Relationships among Co-morbidities, Self-efficacy, and Quality of Life in Caregivers of Community Dwelling Patients with Memory Loss

Monday, 18 November 2013: 11:00 AM

Judith A. Erlen, PhD, RN, FAAN
Jennifer Lingler, PhD, CRNP
Lisa K. Tamres, MS
Susan M. Sereika, PhD
School of Nursing, University of Pittsburgh, Pittsburgh, PA

Caregivers are often burdened by their patients’ health problems, as well as their own health issues. While the impact of patients’ health status on a range of caregiver outcomes is well-established, less is known about how caregivers’ comorbid conditions affect their quality of life and level of confidence in managing these health problems. Using the conceptual model of stress-health processing, this study examines the relationships among caregiver co-morbidities, self-efficacy, and health related quality of life. We examined baseline data from a randomized controlled trial testing the effect of a problem solving intervention on medication deficiencies, clinical outcomes, and quality of life. The sample included 91 informal caregivers who were primarily female (70%), white (85%), and spouses (75%). On average, caregivers were 67 years of age and had 15 years of education. Caregivers had an average of 7 co-morbid conditions and 9 co-morbid symptoms. Their overall physical well-being and mental well-being scores were moderately low. Correlational analyses showed statistically significant relationships between the number of co-morbid conditions and a) the number of co-morbid symptoms (r= .625, p=.000), b) physical well-being (r= -.288, p=.009), c) depressive symptoms (r= .288, p=.006), and d) self-efficacy (r= -.228, p=.038).  Physical well-being was negatively associated with co-morbid symptoms (r= -. 575, p-.000). Mental well-being was positively associated with depressive symptoms (r= .431, p=.000) and self-efficacy (r= .588, p= .000). Multivariate analysis of potential mediated or indirect effects of the number of co-morbid conditions on self-efficacy using quality of life (physical and mental well-being subscales), depressive symptoms, and number of medications as mediators, showed no statistically significant indirect effects. These findings support linkages in the stress-health processing model. Future research should examine other potential mediators, as well as examine these relationships over time to gain a more integrated understanding of the pathways and mechanisms affecting caregiver outcomes.