Caregiver Stress and Burden among Hispanic Elderly with Stroke and Multicomorbidity Open Access

Chen, Haobin (Spring 2021)

Permanent URL: https://etd.library.emory.edu/concern/etds/tx31qj85c?locale=en%5D
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Abstract

Background: Hispanic elderly has high prevalence of stroke and chronic diseases that result in impaired function. Caregivers caring for Hispanic elderly have higher caregiving duties than other ethnicities.(Benjamin et al., 2018; Rote, Angel, & Markides, 2015; Velasco-Mondragon, Jimenez, Palladino-Davis, Davis, & Escamilla-Cejudo, 2016) Objective: The purpose of this study was to investigate the association between Hispanic elderly’s demographics, stroke, multicomorbidity (MCM), interaction between stroke and MCM of elderly, and caregiver MCM, affecting caregiver stress and burden (CSB).

Method: Data was extracted from the Hispanic Established Populations for the Epidemiologic Study of the Elderly (HEPESE) study Wave 7. CSB was defined as stressor count using Bakas Caregiving Outcomes Scale and as level of burden using Level of Burden Index by matching items from each scale to HEPESE caregiver survey. Negative binomial regression was applied to model caregiver stressor count and cumulative logit model was applied to model caregiver level of burden.

Results: The outcome caregiver stressor count yielded a range from 0 to 12 and level of burden took on three levels: low burden, medium burden, and high burden. Negative binomial model on caregiver stressor count did not show an association between presence of stroke in elderly and CSB but demonstrated that caregivers who had MCM themselves had higher CSB and had higher household income had lower CSB. Cumulative logit model on caregiver level of burden revealed that caregivers caring for elderly with stroke or with MCM had higher CSB. Caregivers who were children, other family member, or spouse of elderly or had higher household income had lower CSB. The interaction between elderly stroke and multicomorbidity was not observed. Conclusion: This study showed that Hispanic caregivers had higher stress and burden when caring for elderly who had stroke and multicomorbidity. Future studies must expand upon our results to build culturally tailored policies and community interventions to support Hispanic caregivers susceptible to high stress and burden. (Isakson, 2018)f

Table of Contents

Table of Contents Introduction………………………………………………………………………………………………. 1

Methods…………………………………………………………………………………………..………. 2

- Sample sample……………………………………………………………………………………. 2

- Outcome…………………………………………………………………………………………... 3

o Caregiver stressor (BCOS) ………………………………………………………………. 3

o Level of burden (LBI) ……………………………………………………………………. 4

- Predictors…………………………………………………………………………………………. 5

- Statistical Analyses……………………………………………………………………………….. 6

Results…………………………………………………………………………………………………….. 7

- Descriptive statistics……………………………………………………………………………..... 7

- Quasi-Poisson model and negative binomial model……………………………………………… 10

- Cumulative logit model………………………………………………………………………….... 12

Discussion………………………………………………………………………………………………… 16

Conclusion……………………………………………………………………………………………….... 20

Appendix………………………………………………………………………………………………….. 21

- Appendix 1.A……………………………………………………………………………………... 21

- Appendix 1.B……………………………………………………………………………………... 22

- Appendix 2.A……………………………………………………………………………………... 25

Reference……………………………………………………………………………………...…………... 26

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