Caregivers' Descriptions of Sleep Changes and Depressive Symptoms

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Abstract
To describe caregiver sleep and depression using caregiver narratives. To compare qualitative descriptions with quantitative scores. Descriptive, one-time, open-ended interview followed by structured sleep and depression questions. Interview conducted in person or via telephone at caregiver's preference. 47 caregivers of patients with advanced stage cancer. Caregivers had a mean age of 54 years, and most were female (81%), Caucasian (82%), and spouses (61%). They provided care for a mean of 24 months. Patients' diagnoses were lung cancer (36%), colorectal cancer (13%), or recurrences (51%). Two cancer care sites in southern California provided participants. After consent, the researcher conducted interviews. The Pittsburgh Sleep Quality Index (PSQI) and Center for Epidemiological Studies-Depression (CES-D) instruments were administered following interviews. Sleep pattern changes and depression levels over time as defined by caregivers. Caregivers described severe fluctuations in sleep patterns over time and how these changes affected caregiver depressive symptoms. PSQI and CES-D scores matched narrative comments. Caregivers' narratives suggest they suffer progressive sleep deprivation that affects their emotions and ability to continue as caregivers. Nurses must recognize the severe sleep problems experienced by caregivers and respond with interventions to increase sleep quality and decrease depression.