title: Migrant care workers as protective factor against caregiver burden: results from a longitudinal analysis of the EUROFAMCARE study in Italy.
abstract: OBJECTIVE
  The aim of the analysis is to assess the impact of privately employed migrant care workers (MCWs) on the burden of Italian family members who care for a disabled older person.
  
  
  METHODS
  EUROFAMCARE is a one-year prospective survey carried out to provide evidence on the availability and use of support services by family carers of older people in Europe. In Italy, 990 family caregivers were enrolled and successful follow-ups were completed for 863 subjects. The survey also assessed the level of caregiver burden using the COPE index, which has three sub-sections: 'Positive Value' (PV), 'Quality of Support' (QS) and 'Negative Impact' (NI). We used the one-year change of the COPE-NI as dependent variable and we realised multilevel regression models to estimate the longitudinal predictors of caregivers' burden increase.
  
  
  RESULTS
  At a cross-sectional level, most burdened caregivers are those caring for a demented relative (COPE-NI = 13.6), with no educational title (14.5) and looking after their own spouses (15.1). Longitudinally those employing an MCW are significantly protected against burden increase (regression coefficient: -1.52; p < 0.01) while those who cannot rely on the support of other family members are exposed to the risk of burden increase (0.991; p < 0.05). Other formal services do not have any protective effect.
  
  
  CONCLUSIONS
  Our study suggests that employing an MCW, rather than using formal services, is associated with a reduction of caregiving burden. Further research should assess whether the shift in care responsibilities to the MCWs also implies a transfer of care burden, and understand how these workers can be better supported by existing formal services.
authors: Scientific Technological Area, National Institute for Health and Science on Ageing, INRCA, Ancona, Italy. c.chiatti@inrca.it
authors: Carlos
authors: C
authors: Chiatti
authors: Mirko
authors: M
authors: Di Rosa
authors: Maria Gabriella
authors: MG
authors: Melchiorre
authors: Lamberto
authors: L
authors: Manzoli
authors: Joseph M
authors: JM
authors: Rimland
authors: Giovanni
authors: G
authors: Lamura
mesh_terms: D017028:Caregivers / Q000523:psychology*; D017281:Cost of Illness; D006233:Persons with Disabilities; D005260:Female; D018576:Home Health Aides; D006801:Humans; D007558:Italy; D008297:Male; D011446:Prospective Studies; D012944:Social Support; D013315:Stress, Psychological / Q000517:prevention & control*; D011795:Surveys and Questionnaires