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 Table of Contents  
LETTER TO EDITOR
Year : 2019  |  Volume : 35  |  Issue : 4  |  Page : 246

Comment on the Article “Assessment of Caregiver Burden and Their Quality of Life at a Tertiary Care Center: A Cross-Sectional Study”


Department of Psychiatry, IMH, Rohtak, Haryana, India

Date of Submission24-May-2019
Date of Acceptance01-Sep-2019
Date of Web Publication15-Nov-2019

Correspondence Address:
Dr. Mayank Jain
Department of Psychiatry, IMH, Rohtak, Haryana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijsp.ijsp_55_19

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How to cite this article:
Jain M, Khurana H, Sethi S, Batra P. Comment on the Article “Assessment of Caregiver Burden and Their Quality of Life at a Tertiary Care Center: A Cross-Sectional Study”. Indian J Soc Psychiatry 2019;35:246

How to cite this URL:
Jain M, Khurana H, Sethi S, Batra P. Comment on the Article “Assessment of Caregiver Burden and Their Quality of Life at a Tertiary Care Center: A Cross-Sectional Study”. Indian J Soc Psychiatry [serial online] 2019 [cited 2019 Dec 11];35:246. Available from: http://www.indjsp.org/text.asp?2019/35/4/246/271098



Sir,

We have read the article, “Assessment of caregiver burden and their quality of life at a tertiary care center: A cross-sectional study.”[1] Finding it interesting and having utility in service and policy-making, we discussed this article in our academic forum too. The work gives an insight about role of economic factors, physical comorbidities, and duration of care giving in caregiver burden. Many studies have been done earlier;[2],[3] however, those apparently did not gain any attention of the authors and policy-makers. This study being the replication of previously available findings does not add anything new but strengthens the previously observed findings. However, it seems that the policy-makers overlooked the findings of these studies,[2],[3] leading the authors to state that some employment benefit needs to be given to the family of mentally ill persons. Besides this, the study is likely to contribute little to the understanding due to the methodological shortcomings. Inclusion of both indoor and outdoor patients in the small sample along with four diagnostic categories makes it too heterogeneous leading to more chances of type-II error.[4] Further, the indoor and outdoor groups have different factors accounting for burden such as hospital stay and absence from job and hence should not be mixed especially when the sample is small. Inclusion criteria do not take into consideration how caregivers were defined free from any mental illness and duration of care giving needed to classify them as primary caregivers. Using government identity cards for economic classification serves as an extra tool which can be covered through Kuppuswamy scale. Only one measure for socioeconomic status either using state issued identity cards or Kuppuswamy scale could have been sufficient. In [Table 7], the authors have given mean and standard deviation values for the sources of variance instead of mean square values, making the ANOVA results difficult to verify.[5] In the discussion, it is not clear why authors felt that remaining unemployed in productive years will lead to better care giving as mentioned. This also contradicts burden difference in those above and below poverty line in the sample. The observation about burden of care among those above and below poverty line could have been more clear, had the authors matched both groups for employment status. Not matching on employment status is confounding the results with economic status. The title of the study would have been better if it could highlight the patient population under study. It is difficult to guess from the title that the study refers to the mentally ill patients.

Last but not the least, we agree with the authors that now instead of focusing more on gathering data about burden of care, the policy-makers should consider the data available for social welfare schemes for the caregivers and the patients with mental illness.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Puzhakkal JC, Kallivayalil RA, Sudhakar S. Assessment of caregiver burden and their quality of life at a tertiary care center: A cross-sectional study. Indian J Soc Psychiatry 2019;35:88-92.  Back to cited text no. 1
  [Full text]  
2.
Swapna B, Sudarshan CY, Shamshad B. Burden on caregivers in bipolar affective disorder and alcohol. Int J Biol Med Res 2012;3:1992-7.  Back to cited text no. 2
    
3.
Hyder S, Chenganakkattil S, Babu J. Comparison of caregiver's burden in schizophrenia and alcohol dependence syndrome. J Community Health Manag 2016;3:213-6.  Back to cited text no. 3
    
4.
Banerjee A, Chitnis UB, Jadhav SL, Bhawalkar JS, Chaudhury S. Hypothesis testing, type I and type II errors. Ind Psychiatry J 2009;18:127-31.  Back to cited text no. 4
[PUBMED]  [Full text]  
5.
Kim HY. Analysis of variance (ANOVA) comparing means of more than two groups. Restor Dent Endod 2014;39:74-7.  Back to cited text no. 5
    




 

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