The relationships between depression and other outcomes of chronic illness caregiving

The sample for this secondary data analysis consisted of 236 and 271 subjects from the Americans' Changing Lives, Wave 1, 1986, and Wave 2, 1989, data sets. Measures were constructed from the original study. Structural equation modeling was used to test the hypothesized model, and an exploratory structural modeling method, specification search, was used to develop a data-derived model. Cross-validation was used to verify the paths among variables.Hours of care, age, and gender predicted caregivers' outcomes directly or through perceived caregiver stress (p < .01). Depression mediated the relationship between perceived stress and psychological outcomes and explained 40% and 11% of the variance in self-esteem and marital satisfaction, respectively.Depression predicted psychological outcomes. Whether depression predicts physical health outcomes needs to be further explored.It is estimated that 31–55% of caregivers of chronically ill elderly relatives experience depression [1], and depression is likely to be one of the first [2] and most enduring psychological outcomes for caregivers [3,4]. Caregivers' depression scores have been found to be substantially higher than those of the general population [1,5,6], and higher levels of caregiving stress have been related to greater depression [7,8] and to more depressive symptoms in caregivers [9].Factors that may be related to stress and depression in caregivers include hours of care, stressful life events, social support, age, and gender. Studies have found that hours of care were significantly related to caregivers' anxiety/depression and somatic symptoms [10,11], and to their emotional and physical strain [12]. Though stressful life events have been associated with both psychological wellbeing [13,14] and physical symptoms among the general population [14], no studies have examined stressful life events in combination with caregiving stress. Stressful life events might have additional impact on caregivers' health other than