Caregiver Contribution to Patient Self-Care and Associated Variables in Older Adults with Multiple Chronic Conditions Living in a Middle-Income Country: Key Findings from the 'SODALITY-AL' Observational Study

照护者对患有多种慢性疾病的中低收入国家老年人自我照护的贡献及其相关变量:来自“SODALITY-AL”观察性研究的主要发现

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Abstract

Background/Objectives: Multiple chronic conditions (MCCs) pose global health and social challenges, with caregiving often relying on family members, especially in low- and middle-income countries (LMICs). However, limited evidence exists regarding the factors influencing caregiver contribution (CC) to patient self-care among older adults with MCCs in these settings. Aim: The aim of this study was to examine the associations between caregivers' and patients' socio-demographic characteristics and patients' clinical variables and the CC to patient self-care behaviors in adults with MCCs in an LMIC context. Methods: This multicenter, cross-sectional study included patient-caregiver dyads recruited from outpatient and community settings across Albania, between August 2020 and April 2021. CC was assessed using the Caregiver Contribution to Self-Care of Chronic Illness Inventory scale (CC-SCCII). Three multivariable linear regression models were used to explore associations with the three dimensions of CC to self-care maintenance, monitoring, and management. Results: Caregivers were mostly female, children, or spouses with a high level of education and employed. Patients were primarily female and had low education. Hypertension and diabetes were the most prevalent. Older and employed caregivers contributed less to CC to self-care maintenance, while higher education and caregiving experience increased it. Living with the patient and being a spouse reduced CC to self-care monitoring, whereas more caregiving hours and experience improved it. CC to self-care management was negatively influenced by cohabitation, presence of a second caregiver, and being a spouse, but improved with more caregiving hours. Conclusions: Socio-demographic and caregiving factors differently influence CC to self-care dimensions in older adults with MCCs in an LMIC. Tailored caregiver support programs are essential to enhance caregiver involvement and improve MCC patient outcomes in LMICs.

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