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Health-related quality of life of family caregivers—Evidence from Hesse

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Abstract

Aim

The aim of this study was to analyse the health-related quality of life (HRQOL) of primary family caregivers in comparison to the reference values of the average population.

Subjects and methods

Data collection took place in the Werra-Meißner district in 2009 with a response rate of 102 primary family caregivers of frail elderly people. The health-related quality of life was measured with the Short Form 36 health survey (SF 36) and compared with the German reference values.

Results

Compared to the health values of the normative sample, primary caregivers show significantly lower rates in all dimensions of health-related quality of life. In particular, caregivers between the ages of 53 to 61 report extremely low health values. Caregiving women compared to non-caregiving women have highly significant differences in all subscales of the SF 36. Caregiving men also report highly significant differences to non-caregiving men in all dimensions of the SF 36 except for Physical Functioning and General Health (p < 0.01). Caregivers in general and especially caregiving women aged 53 to 61 (midlife) were identified as at-risk groups for poor health. The latter report lower vitality and well-being, which may be a consequence of both social isolation and social impacts from multiple role demands.

Conclusion

The identified high-risk groups of family caregivers, caregivers in midlife and especially caregiving women in midlife, should be supported by social measures, e.g., training courses for family caregivers, particularly in their home setting, and various types of respite care in order to sustain their health.

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References

  • Abel EK (1990) Informal care for the disabled elderly: a critique of recent literature. Res Aging 12:139–157

    Article  PubMed  CAS  Google Scholar 

  • Almberg B, Grafstrom M, Winblad B (1997) Caring for a demented elderly person—burden and burnout among caregiving relatives. J Adv Nurs 25:109–116

    Article  PubMed  CAS  Google Scholar 

  • Badr H, Acitelli LK, Taylor CL (2007) Does couple identify mediate the stress experienced by caregiving spouses? Psychol Health 22:211–229

    Article  Google Scholar 

  • Barnes CL, Given BA, Given CW (1992) Caregivers of elderly relatives: spouses and adult children. Health Soc Work 17:282–389

    PubMed  CAS  Google Scholar 

  • Bartholomeyczik (2007) Einige kritische Anmerkungen zu standardisierten Assessmentinstrumenten in der Pflege. Pflege 20:211–217

    Article  PubMed  Google Scholar 

  • Baumgarten M, Battista RN, Infante-Rivard C, Hanley JA, Becker R, Gauthier S (1992) The psychological and physical health of family members caring for an elderly person with dementia. J Clin Epidemiol 45:61–70

    Article  PubMed  CAS  Google Scholar 

  • Beyweiss M, Ostermann H (2009) Gesundheitszustand pflegender Angehöriger über 65 Jahren unter Berücksichtigung gesundheitsfördernder und -präventiver Projekte in Vorarlberg. Pflegenetz:23–28

  • Blaxter M (1990) Health and lifestyles. Routledge, London, New York, p 50

    Book  Google Scholar 

  • Brown SL, Smith DM, Schulz R, Kabeto MU, Ubel PA, Poulin M, Yi J, Kim C, Langa KM (2009) Caregiving behavior is associated with decreased mortality risk. Psychol Sci 20:488–494

    Article  PubMed  Google Scholar 

  • Bullinger M (2000) Erfassung der gesundheitsbezogenen Lebensqualität mit dem SF-36-Health Survey. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 43:190–197

    Article  Google Scholar 

  • Bullinger M, Kirchberger I (1998) Der SF-36 Fragebogen zum Gesundheitszustand—Handbuch für die deutschsprachige Fragebogen-Version. Hogrefe, Göttingen

    Google Scholar 

  • Bullinger M, Kirchberger I, Ware J (1995) Der deutsche SF-36 Health Survey Übersetzung und psychometrische Testung eines krankheitsübergreifenden Instruments zur Erfassung der gesundheitsbezogenen Lebensqualität. J Public Health 3:21–36

    Google Scholar 

  • Burton LC, Zdaniuk B, Schulz R, Jackson S, Hirsch C (2003) Transitions in spousal caregiving. Gerontologist 43:230–241

