Abstract
Introduction
The growing obstacles to balancing work and family caregiving responsibilities (work–family care obstacles) have led to heightened difficulties in work–life adjustment among employees, potentially resulting in decreased life satisfaction.
Objectives
The aims of this study were to investigate whether facing work–family care obstacles is associated with poor life satisfaction and whether it moderates the association between caregiver burden and life satisfaction among working family caregivers in Japan.
Methods
A cross-sectional descriptive study was conducted involving 141 family caregivers, all of whom were under 65 years old and living with older long-term care recipients. Multiple logistic regression analysis was conducted to examine the primary and moderating effects of work–family care obstacles on life satisfaction in the context of caregiver burden.
Results
Experiencing significant work–family care obstacles was associated with poor life satisfaction among employed family caregivers. Moreover, work–family care obstacles exacerbated the relationship between caregiver burden and poor life satisfaction. Family caregivers who faced work–family care obstacles and experienced two or more caregiver burdens exhibited poor life satisfaction (odds ratio = 5.51, 95% confidence interval = [1.97, 15.43]) compared to those who had one or fewer caregiver burden. For family caregivers without work–family care obstacle, the risk of poor life satisfaction did not vary depending on the number of caregiver burdens.
Conclusion
These findings suggest that work–life adaptation is more important than work–life balance for maintaining feelings of satisfaction in both life and work.
Keywords: work–family care obstacles, family caregiver, life satisfaction, well-being, work–life adaptation
Introduction
Life satisfaction is closely related to physical health and emotional well-being (Haybron, 2008), and comprises multiple domains of one's life, including work, family, and social networks. Higher work–family conflict can negatively affect life satisfaction; specifically, work–life conflict has a more significant impact on the life satisfaction of family caregivers living with an older care recipient (Clancy et al., 2020; Lam et al., 2022). Many studies on work–life conflict have focused on time aspects, emotional and physical strains, and role demands.
In the working population for individuals who provide care for an older loved one at home, experiences of work–family balance can differ for men versus women in Japan. Male working family caregivers living with family members can maintain a balance between work and family care without adjusting job demands and working time through support from a spouse or another family member (Gender Equality Bureau Cabinet Office, 2016; Clancy et al., 2020). However, female working family caregivers regardless of the presence of other family members have to balance their work–family care through combined adjustments of employment status and formal care options, including long-term care (LTC) services, such as adult day service, home-helper service, and short-stay respite care (Gender Equality Bureau Cabinet Office, 2016). Regardless of gender, providing care for a loved one for four or more hours a day on average is more likely to experience distress and perceive themselves as having poorer health and quality of life (Gender Equality Bureau Cabinet Office, 2021). Consistent with the findings of Lewis et al. (2007), female family caregivers may experience greater difficulties in achieving work–life balance compared to their male counterparts, leading to lower levels of life satisfaction.
Work–life balance is defined as the management of time, finances, and physical and emotional energies in response to the demands of both work and family roles, such as those of a parent, spouse, caregiver, and paid employee (Evandrou et al., 2002; Martinengo et al., 2010; Burch et al., 2019). In contrast, work–life adaptation is defined as the ability to adjust to the changing demands of both work and family roles. Researchers have argued for a shift away from achieving work–life balance toward increasing work–life adaptation (Ikegami, 2020; Kanda et al., 2022; Wang et al., 2020); work–life adaption is made possible with additional support from LTC and other care services. The increasing number of obstacles to balancing work and family caregiving responsibilities (work–family care obstacles), however, has led to more difficulties in adjusting to work and life among employees. In turn, these contexts may reduce life satisfaction. For the aims of this study, we defined work–family care obstacles as a lack of understanding at one's workplace regarding domestic care provision, limitations on an individual's usual social activities, and apprehension regarding one's life and work in the future because of reduced job-related benefits such as low income and reduced formal social insurance program. Above all, working family caregivers with an older frail relative are more likely to experience higher stress levels, feelings of social isolation, financial hardship, strained relationships within the family, and poor physical health due to caregiving responsibilities (Li et al., 2015). Increasing caregiving stressors and burdens are also associated with reduced life satisfaction (Ju et al., 2022). Therefore, working family caregivers may experience not only caregiving burden but also some work–family care obstacles.
