Invisible partners in care: Snapshot of well-being among caregivers receiving comprehensive support from Veterans Affairs.

Veterans caregiving depression informal carers long‐term care post‐9/11 Veterans quality‐of‐life

Journal

Health science reports
ISSN: 2398-8835
Titre abrégé: Health Sci Rep
Pays: United States
ID NLM: 101728855

Informations de publication

Date de publication:
Mar 2019
Historique:
received: 19 04 2018
revised: 22 10 2018
accepted: 07 12 2018
entrez: 3 4 2019
pubmed: 3 4 2019
medline: 3 4 2019
Statut: epublish

Résumé

Since May 2011, over 23 000 caregivers of Veterans seriously injured on or after September 11, 2001 have enrolled in the Program of Comprehensive Assistance for Family Caregivers (PCAFC). PCAFC provides caregivers training, a stipend, and access to health care. The aim of this study is to describe the characteristics of caregivers in PCAFC and examine associations between caregiver characteristics and caregiver well-being outcomes. We sent a web survey invitation to 10 000 PCAFC caregivers enrolled as of September 2015. Using linear and logistic regressions, we examine associations between PCAFC caregiver characteristics and caregiver outcomes: perceived financial strain, depressive symptoms (Center for Epidemiologic Studies Depression Scale [CESD-10]), perceived quality of Veteran's Veterans Health Administration (VHA) care, and self-reported caregiver health. We had complete survey data for 899 respondents. Since becoming a caregiver, approximately 50% of respondents reported reducing or stopping work. Mean time spent providing care was 3.8 years (median 3, IQR 1-5) with an average of 4.9 weekdays (median 5, IQR 5-5) and 1.9 weekend days (median 2, IQR 2-2). The mean CESD-10 score was 8.2 (median 7, 4-12), at the cutoff for screening positive for depressive symptoms. A longer duration of caregiving was associated with having 0.08 increase in rating of financial strain (95% CI, 0.02-0.14). Caregiver rating of the Veteran's health status as "fair" or better was a strong predictor of better caregiver outcomes, ie, self-reported caregiver health. However, higher levels of education were associated with worse caregiver outcomes, ie, lower global satisfaction with VHA care, higher CESD-10 score, and higher rating of financial strain. Higher depressive symptoms among longer duration caregivers, coupled with high rates of reductions in hours worked, suggest interventions are needed to address the long-term emotional and financial needs of these caregivers of post-9/11 Veterans and identify subpopulations at risk for worse outcomes.

Sections du résumé

BACKGROUND AND AIMS OBJECTIVE
Since May 2011, over 23 000 caregivers of Veterans seriously injured on or after September 11, 2001 have enrolled in the Program of Comprehensive Assistance for Family Caregivers (PCAFC). PCAFC provides caregivers training, a stipend, and access to health care. The aim of this study is to describe the characteristics of caregivers in PCAFC and examine associations between caregiver characteristics and caregiver well-being outcomes.
METHODS METHODS
We sent a web survey invitation to 10 000 PCAFC caregivers enrolled as of September 2015. Using linear and logistic regressions, we examine associations between PCAFC caregiver characteristics and caregiver outcomes: perceived financial strain, depressive symptoms (Center for Epidemiologic Studies Depression Scale [CESD-10]), perceived quality of Veteran's Veterans Health Administration (VHA) care, and self-reported caregiver health.
RESULTS RESULTS
We had complete survey data for 899 respondents. Since becoming a caregiver, approximately 50% of respondents reported reducing or stopping work. Mean time spent providing care was 3.8 years (median 3, IQR 1-5) with an average of 4.9 weekdays (median 5, IQR 5-5) and 1.9 weekend days (median 2, IQR 2-2). The mean CESD-10 score was 8.2 (median 7, 4-12), at the cutoff for screening positive for depressive symptoms. A longer duration of caregiving was associated with having 0.08 increase in rating of financial strain (95% CI, 0.02-0.14). Caregiver rating of the Veteran's health status as "fair" or better was a strong predictor of better caregiver outcomes, ie, self-reported caregiver health. However, higher levels of education were associated with worse caregiver outcomes, ie, lower global satisfaction with VHA care, higher CESD-10 score, and higher rating of financial strain.
CONCLUSIONS CONCLUSIONS
Higher depressive symptoms among longer duration caregivers, coupled with high rates of reductions in hours worked, suggest interventions are needed to address the long-term emotional and financial needs of these caregivers of post-9/11 Veterans and identify subpopulations at risk for worse outcomes.

