1
|
Keller AO, Ohlendorf JM. Engagement in physical activity among African American women caregivers: a cross-sectional study. J Women Aging 2024; 36:286-298. [PMID: 38441910 DOI: 10.1080/08952841.2024.2325201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 02/26/2024] [Indexed: 06/18/2024]
Abstract
Family caregivers and African Americans often do not achieve the recommended 150 minutes of moderate-intensity aerobic activity per week. Factors associated with engaging in physical activity among African American caregivers have not been systematically examined. This cross-sectional study examined how contextual factors were associated with meeting the recommended amount of physical activity among African American women caregivers. We used a population-based sample of 1,478 African American women caregivers in the U.S. from the 2015, 2017, and 2019 Behavioral Risk Factor Surveillance System. We used survey-weighted multivariate regression analyses to examine associations between condition-specific factors, physical and social environment, and individual and family factors and meeting the national aerobic physical activity guideline (i.e., participating in 150 minutes (or vigorous equivalent minutes) of physical activity per week). Over half (53.9%) of African American women caregivers in the U.S. did not meet the guideline. Being age 65 years or older was associated with decreased odds of meeting the guideline compared to being between the ages of 25-44 years (OR = 0.50, 95% CI[0.26-0.99]). Compared to college graduates, women with partial college education had higher odds of meeting the guideline (OR = 2.08, 95%CI[1.24-3.51]). Having health insurance was associated with increased odds of meeting the guideline (OR = 2.28, 95%CI[1.12-4.63]). Our findings suggest several contextual factors are independently associated with meeting the national guideline. Understanding the relationships between contextual factors and engaging in physical activity among African American women caregivers can inform interventions aimed at protecting and promoting the health of these women.
Collapse
Affiliation(s)
- Abiola O Keller
- College of Nursing, Marquette University, Milwaukee, WI, USA
| | | |
Collapse
|
2
|
Baik D, Centi S, McNair B. Caregiving intensity and duration, cardiovascular disease, and race/ethnicity in family caregivers of persons with dementia. Geriatr Nurs 2024; 56:173-183. [PMID: 38354660 PMCID: PMC10990827 DOI: 10.1016/j.gerinurse.2024.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 01/28/2024] [Accepted: 02/05/2024] [Indexed: 02/16/2024]
Abstract
We investigated if caregiving intensity and duration affected cardiovascular disease (CVD) risks and diagnosis and whether the relationship differed by race and ethnicity in family caregivers (FCGs) of persons with dementia. We conducted a secondary analysis of the 2015-2020 CDC Behavioral Risk Factor Surveillance System data using a logistic regression analysis. A total of 6132 dementia FCGs were included. We found that the more time FCGs spent providing care per week (intensity) or over time (duration), the more likely they reported CVD risks and diagnosis. However, the associations between caregiving intensity and CVD risks and diagnosis did not differ by race and ethnicity, nor did the associations between caregiving duration and the outcomes. These findings suggest future studies should be conducted to develop preventive strategies for FCGs' cardiovascular health. Further work is needed to identify the impact of race and ethnicity on the relationship between caregiving conditions and CVD with larger samples of racial and ethnic minorities.
Collapse
Affiliation(s)
- Dawon Baik
- College of Nursing, University of Colorado, 13120 E. 19th Ave., Aurora, CO 80045, USA.
| | - Sophia Centi
- College of Nursing, University of Colorado, 13120 E. 19th Ave., Aurora, CO 80045, USA
| | - Bryan McNair
- Department of Biostatistics and Informatics, Colorado School of Public Health University of Colorado, USA
| |
Collapse
|
3
|
Chu HS, Jang HY. Predictors of Sleep Quality in Spouse Caregivers of Community-Dwelling People With Dementia Using Propensity Score Matching Analysis. J Nurs Res 2023; 31:e299. [PMID: 37962915 DOI: 10.1097/jnr.0000000000000582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Many family caregivers of people with dementia (PwDs) have sleep problems and poor sleep quality. Sleep may be negatively affected by caring for a family member with dementia, especially a spouse. PURPOSE This study was designed to assess sleep quality in spouse caregivers of PwDs and determine the impact of care provision on their sleep quality. METHODS A secondary analysis of 58,050 participants in the 2018 Korea Community Health Survey was conducted. To prevent selection bias, a propensity score matching analysis was performed. Multiple logistic regression analysis was conducted to investigate the predictors of sleep quality. RESULTS After obtaining a propensity score matching threshold of 3:1, the percentage of poor sleepers was 24.2% in the control group and 33.3% in the spouse-caregiver group, which indicates a significant difference (χ 2 = 11.79, p = .001). After adjusting for depressive symptoms in the multiple logistic analyses, no intergroup difference was found in terms of risk of poor sleep quality (odds ratio = 1.12, 95% CI [0.90, 1.61]). CONCLUSIONS/IMPLICATIONS FOR PRACTICE The findings of this study support that spouse caregivers of PwDs have poorer sleep quality than their nonspouse peers and that management of depressive symptoms is important to improving the sleep quality of spouses providing care to PwDs. Nursing interventions such as light therapy and exposure to sunlight during daytime hours to both improve sleep quality and reduce depressive symptoms can improve sleep quality in this vulnerable caregiver group.
