Factors associated with high psychological distress in primary carers of people with disability

Abstract

In Australia, there are 856,000 primary caregivers providing extensive informal care in terms of assistance to people with disability in daily activities such as eating and showering.1 The total replacement cost, defined as the total value that would need to be diverted from the formal economy to replace the services provided by informal carers, has been estimated to reach $60 billion a year.2 However, extensive informal caregiving is a stressor for many people who are caring for people with disability,3 and it is associated with increased all-cause mortality risks when compared with their non-caregiving counterparts.4 Poorer psychological health has been observed among primary carers.3 Identification of primary carers with different characteristics and needs is crucial to inform mental health services for providing appropriate care.5 Psychological distress, a well-established measure reflecting complicated personenvironment elements, is useful for informing mental health services and intervention strategies.6 However, empirical research to assess prevalence rates and investigate modifiable risk factors in the general population is limited. Using multistage sampling schemes, the ABS conducted the 2015 SDAC with strict quality control measures to ensure survey coverage, reliability and confidentiality to derive a nationally representative sample.7 It comprised rich individual demographic, socioeconomic and contextual environmental information for primary carers of people with disability.8 Additional approval for the current study was granted by the Australian National University Human Research Ethics Committee (Reference: 2017/175). The 'glmnet' package was first used to run lasso models performing variable selection in the presence of multicollinearity.11 Multivariable logistic regression was then performed using the 'survey' package to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for high psychological distress in relation to the selected explanatory variables. [...]prospective study of these factors on carers' mental health is warranted. [...]bias may arise partly as a result of errors in self-reporting and data collection.