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Journal of Public Health Policy

, Volume 37, Issue 2, pp 173–189 | Cite as

Associations between informal care, disease, and risk factors: A Spanish country-wide population-based study

  • Luís González-de PazEmail author
  • Jordi Real
  • Alicia Borrás-Santos
  • José M Martínez-Sánchez
  • Virginia Rodrigo-Baños
  • María Dolores Navarro-Rubio
Original Article

Abstract

This population-based study using 2011–2012 Spanish National Health Survey data aimed to measure the impact of disease, health-related habits, and risk factors associated with informal caregiving. We included and matched self-reported informal caregivers [ICs] with controls (1:4) from the same survey. For each outcome, we analyzed associations between ICs and controls using linear regression or logistic regression models. ICs had 3.4 per cent more depression (OR: 1.33, 95 per cent confidence intervals [CI]:1.06, 1.68). ICs had lower social support (95 per cent CI: 1.64, 3.28), they did more housework alone (OR:3.6, 95 per cent CI:2.65, 4.89), and had greater stress (95 per cent CI:0.13, 0.83). Women ICs caring alone had more anxiety than other groups. We found no statistical association between caregivers and worse health-related habits or increased risk factors (less physical activity, smoking, drinking, and cholesterol). Our results provide evidence that health-care professionals and organizations should recognize the importance of caring for those who care.

Keywords

caregivers risk factors burden social support quality of life 

Notes

Acknowledgements

The authors thank Dr. Belchin Kostov, Transverse Group for Research in Primary Care, IDIBAPS, Barcelona, Spain, for his valuable comments, Dr Montse Neira León, Deputy Director of Health Information and Innovation, Spanish Ministry of Health and Social Policy, Madrid, Spain, and David Buss for technical help.

Supplementary material

References

  1. World Health Organization Europe. (2013) The European health report 2012: Charting the way to well-being, http://www.euro.who.int/en/data-and-evidence/european-health-report-2012, accessed 28 October 2015.
  2. Adelman, R.D., Tmanova, L.L., Delgado, D., Dion, S. and Lachs, M.S. (2014) Caregiver burden: A clinical review. The Journal of American Medical Association 311 (10): 1052–1060.CrossRefGoogle Scholar
  3. Sorensen, S., Pinquart, M. and Duberstein, P. (2002) How effective are interventions with caregivers? An updated meta-analysis. The Gerontologist 42 (3): 356–372.CrossRefGoogle Scholar
  4. Hartmann, M., Bazner, E., Wild, B., Eisler, I. and Herzog, W. (2010) Effects of interventions involving the family in the treatment of adult patients with chronic physical diseases: A meta-analysis. Psychotherapy and Psychosomatics 79 (3): 136–148.CrossRefGoogle Scholar
  5. Oliva, J., Vilaplana, C. and Osuna, R. (2011) The social value of informal care provided to elderly dependent people in Spain. Gaceta Sanitaria 25 (Suppl 2): 108–114.CrossRefGoogle Scholar
  6. Hurd, M.D., Martorell, P., Delavande, A., Mullen, K.J. and Langa, K.M. (2013) Monetary costs of dementia in the United States. The New England Journal of Medicine 368 (14): 1326–1334.CrossRefGoogle Scholar
  7. Borghi, A.C., de Castro, V.C., Marcon, S.S. and Carreira, L. (2013) Overload of families taking care of elderly people with Alzheimer’s disease: A comparative study. Revista Latino-Americana de Enfermagem 21 (4): 876–883.CrossRefGoogle Scholar
  8. Etters, L., Goodall, D. and Harrison, B.E. (2008) Caregiver burden among dementia patient caregivers: A review of the literature. Journal of the American Academy of Nurse Practitioners 20 (8): 423–428.CrossRefGoogle Scholar
  9. Zarit, S.H., Todd, P.A. and Zarit, J.M. (1986) Subjective burden of husbands and wives as caregivers: A longitudinal study. The Gerontologist 26 (3): 260–266.CrossRefGoogle Scholar
  10. Northouse, L., Williams, A.L., Given, B. and McCorkle, R. (2012) Psychosocial care for family caregivers of patients with cancer. Journal of Clinical Oncology 30 (11): 1227–1234.CrossRefGoogle Scholar
  11. Thielemann, P.A. and Conner, N.E. (2009) Social support as a mediator of depression in caregivers of patients with end-stage disease. Journal of Hospice and Palliative Nursing 11 (2): 82–90.CrossRefGoogle Scholar
  12. National Institute for Health and Clinical Excellence. (2004) The NICE-GSGSP guidance on cancer services: Improving supportive and palliative care for adults with cancer. The manual (online), https://www.nice.org.uk/guidance/csgsp, accessed 28 October 2015.
  13. National Institute for Health and Clinical Excellence. (2012) The NICE-SCIE guideline on supporting people with Dementia and their carers in health and social care (online), https://www.nice.org.uk/guidance/CG42, accessed 28 October 2015.
  14. Ngo, J. and Holroyd-Leduc, J.M. (2015) Systematic review of recent dementia practice guidelines. Age and Ageing 44 (1): 25–33.CrossRefGoogle Scholar
  15. Guedes, A.C. and Pereira Mda, G. (2013) Burden, coping, physical symptoms and psychological morbidity in caregivers of functionally dependent family members. Revista Latino-Americana de Enfermagem 21 (4): 935–940.CrossRefGoogle Scholar
  16. Cabral, L., Duarte, J., Ferreira, M. and dos Santos, C. (2014) Anxiety, stress and depression in family caregivers of the mentally ill. Atención Primaria 46 (Suppl): 5176–179.Google Scholar
  17. Badia Llach, X., Lara Surinach, N. and Roset Gamisans, M. (2004) Quality of life, time commitment and burden perceived by the principal informal caregiver of Alzheimer’s patients. Atención Primaria 34 (4): 170–177.CrossRefGoogle Scholar
  18. Pena-Longobardo, L.M. and Oliva-Moreno, J. (2015) Caregiver burden in Alzheimer’s disease patients in Spain. Journal of Alzheimer’s Disease 43 (4): 1293–1302.Google Scholar
  19. Instituto Nacional de Estadística de España. (2015) National health survey. General methodology, http://www.ine.es/en/metodologia/t15/t153041912_en.pdf, accessed 28 October 2015.Google Scholar
  20. Stuart, E.A. (2010) Matching methods for causal inference: A review and a look forward. Statistical Science 25 (1): 1–21.CrossRefGoogle Scholar
  21. Bellon Saameno, J.A., Delgado Sanchez, A., Luna del Castillo, J.D. and Lardelli Claret, P. (1996) Validity and reliability of the Duke-UNC-11 questionnaire of functional social support. Atención Primaria 18 (4): 153–156, 158–163.Google Scholar
  22. Sanchez-Lopez Mdel, P. and Dresch, V. (2008) The 12-item general health questionnaire (GHQ-12): Reliability, external validity and factor structure in the Spanish population. Psicothema 20 (4): 839–843.Google Scholar
  23. Herdman, M. et al (2011) Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Quality of Life Research 20 (10): 1727–1736.CrossRefGoogle Scholar
  24. World Health Organization. (2014) Global status report on noncommunicable diseases 2014, http://www.who.int/nmh/publications/ncd-status-report-2014/en/, accessed 15 May 2015.
  25. Valencia Martin, J.L., Gonzalez, M.J. and Galan, I. (2014) Methodological issues in the measurement of alcohol consumption: The importance of drinking patterns. Revista Española de Salud Pública 88 (4): 433–446.CrossRefGoogle Scholar
  26. Preacher, K.J. and Kelley, K. (2011) Effect size measures for mediation models: Quantitative strategies for communicating indirect effects. Psychological Methods 16 (2): 93–115.CrossRefGoogle Scholar
  27. R Core Team. (2015) R: A Language and Environment for Statistical Computing. Vienna, Austria: R Foundation for Statistical Computing.Google Scholar
  28. Tingley, D., Yamamoto, T., Hirose, K., Keele, L. and Imai, K. (2014) Mediation: R package for causal mediation analysis. Journal of Statistical Software 59 (5): 1–38.CrossRefGoogle Scholar
  29. Cuijpers, P. (2005) Depressive disorders in caregivers of dementia patients: A systematic review. Aging & Mental Health 9 (4): 325–330.CrossRefGoogle Scholar
  30. Torres, Á., Blanco, V., Vázquez, F., Díaz, O., Otero, P. and Hermida, E. (2015) Prevalence of major depressive episodes in non-professional caregivers. Psychiatry Research 226 (1): 333–339.CrossRefGoogle Scholar
  31. Adams, R.N., Mosher, C.E., Cannady, R.S., Lucette, A. and Kim, Y. (2014) Caregiving experiences predict changes in spiritual well-being among family caregivers of cancer patients. Psycho-oncology 23 (10): 1178–1184.CrossRefGoogle Scholar
  32. McLennon, S.M., Bakas, T., Jessup, N.M., Habermann, B. and Weaver, M.T. (2014) Task difficulty and life changes among stroke family caregivers: Relationship to depressive symptoms. Archives of Physical Medicine and Rehabilitation 95 (12): 2484–2490.CrossRefGoogle Scholar
  33. Schneider, U. and Kleindienst, J. (2015) Monetising the provision of informal long-term care by elderly people: Estimates for European out-of-home caregivers based on the well-being valuation method. Health & Social Care in the Community, advance online publication May 4, doi:10.1111/hsc.12250.Google Scholar
  34. Legg, L., Weir, C.J., Langhorne, P., Smith, L.N. and Stott, D.J. (2013) Is informal caregiving independently associated with poor health? A population-based study. Journal of Epidemiology and Community Health 67 (1): 95–97.CrossRefGoogle Scholar
  35. Molinuevo, J.L. and Hernandez, B., Grupo de Trabajo del Estudio IMPACT. (2011) Profile of the informal carer associated with the clinical management of the Alzheimer’s disease patient refractory to symptomatic treatment of the disease. Neurologia (Barcelona, Spain) 26 (9): 518–527.CrossRefGoogle Scholar
  36. Yesufu-Udechuku, A. et al (2015) Interventions to improve the experience of caring for people with severe mental illness: systematic review and meta-analysis. The British Journal of Psychiatry 206 (4): 268–274.CrossRefGoogle Scholar
  37. Courtin, E., Jemiai, N. and Mossialos, E. (2014) Mapping support policies for informal carers across the European Union. Health Policy (Amsterdam, Netherlands) 118 (1): 84–94.CrossRefGoogle Scholar
  38. Hoffmann, F. and Rodrigues, R. (2010) Informal carers: Who takes care of them? Policy Briefs, 13 May.Google Scholar
  39. Maayan, N., Soares-Weiser, K. and Lee, H. (2014) Respite care for people with dementia and their carers. The Cochrane Database of Systematic Reviews, 1: CD004396, doi:10.1002/14651858.CD004396.pub3.Google Scholar
  40. Gallo, P. and Gene-Badia, J. (2013) Cuts drive health system reforms in Spain. Health Policy (Amsterdam, Netherlands) 113 (1–2): 1–7.CrossRefGoogle Scholar