The conflict between work and family life is not determined solely by maintaining or losing a proper balance between work and family life; for example, spending time together, managing emotional and physical strain from both roles, and satisfying employer demands (Netemeyer et al., 1996). Facing obstacles in balancing work and family caregiving roles contributes to work–family conflict and may lead to reduced life satisfaction. Role conflict due to multiple roles, such as those involving employment and caregiving, and marriage and parenting, are associated with poor life satisfaction (Fernández & Lay, 2020; Wang et al., 2020). The proportion of persons with multiple roles tends to be higher in the Japanese working generation (i.e., under 65 years old) compared with those aged 65 years or more (Gender Equality Bureau, Cabinet Office, Government of Japan, 2016). Previous studies have examined caregivers in the working generation who are living with older care recipients at home. While focusing on work–family conflict or work interruption, the literature has paid limited attention to caregiver life satisfaction outcomes (Clancy et al., 2020; Lam et al., 2022). Despite life satisfaction being a stronger predictor of adaptive psychosocial functioning for work and life (Suldo & Huebner, 2006), it remains unclear whether poor life satisfaction is related to facing work–family care obstacles, and whether these obstacles potentially exacerbate poor life satisfaction among employed family caregivers for their older relatives.
Review of Literature
Effects of Care Provision and Work on Life Satisfaction
Providing care for an older family member regardless of employment status has both positive and negative effects. Caregiving has the potential to strengthen the bond between the caregiver and the loved one (Boerner et al., 2004), and caring for an older family member is associated with providing a sense of purpose in life (Cohen et al., 2002). Some employed caregivers report positive spillover at work because they feel good about their role as a caregiver (Stephens et al., 1997). Caregiving also poses significant interference with work and other roles; employed individuals who also provide care for a loved one at home are more likely to experience job stress and decreased work productivity (Wolff et al., 2016), as well as higher levels of physical and emotional strain (Duxbury et al., 2011). Kimura et al. (2011) examined the mental health of working family caregivers of older dementia patients and found that one-third experienced burnout, and approximately half of them reported experiencing lower life satisfaction.
Obstacles Between Work and Caregiving
Family caregivers can experience increased work–life conflict because of obstacles such as making necessary adjustments to working times, and workloads because of family caregiving responsibilities, and supervisors or coworkers having difficulty understanding one's family caregiving needs (Fan et al., 2015; Wolff et al., 2016). The increasing number of work–family care obstacles has led to more difficulties in adjusting to work and life among employees. Therefore, work–family care obstacles may be associated with poor life satisfaction; specifically, they can exacerbate poor life satisfaction in the context of family caregiving.
The Present Study
For employed family caregivers, the dual roles of employment and caregiving are important factors associated with one's life satisfaction. According to a recent nationally representative survey in Japan, a total of 99,000 workers retired to care for a family member in 2016 (Ministry of Internal Affairs and Communications, 2018). Stress may still be a problem for caregivers, even when receiving some type of formal care support for their loved ones (Kurasawa et al., 2012). Family caregivers living together with the care receiver experience more caregiver burden than those whose loved ones live in a care facility (Metzelthin et al., 2017). The present study examined whether facing work–family care obstacles is associated with poor life satisfaction, specifically exploring whether work-related obstacles moderate the relationship between caregiver burden and life satisfaction among employed family caregivers living with older care recipients in Japan. The findings may provide strategies that not only improve caregiver life satisfaction but also promote work–life adaptation among working-generation family caregivers.
Research Questions
The authors of this study hypothesized that higher levels of work–family care obstacles are associated with poor life satisfaction, in the context of caregiver burden and other covariates (H1). The authors also hypothesized that work–family care obstacles exacerbate the relationship between caregiver burden and poor life satisfaction. Specifically, family caregivers experiencing work–family care obstacles have poor life satisfaction compared with those having no work–family care obstacles (H2).
Methods
Design
A cross-sectional descriptive survey was conducted using a self-administered questionnaire. This study conforms to the STrengthening the Reporting of Observational studies in Epidemiology (STROBE) guidelines (von Elm et al., 2008).
Sample
The study participants were 141 employed family caregivers under the age of 65 living with an older care recipient.
Inclusion and Exclusion Criteria
The participants who (1) provided care for their older relatives, (2) were living with the older care recipient, (3) were working outside the home, and (4) were younger than 65 years old were included. Participants (1) whose age or gender was missing or (2) who did not answer the question about life satisfaction were excluded.
