Appraisal, Burnout, and Caregiving in Dyads Living With Chronic Illness: A Dyad-Informed Analysis of Informal Care

Vollständiger Abstract

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Background: Informal caregivers play a central role in supporting adults living with chronic illness, particularly in contexts where family caregiving is culturally expected and formal support is limited. However, the extent to which caregiver burnout is associated with caregiving appraisal, psychological symptoms, and dyad-informed relational characteristics remains insufficiently understood. Objective: To examine caregiver burnout among informal caregivers of adults living with chronic illness and to identify associations between burnout and caregiving appraisal, psychological symptoms, caregiving characteristics, and dyad-informed variables. Methods: A cross-sectional correlational study was conducted with 104 patient–caregiver dyads recruited from inpatient and outpatient settings of a tertiary medical center in Lebanon. Participants completed questionnaires assessing caregiver burnout, caregiving appraisal and support, caregiver preparedness, anxiety and depressive symptoms, relationship quality, care typology, and concordance or discordance in perceived care patterns. Caregiver burnout was examined across 3 dimensions: emotional exhaustion, depersonalization, and personal accomplishment. Bivariate analyses and multivariable linear regression models were used to identify factors associated with each burnout dimension. Results: Caregivers reported moderate emotional exhaustion, low depersonalization, and high personal accomplishment. Higher perceived negative impact of caregiving and caregiver anxiety and depressive symptoms explained 68.1% of the variance in emotional exhaustion. Higher negative impact, depressive symptoms, and the presence of other caregivers explained 32.2% of the variance in depersonalization. Lower negative impact and higher positive appraisal of caregiving explained 21.5% of the variance in personal accomplishment. Conclusions: Caregiver burnout was most consistently associated with caregiving appraisal and psychological symptoms, while dyad-informed relational characteristics added important contextual insight. These findings highlight the need to integrate caregiver appraisal, mental health screening, and dyad-informed assessment into chronic illness care, particularly in settings where family caregiving is culturally expected and formal support is limited.