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A'Azman S, Sung P, Malhotra R. Engagement in Physical Activity and Quality of Life Among Informal Caregivers of Older Adults. J Aging Health 2023:8982643231209086. [PMID: 37936406 DOI: 10.1177/08982643231209086] [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: 11/09/2023]
Abstract
OBJECTIVES This study examined (1) the association of caregiver engagement in physical activity (PA) with their quality of life (QoL) and (2) the moderating effect of caregiver engagement in PA on the relationship between several caregiving stressors and their QoL, among informal caregivers of older adults. METHODS Multivariable regression was applied to data from 278 adult caregivers, aged 23-90 years, in Singapore. RESULTS Engagement in PA by caregivers was positively associated with psychological, social relationships, and environment domains of their QoL. Caregiver engagement in PA also mitigated the negative association between care-recipient mood impairment and QoL of caregivers in the physical health and social relationships domains. DISCUSSION QoL of caregivers may be improved or protected by their regular engagement in PA, especially when their care-recipients have mood impairment. Policymakers and practitioners should encourage caregivers to engage in PA and provide them with the necessary support to do so.
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Affiliation(s)
| | - Pildoo Sung
- Department of Sociology, Hong Kong Baptist University, Hong Kong
| | - Rahul Malhotra
- Centre for Ageing Research and Education, Duke-NUS Medical School, Singapore, Singapore
- Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
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2
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Clarke J, Kinchin I, Kochovska S, Johnson MJ, Currow DC. What If… Caregivers' Subsequent Workforce Participation Was a Measure of Palliative Care Services' Impact? An Hypothesis-Generating Study. J Palliat Med 2023; 26:1042-1047. [PMID: 36720072 DOI: 10.1089/jpm.2022.0498] [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] [Indexed: 02/02/2023] Open
Abstract
Background: Hospice/palliative care emphasizes excellent care for patients, but what about longer-term caregiver outcomes after their caregiving role? What is the role of services in working to ensure that caregivers can re-engage with all aspects of life, including paid employment given that this is an identified stressor for caregivers? Aim: This hypothesis-generating study aimed to explore self-reported, post-care workforce participation, and any association with hospice/palliative care contact. Design: Cross-sectional random population interviews. Setting/Participants: People in the general population were randomly selected for face-to-face interviews about well-being including end-of-life care in South Australia. Questions included experiences of people dying an expected death and whether interviewees provided care. Demographic data included current workforce participation. A regression model explored associations with workforce participation. Results: Of 8945 interviews over three years, 171 participants aged 20-60 years (working age) provided intermittent hands-on care: two in five were men and two in three had qualifications beyond high school; one in two decedents had accessed palliative care services. Reflecting the bivariable analyses, logistic regression models showed associations with workforce participation and: being male (odds ratio [OR] 6.71); use of palliative care services (OR 4.85); and higher levels of education (OR 3.54). Conclusion: An association between workforce participation after caregiving ceased and the use of palliative care services was described, controlling for key factors. Reasons may include continued working, greater rates of return to work, earlier return to work or that people in the workforce are more likely to access services.
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Affiliation(s)
- Joseph Clarke
- Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, United Kingdom
| | - Irina Kinchin
- Trinity College Institute of Medicine, School of Medicine, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Slavica Kochovska
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Miriam J Johnson
- Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, United Kingdom
| | - David C Currow
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
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3
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Hengelaar AH, Wittenberg Y, Kwekkeboom R, Van Hartingsveldt M, Verdonk P. Intersectionality in informal care research: a scoping review. Scand J Public Health 2023; 51:106-124. [PMID: 34232094 PMCID: PMC9903248 DOI: 10.1177/14034948211027816] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Aim: Informal caregivers share common experiences in providing care to someone with health and/or social needs, but at the same time their experiences differ across diverse backgrounds such as gender, age, culture, as these aspects of diversity co-shape these experiences. This scoping review aims to explore how aspects of diversity, across their intersections, are currently incorporated in informal care research and discusses how an intersectional perspective can further develop our understanding of informal care. Methods: A scoping review was performed to map relevant caregiving literature from an intersectionality perspective. Key terms 'informal care' and 'intersectionality' were used for a search in four databases resulting in the inclusion of 28 articles. All 28 studies were analysed based on a scoping review created intersectionality informed coding scheme. Results: Aspects of diversity are largely understudied in informal care research, in particular across their intersections and from a critical perspective. This intersectional informed analysis revealed that when studying diverse caregiving experiences the use of intersections of dimensions of diversity provides a nuanced understanding of these experiences. Conclusions: Adopting an intersectional perspective ensures that not only different categories or social identities of caregivers are included in future studies, but the mutual relationships between these categories embedded in their specific context are actually studied.