    PubMed  Google Scholar 

  • Cantor MH (1983) Strain among caregivers: a study of experience in the United States. Gerontologist 23:597–604

    PubMed  CAS  Google Scholar 

  • Cantor M (1992) Families and caregiving in an aging society. Generations 16:67–71

    Google Scholar 

  • Chang CF, White-Means SI (1991) The men who care: an analysis of male primary caregivers who care for frail elderly at home. J Appl Gerontol 10:343–358

    Article  Google Scholar 

  • Cossette S, Lévesque L, Laurin L (1995) Informal and formal support for caregivers of a demented relative: Do gender and kinship make a difference? Res Nurs Health 18:437–451

    Article  PubMed  CAS  Google Scholar 

  • Covinsky KE, Newcomer R, Fox P, Wood J, Sands L, Dane K, Yaffe K (2003) Patient and caregiver characteristics associated with depression in caregivers of patients with dementia. J Gen Intern Med 18:1006–1014

    Article  PubMed  Google Scholar 

  • Deimling GT, Poulshock SW (1985) The transition from family in-home care to institutional care: focus on health and attitudinal issues as predisposing factors. Res Aging 7:563–576

    Article  PubMed  CAS  Google Scholar 

  • Spitzenverbände der Pflegekassen (2008) Gemeinsames Rundschreiben der Spitzenverbände der Pflegekassen zu den leistungsrechtlichen Vorschriften des PflegeVG [ updated edition - 15.07.2008 ]. http://infomed.mds-ev.de/sindbad.nsf/8bb1853631e866ecc1256f550036750b/b6faf6382466683e00256c72005c0d2c?OpenDocument. Accessed 23 August 2010

  • Döhner H, Rothgang H (2006) Pflegebedürftigkeit. Zur Bedeutung der familialen Pflege für die Sicherung der Langzeitpflege. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 49:583–594

    Article  PubMed  Google Scholar 

  • Donath C, Bleich S, Gräßel E (2009) Gerontopsychiatrische Tageskliniken—Prädiktoren der Inanspruchnahme und Qualitätserwartungen aus Sicht pflegender Angehöriger von Demenzpatienten. Day hospitals—predictors for utilisation and quality expectations from the perspective of family caregivers of dementia patients. Psychiatr Prax 36:175–181

    Article  PubMed  Google Scholar 

  • Dörpinghaus S (2006) Evaluation von Pflegekursen: Stärken und Herausforderungen. Pflege & Gesellschaft 11:223–240

    Google Scholar 

  • Eith T, Stummer H, Schusterschitz C (2010) Career success perception and work-related behaviour of employees in geriatric care—an empirical study in a German geriatric care facility. Scand J Caring Sci. doi:10.1111/j1471-6712.2010.00789.x

    Google Scholar 

  • Ellert U, Kurth BM (2004) Methodische Betrachtungen zu den Summenscores des SF-36 anhand der erwachsenen bundesdeutschen Bevölkerung. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 47:1027–1032

    Article  PubMed  CAS  Google Scholar 

  • Federal Statistical Office (2009) Statistical yearbook 2009 for the Federal Republic of Germany. Statistisches Bundesamt, Wiesbaden, pp 209–215

    Google Scholar 

  • Fillenbaum GG, Smyer MA (1981) The development, validity, and reliability of the oars multidimensional functional assessment questionnaire. Gerontologist 36:428–434

    CAS  Google Scholar 

  • Foley KL, Tung H, Mutran EJ (2002) Self-gain and self-loss among African American and white caregivers. J Gerontol B Psychol Sci Soc Sci 57:14–22

    Google Scholar 

  • George LK, Gwyther LP (1986) Caregiver well-being: a multidimensional examination of family caregivers of demented adults. Caregivers for dementia patients: complex determinants of well-being and burden. Gerontologist 26:245–247

    PubMed  Google Scholar 

  • Gilhooly ML, Sweeting H (1994) Family care of the dementing elderly. Int Rev Psychiatry 6:29–40

