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Gaspar T, Raimundo M, de Sousa SB, Barata M, Cabrita T. Relationship between Burden, Quality of Life and Difficulties of Informal Primary Caregivers in the Context of the COVID-19 Pandemic: Analysis of the Contributions of Public Policies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5205. [PMID: 36982114 PMCID: PMC10048817 DOI: 10.3390/ijerph20065205] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/06/2023] [Accepted: 03/13/2023] [Indexed: 06/18/2023]
Abstract
The study aimed to characterize and understand the difficulties experienced by informal caregivers from a bio-psychosocial and environmental perspective, taking into account the socio-demographic and health characteristics of the informal caregiver and the person cared for, quality of life, perceived burden, social support, and the impact of the COVID-19 pandemic on the informal caregiver and the person cared for. The participants were 371 informal primary caregivers, 80.9% female, aged between 25 and 85 years, mean 53.17 (SD = 11.45) years. Only 16.4% of the informal caregivers benefited from monitoring and training for informal caregiver skills; 34.8% received information on the rights of the person being cared for; 7.8% received advice or guidance on the rights and duties of the informal caregiver; 11.9% of the caregivers benefited from psychological support; and 5.7% participated in self-help groups. A convenience sample was used, and data were collected via an online questionnaire. The main findings show that the major difficulties experienced by caregivers are related to social constraints, the demands of caring, and the reactions of the person cared for. The results reveal that the burden of the main informal caregivers is explained by the level of education, quality of life, level of dependence of the person cared for, level of difficulties, and social support. The COVID-19 pandemic impacted caregiving by increasing the perceived difficulty of accessing support services, such as consultations, services, and support; causing distress feelings in the caregiver, such as, anxiety and worry; increasing the needs and symptoms of the person cared for; and increasing the degree of isolation, for both, the informal caregiver and the person cared for.
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Affiliation(s)
- Tania Gaspar
- SPIC, Hei-Lab, Lusófona University, 1749-024 Lisbon, Portugal
- ISAMB, Medicine Faculty, Lisbon University, 1649-026 Lisbon, Portugal
| | - Marta Raimundo
- SPIC, Psychology and Life Sciences School, Lusófona University, 1749-024 Lisbon, Portugal
- Aventura Social Associação, 1649-026 Lisbon, Portugal
| | - Sofia Borges de Sousa
- SPIC, Psychology and Life Sciences School, Lusófona University, 1749-024 Lisbon, Portugal
- Aventura Social Associação, 1649-026 Lisbon, Portugal
| | - Marta Barata
- SPIC, Psychology and Life Sciences School, Lusófona University, 1749-024 Lisbon, Portugal
- Aventura Social Associação, 1649-026 Lisbon, Portugal
| | - Tulia Cabrita
- CLISSIS, Psychology Institute, Lusiada University, 1349-001 Lisbon, Portugal
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Hajek A, Kretzler B, König HH. Informal caregiving for adults, loneliness and social isolation: a study protocol for a systematic review. BMJ Open 2021; 11:e044902. [PMID: 33947734 PMCID: PMC8098962 DOI: 10.1136/bmjopen-2020-044902] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 04/19/2021] [Accepted: 04/20/2021] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Some empirical studies have identified an association between informal caregiving for adults and loneliness or social isolation. However, there is a lack of a review systematically synthesising empirical studies that have examined these associations. Hence, the aim of this systematic review is to provide an overview of evidence from observational studies. METHODS AND ANALYSIS Three electronic databases (Medline, PsycINFO, CINAHL) will be searched (presumably in May 2021), and reference lists of included studies will be searched manually. Cross-sectional and longitudinal observational studies examining the association between informal caregiving for adults and loneliness or social isolation will be included. Studies focusing on grandchildren care or private care for chronically ill children will be excluded. Data extraction will include information related to study design, definition and measurement of informal caregiving, loneliness and social isolation, sample characteristics, statistical analysis and main results. The quality of the studies will be evaluated using the National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Two reviewers will perform the selection of studies, data extraction and assessment of study quality. Figures and tables will be used to summarise and report results. A narrative summary of the findings will be provided. If data permit, a meta-analysis will be conducted. ETHICS AND DISSEMINATION No primary data will be collected. Therefore, approval by an ethics committee is not required. We plan to publish our findings in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD42020193099.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Benedikt Kretzler
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Dixe MDACR, da Conceição Teixeira LF, Areosa TJTCC, Frontini RC, de Jesus Almeida Peralta T, Querido AIF. Needs and skills of informal caregivers to care for a dependent person: a cross-sectional study. BMC Geriatr 2019; 19:255. [PMID: 31533637 PMCID: PMC6749667 DOI: 10.1186/s12877-019-1274-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Accepted: 09/10/2019] [Indexed: 01/10/2023] Open
