The socio-cultural context of family caregiving and psychological distress: A comparison of immigrant and non-immigrant caregivers in Israel

Abstract

The study aimed to examine the differences in caregiving context and psychological distress outcome between non-immigrant and immigrant caregivers; to investigate these differences by relationship type; and to examine the factors related to psychological distress. Spouse or adult child caregivers (213 non-immigrants and 206 immigrants from the Former Soviet Union) were interviewed. Based on stress and appraisal conceptual framework, caregiving stressors, primary appraisal, psychosocial resources, secondary appraisal and psychological distress were measured. A series of two-way MANOVA, followed by ANOVA, was used to examine the differences by immigration status, by relationship type and their interaction. Hierarchical multiple linear regression was conducted to examine variables associated with psychological distress. Negligible differences in caregiving stressors, but significant differences in caregiving primary and secondary appraisal, psychosocial resources and psychological distress were found by immigration status and by relationship type, and significant interactions only in caregiving primary appraisal. The regression models showed that the differences in psychological distress by immigration status and by relationship type were fully explained by caregiving stressors (care recipient's problem behavior), psychosocial resources (mastery) and caregiving secondary appraisal (role overload, captivity, economic difficulties). The results suggest that socio-cultural background and role relationship shape caregiving appraisal and psychosocial resources, and that these factors explain psychological distress outcomes.

Acknowledgements

The study was funded by the Chief Scientist Office, Israel Ministry of Health (# 4745). We thank the staff of the home-care units of Maccabi, Meuhedet, Leumit and Clalit Health Services, and of the Geriatric Unit, Hospice Home Care Unit and the Retired Personnel Services of Hadassah University Hospitals for their assistance.