Quality of life of Korean family caregivers with older stroke patients: Using the stress and coping model

Abstract

The study was designed to examine the proposed antecedents and mediators of QOL of family caregivers for older stroke patients in Korea using the stress and coping model (Lazarus & Folkman, 1984). This study identified relationships between antecedent variables (caregiver, stroke patient, and environmental variables) and the caregiver QOL. Additionally, this study examined potential moderating effect of obligation, the cultural characteristic, as well as the mediating effect of perceived social support and caregiver appraisal. Using the general linear model, the caregiver QOL differences by caregiving duration were examined. A cross-sectional design was employed to examine factors that influenced QOL of Korean family caregivers of older stroke patients. The stress and coping model (Lazarus & Folkman, 1984) guided the study. Data were collected from participants at an outpatient clinic of a stroke center at three hospitals and two home health agencies located in Seoul, the capital city of Korea and its suburban area of Kyunggi-do. The questionnaire was self-administered. The Statistical Package Social Sciences (SPSS) 13.0 was used for data analyses. A total of 147 caregivers participated in this study. The mean age of caregivers for this study was 50 (SD = 14.15). Most of caregivers were female (77.6%), married (78.2%), educated greater than high school (80.9%), and unemployed (71.4%). Sixty-four caregivers (43.5%) were spouses of older stroke patients, while 81 subjects (55%) were adult children (i.e., daughter, daughter-in-law, and son). The hypothesis test revealed that 13 predictors explained 23% of the variability in caregiver QOL. Especially, weekly caregiving hour and caregiver gender were found to be significant predictors of caregiver QOL. Furthermore, perceived social support was a mediator between the antecedent variables and QOL. However, caregiver appraisal did not mediate the relationship of antecedent variables and QOL. Although there was a weak relationship between the caregiver appraisal and the caregiver QOL, the cultural characteristic--obligation level moderated the relationship between caregiver appraisal and QOL. Only in situations of high obligation, the effect of stress appraisal on QOL was buttressed in spouse caregivers. There was a difference between short-term and long-term caregivers in their QOL. Those caregivers who cared for stroke patients more than 13 months reported better QOL than those caregivers who took care of patients ≤12 months. The study results contributed to the understanding of caregiving process and the importance of examining of both mediators and moderators of the process among Korean family caregivers. The knowledge gained from this study will be used to develop culture-specific and timely caregiver interventions and social policies to directly support the Korean family caregivers and indirectly stroke patients.