López-Martínez Catalina, Orgeta Vasiliki, Gutiérrez-Sánchez Belén, Del-Pino-Casado Rafael
Department of Nursing, Faculty of Health Sciences, University of Jaén, Jaén, Spain.
Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK.
J Clin Nurs. 2025 Oct;34(10):4177-4185. doi: 10.1111/jocn.17626. Epub 2025 Jan 9.
Although a substantial amount of research has focused on negative aspects of caregiving, less research has been conducted investigating positive aspects of providing informal care. The aim of this study was to investigate the longitudinal association between caregiving satisfaction and psychological distress in informal carers of dependent older people, and whether this relationship is mediated by caregiver burden.
Prospective longitudinal study with a probabilistic sample of 332 caregivers of older relatives, with data collected at baseline and at 1-year follow-up. We measured caregiving satisfaction, psychological distress, subjective caregiver burden and several covariates (caregivers' sex, age and objective caregiver burden). Data were analysed using generalised estimation equations with multiple imputation. The STROBE checklist was used to support the writing of this document.
After controlling for covariates, caregiving satisfaction was significantly negatively associated with lower levels of subjective caregiver burden (B = -0.17, 95% CI: -0.23, -0.11) and emotional distress (B = -0.23, 95% CI: -0.36, -0.11). When subjective burden was included in the model, the relationship between caregiving satisfaction and psychological distress was no longer significant (B = -0.11, 95% CI: -0.23, 0.02), whereas the association between subjective burden and psychological distress remained (B = 0.75, 95% CI: 0.57, 0.92). The Sobel test confirmed these results (p < 0.001), indicating that subjective caregiver burden mediates the relationship between caregiving satisfaction and psychological distress (complete mediation) over time.
Caregiving satisfaction exerts a longitudinal protective effect on carers' psychological distress via subjective burden. Our findings indicate that interventions aimed at strengthening caregiving satisfaction may play a significant role in maintaining positive mental health outcomes for informal caregivers.
尽管大量研究聚焦于照护的负面方面，但对提供非正式照护的积极方面进行调查的研究较少。本研究旨在调查依赖他人的老年人的非正式照护者的照护满意度与心理困扰之间的纵向关联，以及这种关系是否由照护者负担介导。
对332名老年亲属的照护者进行概率抽样的前瞻性纵向研究，在基线和1年随访时收集数据。我们测量了照护满意度、心理困扰、主观照护者负担和几个协变量（照护者的性别、年龄和客观照护者负担）。使用多重填补的广义估计方程对数据进行分析。采用STROBE清单来辅助撰写本文。
在控制协变量后，照护满意度与较低水平的主观照护者负担（B = -0.17，95%CI：-0.23，-0.11）和情绪困扰（B = -0.23，95%CI：-0.36，-0.11）显著负相关。当模型中纳入主观负担时，照护满意度与心理困扰之间的关系不再显著（B = -0.11，95%CI：-0.23，0.02），而主观负担与心理困扰之间的关联仍然存在（B = 0.75，95%CI：0.57，0.92）。索贝尔检验证实了这些结果（p < 0.001），表明主观照护者负担随时间推移介导了照护满意度与心理困扰之间的关系（完全中介）。
照护满意度通过主观负担对照护者的心理困扰产生纵向保护作用。我们的研究结果表明，旨在提高照护满意度的干预措施可能在维持非正式照护者的积极心理健康结果方面发挥重要作用。
