How is an informal caregiver’s psychological distress associated with prolonged caregiving? Evidence from a six-wave panel survey in Japan
- 302 Downloads
The provision of informal nursing care can adversely affect a caregiver’s mental health, but the dynamic association of the variables is still under debate. We examined how an informal caregiver’s psychological distress is associated with prolonged caregiving.
We used data collected from a nationwide six-wave panel survey in Japan, with 25,186 observations of 9192 individuals. We focused on informal caregivers, who provided help and support for ill family members. We used Kessler 6 (K6) scores (range 0–24), where higher scores reflect higher levels of psychological distress. We employed mixed-effects models to examine how caregivers’ psychological distress was associated with caregiving commencement and duration.
Commencement of caregiving raised the K6 score for female caregivers by 0.55 (equivalent to 0.12 SD, 95 % CI 0.34–0.75) and that for male caregivers by 0.41 (0.09 SD, 95 % CI 0.18–0.63). However, prolonged caregiving had gender-asymmetric, dynamic associations with psychological distress. One additional year of caregiving added 0.22 (0.05 SD, 95 % CI 0.10–0.35) to the K6 score of female caregivers, while it had no significant association for male caregivers. For female caregivers, prolonged caregiving was positively associated with K6 score entirely through its interaction effects with longer hours of care, co-residence with a care recipient, and the non-working status of a caregiver.
Results revealed a gender-asymmetric, dynamic association between informal care provision and caregivers’ psychological distress. Additional policy measures targeted at caregivers deeply involved in in-house care are needed to reduce their distress.
KeywordsInformal caregiving Caregiver Psychological distress Kessler 6 scores Japan
- 17.Cameron, J. I., Stewart, D. E., Tomlinson, G. A., Franche, R. L., Hyman, I., & Cheung, A. M. (2008). Emotional distress among family caregivers in Canada: Longitudinal analysis of the National Population Health Survey. Archives of Public Health, 66, 35–45.Google Scholar
- 21.West, B. T., Welch, K. B., & Galecki, A. T. (2007). Linear mixed models: A practical guide to using statistical software. New York: Chapman & Hall/CRC.Google Scholar
- 23.Ministry of Health, Labour and Welfare (MHLW). (2014). The survey of long-term nursing care benefits. http://www.mhlw.go.jp/toukei/list/45-1b.html Accessed January 22, 2015.
- 26.Kurasawa, S., Yoshimasu, K., Washio, M., Fukumoto, J., Takemura, S., Yokoi, K., et al. (2012). Factors influencing caregivers’ burden among family caregivers and institutionalization of in-home elderly people cared for by family caregivers. Environmental Health and Preventive Medicine, 17(6), 474–483.PubMedCentralCrossRefPubMedGoogle Scholar
- 29.Kessler, R. C., Green, J. G., Gruber, M. J., Sampson, N. A., Bromet, E., Cuitan, M., et al. (2010). Screening for serious mental illness in the general population with the K6 screening scale: Results from the WHO World Mental Health (WMH) survey initiative. International Journal of Methods in Psychiatric Research, 19(Suppl. 1), 4–22.PubMedCentralCrossRefPubMedGoogle Scholar
- 33.Organisation for Economic Co-operation and Development (OECD). (2008). Growing unequal? income distribution and poverty in OECD countries. Paris: OECD.Google Scholar
- 34.Organisation for Economic Co-operation and Development (OECD). (2011). Divided we stand. Why inequality keeps rising. Paris: OECD.Google Scholar
- 35.Sugihara, Y., Sugisawa, H., Shibata, H., & Harada, K. (2008). Productive roles, gender, and depressive symptoms: Evidence from a national longitudinal study of late-middle-aged Japanese. Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 63(4), 227–234.CrossRefGoogle Scholar