Objective Caregiver Burden Research Articles

Caregiving Burdens in Aphasic Dementia and the Relationship to Communication Challenges

AbstractBackgroundPrimary progressive aphasia (PPA) is a clinical dementia syndrome. Impairments in language are the primary and persistent symptom, and severely limit participation in everyday activities and family conversations. PPA is also associated with high caregiving burden. Few studies have examined the relationship between conversation difficulties and caregiving burdens. We tested the hypothesis that the severity of care partner (CP) perceived conversation difficulties predicts caregiving burdens.MethodA mediation analysis focusing on the Baron‐Kenny approach was conducted using baseline data from 78 CPs (62% female) enrolled in the Communication BridgeTM‐2 randomized control trial of a speech‐language intervention for mild to moderate PPA. Measures included the Conversation Difficulties subscale of the Perception of Conversation Index‐Dementia Alzheimer’s Type (PCI‐DAT) and the subscales of Montgomery Burden Interview (MBI), namely objective burden subscale (perceived infringement on tangible aspects of life), subjective demand subscale (perception that the dependent person is overly demanding), and subjective stress subscale (perception of emotional impact). Higher ratings indicate higher burden and greater conversation difficulties.ResultCPs had a mean age of 64.5 years (SD = 10.76), education level of 16.2 years (SD = 2.77), and a relationship duration with the PPA participant of 38.6 years (SD = 15.29). Eighty‐six percent were spouses, 5% were adult children, and 9% were friends or siblings. CPs endorsed a broad range of burden severity with a mean objective burden score of 9.29/30 (Range = 6 to 26; SD = 4.01), subjective demand burden score of 5.81/15 (Range = 5 to 12; SD = 1.41), and subjective stress burden score of 8.43/20 (Range = 5 to 16; SD = 2.72) as well as a range of perceive conversation difficulties (M = 42.34/154, Range = 6 to 105, SD = 22.88). Higher conversation difficulties were associated with higher ratings of caregiving burden for objective burden (p < 0.001) and subjective stress burden (p = 0.010). Significant mediating variables included activities of daily living and CP depression scores.ConclusionThe current study shows an association between both subjective and objective caregiving burden and conversation difficulties. Given this relationship, it will be important to determine whether interventions that successfully address conversation difficulties may also decrease caregiving burden.

Comparing adult-child and spousal caregiver burden and potential contributors.

Adult-children caring for a parent with cancer comprise a significant segment of caregivers. Yet less is known about adult-child caregivers, their burden, or caregivers' and patients' gender's impact, which may differ from the well-studied spousal caregiver. This knowledge gap may hinder efforts to ameliorate adult-children's caregiver burden. We analyzed caregiver surveys from the Cancer Care Outcomes Research and Surveillance Consortium, a multi-regional population-based study of patients with colorectal or lung cancer. Using t tests and multivariate regression models, we assessed whether adult-child and spousal caregivers' caregiving responsibilities and social/emotional and financial burdens differed and used structural equation models (SEMs) to examine mediating factors. Compared with spouses/partners (N=1007), adult-children (N=227) spent less time caregiving (14 vs 23hours/week; P<.001), but experienced higher social/ emotional burden (P<.01). In models adjusted for objective caregiving burden measures and demographics, adult-children's social/emotional (P<.05) and financial burdens (P<.01) were greater than spouses'. Poor communication quality was associated with greater social/emotional burden for both groups (P<.05). SEMs indicated that gender concordance between caregivers and patients (eg, daughters caring for mothers) and caregiver employment increased the difference between adult-child and spouses' social/emotional burden, whereas caregiver-patient relationship quality reduced it. Adult-children spend less time caregiving than spouses/partners, but have higher social/emotional and financial caregiving burdens, partially due to adult-children's employment, caregiver-patients' gender concordance, and relationship quality. Gender concordance's contribution to greater social/emotional burden adds important context to prior findings, indicating female caregivers experience the most burden. Interventions that improve caregiver-patient communication may reduce both adult-child and spousal caregiver burden.

