Abstract
This population-based study using 2011–2012 Spanish National Health Survey data aimed to measure the impact of disease, health-related habits, and risk factors associated with informal caregiving. We included and matched self-reported informal caregivers [ICs] with controls (1:4) from the same survey. For each outcome, we analyzed associations between ICs and controls using linear regression or logistic regression models. ICs had 3.4 per cent more depression (OR: 1.33, 95 per cent confidence intervals [CI]:1.06, 1.68). ICs had lower social support (95 per cent CI: 1.64, 3.28), they did more housework alone (OR:3.6, 95 per cent CI:2.65, 4.89), and had greater stress (95 per cent CI:0.13, 0.83). Women ICs caring alone had more anxiety than other groups. We found no statistical association between caregivers and worse health-related habits or increased risk factors (less physical activity, smoking, drinking, and cholesterol). Our results provide evidence that health-care professionals and organizations should recognize the importance of caring for those who care.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
World Health Organization Europe. (2013) The European health report 2012: Charting the way to well-being, http://www.euro.who.int/en/data-and-evidence/european-health-report-2012, accessed 28 October 2015.
Adelman, R.D., Tmanova, L.L., Delgado, D., Dion, S. and Lachs, M.S. (2014) Caregiver burden: A clinical review. The Journal of American Medical Association 311 (10): 1052–1060.
Sorensen, S., Pinquart, M. and Duberstein, P. (2002) How effective are interventions with caregivers? An updated meta-analysis. The Gerontologist 42 (3): 356–372.
Hartmann, M., Bazner, E., Wild, B., Eisler, I. and Herzog, W. (2010) Effects of interventions involving the family in the treatment of adult patients with chronic physical diseases: A meta-analysis. Psychotherapy and Psychosomatics 79 (3): 136–148.
Oliva, J., Vilaplana, C. and Osuna, R. (2011) The social value of informal care provided to elderly dependent people in Spain. Gaceta Sanitaria 25 (Suppl 2): 108–114.
Hurd, M.D., Martorell, P., Delavande, A., Mullen, K.J. and Langa, K.M. (2013) Monetary costs of dementia in the United States. The New England Journal of Medicine 368 (14): 1326–1334.
Borghi, A.C., de Castro, V.C., Marcon, S.S. and Carreira, L. (2013) Overload of families taking care of elderly people with Alzheimer’s disease: A comparative study. Revista Latino-Americana de Enfermagem 21 (4): 876–883.
Etters, L., Goodall, D. and Harrison, B.E. (2008) Caregiver burden among dementia patient caregivers: A review of the literature. Journal of the American Academy of Nurse Practitioners 20 (8): 423–428.
Zarit, S.H., Todd, P.A. and Zarit, J.M. (1986) Subjective burden of husbands and wives as caregivers: A longitudinal study. The Gerontologist 26 (3): 260–266.
Northouse, L., Williams, A.L., Given, B. and McCorkle, R. (2012) Psychosocial care for family caregivers of patients with cancer. Journal of Clinical Oncology 30 (11): 1227–1234.
Thielemann, P.A. and Conner, N.E. (2009) Social support as a mediator of depression in caregivers of patients with end-stage disease. Journal of Hospice and Palliative Nursing 11 (2): 82–90.
National Institute for Health and Clinical Excellence. (2004) The NICE-GSGSP guidance on cancer services: Improving supportive and palliative care for adults with cancer. The manual (online), https://www.nice.org.uk/guidance/csgsp, accessed 28 October 2015.
National Institute for Health and Clinical Excellence. (2012) The NICE-SCIE guideline on supporting people with Dementia and their carers in health and social care (online), https://www.nice.org.uk/guidance/CG42, accessed 28 October 2015.
Ngo, J. and Holroyd-Leduc, J.M. (2015) Systematic review of recent dementia practice guidelines. Age and Ageing 44 (1): 25–33.
Guedes, A.C. and Pereira Mda, G. (2013) Burden, coping, physical symptoms and psychological morbidity in caregivers of functionally dependent family members. Revista Latino-Americana de Enfermagem 21 (4): 935–940.
Cabral, L., Duarte, J., Ferreira, M. and dos Santos, C. (2014) Anxiety, stress and depression in family caregivers of the mentally ill. Atención Primaria 46 (Suppl): 5176–179.
Badia Llach, X., Lara Surinach, N. and Roset Gamisans, M. (2004) Quality of life, time commitment and burden perceived by the principal informal caregiver of Alzheimer’s patients. Atención Primaria 34 (4): 170–177.
Pena-Longobardo, L.M. and Oliva-Moreno, J. (2015) Caregiver burden in Alzheimer’s disease patients in Spain. Journal of Alzheimer’s Disease 43 (4): 1293–1302.
Instituto Nacional de Estadística de España. (2015) National health survey. General methodology, http://www.ine.es/en/metodologia/t15/t153041912_en.pdf, accessed 28 October 2015.
Stuart, E.A. (2010) Matching methods for causal inference: A review and a look forward. Statistical Science 25 (1): 1–21.
