Association Between Caregiver Strain and Self-Care Among Caregivers With Diabetes

Abstract

IMPORTANCE Caregiver strain has been shown to be associated with adverse effects on caregivers' health, particularly among those with cardiovascular disease. Less is known about the association of caregiver strain with health behaviors among caregivers with diabetes, a disease that requires a high degree of self-care. OBJECTIVE To examine the association between caregiver strain and diabetes self-care among caregivers with diabetes. DESIGN, SETTING, AND PARTICIPANTS This cohort study was conducted between July 13, 2018, and June 25, 2020, using data on 795 US caregivers aged 45 years or older with self-reported diabetes from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, which comprised 30 239 Black and White adults 45 years or older throughout the US enrolled from January 2003 to October 2007. EXPOSURES Caregiver strain, assessed by self-report in response to the question, "How much of a mental or emotional strain is it to provide this care?" Response options were no strain, some strain, or a lot of (high) strain. MAIN OUTCOMES AND MEASURES Diabetes self-care, which was assessed across 4 domains (Mediterranean diet adherence, physical activity, smoking status, and medication adherence), and a composite self-care score summing performance across these domains. The association between caregiver strain and diabetes self-care was examined with multivariable Poisson regression adjusting for demographic, clinical, physical and mental functioning, and caregiving covariates. RESULTS Among the 795 caregivers with diabetes included in the study, the mean (SD) age was 63.7 (8.6) years, 469 (59.0%) were women, and 452 (56.9%) were Black individuals. Overall, 146 caregivers (18.4%) reported high caregiver strain. In unadjusted models, high caregiver strain was associated with less physical activity (prevalence ratio [PR], 0.66; 95% CI, 0.45-0.97), low medication adherence (PR, 0.80; 95% CI, 0.68-0.94), and worse self-care (PR, 0.65; 95% CI, 0.44-0.98). In adjusted models, the association between some and high caregiving strain with low medication adherence remained significant (adjusted PR: some strain, 0.88 [95% CI, 0.78-0.99]; high strain, 0.83 [95% CI, 0.69-0.99]). CONCLUSIONS AND RELEVANCE In this cohort study of US adult caregivers with diabetes, a high level of strain was associated with low medication adherence. Increased awareness of the prevalence of caregiver strain and potential ramifications on caregivers' self-care appears to be warranted among health care professionals and caregivers.

The relationship of caregiver strain with resilience and hardiness in family caregivers of older adults with chronic disease: a cross-sectional study

“…Also, in a study in the United States, 45.9% of caregivers reported moderate caregiver strain [ 8 ], which is consistent with the results of the present study [ 28 ]. .Also, in a study in the United States, 45.9% of caregivers reported moderate caregiver strain [ 8 ], which is consistent with the results of the present study. Zhang et al in a study using the CSI found that more than 50% of caregivers of dementia patients experienced high levels of caregiver strain, which is not consistent with the present study [ 29 ].…”

“…Shafiezadeh et al found that caregiver strain was higher than average in family caregivers of older adults with Alzheimer's disease [28]. Also, in a study in the United States, 45.9% of caregivers reported moderate caregiver strain [8], which is consistent with the results of the present study [28]. .Also, in a study in the United States, 45.9% of caregivers reported moderate caregiver strain [8], which is consistent with the results of the present study.…”

“…Caregiver strain can be defined as “the level of multifaceted strain perceived (objective or subjective) by the caregiver from caring for a family member and/or loved one over time”. Caregiver strain is a condition that seeks to endure the problems and difficulties of care for caregivers and leads to negative effects on various aspects of health [ 8 ]. In a community-based survey, Koyanagi et al reported that family caregivers are under the stress of caring, while caregiver strain is also linked to factors such as gender, education, care hours, depression, and financial problems [ 9 ].…”

Assessment of Type II Diabetes Patients’ Caregivers’ Burnout Level: A Cross-Sectional Study in Taif, Saudi Arabia

“…A recent study also showed that only 18.4% of T2D patients’ caregivers report high level of strain. 19 The observed difference likely related to the screening tool difference along with the caregiver age in our study. Another study showed that 42% of the caregivers had little to no stress and the difference observed may be related to the caregiver’s relation to patients as 92.6% of our study caregivers were patient’s offspring compared with 40%.…”

Providing Physical Assistance for Family or Friends: An Overview for the Home Health Care Professional—Part 1

“…2,5 Metabolic conditions, such as metabolic syndrome or diabetes mellitus, are also increasingly common in 21st century patient care, and these types of conditions present unique challenges for individuals who wish to remain in their homes. 6 More severe progressions of these and other diagnoses may have significant impact on functional mobility, requiring assistance from informal caregivers for activities such as transfers, gait, stairs, wheelchair use, among other tasks. 7 For some patients, there is significant physical assistance required with lifting such individuals within a home healthcare environment, including the regular execution of activities such as bathing, bed mobility, and wheelchair propulsion.…”