    Article  Google Scholar 

  • Goode KT, Haley WE, Roth DL, Ford GR (1998) Predicting longitudinal changes in caregiver physical and mental health: A stress process model. Health Psychol 17:190–198

    Article  PubMed  CAS  Google Scholar 

  • Gräßel E (1998) Häusliche Pflege dementiell und nicht dementiell Erkrankter Teil II: Gesundheit und Belastung der Pflegenden. Z Gerontol Geriatr 31:57–62

    Article  PubMed  Google Scholar 

  • Haberkern K, Szydlik M (2008) Pflege der Eltern. Ein Europäischer Vergleich. KZfSS 60:78–101

    Google Scholar 

  • Hughes SL, Giobbie-Hurder A, Weaver FM, Kubal JD, Henderson W (1999) Relationship between caregiver burden and health-related quality of life. Gerontologist 39:534–545

    PubMed  CAS  Google Scholar 

  • Jeon Y (2003) Mental health nurses' work with family caregivers of older people with depression: review of the literature. Issues Ment Health Nurs 24:813–828

    PubMed  Google Scholar 

  • Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW (1963) Studies of illness in the aged: the index of ADL: a standardized measure of biological and psychosocial function. JAMA 185:914–919

    PubMed  CAS  Google Scholar 

  • Kim Y, Schulz R (2008) Family caregivers' strains: comparative analysis of cancer caregiving with dementia, diabetes, and frail elderly caregiving. J Aging Health 20:483–503

    Article  PubMed  Google Scholar 

  • Klie T, Monzer M (2008) Case management in der Pflege. Z Gerontol Geriatr 41:92–105

    Article  PubMed  Google Scholar 

  • Kramer BJ (1997) Gain in the caregiving experience: Where are we? What next? Gerontologist 37:218–232

    PubMed  CAS  Google Scholar 

  • Lamura G, Mnich E, Wojszel B, Nolan M, Krevers B, Mestheneos L, Döhner H (2006) Erfahrungen von pflegenden Angehörigen älterer Menschen in Europa bei der Inanspruchnahme von Unterstützungsleistungen. Z Gerontol Geriatr 39:429–442

    Article  PubMed  CAS  Google Scholar 

  • Lawton MP, Brody EM (1969) Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 9:179–186

    PubMed  CAS  Google Scholar 

  • Lee C, Gramotnev H (2007) Transitions into and out of caregiving: Health and social characteristicsof mid-age Australian women. Psychol Health 22:193–209

    Article  Google Scholar 

  • Leipold B, Schacke C, Zank S (2006) Prädikatoren von Persönlichkeitswachstum bei pflegenden Angehörigen demenziell Erkrankter. Z Gerontol Geriatr 39:227–232

    Article  PubMed  CAS  Google Scholar 

  • Li T, Lee Y, Lin C, Amidon RL (2004) Quality of life of primary caregivers of elderly with cerebrovasular disease of diabetes hospitalized for acute care: Assessment of well-being and functioning using the SF-36 Health Questionnaire. Qual Life Res 13:1081–1088

    Article  PubMed  Google Scholar 

  • Mahoney FI, Barthel DW (1965) Functional evaluation: the Barthel index. Md State Med J 14:61–65

    PubMed  CAS  Google Scholar 

  • Markowitz JS, Gutterman EM, Sadik K, Papadopoulos G (2003) Health-related quality of life for caregivers of patients with alzheimer disease. Alzheimer Dis Assoc Disord 17:209–214

    Article  PubMed  Google Scholar 

  • Matthews BA, Baker F, Spillers RL (2004) Family caregivers' quality of life: influence of health protective stance and emotional strain. Psychol Health 19:625–641

    Article  Google Scholar 

  • Miura H, Arai Y, Yamasaki K (2005) Feelings of burden and health-related quality of life among family caregivers looking after the impaired elderly. Psychiatr Clin Neurosci 59:551–555

