Review: exploration of psychological and physical health differences between caregivers and non-caregivers

摘要

What are the differences between caregivers and non-caregivers in perceived stress, depression, subjective well being, physical health and self efficacy? METHODS, Design: Systematic review with meta-analysis., Data sources: MEDLINE, PsycINF0, Psyndex (search dates not stated). Reference lists were hand searched., Study selection and analysis: Eligible studies compared levels of perceived stress, depression, general subjective well being, physical health, or self-efficacy between a sample of informal caregivers of older adults and a sample of non-caregivers. Exclusions: studies where reported differences between caregivers and non-caregivers could not be converted to standard deviation units (see notes); not written in English, French, German, or Russian., Outcomes: Sociodemographic differences, the impairment of the care receiver, and effect sizes (derived for each study either from the difference in outcome between groups divided by the pooled standard deviation; or from reported significance values; or using a "vote counts" methodology) of perceived stress, depression, subjective well being, physical health, and self efficacy., MAIN RESULTS, Eighty four studies met inclusion criteria (number of participants not stated). There was substantial heterogeneity among studies (see Notes). Approximate ranges in effect sizes between caregivers and non-caregivers (where positive values represent larger impairments of caregivers compared with non-caregivers) were -0.5 to 3.5 for perceived stress (29 studies); -0.25 to 1.7 for depression (78 studies); -1.5 to 0.25 for subjective well being (46 studies); -0.8 to 0.4 for physical health (64 studies), and -1.4 to 0 for self efficacy. Metaanalysis found that caregivers had significantly higher levels of stress and depression and significantly lower levels of subjective well being, physical health, and self efficacy than non-caregivers., CONCLUSIONS, The authors conclude that caregivers had higher levels of stress and depression and were more likely to have lower levels of subjective well being, physical health, and self efficacy than non-caregivers., NOTES, The systematic review did not exclude studies based on their design or quality of their methods. It is not surprising, therefore, to find heterogeneity of results. Under these circumstances, narrative synthesis may be preferable to a meta-analysis. Excluding studies on the basis of the outcome measure used may result in important studies being excluded from the analysis. This may affect the reliability of the results. The majority of studies were focused on caregivers of demented elderly, which may reduce the generaliseability of the results