Abstract
Background The world is facing many socio-demographic changes, such as an increased average life expectancy and the presence of chronic and non-communicable diseases, which in turn, leads to an enhanced dependency on others. Consequently, the demand for informal caregivers has significantly increased during the past few years. Caring for a dependent person is linked to a series of burdens that often leads to physical, psychological and emotional difficulties. Taking into consideration the difficulties faced by informal caregivers, knowing in which areas of functioning they need more guidance may help to relieve their burden. Therefore, the main goal of this study is to better understand the needs and competencies of the informal caregiver when caring for a dependent person in the different self-care domains. Methods This cross-sectional study used a questionnaire administered on a single occasion by face-to-face interview. Descriptive and inferential statistics alongside non-parametric statistical techniques such as the Mann-Whitney test and Spearman’s correlation were used. Results The average age of the 143 informal caregivers is 58 years old, with the youngest in our sample being 21 years of age. Most of them are female, and 50% of them are children taking care of one of their parents. Most of the dependent people are completely dependent in the areas of comfort and hygiene (53.8%) and medication management (55.9%). The female informal caregivers see themselves as having more competencies in sanitary hygiene than the male ones, with no significant differences in their competencies’ perception in the other areas of self-care. Older caregivers see themselves as less competent in certain areas of self-care such as feeding, mobility, transfers, medication and symptoms management and communication. Most of the information given to the informal caregiver is about the disease (82.3%) and the medication management (80.4%). There are still a lot of areas of self-care, where no information, or almost none, is given to the informal caregivers. Conclusions Before home discharge of a dependent person, it is important to acknowledge the needs and competencies of the informal caregiver, to capacitate them in looking after their relatives, to help decrease their burden and consequently, decrease the number of hospital readmissions.
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Affiliation(s)
- Maria Dos Anjos Coelho Rodrigues Dixe
- Center for Innovative Care and Health Technology, Escola Superior de Saúde do instituto Politécnico de Leiria, Campus 2 - Morro do Lena, Alto do Vieiro - Apartado 4137, 2411-901, Leiria, Portugal. .,Escola Superior de Saúde do instituto Politécnico de Leiria, Campus 2 - Morro do Lena, Alto do Vieiro - Apartado 4137, 2411-901, Leiria, Portugal.
| | - Liliana Fernanda da Conceição Teixeira
- Center for Innovative Care and Health Technology, Escola Superior de Saúde do instituto Politécnico de Leiria, Campus 2 - Morro do Lena, Alto do Vieiro - Apartado 4137, 2411-901, Leiria, Portugal.,Escola Superior de Saúde do instituto Politécnico de Leiria, Campus 2 - Morro do Lena, Alto do Vieiro - Apartado 4137, 2411-901, Leiria, Portugal
| | - Timóteo João Teixeira Camacho Coelho Areosa
- Center for Innovative Care and Health Technology, Escola Superior de Saúde do instituto Politécnico de Leiria, Campus 2 - Morro do Lena, Alto do Vieiro - Apartado 4137, 2411-901, Leiria, Portugal
| | - Roberta Caçador Frontini
- Center for Innovative Care and Health Technology, Escola Superior de Saúde do instituto Politécnico de Leiria, Campus 2 - Morro do Lena, Alto do Vieiro - Apartado 4137, 2411-901, Leiria, Portugal
| | - Teresa de Jesus Almeida Peralta
- Center for Innovative Care and Health Technology, Escola Superior de Saúde do instituto Politécnico de Leiria, Campus 2 - Morro do Lena, Alto do Vieiro - Apartado 4137, 2411-901, Leiria, Portugal.,Centro Hospitalar de Leiria, Rua das Olhalvas, 2410-197, Leiria, Portugal
| | - Ana Isabel Fernandes Querido
- Center for Innovative Care and Health Technology, Escola Superior de Saúde do instituto Politécnico de Leiria, Campus 2 - Morro do Lena, Alto do Vieiro - Apartado 4137, 2411-901, Leiria, Portugal
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Hajek A, Brettschneider C, Eisele M, Lühmann D, Mamone S, Wiese B, Weyerer S, Werle J, Fuchs A, Pentzek M, Stein J, Luck T, Weeg D, Mösch E, Heser K, Wagner M, Scherer M, Maier W, Riedel-Heller SG, König HH. Does transpersonal trust moderate the association between chronic conditions and general practitioner visits in the oldest old? Results of the AgeCoDe and AgeQualiDe study. Geriatr Gerontol Int 2019; 19:705-710. [PMID: 31237101 DOI: 10.1111/ggi.13693] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 03/12/2019] [Accepted: 03/25/2019] [Indexed: 01/30/2023]
Abstract
