title: Caregiving demands and caregivers' psychological outcomes: the mediating role of perceived injustice.
abstract: OBJECTIVE
  This study hypothesized that higher caregiving demands are related to higher perceived injustice. Furthermore, this study investigated the mediating role of perceived injustice in the link between caregiving demands and caregivers' psychological well-being.
  
  
  METHODS
  A cross-sectional design.
  
  
  METHODS
  The Pain Centre of the university medical centre.
  
  
  METHODS
  Participants were 184 family caregivers of patients with chronic musculoskeletal pain.
  
  
  METHODS
  Participants completed questionnaires that assessed caregiving demands (i.e. The Dutch Objective Burden Inventory), perceived injustice (i.e. The Injustice Experience Questionnaire), how much they considered different sources responsible for the injustice they experienced (i.e. A newly developed inventory), perceived burden (i.e. The Zarit Burden Interview), distress (i.e. The Depression, Anxiety, and Stress Scale), and anger (i.e. The Hostility subscale of the Symptom Checklist-90-Revised).
  
  
  RESULTS
  The findings showed that caregiving demands are significantly related to perceived injustice in family caregivers (r = .44; P < .001). Only a small group of family caregivers considered the patient or themselves responsible, but more than half of the caregivers considered healthcare providers at least somewhat responsible for the unjust situation. Finally, perceived injustice mediated the association between caregiving demands and burden (b = .11, CI: .04-.23) and distress (b = .05, CI: .006-.12), but not anger (b = .008, CI: -.01-.06).
  
  
  CONCLUSIONS
  The findings suggest that perceived injustice plays an important role in the well-being of family caregivers and caregivers' well-being may be improved by changing their perceptions about their caregiving tasks and their condition.
authors.affiliation: 1 Health Psychology Department, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.|2 Centre for Pediatric Pain Research, IWK Health Centre, Halifax, Canada.
authors.forename: Somayyeh
authors.initials: S
authors.lastname: Mohammadi
authors.affiliation: 3 Pain Centre, Department of Anesthesiology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Maaike J
authors.initials: MJ
authors.lastname: de Boer
authors.affiliation: 1 Health Psychology Department, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.|4 Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands.
authors.forename: Robbert
authors.initials: R
authors.lastname: Sanderman
authors.affiliation: 1 Health Psychology Department, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Mariët
authors.initials: M
authors.lastname: Hagedoorn
mesh_terms: D017028:Caregivers / Q000523:psychology*; D002908:Chronic Disease; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005260:Female; D006791:Hostility; D006801:Humans; D008297:Male; D008875:Middle Aged; D059352:Musculoskeletal Pain / Q000523:psychology* / Q000534:rehabilitation; D009426:Netherlands; D013315:Stress, Psychological / Q000209:etiology / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: Injustice; chronic pain; demands; distress; family caregivers