Burden and resilience in caregivers of patients on maintenance haemodialysis


  • Jomon Joy Department of Psychiatry, Travancore Medical College, Kollam, Kerala, India
  • Hussain Khan T. J. Department of Medicine, Travancore Medical College, Kollam, Kerala, India
  • Pretty M. Abraham Department of Cancer Research Rajiv Gandhi Centre for biotechnology, Trivandrum, Kerala, India
  • Sreedas Gopalakrishnan Department of Nephrology, Travancore Medical College, Kollam, Kerala, India




Burden, Caregiver, Chronic renal failure, Haemodialysis, Resilience


Background: Chronic renal failure is one among the chronic illness which due to persistence of the disease has various effects on the physiological, psychological and functional ability of the patient and his family. Although haemodialysis has become a highly safe medical procedure that significantly extended life of such patients, it is nevertheless a stressful and lengthy treatment process. The task of personal life care for such patients falls primarily on the family members. The caregiver is expected to aid in patient’s daily life activities resulting in increased physical and emotional burden. With the considerable level of burden involved the concept of resilience thus become crucial as they could function as protective factors. The current study aims to assess the level of caregiver burden and resilience in caregivers of haemodialysis patients.

Methods: A cross sectional observational study was done in 120 caregivers of patients diagnosed as having ESRD on maintenance hemodialysis. Zarit Burden Interview was used for assessing caregiver’s burden. Brief Resilience Scale was used to assess caregiver’s resilience.

Results: 35.8% of caregivers had severe caregiver burden while looking after dialysis patients while 45% of caregivers had moderate burden. Caregivers showed low resilience about 72.5% which displays poor problem solving and emotion-focused coping strategies.

Conclusions: The study shows that more than 80% of caregivers suffered from moderate to severe burden and poor resilience among them would be a contributing factor. The study also shows that female caregivers were most affected. The burden was significantly higher in caregivers as the years spent on caregiving increased and more hours spent per day looking after the patients. Health-care providers need to address these concerns based on both patient- and caregiver-focused approaches, rather than only patient focused.


Singh AK, Farag YM, Mittal BV, Subramanian KK, Reddy SR, Acharya VN, et al. Epidemiology and risk factors of chronic kidney disease in India–results from the SEEK (Screening and Early Evaluation of Kidney Disease) study. BMC nephrology. 2013 Dec;14(1):114.

Yeh SC, Huang CH, Chou HC. Relationships among coping, comorbidity and stress in patients having haemodialysis. J Advanced Nursing. 2008 Jul;63(2):166-74.

Griffin KW, Wadhwa NK, Friend R, Suh H, Howell N, Cabralda T, et al. Comparison of quality of life in hemodialysis and peritoneal dialysis patients. In Advances in peritoneal dialysis. Conference on peritoneal dialysis. 1994;(10):104-8.

Collins LG, Swartz K. Caregiver care. Am Fam Physician. 2011 Jun 1;83(11):1309-17.

Simon BS, Budó ML, Garcia RP, Gomes TF, Oliveira SG, Silva MM. Social support network to the caregiving family of an individual with a chronic disease: integrative review. J Nursing UFPE Online. 2013;7:4243-50.

Robinson K. The relationships between social skills, social support, self‐esteem and burden in adult caregivers. J Advanced Nursing. 1990 Jul;15(7):788-95.

Dias R, Santos RL, Sousa MF, Nogueira MM, Torres B, Belfort T, et al. Resilience of caregivers of people with dementia: a systematic review of biological and psychosocial determinants. Trends Psychiat Psychot. 2015 Mar;37(1):12-9.

Gaugler JE, Kane RL, Newcomer R. Resilience and transitions from dementia caregiving. J Gerontol Series B: Psycholo Sci Social Sci. 2007 Jan 1;62(1):P38-44.

Han J, Kim KW, Kim TH, Jeong H, Park JY, Youn J, et al. The impact of social support on caregiver burden in dementia. Alzheimer's and Dementia: J Alzheimer's Assoc. 2012 Jul 1;8(4):P249.

Séoud JN, Ducharme F. Factors associated with resilience among female family caregivers of a functionally or cognitively impaired aging relative in Lebanon: A correlational study. J Resea Nursing. 2015 Nov;20(7):567-79.

Yap P. Validity and reliability of the Zarit Burden Interview in assessing caregiving burden. Ann Acad Med Singapore. 2010;39:758-63.

Smith BW, Dalen J, Wiggins K, Tooley E, Christopher P, Bernard J. The brief resilience scale: assessing the ability to bounce back. Intern J Behavioral Med. 2008 Sep 1;15(3):194-200.

Mashayekhi F, Pilevarzadeh M, Rafati F. The assessment of caregiver burden in caregivers of hemodialysis patients. Materia socio-medica. 2015 Oct;27(5):333-6.

Jafari H, Ebrahimi A, Aghaei A, Khatony A. The relationship between care burden and quality of life in caregivers of hemodialysis patients. BMC nephrology. 2018 Dec;19(1):321.




How to Cite

Joy, J., T. J., H. K., Abraham, P. M., & Gopalakrishnan, S. (2019). Burden and resilience in caregivers of patients on maintenance haemodialysis. International Journal of Research in Medical Sciences, 7(11), 4033–4037. https://doi.org/10.18203/2320-6012.ijrms20194586



Original Research Articles