The impact on health-related quality of life of caregiving within the household for people with arthritis

Abstract

Approximately 10% of people in England and Wales provide care to a family member or a friend. Such care helps people stay in their own homes and saves costs to the NHS and social care systems, but is not without physical and mental effects to the caregivers. This thesis considers the effect on health-related quality of life (HRQOL) of providing care to people with arthritis and investigates the association between (1) time spent caregiving and caregiver HRQOL and (2) the HRQOL of the person with arthritis and caregiver HRQOL. First, a systematic review of the existing literature was undertaken. Second, data pairs from Understanding Society for people with arthritis and their caregivers were used in a regression analysis of the association between time spent caring, caregiver SF-6D values and SF-6D values of the person with arthritis. The analysis suggests that lower caregiver SF-6D values are associated with lower patient SF-6D values, increased time spent caregiving and the presence of caregiver external conflicts (issues with finances, leisure and relationships) and internal conflicts (lack of optimism, usefulness and presence of stress). An interaction is identified between the SF-6D values of the person with arthritis and the presence of caregiver external conflicts. In the absence of external conflicts as the SF-6D values of the person with arthritis increase so do caregiver SF-6D values. In the presence of external conflicts the association between SF-6D values in the person with arthritis and the caregiver is flat. The association identified in this thesis uses measures that could be formally included in economic evaluations such as those used by the National Institute for Health and Care Excellence (NICE). Policy and research relating to household caregiving should account for the effects on caregiver HRQOL that arise from increased time spent caring and caregiver external conflicts.