The Stressful Caregiving Adult Reactions to Experiences of Dying (SCARED) Scale: a measure for assessing caregiver exposure to distress in terminal care

Am J Geriatr Psychiatry. 2003 May-Jun;11(3):309-19.

Abstract

Objective: The authors evaluated the performance of the Stressful Caregiving Adult Reactions to Experiences of Dying (SCARED) scale, a new tool to assess caregiver exposure to patient distress, and the fear and helplessness evoked by these experiences.

Methods: The SCARED was administered to 76 hospice-patient caregivers (e.g., family members). Major depressive disorder (MDD) was diagnosed with the Structured Clinical Interview for the DSM-IV; complicated grief (CG) "caseness" was diagnosed with the Inventory of Complicated Grief-Caregiver items, and quality-of-life domains were assessed with the Medical Outcomes Survey Short Form-36.

Results: Respondents endorsed frequent exposure to each SCARED experience-from 30.3% who mistakenly thought the patient had died, to 80.3% who witnessed the patient in severe pain. Adjusted analyses revealed that the odds of MDD increased by 3.08 for each standard-deviation increase in the SCARED event frequency score and that higher SCARED scores were positively associated (p <0.05) with social and role impairment, less energy, and more negative health perceptions.

Conclusion: The SCARED may be a clinically useful tool for identifying caregivers at risk for MDD and quality-of-life impairments, as well as potential aspects of caregiving to target for treatment.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Attitude to Death*
  • Caregivers / psychology*
  • Cross-Sectional Studies
  • Depressive Disorder, Major / epidemiology
  • Depressive Disorder, Major / etiology
  • Female
  • Humans
  • Male
  • Stress, Psychological / epidemiology
  • Stress, Psychological / etiology
  • Stress, Psychological / psychology*
  • Surveys and Questionnaires*
  • Terminal Care*