Collapse
Affiliation(s)
- Hyeon Sik Chu
- PhD, RN, Assistant Professor, College of Nursing, Dankook University, Republic of Korea
| | - Hye-Young Jang
- PhD, RN, Associate Professor, College of Nursing, Hanyang University, Seoul, Republic of Korea
| |
Collapse
|
4
|
Ao SH, Zhang L, Liu PL, Zhao X. Social media and partnership jointly alleviate caregivers' psychological distress: exploring the effects of online and offline connectedness. BMC Psychol 2023; 11:394. [PMID: 37964344 PMCID: PMC10647055 DOI: 10.1186/s40359-023-01415-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 10/26/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND The prevalence of caregiving in the United States has increased from 16.6% to 19.2% during the period between 2015 and 2020. Caregivers play a critical public health role post-pandemic and as the population ages. However, caregiving can be detrimental to the health of caregivers. Many studies have shown that communication and connectedness are effective forms of health intervention for caregivers, but how this can be achieved requires further investigation. OBJECTIVE This study aimed to investigate the indirect effect of caregiving on problems of alcohol drinking through psychological distress. Moreover, this study aimed to provide initial evidence of the distinct effects of online and offline communication and connectedness on caregivers' well-being. METHODS The predictions were evaluated by examining responses to the Health Information National Trends Survey 2020 (n = 3,865). A mediation analysis was conducted to test the mediating effect of psychological distress on the association between caregiving and alcohol drinking. A second-level moderation analysis was performed. The online communication and connectedness, social media use for health, and the offline type, marital or romantic partnership, were tested as moderators to lessen the psychological distress of caregiving. RESULTS A competitive mediation was identified. We found a positive indirect effect from caregiving to alcohol drinking mediated by psychological distress (bp = .0017, p < .05) but a negative direct effect from caregiving to alcohol drinking (bp = -.0340, p < .05). Furthermore, the study reported a strongly positive effect of moderated moderation on the linkage from caregiving to psychological distress. The negative impact of caregiving on mental distress was greater among those who used social media less, particularly those without a romantic or marital partner. CONCLUSIONS The findings indicate that caregivers experience more mental distress, which leads to risky behavior. This study highlights the crucial role of both online and offline connectedness in mitigating the adverse consequences of caregiving.
Collapse
Affiliation(s)
- Song Harris Ao
- Department of Communication / Institute of Collaborative Innovation / Center for Research in Greater Bay Area, University of Macau, Macau, China
| | - Luxi Zhang
- Department of Communication / Institute of Collaborative Innovation, University of Macau, Macau, China
| | - Piper Liping Liu
- Department of Communication / Institute of Collaborative Innovation, University of Macau, Macau, China
| | - Xinshu Zhao
- Department of Communication / Institute of Collaborative Innovation / Center for Research in Greater Bay Area, University of Macau, Macau, China.
| |
Collapse
|
5
|
Baik D, Centi S, McNair B. Assessing Racial and Ethnic Differences in Cardiovascular Disease in U.S. Family Caregivers of Persons With Dementia: Analysis of Data from the 2015-2020 Behavioral Risk Factor Surveillance System. Res Gerontol Nurs 2023; 16:241-249. [PMID: 37450782 PMCID: PMC10990473 DOI: 10.3928/19404921-20230706-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/15/2023]
Abstract
The current study examined racial and ethnic differences in psychological, behavioral, and metabolic risk factors for cardiovascular disease (CVD) and CVD conditions among family caregivers (FCGs) of persons with dementia. We used the 2015-2020 Behavioral Risk Factor Surveillance System data. The sample included a total of 6,132 FCGs of persons with dementia. Compared to non-Hispanic White FCGs, non-Hispanic Black and non-Hispanic Asian FCGs were less likely to have depression. The Other racial/ethnic FCG group was more likely to currently smoke. Non-Hispanic Black FCGs were less likely to have exercised, more likely to be obese, and more likely to have been diagnosed with diabetes. No differences in CVD conditions (e.g., angina/coronary heart disease, stroke, myocardial infarction) were detected between racial/ethnic minority FCGs and non-Hispanic White FCGs. Future studies should investigate relationships between racial/ethnic minority-specific caregiving and CVD by including a larger, racially and ethnically diverse population of FCGs. [Research in Gerontological Nursing, 16(5), 241-249.].
