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Liang J, Aranda MP, Jang Y, Wilber K. The Role of Social Isolation on Mediating Depression and Anxiety among Primary Family Caregivers of Older Adults: A Two-Wave Mediation Analysis. Int J Behav Med 2024; 31:445-458. [PMID: 37878186 PMCID: PMC11043211 DOI: 10.1007/s12529-023-10227-5] [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] [Accepted: 10/04/2023] [Indexed: 10/26/2023]
Abstract
BACKGROUND Primary family caregivers of older people with chronic care conditions are highly vulnerable to social isolation and psychological strains such as depression and anxiety due to their demanding responsibilities. This study examines how social isolation mediates the relationship between caregiving stress and mental health symptoms of primary family caregivers. METHODS The analytic sample included 881 primary caregivers of older adults from the 2015 and 2017 National Study of Caregiving (NSOC). Social isolation was measured using a composite structure that includes objective social disconnectedness and subjective loneliness. Two-wave mediation models were estimated to examine longitudinally if social isolation mediated the relationship between caregiving stress (subjective & objective stress) and mental health symptoms (depression & anxiety) of primary caregivers. RESULTS The study findings indicate that both subjective (β = 0.32, p < 0.001) and objective stress (β = 0.21, p = 0.003) have direct effects on depression among primary caregivers. Social isolation was found to only mediate the relationship between objective stress and depression (β = 0.18, p < 0.001). In contrast, no significant direct and indirect pathway was found in the anxiety model. CONCLUSIONS The study demonstrates the internal mechanism where objective strains of caregiving make family caregivers socially isolated, which in turn leads to increased symptoms of depression. Future interventions and practices aimed at improving the psychological well-being of family caregivers should prioritize strategies aimed at increasing social engagement, particularly for those with heavy caregiver burdens.
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Affiliation(s)
- Jiaming Liang
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, USA.
- Edward R. Roybal Institute on Aging, University of Southern California, Los Angeles, USA.
| | - Maria P Aranda
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, USA
- Edward R. Roybal Institute on Aging, University of Southern California, Los Angeles, USA
| | - Yuri Jang
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, USA
- Edward R. Roybal Institute on Aging, University of Southern California, Los Angeles, USA
- Department of Social Welfare, Ewha Womans University, Seoul, Republic of Korea
| | - Kathleen Wilber
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, USA
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2
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Georges D, Doblhammer G. Informal care and mental health in Germany: What are the differences between non-migrants and ethnic German immigrants? A longitudinal comparative analysis. Aging Ment Health 2024; 28:436-447. [PMID: 37885248 DOI: 10.1080/13607863.2023.2271866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 10/11/2023] [Indexed: 10/28/2023]
Abstract
OBJECTIVE In aging Germany, a large part of care is provided by informal caregivers. We aimed to analyze the main drivers of the mental health of caregivers and their intersection with migration status. METHODS Using panel data covering 18 years (n = 25,659 individuals, aged 16 to 103 years; mean age of 49.5 years) and applying linear regression models we investigated the association between informal caregiving and mental health. We compared non-migrant Germans (NMG) and ethnic German immigrants (EGI), who are the oldest immigrant group in Germany. Informal caregiving was defined as living with a person in need of care or by providing care for ≥2 h per day; the main health outcomes were mental health and mental health changes, measured by a metric scale of six items. RESULTS Even accounting for selection into caregiving, short-term care seemed to be disadvantageous only for NMG, while long-term care was generally associated with poorer mental health, with a particular disadvantage for EGI. Socio-economic characteristics and personality traits affected mental health changes, but only weakly the caregiving-health association. CONCLUSION Informal caregiving presents a health burden which is not explained by socio-economic characteristics and personality, but by migration status. Policies to promote health in an aging society need to consider differences in short- and long-term care provision and between migrants and the non-migrants.
