TitleRole of global stress in the health-related quality of life of caregivers: evidence from the Survey of the Health of Wisconsin.
Publication TypeJournal Article
Year of Publication2014
AuthorsLitzelman, K, Skinner, HG, Gangnon, RE, F. Nieto, J, Malecki, K, Witt, WP
JournalQual Life Res
Date Published06/2014
KeywordsAdult, Aged, Aged, 80 and over, Caregivers, Chronic Disease, Cluster Analysis, Cross-Sectional Studies, Female, Health Status, Health Status Indicators, Health Surveys, Humans, Interpersonal Relations, Linear Models, Male, Mental Health, Middle Aged, Quality of Life, Sickness Impact Profile, Socioeconomic Factors, Stress, Psychological, Surveys and Questionnaires, Wisconsin, Young Adult

PURPOSE: Informal caregivers play a critical role in the care of individuals who are aging or have disabilities and are at increased risk for poor health outcomes. This study sought to determine whether and to what extent: (1) global stress and health-related quality of life (HRQoL) differed between caregivers and non-caregivers; (2) global stress mediated the relationship between caregiving status and HRQoL; and (3) caregiver strain (i.e., stress attributable to caregiving) was associated with worse HRQoL after accounting for global stress.

METHODS: Cross-sectional data were from the 2008-2010 Survey of the Health of Wisconsin, a representative sample of adults aged 21-74 years. Participants (n = 1,364) completed questionnaires about caregiving status, sociodemographics, global stress, and HRQoL. Staged generalized additive models assessed the impact of caregiving on HRQoL and the role of caregiver strain and global stress in this relationship.

RESULTS: In the last 12 months, 17.2% of the sample reported caregiving. Caregivers reported worse mental HRQoL than non-caregivers (β -1.88, p = 0.02); global stress mediated this relationship (p < 0.01). Caregivers with the highest levels of strain reported worse mental and physical HRQoL (β -7.12, p < 0.01), and caregivers with the lowest levels of strain reported better mental HRQoL (β 2.06, p = 0.01) than non-caregivers; these associations were attenuated by global stress (p < 0.01).

CONCLUSION: Global stress, rather than caregiving per se, contributes to poor HRQoL among caregivers, above and beyond the effect of caregiving strain. Screening, monitoring, and reducing stress in multiple life domains presents an opportunity to improve HRQoL outcomes for caregivers.

Alternate JournalQual Life Res
PubMed ID24322907
PubMed Central IDPMC4032607
Grant ListP30 HD003352 / HD / NICHD NIH HHS / United States
UL1 TR000427 / TR / NCATS NIH HHS / United States
F31 AG044073 / AG / NIA NIH HHS / United States
5UL 1RR025011 / RR / NCRR NIH HHS / United States
RC2 HL101468 / HL / NHLBI NIH HHS / United States
UL1 RR025011 / RR / NCRR NIH HHS / United States
1 RC2 HL101468 / HL / NHLBI NIH HHS / United States
F31 AG 044073 / AG / NIA NIH HHS / United States