Data Collection
The authors of this study explained the study protocol, including the survey's purpose, various ethical considerations, and the nature of voluntary participation explained by the directors of long-term care facilities in rural areas before recruiting the family caregivers. Figure 1 shows the sample selection of this study. After obtaining permission from the directors to conduct the survey, self-administered questionnaires were distributed to a sample of 2269 family caregivers (1473 persons with older care relatives who utilized community care services, 796 persons with older care relatives in a care facility) via postal mail between September 2015 and December 2017. Data for this study were collected from 1392 questionnaires and the response rate was 61.3%. Among the 1392 questionnaires, 330 were excluded due to “Refuse to accept a survey” (n = 286) and “All nonresponse to questionnaire” (n = 44), and the remaining were 1062 questionnaires. Of the 1062 persons, 568 persons were family caregivers with older care relatives who utilized community care services, and 494 persons were family caregivers with older care relatives in a care facility. Among the 568 family caregivers with older care relatives who utilized community care services, 427 family caregivers were excluded for “not living with the older care relatives” and/or “not working outside the home” and/or “being aged 65 or older.” A total of 141 employed family caregivers constituted the final sample (73.8% women).
Figure 1.
Sample selection.
Ethical Consideration
Permission to conduct the survey was obtained from the directors of all care facilities of Japan. The questionnaire was accompanied by a cover letter that outlined the study protocol, its objectives, and ethical considerations. Informed consent was obtained from all participants among family caregivers. The Institutional Ethics Committee of Nagasaki University School of Medicine reviewed and approved the current study (No. 15082038).
Measurements
Outcome Variables Life satisfaction
Suldo & Huebner (2006) defined life satisfaction as subjective well-being and adaptive psychosocial functioning. Diener et al. (1985) developed the Satisfaction with Life Scale (SWLS) as a reliable self-rating scale with five items that measure whether perceived life circumstances are in-line with individual standards. The present study used a single-item measure derived from the SWLS, “In general, how satisfied are you with your life?” Participants were asked to rate their life satisfaction on a five-point Likert scale ranging from 1 = very satisfied to 5 = very dissatisfied. The original life satisfaction measure was dichotomized such that 1 indicated very dissatisfied and dissatisfied, while 0 indicated very satisfied, satisfied, and intermediate.
Independent Variables
Number of work–family care obstacles. The items were developed questions that assessed work–family care obstacles for caregivers of older relatives based on a previous national survey (Gender Equality Bureau Cabinet Office, 2016). The following eight dichotomous items were identified and comprised the measure (1 = presence or 0 = absence; Cronbach's alpha = 0.56): (a) “My superior and coworkers do not understand my work and care situation”, (b) “I had to stop working and I cannot get my former job back”, (c) “I must reduce my working hours and/or days to care for my older relative”, (d) “I do not have enough days off for caregiving”, (e) “I must change my workplace or duties in the same company to care for my older relative”, (f) “I must change to another job or company to care for my older relative”, (g) “My steady income has decreased because of changes in my work style/schedule”, and (h) “My future life and caring for my older relative looks dim”. The eight work–family care obstacles were classified into the following three elements: receptive capacity in one's workplace in regard to domestic care provision (i.e., questions (a) and (b)), individual adjustments in social activity (i.e., questions (c), (d), (e), (f), and (g)), and suspense regarding one's life and work in the future (i.e., question (h)). A higher number of work–family care obstacles reflected a reduced ability to adapt to work–life demands. The mean number of work–family care obstacles in the present study was 0.78 (standard deviation [SD] = 1.12; range = 0–5).
Number of caregiver burdens. The items were developed questions that assessed the caregiver burden based on the Caregiver Strain Index (Robinson, 1983) and the Caregiver Burden Inventory (Novak & Guest, 1989). The measure was quantified using a set of eight dichotomous items, with responses encoded as 1 (yes) or 0 (no). The internal consistency of this scale was documented with a Cronbach’s alpha of 0.66. The items were organized into five indices: physical burden (consisting of two items), psychological burden (two items), financial burden (one item), distress related to social support (two items), and social restrictions (one item). Specifically, the physical burden index measured the presence of physical pain, targeting back, knee, and shoulder pain, as well as fatigue. The psychological burden index addressed challenges in communicating with the care recipient and the reduction in personal free time due to caregiving responsibilities. The index for distress related to social support evaluated the perceived inadequacy of information regarding care services and the absence of a dependable consultation resource for caregiving issues. The social restrictions index assessed constraints on the caregiver's ability to leave the home, reflecting the impact of caregiving on the caregiver's personal mobility and social life. Among the caregiver burdens examined, the mean number was 1.66 (SD = 1.57; range = 0–7), with a higher number reflecting greater burden and stress due to care provision for an older care relative.
