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The Influence of the Caregiver on Healthcare Outcomes in Patients with Chronic Obstructive Pulmonary Disease (COPD)

Hammonds, Tracy Lynn
http://orcid.org/0000-0001-8292-1898
http://rave.ohiolink.edu/etdc/view?acc_num=kent1426543939

Abstract Details

2015, PHD, Kent State University, College of Arts and Sciences / Department of Psychological Sciences.
Research has shown that the rate of depression in patients with COPD is higher than in other chronic diseases and that depression in this population negatively impacts self-care (Qian et al., 2013). Unfortunately, depression is poorly managed in COPD patients (Norwood & Balkissoon, 2005); thus necessitating the development of alternative ways to manage COPD in the home. Often the burden of COPD management falls on an informal caregiver, who is expected to provide instrumental support by assisting with activities of daily living (Gardiner et al., 2010). Unfortunately, many informal caregivers lack the mental and physical capacity necessary to perform these activities. The aim of this investigation was to identify whether mental and physical morbidity in the informal caregivers of depressed patients with COPD influenced healthcare utilization in this population. Participants for this study were 50 COPD patients and their caregivers who were recruited from the pulmonary physicians’ practices, pulmonary function testing laboratories, and pulmonary rehabilitation programs associated with a single, multi-center health system. The patients were asked to complete an in-home interview that addressed questions related to symptomology, adherence, healthcare utilization, and depression. In addition, presence of anxiety, depression, and physical morbidity were addressed during the caregiver interview. A moderated mediation analysis was conducted using structural equation modeling. Results of the analysis showed that patient depression was related to increased self-report of symptoms related to shortness of breath, decreased willingness to adhere to health behaviors, and increased healthcare facility admissions. Unexpectedly, the presence of physical morbidities in the caregiver attenuated the positive relationship between patient depression and healthcare utilization, although this became non-significant after controlling for patient age and COPD severity. In conclusion, results of this study showed that depression in patients with COPD is responsible for increased healthcare utilization and that the health of the caregiver may impact this relationship. Further studies are merited in order to more fully elucidate the impact of the caregiver on patient outcomes in order to develop appropriate care coordination and support mechanisms for those managing COPD within the home.
Joel Hughes, PhD (Advisor)
John Gunstad, PhD (Committee Member)
John Updegraff, PhD (Committee Member)
Barbara Drew, PhD (Committee Member)
Wendy Umberger, PhD (Committee Member)
57 p.
Experimental Psychology; Health
COPD; chronic obstructive pulmonary disease; respiratory; pulmonary,depression; anxiety; health habits; caregiver; utilization

Recommended Citations

Citations

  • Hammonds, T. L. (2015). The Influence of the Caregiver on Healthcare Outcomes in Patients with Chronic Obstructive Pulmonary Disease (COPD) [Doctoral dissertation, Kent State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=kent1426543939

    APA Style (7th edition)

  • Hammonds, Tracy. The Influence of the Caregiver on Healthcare Outcomes in Patients with Chronic Obstructive Pulmonary Disease (COPD). 2015. Kent State University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=kent1426543939.

    MLA Style (8th edition)

  • Hammonds, Tracy. "The Influence of the Caregiver on Healthcare Outcomes in Patients with Chronic Obstructive Pulmonary Disease (COPD)." Doctoral dissertation, Kent State University, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=kent1426543939

    Chicago Manual of Style (17th edition)

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© 2015, all rights reserved.
This open access ETD is published by Kent State University and OhioLINK.