Health capability of family caregivers; ayesian approach; Fatigue; Stroke; Feeling abandoned; Health inequalities
Abstract :
[en] Background:
The lifestyles of family caregivers pose risks to their physical, mental and social health. The capability to stay healthy may be protective in the context of poor socioeconomic conditions and risk behaviours, but the interrelations between its aspects and their respective influences remain unclear. The aim of this study was to evaluate the interrelations between the factors comprising health capability of family caregivers (HCFC) and the respective contributions of its components.
Methods:
All stroke patients admitted to all hospitals in Luxembourg were identified by the ‘Inspection Générale de la Sécurité Sociale’ using the national database system for care expenditure reimbursement, and asked to designate the main person caring for them. Sixty-two caregivers (mean age 59.3 years; 40 women and 22 men) responded face to face, to a questionnaire including 20 items measuring eight aspects of health capability (physical functioning,
psychological functioning, lifestyle value, self-efficacy towards the use of health services, family support, social capital, material conditions/sense of security, and satisfaction with the interactions with health services). Using a Bayesian approach, significance values were estimated by comparing the test values to the posterior distribution of the parameters. Structural equation modelling with standard deviations was applied.
Results:
Female family caregivers had lower scores than men in physical and psychological functioning. Family caregivers with the lowest incomes had the least lifestyle value, social capital and material conditions/security. Self-efficacy towards health services increased with age. The material conditions/sense of security factor was positively correlated with almost all the others. The items that impacted health capability factors the most were - for physical functioning –
atigue, and - for family support - feeling abandoned by the family.
Conclusions:
During the chronic phase, relationships between risk behaviours can help guide social and health
decision-makers to determine their priorities in improving the lives of family caregivers. Enhancing health capability involves implementing programs that relieve family caregivers physically, and foster family networking around the person being cared for. Special attention should also be paid to the socially disadvantaged in order to fight inequalities in health capability.
Disciplines :
Treatment & clinical psychology
Author, co-author :
Bucki, Barbara; University of Luxembourg - UL
Spitz, Elisabeth; Université de Lorraine
Etienne, Anne-Marie ; Université de Liège > Département de Psychologie > Psychologie de la santé
Le Bihan, Etienne; University of Luxembourg - UL
Baumann, Michèle; University of Luxembourg - UL
Language :
English
Title :
Health capability of family caregivers: how different factors interrelate and their respective contributions using a Bayesian approach
GBD 2013 Mortality and Causes of Death Collaborators. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;385:117-71.
Eurostat. Health statistics - Atlas on mortality in the European Union. Office for Official Publications of the European Communities. Luxembourg. 2009. http://www.eurosfaire.prd.fr/7pc/doc/1252488295-atlas-mortalite-ue-2009.pdf. Accessed 28 Apr 2016.
Mello JDA, Van Durme T, Macq J, Declercq A. Interventions to delay institutionalization of frail older persons: design of a longitudinal study in the home care setting. BMC Public Health. 2012;12:615.
Guinchard P, Petit J-F. Une société de soins: santé, travail, philosophie, politique [A society of care: health, labor, philosophy, politics]. 2011. Editions de l'Atelier.
Pierce LL, Steiner V. What are male caregivers talking about? Top Stroke Rehabil. 2004;11:77-83.
Peacock S, Forbes D, Markle-Reid M, Hawranik P, Morgan D, Jansen L, Leipert BD, Henderson SR. The Positive Aspects of the Caregiving Journey With Dementia: Using a Strengths-Based Perspective to Reveal Opportunities. J Appl Gerontol. 2010;29:640-59.
Vitaliano PP, Zhang J, Scanlan JM. Is caregiving hazardous to one's physical health? A meta-analysis. Psychol Bull. 2003;129:946-72.
Pinquart M, Sörensen S. Differences between caregivers and noncaregivers in psychological health and physical health: a meta-analysis. Psychol Aging. 2003;18:250-67.
Spitz E, Sordes Ader F. Qualité de vie, entourage, soutien social. Qualité de vie et maladies rénales chroniques: satisfaction des soins et autres Patient-Reported Outcomes [Quality of life, environment, social support. Quality of life and chronic kidney disease: care satisfaction and other Patient-Reported Outcomes]. Paris: John Libbey Eurotext; 2007. p. 109-23.