Covariates Number of caregiving tasks
The items were developed questions on caregiving tasks based on a commonly used the Lawton–Brody instrumental activities of daily living scale (Lawton & Brody, 1969) and the Katz activities of daily living index (Katz et al., 1963). The assessment comprises five dichotomous items concerning whether the caregiver engages in the following tasks (coded as 1 = yes or 0 = no; Cronbach's alpha = 0.64): (a) providing physical care such as bathing, feeding, and dressing; (b) offering financial support (e.g., sending money, sharing the cost of care services); (c) assisting with household management; (d) communicating with care managers and professionals regarding the care recipient; and (e) completing necessary administrative procedures to access LTC services for an older family member. Among the caregiving tasks investigated, the mean number of tasks performed was 2.72 (SD = 1.48; range = 0–5), with a higher score indicating greater support provided to the older family member.
Employment status. The employment status of caregivers was dichotomized into part-time (= 0) or full-time (= 1).
Informal support for care provision. The participants were asked to indicate (0 = presence or 1 = absence) whether they received care support from family members, friends, or others.
Relationship between family caregiver and care recipient. Participants were required to assess their relationship with the care recipient using a validated single-item scale ranging from 1 (poor) to 5 (very good). Prior research has validated the reliability and validity of this measure in studies conducted by Bangerter et al. (2019) and Chunga et al. (2021).
The following measures were considered covariates in the models on life satisfaction: age, gender (0 = male or 1 = female), marital status (0 = married or 1 = unmarried or divorced), self-rated health condition (1 = very good, 2 = fairly good, 3 = intermediate, 4 = slightly poor, or 5 = poor), and behavioral symptoms of the older care recipient.
Statistical Analysis
The preliminary analysis included descriptive analysis of the sample (age, work–family care obstacles, caregiver burdens, BPSD of care recipient, and caregiving tasks). Next, a preliminary univariate logistic regression was performed to examine the associations between life satisfaction and each of the individual predictors, including the number of work–family care obstacles, caregiving tasks, caregiver burden, employment status, informal support for care provision, and the relationship between the family caregiver and the care recipient. To test H1, multiple logistic regression was performed to evaluate whether facing work–family care obstacles has the main effect on poor life satisfaction while controlling for all covariates. To test H2, multiple logistic regression was performed to evaluate the moderating effect of work–family care obstacles on the association between caregiver burdens and life satisfaction. The combination of work–family care obstacles and caregiver burdens was coded into the following four categories, where category 1 indicating “Work–family care obstacle (<1)” and “Caregiver burden (≤1)”, category 2 indicating “Work–family care obstacles (≥1)” and “Caregiver burden (≤1)”, category 3 indicating “Work–family care obstacle (<1)” and “Caregiver burdens (≥2)”, and category 4 indicating “Work–family care obstacles (≥1)” and “Caregiver burdens (≥2)”. Next, three dummy variables were created for categories 2, 3, and 4, with category 1 as the reference. A multiple logistic regression model was then conducted, including the prior dummy variables while controlling for covariates. Statistical hypothesis testing was conducted for each variable. Odds ratios for trend (the increase in the odds of the outcome for poor life satisfaction) and 95% CI for ORs were estimated. All analyses were conducted by using IBM SPSS Statistics 24.
Results
Sample Characteristics
Table 1 shows the characteristics of the study participants. The mean age was 56 (SD = 6.28; median = 57) years. Among the 141 working family caregivers, approximately 87% reported their health status as intermediate, fairly good, or very good, while 12.8% rated their health as poor. In addition, 106 family caregivers (75.2%) reported having caregiver burdens. The proportion of participants with poor life satisfaction was 36.9%. In addition, the mean number of behavioral symptoms per care recipient was 1.18 (SD = 1.43; median = 1).
Table 1.
