Impact of mental health and caregiver burden on family caregivers' physical health

Hsing-Yi Chang, Chii-Jun Chiou, Nain-Sen Chen, Hsing-Yi Chang, Chii-Jun Chiou, Nain-Sen Chen

Abstract

Caregivers providing care to chronically ill family members at home are potentially at risk for caregiver burden and declining physical and psychological health. This study aims to understand how family caregivers' mental health and caregiver burden affects physical health simultaneously, controlling for factors such as age, education level, caring hours per day, and emotional, functional, and physical support systems used by caregivers. We recruited 388 caregivers from Kaohsiung and Pingtong region in Taiwan. Caregivers had to be 18 years or older and spend most of their time taking care of an ill family member at home. Mental health was assessed by the 12-item Chinese Health Questionnaire (CHQ-12) and burden was measured using a modified scale for caregiver's burden. Health status was assessed by self-perceived health (SPH), illness symptoms and the number of diagnosed chronic diseases. A high number of hours per day of caregiving was associated with low emotional support and SPH, poor mental health and high burden. Higher emotional support was associated with better mental health and fewer illness symptoms. Higher physical support was associated with poorer mental health, higher burden, a greater number of illness symptoms and chronic diseases, and a lower SPH score. Hours per day of caregiving, and use of emotional, functional, and physical support were associated with mental health, and the hours per day of caregiving and use of physical support were predictors of burden. Mental health and burden were significantly associated with caregivers' health problems simultaneously. Our results show the important influence of mental health on caregivers' physical health. Interventions for caregivers need to target health in a holistic way.

Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.

Figures

Fig. 1
Fig. 1
Structural equation model for the physical health of caregivers.