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Affiliation(s)
- Aldiene H. Hengelaar
- Department of Ethics, Law and Humanities, Amsterdam Public Health Research Institute, The Netherlands,Department of Occupational Therapy, Amsterdam University of Applied Sciences, The Netherlands,Aldiene H Hengelaar, Department of Ethics, Law and Humanities, Amsterdam Public Health Research Institute, Amsterdam UMC, location VUmc, Tafelbergweg 51, PO box 2557/1000, 1081 Amsterdam, HV, The Netherlands. E-mail:
| | - Yvette Wittenberg
- Faculty of Social and Behavioral Sciences, University of Amsterdam, The Netherlands,Faculty of Applied Social Sciences and Law, Amsterdam University of Applied Sciences, The Netherlands
| | - Rick Kwekkeboom
- Faculty of Applied Social Sciences and Law, Amsterdam University of Applied Sciences, The Netherlands
| | - Margo Van Hartingsveldt
- Department of Occupational Therapy, Amsterdam University of Applied Sciences, The Netherlands
| | - Petra Verdonk
- Department of Ethics, Law and Humanities, Amsterdam Public Health Research Institute, The Netherlands
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4
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Tieu M, Mudd A, Conroy T, Pinero de Plaza A, Kitson A. The trouble with personhood and person-centred care. Nurs Philos 2022; 23:e12381. [PMID: 35416420 DOI: 10.1111/nup.12381] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 01/04/2022] [Accepted: 02/05/2022] [Indexed: 12/30/2022]
Abstract
The phrase 'person-centred care' (PCC) reminds us that the fundamental philosophical goal of caring for people is to uphold or promote their personhood. However, such an idea has translated into promoting individualist notions of autonomy, empowerment and personal responsibility in the context of consumerism and neoliberalism, which is problematic both conceptually and practically. From a conceptual standpoint, it ignores the fact that humans are social, historical and biographical beings, and instead assumes an essentialist or idealized concept of personhood in which a person is viewed as an individual static object. From a practical standpoint, the application of such a concept of personhood can lead to neglect of a person's fundamental care needs and exacerbate the problems of social inequity, in particular for older people and people with dementia. Therefore, we argue that our understanding of PCC must instead be based on a dynamic concept of personhood that integrates the relevant social, relational, temporal and biographical dimensions. We propose that the correct concept of personhood in PCC is one in which persons are understood as socially embedded, relational and temporally extended subjects rather than merely individual, autonomous, asocial and atemporal objects. We then present a reconceptualization of the fundamental philosophical goal of PCC as promoting selfhood rather than personhood. Such a reconceptualization avoids the problems that beset the concept of personhood and its application in PCC, while also providing a philosophical foundation for the growing body of empirical literature that emphasizes the psychosocial, relational, subjective and biographical dimensions of PCC.
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Affiliation(s)
- Matthew Tieu
- College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia.,College of Arts Humanities and Social Sciences, Flinders University, Bedford Park, South Australia, Australia
| | - Alexandra Mudd
- College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia.,Caring Futures Institute, Flinders University, Bedford Park, South Australia, Australia
| | - Tiffany Conroy
- College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia.,Caring Futures Institute, Flinders University, Bedford Park, South Australia, Australia
| | - Alejandra Pinero de Plaza
- College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia.,Caring Futures Institute, Flinders University, Bedford Park, South Australia, Australia
| | - Alison Kitson
- College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia.,Caring Futures Institute, Flinders University, Bedford Park, South Australia, Australia
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5
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Calvó-Perxas L, Vilalta-Franch J, Litwin H, Mira P, Garre-Olmo J. A longitudinal study on public policy and the health of in-house caregivers in Europe. Health Policy 2021; 125:436-441. [PMID: 33602532 DOI: 10.1016/j.healthpol.2021.02.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 01/25/2021] [Accepted: 02/01/2021] [Indexed: 01/23/2023]
Abstract
Caregiving has negative effects on the health of informal caregivers. The current aging of the population predicts an increase in the number of informal caregivers worldwide. The effect of available public policies that support informal caregivers in their self-perceived health is an understudied topic. We analyzed the differences in the effects of public support policies in 11 European countries using longitudinal data from waves 5 and 6 of the Survey of Health Ageing and Retirement in Europe. In this cohort, 2303 respondents were in-house informal caregivers. Logistic regression models were fitted adjusting for the main determinants of caregiving. Respite care and caregiver allowances emerged as the most effective measures of support for caregivers' health maintenance (relative risk [RR] = 0.2; 95 % CI = 0.1-0.8 and RR = 0.5; 95 % CI = 0.3-0.9). Despite the differences in the welfare systems of Scandinavian and Mediterranean countries, informal caregivers in these countries were less likely than those living in Continental or Eastern countries to have declined health two years later. Our results indicate that public support policies are significantly related to caregivers' subsequent health, but the effects vary by country. Country-specific studies should be performed to take into account the determinants of caregiving linked to the social context of each country.
