Social Support and Stress among Caregivers of Hemodialysis Patients in Nakhon Nayok Province.

Abstract

      This descriptive cross-sectional analysis focuses on social support, stress, and the association between social support and stress levels experienced by caregivers of hemodialysis patients in the Nakhon Nayok Province. The data was collected from December 2021 to April 2022. The sample was selected from the list of hemodialysis patients receiving services at general hospitals in the Nakhon Nayok Province. To guarantee that each unit of the population had an equal chance of being included in the study, systematic random sampling was used. A total of 200 caregivers were recruited for the study. There was face-to-face interviews by well-trained research assistants. The questionnaires covered caregivers’ general characteristics, stress levels, and social support. The following descriptive statistics were used: number, percent, and mean. Multiple linear regression analysis was applied to identify the relationship between independent variables and stress levels at a statistical significance of less than 0.05.

The results found that 61.5% of the sample were female with an average age of 48.31 ± 12.90 years, 32.0% held a bachelor's degree, followed by 22.0% with primary school diplomas. 69.0% were married, 58.0% had no underlying disease, and 32% had hypertension. The caregivers’ average income was 16,653.7 baht per month, and the average time period for taking care of hemodialysis patients was 4.31 years, with 2-3 hours per day. About 67.5% had knowledge and understanding of how to take care of hemodialysis patients.

The study found that the social support was in the range of moderate to high. 71% of patients received their social support from family members, followed by 43.5% and 6.0% from relatives and health professionals, respectively. Caregivers’ overall stress level was at 18.5%, moderate to high was at 0.5%, with the highest physical stress at 6.5%. Moderate to high economic stress was found in 6.0% of cases.

The study revealed that caregivers’ characteristics and social support were highly related to their stress levels. Caregivers with health problems showed higher stress levels than healthy caregivers (p < 0.001), and greater social support from healthcare professionals increased caregivers’ stress levels (p = 0.003). Caregivers who had to assist patients with daily activities had higher stress levels than those who did not have to do that (p = 0.005). Social support from relatives also increased caregivers’ stress (p = 0.011). Caregivers who were responsible for the extra medical fee of patients showed higher stress levels than those who were not (p = 0.032). Caregivers who had insufficient income had higher stress levels than those who had enough income (p = 0.033). Caregivers with higher levels of education showed less stress than those with lower education levels (p = 0.047). Therefore, when controlling the remaining variables in the equation, the study found that the patient characteristics, caregivers’ characteristics, and social support can jointly explain the variation of 50.7% of caregivers’ stress.

The results of this study suggest there should be an assistant to take care of the patient. So that caregivers have time to rest and have time for personal activities. By using social support from family, relatives, and community health networks to take part in caring for patients.

This study was approved by The Ethics Committee of Thammasat University (COA No. 118/2564). Permission to conduct research was given on November 6, 2021.