An online cross-sectional survey of the health risk behaviours among informal caregivers

Caring for yourself while you care for someone else: a qualitative study exploring the mental and cardiovascular health behaviours of female carers of stroke survivors

PURPOSE

Female carers of stroke survivors may experience increased risk of developing chronic health issues, such as cardiovascular disease. This study aims to understand: (i) how female carers of stroke survivors manage their mental and cardiovascular health and (ii) the characteristics they would find helpful in an intervention to support their ability to manage their health and wellbeing.

MATERIALS AND METHODS

A qualitative descriptive design was used with data collected via semi-structured interviews and analysed using inductive thematic analysis.

RESULTS

Eighteen female carers of stroke survivors participated in the study. Three key themes were identified: (i) struggling to prioritise own health and wellbeing; (ii) new roles and responsibilities impact on self-care; and (iii) peer-support improves mental health and well-being. Carers described preferences for group interventions to include peer support and have flexible delivery to allow easy access to information. One-to-one sessions with different health professionals may also be useful at times through the caregiving journey.

CONCLUSIONS

These findings suggest that current interventions do not address cardiovascular risk self-management for female carers and provide insight into characteristics of interventions that may increase acceptability and feasibility of interventions to support long-term cardiovascular and mental health-promoting behaviours.

Caregiving and allostatic load predict future illness and disability: A population-based study

Background

Caring for sick or disabled relatives is a key model for understanding the effects of chronic stress on immunity/inflammation; biomarkers which are part of an index of allostatic load. Here, we examine whether caring and allostatic load are predictive of future illness/disability and if the association between caring and illness/disability is mediated by allostatic load.

Method

Using data from the Understanding Society Wave 2 (2011) and Wave 9 (2017–2019) datasets in the UK, a sample of 471 of caregivers and 2,151 non-caregivers (all initially healthy) were compared on allostatic load and future illness/disability.

Results

Caregivers had higher allostatic risk scores, for total as well as immune and non-immune biomarkers, and were more likely (23.3% vs 17.4%) to have an illness/disability in the future compared to non-caregivers. Moreover, caregiving was responsible for a 33% future illness/disability risk. Further, allostatic load was also predictive of excess risk (OR ​= ​1.18, 95% CI ​= ​1.08 – 1.26; p ​< ​.001); higher allostatic load was associated with increased risk of illness/disability in the future. In an unadjusted mediation model, allostatic load mediated the association between caregiving and future illness/disability. However, after controlling for confounding, the mediation became non-significant.

Conclusions

These results confirm that caregiving and allostatic load are damaging for future health. Results are also discussed in relation to public health aspects of caregiving.

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Caregivers have a greater risk of future illness and disability relative to non-caregivers.

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Allostatic load is higher among caregivers.

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Risk of illness and disability continued beyond cessation of caring.

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Caregiving and allostatic load predicted future illness and disability.