Characteristics of the Working Family Caregivers Aged Less Than 65 Years Providing Care to an Older Relative (n = 141).
| Number (%) | |
|---|---|
| Age (years) | |
| Mean (SD) years | 56.01 (6.28) |
| Range | 34–64 |
| Gender | |
| Male | 37 (26.2) |
| Female | 104 (73.8) |
| Marital status | |
| Married | 87 (61.7) |
| Unmarried or divorced | 54 (38.3) |
| Self-rated health | |
| Intermediate, fair, or very good | 123 (87.2) |
| Poor or slightly poor | 18 (12.8) |
| Employment status | |
| Part time | 73 (51.8) |
| Full time | 68 (48.2) |
| Number of obstacles to balancing work and family caregiving responsibilities | |
| Mean (SD) | 0.78 (1.12) |
| Range | 0–5 |
| Caregiver burdens | |
| Mean (SD) | 1.66 (1.57) |
| Range | 0–7 |
| Number of BPSD of care recipient | |
| Mean (SD) | 1.18 (1.43) |
| Range | 0–5 |
| Number of caregiving tasks | |
| Mean (SD) | 2.72 (1.48) |
| Range | 0–5 |
| Support from family members, friends, or others | |
| Yes | 105 (74.5) |
| No | 35 (24.8) |
| Unknown | 1 (0.7) |
| Relationship between the family caregiver and the care recipient | |
| Poor or slightly poor | 7 (5.0) |
| Intermediate, fair, or very good | 125 (88.7) |
| Unknown | 9 (6.4) |
| Life satisfaction | |
| Unsatisfied | 52 (36.9) |
| Intermediate, satisfied | 89 (63.1) |
Note. BPSD = behavioral and psychological symptoms of dementia, SD = standard deviation.
Research Question Results
Table 2 and Appendix 1 show the work–family care obstacles related to life satisfaction (H1) based on the univariate and multiple logistic regression analyses. The results of both univariate and multiple logistic regressions suggested that facing work–family care obstacles (odds ratio [OR] = 3.38, 95% confidence interval [CI] = [1.64, 6.96]; and OR = 3.18, 95% CI = [1.27, 7.99], respectively) was associated with poor life satisfaction among employed family caregivers. These results supported H1. The family caregiver's characteristics (age, gender, and marital status), employment status, caregiving tasks, informal care support, and relationship between the family caregiver and the care recipient were not statistically significant.
Table 2.
Results of Number of Obstacles to Balancing Work and Family Caregiving Responsibilities (Work–Family Care Obstacles) and Caregiver Burdens in Univariate/Multiple Logistic Regression Models for Life Satisfaction.
| Life satisfied | Life unsatisfied | Univariate regression | Multiple regression | ||||||
|---|---|---|---|---|---|---|---|---|---|
| Number (%) | 89 (63.1) | 52 (36.9) | OR | 95%CI | p value | OR | 95% CI | p value | |
| Number of obstacles to balancing work and family caregiving responsibilities | |||||||||
| 0 | 60 (75.9) | 19 (24.1) | Ref. | .001 | Ref. | .014 | |||
| ≥1 | 29 (48.3) | 31 (51.7) | 3.38 | 1.64–6.96 | 3.18 | 1.27–7.99 | |||
| Caregiver burdens | |||||||||
| 0–1 | 58 (74.4) | 20 (25.6) | Ref. | .002 | Ref. | .424 | |||
| ≥2 | 31 (49.2) | 32 (50.8) | 2.99 | 1.47–6.08 | 1.45 | 0.58–3.62 | |||
Note. OR = odds ratio, 95% CI = 95% confidence interval.
The results were adjusted by age, gender, marital status, self-rated health, employment status, number of BPSD of care recipient, number of caregiving tasks, support from family members/friends/others, and relationship between the family caregiver and the care recipient.
In the univariate analysis, although the number of caregiver burdens was significantly associated with poor life satisfaction (OR = 2.99; 95% CI = [1.47, 6.08]), the association between life satisfaction and the number of caregiver burdens was not significant in the multiple analysis (OR = 1.45; 95% CI = [0.58, 3.62]). The impact of the number of caregiver burdens on life satisfaction was moderated by the number of work–family care obstacles.
