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Subjective Caregiver Burden and Caregiver Satisfaction: The Role of Partner Relationship Quality and Reciprocity

Published:March 09, 2017DOI:https://doi.org/10.1016/j.apmr.2017.02.009

      Highlights

      • Good relationship quality relates to lower subjective caregiver burden.
      • Good relationship quality enhances satisfaction with the caregiver role.
      • Interventions for caregiving partners may target relationship quality.

      Abstract

      Objective

      To explore the effect of relationship quality and reciprocity in partnerships on subjective caregiver burden and caregiver satisfaction in partners of persons with a severe physical disability (spinal cord injury).

      Design

      Cross-sectional, observational.

      Setting

      Community setting.

      Participants

      Caregiving partners of persons with spinal cord injury (N=118).

      Interventions

      Not applicable.

      Main Outcome Measures

      Subjective caregiver burden measured by the Zarit Burden Interview (short form) and caregiver satisfaction measured by a single item on feelings of satisfaction resulting from the caregiver role.

      Results

      Caregiving partners who rated their relationship quality as high encountered less subjective caregiver burden (β=−1.10; 95% confidence interval [CI], −1.47 to −0.72; P<.001) and more caregiver satisfaction (odds ratio [OR], 1.18; 95% CI, 1.01–1.45; P=.049). These associations persisted even after controlling for sociodemographic characteristics, lesion severity of the care receiver, and objective caregiver burden. Partners who indicated high reciprocity in their relationship to the care receiver indicated less subjective caregiver burden and more caregiver satisfaction when relationship quality was excluded from the final models; however, the effect of reciprocity on subjective burden (β=−.38; 95% CI, −3.71 to 2.95; P=.82) and caregiver satisfaction (OR, 1.21; 95% CI, 0.28–5.22; P=.80) disappeared when including relationship quality.

      Conclusions

      Results highlight the importance of relationship quality as a target for couple interventions aimed at reducing subjective caregiver burden and increasing satisfaction in the caregiving role.

      Keywords

      List of abbreviations:

      ADL (activities of daily living), IADL (instrumental activities of daily living), OR (odds ratio), SCI (spinal cord injury)
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      References

