Violent Patient Behavior Is Associated with Bodily Pain and a High Burden on Informal Caregivers
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There have been no studies of the relationship between violent behavior by older patients and the physical and mental health of caregivers.
To evaluate the influence of violent behavior in vulnerable elderly patients on bodily pain and caregiver burden in their informal caregivers.
One hundred thirty-seven patients aged ≥40 years old with limited activity and mobility in ten facilities providing home-care services in Japan.
Degree of caregiver-perceived violent patient behavior and caregivers’ bodily pain derived from a self-administered questionnaire, and caregiver burden assessed using scores from both the Burden Index of Caregivers and the Zarit Burden Interview.
The mean age of the 137 patients enrolled in this study was 80.9 years. Of these patients, 31.4% were men, and 34.3% had violent behavior. The mean caregiver age was 65.0 years, and 29.2% were men. Caregivers who looked after violent patients experienced significantly higher odds of having bodily pain [AOR = 3.51; 95% confidence interval (CI): 1.81 to 6.85]. Caregivers of violent patients also reported significant caregiver burden as assessed by the Burden Index of Caregivers (β-coefficient = 4.92; 95% CI: 1.95 to 7.88) and the Zarit Burden Interview (β-coefficient = 5.81; 95% CI: 2.92 to 8.70).
Violent behavior among older patients is associated with significant increases in both physical and psychological burden in their informal caregivers.
- Brodaty H, Low L. Aggression in the elderly. J Clin Psychiatry. 2003;64(Suppl 4):36–43.
- Raskind M. Evaluation and management of aggressive behavior in the elderly demented patient. J Clin Psychiatry. 1999;60(Suppl 15):45–9.
- Duffin C. Managing violent patients. Nurs Older People. 2007;19:14–6.
- Elliott F. Violence. The neurologic contribution: an overview. Arch Neurol. 1992;49:595–603.
- Paradiso S, Robinson R, Arndt S. Self-reported aggressive behavior in patients with stroke. J Nerv Ment Dis. 1996;184:746–53. CrossRef
- Thompson M. Violence and the costs of caring for a family member with severe mental illness. J Health Soc Behav. 2007;48:318–33. CrossRef
- Abe K. Reconsidering the caregiving stress appraisal scale: validation and examination of its association with items used for assessing long-term care insurance in Japan. Arch Gerontol Geriatr. 2007;44:287–97. CrossRef
- Miyashita M, Yamaguchi A, Kayama M, et al. Validation of the Burden Index of Caregivers (BIC), a multidimensional short care burden scale from Japan. Health Qual Life Outcomes. 2006;4:52. CrossRef
- Zarit S, Reever K, Bach-Peterson J. Relatives of the impaired elderly: correlates of feelings of burden. Gerontologist. 1980;20:649–55.
- Arai Y, Kudo K, Hosokawa T, et al. Reliability and validity of the Japanese version of the Zarit Caregiver Burden interview. Psychiatry Clin Neurosci. 1997;51:281–7. CrossRef
- Caqueo-Urízar A, Gutiérrez-Maldonado J. Burden of care in families of patients with schizophrenia. Qual Life Res. 2006;15:719–24. CrossRef
- Serrano-Aguilar P, Lopez-Bastida J, Yanes-Lopez V. Impact on health-related quality of life and perceived burden of informal caregivers of individuals with Alzheimer’s disease. Neuroepidemiology. 2006;27:136–42. CrossRef
- Kim S, Kim J, Stewart R, et al. Correlates of caregiver burden for Korean elders according to cognitive and functional status. Int J Geriatr Psychiatry. 2006;21:853–61. CrossRef
- Chou K. Reciprocal relationship between pain and depression in older adults: evidence from the English Longitudinal Study of Ageing. J Affect Disord. 2007;102:115–23. CrossRef
- Breivik H, Borchgrevink P, Allen S, et al. Assessment of pain. Br J Anaesth. 2008;101:17–24. CrossRef
- Bousema E, Verbunt J, Seelen H, et al. Disuse and physical deconditioning in the first year after the onset of back pain. Pain. 2007;130:279–86. CrossRef
- Kumamoto K, Arai Y. Validation of ‘personal strain’ and ‘role strain’: subscales of the short version of the Japanese version of the Zarit Burden Interview (J-ZBI_8). Psychiatry Clin Neurosci. 2004;58:606–10. CrossRef
- Wang J, Lin J, Lee F. Psychologically abusive behavior by those caring for the elderly in a domestic context. Geriatr Nurs. 2006;27:284–91. quiz 92. CrossRef
- Restrepo H, Rozental M. The social impact of aging populations: some major issues. Soc Sci Med. 1994;39:1323–38. CrossRef
- Khaw K. How many, how old, how soon? BMJ. 1999;319:1350–2.
- Schulz R, Beach S. Caregiving as a risk factor for mortality: the Caregiver Health Effects Study. JAMA. 1999;282:2215–9. CrossRef
- Hurwitz E, Morgenstern H, Yu F. Cross-sectional and longitudinal associations of low-back pain and related disability with psychological distress among patients enrolled in the UCLA Low-Back Pain Study. J Clin Epidemiol. 2003;56:463–71. CrossRef
- Arnow B, Hunkeler E, Blasey C, et al. Comorbid depression, chronic pain, and disability in primary care. Psychosom Med. 68:262–8.
- Berger G, Bernhardt T, Weimer E, et al. Longitudinal study on the relationship between symptomatology of dementia and levels of subjective burden and depression among family caregivers in memory clinic patients. J Geriatr Psychiatry Neurol. 2005;18:119–28. CrossRef
- Violent Patient Behavior Is Associated with Bodily Pain and a High Burden on Informal Caregivers
Journal of General Internal Medicine
Volume 24, Issue 10 , pp 1085-1088
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- violent behavior
- bodily pain
- caregiver burden
- informal caregivers
- Industry Sectors
- Author Affiliations
- 1. Department of Epidemiology and Healthcare Research, Graduate School of Medicine, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, Kyoto, 606–8501, Japan
- 2. Department of Dermatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan