Positive and Negative Appraisals and Quality of Life Among Family Caregivers of Adults With Formal Long-Term Care Needs: An Exploration of Model Using Structural Equation Modelling.
Mika Sakurai, Junko Hoshino
PMID 40523867WHAT IT FOUND
Among family caregivers, feeling caregiving was rewarding was linked to less burden; burden was strongly linked to lower quality of life.
Nurse support, care-service satisfaction, secondary caregivers, and home-visit nursing were linked to more rewarding feelings.
Key findings
01Negative appraisal of care had a significant negative direct effect on caregivers' quality of life in the model (β = -0.56, p < 0.01).
02Positive appraisal of care did not directly affect quality of life significantly (β = 0.17, p = 0.06), but it had a significant negative effect on negative appraisal (β = -0.26, p < 0.01), giving an indirect path to quality of life.
03External resources, comprising support from nurses, satisfaction with care services, secondary caregivers, and use of home-visit nursing, had a significant positive direct relationship with positive appraisal (β = 1.22, p = 0.03).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The response rate was 26.6%, and 122 returned questionnaires were excluded for incomplete or missing data. The main text says 168 questionnaires were analysed, but Table 2 reports N=167. The study is cross-sectional, so the paths cannot show that external resources, positive appraisal, negative appraisal, or quality of life caused one another. The external-resource path coefficient was β = 1.22. A coefficient exceeding 1 makes the strength of that association difficult to interpret. External resources were combined into one variable, so the study cannot separate support from nurses from satisfaction with care services, secondary caregivers, or home-visit nursing use. Caregivers were recruited through home-visit nursing stations in Japan, so the sample may not represent caregivers without home-visit nursing contact or caregivers in other countries. The authors reported CFI = 0.81 and TLI = 0.77, but their stated acceptance criteria were RMSEA < 0.08 and SRMR < 0.08.
Declared interests
The authors declare no conflicts of interest. No funding statement is provided in the supplied text.
The easy way to misread this
Do not conclude that nurse support caused better caregiver quality of life. The study is cross-sectional, and the reported external-resource path coefficient exceeded 1, so it cannot establish cause.