Quality of Life Research

, Volume 24, Issue 12, pp 2907–2915 | Cite as

How is an informal caregiver’s psychological distress associated with prolonged caregiving? Evidence from a six-wave panel survey in Japan

Article

Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusions

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.

Keywords

Informal caregiving Caregiver Psychological distress Kessler 6 scores Japan 

References

  1. 1.
    Cooper, C., Balamurali, T. B., & Livingston, G. (2007). A systematic review of the prevalence and covariates of anxiety in caregivers of people with dementia. International Psychogeriatrics, 19(2), 175–195.CrossRefPubMedGoogle Scholar
  2. 2.
    Ennis, E., & Bunting, B. P. (2003). Family burden, family health and personal mental health. BMC Public Health, 13, 255.CrossRefGoogle Scholar
  3. 3.
    Pinquart, M., & Sorensen, S. (2003). Differences between caregivers and noncaregivers in psychological health and physical health: A meta-analysis. Psychology and Aging, 18(2), 250–267.CrossRefPubMedGoogle Scholar
  4. 4.
    Amirkhanyan, A. A., & Wolf, D. A. (2006). Parent care and the stress process: Findings from panel data. Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 61(5), 248–255.CrossRefGoogle Scholar
  5. 5.
    Bookwala, J. (2009). The impact of parent care on marital quality and well-being in adult daughters and sons. Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 64(3), 339–347.CrossRefGoogle Scholar
  6. 6.
    Hiel, L., Beenackers, M. A., Renders, C. M., Robroek, S. J., Burdorf, A., & Croezen, S. (2015). Providing personal informal care to older European adults: Should we care about the caregivers’ health? Preventive Medicine, 70, 64–68.CrossRefPubMedGoogle Scholar
  7. 7.
    Marks, N. F., Lambert, J. D., & Choi, H. (2002). Transitions to caregiving, gender, and psychological well-being: A prospective U.S. national study. Journal of Marriage and Family, 64(3), 657–667.CrossRefGoogle Scholar
  8. 8.
    Smith, G. R., Williamson, G. M., Miller, L. S., & Schulz, R. (2011). Depression and quality of informal care: A longitudinal investigation of caregiving stressors. Psychology and Aging, 26(3), 584–591.PubMedCentralCrossRefPubMedGoogle Scholar
  9. 9.
    Diener, E., Lucas, R. E., & Scollon, C. N. (2006). Beyond the Hedonic treadmill: Revising the adaptation theory of well-being. American Psychologist, 61(4), 305–314.CrossRefPubMedGoogle Scholar
  10. 10.
    Lucas, Richard E. (2007). Adaptation and the set-point model of subjective well-being. Current Directions in Psychological Science, 16(2), 75–79.CrossRefGoogle Scholar
  11. 11.
    Lawton, M. P., Moss, M., Hoffman, C., & Perkinson, M. (2000). Two transitions in daughters’ caregiving careers. Gerontologist, 40(4), 437–448.CrossRefPubMedGoogle Scholar
  12. 12.
    Seltzer, M. M., & Li, L. W. (2000). The dynamics of caregiving: Transitions during a three-year prospective study. Gerontologist, 40(2), 165–178.CrossRefPubMedGoogle Scholar
  13. 13.
    Lutzky, S. M., & Knight, B. G. (1994). Explaining gender differences in caregiver distress: The roles of emotional attentiveness and coping styles. Psychology and Aging, 9(4), 513–519.CrossRefPubMedGoogle Scholar
  14. 14.
    Pinquart, M., & Sörensen, S. (2006). Gender differences in caregiver stressors, social resources, and health: An updated meta-analysis. Journal of Gerontology: Psychological Sciences, 61(1), 33–45.CrossRefGoogle Scholar
  15. 15.
    Nieboer, A. P., Schulz, R., Matthews, K. A., Scheier, M. F., Ormel, J., & Lindenberg, S. M. (1998). Spousal caregivers’ activity restriction and depression: A model for changes over time. Social Science and Medicine, 47(9), 1361–1371.CrossRefPubMedGoogle Scholar
  16. 16.
    Pinquart, M., & Sörensen, S. (2011). Spouses, adult children, and children-in-law as caregivers of older adults: A meta-analytic comparison. Psychology and Aging, 26(1), 1–14.PubMedCentralCrossRefPubMedGoogle Scholar
