Department of Geography and Planning, Queen's University, Kingston, ON, K7L 3N6, Canada.
College of Education, Psychology and Social Work, Flinders University, Adelaide, SA, Australia.
J Health Popul Nutr. 2024 Feb 21;43(1):31. doi: 10.1186/s41043-024-00509-3.
Similar to many developing countries, caregiver burden remains high in Ghana which may affect informal caregivers of older adults' health-related quality of life (HRQoL). However, no study has examined the association between caregiver burden and HRQoL among informal caregivers of older adults in Ghana to date. Understanding this association may well help to inform health and social policy measures to improve HRQoL among informal caregivers of older adults in Ghana. Situated within a conceptual model of HRQoL, the purpose of this study was to examine the relationship between caregiver burden and HRQoL among informal caregivers of older adults in Ghana.
We obtained cross-sectional data from informal caregiving, health, and healthcare (N = 1853) survey conducted between July and September 2022 among caregivers (≥ 18 years) of older adults (≥ 50 years) in the Ashanti Region of Ghana. The World Health Organization Impact of Caregiving Scale was used to measure caregiver burden. An 8-item short form Health Survey scale developed by the RAND Corporation and the Medical Outcomes Study was used to measure HRQoL. Generalized Linear Models were employed to estimate the association between caregiver burden and HRQoL. Beta values and standard errors were reported with a significance level of 0.05 or less.
The mean age of the informal caregivers was 39.15 years and that of the care recipients was 75.08 years. In our final model, the results showed that caregiver burden was negatively associated with HRQoL (β = - .286, SE = .0123, p value = 0.001). In line with the conceptual model of HRQoL, we also found that socio-economic, cultural, demographic and healthcare factors were significantly associated with HRQoL. For instance, participants with no formal education (β = -1.204, SE= .4085, p value = 0.01), those with primary level of education (β = -2.390, SE= .5099, p value = 0.001) or junior high school education (β = -1.113, SE= .3903, p value= 0.01) had a significantly decreased HRQoL compared to those with tertiary level of education. Participants who were between the ages of 18-24 (β = 2.960, SE= .6306, p value=0.001), 25-34 (β = 1.728, SE= .5794, p value = 0.01) or 35-44 (β = 1.604, SE= .5764, p value= 0.01) years significantly had increased HRQoL compared to those who were 65 years or above. Also, participants who did not utilize healthcare services in the past year before the survey significantly had increased HRQoL compared to those who utilized healthcare services five or more times in the past year (β = 4.786, SE=. 4610, p value= 0.001).
Consistent with our hypothesis, this study reported a significant negative association between caregiver burden and HRQoL. Our findings partially support the conceptual model of HRQoL used in this study. We recommend that health and social policy measures to improve HRQoL among informal caregivers of older adults should consider caregiver burden as well as other significant socio-economic, cultural, demographic, and healthcare factors.
与许多发展中国家一样，加纳的照顾者负担仍然很高，这可能会影响到老年人的非正式照顾者的健康相关生活质量（HRQoL）。然而，迄今为止，还没有研究检查加纳老年人大龄照护者的非正式照顾者的照顾者负担与 HRQoL 之间的关系。了解这种关联很可能有助于为加纳的老年人大龄照护者的非正式照顾者的 HRQoL 提供信息，制定卫生和社会政策措施。在 HRQoL 的概念模型的基础上，本研究的目的是检查加纳老年人大龄照护者的非正式照顾者的照顾者负担与 HRQoL 之间的关系。
我们从 2022 年 7 月至 9 月在加纳阿散蒂地区进行的一项针对年龄在 50 岁及以上的老年人的照顾者（年龄在 18 岁及以上）的横断面调查中获得了数据。使用世界卫生组织的照顾者影响量表来衡量照顾者负担。使用由兰德公司和医疗结果研究开发的 8 项短格式健康调查量表来衡量 HRQoL。采用广义线性模型来估计照顾者负担与 HRQoL 之间的关联。报告了 beta 值和标准误差，显著性水平为 0.05 或更低。
非正式照顾者的平均年龄为 39.15 岁，照顾对象的平均年龄为 75.08 岁。在我们的最终模型中，结果表明照顾者负担与 HRQoL 呈负相关（β=-.286，SE=.0123，p 值=0.001）。与 HRQoL 的概念模型一致，我们还发现社会经济、文化、人口和医疗保健因素与 HRQoL 显著相关。例如，没有正规教育的参与者（β=-1.204，SE=0.4085，p 值=0.01）、接受过小学教育的参与者（β=-2.390，SE=0.5099，p 值=0.001）或初中教育的参与者（β=-1.113，SE=0.3903，p 值=0.01）与接受过高等教育的参与者相比，HRQoL 显著降低。年龄在 18-24 岁（β=2.960，SE=0.6306，p 值=0.001）、25-34 岁（β=1.728，SE=0.5794，p 值=0.01）或 35-44 岁（β=1.604，SE=0.5764，p 值=0.01）的参与者与 65 岁及以上的参与者相比，HRQoL 显著增加。此外，与过去一年中使用过五次或以上医疗服务的参与者相比，过去一年中没有使用过医疗服务的参与者的 HRQoL 显著增加（β=4.786，SE=0.4610，p 值=0.001）。
与我们的假设一致，本研究报告了照顾者负担与 HRQoL 之间存在显著的负相关。我们的研究结果部分支持了本研究中使用的 HRQoL 的概念模型。我们建议，改善老年人大龄照护者的非正式照顾者的 HRQoL 的卫生和社会政策措施应考虑照顾者负担以及其他重要的社会经济、文化、人口和医疗保健因素。
