Documentation and interventions in the problem of caregiver burden

The research study by Ågren et al. ¹ has a number of issues that affect conclusions and recommendations. First, conclusions and recommendations are drawn in the study that go far beyond the data in the study or in the literature that was cited. The authors concluded that ‘a partner-centered approach to educate and support patients with HF and their partners is essential’. However, the authors did not study the effect of partner-centered approaches, so they have no evidence to bear on whether this would be more effective or not. This requires a needed experimental study. The study also concludes that ‘interventions to improve self-care in patients with chronic HF should also include their partners in order to strengthen the relationship during the illness process’. Neither interventions nor the strength of the relationship were studied, so there is no evidence provided to support these conclusions.

A broader issue is that caregiver research has completely fallen off the tracks. An endless series of studies have shown how big caregiver burden is, who is more susceptible, the impact that suffering has on both the patient and the participant, and more. A study published over two decades ago concluded that burden was related to worsening mental and physical health of patients and participants, ² a conclusion that sounds the same as that of this study: ‘We found that a higher degree of caregiver burden was related to worse physical function of the patient’. On the other hand, studies that test interventions to improve caregiver burden ³ are rare, as a quick literature search can attest. A focus on effective interventions for easing caregiver burden rather than endlessly documenting the burden is long overdue.

The study has many strengths, including a large sample size, high quality measurement instruments, clear depiction of previous research on caregivers and caregiver burden, a thorough listing of study limitations, and good writing. However, the weakness of the findings and the jumping to conclusions indicate that healthcare professionals should not count on interventions geared toward the caregiving partner to be effective in easing caregiver burden.

The authors affirm that they have received no funding and have no conflicts of interest related to this analysis.