246339 Association between caregiver stress, caregiver burden, and health outcomes in a large population based sample

Wednesday, November 2, 2011: 12:48 PM

Maya Rom Korin, PhD, MS , Department of Health and Behavior Studies, Columbia University Teachers College, New York, NY
Brooke Aggarwal, EdD, MS, CHES , Department of Medicine, Columbia University Medical Center, New York, NY
Susan Kirkland, PhD , Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada
William Chaplin, PhD , Department of Psychology, St. John's University, Jamaica, NY
Karina Davidson, PhD , Department of Medicine, Columbia University Medical Center, New York, NY
Objective: To test the hypothesis that caregiving stress and/or caregiving burden, is associated with cardiovascular and mental health outcomes for caregivers. Methods: This was a secondary analysis of a prospective study of 2,688 Nova Scotians enrolled in the Nova Scotia Health Study (NSHS95) in 1995 and followed until 2005. Caregiving was defined as helping a person with an illness or physical/mental disability. Caregiving stress (emotional strain), caregiving burden (amount of care provided), general health measures, as well as depression, anxiety, and hostility measures were gathered during a home interview. Incident coronary heart disease (CHD) hospitalizations were determined from the provincial health care administrative databases. Results: The prevalence of caregiving in this population was 8%. Caregiver stress contributed significantly to the prediction of CHD incidence in a Cox regression model; this association remained after controlling for age and Framingham score (HR= 1.08, 1.02-1.13CI, p=.004). Caregiver stress also significantly predicted higher depression scores (b=.45, .39-.67 CI, p<.0001), higher anxiety (b=.33, .22-.58 CI, p<.0001), and greater hostility (b=.22, .10-.40 CI, p=.002) in regression models. Caregiver burden did not significantly predict health outcomes in any model. Conclusion: Caregivers who reported higher levels of stress were significantly more likely to be hospitalized for CHD and experience poorer mental health compared to those with lower levels of caregiver stress; there was no relation between caregiver burden and outcomes. These findings suggest that it may not be the amount of caregiving that has negative health effects, but how one copes with caregiving responsibilities that predicts health status.

Learning Areas:
Public health or related research
Social and behavioral sciences

Learning Objectives:
At the end of this presentation participants will be able to: 1) describe the differences between caregiver stress and caregiver burden; 2) assess the roles that caregiver stress and burden have on cardiovascular and mental health outcomes; 3) recognize the importance of providing support for caregivers who are not coping well; and 4) explain why it is necessary to differentiate between caregiving stress and caregiving burden when discussing health outcomes for caregivers.

Keywords: Caregivers, Stress

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conduct research in health behaviors and social determinants of health. I have completed two postdoctoral fellowships - in behavioral cardiovascular health and medical ethics. Additionally, I have been an adjunct assitant professor for the last five years at Teachers College, Columbia University, and recently have taught at Hunter College School of Urban Public Health.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.