AIM The purpose of this study was to investigate whether transpersonal trust (TPT) moderates the relationship between chronic conditions and general practitioner (GP) visits among the oldest old in Germany. METHODS The multicenter prospective cohort Study on Needs, health service use, costs and health-related quality of life in a large sample of oldest old primary care patients (85+) (AgeQualiDe) was carried out. Individuals were recruited through GP offices at six study centers in Germany (follow-up wave 7). Primary care patients were aged ≥85 years (n = 861, mean age 89.0 years; range 85-100 years). The self-reported number of outpatient visits to the GP was used as the outcome measure. To explore religious and spiritual beliefs, the short form of the Transpersonal Trust scale was used. The presence or absence of 36 chronic conditions was recorded by the GP. RESULTS Multiple Poisson regressions showed that GP visits were positively associated with the number of chronic conditions (incidence rate ratio 1.03, P < 0.05). TPT moderated the relationship between chronic conditions and GP visits (incidence rate ratio 1.01, P < 0.05). The association between chronic conditions and GP visits was significantly more pronounced when TPT was high. CONCLUSION Our findings highlight the importance of TPT in the relationship between chronic conditions and GP visits. Future longitudinal studies are required to clarify this subject further. Geriatr Gerontol Int 2019; 19: 705-710.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christian Brettschneider
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marion Eisele
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Dagmar Lühmann
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Silke Mamone
- Institute of General Practice, Hannover Medical School, Hannover, Germany
| | - Birgitt Wiese
- Institute of General Practice, Hannover Medical School, Hannover, Germany
| | - Siegfried Weyerer
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Jochen Werle
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Angela Fuchs
- Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Michael Pentzek
- Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Janine Stein
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Tobias Luck
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany.,Department of Economic & Social Sciences, University of Applied Sciences Nordhausen, Nordhausen, Germany
| | - Dagmar Weeg
- Department of Psychiatry, Technical University of Munich, Munich, Germany
| | - Edelgard Mösch
- Department of Psychiatry, Technical University of Munich, Munich, Germany
| | - Kathrin Heser
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn, Bonn, Germany
| | - Michael Wagner
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn, Bonn, Germany.,DZNE, German Center for Neurodegenerative Diseases, Bonn, Germany
| | - Martin Scherer
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Wolfgang Maier
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn, Bonn, Germany.,DZNE, German Center for Neurodegenerative Diseases, Bonn, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Hajek A, König HH. Informal caregiving and personality: Results of a population-based longitudinal study in Germany. PLoS One 2018; 13:e0203586. [PMID: 30188939 PMCID: PMC6126863 DOI: 10.1371/journal.pone.0203586] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 08/23/2018] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The aim of this study was to identify whether informal caregiving time is associated with personality factors longitudinally. METHODS Longitudinal data were gathered from the German Socio-Economic Panel (GSOEP), a large nationally representative, longitudinal study of German households beginning in 1984. Focusing on the association between informal caregiving and personality factors, data were used from the years 2005, 2009 and 2013. The GSOEP Big Five Inventory was used to assess personality factors. Informal caregiving hours were used as explanatory variable. The explanatory variable informal caregiving hours was categorized into 0 hours (reference), 1 hours, 2 hours, 3 hours, 4 hours, and 5 hours and more. Age, marital status, educational level, employment status, income, self-rated health and disability were included as potential confounders in regression analysis. RESULTS Adjusting for potential confounders, fixed effects regressions showed that whether or not someone provides informal care is markedly associated with changes in neuroticism. Given that an individual provides informal care, the actual number of care hours did not matter in most cases. Informal caregiving was not associated with openness to experience, extraversion and agreeableness. As regards conscientiousness, only '5 hours and more' on a typical Sunday was associated with an increase in conscientiousness (β = .32, p < .05). Informal caregiving on a typical weekday or Saturday was not associated with changes in conscientiousness. CONCLUSION Our findings stress the longitudinal association between informal caregiving and neuroticism.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Hajek A, König HH. The relation between personality, informal caregiving, life satisfaction and health-related quality of life: evidence of a longitudinal study. Qual Life Res 2018; 27:1249-1256. [PMID: 29335851 DOI: 10.1007/s11136-018-1787-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2018] [Indexed: 11/27/2022]
Abstract
