Factors associated with caregiver burden in mental illness: A critical review of the research literature
Section snippets
Literature review
Maurin and Boyd (1990) conducted a critical review of the caregiving literature in mental illness and provided a good evaluation of the methodological problems existing in this field of research. Methodological issues highlighted included the inconsistent use of theoretical and operational definitions, reliability and validity issues in the measurement of burden, problems in sampling, lack of theoretical frameworks, heterogeneity of the population studied, the absence of longitudinal research
Inclusion criteria
Study abstracts that included the word burden and any of the following words: family, caregiver, caretaker, or careprovider were identified through a computer search in the Psych Info system, 1967 to 1997. The reference sections of these studies were also verified to ensure that no burden studies were left out. Selected studies were designed to evaluate burden (behaviors and feelings specifically associated with mental illness) rather than distress (global picture of the caregivers' physical
Sample selection and characteristics
Respondents of the studies reviewed were mostly female caregivers (69%), and they averaged 52 years of age. Most of them were White (75%) and often resided with the ill relative (43%). Minority caregivers of the reviewed studies were Black. Caregivers usually had a high school diploma and an average family income of $25,000. Respondents were often parents of a severely mentally ill child (55%) or spouse of the ill relative (22%). Studies included in this review either recruited caregivers
Research findings
Three types of research findings were reported in the reviewed studies. Descriptive statistics present the relative occurrence of OB and SB and identify activities found most burdensome to caregivers. Correlations are computed between burden and different variables, as well as between OB and SB. Regression analyses identify the relationship between a specific variable and burden, while controlling for the confounding effects of other variables on burden. Findings about associations between
Recent advances in the research literature
In the last decade, advances in the research literature were made to overcome some of the methodological issues in the field of caregiving in mental illness. They include increased simultaneous control of variables influencing caregiver burden, the differentiation of OB and SB into dimensions of burden, and increased attention to validity and reliability issues in operationalizing caregiver burden. Less than 20% of the studies reviewed which were published prior to 1990 used regression
Future research
Areas that need further attention from researchers include the use of theoretical frameworks, the use of longitudinal research designs, the heterogeneity of the caregiver population, the replication of single study findings, and the theoretical definitions of burden concepts. Most studies reviewed were more or less exploratory in nature and did not attempt to test specific models of caregiver burden. However, many of them were implicitly based on a stress and coping framework, which suggests
Acknowledgements
The author thanks Dr. Gary Gerber and Dr. Catherine Lee, University of Ottawa, for their support, suggestions, and editorial assistance. Acknowledgements and thanks are also due to the two anonymous reviewers for their helpful comments on the original manuscript.
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