        • Schulz R.
        • Beach S.R.
        Caregiving as a risk factor for mortality: the Caregiver Health Effects Study.
        J Am Med Assoc. 1999; 282: 2215-2219
        • Schulz R.
        • Visintainer P.
        • Williamson G.M.
        Psychiatric and physical morbidity effects of caregiving.
        J Gerontol. 1990; 45: P181-P191
        • Schulz R.
        • Sherwood P.R.
        Physical and mental health effects of family caregiving.
        Am J Nurs. 2008; 108: 23
        • Houser A.
        • Gibson M.J.
        Valuing the invaluable: the economic value of family caregiving, 2008 update.
        Washington (DC): AARP Public Policy Institute. 2008;
        • Kasselbaum N.J.
        • Arora M.
        • Barber R.M.
        • et al.
        Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015.
        Lancet. 2016; 388: 1603-1658
        • Pearlin L.I.
        • Mullan J.T.
        • Semple S.J.
        • Skaff M.M.
        Caregiving and the stress process: an overview of concepts and their measures.
        Gerontologist. 1990; 30: 583-594
        • McCubbin H.I.
        • Patterson J.M.
        The family stress process: the double ABCX model of adjustment and adaptation.
        Marriage Fam Rev. 1983; 6: 7-37
        • Wahrendorf M.
        • Ribet C.
        • Zins M.
        • Goldberg M.
        • Siegrist J.
        Perceived reciprocity in social exchange and health functioning in early old age: prospective findings from the GAZEL study.
        Aging Ment Health. 2010; 14: 425-432
        • Cairo Notari S.
        • Favez N.
        • Notari L.
        • Charvoz L.
        • Delaloye J.F.
        The caregiver burden in male romantic partners of women with non-metastatic breast cancer: the protective role of couple satisfaction.
        J Health Psychol. 2016 Mar 3; ([Epub ahead of print])
        • Quinn C.
        • Clare L.
        • Woods B.
        The impact of the quality of relationship on the experiences and wellbeing of caregivers of people with dementia: a systematic review.
        Aging Ment Health. 2009; 13: 143-154
        • Steadman P.L.
        • Tremont G.
        • Davis J.D.
        Premorbid relationship satisfaction and caregiver burden in dementia caregivers.
        J Geriatr Psychiatry Neurol. 2007; 20: 115-119
        • Chandola T.
        • Marmot M.
        • Siegrist J.
        Failed reciprocity in close social relationships and health: findings from the Whitehall II study.
        J Psychosom Res. 2007; 63: 403-411
        • Schulz R.
        • Tompkins C.A.
        • Wood D.
        • Decker S.
        The social psychology of caregiving: physical and psychological costs of providing support to the disabled.
        J Appl Soc Psychol. 1987; 17: 401-428
        • Kuijer R.G.
        • Buunk B.P.
        • Ybema J.F.
        Are equity concerns important in the intimate relationship when one partner of a couple has cancer?.
        Soc Psychol Quart. 2001; 64: 267-282
        • Walster E.
        • Walster G.
        • William B.
        Equity: theory and research.
        Allyn and Bacon, Boston1978
        • Kulik L.
        Marital equality and the quality of long-term marriage in later life.
        Ageing Soc. 2002; 22: 459-481
        • Kuijer R.G.
        • Buunk B.P.
        • De Jong G.M.
        • Ybema J.F.
        • Sanderman R.
        Effects of a brief intervention program for patients with cancer and their partners on feelings of inequity, relationship quality and psychological distress.
        Psychooncology. 2004; 13: 321-334
        • Montgomery R.J.
        • Gonyea J.G.
        • Hooyman N.R.
        Caregiving and the experience of subjective and objective burden.
        Fam Rel. 1985; : 19-26
        • Haley W.E.
        • LaMonde L.A.
        • Han B.
        • Burton A.M.
        • Schonwetter R.
        Predictors of depression and life satisfaction among spousal caregivers in hospice: application of a stress process model.
        J Palliat Med. 2003; 6: 215-224
        • Cohen C.A.
        • Colantonio A.
        • Vernich L.
        Positive aspects of caregiving: rounding out the caregiver experience.
        Int J Geriatr Psychiatry. 2002; 17: 184-188
        • Noonan A.E.
        • Tennstedt S.L.
        Meaning in caregiving and its contribution to caregiver well-being.
        Gerontologist. 1997; 37: 785-794
      1. Bickenbach J. Officer A. Shakespeare T. Von Groote P. International perspectives on spinal cord injury. World Health Organization, Geneva2013
        • Fekete C.
        • Brinkhof M.W.
        • Tough H.
        • Siegrist J.
        Cohort profile: a longitudinal study of social participation and wellbeing among persons with spinal cord injury and their partners (pro-WELL).
        BMJ Open. 2017; 7: e011597
        • Brinkhof M.W.
        • Fekete C.
        • Chamberlain J.D.
        • Post M.W.
        • Gemperli A.
        Swiss national community survey on functioning after spinal cord injury: protocol, characteristics of participants and determinants of non-response.
        J Rehabil Med. 2016; 48: 120-130
        • Fekete C.
        • Segerer W.
        • Gemperli A.
        • Brinkhof M.W.
        Participation rates, response bias and response behaviours in the community survey of the Swiss Spinal Cord Injury Cohort Study (SwiSCI).
        BMC Med Res Methodol. 2015; 15: 80
        • Zarit S.H.
        • Reever K.E.
        • Bach-Peterson J.
        Relatives of the impaired elderly: correlates of feelings of burden.
        Gerontologist. 1980; 20: 649-655
        • Bedard M.
        • Molloy D.W.
        • Squire L.
        • Dubois S.
        • Lever J.A.
        • O'Donnell M.
        The Zarit Burden Interview: a new short version and screening version.
        Gerontologist. 2001; 41: 652-657
        • Rajabi-Mashhadi M.T.
        • Mashhadinejad H.
        • Ebrahimzadeh M.H.
        • Golhasani-Keshtan F.
        • Ebrahimi H.
        • Zarei Z.
        The Zarit Caregiver Burden Interview Short Form (ZBI-12) in spouses of veterans with chronic spinal cord injury, validity and reliability of the Persian version.
        Arch Bone Jt Surg. 2015; 3: 56-63
      2. Hagenaars A.K. de Vos K. Zaidi M.A. Poverty statistics in the late 1980s: research based on micro-data. Office for Official Publications of the European Communities, Luxembourg1994
        • Schofield H.L.
        • Murphy B.
        • Herrman H.E.
        • Bloch S.
        • Singh B.
        Family caregiving: measurement of emotional well-being and various aspects of the caregiving role.
        Psychol Med. 1997; 27: 647-657
        • Pierce G.R.
        • Sarason I.G.
        • Sarason B.R.
        General and relationship-based perceptions of social support: are two constructs better than one?.
        J Pers Soc Psychol. 1991; 61: 1028-1039
        • Reiner I.
        • Beutel M.
        • Skaletz C.
        • Brahler E.
        • Stobel-Richter Y.
        Validating the German version of the Quality of Relationship Inventory: confirming the three-factor structure and report of psychometric properties.
        PLoS One. 2012; 7: e37380
        • Post M.W.
        • Bloemen J.
        • de Witte L.P.
        Burden of support for partners of persons with spinal cord injuries.
        Spinal Cord. 2005; 43: 311-319
        • Tobin J.
        Estimation of relationships for limited dependent variables.
        Econometrica. 1958; 26: 24-36
        • Baron R.M.
        • Kenny D.A.
        The moderator–mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations.
        J Pers Soc Psychol. 1986; 51: 1173
        • Cameron A.C.
        • Windmeijer F.A.
        An R-squared measure of goodness of fit for some common nonlinear regression models.
        J Econom. 1997; 77: 329-342
        • White I.
        • Royston P.
        • Wood A.
        Multiple imputation using chained equations: issues and guidance for practice.
        Stat Med. 2011; 30: 377-399
        • Rubin D.B.
        Multiple imputation for nonresponse in surveys.
        John Wiley & Sons, Hoboken2004
        • Snyder J.R.
        Impact of caregiver-receiver relationship quality on burden and satisfaction.
        J Women Aging. 2000; 12: 147-167
        • Horowitz A.
        • Shindelman L.W.
        Reciprocity and affection: past influences on current caregiving.
        J Gerontol Soc Work. 1983; 5: 5-20
        • Kiesler C.A.
        The psychology of commitment.
        Academic Press, New York1971
        • Holicky R.
        • Charlifue S.
        Ageing with spinal cord injury: the impact of spousal support.
        Disabil Rehabil. 1999; 21: 250-257
        • Shackelford M.
        • Farley T.
        • Vines C.L.
        A comparison of women and men with spinal cord injury.
        Spinal Cord. 1998; 36: 337-339
        • Rodakowski J.
        • Skidmore E.R.
        • Rogers J.C.
        • Schulz R.
        Role of social support in predicting caregiver burden.
        Arch Phys Med Rehabil. 2012; 93: 2229-2236
        • Bakas T.
        • Lewis R.R.
        • Parsons J.E.
        Caregiving tasks among family caregivers of patients with lung cancer.
        Oncol Nurs Forum. 2001; 28: 847-854