Reid RC, Stajduhar KI, Chappell NL. The impact of work interferences on family caregiver outcomes. J Appl Gerontol. 2010;29:267-89.
Baumann M, Bucki B. Lifestyle as a health risk of the family caregivers with a least life satisfaction, in home-based post-stroke caring. Health Policy. 2013;9:98-111.
Idstad M, Ask H, Tambs K. Mental disorder and caregiver burden in spouses: the Nord-Trøndelag health study. BMC Public Health. 2010;10:516.
Talley RC, Crews JE. Framing the public health of caregiving. Am J Public Health. 2007;97:224-8.
Sen A. Inequality reexamined. New York: Clarendon Press; 1992.
Bucki B. Health Capability: an Attempt to Clarify an Alternative Approach for Health Sociology. Sci Ann Alexandru Ioan Cuza Univ New Ser Sociol Soc Work Sect. 2014;7:19-31.
Al-Janabi H, Coast J, Flynn TN. What do people value when they provide unpaid care for an older person? A meta-ethnography with interview follow-up. Soc Sci Med. 2008;67:111-21.
Al-Janabi H, Flynn TN, Coast J. Estimation of a preference-based carer experience scale. Med Decis Making. 2011;31:458-68.
Ruger JP. Health capability: conceptualization and operationalization. Am J Public Health. 2010;100:41-9.
Harper A, Power M, on the behalf of the WHOQOL Group. Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychol Med. 1998;28:551-8.
Baumann M, Couffignal S, Le Bihan E, Chau N. Life satisfaction two-years after stroke onset: the effects of gender, sex occupational status, memory function and quality of life among stroke patients (Newsqol) and their family caregivers (Whoqol-bref) in Luxembourg. BMC Neurol. 2012;12:105.
Given CW, Given B, Stommel M, Collins C, King S, Franklin S. The caregiver reaction assessment (CRA) for caregivers to persons with chronic physical and mental impairments. Res Nurs Health. 1992;15:271-83.
McPherson CJ, Wilson KG, Chyurlia L, Leclerc C. The caregiving relationship and quality of life among partners of stroke survivors: a cross-sectional study. Health Qual Life Outcomes. 2011;9:29. https://www.york.ac.uk/inst/spru/pubs/pdf/healthinequalities.pdf.
Simon C, Kumar S, Kendrick T. Formal support of stroke survivors and their informal carers in the community: a cohort study. Health Soc Care Community. 2008;16:582-92.
Simon C, Little P, Birtwistle J, Kendrick T. A questionnaire to measure satisfaction with community services for informal carers of stroke patients: construction and initial piloting. Health Soc Care Community. 2003;11:129-37.
Franzén-Dahlin A, Larson J, Murray V, Wredling R, Billing E. Predictors of psychological health in spouses of persons affected by stroke. J Clin Nurs. 2007;16:885-91.
Gaugler JE, Kane RL, Kane RA, Newcomer R. Early Community-Based Service Utilization and Its Effects on Institutionalization in Dementia Caregiving. The Gerontologist. 2005;45:177-85.
Nijboer C, Triemstra M, Tempelaar R, Sanderman R, Van den Bos GAM. Determinants of caregiving experiences and mental health of partners of cancer patients. Cancer. 1999;86:577-88.
Fortinsky RH, Kercher K, Burant CJ. Measurement and correlates of family caregiver self-efficacy for managing dementia. Aging Ment Health. 2002;6:153-60.
Hirst M. Health inequalities and informal care: end of project report. Social Policy Research Unit, University of York; 2004. https://www.york.ac.uk/inst/spru/pubs/pdf/healthinequalities.pdf. Accessed 28 Apr 2016.
Pearlin LI, Schieman S, Fazio EM, Meersman SC. Stress, health, and the life course: Some conceptual perspectives. J Health Soc Behav. 2005;46:205-19.
Pinquart M, Sörensen S. Correlates of physical health of informal caregivers: a meta-analysis. J Gerontol B Psychol Sci Soc Sci. 2007;62:P126-37.