  17. 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
  18. 18.
    Oshio, T. (2014). The association between involvement in family caregiving and mental health among middle-aged adults in Japan. Social Science and Medicine, 115, 121–129.CrossRefPubMedGoogle Scholar
  19. 19.
    Van den Berg, B., Fiebig, D. G., & Hall, J. (2014). Well-being losses due to care-giving. Journal of Health Economics, 35, 123–131.PubMedCentralCrossRefPubMedGoogle Scholar
  20. 20.
    Graubard, B. I., & Korn, E. L. (1996). Modelling the sampling design in the analysis of health surveys. Statistical Methods in Medical Research, 5(3), 263–281.CrossRefPubMedGoogle Scholar
  21. 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
  22. 22.
    Takeda, Y., Kawachi, I., Yamagata, Z., Hashimoto, S., Matsumura, Y., Oguri, S., et al. (2004). Multigenerational family structure in Japanese society: Impacts on stress and health behaviors among women and men. Social Science and Medicine, 59(1), 69–81.CrossRefPubMedGoogle Scholar
  23. 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.
  24. 24.
    Tamiya, N., Noguchi, H., Nishi, A., Reich, M. R., Ikegami, N., Hashimoto, H., et al. (2011). Population ageing and wellbeing: Lessons from Japan’s long-term care insurance policy. Lancet, 378(9797), 1183–1192.CrossRefPubMedGoogle Scholar
  25. 25.
    Arai, Y., Zarit, S. H., Sugiura, M., & Washio, M. (2002). Patterns of outcome of caregiving for the impaired elderly: A longitudinal study in rural Japan. Aging and Mental Health, 6(1), 39–46.CrossRefPubMedGoogle Scholar
  26. 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
  27. 27.
    Sugihara, Y., Sugisawa, H., Nakatani, Y., & Hougham, G. W. (2004). Longitudinal changes in the well-being of Japanese caregivers: Variations across kin relationships. Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 59(4), 177–184.CrossRefGoogle Scholar
  28. 28.
    Kessler, R. C., Andrews, G., Colpe, L. J., Hiripi, E., Mroczek, D. K., Normand, S. L., et al. (2002). Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychological Medicine, 32(6), 959–976.CrossRefPubMedGoogle Scholar
  29. 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
  30. 30.
    Furukawa, T. A., Kawakami, N., Saitoh, M., Ono, Y., Nakane, Y., Nakamura, Y., et al. (2008). The performance of the Japanese version of the K6 and K10 in the World Mental Health Survey Japan. International Journal of Methods in Psychiatric Research, 17(3), 152–158.CrossRefPubMedGoogle Scholar
  31. 31.
    Sakurai, K., Nishi, A., Kondo, K., Yanagida, K., & Kawakami, N. (2011). Screening performance of K6/K10 and other screening instruments for mood and anxiety disorders in Japan. Psychiatry and Clinical Neurosciences, 65(5), 434–441.CrossRefPubMedGoogle Scholar
  32. 32.
    Hirst, M. (2005). Carer distress: A prospective, population-based study. Social Science and Medicine, 61(3), 697–708.CrossRefPubMedGoogle Scholar
  33. 33.
    Organisation for Economic Co-operation and Development (OECD). (2008). Growing unequal? income distribution and poverty in OECD countries. Paris: OECD.Google Scholar
  34. 34.
    Organisation for Economic Co-operation and Development (OECD). (2011). Divided we stand. Why inequality keeps rising. Paris: OECD.Google Scholar
  35. 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
  36. 36.
    Beach, S. R., Schulz, R., Yee, J. L., & Jackson, S. (2000). Negative and positive health effects of caring for a disabled spouse: Longitudinal findings from the Caregiver Health Effects Study. Psychology and Aging, 15(2), 259–271.CrossRefPubMedGoogle Scholar
  37. 37.
    Harmell, A. L., Chattillion, E. A., Roepke, S. K., & Mausbach, B. T. (2011). A review of the psychobiology of dementia caregiving: A focus on resilience factors. Current Psychiatry Reports, 13(3), 219–224.PubMedCentralCrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  1. 1.Institute of Economic ResearchHitotsubashi UniversityKunitachiJapan

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