    Article  Google Scholar 

  • Montgomery RJ, Gonyea JG, Hooyman NR (1985) Caregiving and the experience of subjective and objective burden. Fam Relat 34:19–26

    Article  Google Scholar 

  • Navaie-Waliser M, Feldman PH, Gould DA, Levine C, Kuerbis AN, Donelan K (2002) When the caregiver needs care: the plight of vulnerable caregivers. Am J Public Health 92:409–413

    Article  PubMed  Google Scholar 

  • Ostermann H, Staudinger B, Staudinger O, Kern K, Them C, Staudinger R (2009) Policy, structure and evaluation of nursing networks. Differentiated requirements referred to the example of integrated nursing care in Austria. Int J Networking Virtual Org 6:270–302

    Article  Google Scholar 

  • Pearlin L, Mullan JT, Semple S, Skaff MM (1990) Caregiving and the stress process: an overview of concepts and their measures. Gerontologist 30:583–594

    PubMed  CAS  Google Scholar 

  • Pinquart M, Sörensen S (2003) Differences between caregivers and noncaregivers in psychological health and physical health: A meta-analysis. Psychol Aging 18:250–267

    Article  PubMed  Google Scholar 

  • Pinquart M, Sörensen S (2006) Gender differences in caregiver stressors, social resources, and health: an updated meta-analysis. J Gerontol B Psychol Sci Soc Sci 61:P33–P45

    PubMed  Google Scholar 

  • Pinquart M, Sörensen S (2007) Correlates of physical health of informal caregivers: a meta-analysis. J Gerontol B Psychol Sci Soc Sci 62:P126–P137

    PubMed  Google Scholar 

  • Pruchno RA, Brill JE, Shands Y, Gordon JR, Genderson MW, Rose M, Cartwright F (2008) Convenience samples and caregiving research: how generalizable are the findings? Gerontologist 48:820–827

    Article  PubMed  Google Scholar 

  • Rösler-Schidlack B, Stummer H, Ostermann H (2010) Gesundheitsbezogene Lebensqualität und soziale Unterstützung bei pflegenden Angehörigen. Pflegewissenschaft 12:75–86

    Google Scholar 

  • Sato E (2009) After the launch of long-term care insurance in Germany: analyzing the transition of LTCI from 1999 to 2005 by state. J Public Health 17:409–415

    Article  Google Scholar 

  • Schacke C, Zank S (1998) Zur familiären Pflege demenzkranker Menschen: Die differentielle Bedeutung spezifischer Belastungsdimensionen für das Wohlbefinden der Pflegenden und die Stabilität der häuslichen Pflegesituation. Z Gerontol Geriatr 31:355–361

    Article  PubMed  CAS  Google Scholar 

  • Schaeffer D, Kuhlmey A (2008) Pflegestützpunkte – Impuls zur Weiterentwicklung der Pflege. Z Gerontol Geriatr 41:81–85

    Article  PubMed  Google Scholar 

  • Schneekloth U (2006) Entwicklungstrends und Perspektiven in der häuslichen Pflege. Zentrale Ergebnisse der Studien Möglichkeiten und Grenzen selbständiger Lebensführung (MuG III). Z Gerontol Geriatr 39:405–412

    Article  PubMed  CAS  Google Scholar 

  • Schneekloth U, Wahl HW (eds) (2005) Möglichkeiten und Grenzen selbständiger Lebensführung in privaten Haushalten (MuG III). Repräsentativbefunde und Vertiefungsstudien zu häuslichen Pflegearrangements, Demenz und professionellen Versorgungsangeboten. Integrierter Abschlussbericht im Auftrag des Bundesministeriums für Familie, Senioren, Frauen und Jugend, München. http://www.bmfsfj.de/Publikationen/mug/01-Redaktion/PDF-Anlagen/gesamtdokument,property=pdf,bereich=mug,sprache=de,rwb=true.pdf. Accessed 23 August 2010

  • Schneider N, Schwartz FW (2007) Demographic changes: discussing the data and the consequences for health and morbidity in Germany. J Public Health 15:481–483

