Abstract
Background/Aims Caregiving for a person with dementia is stressful and challenging. Caregiving stress and burdens may have significant negative impact on caregivers (CG) self-reported health status. Despite caregiving stress and burdens, caring is also rewarding and important work for many CGs. The net impact of these positive and negative aspects of caregiving on CGs health is largely unknown. The objectives of this study are to (a) to examine the net impact of positive aspect of caregiving (PAC), depression, stress and burdens on changes in CGs self-reported health status, and (b) how this impact varies by race and ethnicity.
Methods Six-hundred and forty five caregivers (212 Hispanic, 219 White, and 214 Black or African-American) participated in the REACH-II study, a multisite psycho-educational caregiving intervention trial. CGs were randomly assigned into the REACH II intervention or a minimum contact control group. CGs in the intervention group received nine in-home (1.5 hours each), and 3 telephone (half hour each) sessions over a 6-month intervention period. This study examined the change in caregivers’ health status from baseline to six-month follow-up for both the intervention and the control group. Health status was defined as a binary variable indicating whether a caregiver’s health status improved, remained the same, or decreased. Two primary independent covariates were the Zarit burden score (self-reported physical and emotional stress), and the positive aspect of caregiving (PAC) score (based on self-reported reward and satisfaction derived from caregiving). We used logistic regression with Generalized Estimation Equation (GEE) method to account for correlation between responses of same caregiver at baseline and follow-up. PROC GENMOD was used to estimate the model in SAS.
Results Preliminary results indicate that higher caregiving burden was associated with a lower probability of improvement in CGs self-reported health status (2%) while, higher the PAC score among caregivers was associated, with higher likelihood (4%) of improvement in health status for the intervention group than the control group. We did not find any significant impact of race/ ethnicity on changes in CGs self-reported health.
Conclusions The findings support the conclusion that both negative and positive aspects of caregiving are important and influence overall change in CGs self-reported health status.
