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Role of global stress in the health-related quality of life of caregivers: evidence from the Survey of the Health of Wisconsin

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Abstract

Purpose

Informal caregivers play a critical role in the care of individuals who are aging or have disabilities and are at increased risk for poor health outcomes. This study sought to determine whether and to what extent: (1) global stress and health-related quality of life (HRQoL) differed between caregivers and non-caregivers; (2) global stress mediated the relationship between caregiving status and HRQoL; and (3) caregiver strain (i.e., stress attributable to caregiving) was associated with worse HRQoL after accounting for global stress.

Methods

Cross-sectional data were from the 2008–2010 Survey of the Health of Wisconsin, a representative sample of adults aged 21–74 years. Participants (n = 1,364) completed questionnaires about caregiving status, sociodemographics, global stress, and HRQoL. Staged generalized additive models assessed the impact of caregiving on HRQoL and the role of caregiver strain and global stress in this relationship.

Results

In the last 12 months, 17.2 % of the sample reported caregiving. Caregivers reported worse mental HRQoL than non-caregivers (β −1.88, p = 0.02); global stress mediated this relationship (p < 0.01). Caregivers with the highest levels of strain reported worse mental and physical HRQoL (β −7.12, p < 0.01), and caregivers with the lowest levels of strain reported better mental HRQoL (β 2.06, p = 0.01) than non-caregivers; these associations were attenuated by global stress (p < 0.01).

Conclusion

Global stress, rather than caregiving per se, contributes to poor HRQoL among caregivers, above and beyond the effect of caregiving strain. Screening, monitoring, and reducing stress in multiple life domains presents an opportunity to improve HRQoL outcomes for caregivers.

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Notes

  1. Difference in mean global stress between caregivers and non-caregivers; mean global stress in caregivers was 1.11 points higher than non-caregivers, controlling for covariates.

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Acknowledgments

We would like to thank the Survey of the Health of Wisconsin (SHOW) for the use of their data. Funding for this study was provided by a training grant from the National Institute on Aging (F31 AG 044073, PI: K. Litzelman) and The Center for Demography of Health and Aging (CDHA) at the University of Wisconsin-Madison, which supported the caregiving component of the SHOW interviews (PI: W. P. Witt). Funding for the Survey of the Health of Wisconsin was provided by the Wisconsin Partnership Program (233 PRJ56RV), National Institutes of Health’s Clinical and Translational Science Award (5UL 1RR025011), and National Heart Lung and Blood Institute (1 RC2 HL101468).

Conflict of interest

The authors have no competing interests to report.

Author information

Authors and Affiliations

  1. Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA

    Kristin Litzelman, Halcyon G. Skinner, Ronald E. Gangnon, F. Javier Nieto, Kristen Malecki & Whitney P. Witt

  2. Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, WI, USA

    Ronald E. Gangnon

  3. Survey of the Health of Wisconsin, Middleton, WI, USA

    F. Javier Nieto & Kristen Malecki

  4. 9609 Medical Center Dr, MSC 9761, Room 2W-170, Bethesda, MD, 20892-9761, USA

    Kristin Litzelman

  5. 1007 WARF Office Building, 610 Walnut Street, Madison, WI, 53726, USA

    Halcyon G. Skinner

  6. 603 WARF Office Building, 610 Walnut Street, Madison, WI, 53726, USA

    Ronald E. Gangnon

  7. 707c WARF Office Building, 610 Walnut Street, Madison, WI, 53726, USA

    F. Javier Nieto

  8. 585 WARF Office Building, 610 Walnut Street, Madison, WI, 53726, USA

    Kristen Malecki

  9. 502 WARF Office Building, 610 Walnut Street, Madison, WI, 53726, USA

    Whitney P. Witt

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  1. Kristin Litzelman
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  2. Halcyon G. Skinner
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  3. Ronald E. Gangnon
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  4. F. Javier Nieto
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Correspondence to Kristin Litzelman.

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Litzelman, K., Skinner, H.G., Gangnon, R.E. et al. Role of global stress in the health-related quality of life of caregivers: evidence from the Survey of the Health of Wisconsin. Qual Life Res 23, 1569–1578 (2014). https://doi.org/10.1007/s11136-013-0598-z

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