Bellon Saameno, J.A., Delgado Sanchez, A., Luna del Castillo, J.D. and Lardelli Claret, P. (1996) Validity and reliability of the Duke-UNC-11 questionnaire of functional social support. Atención Primaria 18 (4): 153–156, 158–163.
Sanchez-Lopez Mdel, P. and Dresch, V. (2008) The 12-item general health questionnaire (GHQ-12): Reliability, external validity and factor structure in the Spanish population. Psicothema 20 (4): 839–843.
Herdman, M. et al (2011) Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Quality of Life Research 20 (10): 1727–1736.
World Health Organization. (2014) Global status report on noncommunicable diseases 2014, http://www.who.int/nmh/publications/ncd-status-report-2014/en/, accessed 15 May 2015.
Valencia Martin, J.L., Gonzalez, M.J. and Galan, I. (2014) Methodological issues in the measurement of alcohol consumption: The importance of drinking patterns. Revista Española de Salud Pública 88 (4): 433–446.
Preacher, K.J. and Kelley, K. (2011) Effect size measures for mediation models: Quantitative strategies for communicating indirect effects. Psychological Methods 16 (2): 93–115.
R Core Team. (2015) R: A Language and Environment for Statistical Computing. Vienna, Austria: R Foundation for Statistical Computing.
Tingley, D., Yamamoto, T., Hirose, K., Keele, L. and Imai, K. (2014) Mediation: R package for causal mediation analysis. Journal of Statistical Software 59 (5): 1–38.
Cuijpers, P. (2005) Depressive disorders in caregivers of dementia patients: A systematic review. Aging & Mental Health 9 (4): 325–330.
Torres, Á., Blanco, V., Vázquez, F., Díaz, O., Otero, P. and Hermida, E. (2015) Prevalence of major depressive episodes in non-professional caregivers. Psychiatry Research 226 (1): 333–339.
Adams, R.N., Mosher, C.E., Cannady, R.S., Lucette, A. and Kim, Y. (2014) Caregiving experiences predict changes in spiritual well-being among family caregivers of cancer patients. Psycho-oncology 23 (10): 1178–1184.
McLennon, S.M., Bakas, T., Jessup, N.M., Habermann, B. and Weaver, M.T. (2014) Task difficulty and life changes among stroke family caregivers: Relationship to depressive symptoms. Archives of Physical Medicine and Rehabilitation 95 (12): 2484–2490.
Schneider, U. and Kleindienst, J. (2015) Monetising the provision of informal long-term care by elderly people: Estimates for European out-of-home caregivers based on the well-being valuation method. Health & Social Care in the Community, advance online publication May 4, doi:10.1111/hsc.12250.
Legg, L., Weir, C.J., Langhorne, P., Smith, L.N. and Stott, D.J. (2013) Is informal caregiving independently associated with poor health? A population-based study. Journal of Epidemiology and Community Health 67 (1): 95–97.
Molinuevo, J.L. and Hernandez, B., Grupo de Trabajo del Estudio IMPACT. (2011) Profile of the informal carer associated with the clinical management of the Alzheimer’s disease patient refractory to symptomatic treatment of the disease. Neurologia (Barcelona, Spain) 26 (9): 518–527.
Yesufu-Udechuku, A. et al (2015) Interventions to improve the experience of caring for people with severe mental illness: systematic review and meta-analysis. The British Journal of Psychiatry 206 (4): 268–274.
Courtin, E., Jemiai, N. and Mossialos, E. (2014) Mapping support policies for informal carers across the European Union. Health Policy (Amsterdam, Netherlands) 118 (1): 84–94.
Hoffmann, F. and Rodrigues, R. (2010) Informal carers: Who takes care of them? Policy Briefs, 13 May.
Maayan, N., Soares-Weiser, K. and Lee, H. (2014) Respite care for people with dementia and their carers. The Cochrane Database of Systematic Reviews, 1: CD004396, doi:10.1002/14651858.CD004396.pub3.
Gallo, P. and Gene-Badia, J. (2013) Cuts drive health system reforms in Spain. Health Policy (Amsterdam, Netherlands) 113 (1–2): 1–7.
Acknowledgements
The authors thank Dr. Belchin Kostov, Transverse Group for Research in Primary Care, IDIBAPS, Barcelona, Spain, for his valuable comments, Dr Montse Neira León, Deputy Director of Health Information and Innovation, Spanish Ministry of Health and Social Policy, Madrid, Spain, and David Buss for technical help.
Author information
Authors and Affiliations
Corresponding author
Additional information
Supplementary information accompanies this article on the Journal of Public Health Policy website (www.palgrave-journals.com/jphp)
Those providing informal care in people's homes face risks of disease and health related habits associated with caregiving. Using population data, these researchers explore what might be done to protect caregivers.
Electronic supplementary material
Rights and permissions
About this article
Cite this article
González-de Paz, L., Real, J., Borrás-Santos, A. et al. Associations between informal care, disease, and risk factors: A Spanish country-wide population-based study. J Public Health Pol 37, 173–189 (2016). https://doi.org/10.1057/jphp.2016.3
Published:
Issue Date:
DOI: https://doi.org/10.1057/jphp.2016.3