title: Health capability of family caregivers: how different factors interrelate and their respective contributions using a Bayesian approach.
abstract: The lifestyles of family caregivers pose risks to their physical, mental and social health. The capability to stay healthy may be protective in the context of poor socioeconomic conditions and risk behaviours, but the interrelations between its aspects and their respective influences remain unclear. The aim of this study was to evaluate the interrelations between the factors comprising health capability of family caregivers (HCFC) and the respective contributions of its components.
  
  
  
  All stroke patients admitted to all hospitals in Luxembourg were identified by the 'Inspection Générale de la Sécurité Sociale' using the national database system for care expenditure reimbursement, and asked to designate the main person caring for them. Sixty-two caregivers (mean age 59.3 years; 40 women and 22 men) responded face to face, to a questionnaire including 20 items measuring eight aspects of health capability (physical functioning, psychological functioning, lifestyle value, self-efficacy towards the use of health services, family support, social capital, material conditions/sense of security, and satisfaction with the interactions with health services). Using a Bayesian approach, significance values were estimated by comparing the test values to the posterior distribution of the parameters. Structural equation modelling with standard deviations was applied.
  
  
  
  Female family caregivers had lower scores than men in physical and psychological functioning. Family caregivers with the lowest incomes had the least lifestyle value, social capital and material conditions/security. Self-efficacy towards health services increased with age. The material conditions/sense of security factor was positively correlated with almost all the others. The items that impacted health capability factors the most were - for physical functioning - fatigue, and - for family support - feeling abandoned by the family.
  
  
  
  During the chronic phase, relationships between risk behaviours can help guide social and health decision-makers to determine their priorities in improving the lives of family caregivers. Enhancing health capability involves implementing programs that relieve family caregivers physically, and foster family networking around the person being cared for. Special attention should also be paid to the socially disadvantaged in order to fight inequalities in health capability.
authors.affiliation: University of Luxembourg, Research Unit INSIDE, Institute of Health & Behaviour, Maison des Sciences Sociales, Campus Belval, L-4633, Esch-sur-Alzette, Luxembourg.
authors.forename: Barbara
authors.initials: B
authors.lastname: Bucki
authors.affiliation: University of Lorraine, University Paris Descartes, APEMAC EA4360, Campus du Saulcy, 57006, Metz, France.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Spitz
authors.affiliation: Unité de psychologie de la santé, Faculté de Psychologie, Logopédie et Sciences de l'Education, University of Liège, 4000, Liège, Belgium.
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Etienne
authors.affiliation: University of Luxembourg, Research Unit INSIDE, Institute of Health & Behaviour, Maison des Sciences Sociales, Campus Belval, L-4633, Esch-sur-Alzette, Luxembourg.
authors.forename: Etienne
authors.initials: E
authors.lastname: Le Bihan
authors.affiliation: University of Luxembourg, Research Unit INSIDE, Institute of Health & Behaviour, Maison des Sciences Sociales, Campus Belval, L-4633, Esch-sur-Alzette, Luxembourg. michele.baumann@uni.lu.
authors.forename: Michèle
authors.initials: M
authors.lastname: Baumann
mesh_terms: D001499:Bayes Theorem; D017028:Caregivers / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D006304:Health Status; D006801:Humans; D008019:Life Style; D008189:Luxembourg; D008297:Male; D008875:Middle Aged; D010549:Personal Satisfaction; D020377:Self Efficacy; D017678:Sex Distribution; D012944:Social Support; D012959:Socioeconomic Factors; D000071939:Stroke Rehabilitation / Q000523:psychology / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires
keywords: Bayesian approach; Fatigue; Feeling abandoned; Health capability of family caregivers; Health inequalities; Material conditions; Stroke