Primary care can relieve stress for patients caring for family members

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Primary care physicians can help relieve stress in patients who in turn are caring for others.

A new study found patients who had better primary care experiences also had lower stress due to aiding parents, children, and spouses who cannot carry out essential tasks, without pay. Most helpful were longitudinality, or focusing attention on individual patients as whole persons, and comprehensiveness in building provider-patient relationships that make consultation easier when needed.

“Family caregivers may be positively influenced in their caregiving experience by person-centered, high-quality primary care,” the study said. The finding may be important due to the graying not just of America, but the world.

“With a rapidly aging world population and increasing incidence of chronic illness, older people rely increasingly on family members to support their daily activities, extending the roles and needs of family caregivers,” the study said. But that work can generate mental and emotional stress that contributes to mortality of caregivers.

The study involved 406 family caregivers around Tokyo, Japan, with 48.8% of the reporting higher caregiver stress. The were aged 40 to 74 years and cared for family members using that nation’s Long-Term Care Insurance for at least a year.

Respondents answered questionnaires about personal strain, such as feeling angry around the person or a desire to leave care to someone else, and role strain, such as feeling their social lives have suffered because of caring for a relative.

They also evaluated their primary care experiences using the Japanese version of a rating scale developed from the Primary Care Assessment Tool by the Johns Hopkins Primary Care Policy Center.

The researchers proffered several hypotheses about how primary care attributes influence caregiver stress.

For example, “physicians who provide holistic care with longitudinal responsibility recognize that the person in front of them provides care for their loved ones, and may naturally engage in conversation s regarding caregiving,” the study said. “Such conversations may provide emotional support and, as a result, reduce caregivers’ stress related to caregiving.”

Measuring comprehensiveness did not include direct wording regarding family caregiving. But “family caregivers who experienced better comprehensiveness (services) available may have felt that they could receive advice and support regarding caregiving from their physicians. This could contribute to reducing the caregiver stress,” the study said.

The researchers acknowledged previous reports about caregivers and primary care from Germany and Canada, and limitations in the research. But the study “is the first to reveal an association between family caregivers’ primary care experience and their stress, using (an) internationally established measure as a tool for assessing the quality of primary care.”

The study, “Association between family caregivers' primary care experience when they report as patients and their stress related to caregiving: A pilot cross-sectional study,” was published in the Journal of General and Family Medicine.