Burden, stress and depression in caregivers of cirrhosis patients before and after liver transplantation

Table 1 Comparative analysis of the sociodemographic characteristics of the family caregivers and patients included in the study, n (%)

Characteristics	Family caregivers			Patients
	CP (n = 77)	LT (n = 65)	P value	CP (n = 77)	LT (n = 65)	P value
Sex
Male	11 (14.3)	10 (15.4)	0.854	62 (80.5)	46 (70.8)	0.175
Female	66 (85.7)	55 (84.6)		15 (19.5)	19 (29.2)
Age, years, median (min-max)	55.4 (23.3-76.3)	54.6 (25.7-82.1)	0.949	57 (27-80)	61.6 (22.5-80.5)	0.118
≤ 59	53 (68.8)	48 (73.8)	0.511	43 (55.8)	24 (37)	0.024a
≥ 60	24 (31.2)	17 (26.2)		34 (44.2)	41 (63.1)
Education, years
1 to 8	31 (40.3)	17 (26.2)	0.032a	45 (58.4)	35 (53.9)	0.007a
9 to 11	32 (41.6)	24 (36.9)		26 (33.8)	13 (20.0)
≥ 12	14 (18.2)	24 (36.9)		6 (7.8)	17 (26.2)
Employment status
Working	35 (45.5)	37 (56.9)	0.093	10 (13.0)	18 (27.7)	0.030a
Unemployed	5 (6.5)	2 (3.1)		8 (10.4)	7 (10.8)
Leave	13 (16.9)	13 (20.0)		13 (16.9)	2 (3.1)
From home	29 (37.7)	14 (21.5)		3 (3.9)	4 (6.2)
Retired	8 (10.4)	12 (18.5)		43 (55.8)	34 (52.3)
Work reduction
Yes	37 (48.1)	31 (47.7)	0.966	NA	NA	-
No	40 (51.9)	34 (52.3)		NA	NA

^aP < 0.05.

CP: Cirrhosis patient; LT: Liver transplantation; min-max: Minimum-maximum; NA: Not available.

Table 2 Clinical characteristics of the patients, n (%)

Characteristics	CP (n = 77)	LT (n = 65)
Etiology of cirrhosis
Alcoholic	42 (54.5)	33 (50.8)
Nonalcoholic fatty liver disease	23 (29.9)	10 (15.4)
Hepatitis C virus	13 (16.9)	21 (32.3)
Hepatocellular carcinoma	12 (15.6)	16 (24.6)
Other	15 (19.5)	26 (40)
Model for end-stage liver disease score
6 to 10	17 (22.1)	NA
11 to 14	27 (35.1)	NA
15 to 20	18 (23.4)	NA
≥ 21	3 (3.9)	NA
Not available	12 (15.6)	NA
Child-turcotte-Pugh classification
A	27 (35.1)	NA
B	32 (41.6)	NA
C	6 (7.8)	NA
Not available	12 (15.6)	NA
Decompensations/complications
0	7 (9.1)	27 (41.5)
1 to 2	35 (45.5)	32 (49.2)
≥ 3	35 (45.5)	6 (9.2)
Number of hospitalizations
0	19 (24.7)	21 (32.3)
1	14 (18.2)	16 (24.6)
2 to 4	27 (35.1)	16 (24.6)
≥ 5	17 (22.1)	12 (18.5)

CP: Cirrhosis patient; LT: Liver transplantation; NA: Not available.