Collapse
|
6
|
Fuchs J, Gaertner B, Rommel A, Starker A. Informal caregivers in Germany - who are they and which risks and resources do they have? Front Public Health 2023; 11:1058517. [PMID: 36875417 PMCID: PMC9978811 DOI: 10.3389/fpubh.2023.1058517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 01/24/2023] [Indexed: 02/18/2023] Open
Abstract
Background The aim of this study is to describe the social characteristics, the health and living situation and the prevalence of behavioral risk factors of adult informal caregivers compared to non-caregivers in Germany. Methods We used data from the German Health Update (GEDA 2019/2020-EHIS survey) which is a cross-sectional population-based health interview survey conducted between 04/2019 and 09/2020. The sample comprised 22,646 adults living in private households. Three mutually exclusive groups of providing informal care or assistance were differentiated: intense caregivers (informal care ≥10 h/week), less-intense caregivers (informal care<10 h/week) and non-caregivers. For the three groups weighted prevalences of social characteristics, health status (self-perceived health, health-related activity limitations, chronic diseases, low back disorder or other chronic back defect, depressive symptoms), behavioral risk factors (at-risk drinking, current smoking, insufficient physical activity, non-daily fruit and vegetable consumption, obesity) and social risk factors (single household, low social support) were calculated and stratified by gender. Separate regression analyses adjusted for age-group were conducted to identify significant differences between intense and less-intense caregivers vs. non-caregivers, respectively. Results Overall, 6.5% were intense caregivers, 15.2% less-intense caregivers and 78.3% non-caregivers. Women provided care more often (23.9%) than men (19.3%). Informal care was most frequently provided in the age group of 45 to 64 years. Intense caregivers reported worse health status, were more often current smokers, physical inactive, obese and lived less often alone than non-caregivers. However, in age-group adjusted regression analyses only few significant differences were seen: Female and male intense caregivers had more often a low back disorder and lived less often alone compared to non-caregivers. In addition, male intense care-givers reported more often worse self-perceived health, health-related activity limitation, and the presence of chronic diseases. In contrast, less-intense caregivers and non-caregivers differed in favor of the less-intense caregivers. Discussion A substantial proportion of the adult German population provides informal care regularly, especially women. Intense caregivers are a vulnerable group for negative health outcomes, especially men. In particular measures to prevent low back disorder should be provided. As the necessity of providing informal care will probably increase in the future, this will be important for the society and public health.
Collapse
Affiliation(s)
- Judith Fuchs
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Beate Gaertner
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Alexander Rommel
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Anne Starker
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| |
Collapse
|
7
|
Zan H, Shin SH. The positive impact of informal spousal caregiving on the physical activity of older adults. Front Public Health 2022; 10:977846. [PMID: 36589971 PMCID: PMC9800888 DOI: 10.3389/fpubh.2022.977846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 12/01/2022] [Indexed: 12/23/2022] Open
Abstract
Introduction Although physical activity (PA) is crucial for health, the literature is mixed about how individuals' PA decisions are affected by their spouses. To fill this gap, we examined the extent to which providing care for one spouse affects the PA of the other spouse among those aged 50 or older in the United States. Methods We analyzed 9,173 older adults living with their spouses or partners from the 2004 to 2016 waves of the Health and Retirement Study. To identify the causal effect of spousal caregiving on the PA of older adults, we estimated individual-fixed effects models using a two-stage least squared instrumental variable approach with spousal falls as our instrument. We also estimated the models by splitting the sample by gender and race/ethnicity to identify heterogeneous impacts of spousal caregiving on PA decisions among subgroups. Results We found that a one percentage point increase in the probability of providing care to spouses led to an increase in the probability of initiating moderate or vigorous PA (MVPA) by 0.34-0.52 percentage points. This effect was salient, especially among female and non-Hispanic white older adults. Discussion Caregiving experience might provide opportunities to learn about caregiving burdens and trigger an emotional response about the salience of an event (i.e., they need care in the future). Older caregivers might start MVPA in an effort to improve or maintain their health and avoid burdening their families for caregiving in the future. This study demonstrated spousal influence on PA. Instead of delivering PA-promotion information (e.g., the harm of sedentary lifestyle and benefits of regular PA) to individuals, risk communication and education efforts on PA promotion might be more effective considering the family context. Family events such as health shocks or the emergence of caregiving needs from family members provide windows of opportunities for intervening. Subgroup differences should also be considered in targeted interventions.
