Research That Matters (January 17 - 20, 2008)

Background and Purpose: Our focus on caregivers' beliefs stems from the caregiving literature that points to the importance of considering the socio-cultural context that can influence the experience and outcomes of caregiving. While cross-cultural examination of beliefs is important, the examination of African American women caregivers can shed light on the diversity of their beliefs, especially since beliefs can both reflect larger cultural themes as well as the idiosyncratic experience of the individual. Drawing from the stress-and-coping and the multi-contextual frameworks, this paper investigates the relationship between caregivers' beliefs (i.e., their beliefs about their caregiving role, health locus of control and mental health) and their depressive symptoms and perceived stress, while controlling for personal, interpersonal, and social contexts.

Methods: Data came from a cross-sectional study in a midwestern state of a community sample of 521 urban and rural Black female caregivers. To obtain a sample of caregivers, we screened older adults and their caregivers from a list of Medicare enrollees obtained from the then Healthcare Financing Administration. Eligibility criteria including being female, self-identifying as African American, providing unpaid care to an older adults, and be 18 years or older. We used a number of standardized instruments to measure the dependent variables (the Center for Epidemiological Study – Depression Scale and the Perceived Stress Scale) and the independent variables of interest (Caregiving Beliefs, Internal Health Locus of Control, and Beliefs about Mental Illness). Additionally, we controlled for the personal (age, education, employment status, self-rated health, mastery), situational (functional ability of the older relative, number of caregiving years, geographical location), interpersonal (relationship with elder, quality of the relationship) context in the hierarchical regression models, where we regressed the well-being variables on the independent variables separately.

Results: We found that caregivers who held more traditional beliefs about their caregiving role reported higher levels of depressive symptoms (b=.423, p=.0003). Additionally, we also found that caregivers who were older, more educated, employed, living in rural locations, rated their health better, had better relationships with their care receivers, and reported higher mastery were more likely to report lower depressive symptoms. We found a similar finding for perceived stress levels. Caregivers with more traditional beliefs about their caregiving role had higher levels of depressive symptoms (b=.235, p=.0024). Moreover, we found that caregivers who were older, more educated, rated their health better, had better relationships with their care receivers, and reported higher levels of mastery were more likely to report lower levels of depression.

Implications: Our findings indicate that caregiver beliefs about their caregiving role can have negative implications for their outcomes, highlighting the influence of the socio-cultural context on caregiver well-being. As such, these findings support the theoretical considerations of context especially for African American caregivers. Further, in considering culturally-sensitive services, social workers need to be cognizant of the potentially negative outcomes of caregivers with traditional beliefs about their role, while appropriately supporting them in their caregiving efforts.