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Affiliation(s)
- Laia Calvó-Perxas
- Girona Biomedical Research Institute (IdIBGI), Girona, Catalonia, Spain.
| | - Joan Vilalta-Franch
- Girona Biomedical Research Institute (IdIBGI), Girona, Catalonia, Spain; Memory and Dementia Assessment Unit, Hospital Santa Caterina, Institut d'Assistència Sanitària, Salt, Catalonia, Spain; Department of Medical Sciences, University of Girona, Girona, Catalonia, Spain
| | - Howard Litwin
- Paul Baerwald School of Social Work and Social Welfare, The Hebrew University in Jerusalem, Jerusalem, Israel
| | - Pedro Mira
- Centro de Estudios Monetarios y Financieros, Banco de España, Madrid, Spain
| | - Josep Garre-Olmo
- Girona Biomedical Research Institute (IdIBGI), Girona, Catalonia, Spain; Department of Medical Sciences, University of Girona, Girona, Catalonia, Spain
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6
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Khadka J, Visvanathan R, Theou O, Moldovan M, Amare AT, Lang C, Ratcliffe J, Wesselingh SL, Inacio MC. Development and validation of a frailty index based on Australian Aged Care Assessment Program data. Med J Aust 2020; 213:321-326. [DOI: 10.5694/mja2.50720] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 04/16/2020] [Indexed: 11/17/2022]
Affiliation(s)
- Jyoti Khadka
- Registry of Senior Australians South Australian Health and Medical Research Institute Adelaide SA
- UniSA Business School University of South Australia Adelaide SA
- Caring Future Institute Flinders University Adelaide SA
| | - Renuka Visvanathan
- Adelaide Geriatrics Training and Research with Aged Care (G‐TRAC) Centre University of Adelaide Adelaide SA
- NHMRC Centre of Research Excellence in Frailty and Healthy Ageing Adelaide SA
- Basil Hetzel Institute Central Adelaide Local Health Network Adelaide SA
| | - Olga Theou
- Basil Hetzel Institute Central Adelaide Local Health Network Adelaide SA
- Dalhousie University Halifax Nova Scotia Canada
| | - Max Moldovan
- Registry of Senior Australians South Australian Health and Medical Research Institute Adelaide SA
| | - Azmeraw T Amare
- Registry of Senior Australians South Australian Health and Medical Research Institute Adelaide SA
| | - Catherine Lang
- Registry of Senior Australians South Australian Health and Medical Research Institute Adelaide SA
| | - Julie Ratcliffe
- Registry of Senior Australians South Australian Health and Medical Research Institute Adelaide SA
- Caring Future Institute Flinders University Adelaide SA
| | - Steven L Wesselingh
- Registry of Senior Australians South Australian Health and Medical Research Institute Adelaide SA
| | - Maria C Inacio
- Registry of Senior Australians South Australian Health and Medical Research Institute Adelaide SA
- Sansom Institute for Health Research University of South Australia Adelaide SA
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7
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Leslie M, Gray RP, Khayatzadeh-Mahani A. What is 'care quality' and can it be improved by information and communication technology? A typology of family caregivers' perspectives. Scand J Caring Sci 2020; 35:220-232. [PMID: 32168399 DOI: 10.1111/scs.12837] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 02/11/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION With governments worldwide reducing their involvement in the provision of institutional long-term elder care, community-based family caregivers (FCs) have become a key element in policies aimed at improving the quality of healthcare systems and maintaining their financial sustainability. This paper uses data from focus groups with FCs providing care to older adults to describe their approaches to and priorities for achieving care quality and sustainability as they work with formal health and social care systems. It describes FCs' views on information and communications technology (ICT) as potential supports for achieving these care quality and sustainability goals. METHODS We held 10 focus groups from May 2017 to August 2018 and recruited 25 FCs through a mix of convenience and snowball sampling strategies. We employed an inductive approach and used qualitative thematic content analysis methods to examine and interpret the resulting data. We used NVIVO 12 software for data analysis. RESULTS Quality of care - as delivered by both FCs themselves, and formal health and social care systems - was a major preoccupation for our participants. They saw communications quality as a key aspect of the broader concept of care quality. Our data analysis produced a typology of communications quality from the FC perspective. Analysis of our data also revealed ICT development opportunities and available products in key areas. CONCLUSIONS Our findings suggest that the formal care system providers could be more caregiver-oriented in their communications by engaging FCs in the decision-making process and allowing them to express their own concerns and goals. The implication of our findings for those seeking to develop policies and ICT products in support of FCs is that these should focus on human relationships and seek to expand facilitative communications.