Collapse
Affiliation(s)
- Hua Zan
- Center on the Family, University of Hawai'i at Mānoa, Honolulu, HI, United States,*Correspondence: Hua Zan, ✉
| | - Su Hyun Shin
- Department of Family and Consumer Studies, University of Utah, Salt Lake City, UT, United States
| |
Collapse
|
8
|
LaVela SL, Pedersen J, Ehrlich-Jones L, Heinemann AW. Positive and negative ways that informal caregivers are affected by weight and weight management efforts for care recipients with spinal cord injury. Disabil Rehabil 2022; 44:7152-7160. [PMID: 34613825 DOI: 10.1080/09638288.2021.1985629] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE To understand how informal caregivers are affected by weight and weight management of care recipients with SCI. MATERIALS AND METHODS In-depth qualitative interviews were conducted with 24 informal caregivers of community-dwelling Veterans and civilians with SCI. Thematic analysis was conducted. RESULTS Three themes described how the care recipient's weight management efforts impacted the caregiver, including: (1) motivation and involvement in weight management efforts for themselves, (2) emotional well-being (positive and negative aspects), and (3) physical tasks (both ease and burden). Caregivers may experience emotional and/or physical burden by taking on extra caregiving tasks to help with care recipient's weight management. Caregivers also may experience positive impacts from the care recipient's weight management efforts, regardless of who drove the efforts, including improvement in their own motivation and involvement in weight management, enhanced emotional well-being (happiness for and with the care-recipient), and making physical caregiving tasks easier. CONCLUSIONS Rehabilitation providers can use these findings to educate dyads about potential impacts of weight management efforts for the care recipient, specifying areas that may cause burden but emphasizing the potential benefits for both recipient and caregiver. Integrating this education into rehabilitation practice may reduce overweight-related problems with function and declines in disability among dyads.Implications for RehabilitationInformal caregivers experience both positive and negative consequences with regard to weight management for individuals with SCI.Helping their loved one with weight management can facilitate informal caregivers' involvement in their own weight management activities.Findings may offer guidance to healthcare and rehabilitation providers as they incorporate weight management into education programs for informal caregivers of persons with SCI.Integrating this education into rehabilitation practice may reduce or delay overweight-related problems with function and declines in disability among dyads.
Collapse
Affiliation(s)
- Sherri L LaVela
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Department of Veterans Affairs, Edward Hines Jr. VA Hospital, Hines, IL, USA.,Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Jessica Pedersen
- Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Midwest Regional SCI Care System (MRSCICS), Shirley Ryan AbilityLab (SRAlab), Chicago, IL, USA
| | - Linda Ehrlich-Jones
- Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Midwest Regional SCI Care System (MRSCICS), Shirley Ryan AbilityLab (SRAlab), Chicago, IL, USA
| | - Allen W Heinemann
- Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Midwest Regional SCI Care System (MRSCICS), Shirley Ryan AbilityLab (SRAlab), Chicago, IL, USA
| |
Collapse
|
9
|
Weinstein JM, Kahkoska AR, Berkowitz SA. Food Insecurity, Missed Workdays, And Hospitalizations Among Working-Age US Adults With Diabetes. Health Aff (Millwood) 2022; 41:1045-1052. [PMID: 35787082 PMCID: PMC9840294 DOI: 10.1377/hlthaff.2021.01744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Food insecurity is associated with poor clinical outcomes among adults with diabetes, but associations with nonclinical outcomes, such as missed work, have not been well characterized. Our objective was to assess the associations between food insecurity, health-related missed workdays, and overnight hospitalizations. We pooled National Health Interview Survey data from the period 2011-18 to analyze food insecurity among 13,116 US adults ages 18-65 who had diabetes. Experiencing food insecurity, compared with being food secure, was associated with increased odds of reporting any health-related missed workdays, more than twice the rate of health-related missed workdays, and increased odds of overnight hospitalization within the prior twelve months. There was no significant association between food insecurity and the number of nights spent hospitalized. These findings underscore the broad impacts of food insecurity on health and wellness for working-age adults with diabetes. When weighing the costs and benefits of proposed interventions to address food insecurity, policy makers should consider potential benefits related to productivity in addition to implications for health care use.
