title: Caregiver strain and factors associated with caregiver self-efficacy and quality of life in a community cohort with multiple sclerosis.
abstract: OBJECTIVE
  To describe the level of caregiver strain and factors associated with caregiver self-efficacy and quality of life (QoL) in a community cohort with multiple sclerosis (MS).
  
  
  METHODS
  A cross-sectional survey of 62 informal caregivers and 101 participants with confirmed MS and quantified physical and cognitive disability recruited from a tertiary hospital MS database. Structured interviews conducted at home using standardized assessments to measure: (i) Caregiver strain and subjective burden of care; (ii) participant with MS and caregiver QoL and self-efficacy; and (iii) participant with MS level of depression, anxiety and stress.
  
  
  RESULTS
  The mean caregiver age was 54 years (range 37 - 62). The mean caregiver strain score was 5.63 (SD 3.63). Twenty-six of 62 (42%) caregivers reported strain for items such as emotional adjustments, demands on time, change in personal plan and disrupted sleep. Caregiver burden was higher in those caring for the more severely affected persons with MS, especially those with higher depression, anxiety and stress levels. The caregiver strain correlated with a lower QoL in both the person with MS and their caregiver, but not with their self-efficacy scores.
  
  
  CONCLUSIONS
  Caregivers of persons with MS reporting high levels of caregiver strain experienced a lower QoL and were caring for persons with MS with a lower QoL and higher levels of depression and anxiety. Interventions to reduce caregiver strain and burden in those at risk are necessary to reduce poor outcomes among both caregivers and care recipients with MS.
authors.affiliation: Department of Rehabilitation Medicine, Royal Melbourne Hospital, Melbourne, Australia. fary.khan@mh.org.au
authors.forename: Fary
authors.initials: F
authors.lastname: Khan
authors.forename: Julie
authors.initials: J
authors.lastname: Pallant
authors.forename: Caroline
authors.initials: C
authors.lastname: Brand
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000453:epidemiology / Q000209:etiology; D017028:Caregivers / Q000523:psychology*; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000451:nursing*; D011788:Quality of Life; D020377:Self Efficacy; D018709:Statistics, Nonparametric; D013315:Stress, Psychological / Q000453:epidemiology / Q000209:etiology; D011795:Surveys and Questionnaires