title: Factors associated with health-related quality of life among Chinese caregivers of the older adults living in the community: a cross-sectional study.
abstract: BACKGROUND
  Under the culture of filial piety and due to the Confucianism spirit in China, family caregivers usually undertake the responsibilities of caring for the older adults. They usually suffer from a heavy burden which is believed to impair their mental and physical health. Thus this study aims to describe the health-related quality of life (HRQOL) among Chinese caregivers of the older adults living in the community and explore the predictors of caregivers' HRQOL.
  
  
  METHODS
  A cross-sectional study was conducted through convenience sampling. The study population was composed of 1,144 caregivers of older adults who suffered from one or more types of chronic diseases in 15 communities in 3 eastern cities of China. Family caregivers were interviewed face-to-face using the 36-item Short-Form Health Survey (SF-36) and the ZARIT Caregiver Burden interview (ZBI) scales. The Antonovsky's Sense of coherence (SOC) scale was also used to measure personal coping capability of the caregivers. Hierarchical multiple regression analysis (HMR) was performed to explore the predictors of caregivers' HRQOL.
  
  
  RESULTS
  The majority of the caregivers were females (60.0%) or adult children (66.5%). Mental QOL was significantly lower than physical QOL. Hierarchical multiple regression analysis showed that Demographic Characteristics of Caregivers, Patients' Characteristics, and Subjective Caregiver Burden explained most of the total variance of all aspects of HRQOL. While, Objective Caregiving Tasks was only associated with physical QOL. Subjective Caregiver Burden was the strongest predictor of both physical and mental QOL. SOC was also a strong predictor of physical and mental QOL.
  
  
  CONCLUSIONS
  The mental QOL of the caregivers of older adults was disrupted more seriously than physical QOL. Additionally, Subjective Caregiver Burden might decrease caregiver' health. A decrease in caregiver burden could promote better management of caregiving tasks, and improve HRQOL. Also, coping capabilities, like SOC, are needed to decrease the impact of caregiving on HRQOL of Chinese caregivers of the older adults.
authors.affiliation: Department of Social Medicine, School of public health, China medical university, No,92 North second road, Heping District, Shenyang, 110001, China.
authors.forename: Xiaoshi
authors.initials: X
authors.lastname: Yang
authors.forename: Yiming
authors.initials: Y
authors.lastname: Hao
authors.forename: Shernelle Marlah
authors.initials: SM
authors.lastname: George
authors.forename: Lie
authors.initials: L
authors.lastname: Wang
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D017028:Caregivers / Q000523:psychology*; D002681:China; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006801:Humans; D057187:Independent Living; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D036301:Qualitative Research; D011788:Quality of Life / Q000523:psychology*; D012044:Regression Analysis; D060685:Sense of Coherence; D011795:Surveys and Questionnaires; D055815:Young Adult