Obligation and negative consequences in primary caregivers of dependent older relatives.

Rafael Del-Pino-Casado,Laura Parra-Anguita,Maria Del Mar Pastor-Bravo,Natalia Serrano-Ortega,Catalina López-Martínez

doi:10.1371/journal.pone.0203790

Rafael Del-Pino-Casado, Laura Parra-Anguita + Show 3 more

Open Access

https://doi.org/10.1371/journal.pone.0203790

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Abstract

The purpose of this study was to analyse the multidimensional nature of obligation and the relations between each dimension of obligation and both anxiety and depression. A secondary analysis of data from two cross-sectional studies of primary home caregivers (N = 400; probabilistic sample) of older adult relatives in Spain was conducted. Data regarding obligation (four categories basing on beliefs of obligation and social pressure: low pressure and low beliefs, low pressure and high beliefs, high pressure and low beliefs and high pressure and high beliefs), stressors, anxiety and depression were collected by interview in 2013. The combination of high pressure and low beliefs had the highest levels of anxiety and depression, and the combination of low pressure and high beliefs had the lowest levels of anxiety and depression. When the relation of behavioural problems with anxiety and depression stratified by the previous four categories of obligation was analysed, behavioural problems were associated with anxiety and depression in the subgroups with low beliefs of obligation, whereas this association disappeared in the subgroups with high beliefs of obligation.

Highlights

In developed countries, the increase in ageing and dependence [1] has increased the need for long-term care
Because the combination high pressure and low beliefs (HPLB) had the highest levels of anxiety and depression and the combination low pressure and high beliefs (LPHB) had the lowest levels of anxiety and depression, our findings may support that internal motives for caregiving protect one from the negative consequences of caregiving and that external motives increase the risk of such consequences
Obligation has usually been studied in caregiving as a unique dimension, our findings supported the existence of two dimensions: an external obligation represented by the social pressure and an internal obligation represented by beliefs of obligation

Summary

Introduction

The increase in ageing and dependence [1] has increased the need for long-term care. In these countries, most long-term care is provided by the family [2]. Caring for an older adult dependent may have negative consequences for the caregiver’s health [3]. Such negative consequences include those related to emotional health, especially depression and anxiety [3,4].

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