Date of Award


Document Type


Degree Name

Doctor of Philosophy (PhD)


Nursing Science

Research Advisor

Mona N. Wicks, PhD


Leon D. Caldwell, PhD Patricia A. Cowan, PhD Joyce Carolyn Graff, PhD Elizabeth A. Tolley, PhD Shelly I. White-Means, PhD


Burden, Caregivers, Depression, ESRD, Male


Introduction: Men are increasingly assuming the role of caregiver to individuals with chronic illnesses. The debilitating effects of ESRD cause many of those diagnosed with the disease to require assistance from family caregivers. Caregiver literature well reports that caregivers experience mental and physical health effects related to this role. However, research involving the experiences of male caregivers of individuals with ESRD is understudied. These studies use the background and contextual as well as primary and secondary domains of the Stress Process Model to determine the levels of and explore the experiences associated with caregiver burden, depressive symptoms, and perceived health in two independent samples of male caregivers of persons diagnosed with ESRD.

Methods: A series of studies were used to determine the levels of and explore factors associated with caregiver burden, depressive symptoms, and perceived health status. The initial retrospective quantitative study involved completion of questionnaires as measures of objective burden, subjective burden, depressive symptoms, and perceived health status in 29 male caregivers. The second prospective study involved a focus group interview consisting of 6 participants. This study was designed to further explore the experiences contributing to caregiver burden, depressive symptoms, and perceived health. SAS 9.4 and QDA Miner software were used to analyze the quantitative and qualitative data, respectively.

Results: Demographic characteristics of caregivers in the retrospective study included a mean age of 57.1 years. The majority of participants were Black, married, unemployed and cared only for the dialysis recipient. Caregivers reported moderate levels of objective and subjective burden, mild depressive symptoms, and good perceived health status. Male caregivers in the prospective study had an average age of 43.7 years. Most participants were Black, employed, and cared for one person. One-half of the caregivers were married. Four themes emerged from the qualitative prospective study, which included care giving experiences, effects of caregiving, and coping strategies.

Conclusion: Results of the retrospective study indicated that male caregivers of persons with ESRD experienced significant objective and subjective burden. Overall, caregivers reported mild depressive symptoms, however, one-third reported moderate to severe symptoms. The majority of caregivers in the prospective qualitative study also expressed feeling psychological distress and depression related to the caregiving role. One-third of caregivers in the retrospective study reported their health status as fair or poor, and 14% indicated that their health had worsened since assuming the caregiving role. One-half of caregivers in the prospective study indicated that caregiving responsibilities had negatively affected their physical health. Numerous factors are associated with caregiver burden and depressive symptoms including background and contextual factors such as caregiver age, race, and hours of care. The primary stressor, care recipients’ activities of daily living status, was also associated with caregiver objective burden. Caregiver psychiatric morbidity could impede their ability to continue in the caregiving role. Thus, findings from these studies provide support for further research including intervention trials addressing the specific needs of this hidden population of male caregivers.