Challenges of caregiving to neurological patients.

A substantial number of neurological diseases lead to chronic impairment of activities of daily living (ADL) and physical or mental dependence. In Austria, homecare is provided mostly by female family members. Moreover, mainly female personnel, in the majority from southern and eastern European countries, contributes to care. Dependence and need for care vary between neurological diagnoses and accompanying diseases. Caregiver burden (CB) depends on patient- and caregiver-related and external factors, such as integrity of a family network, spatial resources, and socioeconomic factors. Depending on the neurological diagnosis, disease severity, and behavioral impairment and psychiatric symptoms, caregivers (CG) are at a significant risk of mental and somatic health problems because of limitations in personal needs, occupational and social obligations, financial burden, and restricted family life and leisure. Subjective and objective CB needs to be assessed in time and support should be provided on an individual basis. Recently, COVID-19 has caused additional multifactorial distress to dependent patients and informal and professional CG.

Psychometric Examination of the Dutch Objective Burden Inventory in Heart Failure Caregivers.

Psychometric properties of the 38-item version of the Dutch Objective Burden Inventory (DOBI) have been evaluated primarily in older female caregivers, with no published studies that vary by a different gender and age distribution. The aim of this study was to test the construct validity and reliability of the DOBI in caregivers of individuals with heart failure from the United States and other countries. This secondary analysis from a cross-sectional study used an online survey. Factorial validity was tested with confirmatory factor analysis, item performance was examined with ordinal item response analysis, and convergent validity was tested correlating DOBI subscale scores with Bakas Caregiving Outcomes Scale scores. Internal consistency reliability was assessed with Cronbach α. Item response analysis removed 14 items. Confirmatory factor analysis retained the original 4-factor solution. Original and reduced instruments demonstrated good internal consistency. Validity was supported by meaningful associations with the Bakas Caregiving Outcomes Scale. Both the original 38-item DOBI and the reduced 24-item DOBI had support for their construct validity and internal consistency. The 24-item DOBI may be a useful alternative to the 38-item version, because it maintains psychometric properties of the original instrument while decreasing data collection burden. However, more research is needed to assess whether the shorter version is useful in assessing objective caregiving burden.

General and gender-specific dynamics determining the health status of employed family caregivers

ABSTRACT We examined whether gender plays a role in how financial strain moderates the relationship between health status and objective burden among employed family caregivers. Using data from “Caregiving in the U.S., 2015,” the sample included 704 employed caregivers (311 males and 393 females) of adults 50 years of age and older. The relationship between objective caregiver burden and self-reported health was moderated by financial strain in the full sample. However, in separate analyses by gender, this moderated relationship was limited to females. Findings inform interventions to improve caregiver health while accounting for the financial strain experienced by women in particular.

Caregiver burden: A concept analysis

ObjectiveCaregiver burden is used frequently within the nursing literature. It has not yet been clearly defined as there are different opinions regarding this concept. The purpose of this paper is to provide clarity surrounding the concept caregiver burden. MethodsAn electronic search of MEDLINE, CINAHL, Health Source Nursing/Academic Edition and Academic Search Complete (ASC) of EBSCO, China National Knowledge Infrastructure (CNKI) and Google Scholar were searched with a limit of 10 years and published in the English or Chinese language. The paper adopted the framework by Walker and Avant. The attributes, antecedents, consequences and uses of the concept were identified. ResultsAt total of 33 articles were included. The three attributes of caregiver burden were identified as self-perception, multifaceted strain, and over time. The antecedents included insufficient financial resources, multiple responsibility conflict, lack of social activities. The consequences of caregiver burden resulted in negative change which included decreased care provision, decrease in quality of life, physical and psychological health deterioration. ConclusionA definition of caregiver burden was developed. Tools to measure caregiver burden were identified. The findings from this analysis can be used in nursing practice, nursing education, research and administration.

