Page 126 - GHES-2-3

Global Health Economics and
Sustainability
Positive and negative aspects of caregiving

(Yap et al., 2010) in its Spanish adaptation (Fabá & Villar, relationships between most variables, except for education
2013). The 10 items were responded to using a Likert scale and hours of care per day, which were analyzed using
with five levels ranging from 0 (very disagree) to 4 (very Spearman’s rho. Based on these relationships, the following
agree). The scale assesses the perceived gain and benefits analyses were performed:
in caregivers of PWAD, with the higher scores indicating (i) Differences in happiness, gain in caregiving, quality
greater levels of perceived gain. The reliability of this of life, psychological distress, and perceived burden
variable in this study was adequate (Cronbach’s α = 0.81). across four levels of hours of care per day.
(ii) Differences in happiness, gain, quality of life, and
2.2.4. Happiness psychological distress across three levels of perceived
The Subjective Happiness Scale (Lyubomirsky & burden.
Lepper, 1999) was used to assess happiness. The Spanish (iii) Differences in psychological distress and perceived
adaptation (Extremera & Fernández-Berrocal, 2014) of burden across two levels.
this unidimensional scale contains four items answered Finally, a three-step hierarchical multiple regression
on a seven-level response scale (1 – 7), with the higher analysis was performed to determine the relevance of
scores indicating greater levels of subjective happiness. objective burden, subjective burden, and positive aspects
The reliability of this variable in this study was adequate of caregiving on the caregivers’ psychological distress.
(Cronbach’s α = 0.76).
In Model 1, participants’ age, gender, and education
2.2.5. Quality of life level were entered to control for their effects. In Model
2, objective burden (measured as hours of care per day)
The quality of life in life-threatening illness-family carer and perceived burden (subjective burden) were added. In
version (Cohen et al., 2006) measures the quality of Model 3, gain, happiness, and quality of life were added.
life in family caregivers of people with serious illness. Statistical analyses were conducted using Statistical
It is composed of 16 items, each answered on a 10-level Package for the Social Sciences version 28.0 software
response scale (1 – 10). The higher scores indicate greater (IBM Corporation, USA).
levels of quality of life. The reliability of this variable in this
study was adequate (Cronbach’s α = 0.81). 3. Results

2.2.6. Sociodemographic variables and caring aspects 3.1. Participants’ characteristics
Sociodemographic variables, such as age, marital status, As shown in Table 1, the average age of the caregivers of
educational level, care aspects, including the relationship PWAD was 55.89 years, with a wide range from 18 to 91 years
between the caregiver and care recipient, and hours of care old. The majority of the caregivers were women (68.4%),
per day, were collected. married (84.3%), and children of PWAD (67.9%). Half of
the sample had an education level of high school or higher.
2.3. Design and procedure The objective burden, measured as hours of care per day,
The study employed a convenience sample and a revealed that almost half of the caregivers dedicated more
cross-sectional descriptive design. Participants were than 15 h of care per day (44.3%). The positive aspects of
recruited from Family Alzheimer’s Disease Associations, caregiving, assessed through the variables gain, happiness,
and questionnaires were completed individually. All and quality of life, presented average scores higher than the
participants signed the informed consent, and their medium point in the score range of each scale, indicating
participation was voluntary. To ensure anonymity, each that these caregivers experienced positive emotions
questionnaire and datasheet was assigned a unique number. associated with caregiving. On the other hand, the negative
Permissions to perform this research were obtained from aspect of caregiving, psychological distress, was also above
both the Family Alzheimer’s Disease Associations and the the medium score in the scale range. According to the cut-
Ethical Committee for Scientific Research of the University point suggested by Lundin et al. (2017) of ≥4 to distinguish
of Valencia (H1367489852167). high from low levels of psychological distress, 71 caregivers
(50.7%) had high levels of psychological distress, while
2.4. Statistical analysis 69 caregivers (49.3%) had low levels. Finally, according
Internal consistency was assessed using Cronbach’s to the perceived burden levels proposed by Mulund and
α coefficient. Descriptive statistics, including means, McCarthy (2017), no caregiver was in the no-burden level,
standard deviations, score ranges, and percentages, were 32 caregivers (22.9%) presented mild burden, 76 caregivers
calculated to describe the participant characteristics. (54.2%) reported moderate burden, and 32 caregivers
Pearson’s correlation coefficient was used to examine (22.9%) reported severe burden.

Volume 2 Issue 3 (2024) 4 https://doi.org/10.36922/ghes.3145