Caregiving, health-related quality of life and healthcare-seeking behaviour: A study of informal caregivers of older adults in Ghana

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Date
2024-05-03
Authors
Agyemang-Duah, Williams
Keyword
Informal Caregiving , Informal Caregivers , Caregiver Burden , Caregiving Motivation , Health-Related Quality of Life , Healthcare Utilization , Older Adults , Ghana
Abstract
Research to understand the caregiving and health(care) experiences among informal caregivers of older adults in sub-Saharan Africa is limited. This thesis examines caregiving motivation, caregiver burden, health-related quality of life (HRQoL), and healthcare utilization among informal caregivers of older adults in Ghana. This thesis is framed within the informal care model, the stress process model, the conceptual model of HRQoL, and the health belief model (HBM). This study recruited a sample of 1,853 informal caregivers (aged ≥ 18 years; mean age =39.15 years) of older adults (aged ≥ 50 years; mean age =75.08 years) from 13 districts comprising 18 rural and 21 urban communities in the Ashanti Region of Ghana between July and September 2022. Key variables, including caregiver burden, HRQoL, caregiving motivation, and domains of HBM, were measured using standardized and validated instruments. Analytical frameworks such as generalized multivariable linear regression models, and Poisson regression models estimated the hypothesized associations. Beta values (β), standard errors (SE), confidence intervals (CI), and incidence rate ratio (IRR) were reported (p-value ≤ 0.05 as statistically significant). The analysis indicated that rural informal caregivers have an increased caregiving motivation (β =.542, SE= .2242, p-value < .05) and a decreased caregiver burden (β = -1.64; SE= 0.41, p-value < .01) compared to urban participants. Caregiver burden was negatively associated with HRQoL (β = -0.286, SE=.0123, p-value < .001). Perceived susceptibility to a health problem (β=0.054, IRR =1.056, p-value < .001), cues to action (β=0.076, IRR =1.079, p-value < .001), and self-efficacy (β= 0.042, IRR =1.043, p-value < .01) were positively associated with healthcare utilization. The findings support the hypotheses that rural informal caregivers have an increased caregiving motivation, and perceived susceptibility, cues to action, and self-efficacy are positively associated with healthcare utilization. In contributing to social and global health policy discussions, policymakers should develop policies and programs to reduce caregiver burden and improve caregiving motivation as well as informal caregivers’ HRQoL and healthcare-seeking behaviour. This study further makes a strong argument for strengthening the caregiving and healthcare-seeking capacities of informal caregivers of older adults across different geographical scales through adequate training and social support.
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