Caregiver burden in psychogenic non-epileptic seizures

ObjectiveCaregiver burden in psychogenic non-epileptic seizures (PNES) is an important but understudied reality. The objective of this exploratory study was to quantify caregiver burden in PNES and to identify the patient and caregiver characteristics associated with it. MethodsPNES patients and their identified caregivers completed surveys about demographic, disease related and psychosocial characteristics during their Epilepsy Monitoring Unit (EMU) admission. Associations were evaluated using the Zarit Caregiver Burden Inventory (ZCBI) score as an independent variable and the patient and caregiver related characteristics as dependent variables. Results43 patients and 28 caregivers were recruited. The patients were on average 36 years old, single women, unemployed, with some college education. They suffered from PNES on average for 8 years, having approximately 20 seizures per month, and were previously maintained on ≥ 2 antiseizure medications. Most caregivers were first degree relatives with a mean age of 43 years, married employed women of higher educational attainment, typically cohabitating with the patients. Caregiver burden was within the mild-moderate range (ZCBI mean score 28). The burden appeared higher in caregivers of male patients. Patient quality of life, depression and medication side effects were associated with that burden. Additionally, caregiver stigma, depression and anxiety emerged as potential contributors. In the multivariate analysis, patient quality of life and caregiver depression stood out as the most robust factors. ConclusionThere is substantial caregiver burden in PNES. It is associated with both the patient and the caregiver psychosocial well-being in a reciprocal relationship.

Objective and Subjective Dementia Caregiving Burden: The Moderating Role of Immanent Justice Reasoning and Social Support.

Caregiving burden significantly effects the physical and mental health of family dementia caregivers. While the association between objective caregiving burden (OCB) and subjective caregiving burden (SCB) of family dementia caregivers is well documented, little is known as with how the association is moderated by the configuration of intrapersonal resource (e.g., immanent justice reasoning) and interpersonal resource (e.g., social support). The present study collected cross-sectional data on 157 major family caregivers of non-institutionalized persons with dementia in an urbanizing region of Western China’s Sichuan Province. They responded to questions on daily time spent on caregiving, the short version of Zarit Burden Interview (ZBI), a sub-scale of a caregiver meaning scale, Social Support Rating Scale (SSRS), and demographic questions. Controlling for the demographic variables of the caregivers, this study found that the objective and subjective dementia caregiving burden were significantly associated (p < 0.001), and immanent justice reasoning was positively correlated with subjective burden (p < 0.01). Moreover, the association between OCB and SCB was significantly positive when social support and immanent justice reasoning were both high (p < 0.001), but neutral when social support was high and immanent justice reasoning was low. The association between OCB and SCB was significantly positive when social support and immanent justice reasoning were both low (p < 0.05), but neutral when social support was low and immanent justice reasoning was high. This research suggests the importance of developing intervention programs that consider the configuration of the external supporting resources and internal meaning-making of caregiving of the family dementia caregivers.

Is informal caregiving at odds with optimal health behaviour? A cross-sectional analysis in the caregiving partners of persons with spinal cord injury

ABSTRACT Background The intricate relationship between caregiving and health may to some extent be determined by the burden and restrictions imposed on informal caregivers, and the impact these experiences have on health behaviours. It is assumed that a positive caregiver experience leads to health promoting behaviours in caregivers, whereas a negative experience induces the opposite. The objective of this study is to test these assumptions and to investigate the association between the caregiver experience and health behaviours in the caregiving partners of persons with severe physical impairment, due to spinal cord injury. Methods Cross-sectional survey data from 133 couples of caregiving partners and persons with spinal cord injury living in Switzerland was used. We employed multivariable regression to evaluate the associations of the caregiver experience (objective and subjective caregiver burden, and satisfaction with caregiving) with health behaviours (physical activity, fruit and vegetable consumption, alcohol consumption, smoking, and sleep duration). Results The most robust associations were found between subjective caregiver burden and health behaviours, whereby caregivers reporting a higher burden reported less physical activity (Incidence Rate Ratio [IRR]:0.41; 95% CI 0.35-0.49), more alcohol consumption (IRR: 1.46; 1.20-1.77), greater smoking intensity (IRR: 1.29; 0.95-1.73), and a higher likelihood of insufficient sleep duration (Odds Ratio [OR]: 4.98; 1.58-15.74). Caregivers, who reported high objective burden, i.e. invested long hours in caregiving, were more prone to partake in health adverse behaviours, in particular greater alcohol consumption. Results also suggested that caregivers who were satisfied in their role and who received social support in caregiving were more likely to be physically active. Conclusion Caregivers suffering from high emotional and time burden may benefit from both practical and psychological support. This support may release resources enabling individuals to partake in health promoting behaviours, or to develop coping strategies to better deal with the burden of caregiving.