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Affiliation(s)
- Myles Leslie
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,School of Public Policy, University of Calgary, Calgary, AB, Canada
| | | | - Akram Khayatzadeh-Mahani
- School of Public Policy, University of Calgary, Calgary, AB, Canada.,Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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8
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Leslie M, Khayatzadeh-Mahani A, MacKean G. Recruitment of caregivers into health services research: lessons from a user-centred design study. RESEARCH INVOLVEMENT AND ENGAGEMENT 2019; 5:17. [PMID: 31139432 PMCID: PMC6528243 DOI: 10.1186/s40900-019-0150-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 05/08/2019] [Indexed: 05/23/2023]
Abstract
BACKGROUND With patient and public engagement in many aspects of the healthcare system becoming an imperative, the recruitment of patients and members of the public into service and research roles has emerged as a challenge. The existing literature carries few reports of the methods - successful and unsuccessful - that researchers engaged in user-centred design (UCD) projects are using to recruit participants as equal partners in co-design research. This paper uses the recruitment experiences of a specific UCD project to provide a road map for other investigators, and to make general recommendations for funding agencies interested in supporting co-design research. METHODS We used a case study methodology and employed Nominal Group Technique (NGT) and Focus Group discussions to collect data. We recruited 25 family caregivers. RESULTS Employing various strategies to recruit unpaid family caregivers in a UCD project aimed at co-designing an assistive technology for family caregivers, we found that recruitment through caregiver agencies is the most efficient (least costly) and effective mechanism. The nature of this recruitment work - the time and compromises it requires - has, we believe, implications for funding agencies who need to understand that working with caregivers agencies, requires a considerable amount of time for building relationships, aligning values, and establishing trust. CONCLUSIONS In addition to providing adaptable strategies, the paper contributes to discussions surrounding how projects seeking effective, meaningful, and ethical patient and public engagement are planned and funded. We call for more evidence to explore effective mechanisms to recruit family caregivers into qualitative research. We also call for reports of successful strategies that other researchers have employed to recruit and retain family caregivers in their research.
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Affiliation(s)
- Myles Leslie
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta Canada
- School of Public Policy, University of Calgary, Downtown Campus, 906 8th Avenue S.W., 5th Floor, Calgary, Alberta T2P 1H9 Canada
| | - Akram Khayatzadeh-Mahani
- School of Public Policy, University of Calgary, Downtown Campus, 906 8th Avenue S.W., 5th Floor, Calgary, Alberta T2P 1H9 Canada
- Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Gail MacKean
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta Canada
- IMAGINE Citizens Collaborating for Health, Calgary, Alberta Canada
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9
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Schofield D, Shrestha RN, Zeppel MJB, Cunich MM, Tanton R, Veerman JL, Kelly SJ, Passey ME. Economic costs of informal care for people with chronic diseases in the community: Lost income, extra welfare payments, and reduced taxes in Australia in 2015-2030. HEALTH & SOCIAL CARE IN THE COMMUNITY 2019; 27:493-501. [PMID: 30378213 DOI: 10.1111/hsc.12670] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 07/26/2018] [Accepted: 09/12/2018] [Indexed: 06/08/2023]
Abstract
We estimated the economic costs of informal care in the community from 2015 to 2030, using an Australian microsimulation model, Care&WorkMOD. The model was based on data from three Surveys of Disability, Ageing, and Carers (SDACs) for the Australian population aged 15-64 years old. Estimated national income lost was AU$3.58 billion in 2015, increasing to $5.33 billion in 2030 (49% increase). Lost tax payments were estimated at AU$0.99 billion in 2015, increasing to AU$1.44 billion in 2030 (45% increase), and additional welfare payments were expected to rise from $1.45 billion in 2015 to AU$1.94 in 2030 (34% increase). There are substantial economic costs both to informal carers and the government due to carers being out of the labour-force to provide informal care for people with chronic diseases. Health and social policies supporting carers to remain in the labour force may allow governments to make substantial savings, while improving the economic situation of carers.
