Positive and Negative Appraisals and Quality of Life Among Family Caregivers of Adults With Formal Long‐Term Care Needs: An Exploration of Model Using Structural Equation Modelling

ABSTRACT

Aims

To examine a model of the caregiving adaptation process among family caregivers supporting care recipients at home.

Background

Global demand for the support of adults with long-term care needs and family caregivers is increasing. Caregivers' quality of life is affected by positive and negative appraisals of care; however, few studies have simultaneously investigated these factors.

Design

A cross-sectional study.

Method

The STROBE checklist for cross-sectional studies was followed. Seventy-four randomly selected home-visit nursing stations in Japan participated in this study from June 2023 to June 2024. A self-administered anonymous questionnaire was provided to family caregivers with care recipients at home. A total of 168 questionnaires were analysed. The variables included in the model were the European Quality of Life five-dimension five-level (EQ-5D-5L) instrument, positive and negative appraisals of care scale, four external resources and three internal resources, and six characteristics of caregivers and care recipients. Descriptive statistics and correlations between variables were analysed. The model was tested using structural equation modelling.

Results

Family caregivers' negative appraisal of care directly and negatively affected quality of life, and positive appraisal of care had no statistically significant association with quality of life. Positive appraisal of care had a direct negative association with negative appraisal of care. External resources such as support from nurses directly affected the positive appraisal of care. Internal resources such as caregivers' coping strategies had a significant negative effect on negative appraisal of care.

Conclusion

The findings suggest that improving caregivers' quality of life requires support to decrease negative appraisal of care by increasing internal resources and increase positive appraisal of care by providing external resources. Understanding the caregivers' adaptation process model is essential to prevent the deterioration of their quality of life.

Reporting Method

STROBE guidelines.

Patient or Public Contribution

Seventy-four home visit nursing stations and participants who care for family members through home visit nursing were involved in the survey investigation and answering the questionnaires.

Implications for the Profession and Patient Care

For supporting family caregivers' QoL, a reduction in negative appraisals of care is essential, increasing internal resources such as caregivers' coping and positive appraisal of care directly reduces negative appraisal of care.