Intensity of Care and Level of Life Interference as Possible Predictors of the Physical Health of Family Caregivers of Individuals with Schizophrenia

Abstract

Purpose: The deinstitutionalization movement formalized the role of the family caregiver in mental health, yet the needs of these family caregivers have received little attention. Additionally, while a wide body of literature has focused on the effects of socio-demographic factors and level of social support on caregiver well-being, less attention has been paid to the nature of the caregiving relationship. This study aimed to address this gap by developing and assessing scales to measure two indicators of the nature of the caregiver-care recipient relationship: intensity of care and life interference, and to use these scales to assess the relationship between these constructs and caregiver physical health. Methods: Using data from a national survey of members of the Schizophrenia Society of Canada, we employed reliability and factor analyses to evaluate whether the multiple items describing the caregiving role from the Caregiver Survey could be combined to form reliable and novel intensity of care and life interference scales. We then employed least squares regression to examine these constructs as predictors of physical health. Results: Factor analysis of the ten items describing intensity of care revealed one strong factor accounting for 44.0% of variance. The Intensity of Care Scale revealed high reliability (Cronbach’s alpha=0.85). Two underlying factors emerged for the life interference items, one accounting for 60.0% of variance and the other for 8.8%. Cronbach’s alpha for the 10-item Daily Life Interference Scale was 0.95. For the 5-item Peace of Mind Interference Scale, Cronbach’s alpha was 0.88. Based on a least squares regression, these scale scores were not significant predictors of physical health. A decline/fluctuation in physical health status as a result of caregiving, lower reported emotional health, and older age predicted lower current physical health ratings and this model accounted for 37.5% of variance. Conclusions: This study contributed three novel and internally consistent scales to the literature to be used and further refined. It also added to the limited body of literature aimed at identifying characteristics of high-risk caregivers and shed light on potential future research directions to ultimately ensure that interventions can be directed towards those at greatest risk of caregiver burnout.