The Effects of Caregiving Resources On the Psychological Health Among Korean American Caregivers

Background and Purpose: With the growing diversity in the older population, there is an increasing need for better understanding caregiving experiences among ethnic minority groups. Caregiving literature suggests that differences in resources and unique cultural background may affect caregiving experiences of ethnic minority caregivers. The Conservation of Resources (COR) theory explains that people in a stressful situation try to seek resources that would relive their stress. Guided by the COR theory, this study aimed to test a psychological health model in relation to resources with caregivers of older Korean Americans (KA), one of the fastest growing ethnic minority populations in the U.S. Specifically, we conceptualized caregiving resources as psychological (i.e. self efficacy), financial (i.e., financial hardship), informal (i.e., social network and family conflict), formal (i.e., use of formal services), and acculturation resources (i.e. English proficiency), and tested following hypothesized relationships: (1) direct effects of caregiving conditions (functional limitations and cognitive impairment of older adults, and caregiving time) on resources, primary outcomes (caregiving burden and stress), and psychological health of caregivers (depression); (2) direct effects of resources on primary outcomes and psychological health of caregivers; and (3) indirect effects of caregiving conditions on psychological health of caregivers.

Methods: The data were drawn from a survey interview of 145 Korean American caregivers in the Washington D.C. metropolitan area. Structural equation modeling (SEM) was conducted to examine the model of the relationships between caregiving conditions, caregiving resources, primary outcomes, and psychological health of KA caregivers using Mplus Version 6.0.

Results: The average age of the participants was 57.95 years (SD=12.75, Range= 27-84). The majority of them was married (82%) and female (79%), and completed more than a high school education (56%). Only 2% of the respondents were born in the U.S. The psychological health model exceeds criteria for the good model, χ² (49) = 66.621, TLI=.950, CFI = .963, and RMSEA = .050. All indicators were significant at p <.001. The direct effect of cargiving condition on primary outcomes and the direct effects of resources on primary outcomes and psychological health of caregivers were found. No indirect relationship was found from caregiving condition to psychological health. Negative caregiving condition (i.e., caring for older adults with more cognitive problems and functional limitations, and longer caregiving hours) was associated with negative primary outcomes (i.e., greater burden and greater stress). In addition, more resources (i.e., lower financial hardship, higher self-efficacy in caring, greater level of social network, greater family harmony, and higher English proficiency) were associated with better primary outcomes (i.e., less stress and less burden) and better psychological health (less depressive symptoms). 

Conclusion and implication: This study underscores the important role of caregiving resources both on primary outcomes and the psychological health among caregivers of older Korean Americans. Among multiple indicators of resources, self-efficacy, social network, and English proficiencies were identified as important factors affecting psychological health of caregivers, suggesting the need of educational and skill-based interventions to improve self-efficacy and social support network, and reduce language barriers for the Korean American caregivers.