Migrant care workers as protective factor against caregiver burden: results from a longitudinal analysis of the EUROFAMCARE study in Italy

Abstract

Objective: The aim of the analysis is to assess the impact of privately employed migrant care workers (MCWs) on the burden of Italian family members who care for a disabled older person.

Methods: EUROFAMCARE is a one-year prospective survey carried out to provide evidence on the availability and use of support services by family carers of older people in Europe. In Italy, 990 family caregivers were enrolled and successful follow-ups were completed for 863 subjects. The survey also assessed the level of caregiver burden using the COPE index, which has three sub-sections: ‘Positive Value’ (PV), ‘Quality of Support’ (QS) and ‘Negative Impact’ (NI). We used the one-year change of the COPE-NI as dependent variable and we realised multilevel regression models to estimate the longitudinal predictors of caregivers’ burden increase.

Results: At a cross-sectional level, most burdened caregivers are those caring for a demented relative (COPE-NI = 13.6), with no educational title (14.5) and looking after their own spouses (15.1). Longitudinally those employing an MCW are significantly protected against burden increase (regression coefficient: −1.52; p < 0.01) while those who cannot rely on the support of other family members are exposed to the risk of burden increase (0.991; p < 0.05). Other formal services do not have any protective effect.

Conclusion: Our study suggests that employing an MCW, rather than using formal services, is associated with a reduction of caregiving burden. Further research should assess whether the shift in care responsibilities to the MCWs also implies a transfer of care burden, and understand how these workers can be better supported by existing formal services.

Keywords:

• stress/burden
• usage
• health service use

Notes

^AIn bold we reported p value below the significance level of 0.05. Unless differently stated, the p values reported in the table refer to the results of the t-tests for comparison of COPE index 1-year variation (T1–T0) and study variables. ^B The value represents the correlation coefficient between study variable and COPE index 1-year variation. ^§ The p value refers to the results of the Spearman tests for correlation of COPE 1-year variation and the continuous variable.

^AThe coefficient of the regressors can be read as the marginal contribution of the covariate on the dependent variable. ^B Standard error of the regressor coefficients. ^C In bold we reported predictors below the significance level of 0.05.