Anxiety, Depression, Quality of Life, and Family Support Among Family Caregivers of Children with Disabilities

Figures & data

Table 1 Content of Family Support Questionnaire

Dimension	Item
Childcare Support (CS)	CS1: Assist with respite care and household tasks
	CS2: Provide short-term childcare (eg daycare)
Rehabilitation Support (RS)	RS1: Effective rehabilitation for children (eg physical therapy)
	RS2: Appropriate surgery for children
Financial Support (FS)	FS1: Support for rehabilitation expenses
	FS2: Support for daily life expenses (eg clothing, food, housing, and transportation)
	FS3: Support for caregivers’ unemployment due to caregiving
Psychological Support (PS)	PS1: Psychological support from families
	PS2: Psychological support from relatives and friends
	PS3: Psychological support from professional psychologists
Informational Support (IS)	IS1: Information about children’s future development
	IS2: Knowledge and skills about children’s rehabilitation
	IS3: Information about caregiver’s health management

Table 2 Sociodemographic Characteristics^†

	Total (n=327)		Parents (n=238)		Grandparents (n=89)		Statistics	p
	n	%	n	%	n	%
Gender
Male	83	25.4	55	23.1	28	31.5	2.385^a	0.122
Female	244	74.6	183	76.9	61	68.5
Age (Mdn, IQR)	(39.32, 19.68)		(37.05, 6.64)		(61.66, 10.58)		−13.849^b	<0.001
Household registration
Urban	265	81.0	193	81.1	72	80.9	0.002^a	0.968
Rural	62	19.0	45	18.9	17	19.1
Marital status
Married	312	95.4	229	96.2	83	93.3	1.297^a	0.255
Single, divorced, or widowed	15	4.6	9	3.8	6	6.7
Education
Junior high school and below	56	17.1	11	4.6	45	50.6	138.777^a	<0.001
Senior high school	69	21.1	37	15.5	32	36.0
Junior college and above	202	61.8	190	79.8	12	13.5
Religion
Yes	55	16.8	41	17.2	14	15.7	0.104^a	0.747
No	272	83.2	197	82.8	75	84.3
Employment status
Not employed	173	52.9	90	37.8	83	93.3	79.919^a	<0.001
Part-time	27	8.3	26	10.9	1	1.1
Full-time	127	38.8	122	51.3	5	5.6
Comorbidities
Yes	96	29.4	39	16.4	57	64.0	70.943^a	<0.001
No	231	70.6	199	83.6	32	36.0
Disability type of children
Hearing & speech	82	25.1	64	26.9	18	20.2	17.522^a	0.004
Vision	14	4.3	10	4.2	4	4.5
Physical	61	18.7	35	14.7	26	29.2
Intellectual	33	10.1	22	9.2	11	12.4
Mental	47	14.4	43	18.1	4	4.5
Multiple	90	27.5	64	26.9	26	29.2

Notes: ^†The total percentage of some variables is not equal to 100 due to rounding. ^aChi-square test. ^bMann–Whitney U-test.

Abbreviations: Mdn, median; IQR, interquartile range.

Figure 1 Answers to the question: what is currently most needed in your family?.

Table 3 Intergenerational Differences in Family Support Received by Family Caregivers

	Total (n=327)		Parents (n=238)		Grandparents (n=89)		χ2	p
	n	%	n	%	n	%
CS1
Yes	239	73.1	177	74.4	62	69.7	0.730	0.393
No	88	26.9	61	25.6	27	30.3
CS2
Yes	222	67.9	164	68.9	58	65.2	0.415	0.519
No	105	32.1	74	31.1	31	34.8
RS1
Yes	304	93.0	222	93.3	82	92.1	0.129	0.719
No	23	7.0	16	6.7	7	7.9
RS2
Yes	297	90.8	218	91.6	79	88.8	0.624	0.430
No	30	9.2	20	8.4	10	11.2
FS1
Yes	254	77.7	179	75.2	75	84.3	3.066	0.080
No	73	22.3	59	24.8	14	15.7
FS2
Yes	183	56.0	137	57.6	46	51.7	0.908	0.341
No	144	44.0	101	42.4	43	48.3
FS3
Yes	150	45.9	94	39.5	56	62.9	14.316	<0.001
No	177	54.1	144	60.5	33	37.1
PS1
Yes	306	93.6	233	93.7	83	93.3	0.021	0.885
No	21	6.4	15	6.3	6	6.7
PS2
Yes	300	91.7	221	92.9	79	88.8	1.433	0.231
No	27	8.3	17	7.1	10	11.2
PS3
Yes	244	74.6	168	70.6	76	85.4	7.497	0.006
No	83	25.4	70	29.4	13	14.6
IS1
Yes	168	51.4	125	52.5	43	48.3	0.459	0.498
No	159	48.6	113	47.5	46	51.7
IS2
Yes	253	77.4	182	76.5	71	79.8	0.404	0.525
No	74	22.6	56	23.5	18	20.2
IS3
Yes	249	76.1	178	74.8	71	79.8	0.886	0.346
No	78	23.9	60	25.2	18	20.2

