Date of Award

5-2016

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Program

Nursing Science

Research Advisor

Mona Newsome-Wicks, Ph.D., RN

Committee

Joyce Carolyn Graff, Ph.D., RN Wendy Likes, Ph.D., D.N.Sc. George Relyea, M.S. Zandria Robinson, Ph.D. Shelly White-Means, Ph.D., M.A.

Keywords

African American, Caregiver, End Stage Renal Disease, Predictors, Quality of life, Women

Abstract

The purpose of this predictive correlational study was to describe predictors of quality of life (QoL) for African American women who were caregivers of persons with end stage renal disease (ESRD). Five purposes, derived from a review of literature and conceptual model, guided this study. First, the study described the association between demographic factors (i.e., education, employment, age, marital status), and QoL. Second, the study explored the relationship between stress and QoL. Third, the study described the association between depressive symptoms and QoL. Fourth, the study described the association between family health/happiness and QoL. Fifth, the study described the extent to which demographic factors, stress, depressive symptoms, and family health/happiness predicted QoL. A secondary analysis of data from 75 African American women derived from a previous study of 120 caregivers of persons receiving either maintenance in-center hemodialysis or home peritoneal dialysis was conducted. Specifically data from the following instruments were included in the current analysis: The Caregiver Demographic Data Form, Quality of Life Index, Family APGAR, Burden Interview, and the Center for Epidemiological Studies Depression Scale (CES-D). Data were analyzed using descriptive statistics, Pearson’s r coefficient one -way ANOVA on ranks (Kruskal-Wallis), independent t-test, and backward elimination, forward selection, and step-type multiple regression analysis. The caregivers in this sample rated their QoL as moderate. Caregivers also reported clinically significant depressive symptom scores, little to no stress, and were satisfied with their family health/happiness. Significant negative correlations were found between hours worked, education, stress, and QoL. Significant positive relationships were found between age, educational level, recipients’ relationship to the caregiver, family health/happiness, satisfaction with support, and QoL. Four variables—education, full time employment, part time employment, marital status, and stress—explained 63% of the total variance in QoL scores (p < 0.0001). Caregivers who had more education, were employed full time or part time, and reported more stress experienced the lowest QoL. In addition, caregivers who were married experienced the highest QoL. The findings of this study suggest that QoL is multifaceted and is affected by many areas of a person’s life. Social and economic factors and stress were the strongest predictors of QoL for African American women caring for persons with ESRD. The African American women in this study did not experience high levels of stress even though stress was a significant predictor of QoL. This finding may reflect a problem with the measurement of stress used in this population. Several factors, including caregiver work status, explained caregivers’ QoL. Findings from this study provide support for exploring the needs of working caregivers, as QoL was lowest in this group. Understanding better the experiences of working caregivers would inform clinical practice, health policies, and theory development that address the needs of understudied African American women who help persons manage ESRD.

ORCID

http://orcid.org/0000-0002-1117-5485

DOI

10.21007/etd.cghs.2016.0398

Comments

The purpose of this predictive correlational study was to describe predictors of quality of life (QoL) for African American women who were caregivers of persons with end stage renal disease (ESRD). Five purposes, derived from a review of literature and conceptual model, guided this study. First, the study described the association between demographic factors (i.e., education, employment, age, marital status), and QoL. Second, the study explored the relationship between stress and QoL. Third, the study described the association between depressive symptoms and QoL. Fourth, the study described the association between family health/happiness and QoL. Fifth, the study described the extent to which demographic factors, stress, depressive symptoms, and family health/happiness predicted QoL. A secondary analysis of data from 75 African American women derived from a previous study of 120 caregivers of persons receiving either maintenance in-center hemodialysis or home peritoneal dialysis was conducted. Specifically data from the following instruments were included in the current analysis: The Caregiver Demographic Data Form, Quality of Life Index, Family APGAR, Burden Interview, and the Center for Epidemiological Studies Depression Scale (CES-D). Data were analyzed using descriptive statistics, Pearson’s r coefficient one -way ANOVA on ranks (Kruskal-Wallis), independent t-test, and backward elimination, forward selection, and step-type multiple regression analysis. The caregivers in this sample rated their QoL as moderate. Caregivers also reported clinically significant depressive symptom scores, little to no stress, and were satisfied with their family health/happiness. Significant negative correlations were found between hours worked, education, stress, and QoL. Significant positive relationships were found between age, educational level, recipients’ relationship to the caregiver, family health/happiness, satisfaction with support, and QoL. Four variables—education, full time employment, part time employment, marital status, and stress—explained 63% of the total variance in QoL scores (p < 0.0001). Caregivers who had more education, were employed full time or part time, and reported more stress experienced the lowest QoL. In addition, caregivers who were married experienced the highest QoL. The findings of this study suggest that QoL is multifaceted and is affected by many areas of a person’s life. Social and economic factors and stress were the strongest predictors of QoL for African American women caring for persons with ESRD. The African American women in this study did not experience high levels of stress even though stress was a significant predictor of QoL. This finding may reflect a problem with the measurement of stress used in this population. Several factors, including caregiver work status, explained caregivers’ QoL. Findings from this study provide support for exploring the needs of working caregivers, as QoL was lowest in this group. Understanding better the experiences of working caregivers would inform clinical practice, health policies, and theory development that address the needs of understudied African American women who help persons manage ESRD.

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