Identifiants

pubmed: 30937391
doi: 10.1002/hsr2.112
pii: HSR2112
pmc: PMC6427058
doi:

Types de publication

Journal Article

Langues

eng

Pagination

e112

Déclaration de conflit d'intérêts

The authors declare that they have no conflicts of interest.

Références

Health Sci Rep. 2019 Jan 31;2(3):e112
pubmed: 30937391
Rand Health Q. 2014 Jun 1;4(2):14
pubmed: 28083343
J Head Trauma Rehabil. 2012 Jan-Feb;27(1):3-13
pubmed: 21873883
Med Care Res Rev. 2019 Feb;76(1):89-114
pubmed: 29148338
Pediatrics. 2006 Jan;117(1):e48-60
pubmed: 16396848
Health Serv Res. 2003 Dec;38(6 Pt 1):1509-27
pubmed: 14727785
Med Care. 1992 Jun;30(6):473-83
pubmed: 1593914
Res Nurs Health. 1992 Aug;15(4):271-83
pubmed: 1386680
Health Econ. 2009 Sep;18(9):991-1010
pubmed: 19582755
J Trauma Stress. 2002 Jun;15(3):205-12
pubmed: 12092912
Am J Prev Med. 1994 Mar-Apr;10(2):77-84
pubmed: 8037935
Pediatrics. 2005 Jun;115(6):e626-36
pubmed: 15930188
Health Serv Res. 2018 Aug;53(4):2011-2019
pubmed: 29740818

Auteurs

Katherine E M Miller (KEM)

Health Services Research and Development Service Durham VA Medical Center Durham North Carolina USA.
Department of Health Policy and Management University of North Carolina Chapel Hill North Carolina USA.

Jennifer H Lindquist (JH)

Health Services Research and Development Service Durham VA Medical Center Durham North Carolina USA.

Maren K Olsen (MK)

Health Services Research and Development Service Durham VA Medical Center Durham North Carolina USA.
Department of Biostatistics and Bioinformatics Duke University Durham North Carolina USA.

Valerie Smith (V)

Health Services Research and Development Service Durham VA Medical Center Durham North Carolina USA.
Department of Population Health Sciences Duke University Durham North Carolina USA.
Division of General Internal Medicine, Department of Medicine Duke University Durham North Carolina USA.

Corrine I Voils (CI)

Research Service William S. Middleton Veterans Memorial Hospital Madison Wisconsin USA.
Department of Surgery University of Wisconsin-Madison Madison Wisconsin USA.

Eugene Z Oddone (EZ)

Health Services Research and Development Service Durham VA Medical Center Durham North Carolina USA.
Division of General Internal Medicine, Department of Medicine Duke University Durham North Carolina USA.

Nina R Sperber (NR)

Health Services Research and Development Service Durham VA Medical Center Durham North Carolina USA.
Department of Population Health Sciences Duke University Durham North Carolina USA.

Megan Shepherd-Banigan (M)

Health Services Research and Development Service Durham VA Medical Center Durham North Carolina USA.
Department of Population Health Sciences Duke University Durham North Carolina USA.

G Darryl Wieland (GD)

Health Services Research and Development Service Durham VA Medical Center Durham North Carolina USA.

Jennifer Henius (J)

Caregiver Support Program Department of Veterans Affairs Washington DC USA.

Margaret Kabat (M)

Caregiver Support Program Department of Veterans Affairs Washington DC USA.

Courtney Harold Van Houtven (CH)

Health Services Research and Development Service Durham VA Medical Center Durham North Carolina USA.
Department of Population Health Sciences Duke University Durham North Carolina USA.

Classifications MeSH