PURPOSE Personality characteristics of the caregiver might play a role in the relation between informal caregiving and health-related quality of life as well as life satisfaction. However, a limited body of research has examined this relation. This study aimed to examine the role personality characteristics of the caregiver might play in the relation between informal caregiving and well-being outcomes using a longitudinal approach. METHODS Data were derived from the large Panel 'Labour Market and Social Security.' This is an annual household survey, which is conducted by order of the Institute for Employment Research covering persons and households registered as residents of Germany. The SF-12 was used to capture health-related quality of life (covering physical and mental health). A short version of the Big Five Inventory (BFI-K) was used to quantify personality factors. Life satisfaction was measured by a single-item measure. Concentrating on these factors, we used data from the third (2008/2009), sixth (2012), and ninth wave (2015). 34,548 observations were used in fixed effects regressions. RESULTS Adjusting for various potential confounders, linear fixed effects regressions showed that the onset of informal caregiving reduced life satisfaction (β = - .14, p < .01), but not physical and mental health. The relation between informal caregiving and life satisfaction was significantly moderated by agreeableness (p < .01). CONCLUSIONS Findings of the present study emphasized that agreeableness moderates the relationship between informal caregiving and life satisfaction. Measuring personality characteristics of the informal caregiver is important for tailoring interventional strategies in order to increase the benefit of these programs.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Hajek A, König HH. Does informal caregiving affect self-esteem? Results from a population-based study of individuals aged 40 and over in Germany from 2002 to 2014. Scand J Caring Sci 2017; 32:1047-1055. [PMID: 29193241 DOI: 10.1111/scs.12550] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 11/05/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND While it is known that informal caregiving is associated with care-derived self-esteem cross-sectionally, little is known about the impact of informal caregiving on general self-esteem longitudinally. Thus, we aimed at examining whether informal caregiving affects general self-esteem using a longitudinal approach. METHODS Data were gathered from a population-based sample of community-dwelling individuals aged 40 and over in Germany from 2002 to 2014 (n = 21 271). General self-esteem was quantified using the Rosenberg scale. Individuals were asked whether they provide informal care regularly. RESULTS Fixed effects regressions showed no significant effect of informal caregiving on general self-esteem longitudinally. General self-esteem decreased with increasing morbidity, increasing age, decreasing social ties, whereas it was not associated with changes in employment status, marital status and body mass index. Additional models showed that decreases in self-esteem were associated with decreases in functional health and increases in depressive symptoms. CONCLUSION Our longitudinal study emphasises that the occurrence of informal caregiving did not affect general self-esteem longitudinally. Further research is needed in other cultural settings using panel data methods.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Hajek A, Bock JO, König HH. Association of informal caregiving with body mass index and frequency of sporting activities: evidence of a population-based study in Germany. BMC Public Health 2017; 17:755. [PMID: 28962607 PMCID: PMC5622456 DOI: 10.1186/s12889-017-4786-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 09/21/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND While most studies focused solely on the comparison between informal caregivers and non-caregivers, little is known about the relation between caregiving time or caregiving activities and lifestyle factors. Thus, the aim of this study was to examine whether informal caregiving time and type of caregiving activities are associated with body mass index (BMI) and the frequency of sporting activities among informal caregivers. METHODS Cross-sectional data were gathered from the German Ageing Survey, a nationally representative study among community-dwelling individuals aged ≥40 that includes a total of n = 1380 people who provide informal care services. Self-reported BMI and self-reported frequency of sporting activities (daily; several times a week; once a week; 1-3 times a month; less often; never) were used as dependent variables. The average time of providing informal care per week as well as four different caregiving activities (help around the house; looking after someone; performing nursing care services; help in another way) were included as independent variables. Multiple ordinal and linear regressions were used to estimate the association between caregiving factors and the frequency of sporting activities and BMI, respectively. RESULTS Among the 1380 informal caregivers, 65% provided help around the house, 83% looked after people, 28% provided nursing care services, and 68% provided any other help. Bivariate analyses showed that sporting activities and BMI differed by status of providing nursing care services, whereas the other three types of informal caregiving were not associated with BMI nor frequency of sporting activities except for the latter and provision of help around the house. Multiple regressions showed that BMI increased with caregiving time and performing nursing care services, whereas it was not associated with the other three caregiving activities. Likewise, the frequency of sporting activities decreased only with caregiving time and performing nursing care services. CONCLUSIONS The present study revealed that caregiving time and performing nursing care services are associated with a higher BMI and a decreased frequency of sporting activities. As both, a higher BMI and fewer sporting activities are in turn related to various adverse health outcomes, this knowledge should be taken into account when planning informal caregiving.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jens-Oliver Bock
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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