Relationship of stigma with burden and coping among caregivers of patients with severe mental disorders

Aim: This study aimed to evaluate the association of stigma with the caregiver burden and coping. Methodology: One hundred and sixteen adult caregivers of persons with severe mental illness were evaluated on the Stigma Scale for Caregivers of People with Mental Illness (CPMI), Family Burden Interview (FBI) Schedule, and Family Coping Questionnaire. Results: In terms of stigma, the mean total score was highest for the affective component followed by behavioral and least for the cognitive component of CPMI. On FBI, the highest burden was reported for the financial burden followed by disruption of routine family activities, disruption of family leisure activities, disruption of family interaction, the effect on the physical health of others, and effect on the mental health of others. The most common coping strategy used by the caregivers was gathering information followed by positive communication and patient's social involvement. A higher level of stigma in all the domains was associated with a significantly higher burden in all the domains of the objective burden, except for effect on physical and mental health on others. Higher use of copings such as positive communication and social interests was associated with higher stigma in all the domains except for lack of significant association between positive communication and cognitive domain of stigma. Higher use of resignation as a coping mechanism was associated with a higher stigma in the cognitive domain of CPMI. Conclusion: This study shows that a higher level of stigma among caregivers of patients with severe mental disorder is associated with higher objective caregiver burden and higher use of coping mechanisms such as positive communication and social interest. Accordingly, it can be said that any effort to mitigate the caregiver burden needs to take stigma into account.

Social inequalities in the burden of care: a dyadic analysis in the caregiving partners of persons with a physical disability

BackgroundSocioeconomic position (SEP) is an important contextual factor in the Stress Process Model of caregiving. However, the basic assumption that low SEP is associated with greater caregiver burden has so far lacked empirical support. The objective of this study was to investigate social inequalities in the caregiver burden among caregiving partners of persons with a physical disability, i.e., spinal cord injury (SCI), applying a dyadic approach. More specifically, we investigated 1) the association of the caregivers’ SEP with caregiver burden (‘actor effect’); 2) the association of the care-receivers’ SEP with caregiver burden (‘partner effect’), and 3) potential mediators of the association between SEP and caregiver burden.MethodsCross-sectional survey data from 118 couples of persons with SCI and their partners living in Switzerland was used. We firstly employed logistic regression to investigate the actor and partner effects of SEP on objective (hours of caregiving) and subjective caregiver burden (Zarit Burden Interview). We additionally used structural equation modelling to explore whether unfulfilled support needs, psychosocial resources and the care-receivers health status mediated the association between SEP and caregiver burden. SEP was operationalized by household income, education, subjective social position, financial strain and home ownership.ResultsWe observed a consistent trend towards higher objective and subjective burden in lower SEP groups. Caregivers with higher subjective social positon and home ownership indicated lower subjective burden, and caregivers with higher education and absence of financial strain reported lower objective burden. Further evidence suggested a partner effect of SEP on caregiver burden, whereby objective caregiver burden was reduced in couples where the care-receiver had a higher educational level. The negative association between SEP and subjective burden was partially mediated by the unfulfilled support needs and deprived psychological resources of the caregiver, and the poor health status of the care-receiver. Similar mediation effects were not supported for objective burden.ConclusionsOur study, in the context of SCI, provides support for the contextual role of SEP in the Stress Process Model of caregiving. To reduce subjective caregiver burden, policy programs may target the strengthening of psychosocial resources, or the improvement of access to support services for caregivers with low SEP.