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Affiliation(s)
- Daniela Georges
- Faculty of Economic and Social Sciences, University of Rostock, Rostock, Germany
| | - Gabriele Doblhammer
- Faculty of Economic and Social Sciences, University of Rostock, Rostock, Germany
- German Centre for Neurodegenerative Diseases, Bonn, Germany
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3
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Ervin J, Taouk Y, Fleitas Alfonzo L, Peasgood T, King T. Longitudinal association between informal unpaid caregiving and mental health amongst working age adults in high-income OECD countries: A systematic review. EClinicalMedicine 2022; 53:101711. [PMID: 36353526 PMCID: PMC9637877 DOI: 10.1016/j.eclinm.2022.101711] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 10/04/2022] [Accepted: 10/05/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Informal unpaid caregivers provide most of the world's care needs, experiencing numerous health and wealth penalties as a result. As the COVID-19 pandemic has highlighted, informal care is highly gendered. Longitudinal evidence is needed to assess the causal effect of caregiving on mental health. This review addresses a gap by summarising and appraising the longitudinal evidence examining the association between unpaid caregiving and mental health among working age adults in high-income Organisation for Economic Co-operation and Development (OECD) countries and examining gender differences. METHODS Six databases were searched (Medline, PsycInfo, EMBASE, Scopus, Web of Science, Econlit) from Jan 1, 2000 to April 1, 2022. Population-based, peer-reviewed quantitative studies using any observational design were included. Population of interest was working age adults. Exposure was any unpaid caregiving, and studies must have had a non-caregiving comparator for inclusion. Mental health outcomes (depression, anxiety, psychological distress/wellbeing) were measurable by validated self-report tools or professional diagnosis. Screening, data extraction and quality assessment (ROBINS-E) were conducted by two reviewers. The study was prospectively registered with PROSPERO (CRD42022312401). FINDINGS Of the 4536 records screened; 13 eligible studies (133,426 participants) were included. Overall quality of evidence was moderate. Significant between-study heterogeneity precluded meta-analysis, so albatross and effect-direction plots complement the narrative synthesis. Results indicate a negative association between informal unpaid care and mental health in adults of working age. Importantly, all included studies were longitudinal in design. Where studies were stratified by gender, caregiving had a consistently negative impact on the mental health of women. Few studies examined men but revealed a negative effect where an association was found. INTERPRETATION Our review highlights the need to mitigate the mental health risks of caregiving in working age adults. Whilst men need to be included in further scholarship, reducing the disproportionate caregiving load on women is a crucial requirement for policy development. FUNDING Melbourne School of Population and Global Health, Targeted Research Support Grant.
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Affiliation(s)
- Jennifer Ervin
- Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
- Corresponding author. Centre for Health Equity, Melbourne School Population and Global Health, The University of Melbourne, Level 4, 207, Bouverie Street, Victoria 3010, Australia.
| | - Yamna Taouk
- Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Ludmila Fleitas Alfonzo
- Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Tessa Peasgood
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Tania King
- Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
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Dong S, Elliott TR, Luo W, Warren AM, Warren R. Personality metatraits predict resilience among family caregivers responsible for a dependent youth's chronic respiratory management. BMC Psychol 2022; 10:85. [PMID: 35365207 PMCID: PMC8973997 DOI: 10.1186/s40359-022-00791-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 03/21/2022] [Indexed: 11/16/2022] Open
Abstract
Background Family caregivers of children and youth with severe neurodisabilities that require chronic respiratory management often report a compromised quality of life. In this cross-sectional study, we used DeYoung’s (Psychol Inq 21(1): 26–33, 2010. 10.1080/10478401003648674) conceptualization of two personality metatraits, Alpha and Beta, to test their theorized role in facilitating resilience among these family caregivers. We expected higher Alpha and Beta would exhibit direct, beneficial effects on caregiver mental and physical health quality of life (QoL), and they would operate through self-reported resilience and coping to exert positive, indirect effects on caregiver QoL. Methods Family caregivers of children and youth at an outpatient chronic respiratory management clinic were informed of the study. Of the 68 who consented, 61 provided complete data on measures of personality traits, coping styles, and physical and mental health-related QoL. Factor analytic techniques verified the two personality metatraits, consistent with the DeYoung model. The metatraits were then used as predictor variables in a path model to predict physical and mental health-related QoL. Self-reported resilience and a coping variable were examined as possible mediators of the personality-QoL relationship. Results Correlational analyses isolated a coping variable that met criteria as a possible mediator. The path model exhibited good fit to the data. The Alpha metatrait—characterized by emotional stability, self-regulation, perseverance, and intrinsic motivation—was directly predictive of caregiver mental health. The Beta metatrait, reflecting a disposition for adaptive flexibility, responsiveness, and interpersonal initiative, demonstrated significant indirect effects to physical and mental health through its positive association with coping efforts to maintain social support and a sense of self. Conclusions Consistent with DeYoung’s conceptualization, higher Alpha and Beta predicted caregiver resilience, albeit through different pathways. The emotional stability, perseverance and emotional regulation associated with Alpha likely accounted for its positive association with caregiver mental health. Beta, in contrast, may operate through their adaptive flexibility, personal resourcefulness and social engagement to augment coping efforts that involve others and support family activities, which, in turn, promote their own physical and mental health. Limitations of the cross-sectional design, and potential theoretical and clinical implications of the personality metatraits and their relation to resilience are discussed. Supplementary Information The online version contains supplementary material available at 10.1186/s40359-022-00791-y.
