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The relationship between environmental health status, the attributes of female caregivers and the health status of care recipients in low-income areas in Cape Town, South Africa

Thesis (DPhil (Environmental Health))--Cape Peninsula University of Technology, 2016. / Informal caregivers play an important role in the well-being of dependent members in a
household. The burdens of these caregivers are multiple and pervasive and may contribute
to mental health epidemiology as a result of worry, grief, anxiety and stress.
The literature review revealed that studies in caregiving and its various facets began from a
pragmatically applied interest rather than from theoretical and intellectual curiosity. The
majority of the research on caregiver burden involves meta-analysis of qualitative studies
with little quantitative research. Also, many of these studies are concentrated on caregivers
of chronically ill patients, such as those suffering from dementia, Alzheimer’s disease, and heart
disease, without much attention to care burden resulting from caring for those who are not
necessarily ill. Similar studies by other researchers did not consider the impact of the physical
health of the care recipients or the environmental factors that are critical in the study of female
caregiver burden in low-income settings. In addition, existing studies did not adequately
evaluate the many potential factors that may vary and influence the lives of the caregivers,
especially in a single, comprehensive model. This study attempted to provide a more complete
picture of these relationships in low-income and culturally diverse settings.
The study population consisted of black/African and coloured populations living in subsidised
or low-cost housing settlements. In each of the two different cultural communities, 100
black/African and 100 coloured female caregivers were selected through a systematic random
sampling procedure. In addition, data were also collected from caregivers in Tamale, Ghana to
assess differences between the socio-demographic profiles of the caregivers in Cape Town,
South Africa and Tamale, Ghana. The theoretical paradigm used in this study is the Stress
Process Model by Pearlin et al., (1990).
The study instrument assessed caregiver burden with both objective and subjective measures
through the use of a fully structured questionnaire. The information that was collected according
to the constructs of the Stress Process Model included personal and role strains and
incorporated the physical health of the care recipients and environmental factors such as
kitchen and toilet hygiene. Inclusion criteria for the respondents in both Cape Town and Tamale
were the principal female caregivers who were present, willing, and able to give informed
consent. The Statistical Package for Social Sciences (SPSS Version 22) was used for the
analyses. The Chi-square test was used to assess the relationships between environmental
health, the socio-demographics of the female caregivers and the health status of the care
recipients. The hierarchical regression analysis in the form of a General Linear Model was used
to model caregiving burden.
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The results showed that the majority of the female caregivers were in the age group 40 – 49
years and in both Cape Town and Tamale, a large proportion was in the low-income group.
Also, the majority of the informal caregivers in the two samples were in care tasks as a
full-time job, providing more than 40 hours of care per week. Regarding the length of time in
caregiving, a large proportion of the caregivers in both Cape Town and Tamale had been in
the care role for more than three years preceding the survey, and almost all the caregivers in
the Cape Town sample (98.4%) did not use any form of caregiving programme to ameliorate
the negative effects of caregiving. Further, the results showed statistically significant
relationships between the socio-demographic characteristics of female caregivers (age,
education, population group and income status) and the diarrhoea status of the care recipients.
Also, a significant relationship was shown between environmental health variables of the home
(kitchen hygiene and toilet hygiene) and the physical health of the care recipients. The
major predictors of female caregiver burden in the samples were the physical health of the care
recipients and access to social grants.
On the basis of the analyses, it was recommended that the government should recognise the
importance of the physical health of the care recipients and increase the amounts of social
grants to the caregivers since this could improve the circumstances of both the caregivers
and the care recipients. In addition, this could aid in improving the standard of living of
caregivers in these households. Future research in similar settings should disaggregate the
data to compare the burden of caring for caregivers of physically strong care recipients with
physically ill care recipients.

Identiferoai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:cput/oai:localhost:20.500.11838/2885
Date January 2016
CreatorsYakubu, Yakubu A.
ContributorsSchutte, De Wet, Prof
PublisherCape Peninsula University of Technology
Source SetsSouth African National ETD Portal
LanguageEnglish
Detected LanguageEnglish
TypeThesis

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