Health outcomes of unpaid caregivers in low- and middleincome countries: A systematic review and meta-analysis
Aims and objectives To explore differences in health outcomes between unpaid caregivers and noncaregivers living in low- and middle-income countries (LMICs). Background Previous meta-analyses found worse health outcomes for unpaid caregivers in high-income nations. However, no meta-analysis has considered unpaid caregivers from LMICs. A systematic integration of this topic may contribute to nursing care for unpaid caregivers in LMICs. Design Systematic review and meta-analysis of observational studies. Methods Following PRISMA statement, studies were searched for using the CINAHL, PubMed and SciELO databases, limited to publications until 31 December 2019. Random- and fixed-effects meta-analyses were used for data synthesis. Results Fourteen studies from Africa, Asia and South America were included. Unpaid caregivers of people with ill-health were more anxious and depressed than noncaregivers. Studies conducted in Asia and South America reported poorer health outcomes for unpaid caregivers than noncaregivers, whereas the trend for African studies was the opposite. Unpaid caregivers of healthy individuals may have better health status than noncaregivers, particularly those caring between 1-14 hr per week. Of the six studies which examined gender differences, two studies informed worse health outcomes for women, one presented the opposite effect, and three found no differences. Conclusions Individual, social, cultural and systemic factors play an important role in the health outcomes of unpaid caregivers in LMICs. More evidence is needed from LMICs. As unpaid caregivers are predominantly female, urgent attention to the health outcomes of female unpaid caregivers is required. Relevance to clinical practice The management of mental health problems, particularly anxiety and depression, should be an integral part of nursing care for unpaid caregivers living in LMICs. To further promote the health of unpaid caregivers in developing countries, stakeholders should consider launching educational campaigns that assist caregivers in finding ways to meet their cultural obligations while also reinforcing caregiver self-care.
Office of Scientific and Technological Research (DICYT) of the Vice-Rector of Research, Development, and Innovation at the University of Santiago of Chile 021793MF_CONT 031693MF
Artículo de publicación ISI
Quote ItemJ Clin Nurs. 2020;29:3950–3965
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