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Affiliation(s)
- Sidai Dong
- Department of Educational Psychology, Texas A&M University (4225 TAMU), College Station, TX, 77843-4225, USA
| | - Timothy R Elliott
- Department of Educational Psychology, Texas A&M University (4225 TAMU), College Station, TX, 77843-4225, USA.
| | - Wen Luo
- Department of Educational Psychology, Texas A&M University (4225 TAMU), College Station, TX, 77843-4225, USA
| | - Ann Marie Warren
- Baylor Scott and White Research Institute, Baylor University Medical Center, Dallas, TX, USA
| | - Robert Warren
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
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5
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Hajek A, König HH. How does beginning or ceasing of informal caregiving of individuals in poor health influence sleep quality? Findings from a nationally representative longitudinal study. Aging Ment Health 2022; 26:314-319. [PMID: 33307767 DOI: 10.1080/13607863.2020.1857700] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Various cross-sectional studies exist examining the association between informal caregiving and sleep quality. However, there is a lack of longitudinal studies investigating whether beginning and ceasing of informal caregiving is associated with changes in sleep quality. AIMS Investigating whether beginning and ceasing of informal caregiving of individuals in poor health is associated with changes in sleep quality in both sexes. METHODS Data were taken from a nationally representative sample of individuals ≥ 40 years in Germany from 2008 to 2017. In our analytical sample, n equaled 22,910 observations. Based on the Pittsburgh Sleep Quality Index, the sleep quality was assessed by the difficulties falling asleep during the last month, difficulties with sleep because of waking up during the last month (in both cases: (from 1 = not during the last month to 4 = three or more times a week) and the overall assessment of sleep quality during the last month (from 1 = very good to 4 = very bad). RESULTS Asymmetric fixed effects regressions showed that in men beginning to provide informal care was associated with decreased overall sleep quality (β=-.09 (95% CI: -.15 - -.03), p<.01) and an increased likelihood of difficulties because of waking up (OR: 1.54 (95% CI: 1.07-2.20), p<.05), whereas ceasing to provide informal care was not associated with the outcome measures (both, in women and in men). DISCUSSION Starting informal caregiving had deleterious effects on sleep quality in men. CONCLUSIONS Efforts to assist men in maintaining sleep quality may be beneficial.
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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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Informal Caregiving, Loneliness and Social Isolation: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182212101. [PMID: 34831857 PMCID: PMC8618455 DOI: 10.3390/ijerph182212101] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 11/16/2021] [Accepted: 11/17/2021] [Indexed: 11/22/2022]
Abstract
Background: Several empirical studies have shown an association between informal caregiving for adults and loneliness or social isolation. Nevertheless, a systematic review is lacking synthesizing studies which have investigated these aforementioned associations. Therefore, our purpose was to give an overview of the existing evidence from observational studies. Materials and Methods: Three electronic databases (Medline, PsycINFO, CINAHL) were searched in June 2021. Observational studies investigating the association between informal caregiving for adults and loneliness or social isolation were included. In contrast, studies examining grandchild care or private care for chronically ill children were excluded. Data extractions covered study design, assessment of informal caregiving, loneliness and social isolation, the characteristics of the sample, the analytical approach and key findings. Study quality was assessed based on the NIH Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Each step (study selection, data extraction and evaluation of study quality) was conducted by two reviewers. Results: In sum, twelve studies were included in our review (seven cross-sectional studies and five longitudinal studies)—all included studies were either from North America or Europe. The studies mainly showed an association between providing informal care and higher loneliness levels. The overall study quality was fair to good. Conclusion: Our systematic review mainly identified associations between providing informal care and higher loneliness levels. This is of great importance in assisting informal caregivers in avoiding loneliness, since it is associated with subsequent morbidity and mortality. Moreover, high loneliness levels of informal caregivers may have adverse consequences for informal care recipients.