Table 4 Intergenerational Differences in Anxiety, Depression, and HRQoL^†

	Total (n=327)		Parents (n=238)		Grandparents (n=89)		Statistics	p
	n	%	n	%	n	%
Anxiety							−0.076^a	0.939
Minimal	217	66.4	157	66.0	60	67.4
Mild	76	23.2	59	24.8	17	19.1
Moderate	20	6.1	15	6.3	5	5.6
Severe	14	4.3	7	2.9	7	7.9
Depression							−0.374^a	0.708
Minimal	209	63.9	150	63.0	59	66.3
Mild	81	24.8	62	26.1	19	21.3
Moderately severe	25	7.6	18	7.6	7	7.9
Moderate	7	2.1	5	2.1	2	2.2
Severe	5	1.5	3	1.3	2	2.2
HRQoL
PCS (M, SD)	51.26 (7.90)		52.17 (7.24)		48.83 (9.03)		3.141^b	0.002
MCS (M, SD)	47.72 (11.03)		47.55 (10.72)		48.17 (11.86)		−0.452^b	0.652

Notes: ^†The total percentage of some variables is not equal to 100 due to rounding. ^aMann–Whitney U-test. ^bTwo independent t-test.

Abbreviations: M, mean; SD, standard deviation.

Table 5 Intergenerational Differences in the Association of Family Support with Anxiety and Depression

	Anxiety				Depression
	Model 1: Parents		Model 2: Grandparents		Model 3: Parents		Model 4: Grandparents
	AOR^α	95% CI	AOR^β	95% CI	AOR^δ	95% CI	AOR^ε	95% CI
CS1	0.597	(0.276, 1.293)	0.323	(0.083, 1.255)	0.399*	(0.187, 0.853)	0.234	(0.043, 1.261)
CS2	0.772	(0.377, 1.580)	0.681	(0.180, 2.583)	1.911	(0.882, 4.142)	0.764	(0.161, 3.623)
RS1			0.134	(0.009, 1.963)			0.045	(0.002, 1.076)
RS2	0.310*	(0.104, 0.919)	0.696	(0.117, 4.139)	0.289*	(0.093, 0.900)
FS1					0.858	(0.399, 1.842)
FS2	0.869	(0.396, 1.905)	0.456	(0.137, 1.516)	0.709	(0.336, 1.498)	0.141*	(0.021, 0.949)
FS3	1.045	(0.443, 2.466)			0.894	(0.401, 1.993)	0.318	(0.049, 2.052)
PS1			0.067	(0.001, 3.863)	1.830	(0.345, 9.714)	0.003*	(0.000,0.477)
PS2	0.284	(0.076, 1.060)	4.808	(0.166, 139.332)	0.182*	(0.038, 0.874)	31.975	(0.549, 1864.003)
PS3	0.325**	(0.152, 0.697)			0.289**	(0.134, 0.625)
IS1	1.793	(0.846, 3.799)			0.759	(0.381, 1.511)	3.351	(0.571, 19.685)
IS2	0.789	(0.320, 1.945)
IS3	0.993	(0.396, 2.492)			2.094	(0.875, 5.015)

Notes: ^αORs in Model 1 were adjusted for education, employment status, and comorbidities. ^βORs in Model 2 were adjusted for gender, education, and religion. ^δORs in Model 3 were adjusted for gender and comorbidities. ^εORs in Model 4 were adjusted for gender, education, employment status, religion, and comorbidities. Reference: no support. *p<0.05. **p<0.01.

Table 6 Intergenerational Differences in the Association of Family Support with Physical HRQoL and Mental HRQoL

	Physical HRQoL				Mental HRQoL
	Model 5: Parents		Model 6: Grandparents		Model 7: Parents		Model 8: Grandparents
	B^γ	95% CI	B^η	95% CI	B^λ	95% CI	B^ξ	95% CI
CS1	1.673	(−0.427, 3.774)	−0.355	(−4.892, 4.181)	2.750	(−0.567, 6.066)	2.555	(−2.649, 7.758)
CS2	−0.109	(−1.991, 1.773)	3.516	(−0.954, 7.986)	0.653	(−2.436, 3.741)	2.896	(−2.029, 7.822)
RS1	1.220	(−2325, 4.765)					1.682	(−8.131, 11.495)
RS2					4.465	(−0.095, 9.025)	4.797	(−2.172, 11.766)
FS1	0.882	(−1.222, 2.985)					0.821	(−5.190, 6.832)
FS2	−0.265	(−2.010, 1.480)	2.230	(−2.720, 7.181)	3.074	(−0.116, 6.264)	5.883	(−0.053, 11.820)
FS3			1.979	(−2.940, 6.898)	−1.786	(−5.183, 1.610)	−3.375	(−10.045, 3.295)
PS1	−0.315	(−4.431, 3.800)			−4.893	(−11.288, 1.503)	16.282*	(2.870, 29.695)
PS2	2.209	(−1.850, 5.907)			8.986**	(2.872, 15.099)	0.256	(−11.875, 12.387)
PS3					2.596	(−0.638, 5.777)	−3.784	(−10.519, 2.952)
IS1	1.332	(0.496, 3.159)			−0.771	(−3.620, 2.078)	0.704	(−4.066, 5.474)
IS2	−1.296	(−3.696, 1.104)
IS3	1.535	(−0.879, 3.949)

Notes: ^γCovariates in Model 5 were gender, age, education, religion, and comorbidities. ^ηCovariates in Model 6 were gender, education, religion, and employment status. ^λCovariates in Model 7 were gender, religion, and employment status. ^ξCovariates in Model 8 were religion and comorbidities. Reference: no support. *p<0.05. **p<0.01.