The influence of social support, care burden, and depression on quality of life among caregivers of patients with severe mental illness: a cross-sectional survey in rural areas of Sichuan, China

Abstract

BackgroundIn China, there were 5·8 million registered patients with severe mental illness in December, 2017. Caring for such patients can affect the health of primary family caregivers, which can influence their quality of life (QoL). We aimed to describe the QoL among caregivers of patients with severe mental illness in rural areas of Sichuan province of China, examine the influence of social support, care burden, and depression on QoL, and explore the mediating effect of depression on the associations between social support, care burden, and QoL. MethodsThis cross-sectional study was done using multi-stage stratified random sampling from a registry of individuals with severe mental illness. Primary caregivers of patients with severe mental illness in rural Sichuan Province in China were asked to complete questionnaires on social support, care burden, depression, and quality of life. Structural equation models (SEM) were used to examine the relationships among these four variables. FindingsBetween Dec 1, 2017, and May 31, 2018, we enrolled 300 caregivers; 256 of whom responded to the questionnaire. The mean scores were 32·1 (SD 7·7) for social support, 42·3 (15·9) for care burden, 10·0 (5·3) for depression, and 53·9 (9·7) for QoL. Of the 256 caregivers, 82 (32%) had a poor QoL. Depression was negatively associated with QoL (β=–0·975 [95% CI −1·058 to −0·889]), social support was negatively associated with care burden (β=–0·498 [–0·638 to −0·349]) and depression (β=–0·521 [–0·679 to −0·368]), and care burden was positively associated with depression (β=0·283 [0·117 to 0·416]). Social support (β=0·645 [0·518 to 0·764]) and care burden (β=–0·276 [–0·410 to −0·110]) had indirect associations with QoL via depression. InterpretationPolicy makers should recognise the important role of primary family caregivers in caring for patients with severe mental illness. Improvements in the QoL of caregivers of such patients will require decreased care burden and depression via enhanced social support. FundingNone.