References

    1. Beach S.R., Schulz R., Yee J.L., Jackson S. Negative and positive health effects of caring for a disabled spouse: longitudinal findings from caregiver health effects study. Psychol. Aging. 2000;15:259–271.
    1. Bull M.J. Factors influencing family caregiver burden and health. West. J. Nurs. Res. 1990;12:758–776.
    1. Chak A. Conceptualizing social support: a micro or macro perspective. Psychologia. 1996;39:74–83.
    1. Chen C.S., Tsang H.Y., Chong M.Y., Tang T.C. Validation of the Chinese Health Questionnaire (CHQ-12) in community elders. Kaohsiung J. Med. Sci. 2000;16:559–565.
    1. Chen, L.J., 2004. The Relationship Between Hardiness, Health Status, and Quality of Life Among Primary Caregivers Involved in Home Care. Master Thesis. Kaohsiung Medical University, Taiwan (in Chinese).
    1. Chiou C.J., Chen I.-P., Wang H.-H. The health status of family caregivers in Taiwan: an analysis of gender differences. Int. J. Geriatr. Psychiatry. 2005;20:821–826.
    1. Douglas S.L., Daly B.J. Caregivers of long-term ventilator patients: physical and psychological outcomes. Chest. 2003;123:1073–1081.
    1. Edwards N.E., Scheetz P.S. Predictors of burden for caregivers of patients with Parkinson's disease. J. Neurosci. Nurs. 2002;34:184–190.
    1. Grov E.K., Fosså S.D., Sørebø Ø., Dahl A.A. Primary caregivers of cancer patients in the palliative phase: a path analysis of variables influencing their burden. Soc. Sci. Med. 2006;63:2429–2439.
    1. Grunfeld E., Glossop R., McDowell I., Danbrook C. Caring for elderly people at home: the consequences to caregivers. Can. Med. Assoc. J. 1997;157:1101–1105.
    1. Happe S., Berger K. The association between caregiver burden and sleep disturbances in partners of patients with Parkinson's disease. Age Aging. 2002;31:349–354.
    1. Li L.W., Seltzer M.M., Greenberg J.S. Social support and depressive symptoms: differential patterns in wife and daughter caregivers. J. Gerontol. B: Psychol. Sci. Soc. Sci. 1997;52:S200–S211.
    1. Li T.-C., Lee Y.-D., Lin C.-C., Amidon R.L. Quality of life of primary caregivers of elderly with cerebrovascular disease or diabetes hospitalized for acute care: assessment of well-being and functioning using the SF-36 health questionnaire. Qual. Life Res. 2004;13:1081–1088.
    1. Lin Y.J., Wan T.T.H. Effect of organizational and environmental factors on service differentiation strategy of integrated healthcare networks. Health Serv. Manage. Res. 2001;14:18–26.
    1. Marriott A., Donaldson C., Tarrier N., Burns A. Effectiveness of cognitive-behavioral family intervention in reducing the burden of care in carers of patients with Alzheimer's disease. Br. J. Psychiatry. 2000;176:557–562.
    1. Morimoto T., Schreiner A.S., Asano H. Caregiver burden and health-related quality of life among Japanese stroke caregivers. Age Ageing. 2003;32:218–223.
    1. Nijboer C., Tempelaar R., Sanderman R., Triemstra M., Spruijt R.J., Van den Bos G.A. Cancer and caregiving: the impact on the caregiver's health. Psychooncology. 1998;7:3–13.
    1. Pickett S.A., Cook J.A., Cohler J., Solomon M.L. Positive parent/adult child relationships: impact of severe mental illness and caregiving burden. Am. J. Orthopsychiatry. 1997;67:220–230.
    1. Pohl J.M., Given C.W., Collins C.E., Given B.A. Caregiving in daughters and daughters-in-law caring for disabled aging parents. Health Care for Women Intern. 1994;15:385–395.
    1. Sander A.M., High W.M.J., Hannay H.J., Sherer M. Predictors of psycho-logical health in caregivers of patients with closed head injury. Brain Injury. 1997;11:235–249.
    1. Savard J., Lebel P., Béland F., Bergman H. Caregiver satisfaction with support services. J. Aging Health. 2006;18:3–27.
    1. Sawatzky J.E., Fowler-Kerry S. Impact of caregiving: listening to the voice of informal caregivers. J. Psychiatr. Ment. Health Nurs. 2003;10:277–286.
    1. Schulz R., Vistainer P., Williamson G.M. Psychiatric and physical morbidity effects of caregiving. J. Gerontol. B: Psychol. Sci. Soc. Sci. 1990;45:P181–P191.
    1. Schulz R., Beach S.R. Caregiving as a risk factor for mortality: the Caregiver Health Effects Study. J. Am. Med. Assoc. 1999;282:2215–2219.
    1. Song L., Biegel D.E., Milligan S.E. Predictors of depressive symptomatology among lower social class caregivers of persons with chronic mental illness. Commun. Mental Health J. 1997;33:269–286.
    1. Song L.Y. The development and validation of a caregiver burden scale- a focus on practice applicability. Soc. Policy Soc. Work. 2002;6:61–100. (in Chinese, with English abstract)
    1. Stommel M., Given C.W., Given B. Depression as an overriding variable explaining caregiver burdens. J. Aging Health. 1999;2:80–103.
    1. Thompson E.H., Futterman A.M., Gallagher-Thompson D., Rose J.M., Lovett S.B. Social support and caregiving burden in family caregivers of frail elders. J. Gerontol. B: Psychol. Sci. Soc. Sci. 1993;28:S245–S254.
    1. Waite A., Bebbington P., Skelton-Robinson M., Orrell M. Social factors and depression in caregivers of people with dementia. Int. J. Geriatric Psychiatry. 2004;19:582–587.
    1. Ward-Griffin C., McKeever P. Relationships between nurses and family caregivers: partners in care? Adv. Nurs. Sci. 2000;22:89–103.
    1. Ware J.E., Gandek B., The International Quality of Life Assessment Project Group The SF-36 health survey: development and use in mental health research and IQOLA project. Int. J. Ment. Health. 1994;23:49–73.
    1. White C.L., Mayo N., Hanley J.A.S., Wood-Dauphines S. Evolution of the caregiving experience in the initial 2 years following stroke. Res. Nurs. Health. 2003;26:177–189.

Source: PubMed

3
订阅