Psychosocial and behavioral effects on patient caregivers of prolonged mechanical ventilation in a respiratory care center: A longitudinal study

A BSTRACT Objectives: Prolonged mechanical ventilation presents substantial challenges not only for patients but also for family caregivers. Although clinical outcomes are often prioritized, the psychosocial and behavioral burden experienced by caregivers remains underexplored, particularly during hospitalization in respiratory care centers (RCCs). Materials and Methods: This longitudinal study examined changes in caregiver well-being before and after RCC admission in northern Taiwan. From January to December 2024, primary family caregivers completed a 15-item questionnaire at admission and discharge, covering stress, physical symptoms, health behaviors, financial strain, and social support. Paired differences were analyzed using the Wilcoxon signed-rank test. Results: A total of 85 caregiver-patient dyads were analyzed. Significant improvements were observed in caregiver psychological stress ( Z = −2.179, P = 0.029, r = 0.235), emotional distress ( Z = −2.673, P = 0.008, r = 0.288), physical activity ( Z = −2.11, P = 0.035, r = 0.23), and appetite ( Z = −2.49, P = 0.013, r = 0.27). However, physical fatigue, sleep quality, and unhealthy coping behaviors remained unchanged. Financial stress and perceived insufficiency of financial resources also showed no significant improvements. Surprisingly, perceived social support declined following patient hospitalization ( Z = −2.72, P = 0.006, r = 0.29), suggesting a shift in family dynamics during institutional care. Conclusion: Hospitalization in an RCC may alleviate the emotional and behavioral burden on caregivers. However, persistent challenges, including physical strain, maladaptive coping, and financial hardship, remain. These findings highlight the need for caregiver-centered interventions addressing emotional resilience, family support systems, and long-term care planning beyond the hospitalization phase.