Relationships between Caregiver Burden, Financial Burden, Family Support, and Quality of Life among Caregivers of the Dependent Person

Abstract

Chronic illness-related health problems are a primary cause of limitations or loss of self-care ability in individuals, resulting in long-term dependency on others for continuous care throughout the course of their treatment. Not only do individuals who depend on others frequently face changes in the pathological progression of their diseases, but caregivers must also continuously adapt to evolving treatment plans. Therefore, chronic illness impacts not only the affected individuals but also their families or relatives who assume caregiver roles. The majority of dependent groups are older people and those with disabilities, bedridden, and complex health conditions. These groups require ongoing daily care and health support, particularly within the family context, where caregiver responsibilities predominantly fall on family members. These family caregivers are typically unpaid and lack formal health care training, yet they bear the burden of providing care. This responsibility often requires reallocating time from their own daily activities to care for the dependent individual, resulting in lost income and increased treatment and care expenses. Consequently, these factors directly affect the caregivers’ living conditions and overall quality of life, especially in communities lacking systematic support systems.

This descriptive study aimed to examine the relationships among caregiver burden,financial burden, and family support with the quality of life of caregivers of dependent persons.The study was guided by Oberst’s Caregiving Burden Theory, which posits that caregiver burden arises from the complexity, intensity, and duration of continuous caregiver activities. Such a burden affects the caregiver’s overall well-being, including physical, psychological, and social dimensions. In particular, when caregiver demands exceed the caregiver’s capacity to cope, this may result in fatigue, stress, and a sense of isolation. In addition, the study incorporated Orem’s Self-Care Deficit Theory, which helps explain the condition of dependent individuals who are unable to care for themselves adequately.Consequently, caregivers must step in to support daily living activities across physical, emotional, and social domains. This caregiving role is carried out under the constraints of time, energy, and personal resources. The sample consisted of 85 pairs of caregivers and their dependents who attended the outpatient department at Phra Nakhon Si Ayutthaya Hospital. Participants were selected through purposive sampling and screened using the Barthel Activities of Daily Living (ADL) assessment. Research instruments included a personal information questionnaire, the Perceived Financial Burden scale, the Caregiver Burden Scale, the Family APGAR Questionnaire, and the WHOQOL-BREF (Thai version) to assess quality of life. Data were analyzed using descriptive statistics and Spearman’s correlation coefficient.

The findings revealed that most dependent individuals were in late adulthood, with a mean age of 60.05 years (range 18–89 years). The majority were previously employed in agriculture (74.11%), utilized the Universal Health Coverage scheme (77.65%), and had a chronic illness lasting more than 10 years (40.03%). More than half of them required medical equipment for daily living (61.17%). All participants had high to very high levels of dependency (18.82% and 81.18%, respectively), with an average Barthel ADL score of 2.69 (SD = 1.67),indicating very limited self-care ability. Most caregivers were male, with a mean age of 57.02 years (range 17–84 years), and were predominantly in late working age to aging. The highest education level achieved was secondary school (31.76%), and their primary occupation was agriculture (37.65%). Caregivers reported a moderate level of caregiving burden. The highest caregiving expenses were for adult diapers, enteral feeding, and medical equipment. Family support was rated high, while caregivers’ quality of life was moderate. Statistical analysis showed a significant negative correlation between caregiver burden and quality of life (r = –.47, p < .01),and a significant positive correlation between family support and quality of life (r = .22, p = .04).However, no significant correlation was found between financial burden and quality of life (r = .04, p = .71). These findings highlight the critical role of family support and burden reduction strategies in promoting caregiver well-being and underscore the need for policies that address caregiver burden to improve their long-term quality of life.

Keywords: Caregivers, Caregiver burden, Dependent persons, Family support, Financial burden, Quality of life Caregiver burden

Author Contributions:
TS: Conceptualization, Method and design, Tool validation, Data collection, Data analysis,Writing and revising the manuscript
NP: Conceptualization, Method and design, Data analysis, Writing, revising, and editing the manuscript, Corresponding with editor-in-chief
AS: Conceptualization, Method and design, Conclusion, Recommendation, Revising the manuscript