Does the obligation have negative consequences in primary caregivers of dependent older relatives?

In developed countries, the increase in ageing and dependency has increased the need for long-term care. In these countries most long-term care is provided by the family. Caring for an older adult dependent may impact the caregiver’s health with negative consequences related to emotional health, especially depression and anxiety. Research conducted by our group within the topic Family caregivers has explored this phenomenon.

The purpose of this study was to analyze the multidimensional nature of obligation and the relations between each dimension of obligation and both anxiety and depression. For this purpose, a secondary analysis of data from two cross-sectional studies of primary home caregivers of older adult relatives in Spain was performed. Data regarding obligation, stressor, anxiety and depression were collected by interview in 2013.

Some of the main findings:

  • There are two dimensions of obligation, an external obligation represented by social pressure, and an internal one represented by beliefs of obligation.
  • Both dimensions of obligation seem to relate with depression and anxiety in different manner, with social pressure being a risk factor for anxiety and depression; and belief in obligation being a protection factor.
  • The combination of high pressure and low beliefs had the highest levels of anxiety and depression, and the combination of low pressure and high beliefs had the lowest levels of anxiety and depression.

The above findings support the following recommendations for nursing practice:

  • to take into account the obligation for caregiving in the nursing assessment of primary caregivers of dependent older relatives, differing between internal and external obligations.
  • a risk profile could be developed to identify caregivers with low beliefs in obligation and high feelings regarding social pressure for prevention and early detection of depression and anxiety in this population.

The full text is available at: del-Pino-Casado R, López-Martínez C, Serrano-Ortega N, Pastor-Bravo MdM, Parra-Anguita L. Obligation and negative consequences in primary caregivers of dependent older relatives. PLoS ONE. 2018; 13 (9): e0203790.

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