Table 3 Comparative analysis of the perception of care by family caregivers, n (%)

Characteristics	CP (n = 77)	LT (n = 65)	P value
Duration of care, years, MD (min-max)	3.9 (1-20)	8 (1.5-24)	0.001a
Well informed about the disease
Yes	62 (80.5)	62 (95.4)	0.008a
No	15 (19.5)	3 (4.6)
Presence of the patient irritates the caregiver
Yes	13 (16.9)	6 (9.2)	0.182
No	64 (83.1)	59 (90.8)
Patient affects relationships
Yes	20 (26.0)	8 (12.3)	0.041a
No	57 (74.0)	57 (87.7)
Fear for the patient’s future
Yes	56 (72.7)	28 (43.1)	< 0.001a
No	21 (27.3)	37 (56.9)
Loss of privacy
Yes	21 (27.3)	10 (15.4)	0.088
No	56 (72.7)	55 (84.6)
Unable to continue caring
Yes	12 (15.6)	3 (4.6)	0.034a
No	65 (84.4)	62 (95.4)
Would assign care to others
Yes	7 (9.1)	1 (1.5)	0.070
No	70 (90.9)	64 (98.5)
Lack of concentration
Yes	17 (22.1)	10 (15.4)	0.311
No	60 (77.9)	55 (84.6)
Insomnia due to concerns
Yes	36 (46.8)	19 (29.2)	0.033a
No	41 (53.2)	46 (70.8)
Feels under pressure
Yes	20 (26.0)	9 (13.8)	0.074
No	57 (74.0)	56 (86.2)
Feels overwhelmed
Not at all	30 (39.0)	43 (66.2)	< 0.001a
A little	18 (23.4)	17 (26.2)
Moderately	19 (24.7)	4 (6.2)
Very	8 (10.4)	0 (0.0)
Extremely	2 (2.6)	1 (1.5)

^aP < 0.05.

CP: Cirrhosis patient; LT: Liver transplantation; MD: Median; min-max: Minimum-maximum.

Table 4 Descriptive analysis of burden, stress and depression in family caregivers, n (%)

Characteristics	CP (n = 77)	LT (n = 65)
Overload
No overload	4 (5.2)	11 (16.9)
Need to seek help	35 (45.5)	40 (61.5)
Risk of overload	38 (49.4)	14 (21.5)
Stress
Yes	28 (36.4)	22 (33.8)
No	49 (63.6)	43 (66.2)
Stress phase
Alert	1 (3.6)	0 (0.0)
Resistance	20 (71.4)	20 (90.9)
Near-exhaustion	5 (17.9)	2 (9.1)
Exhaustion	2 (7.1)	0 (0.0)
Symptoms of stress
Physical	8 (28.6)	6 (27.3)
Psychological	17 (60.7)	15 (68.2)
Physical and psychological	3 (10.7)	1 (4.5)
Symptoms of depression
Minimum	50 (64.9)	55 (84.6)
Light	11 (14.3)	6 (9.2)
Moderate	9 (11.7)	1 (1.5)
Severe	7 (9.1)	3 (4.6)

CP: Cirrhosis patient; LT: Liver transplantation.

Table 5 Comparative analysis of the factor scores of the models by dimension

Variables	CP (n = 77)	LT (n = 65)	P value	Rank-biserial r (95%CI)
General tension	0.16 (-1.22; 2.32)	-0.24 (-1.22; 1.93)	0.012a	0.211 (0.05-0.37)
Isolation	0.11 (-1.14; 2.57)	-0.40 (-1.11; 1.53)	0.014a	0.207 (0.04-0.35)
Disappointment	0.16 (-1.30; 2.46)	-0.25 (-1.30; 1.60)	0.004a	0.240 (0.09-0.38)
Emotional involvement	0.05 (-1.14; 2.43)	-0.20 (-1.14; 1.85)	0.068	0.153 (0.02-0.31)
Depression	0.07 (-1.24; 2.25)	-0.19 (-1.24; 1.96)	0.008a	0.225 (0.06-0.39)
Stress	0.12 (-0.95; 2.74)	-0.05 (-0.95; 1.58)	0.047a	0.167 (0.02-0.32)

^aP < 0.05.

Numerical variables are described as the median (minimum; maximum). CP: Cirrhosis patient; LT: Liver transplantation; CI: Confidence interval.