Ameliorating Caregiver Burden in the Pediatric Palliative Population Utilizing a Psychophysiological Intervention

Background: Providing long-term care for a family member can be a source of severe stress for the untrained caregiver, and is known to cause depression, poor overall health, and lower quality of life for the caregiver. This burden may lead to poorer outcomes for the patient, as well as contribute to overall increasing costs of an already strained healthcare system. The purpose of this quality improvement project was to reduce the stress that accompanies caregiver burden through the intervention of diaphragmatic breathing. Method: Diaphragmatic breathing is a low-cost, psychophysiological intervention found to be helpful for reducing stress, which is a significant component of caregiver burden. Caregivers of pediatric patients enrolled in a homecare program were assessed for caregiver burden utilizing the Zarit Burden Interview-12 (ZBI-12). Those who had scored 15 or higher on the ZBI-12 were taught diaphragmatic breathing, and assessed again, two months after using the intervention. Results: A paired dependent t-test revealed that palliative caregivers showed a reduction in ZBI-12 assessment score after implementation of a diaphragmatic breathing intervention (m = 17.4, s = 6.7), compared to before implementation of a diaphragmatic breathing intervention (m = 12.8, s = 8.6), t(11) = 2.513 , P < .05. Conclusion: The intervention resulted in less anxiety, stress, depression, and burnout among the pediatric palliative caregivers. Improvement of caregiver well-being was evidenced by decreased ZBI-12 scores in a postintervention assessment.