Table 3 and Appendix 2 show parameter estimates from the hypothesized moderation model for H2. Experiencing significant work–family care obstacles was associated with poor life satisfaction among employed family caregivers. Moreover, work–family caregiving obstacles exacerbated the relationship between caregiver burden and poor life satisfaction. Specifically, family caregivers who faced work–family care obstacles and experienced two or more caregiver burdens exhibited poor life satisfaction (OR = 5.51, 95% CI = [1.97, 15.43]) compared to those who had one or fewer caregiver burden. In contrast, family caregivers who had 2 or more caregiver burdens but did not experience work–family care obstacles were not significantly associated with poor life satisfaction (OR = 1.01; 95% CI = [0.29, 3.50]). The findings showed that family caregivers with more work–family care obstacles, compared with those having less work–family care obstacles, had poor life satisfaction supported H2.
Table 3.
Results of Moderations Between Number of Obstacles to Balancing Work and Family Caregiving Responsibilities (Work–Family Care Obstacles) and Caregiver Burdens Using Multiple Logistic Regression Models for Life Satisfaction.
| OR | 95% CI | p value | |
|---|---|---|---|
| Number of work–family care obstacles × Caregiver burdens | |||
| Work–family care obstacle (<1) × Caregiver burden (≤1) | Ref. | ||
| Work–family care obstacles (≥1) × Caregiver burden (≤1) | 0.79 | 0.13–4.70 | .794 |
| Work–family care obstacle (<1) × Caregiver burdens (≥2) | 1.01 | 0.29–3.50 | .983 |
| Work–family care obstacles (≥1) × Caregiver burdens (≥2) | 5.51 | 1.97–15.43 | .001 |
Note. OR = odds ratio, 95% CI = 95% confidence interval.
The results were adjusted by age, gender, marital status, self-rated health, employment status, number of BPSD of care recipient, number of caregiving tasks, support from family members/friends/others, and relationship between family caregiver and care recipient.
Discussion
Work, family caregiving, and leisure time are each a part of life, and the satisfaction with each part depends on whether individuals can continuously adapt to change. The present study aimed to examine the impact of work–family care obstacles on life satisfaction among employed individuals caring for an older relative in Japan. The initial results of the analysis support prior findings, namely, that facing work–family care obstacles is associated with poor life satisfaction. Bakkeli (2021) reported that a negative work situation was associated with lower life satisfaction. In the present study, work–family care obstacles (e.g., more difficulties in adjusting to work and life) was an important factor related to life satisfaction among employed family caregivers (see Table 2 and 3). Workplaces should consider the domestic work responsibilities of their employees caring for older relatives to help prevent decreased life satisfaction. In fact, a direct point of intervention for employers is to minimize the obstacles needed for their employees to care for older loved ones.
In this study, caregiver burdens indirectly impacted life satisfaction by facing work–family care obstacles. Consistent with prior research findings (Duxbury et al., 2011; Kimura et al., 2011), caregiver burden was related to well-being and affected by work–family care obstacles. Therefore, family caregivers who reduce the work–family care obstacles will be better able to maintain their life satisfaction more effectively, even if they have caregiver burdens.
Poor life satisfaction was associated with poor self-rated health among employed family caregivers in the present study. A poor health condition is associated with not only poor life satisfaction but also work–life conflict (Duxbury et al., 2011; O'Dea et al., 1999). Both life satisfaction and health conditions differ by individual responsibilities and the pressure related to work and domestic roles. Family care support includes not only understanding of domestic care from supervisors or coworkers, but also support from utilizing LTC insurance services. Among the family caregivers who experienced poor life satisfaction and/or poor self-rated health due to providing care to an older relative, utilizing LTC insurance services, such as adult day service, home-helper service, and short-stay respite care, more frequently is also important for improving life satisfaction and reducing physical burden. These findings suggest a direct point of intervention for employers: to minimize the obstacles needed for their employees to care for their older loved ones.