Collapse
Affiliation(s)
- Joshua M. Weinstein
- Department of Health Policy and Management, Gillings School
of Global Public Health, University of North Carolina at Chapel Hill
| | - Anna R. Kahkoska
- Department of Nutrition, Gillings School of Global Public
Health, University of North Carolina at Chapel Hill
| | - Seth A. Berkowitz
- Division of General Medicine and Clinical Epidemiology,
Department of Medicine, University of North Carolina at Chapel Hill School of
Medicine, Chapel Hill, NC
| |
Collapse
|
10
|
Secinti E, Wu W, Kent EE, Demark-Wahnefried W, Lewson AB, Mosher CE. Examining Health Behaviors of Chronic Disease Caregivers in the U.S. Am J Prev Med 2022; 62:e145-e158. [PMID: 34579984 DOI: 10.1016/j.amepre.2021.07.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 06/13/2021] [Accepted: 07/13/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Many informal caregivers experience a significant caregiving burden, which may interfere with their health behaviors. Caregiver health behaviors may vary by disease context, but this has rarely been studied. This study compares the health behaviors of prevalent groups of chronic illness caregivers (i.e., dementia, cancer, chronic obstructive pulmonary disease/emphysema, diabetes) with those of noncaregivers and examines whether caregiving intensity is associated with these behaviors. METHODS In 2021, using pooled cross-sectional 2015-2019 Behavioral Risk Factor Surveillance System data, health behaviors (i.e., physical activity, diet, alcohol use, smoking, sleep, and influenza immunization) of caregivers of patients with dementia (n=5,525), cancer (n=4,246), chronic obstructive pulmonary disease/emphysema (n=1,959), and diabetes (n=2,853) and noncaregivers (n=203,848) were compared. Relationships between caregiving intensity (e.g., hours, type of tasks) and caregiver health behaviors were examined. Regression analyses were used to compare groups. RESULTS Compared with noncaregivers, caregiver groups were more likely to report engaging in both risky (i.e., smoking, shorter sleep duration) and health-promoting (i.e., physical activity, vegetable consumption, abstaining from heavy drinking) behaviors, whereas nonsignificant differences were observed for influenza immunization. Longer caregiving hours and providing help with personal care were associated with poorer health behaviors (e.g., shorter sleep duration). Few differences in health behaviors were observed between caregivers of patients with dementia and other caregiver groups. CONCLUSIONS Results suggest that caregivers are more likely to engage in both risky and health-promoting behaviors than noncaregivers. Furthermore, findings suggest that greater caregiving responsibilities are associated with certain risky health behaviors. Findings support the development and implementation of strategies to improve caregivers' health behaviors across disease contexts.
Collapse
Affiliation(s)
- Ekin Secinti
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana.
| | - Wei Wu
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana
| | - Erin E Kent
- Department of Health Policy and Management, UNC Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Wendy Demark-Wahnefried
- Department of Nutrition Sciences, School of Health Professions, The University of Alabama at Birmingham, Birmingham, Alabama
| | - Ashley B Lewson
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana
| | - Catherine E Mosher
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana
| |
Collapse
|
11
|
Kim A, Woo K. Gender differences in the relationship between informal caregiving and subjective health: the mediating role of health promoting behaviors. BMC Public Health 2022; 22:311. [PMID: 35168596 PMCID: PMC8845367 DOI: 10.1186/s12889-022-12612-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 01/18/2022] [Indexed: 11/26/2022] Open
Abstract
Background In most of developed societies, the prevalence of informal care is on the rise due to rapid population ageing. This study investigates longitudinal associations between informal caregiving and health among caregivers and potential gender differences in this relationship. Moreover, drawing on the Health Promotion Model, this study examines the mediating role of health promoting behaviors in the link between informal caregiving and caregiver’s health. Methods Seven waves of a large-scale (N = 9,608), a nationally representative longitudinal study of middle- and old-aged adults in Korea between 2006 and 2018, were used. To address the possibility of omitted variable bias, this study employed ordinary least squares models with lagged dependent variables (OLS-LDV) as well as fixed effects (FE) models. Univariate Sobel-Goodman mediation tests were used. Results Findings from OLS-LDV models showed that transition into informal caregiving is negatively associated with health satisfaction and self-rated health. FE results also suggest that our results are robust to controlling for unobserved heterogeneity. In the model where informal caregiving is interacted with gender, we found that these associations were largely driven by women caregivers. Results from Sobel-Goodman tests revealed that a decrease in regular exercise partially explains the observed association between informal caregiving and subjective health outcomes (11% for health satisfaction and 8% for self-rated health). Conclusions Although informal caregiving can be a rewarding role, it poses a threat to caregiver’s subjective health. Findings of this hold important implications and provide evidence in support of a gender-conscious approach to improve the health and well-being of informal caregivers. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12612-3.
