Title: Caregiver burden, psychosocial-religious profile and quality of life amongst older adults with chronic diseases in Yazd: a mixed method study

Abstract

Abstract

Caregiver burden, psychosocial-religious profile and quality of life amongst older adults with chronic diseases in Yazd: a mixed method study

Introduction: Aging and chronic diseases can lead to reduced quality of life. A process that may help maintain the quality of life is resilience. The use of religious coping strategies will also be an important and influential factor in the quality of life of the elderly people, and the strategies that elderly patients use to address the challenges of chronic disease can be important in predicting their quality of life. Among some groups, especially the elderly people and minorities, religion has been used more than any other source to counter threats and stress. The aim of this study was evaluation of caregiver burden, psychosocial-religious profile and quality of life amongst older adults with chronic diseases in Yazd.

Methods: The present study was a mixed method study of the sequential explanatory design, which was implemented in 2017-19 in two stages, quantitative and qualitative. The first stage of the present study was cross-sectional descriptive-analytical. The sample size in this study was 400 people (200 people in each Zoroastrian and Muslim group). The tools used included the World Health Organization Quality of Life -OLD, Connor and Davidson's Resilience Scale, the Pargament Religious coping Questionnaire, the Social Support Questionnaire, and the Caregiver Burden Assessment Scale. SPSS-24 software was used to analyze the data with a significant level of 0.05. Tests such as independent t-test, ANOVA, two-way analysis of variance were used to determine the factor load of each of the independent variables of multiple simultaneous regression. The second phase of the this study was a qualitative study with a content analysis approach. Participants in the qualitative stage included 14 Zoroastrian elders and 4 Zoroastrian priests who were purposefully selected and the information was collected through semi-structured interviews. Data analysis accomplished according to proposed steps by Graneheim and Lundman.

Results: The average score of positive religious coping in Muslim older adults was higher than that of Zoroastrian, but the mean score of negative religious coping, quality of life and resilience in Zoroastrian older adults was higher than Muslim (p <0.001). Also, the mean score of caregiver burden was higher in Zoroastrian caregivers. Analysis of qualitative findings led to the extraction of 713 primary codes, 18 subcategories and 3 main categories. The main themes extracted are: religious coping behaviors, beliefs related to religious coping, and challenges / barriers to religious coping.

Conclusion: In terms of positive and negative religious coping, the quality of life and resilience between Zoroastrian and Muslim older adults showed a significant difference due to various reasons such as education level, different socio-economic status and some religious factors as well as points hidden in Zoroastrian elderly interviews. The results of a qualitative study also provide new insights into how Zoroastrian seniors with chronic illnesses adapt to and accept or cope with their illness, what strategies they use in this regard, and with barriers of religious coping.

Keywords: Quality of life, Religious coping, Resilience, Social support, Caregiver burden, Older adults