Subjective quality of life and positive appraisal of care among Japanese family caregivers of older adults.

Most family caregiving research has portrayed caregiving as a negative life experience for caregivers, but a broader perspective is necessary to examine its impact on the caregiver quality of life (QL). The role that positive appraisal of care plays in the caregiving experience among Japanese families of older adults was examined in relation to the caregiver's subjective QL. Positive as well as negative appraisal of care was measured by a newly developed multi-dimensional scale, which included the domains of 'relationship satisfaction,' 'role confidence,' 'consequential gain,' 'normative fulfillment' (positive appraisal), 'role exhaustion,' 'isolation,' 'relationship difficulty,' and 'symptom management difficulty' (negative appraisal). Subjective QL was measured by WHO/QL-26. Altogether 337 Japanese family caregivers participated in this survey. Stepwise multiple regression analyses revealed that 'role confidence,' 'normative fulfillment,' and 'role exhaustion' had a significant independent impact on physical QL, while 'role confidence' and 'role exhaustion' on psychological QL. The association of 'normative fulfillment' with physical QL was negative while that of 'role confidence' was positive, despite the positive correlation between the two domains. The results underline the importance of considering positive as well as negative appraisal of care when examining subjective QL of the family caregivers.