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Zwar L, Angermeyer MC, Matschinger H, Riedel-Heller SG, König HH, Hajek A. Are informal family caregivers stigmatized differently based on their gender or employment status?: a German study on public stigma towards informal long-term caregivers of older individuals. BMC Public Health 2021; 21:1868. [PMID: 34656105 PMCID: PMC8520205 DOI: 10.1186/s12889-021-11955-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 10/06/2021] [Indexed: 12/02/2022] Open
Abstract
Background Stigma and informal caregiving are determinants for health and wellbeing, but few studies have examined stigma towards informal caregiving. Public stigma may be expressed differently towards caregivers depending on their gender and employment status due to societal norms. Therefore, this study analyzes if there is a difference in public stigma shown by the general population toward informal caregivers of care recipients aged 65 years or older based on the observed caregiver’s gender or working status. Methods A cross-sectional study was conducted in Germany. Data from 1038 adult participants from the general population in Germany were assessed with an Online-Survey. They were recruited with a quota-system based on the German micro census. Participants were randomly assigned to one of 16 vignettes describing a caregiving situation, which varied in the caregiver’s gender and working status, and care recipient’s gender and type of impairment. After reading the vignette, they were asked to provide sociodemographic information and complete three questionnaires on public stigma assessing their emotional (Emotional Reactions), behavioral (Social Distance) and cognitive reaction (Statements on informal caregivers) to the caregiver described in the vignette. Regression analyses, adjusted for sociodemographic data of the participants, were conducted. Results Findings indicated an association between reading about male caregivers and increased social distance, compared with reading about female caregivers. Reading about working caregivers was associated with decreased social distance and increased appreciative statements, compared to reading about non-working caregivers. Analyses after stratifying by gender of the caregiver in the vignette indicated an association between reading about female working caregivers and increased appreciative statements, compared to reading about female non-working caregivers. When stratifying by working status, an association was found between reading about male working caregivers and increased social distance, when compared to reading about female working caregivers. Conclusions This study’s findings indicate that gender and working status of the perceived informal caregivers are of relevance to the public stigma directed towards these caregivers. Male and non-working informal caregivers were shown more public stigma than female and working informal caregivers. Thus, interventions to reduce public stigma, in particular towards male and non-working caregivers, are recommended.
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Affiliation(s)
- Larissa Zwar
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany.
| | | | - Herbert Matschinger
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany.,Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany
| | - André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany
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8
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Luchetti M, Terracciano A, Stephan Y, Aschwanden D, Sutin AR. Personality and psychological health in caregivers of older relatives: a case-control study. Aging Ment Health 2021; 25:1692-1700. [PMID: 32347105 PMCID: PMC7606331 DOI: 10.1080/13607863.2020.1758907] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 04/11/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Being a caregiver of an older adult is often associated with poor psychological outcomes and stress. Individual differences, such as personality, may moderate responses to caregiving. In this study, we examined (a) personality and psychological health of family caregivers compared to non-caregivers and (b) tested interactions between caregiver status and personality (both domains and facets) in predicting psychological outcomes. METHODS Data were from an online sample of caregivers of older relatives (N = 491; 71.9% females) and matched controls (N = 491). Participants completed the Big Five Inventory-2 and a comprehensive set of psychological health and well-being measures. RESULTS Compared to non-caregivers, caregivers had higher neuroticism, lower energy level (extraversion facet) and higher compassion (agreeableness facet). They also reported higher depression, anxiety, loneliness, and lower well-being and life satisfaction. Personality traits and facets had strong associations with psychological outcomes, and these associations were similar across the two groups. Only a few significant interactions between caregiver status and personality were found: For instance, higher neuroticism (in particular, higher scores on anxiety and depression facets) exacerbated anxiety among caregivers. CONCLUSIONS Personality is a relevant correlate of psychological health. In the context of caregiving, its assessment may help to identify caregivers at risk of poor outcomes and inform intervention programs. Further research is needed to replicate the findings and investigate longitudinal interrelations among variables.
