Author ORCID Identifier

https://orcid.org/0000-0002-9155-8768

Semester

Summer

Date of Graduation

2023

Document Type

Dissertation

Degree Type

PhD

College

School of Nursing

Department

Family/Community Health

Committee Chair

Suzy Walter

Committee Member

Kesheng Wang

Committee Member

Ubolrat Piamjariyakul

Committee Member

Feylyn Lewis

Abstract

Background: Caregiver burden reduces quality of life (QOL) and is associated with poorer health outcomes. Older adults may be more susceptible to caregiver burden due to advancing age and declining health. Spirituality has been shown to reduce caregiver burden and improve QOL.

Purpose: The purpose of this study was to evaluate the direct or indirect influence of spirituality on caregiver burden and caregiver QOL in older adult caregivers. The specific aims were 1) to determine the prevalence of caregiver burden in a nationally representative sample of older adult informal caregivers of other adults and 2) to investigate the relationships among caregiver burden, spirituality, and quality of life in a nationally representative sample of older adult informal caregivers of other adults.

Methods: This was a cross-sectional, descriptive secondary data analysis of data from the 2020 Health and Retirement Study (HRS). The HRS collects data every other year from a large nationally representative sample of adults aged 55 or older and their spouses. Participants who identified as regularly providing care to another adult were included (n = 591). General linear models and structural equation modeling (SEM) were conducted to explore relationships among caregiver burden, spirituality, QOL, and demographic data.

Results: Caregivers had a mean age of 66.32 (7.84). Most caregivers were female (n = 368, 53.1%), White (n = 399, 81.5%), married (n = 378, 68.7%) and had a high school education or general education diploma (n = 290, 47.1%). More than half of the caregivers scored as having moderate (n = 289, 48%) or high (n = 18, 3.5%) levels of caregiver burden. Among all caregivers, 22.5% (n = 126) provided care for more than a year and found caregiving to be somewhat upsetting while 9.6% (n = 51) provided care for more than a year and found it to be very upsetting. GLM showed caregivers who were highly spiritual had lower caregiver burden (p = .023). Lower caregiver burden was correlated with higher QOL (p = < .001). Spirituality did not moderate the effect of caregiver burden on QOL, but an SEM depicting an influencing effect of spirituality revealed a good model fit (NFI = .902; IFI = .928; TLI = .862; CFI = .927; PCFI = .494, RMSEA = .065; χ2= 27.902, p = .000, DF = 8, PCMIN/DF = 3.488)

Conclusions: Spirituality influenced QOL through caregiver burden in this population. Spirituality should be fostered in older adult informal caregivers to help reduce caregiver burden and improve QOL. Nurses can foster spirituality by providing spiritual care and making appropriate referrals. Further research is needed to explore other factors affecting spirituality in this population and to test spiritual interventions for effectiveness in improving QOL.

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