Copyright information

© Palgrave Macmillan, a division of Macmillan Publishers Ltd 2016

Authors and Affiliations

  • Luís González-de Paz
    • 1
    • 2
    Email author
  • Jordi Real
    • 1
    • 3
  • Alicia Borrás-Santos
    • 1
    • 4
    • 5
  • José M Martínez-Sánchez
    • 6
    • 7
    • 8
  • Virginia Rodrigo-Baños
    • 2
  • María Dolores Navarro-Rubio
    • 1
    • 9
    • 10
  1. 1.Facultat de Medicina i Ciencies de la Salut, Public Health Unit, School of Medicine and Health Sciences, Universitat Internacional de CatalunyaBarcelonaSpain
  2. 2.Centre d’Atenció Primària Les Corts. Transverse Group for Research in Primary Care, IDIBAPSBarcelonaSpain
  3. 3.Institut d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol). USR-LleidaLleidaSpain
  4. 4.Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES)MadridSpain
  5. 5.Centre for Research in Environmental Epidemiology (CREAL)BarcelonaSpain
  6. 6.Biostatistics Unit, School of Medicine and Health Sciences, Universitat Internacional de CatalunyaBarcelonaSpain
  7. 7.Tobacco Control Unit, Cancer Prevention and Control Programme, Catalan Institute of Oncology-ICOBarcelonaSpain
  8. 8.Cancer Control and Prevention Group, Bellvitge Biomedical Research Institute-IDIBELLBarcelonaSpain
  9. 9.Albert Jovell Institute for Public Health and Patients. Universitat Internacional de CatalunyaBarcelonaSpain
  10. 10.Spanish Patient’s ForumBarcelonaSpain

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