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Affiliation(s)
- Martina Luchetti
- Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, Tallahassee, FL, USA
| | - Antonio Terracciano
- Department of Geriatrics, College of Medicine, Florida State University, Tallahassee, FL, USA
| | | | - Damaris Aschwanden
- Department of Geriatrics, College of Medicine, Florida State University, Tallahassee, FL, USA
| | - Angelina R Sutin
- Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, Tallahassee, FL, USA
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Viertiö S, Kiviruusu O, Piirtola M, Kaprio J, Korhonen T, Marttunen M, Suvisaari J. Factors contributing to psychological distress in the working population, with a special reference to gender difference. BMC Public Health 2021; 21:611. [PMID: 33781240 PMCID: PMC8006634 DOI: 10.1186/s12889-021-10560-y] [Citation(s) in RCA: 118] [Impact Index Per Article: 39.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 03/04/2021] [Indexed: 12/12/2022] Open
Abstract
Background Psychological distress refers to non-specific symptoms of stress, anxiety and depression, and it is more common in women. Our aim was to investigate factors contributing to psychological distress in the working population, with a special reference to gender differences. Methods We used questionnaire data from the nationally representative Finnish Regional Health and Well-being Study (ATH) collected in the years 2012–2016 (target population participants aged 20 +, n = 96,668, response rate 53%), restricting the current analysis to those persons who were working full-time and under 65 of age (n = 34,468). Psychological distress was assessed using the Mental Health Inventory-5 (MHI-5) (cut-off value <=52). We studied the following factors potentially associated with psychological distress: sociodemographic factors, living alone, having children under18 years of age, lifestyle-related factors, social support, helping others outside of the home and work-related factors. We used logistic regression analysis to examine association between having work-family conflict with the likelihood for psychological distress. We first performed the models separately for men and women. Then interaction by gender was tested in the combined data for those independent variables where gender differences appeared probable in the analyses conducted separately for men and women. Results Women reported more psychological distress than men (11.0% vs. 8.8%, respectively, p < 0.0001). Loneliness, job dissatisfaction and family-work conflict were associated with the largest risk of psychological distress. Having children, active participation, being able to successfully combine work and family roles, and social support were found to be protective factors. A significant interaction with gender was found in only two variables: ignoring family due to being absorbed in one’s work was associated with distress in women (OR 1.30 (95% CI 1.00–1.70), and mental strain of work in men (OR 2.71 (95% CI 1.66–4.41). Conclusions Satisfying work, family life and being able to successfully combine the two are important sources of psychological well-being for both genders in the working population. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10560-y.
