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    • Results Among Thai cohort members at the and follow

    2018-11-05

    Results Among Thai cohort members at the 2009 and 2013 follow-up, 56.1% reported they Calcein AM were not caregivers in either year, 24.5% reported being caregivers in 2009 only, 8.6% in 2013 only, and 10.6% reported being caregivers at both time points (Table 1). Caregivers tended to be older and to reside in rural areas. The least frequent caregiving activities were ‘bathing and dressing’ (3.5%) and ‘help with mobility’ (3.7%) and the most common were ‘help shopping’ (14.1%) and ‘financial support’ (15.2%). Females, older cohort members, and rural residents reported higher caregiving activities. Prevalence of high psychological distress is reported in Table 1 for both 2009 and 2013 by caregiving status. Non-caregivers in both periods had the lowest percentage of high psychological distress (7.2% in 2009 and 9.4% in 2013) compared to cohort members who had taken up caregiving by 2013 (8.5% and 12.5%) and those who were providing caregiving at both time points (11.1% and 13.8%). We report adjusted odds ratios and 95% Confidence Intervals for high psychological distress in 2013, based on multivariate logistic regression (Table 2). After adjusting for potential covariates, 2009–2013 caregiving status was significantly associated with high psychological distress. Model 1 shows Adjusted Odds Ratios (AOR) of 1.26 for ‘new’ caregivers in 2013 compared to those who were never caregivers (but not statistically significant). Model 1 also shows AOR of 1.38 higher risk among those who were caregivers in both 2009 and 2013, compared to those who were never caregivers. After restricting the analyses to those without psychological distress in 2009 (Model 2), the adjusted caregiver effects were 1.40 and 1.64, respectively. Cohort members who no longer reported providing care (only caregiver in 2009) had slightly higher odds of high psychological distress compared to the non-caregivers (statistically significant in Model 2). Being older, unpartnered, and having lower income were associated with high reported psychological Calcein AM distress in 2013. Low job security, low social support (notably from colleagues or supervisors), and dissatisfaction with leisure time were strongly associated with high psychological distress.
    Discussion This study investigated the association between caregiving and mental health among a large nationwide cohort of working Thai adults. All cohort members were in paid work and close to one fifth were caregivers with half providing 20h or more care per week. Longitudinal analyses showed a relationship between changes in caregiving status and high psychological distress and revealed the transitional nature of caregiving (during 4-year follow-up a quarter of the cohort stopped caregiving and 10% started). Associations between caregiving and poor mental health remained after adjusting for job characteristics and other relevant covariates. Our findings support previous studies revealing the adverse impact of caregiving on mental health among workers (Pearlin et al., 1990; Farfan-Portet et al., 2010; Berecki-Gisolf et al., 2008; Lyonette & Yardley, 2006; Wong et al., 2004; Oshio, 2014). In addition, the analyses showed Extranuclear genes several other important covariates were also associated with psychological distress. After mutually adjusting for demographic and work characteristics, job security was also strongly associated with psychological distress among the Thai cohort members. This supports our previous findings on the importance of job characteristics, especially perceived low job security, on mental health. Another important factor could be limited social welfare in middle-income settings such as Thailand (Yiengprugsawan et al., 2015). Cohort members with lower income were more likely to report psychological distress potentially due to limited financial resources. Lack of social support, particularly in the workplace, was also found to be a risk factor for high psychological distress. Similar findings have been reported in other studies examining the importance of support from colleagues and supervisors (Wong et al., 2004; Yiengprugsawan et al., 2015). Workplace flexibility is known to alleviate work-family conflict (Li, Shaffer, & Bagger, 2015). This study found that satisfaction with spare time was associated with reduced psychological distress; time pressure has previously been shown to affect the mental health of caregivers (Brown and Pitt-Catsouphes, 2013).