Collapse
Affiliation(s)
- Aeri Kim
- Center for Human-Caring Nurse Leaders for the Future By Brain Korea 21 (BK 21) four project, College of Nursing, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul, Republic of Korea, 03080
| | - Kyungmi Woo
- College of Nursing, Research Institute of Nursing Science, Seoul National University, 103 Daehak-ro, Jongno-gu, Republic of Korea, Seoul, 03080.
| |
Collapse
|
12
|
Simón MA, Bueno AM, Blanco V, Otero P, Vázquez FL. Prevalence and Associated Factors with Poor Sleep Quality in Non-Professional Caregivers. J Clin Med 2022; 11:719. [PMID: 35160171 PMCID: PMC8836703 DOI: 10.3390/jcm11030719] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/24/2022] [Accepted: 01/27/2022] [Indexed: 02/05/2023] Open
Abstract
This study aimed to determine the prevalence and associated factors of poor sleep quality in non-professional caregivers. With this purpose, cross-sectional data were collected from 201 dependent people's family caregivers using the Pittsburgh Sleep Quality Index (PSQI), the Caregiver Burden Inventory (CBI), the General Health Questionnaire (GHQ-12), and an ad hoc questionnaire to obtain sociodemographic data. A total of 153 family caregivers were categorized as poor sleepers (PSQI > 5), resulting in a prevalence of poor sleep quality of 76.1% (95% CI = 70.5-82.5). Poor sleepers were more likely to care for persons with mental disorders (χ2 = 7.31; p < 0.01) and scored significantly higher on perceived burden (z = -4.44; p < 0.001), psychological distress (z = -6.24; p < 0.001), and in all the PSQI subscales (p < 0.001), compared with good sleepers (PSQI ≤ 5). By contrast, no differences were found between poor and good sleepers in age, gender, years providing care, and daily hours of care. Multiple linear regression analysis showed that the factors of caregiver burden (β = 0.15; p < 0.05) and psychological distress (β = 0.53; p < 0.001) were significantly associated with sleep quality in dependent people's family caregivers. Cognitive-behavioral strategies to improve sleep quality in the primary health care of family caregivers are suggested.
Collapse
Affiliation(s)
- Miguel A. Simón
- Health Psychology Research Unit, Department of Psychology, University of A Coruña, 15071 A Coruña, Spain; (A.M.B.); (P.O.)
| | - Ana M. Bueno
- Health Psychology Research Unit, Department of Psychology, University of A Coruña, 15071 A Coruña, Spain; (A.M.B.); (P.O.)
| | - Vanessa Blanco
- Department of Evolutionary and Educational Psychology, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain;
| | - Patricia Otero
- Health Psychology Research Unit, Department of Psychology, University of A Coruña, 15071 A Coruña, Spain; (A.M.B.); (P.O.)
| | - Fernando L. Vázquez
- Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain;
| |
Collapse
|
13
|
The prevalence of physical activity among informal carers: a systematic review of international literature. SPORT SCIENCES FOR HEALTH 2022. [DOI: 10.1007/s11332-021-00893-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
14
|
Garcia‐Rudolph A, Sauri J, Garcia‐Molina A, Cegarra B, Opisso E, Tormos JM, Frey D, Madai VI, Bernabeu M. The impact of coronavirus disease 2019 on emotional and behavioral stress of informal family caregivers of individuals with stroke or traumatic brain injury at chronic phase living in a Mediterranean setting. Brain Behav 2022; 12:e2440. [PMID: 34910375 PMCID: PMC8785633 DOI: 10.1002/brb3.2440] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 10/30/2021] [Accepted: 11/03/2021] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION Even in nonpandemic times, persons with disabilities experience emotional and behavioral disturbances which are distressing for them and for their close persons. We aimed at comparing the levels of stress in emotional and behavioral aspects, before and during coronavirus disease 2019 (COVID-19), as reported by informal family caregivers of individuals with chronic traumatic brain injury (TBI) or stroke living in the community, considering two different stratifications of the recipients of care (cause and injury severity). METHODS We conducted a STROBE-compliant prospective observational study analyzing informal caregivers of individuals with stroke (IC-STROKE) or traumatic brain injury (IC-TBI). IC-STROKE and IC-TBI were assessed in-person before and during COVID-19 online, using the Head Injury Behavior Scale (HIBS). The HIBS comprises behavioral and emotional subtotals (10 items each) and a total-HIBS. Comparisons were performed using