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Affiliation(s)
- Satu Viertiö
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare in Finland (THL), Helsinki, Finland. .,Adolescent Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
| | - Olli Kiviruusu
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare in Finland (THL), Helsinki, Finland.,Adolescent Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Maarit Piirtola
- University of Helsinki, Institute for Molecular Medicine Finland (FIMM), Helsinki, Finland
| | - Jaakko Kaprio
- University of Helsinki, Institute for Molecular Medicine Finland (FIMM), Helsinki, Finland.,Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Tellervo Korhonen
- University of Helsinki, Institute for Molecular Medicine Finland (FIMM), Helsinki, Finland
| | - Mauri Marttunen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare in Finland (THL), Helsinki, Finland.,Adolescent Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Jaana Suvisaari
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare in Finland (THL), Helsinki, Finland
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10
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Zwar L, König HH, Hajek A. Do Informal Caregivers Expect to Die Earlier? A Longitudinal Study with a Population-Based Sample on Subjective Life Expectancy of Informal Caregivers. Gerontology 2021; 67:467-481. [PMID: 33730734 DOI: 10.1159/000513933] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 12/20/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Subjective life expectancy is a good predictor of health and could therefore be a relevant factor in the informal caregiving context. However, no research has been conducted on the perception of life expectancy by informal caregivers. This is the first study that examines the association between transitioning into, and out of, informal caregiving, and subjective life expectancy, and the relevance of employment status and gender for these associations. METHODS A longitudinal study was conducted with data from the German Ageing Survey (waves 2008, 2011, 2014, and 2017). Up to 20,774 observations pooled over all waves were included in the main models. In total, 1,219 transitions into and 1,198 transitions out of informal caregiving were observed. Fixed effects (FE) regression analysis was used. Moderator and stratified analyses were conducted with gender and employment status used as moderator variables and to stratify the sample. Sociodemographic information, health, and lifestyle factors were controlled for. RESULTS Results of adjusted FE regression analyses indicated a significant reduction of subjective life expectancy when transitioning into informal caregiving. No significant change was found when transitioning out of informal caregiving. Subjective life expectancy was significantly decreased when employed individuals transitioned into informal caregiving and significantly increased when they transitioned out of caregiving. Findings for women transitioning into informal caregiving indicated a significant decrease in subjective life expectancy, while no significant change was found among men. CONCLUSION The study's findings indicate that informal caregivers, female and employed caregivers in particular, perceive informal care provision as dangerous for their longevity and expect to die earlier when transitioning into informal caregiving. Thus, supportive interventions for informal caregivers, particularly employed and female informal caregivers, are recommended.
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Affiliation(s)
- Larissa Zwar
- 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
| | - André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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11
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Brown MJ, Cohen SA. Informal Caregiving, Poor Mental Health, and Subjective Cognitive Decline: Results From a Population-Based Sample. J Gerontol Nurs 2020; 46:31-41. [PMID: 33232495 DOI: 10.3928/00989134-20201106-04] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 07/27/2020] [Indexed: 11/20/2022]
Abstract
The current study examined potential gender differences in the associations between informal caregiving, poor mental health, and subjective cognitive decline (SCD). Data were obtained from the U.S. Behavioral Risk Factor Surveillance System (N = 16,042; 9,410 women, 6,632 men). Multivariate linear and logistic regression models were used to obtain adjusted βs and odds ratios (ORs), and 95% confidence intervals (CIs) depicting the association between informal caregiving, poor mental health, and SCD overall and by gender. Caregiving was positively associated with poor mental health among men (adjusted β = 2.60; 95% CI [2.59, 2.62]) and women (adjusted β = 0.40; 95% CI [0.23, 0.57]). Poor mental health was positively associated with SCD among men (adjusted OR = 1.05; 95% CI [1.02, 1.08]) and women (adjusted OR = 1.07; 95% CI [1.04, 1.10]). Poor mental health may be associated with SCD, irrespective of gender, and additional studies are needed that will identify key variables influencing SCD among male and female informal caregivers. [Journal of Gerontological Nursing, 46(12), 31-41.].
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Hu J, Wang G, Zhou Z, Sun Y, Zhang Q, Wu J, Gao Y. Evaluation of a Novel Quality of Life Scale for Schoolchildren with Nonstrabismic Binocular Vision Anomalies. BIOMED RESEARCH INTERNATIONAL 2020; 2020:4723402. [PMID: 32802847 PMCID: PMC7415120 DOI: 10.1155/2020/4723402] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 07/11/2020] [Accepted: 07/22/2020] [Indexed: 12/05/2022]
Abstract
BACKGROUND The professional Quality of Life Scale (QLS) can provide a valuable reference for the diagnosis of visual function anomalies. In the present study, we aimed to design a novel QLS to specially quantify the life quality of schoolchildren with nonstrabismic binocular vision anomalies (NSBVAs) in China. METHODS The novel QLS, named QOL-CVF20, was established based on classical vision-related scales and the administration of the questionnaire to 116 schoolchildren with NSBVAs and 100 healthy schoolchildren in China. The diagnostic reference value between QOL-CVF20 and VF-14 was evaluated on the questionnaires to 240 schoolchildren with NSBVAs and 238 healthy schoolchildren. RESULTS All the subjects could complete the QOL-CVF20 questionnaires independently. QOL-CVF20 had good structural validity, content validity, and discriminant validity, when it was applied in Chinese schoolchildren. The average score of the NSBVA group was significantly lower than that of the control group (49.0 ± 6.9 vs. 69.7 ± 6.7, respectively; P < 0.01). Moreover, the average score of cured NSBVA schoolchildren after treatment (61.8 ± 22.6) was significantly improved (P < 0.01). Receiver operating characteristic curve analysis showed that QOL-CVF20 reflected strong separation between the NSBVA and healthy groups (AUC = 0.901). Meanwhile, QOL-CVF20 could detect individuals with NSBVAs with specificity of 0.847 and sensitivity of 0.846. The critical value of 58.50 in QOL-CVF20 could be effectively applied for quality of life assessment in schoolchildren with NSBVAs. CONCLUSIONS QOL-CVF20 could quantify the life quality of schoolchildren with NSBVAs and might be served as a valuable reference for early diagnosis and clinical evaluation of NSBVAs.