GENERAL AND GENDER-SPECIFIC DYNAMICS DETERMINING THE HEALTH STATUS OF WORKING INFORMAL CAREGIVERS

As the gender divide among family caregivers closes, it is important to understand whether and how men and women differently experience caregiving. For example, literature suggests that employed family caregivers experience burden and health outcomes differently than unemployed caregivers, but less is known about how these factors affect men and women differently. Using data from Caregiving in the U.S., 2015 (source: AARP and NAC), this study reliably modelled the effect of multiple threats to good health within the caregiving role (e.g. physical, financial, and emotional strain). In the analysis, several moderated relationships were observed using data from 816 working caregivers. In the full sample, the relationship between objective caregiving burden (hours of care and counts of ADLs/IADLs) and self-reported health status was altered by financial strain. In the high burden condition, relatively poor health was progressively related to increasing levels of financial strain controlling for traditional covariates. In separate analyses for males and females, this moderated relationship was discovered to be limited to female caregivers. Physical and emotional strain did not moderate the relationship between burden and health. Several covariates related to employment conditions (e.g., caregiver-friendly workplace policies) behaved differently across models and are presented and discussed in relation to financial strain as a determinant of caregiver health. These findings shed light on gender-based differences in caregiver outcomes, and suggest that interventions aimed at assessing and improving caregiver health should account for the financial strain experienced particularly by women.

A Pilot Trial of Online Training for Family Well-Being and Veteran Treatment Initiation for PTSD.

Family members are important supports for veterans with Posttrauamtic Stress Disroder (PTSD), but they often struggle with their own distress and challenges. The Veterans Affairs-Community Reinforcement and Family Training (VA-CRAFT) website was designed to teach family members of veterans with PTSD effective ways to interact with their veterans to encourage initiation of mental health services as well as to care for themselves and improve their relationships. This article presents a pilot investigation of VA-CRAFT. Spouse/partners of veterans who had screened positive for PTSD but were not in mental health treatment were randomized to either use the VA-CRAFT website (n=22) or to a waitlist control condition (n=19) for 3months. Veteran mental health service initiation was assessed posttreatment. Spouse/partner distress, caregiver burden, quality of life, and relationship quality were assessed pre and posttreatment. The study was approved by the Minneapolis VA Health Care System Institutional Review Board (IRB). Differences between groups on veteran treatment initiation were small (Phi=0.17) and not statistically significant. VA-CRAFT participants reported large and statistically significantly greater decreases in overall caregiver burden (η2=0.10) and objective caregiver burden (η2=0.14) than control participants. Effects were larger for those with greater initial distress. Effects sizes for other partner outcomes were negligible (η2=0.01) to medium (η2=0.09) and not statistically significant. Postintervention interviews suggested that only 33% of the VA-CRAFT participants talked with their veterans about starting treatment for PTSD during the trial. Results from this pilot trial suggest that VA-CRAFT holds initial promise in reducing caregiver burden and as such it could be a useful resource for family members of veterans with PTSD. However, VA-CRAFT does not enhance veteran treatment initiation. It may benefit from enhancements to increase effectiveness and caregiver engagement.

Factors associated with long-term impact on informal caregivers during Alzheimer's disease dementia progression: 36-month results from GERAS.

