Factors Associated with Elevated Depression in Family Caregivers of End Stage Kidney Disease in Nairobi County, Kenya

Winnie Waiyaki, PhD., Lincoln Khasakhala, PhD., Rebecca Oladipo, PhD., (Daystar University)

Abstract

Following a diagnosis of kidney failure, known as End Stage Kidney Disease (ESKD), the patient is normally required to undergo dialysis to sustain life. For most patients, the family is the most affected as it has to cope with changes in medication, diet and dialysis. Usually, one or two members of the family become primarily responsible for taking care of the patient and are referred to as the family caregivers (FCGs). Studies have shown that this population has an onerous caregiving burden with the patient requiring much care due to the unique demands of ESKD which may lead to psychological difficulties, including depression. However, little research has been done regarding the development of depression in this population, yet ESKD is considered a family matter. There is therefore, the need to consider the incidence of and factors associated with depression among FCGs of patients with ESKD. In a cross-sectional study, using a convenience sample of 96 FCGs and their patients in various hospitals in Nairobi and the Beck’s Depression Inventory (BDI) tool, this study found that 33.3% of  the sample, with a mean depression score of 18.9 (+ 6.5 SD) had mild depression. There was no significant association between most socio-demographic and socio-behavioural characteristics of the patients and FCGs and FCG depression that were measured. These variables included substance abuse, age, duration of care for patient and educational level of FCGs and patients. However, gender was found to be significantly associated with depression among the FCGs. Additionally, those not residing with the patients had a significantly high level of depression than those residing with the patients. These findings are significant for clinical practice for the multi-disciplinary team involved in ESKD that includes the medical and psychological practitioners.

Key Words: End stage kidney disease, family caregivers, depression