Home-Based Caregiving Appraisals by Informal Caregivers of the Elderly with High Care Needs in Japan

Wednesday, 24 July 2013: 8:50 AM

Imaiso Junko, PhD, PHN, RN
School of Nursing, University of Shizuoka, Shizuoka-shi, Japan

Learning Objective 1: The learner will be able to perceive associated factors with home-based caregiving negative/positive appraisals in order to prevent worsening informal caregiver health.

Learning Objective 2: The learner will be able to understand which informal caregivers community health nurses should focus on, and to consider how the nurses should support them.

Purpose: This study was to determine factors associated with negative/positive home-based caregiving appraisals by informal caregivers of the elderly with high care needs in Japan to consider which family carers community health nurses should focus on.

Methods: Appraisal means how caregivers perceive their caregiving work.  This quantitative study examined 192 primary caregivers. The Japanese version of the Zarit scale (22 items) was used for negative appraisal and a positive caregiving appraisal scale (14 items) for positive appraisal.  Participants with above-median scores (care burden, 30.0; positive caregiving appraisal, 39.0) were categorized as having a high care burden and high positive appraisal.  To determine factors associated with appraisals, multinomial regression analysis was performed.  Negative/positive appraisals were separately set as a dependent variable, and 25 items relating to caregiver characteristics, care-recipient characteristics, and external variables were set as independent variables. This was followed by stepwise regression and backward elimination.

 Results: With respect to care burden, positively associated factors were sekenteior social pressure (CR 3.81, 95% CI 1.18-12.23), caregiving obligation (CR 4.46, 95% CI 1.89-10.55), household (CR 7.90, 95% CI 0.82-76.12), and depression (CR 78.42, 95% CI 16.09-382.04); negatively associated factors were care recipient age (CR 0.29, 95% CI 0.10-0.79), living with family (CR 0.27, 95% CI 0.10-0.71), and free time for caregivers (CR 0.32, 95% CI 0.13-0.78). With respect to positive appraisal, negatively associated factors were caregiving obligation (CR 0.28, 95% CI 0.15-0.52), caregiver gender (OR 0.44, 95% CI 0.51-1.97), and daughter-in-law as the caregiver (Cl 0.29, 95% CI 0.11-0.73).

 Conclusion: Community health nurses must increase their awareness of informal caregiver feelings toward caregiving duties, assess their health to reduce negative aspects and promote positive aspects of caregiving focusing on community support in their residential community except the factors about caregivers and care-recipients, and prevent deterioration of the health of caregivers.