To identify, in caregivers of patients with Alzheimer's disease (AD) dementia, factors associated with subjective (personal, physical, emotional, and social) and objective (informal caregiver time and costs) caregiver burden. Prospective longitudinal European observational study: post-hoc analysis. Clinic. Community-dwelling patients in France and Germany aged ≥ 55 years (n = 969) with probable AD and their informal caregivers. Mini-Mental State Examination (MMSE), Alzheimer's Disease Cooperative Study-Activities of Daily Living (ADCS-ADL), 12-item Neuropsychiatric Inventory (NPI-12), Zarit Burden Interview (ZBI), informal caregiver basic and instrumental ADL hours (Resource Utilization in Dementia instrument), and informal caregiver costs. Mixed-effect models of repeated measures (MMRM) were run, including baseline and time-dependent covariates (change from baseline [CFB] to 18 months in MMSE, ADCS-ADL, and NPI-12 scores) associated with CFB in ZBI score/informal caregiver time over 36 months (analyzed using linear regression models) and informal caregiver costs over 36 months (analyzed using generalized linear models). Greater decline in patient function (ADCS-ADL) over 18 months was associated with increased subjective caregiver burden (ZBI), hours, and costs over 36 months. Increased behavioral problems (NPI-12) over 18 months also negatively impacted ZBI. Cognitive decline (MMSE) over 18 months did not affect change in caregiver burden. Long-term informal caregiver burden was driven by worsening functional abilities and behavioral symptoms but not cognitive decline, over 18 months in community-dwelling patients with AD dementia. Identifying the drivers of caregiver burden could highlight areas in which interventions may benefit both caregivers and patients.

Does well-being suffer when control in productive activities is low? A dyadic longitudinal analysis in the disability setting

ObjectivesWe investigate the relationship between control in productive activities (paid work, housework, caregiving) and well-being in persons with a physical disability and their caregiving partners from a dyadic perspective, exploring not only the effect of own control on well-being, but also the effect of the partners' control on well-being. We further evaluated socioeconomic and caregiving characteristics as potential risk factors for low control in productive activities. MethodsLongitudinal dyadic data from the pro-WELL survey (n = 246) including persons with spinal cord injury (SCI) and their caregiving partners were used and mixed-effects regression modelling was applied. Well-being was operationalized with a cognitive (Satisfaction with Life Scale, SWLS) and an affective component (Positive and Negative Affect Scale, PANAS). ResultsControl at work was positively related to well-being in persons with SCI, but less so in caregiving partners. Control in housework and caregiving was associated with higher well-being. The partners' control was linked to affective well-being. Poor socioeconomic conditions were negatively related to control at work and in caregiving, but not to control in housework. Caregiving characteristics seem unrelated to control at work or housework, but higher objective caregiver burden was linked to reduced control in caregiving. ConclusionsOur findings suggest that low control in productive activities are common in the disability setting and represent an instrumental factor for reduced well-being that is augmented by poor socioeconomic conditions and high objective burden of care. Interventions aiming to optimize well-being through the integration in productive activities should take into account opportunities of exerting control.

Employed Caregivers’ Response to Family-Role Overload: the Role of Control-at-Home and Caregiver Type

Drawing from role theory, stress and coping, and caregiving literatures, this paper develops a model of family-role overload involving two forms of caregiver burden (subjective, objective) and two types of maladaptive changes in employee behavior (at work, personal), and hypothesizes that caregiver type (eldercare-only vs. sandwich) moderates all paths in the model. Partial Least Squares structural equation modeling (SEM) supported all hypothesized direct paths. Contrary to our hypotheses, data analysis showed two positive relationships (i.e., objective caregiver burden to family-role overload, family-role overload to maladaptive changes in personal behavior) were stronger for those in the eldercare-only sample than for those in the sandwich sample. Post hoc analysis revealed five significant gender differences in the relationships included in our model. This study contributes to work–family theory by reinforcing the need to consider both caregiver type and gender when researching the challenges faced by employees trying to balance work and caregiving.

Economic and objective burden of caregiving on informal caregivers of patients with systemic vasculitis.