the McNemar's test, Wilcoxon signed-rank test or t-test. Recipients of care were stratified according to their injury severity using the National Institutes of Health Stroke Scale (NIHSS) and the Glasgow Coma Scale (GCS). RESULTS One hundred twenty-two informal caregivers (62.3% IC-STROKE and 37.7% IC-TBI) were assessed online between June 2020 and April 2021 and compared to their own assessments performed in-person 1.74 ± 0.88 years before the COVID-19 lockdown. IC-STROKE significantly increased their level of stress during COVID-19 in five emotional items (impatience, frequent complaining, often disputes topics, mood change and overly sensitive) and in one behavioral item (overly dependent). IC-TBI stress level only increased in one behavioral item (impulsivity). By injury severity, (i) mild (14.7%) showed no significant differences in emotional and behavioral either total-HIBS (ii) moderate (28.7%) showed significant emotional differences in two items (frequent complaining and mood change) and (iii) severe (56.6%) showed significant differences in emotional (often disputes topics) and behavioral (impulsivity) items. CONCLUSIONS Our results suggest specific items in which informal caregivers could be supported considering cause or severity of the recipients of care.
Collapse
Affiliation(s)
- Alejandro Garcia‐Rudolph
- Universitat Autònoma de BarcelonaBellaterraCerdanyola del VallèsSpain
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i PujolBadalonaSpain
- Institut Guttmann Hospital de NeurorehabilitacioBadalonaSpain
| | - Joan Sauri
- Universitat Autònoma de BarcelonaBellaterraCerdanyola del VallèsSpain
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i PujolBadalonaSpain
- Institut Guttmann Hospital de NeurorehabilitacioBadalonaSpain
| | - Alberto Garcia‐Molina
- Universitat Autònoma de BarcelonaBellaterraCerdanyola del VallèsSpain
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i PujolBadalonaSpain
- Institut Guttmann Hospital de NeurorehabilitacioBadalonaSpain
| | - Blanca Cegarra
- Universitat Autònoma de BarcelonaBellaterraCerdanyola del VallèsSpain
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i PujolBadalonaSpain
- Institut Guttmann Hospital de NeurorehabilitacioBadalonaSpain
| | - Eloy Opisso
- Universitat Autònoma de BarcelonaBellaterraCerdanyola del VallèsSpain
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i PujolBadalonaSpain
- Institut Guttmann Hospital de NeurorehabilitacioBadalonaSpain
| | - Josep Maria Tormos
- Universitat Autònoma de BarcelonaBellaterraCerdanyola del VallèsSpain
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i PujolBadalonaSpain
- Institut Guttmann Hospital de NeurorehabilitacioBadalonaSpain
| | - Dietmar Frey
- CLAIM Charité Lab for AI in MedicineCharité Universitätsmedizin BerlinBerlinGermany
| | - Vince Istvan Madai
- CLAIM Charité Lab for AI in MedicineCharité Universitätsmedizin BerlinBerlinGermany
- QUEST Center for Transforming Biomedical ResearchBerlin Institute of Health (BIH), Berlin, Germany, Charité – Universitätsmedizin BerlinBerlinGermany
- School of Computing and Digital TechnologyFaculty of Computing, Engineering and the Built Environment, Birmingham City UniversityUnited Kingdom
| | - Montserrat Bernabeu
- Universitat Autònoma de BarcelonaBellaterraCerdanyola del VallèsSpain
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i PujolBadalonaSpain
- Institut Guttmann Hospital de NeurorehabilitacioBadalonaSpain
| |
Collapse
|
15
|
Gavrilov B, Schmidt M, Kasten S, Sommer S, Hunzelar C, Bockheim F, Paños-Willuhn J, Offenberg L, Oberholz M, Ikar N, Weltermann B. More GP contacts and poorer health of informal caregivers with low socioeconomic status in Germany: results from the population-based DEGS1 and the cross-sectional GPCare-1 study. BMJ Open 2021; 11:e053146. [PMID: 36916141 PMCID: PMC8719219 DOI: 10.1136/bmjopen-2021-053146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Informal caregivers are known to have poorer mental health. Risk factors for caregiver burden include low education, female gender, cohabitation with the care recipient and lack of resources. General practitioners (GPs) have an important role in supporting caregivers. Drawing on data from two surveys, associations between caregivers' socioeconomic status (SES), psychophysical health and GP contacts are analysed. DESIGN Cross-sectional study. The study draws on data from two surveys (German Health Interview and Examination Survey for Adults, DEGS1 and General Practice Care-1, GPCare-1). SETTING Germany. PARTICIPANTS