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Affiliation(s)
- Jiali Hu
- Department of Ophthalmology, Hongkou Branch of Changhai Hospital, Naval Medical University, Shanghai 200081, China
- Department of Ophthalmology, Eastern Hepatobiliary Surgery Hospital, Naval Medical University, Shanghai 200433, China
| | - Guokun Wang
- Department of Cardiovascular Surgery, Changhai Hospital, Naval Medical University, Shanghai 200433, China
| | - Zhe Zhou
- Department of Ophthalmology, Hongkou Branch of Changhai Hospital, Naval Medical University, Shanghai 200081, China
| | - Yan Sun
- Department of Ophthalmology, Hongkou Branch of Changhai Hospital, Naval Medical University, Shanghai 200081, China
| | - Qingling Zhang
- College of Science, Hohai University, Nanjing, 210098 Jiangsu, China
| | - Jinhui Wu
- Department of Ophthalmology, Eastern Hepatobiliary Surgery Hospital, Naval Medical University, Shanghai 200433, China
| | - Yu Gao
- Department of Ophthalmology, Hongkou Branch of Changhai Hospital, Naval Medical University, Shanghai 200081, China
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Trappmann M, Bähr S, Beste J, Eberl A, Frodermann C, Gundert S, Schwarz S, Teichler N, Unger S, Wenzig C. Data Resource Profile: Panel Study Labour Market and Social Security (PASS). Int J Epidemiol 2019; 48:1411-1411g. [PMID: 30982900 PMCID: PMC6857753 DOI: 10.1093/ije/dyz041] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2019] [Indexed: 11/13/2022] Open
Affiliation(s)
- Mark Trappmann
- Panel Study Labour Market and Social Security, Institute for Employment Research, Nuremberg, Germany
- Faculty for Social Sciences, Economics, and Business Administration, University of Bamberg, Bamberg, Germany
| | - Sebastian Bähr
- Panel Study Labour Market and Social Security, Institute for Employment Research, Nuremberg, Germany
| | - Jonas Beste
- Panel Study Labour Market and Social Security, Institute for Employment Research, Nuremberg, Germany
| | - Andreas Eberl
- Panel Study Labour Market and Social Security, Institute for Employment Research, Nuremberg, Germany
- University of Erlangen-Nuremberg, Institute of Labor Market and Socioeconomics, Nuremberg, Germany
| | - Corinna Frodermann
- Panel Study Labour Market and Social Security, Institute for Employment Research, Nuremberg, Germany
| | - Stefanie Gundert
- Panel Study Labour Market and Social Security, Institute for Employment Research, Nuremberg, Germany
| | - Stefan Schwarz
- Panel Study Labour Market and Social Security, Institute for Employment Research, Nuremberg, Germany
| | - Nils Teichler
- Panel Study Labour Market and Social Security, Institute for Employment Research, Nuremberg, Germany
| | - Stefanie Unger
- Panel Study Labour Market and Social Security, Institute for Employment Research, Nuremberg, Germany
| | - Claudia Wenzig
- Panel Study Labour Market and Social Security, Institute for Employment Research, Nuremberg, 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: 5] [Impact Index Per Article: 0.8] [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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