Systemic vasculitis (SV) is associated with substantial economic impact to patients and the healthcare system but little is known about the burden of SV on informal caregivers. We evaluated the objective caregiving burden experienced by informal caregivers of patients with SV. We surveyed adult patients and their informal caregivers on the physical, emotional, social and economic impacts of SV. We asked patients about the extent to which they felt they were a burden to their identified caregivers. Caregivers reported the direct and indirect economic impact of SV, including employment disturbance, income loss and relative time investment of caregiving for their care recipient's SV. We used the Inventory of Caregiving Activities Questionnaire to compute the objective caregiving burden. We analysed data from 68 SV patient-caregiver dyads. Patients reported moderate levels of subjective burden to their caregivers. Over one-quarter of caregivers reported ever having lost some income owing to caregiving for SV. Caregivers reported spending a median of 19 weekly hours on various caregiving tasks, including a median 17 weekly hours on household activities. Given the extended hours that caregivers spend caring for their care recipient, intervention targets should aim to reduce caregiver burnout in the SV population. Future research should examine the relationship between the objective burden of caregiving for SV and the overall physical health, mental health and quality of life of caregivers.

Informal Caregivers' Use of Internet-Based Health Resources: An Analysis of the Health Information National Trends Survey.

BackgroundInformal caregivers express strong interest in technology innovations to help them in their caregiving role; however, divides across sociodemographic characteristics in internet and technology access may preclude the most vulnerable caregivers from accessing such resources.ObjectiveThis study aims to examine caregivers’ internet use, both generally and for seeking health-related information, and whether usage differs as a function of caregivers’ characteristics.MethodsData were analyzed from the Health Information National Trends Survey 5 Cycle 1. Participants were included in analyses if they self-identified as providing uncompensated care to a close individual. Caregivers reported internet use factors, age, education, rurality, general health, distress, and objective caregiving burden. We used chi-square tests of independence with jackknife variance estimation to compare whether internet use factors differed by caregivers’ characteristics.ResultsA total of 77.5% (303/391) caregivers surveyed reported ever using the internet. Of internet users, 88.1% (267/303) accessed from a home computer and 83.2% (252/303) from a mobile device. Most caregivers accessed health information for themselves (286/391, 73.1%) or others (264/391, 67.5%); fewer communicated with a doctor over the Web (148/391, 37.9%) or had a wellness app (171/391, 43.7%). Caregivers reporting younger age, more education, and good health were more likely to endorse any of these activities. Furthermore, two-thirds of caregivers (258/391, 66.0%) endorsed trust in health information from the internet.ConclusionsComputers and mobile devices are practical platforms for disseminating caregiving-related information and supportive services to informal caregivers; these modalities may, however, have a more limited reach to caregivers who are older, have less education, and are in poorer health.

Health impact of objective burden, subjective burden and positive aspects of caregiving: an observational study among caregivers in Switzerland

ObjectiveTo investigate associations of objective caregiver burden, subjective caregiver burden and positive aspects of caregiving with self-reported health indicators in caregiving partners of persons with a severe physical disability (spinal...

Mental health and well-being among type 1 diabetes caregivers in India: Evidence from the IDREAM study.

Although more than half of the world's children with T1D live in developing countries, still little is known about how caregiving for children with T1D affects the parent/caregivers' health in low- and middle-income country settings. Caregivers of 178 children with T1D from a specialized diabetes clinic in Maharashtra, India were surveyed. Ordered and standard logistic regression models adjusted for caregiver, household and child characteristics, were fit to estimate the association of caregiving burden (objective caregiving burden and subjective caregiving burden (Zarit Burden Inventory - tertiles)) with caregiver depression (Patient Health Questionnaire [PHQ-9]) and well-being (CDC Unhealthy Days) outcomes. Caregivers with high subjective caregiving burden had a 41% probability of most severe depression category (probability: 0.41, 95% CI: 0.25, 0.57) and an 39% probability of low well-being (probability: 0.39, 95% CI: 0.27, 0.51), compared to caregivers with low subjective burden. Caregivers with high subjective caregiving burden and high objective direct caregiving burden had an adjusted 30% probability of elevated depressive symptoms (PHQ≥10). Among Indian T1D caregivers, high subjective caregiving burden and objective direct caregiving burden were associated with a high risk for caregiver depression and poorer well-being.