Factors Associated with Screening Positive for Depression among Women Caregivers of Primary Palliative Care Patients in Kerala, India

Background: The study encompasses findings from a prospective quantitative screening of women family caregivers for depression as part of a larger mixed methods study designed to develop and validate a caregiver burden inventory for the home-based palliative care programme in Kerala, India. Aim: We assessed the proportion of women caregivers screening positive for depression and explored the associated factors. Methods: The Primary care Screening Questionnaire for Depression (PSQ4D) was used to screen participants for depression. Other variables analysed were caregiver and patient related factors, stresses, strains, support received, caregiver burden and quality of life domain variables as per the EuroQol EQ-5D-5L instrument. Results: Forty women (20.0%, 95% Confidence Intervals [CI] 14.46% - 25.54%) screened positive for depression on the PSQ4D. This was more likely if the care recipient was the spouse, if the care recipient had cancer, if the caregiver perceived a moderate or high physical/psychological burden, or a high financial burden. Pain/ discomfort when included had an adjusted odds ratio (AOR) of 8.2 (95% CI 2.6-26.0) and tended to decrease the AOR of all other significantly associated variables, except cancer diagnosis in the care recipient. Conclusion: Depression levels among women caregivers in primary palliative care settings in Kerala seem comparable to prevalence levels among women in the general population. Those caregivers reporting pain/ discomfort should be screened for depression using simple locally validated measures. Depression is associated with higher caregiver burden and poorer quality of life. Screening and treatment of depression may help mitigate these situations.