (i.e., the elderly who need care)"'. It is estimated that the number of the frail elderly will reach 5.2 million in 2020". In former days, the frail elderly were cared for by the traditional family system because most Japanese elderly, over 60% compared with 20% or less in Western countries, lived with their children". However, the number of children in each family has dramatically decreased, and the nuclear family has become more common (i.e., 59.0% in 2006)".
Caregivers often have to care for the frail elderly without any help from other relatives because they often live too far away to provide assistance. Family caregivers are often both physically and mentally burdened with caring for their frail elderly". Several reports'" have demonstrated that a large amount of time spent on caregiving is related to the feeling among such caregivers of carrying an insupportable burden. Therefore, ways to reduce the burden on caregivers caring for the frail elderly is an important issue for society. According to the increase in the elderly population, many renal failure patients have started dialysis therapy. In 2009, 37,183 patients began dialysis therapy'"'. Among them, 14,611 patients (39.3%) were elderly (65 years old or older). Advances in dialysis therapy have improved the survival rate of dialysis patients. The five-year survival rate of dialysis patients improved from 58.2% in 2004 to 60.4% in 2009'°'. The increasing number of aged patients starting dialysis therapy and the improvement in the survival rate of dialysis patients have led to a great number of elderly dialysis patients in Japan. In 2009, there were 281,996 dialysis patients in Japan'»'. Among them, 159,185 patients (56.4%) were elderly (65 years old or older).
Received on June 25, 2011 and accepted on September 20, 2011 1) St. Mary's College Graduate School of Nursing Sciences 422 TsubukuhonmachI, Kurutne City, Fukuoka 830-8558, Japan 2) Departtnent of Public Health Sapporo Medical University Sapporo, Japan 3) Second Department of Internal Medicine Sapporo Medical University Sapporo, Japan 4) National Center for Geriatrics and Gerontology Aichi, Japan Correspondence to: Masakazu Washio (e-mail: washio(ä'st-mary.ac.jp)
2012 Japan International Cultural Exchange Foundation & Japan Health Sciences University
Washio M. et al.
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Table 2. Characteristics of caregivers
Table 1. Characteristics of hemodialysis patients
age(years old)
heavily
lightly
heavily
lightly
burdened
burdened
burdened
burdened
caregivers
caregivers
caregivers
caregivers
n = 48
n = 60
n = 48
n = 60
74.2 ±7.3
73.2 ±7.2
NS
64.0 ±12.0
61.7±12.5
33.3%
55.0%
