title: Influence of family dynamics on burden among family caregivers in aging Japan.
abstract: Long-term care for the elderly is largely shouldered by their family, representing a serious burden in a hyper-aging society. However, although family dynamics are known to play an important role in such care, the influence of caring for the elderly on burden among caregiving family members is poorly understood.
  
  
  
  To examine the influence of family dynamics on burden experienced by family caregivers.
  
  
  
  We conducted a cross-sectional study at six primary care clinics, involving 199 caregivers of adult care receivers who need long-term care. Participants were divided into three groups based on tertile of Index of Family Dynamics for Long-term Care (IF-Long score), where higher scores imply poorer relationships between care receivers and caregiving family: best, <2; intermediate, 2 to <5; worst, ≥5. The mean differences in burden index of caregivers (BIC-11) between the three groups were estimated by linear regression model with adjustment for care receiver's activity of daily living and cognitive function.
  
  
  
  Mean age of caregivers was 63.2 years (with 40.7% aged ≥ 65 years). BIC-11 scores were higher in the worst IF-Long group (adjusted mean difference: 4.4, 95% confidence interval: 1.2 to 7.5) than in the best IF-Long group. We also detected a positive trend between IF-Long score and BIC-11 score (P-value for trend <0.01).
  
  
  
  Our findings indicate that family dynamics strongly influences burden experienced by caregiving family members, regardless of the care receiver's degree of cognitive impairment. These results underscore the importance of evaluating relationships between care receivers and their caregivers when discussing a care regimen for care receivers.
authors.affiliation: The Hokkaido Centre for Family Medicine, Hokkaido, Japan.
authors.forename: Tesshu
authors.initials: T
authors.lastname: Kusaba
authors.affiliation: The Hokkaido Centre for Family Medicine, Hokkaido, Japan.
authors.forename: Kotaro
authors.initials: K
authors.lastname: Sato
authors.affiliation: Department of Healthcare Epidemiology, Kyoto University School of Public Health and Graduate School of Medicine, Kyoto, Japan, Center for Innovative Research for Communities and Clinical Excellence (CIRC2LE), Fukushima Medical University, Fukushima, Japan, Institute for Health Outcomes and Process Evaluation Research (iHope International), Kyoto, Japan and fukuma.shingo.3m@kyoto-u.ac.jp.
authors.forename: Shingo
authors.initials: S
authors.lastname: Fukuma
authors.affiliation: Department of Healthcare Epidemiology, Kyoto University School of Public Health and Graduate School of Medicine, Kyoto, Japan, Institute for Health Outcomes and Process Evaluation Research (iHope International), Kyoto, Japan and.
authors.forename: Yukari
authors.initials: Y
authors.lastname: Yamada
authors.affiliation: The Hokkaido Centre for Family Medicine, Hokkaido, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Matsui
authors.affiliation: The Hokkaido Centre for Family Medicine, Hokkaido, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Matsuda
authors.affiliation: The Hokkaido Centre for Family Medicine, Hokkaido, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Ando
authors.affiliation: Department of Regulatory Science, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Sakushima
authors.affiliation: Department of Healthcare Epidemiology, Kyoto University School of Public Health and Graduate School of Medicine, Kyoto, Japan, Center for Innovative Research for Communities and Clinical Excellence (CIRC2LE), Fukushima Medical University, Fukushima, Japan, Institute for Health Outcomes and Process Evaluation Research (iHope International), Kyoto, Japan and.
authors.forename: Shunichi
authors.initials: S
authors.lastname: Fukuhara
mesh_terms: D000368:Aged; D000375:Aging; D017028:Caregivers / Q000523:psychology*; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005195:Family Relations; D005260:Female; D006801:Humans; D007564:Japan; D016014:Linear Models; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care
keywords: Aged; caregivers; family; long-term care; primary care physicians; primary health care.