Factors associated with caregiver burden among adults caring for children admitted with severe acute malnutrition at Mulago Hospital, Kampala.

Abstract

Caregiving burden negatively influences caregivers' responses to their roles. It encompasses the distress and/or the extent of perceived adverse effects arising from fulfilling physical, emotional, financial, social, and spiritual responsibilities while caring for a chronically ill child.In caregiving for children hospitalized with severe acute malnutrition(SAM) the caregiver has to attend to daily anthropometric measurements, attend education sessions, participate in tasks to prepare meals, investigations, social stimulation and protection. These may ellicit negative feelings of anxiety, anger, jitteriness, inadequacy etc. The consequences of which may lead to poor adherence to treatment instructions, incomplete therapy for the children, abandonment of care, poor recovery rates and deteriorating health of the child. The child’s state of illness, competing priorities of the caregiver, knowledge of caregiving tasks, marital status etc. can further affect the degree of burden. This study aimed to determine the extent of caregiver burden and the factors associated among adult caregivers of children admitted at Mulago Mwanamugimu nutrition unit in Kampala, Uganda. METHODS: A cross-sectional study design and consecutive sampling technique were used for the study. A total of 329 adult caregivers who attended at MHMNU were interviewed between 7th June and December 6th 2023. Using a validated Zarit Burden score tool(ZBI-22) which included caregiver characteristics, child characteristics, family, religious and community support, time motion and health facility’s data were collected, entered into EpiData and analyzed using SPSS15.Logistic regression analyses were also done. RESULTS: The extent of caregiver burden score was 69.8 in the sample. The prevalence of Little or no burden (0-21) was 5.8 %(n=19); mild to moderate (22-40) 0.9%(n=3); moderate to severe burden (41-60)19.2%(n=63) and severe burden was (61-88) 74.2%(n=244). 0-85 was conscripted as low burdened while 244 was severe burdened. Marriage/cohabiting was found to be protective against significant burden. A logistics regression model showed that burden was significant among the separated/divorced caregivers (AOR1.21; 95% CI1.05-1.39; p= 0.007), age greater than 35, (AOR 1.20; 95% CI 1.01-1.42; p= 0.033) and lack of professional information (AOR 5.47E-6; 95% CI 5.47E-6(7.65E-7-3.92E-5); p = <0.001). CONCLUSION: There is caregiver burden among adults caring for children with SAM admitted at Mulago Mwanamugimu nutrition unit. The factors significantly associated with caregiver burden in ascending strength are age >35,being separated/divorced and lack of professional knowledge provision on caregiving roles.