Testing a modified model of stress process for understanding quality of life among informal caregivers and assessing their formal service use

Informal caregivers provide timely care to family members who are disabled or have a chronic condition that requires close monitoring or constant assistance. To provide adequate support to informal caregivers there is a need to assess ways to improve their quality of life (QOL) and understand how formal services can be improved. This dissertation strives to extend the knowledge available for policy makers by examining the factors that can be targeted by policy makers to improve QOL of informal caregivers as well as the factors that enable the use of formal services provided to support informal caregivers. The psychometric properties of the QOL instrument should be established before assessing QOL in informal caregivers. First we assessed the psychometric properties of the World Health Organization’s Quality of Life – Brief (WHOQOL-BREF) in the sample of informal caregivers. The WHOQOL-BREF was found to be psychometrically sound for use in assessment of QOL among informal caregivers with good internal consistency reliability convergent and discriminant validity and known-groups validity. Overall the results provide basis for the use of WHOQOL-BREF for the assessment of QOL in informal caregivers. Secondly we explored the role of personality in influencing psychosocial factors and QOL of informal caregivers and whether its influence differs between two groups of informal caregivers. We found that only specific personality traits were associated with coping measures and QOL where they also differed in their effect at different levels of the personality trait. However the effect of personality was different when compared between the two groups of informal caregivers. This resulted in two different models unique to the informal caregivers of the two groups. Lastly we explored the factors that were associated with the use of each of the formal services that included paid help respite care and training sessions in a national sample of caregivers to get generalizable results. Paid help respite care and training sessions all had some unique factors that predicted their use that shows that each service should be treated separately. These factors can serve as starting points for practitioners and policy makers extending the use of these formal services