DEGS1: German general population (18+ years) n=7987. GPCare-1: general practice patients (18+ years) n=813. PRIMARY OUTCOME Psychophysical health, GP contacts and communication. METHODS Using representative DEGS1 data, the prevalence of informal caregivers, caregivers' burden, chronic stress, various health conditions and frequency of GP contacts were evaluated stratified by SES. Data from the GPCare-1 study addressed caregivers' experiences and communication preferences with GPs. RESULTS In the DEGS1, the prevalence of caregivers was 6.5%. Compared with non-caregivers, caregivers scored significantly higher for chronic stress (15.45 vs 11.90), self-reported poor health (37.6% vs 23.7%) and GP visits last year (3.95 vs 3.11), while lifestyle and chronic diseases were similar. Compared with caregivers with medium/high SES, those with low SES had a significantly lower prevalence of high/medium caregiver burden (47.9% vs 67.7%) but poorer self-reported health (56.9% vs 33.0%), while other characteristics did not differ. In the GPCare-1 study, the prevalence of caregivers was 12.6%. The majority of them felt that their GP takes their problems seriously (63.6%) without difference by SES. CONCLUSION Caregivers with low SES constitute an especially high-risk group for psychological strain, requiring special GP attention to support their needs.
Collapse
Affiliation(s)
- Boris Gavrilov
- Institute of General Practice and Family Medicine, University Hospital Bonn, Bonn, Germany
| | - Manuela Schmidt
- Institute of General Practice and Family Medicine, University Hospital Bonn, Bonn, Germany
| | - Stefanie Kasten
- Institute of General Practice and Family Medicine, University Hospital Bonn, Bonn, Germany
| | - Samira Sommer
- Institute of General Practice and Family Medicine, University Hospital Bonn, Bonn, Germany
| | - Carmen Hunzelar
- Institute of General Practice and Family Medicine, University Hospital Bonn, Bonn, Germany
| | - Florian Bockheim
- Institute of General Practice and Family Medicine, University Hospital Bonn, Bonn, Germany
| | - Joana Paños-Willuhn
- Institute of General Practice and Family Medicine, University Hospital Bonn, Bonn, Germany
| | - Luisa Offenberg
- Institute of General Practice and Family Medicine, University Hospital Bonn, Bonn, Germany
| | - Maja Oberholz
- Institute of General Practice and Family Medicine, University Hospital Bonn, Bonn, Germany
| | - Nur Ikar
- Institute of General Practice and Family Medicine, University Hospital Bonn, Bonn, Germany
| | - Birgitta Weltermann
- Institute of General Practice and Family Medicine, University Hospital Bonn, Bonn, Germany
| |
Collapse
|
16
|
Predicting Caregiver Burden in Informal Caregivers for the Elderly in Ecuador. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197338. [PMID: 33049971 PMCID: PMC7579437 DOI: 10.3390/ijerph17197338] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 09/30/2020] [Accepted: 10/02/2020] [Indexed: 12/24/2022]
Abstract
Informal caregivers are the main providers of care for the elderly. The aim of this study is to examine the predictive value of different variables regarding caregivers and their elderly patients with respect to the caregiver’s burden. A convenience sample of 688 informal caregivers and 688 elderly people from Ecuador was surveyed. Only households with one caregiver and one elderly person were considered for the study. For informal caregivers, the following standardized measures were obtained: burden (Zarit Burden Interview), neuroticism (Eysenck Personality Questionnaire Revised-Abbreviated, EPQR-A), caregiver’s general health (GHQ-12), and social support (modified Duke-UNC Functional Social Support Questionnaire, FSSQ11). For the elderly, we employed standardized measures of cognitive function (short portable mental status questionnaire, SPMSQ), Pfeiffer’s test, and functional dependency (Barthel scale/Index, BI). Females were over-represented in caregiving and reported significantly higher burden levels than those of males. In both male and female caregivers, the burden was best predicted by the time of caring, neuroticism, and elderly cognitive impairment. However, some predictors of burden were weighted differently in males and females. The functional independence of the elderly was a significant predictor of burden for male caregivers but not females, while caregiver competence was a significant predictor for females but not males. These variables accounted for more than 88% of the variability in informal caregivers.
Collapse
|