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Affiliation(s)
- Deborah Schofield
- Department of Economics, Faculty of Business and Economics, GenIMPACT, Centre for Economic Impacts of Genomic Medicine, Macquarie University, NSW, Australia
| | - Rupendra N Shrestha
- Department of Economics, Faculty of Business and Economics, GenIMPACT, Centre for Economic Impacts of Genomic Medicine, Macquarie University, NSW, Australia
| | - Melanie J B Zeppel
- Department of Economics, Faculty of Business and Economics, GenIMPACT, Centre for Economic Impacts of Genomic Medicine, Macquarie University, NSW, Australia
| | - Michelle M Cunich
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
- Co-Director, Sydney Health Economics, Sydney Local Health District
| | - Robert Tanton
- National Centre for Social and Economic Modelling, University of Canberra, Canberra, ACT, Australia
| | | | - Simon J Kelly
- Department of Economics, Faculty of Business and Economics, GenIMPACT, Centre for Economic Impacts of Genomic Medicine, Macquarie University, NSW, Australia
- National Centre for Social and Economic Modelling, University of Canberra, Canberra, ACT, Australia
| | - Megan E Passey
- The University of Sydney, University Centre for Rural Health, Lismore, NSW, Australia
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10
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Luckett T, Agar M, DiGiacomo M, Ferguson C, Lam L, Phillips J. Health status of people who have provided informal care or support to an adult with chronic disease in the last 5 years: results from a population-based cross-sectional survey in South Australia. AUST HEALTH REV 2019; 43:408-414. [DOI: 10.1071/ah17289] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 03/01/2018] [Indexed: 11/23/2022]
Abstract
Objective
The aim of the present study was to compare the health status of South Australians with recent experience of caring for an adult with chronic disease with non-carers drawn from the same population.
Methods
Data were collected via the South Australian Health Omnibus, an annual population-based, cross-sectional survey. Respondents were asked whether they had provided care or support in the last 5 years to someone with cancer, heart disease, respiratory disease, mental illness, neurological disease or dementia. Health status was measured using the Short Form-12 version 1 (SF-12) physical and mental component scale summary scores (PCS and MCS respectively), with poor health status defined as ≥0.5 standard deviation below the normative mean. Logistic regression explored characteristics associated with poor health status.
Results
Of 3033 respondents analysed, 987 (32.5%) reported caring experience. Poor PCS and MCS were associated with carer status, lower-than-degree-level education, employment status other than employed and annual household income less than A$60000. Being Australian born was a protective factor for PCS, whereas factors protective for MCS were being married or in a de facto relationship and age ≥65 years.
Conclusions
Providing care or support in the last 5 years is independently associated with poorer health status, but not with the magnitude found in studies of current carers. Future research should explore health status recovery after completion of the caring role, and investigate whether relationships between health and socioeconomic status differ for carers versus non-carers.
What is known about the topic?
Population-based survey studies in Australia and overseas have consistently found that informal carers have worse health status than non-carers.
What does this paper add?
Including recent as well as current carers in a population-based sample was associated with less effect on health status compared with studies focused on current carers only. This finding is consistent with the possibility that health status recovers during the 5 years after caring.
What are the implications for practitioners?
Support for Australian carers is warranted to ensure their continuing contributions to society and return to productivity after their caring role is completed.