    Article  Google Scholar 

  • Schulz R, Beach SR (1999) Caregiving as a risk factor for mortality: the caregiver health effects study. JAMA 282:2215–2219

    Article  PubMed  CAS  Google Scholar 

  • Schulz R, O'Brien A, Bookwala J, Fleissner K (1995) Psychiatric and physical morbidity effects of dementia caregiving: prevalence, correlates, and causes. Gerontologist 35:771–791

    PubMed  CAS  Google Scholar 

  • Sieverding M (2005) Geschlecht und Gesundheit. In: Schwarzer (Hg.)—Gesundheitspsychologie. Hogrefe, Göttingen, pp 55-69

  • Smerglia VL, Miller NB, Sotnak DL, Geiss CA (2007) Social support and adjustment to caring for elder family members: A multi-study analysis. Aging Ment Health 11:205–217

    Article  PubMed  Google Scholar 

  • Sörensen S, Pinquart M, Duberstein P (2002) How effective are interventions with caregivers? An updated meta-analysis. Gerontologist 42:356–372

    PubMed  Google Scholar 

  • Bundesministerium für Gesundheit und Soziale Sicherung (2003) Nachhaltigkeit in der Finanzierung der sozialen Sicherungssysteme, Bericht der Kommission

  • Statistisches Bundesamt (2009) Pflegestatistik - Pflegebedürftige (Anzahl). Gliederungsmerkmale: Jahre, Deutschland, Alter, Geschlecht, Pflegestufe, Art der Betreuung. www.gbe-bund.de. Accessed 28 February 2010

  • Stoltz P, Udén G, Willman A (2004) Support for family carers who care for an elderly person at home—a systematic literature review. Scand J Caring Sci 18:111–119

    Article  PubMed  Google Scholar 

  • Strawbridge WJ, Wallhagen MI, Shema SJ, Kaplan GA (1997) New burdens or more of the same? Comparing grandparent, spouse, and adult-child caregivers. Gerontologist 37:505–510

    PubMed  CAS  Google Scholar 

  • Stummer H (2007) Entsolidarisierung von Führungsverhalten und mögliche Auswirkungen auf die Gesundheit. Industrielle Beziehungen 14:270–278

    Google Scholar 

  • Szinovacz ME, Davey A (2004) Retirement transitions and spouse disability: effects on depressive symptoms. J Gerontol B Psychol Sci Soc Sci 59:S333–S342

    PubMed  Google Scholar 

  • Vitaliano PP, Zhang J, Scanlan JM (2003) Is caregiving hazardous to one's physical health? A meta-analysis. Psychol Bull 129:946–972

    Article  PubMed  Google Scholar 

  • Ware JE Jr, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36): I. Conceptual framework and item selection. Med Care 30:473–483

    Article  PubMed  Google Scholar 

  • Ware JE Jr, Kosinski M, Bayliss MS, McHorney CA, Rogers W, Raczek A (1995) Comparison of methods for the scoring and statistical analysis of SF-36 health profile an summary measures: summary of results from the medical outcomes study. Med Care 33:AS264–AS279

    Article  PubMed  Google Scholar 

  • Wilz G, Kalytta T, Küssner C (2005) Quantitative und qualitative Diagnostik von Belastungen und Belastungsverarbeitung bei pflegenden Angehörigen. GeroPsych 18:259–277

    Google Scholar 

  • Yee JL, Schulz R (2000) Gender differences in psychiatric morbidity among family caregivers: a review and analysis. Gerontologist 40:147–164

    PubMed  CAS  Google Scholar 

  • Zarit SH, Todd PA, Zarit JM (1986) Subjective burden of husbands and wives as caregivers: a longitudinal study. Gerontologist 26:260–266

    PubMed  CAS  Google Scholar 

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Rösler-Schidlack, B., Stummer, H. & Ostermann, H. Health-related quality of life of family caregivers—Evidence from Hesse. J Public Health 19, 269–280 (2011). https://doi.org/10.1007/s10389-010-0369-z

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