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Introduction: Caring for a child with a tracheostomy carries numerous financial, physical, and emotional challenges. Literature has shown that these caregivers experience burden that correlates with their child’s illness severity and their own mental health status. Caregivers of technology-dependent and chronically ill children have been found to have higher rates of depression, but similar findings have not been reported for pediatric tracheostomy caregivers. Thus, the objective of this study was to assess rates of depression among primary caregivers of children with tracheostomies.

Methods: A database of children (ages 0-18) with tracheostomies at a tertiary pediatric hospital was screened to identify patients’ primary caregivers. Exclusion criteria included state custody/foster care, lack of follow-up within the past 2 years, caregiver age < 18, and a caregiver-reported history of depression. Eligible caregivers were contacted over a 3-month period; participants completed a demographic form and the Beck Depression Inventory-II (BDI-II). Mental health resources were offered if BDI-II scores indicated any level of depression and caregivers agreed to receiving resources. Basic patient health data were also collected.

Results: Of 207 children, 129 had caregivers eligible for participation. Forty-five caregivers (35% response rate) participated; 6 had prior diagnoses of depression, leaving 39 caregivers for analysis. The majority of caregivers were female (95%), aged 25-44 (77%), white/Caucasian (77%), married (77%), and receiving some Medicaid benefits (97%). Of 38 caregivers who completed the BDI-II, 29% (11) met criteria for at least mild clinical depression, with 7/11 meeting criteria for moderate or severe depression. Only 1 of these 11 caregivers agreed to receive mental health resources. There was no significant association between BDI-II scores and patient comorbidities or caregiver insurance, age, gender, or race.

Conclusion: Nearly 1/3 of our pediatric tracheostomy caregivers had some degree of clinical depression based on BDI-II scores. To our knowledge, this is the first study assessing rates of depression within this caregiver cohort. Based on our findings, these caregivers’ psychosocial needs may benefit from further exploration to enhance available supportive resources.

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Rate Of Depression Among Primary Caregivers Of Children With Tracheostomies