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11
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Stacey AF, Gill TK, Price K, Taylor AW. Differences in risk factors and chronic conditions between informal (family) carers and non-carers using a population-based cross-sectional survey in South Australia. BMJ Open 2018; 8:e020173. [PMID: 30037861 PMCID: PMC6059288 DOI: 10.1136/bmjopen-2017-020173] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND There is growing discussion on the impact of informal caregiving on the health status and morbidity of family carers. Evidence suggests a proportion of carers may be at risk of poor health outcomes. However, there are limited population-based studies that provide representative data on specific risk factors among carers (eg, blood pressure, cholesterol, smoking status, activity and body mass index) and major chronic conditions (eg, asthma, diabetes and arthritis). This study aimed to redress that imbalance. METHOD Self-reported data were from the South Australian Monitoring and Surveillance System (SAMSS), a representative cross-sectional state-wide population-based survey of 600 randomly selected persons per month. SAMSS uses computer-assisted telephone interviewing (CATI) to monitor chronic health-related problems and risk factors and to assess health outcomes. In total, 2247 family carers were identified from 35 195 participants aged 16 years and older for the 5-year period from 2010 to 2015. Logistic regression analyses examined associations of being a carer with self-reported chronic diseases and health risk factors. In addition, the population attributable risk (PAR) of being a carer was examined for selected chronic conditions. RESULTS The prevalence of carers was 6.4%, and peak age group for carers was 50-59 years. Adjusted ORs for chronic conditions in carers were significant for all chronic conditions examined. Although there is a high prevalence of self-reported risk factors and chronic conditions among carers compared with non-carers at the population level, PAR findings suggest that caregiving is associated with a small to moderate increased risk of having these chronic conditions. CONCLUSIONS Monitoring of carer health and morbidity particularly 'at risk' individuals such as female carers with asthma or diabetes remains important and provides an ongoing baseline for future surveys. To achieve this, caregiver-based studies need to become part of mainstream biomedical research at both epidemiological and clinical levels.
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Affiliation(s)
- Anne F Stacey
- Population Research & Outcome Studies, Discipline of Medicine, The University of Adelaide, Adelaide, South Australia, Australia
| | - Tiffany K Gill
- Population Research & Outcome Studies, Discipline of Medicine, The University of Adelaide, Adelaide, South Australia, Australia
| | - Kay Price
- School of Nursing and Midwifery, University of South Australia, Adelaide, South Australia, Australia
| | - Anne W Taylor
- Population Research & Outcome Studies, Discipline of Medicine, The University of Adelaide, Adelaide, South Australia, Australia
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12
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Calvó-Perxas L, Vilalta-Franch J, Litwin H, Turró-Garriga O, Mira P, Garre-Olmo J. What seems to matter in public policy and the health of informal caregivers? A cross-sectional study in 12 European countries. PLoS One 2018. [PMID: 29518147 PMCID: PMC5843287 DOI: 10.1371/journal.pone.0194232] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
In Europe, informal caregiving is frequent and is expected to grow. Caregiving has an impact on caregivers’ health, but its effect may vary according to the policies of support that are available to caregivers. The aim of this study was to assess the association between the policies of support to caregivers available in 12 European countries and the health of caregivers, considering separately the policies based on financial help and those based on training and other non- financial services. We used data from 13,507 caregivers from 12 European countries from the fifth wave of the Survey of Health, Ageing and Retirement in Europe (SHARE) to build a path model. Poor health among caregivers was associated with living in a family-based care country (β = 0.50; 95% CI = 0.42–0.59), and with an increased extent of caregiving (β = 0.18; 95% CI = 0.15–0.22). Non-financial support measures seem to have a larger protective impact (β = –0.33; 95% CI = –0.38 - –0.28) on the health of caregivers than do financial support measures (β = 0.03; 95% CI = 0.01–0.04), regardless of the gender of the caregiver. According to our results, the currently available policies of support associated with better health among caregivers are those that: 1) provide them with some free time, 2) help them to deal emotionally with caregiving, and 3) give them skills to both improve the care situation and to deal with it better.
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Affiliation(s)
- Laia Calvó-Perxas
- Girona Biomedical Research Institute (IdIBGI), Girona, Catalonia, Spain
- * E-mail:
| | - Joan Vilalta-Franch
- Girona Biomedical Research Institute (IdIBGI), Girona, Catalonia, Spain
- Memory and Dementia Assessment Unit, Hospital Santa Caterina, Institut d’Assistència Sanitària, Salt, Catalonia, Spain
- Department of Medical Sciences, University of Girona, Girona, Catalonia, Spain
| | - Howard Litwin
- Paul Baerwald School of Social Work and Social Welfare, The Hebrew University in Jerusalem, Jerusalem, Israel
| | - Oriol Turró-Garriga
- Girona Biomedical Research Institute (IdIBGI), Girona, Catalonia, Spain
- Memory and Dementia Assessment Unit, Hospital Santa Caterina, Institut d’Assistència Sanitària, Salt, Catalonia, Spain
| | - Pedro Mira
- Centro de Estudios Monetarios y Financieros, Banco de España, Madrid, Spain
| | - Josep Garre-Olmo
- Girona Biomedical Research Institute (IdIBGI), Girona, Catalonia, Spain
- Memory and Dementia Assessment Unit, Hospital Santa Caterina, Institut d’Assistència Sanitària, Salt, Catalonia, Spain
- Department of Medical Sciences, University of Girona, Girona, Catalonia, Spain
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