Bugge C, Alexander H, Hagen S. Stroke Patients' Informal Caregivers Patient, Caregiver, and Service Factors That Affect Caregiver Strain. Stroke. 1999;30:1517-23.
McCullagh E, Brigstocke G, Donaldson N, Kalra L. Determinants of caregiving burden and quality of life in caregivers of stroke patients. Stroke J Cereb Circ. 2005;36:2181-6.
Mackenbach JP. The persistence of health inequalities in modern welfare states: the explanation of a paradox. Soc Sci Med. 2012;75:761-9.
Goetz C, Coste J, Lemetayer F, Rat A-C, Montel S, Recchia S, Debouverie M, Pouchot J, Spitz E, Guillemin F. Item reduction based on rigorous methodological guidelines is necessary to maintain validity when shortening composite measurement scales. J Clin Epidemiol. 2013;66:710-8.
Robert CP. Méthodes de Monte Carlo par chaînes de Markov. Paris: Economica; 1996.
Lee S-Y. Structural equation modeling: A Bayesian approach. England: John Wiley and Sons; 2007.
Lee EC, Whitehead AL, Jacques RM, Julious SA. The statistical interpretation of pilot trials: should significance thresholds be reconsidered? BMC Med Res Methodol. 2014;14:41.
Lunn D, Spiegelhalter D, Thomas A, Best N. The BUGS project: Evolution, critique and future directions. Stat Med. 2009;28:3049-67.
Mikolajczak M, Quoidbach J, Kotsou I, Nelis D. Les compétences émotionnelles. Dunod, Paris: Hachette; 2009.
Pawl JD, Lee S-Y, Clark PC, Sherwood PR. Sleep Loss and Its Effects on Health of Family Caregivers of Individuals with Primary Malignant Brain Tumors. Res Nurs Health. 2013;36:386-99.
Braveman P. Health disparities and health equity: concepts and measurement. Annu Rev Public Health. 2006;27:167-94.
Mold F, McKevitt C, Wolfe C. A review and commentary of the social factors which influence stroke care: issues of inequality in qualitative literature. Health Soc Care Community. 2003;11:405-14.
Bakker M, Mackenbach J. Reducing Inequalities in Health: A European Perspective. Routledge, New York; 2003.
European Portal for Action on Health Inequalities. Policy Database. 2014. http://www.health-inequalities.eu/HEALTHEQUITY/EN/policies/policy-database/. Accessed 28 Apr 2016.
Tchicaya A, Demarest S, Lorentz N. Comparaison internationale des inégalités sociales de santé en Europe : Cas du Luxembourg avec 23 autres pays [International comparison of health inequalities in Europe: the case of Luxembourg and 23 other countries]. Luxembourg: CEPS-INSTEAD; 2011. p. 24.
Whitehead M. A typology of actions to tackle social inequalities in health. J Epidemiol Community Health. 2007;61:473-8.
Navaie-Waliser M, Spriggs A, Feldman PH. Informal caregiving: differential experiences by gender. Med Care. 2002;40:1249-59.
Pinquart M, Sörensen S. Gender differences in caregiver stressors, social resources, and health: An updated meta-analysis. J Gerontol B Psychol Sci Soc Sci. 2006;61:P33-45.
Bucki B, Spitz E, Baumann M. Prendre soin des personnes après AVC: réactions émotionnelles des aidants informels hommes et femmes [Caring for a stroke victim: the emotional reactions of male and female caregivers]. Santé Publique. 2012;24:143-56.
Health E, System LEI. EurOhex countryreports. 2010. http://www.eurohex.eu/index.php?option=countryreports. Accessed 28 Apr 2016.
Ostwald SK. Who is caring for the caregiver? Promoting spousal caregiver's health. Fam Community Health. 2009;32:S5-S14.
Horrell B, Stephens C, Breheny M. Capability to Care: Supporting the Health of Informal Caregivers for Older People. Health Psychol. 2015;34:339-48.
Grant JS, Elliott TR, Weaver M, Bartolucci AA, Giger JN. Telephone intervention with family caregivers of stroke survivors after rehabilitation. Stroke. 2002;33:2060-5.
