.Role of caregivers in promoting mental health.

.Role of caregivers in promoting mental health.

Role of caregivers in promoting mental health.

Abstract

Background

The responsibility of caring for relatives with mental illness often falls on the family members. It has been reported that the reactions to or consequences of providing care are what rendered the role of a caregiver challenging and hence a source of distress. This present study thus aimed to identify socio-demographic correlates of caregiving experiences using the Caregiver Reaction Assessment (CRA) and to examine the associations between reactions to caregiving and psychological distress.Role of caregivers in promoting mental health.

A total of 350 caregivers with relatives seeking outpatient care at a tertiary psychiatric hospital were recruited for this study. Distress among caregivers was assessed using the Patient Health Questionnaire (PHQ-9). The CRA was administered to measure reactions from caregiving in four domains including impact on schedule and health (ISH), impact on finance (IF), lack of family support (LFS) and caregiver esteem (CE). Participants also completed a questionnaire that asked for their socio-demographic information. Multivariable linear regression analysis was first used with domains of CRA as outcome variables and socio-demographic variables as predictors in the models. The next set of multivariable linear regression analysis tested for the association between CRA domains and distress with CRA domain scores as outcome variables and PHQ-9 score as predictor, controlling for socio-demographic variables.Role of caregivers in promoting mental health.

Results

Socio-demographic correlates of CRA domains identified were age, education, employment, income and ethnicity. Domain scores of CRA were significantly associated with PHQ-9 score even after controlling for socio-demographic variables. A higher distress score was associated with greater impact felt in the domain of ISH (β = 0.080, P < 0.001), IF (β = 0.064, P < 0.001), and LFS (β = 0.057, P < 0.001), and was associated with lower CE domain scores (β = −0.021, P < 0.05).

Conclusion

This study identified several socio-demographic correlates of caregiving reaction in the different domains. Each of these domains was found to be significantly associated with caregiver distress. Higher distress was associated with stronger impact on the negative domains and a lower impact in the positive domain of caregiving reaction. Interventions such as educational programs at the caregiver level, and also promoting wider social care support in these domains may help to address caregiver distress.Role of caregivers in promoting mental health.

The Present Study

The preceding review suggests a need to focus attention on the implications of the caregiver’s relationship to the care recipient and gender for understanding of the caregiving experience, including the mental health and well-being of caregivers. Despite extensive attention to the implications of caregiving for caregiver mental health and well-being, little is known regarding the impact of the relationship of the caregiver to care receiver. Role of caregivers in promoting mental health.Where studied, the focus tends to be on older adults as recipients of care, most often provided by adult children. Consequently, the implications of parental caregiving compared with those associated with caregiving to a spouse/partner, to children, or to others, remain unclear. Furthermore, although gender differences in caregiving outcomes are well-documented, little is known regarding whether and how the implications of the caregiver to care recipient relationship differ by gender. Thus, although research tends to report finding that female caregivers report more burden as well as greater stress and depression than do male caregivers (Kim et al., 2012; Li, Mak, & Loke, 2013; Litwin et al., 2014), the implications of intersections involving gender and relationship status are less clear.Role of caregivers in promoting mental health.

To address these gaps, this study drew on national survey data to examine the stress and overall mental health implications of spousal caregiving compared with those associated with providing care for children, parents, siblings, other family members, and nonfamily (friends, neighbors, coworkers). Two research questions were examined: (a) What impact does the relationship of the caregiver to the care receiver have on stress and mental health outcomes of caregivers? (b) Secondly, does this impact vary depending on caregivers’ gende