Strengths and Limitations
The limitations of the present study were six-fold. First, the authors did not conduct a detailed examination of employment situations, so nuanced analyses of the associations between work-related characteristics and life satisfaction were not possible. Second, some obstacles are related to poor life satisfaction, but which ones are also related to poor life satisfaction is unclear. Further studies need to investigate the impact of individual obstacles on life dissatisfaction and develop obstacle measures with greater validity and reliability. Third, since the authors did not collect detailed socioeconomic status information, the authors were unable to analyze the association between family income and caregiver burden, which is worth further study. Fourth, due to the small and limited sample size in this study, caution should be exercised when generalizing the current findings to other populations. Fifth, since the response rate was 61%, some selection bias may have occurred, potentially undermining the internal validity of the present study. Finally, the cross-sectional nature of the study design precluded the establishment of a causal relationship between predictors and life satisfaction. Despite these limitations, the results of this study expand prior work on life satisfaction by demonstrating that work–family care obstacles are associated with poor life satisfaction.
Implications for Practice
The association between caregiver burden and poor life satisfaction can vary depending on work–family care obstacles. Therefore, nursing staff who provided community-based care or occupational health care must consider for developing a comprehensive understanding of moderating effect of work–family care obstacles among family caregivers. Especially, it will be important to consider how to improve adaptation between work and caregiving for family.
Conclusion
For employed family caregivers in Japan, facing obstacles between work and family caregiving was associated with poor life satisfaction. We also found that obstacles between work and family caregiving moderated the impact of caregiver burdens on life satisfaction. Recently, the shift from institutional care to home- and community-based care has been accelerating, as have the demands for informal care. Therefore, the number of employees who must provide care for older relatives is expected to increase. The government must promote flexible work depending on individual family care situations to support work–life adaptation among workers. While there has been a push to increase care support and help caregivers reduce subjective feelings of burden for many years, a key intervention that employers can endorse is reducing obstacles for their employees. By reducing obstacles, employers can recognize and contribute to their employees’ multifaceted perceptions of success and life satisfaction.
Supplemental Material
Supplemental material, sj-docx-1-son-10.1177_23779608241293686 for Work–Family Care Obstacles and Life Satisfaction among Japanese Working Family Caregivers Living with an Older Care Recipient by Ayumi Honda, Yin Liu, Elizabeth B. Fauth and Sumihisa Honda in SAGE Open Nursing
Supplemental material, sj-docx-2-son-10.1177_23779608241293686 for Work–Family Care Obstacles and Life Satisfaction among Japanese Working Family Caregivers Living with an Older Care Recipient by Ayumi Honda, Yin Liu, Elizabeth B. Fauth and Sumihisa Honda in SAGE Open Nursing
Acknowledgments
The authors express their gratitude to all participants for their invaluable contributions to this study.
Appendix
Appendix 1.
Results of univariate/multiple logistic regression models for life satisfaction.
| Life satisfied | Life unsatisfied | Univariate regression | Multiple regression | |||||
|---|---|---|---|---|---|---|---|---|
| Number (%) | 89 (63.1) | 52 (36.9) | OR | 95% CI | p | OR | 95% CI | p |
| Age (years) | ||||||||
| ≥58 | 46 (65.7) | 24 (34.3) | Ref. | .526 | Ref. | .833 | ||
| <57 | 43 (60.6) | 28 (39.4) | 1.25 | 0.63–2.48 | 1.09 | 0.48–2.49 | ||
| Gender | ||||||||
| Male | 26 (70.3) | 11 (29.7) | Ref. | .296 | Ref. | .076 | ||
| Female | 63 (60.6) | 41 (39.4) | 1.54 | 0.69–3.45 | 2.74 | 0.90–8.30 | ||
| Marital status | ||||||||
| Married | 56 (64.4) | 31 (35.6) | Ref. | .697 | Ref. | .500 | ||
| Unmarried or divorced | 33 (61.1) | 21 (38.9) | 1.15 | 0.57–2.32 | 1.34 | 0.57–3.15 | ||
| Self-rated health | ||||||||
| Intermediate, fair, or very good | 82 (66.7) | 41 (33.3) | Ref. | .028 | Ref. | .012 | ||
| Poor or slightly poor | 7 (38.9) | 11 (61.1) | 3.14 | 1.13–8.71 | 4.93 | 1.41–17.19 | ||
| Employment status | ||||||||
| Part time | 48 (65.8) | 25 (34.2) | Ref. | .502 | Ref. | .203 | ||
| Full time | 41 (60.3) | 27 (39.7) | 1.26 | 0.64–2.51 | 1.79 | 0.73–4.40 | ||
| Number of obstacles to balancing work and family caregiving responsibilities | ||||||||
| 0 | 60 (75.9) | 19 (24.1) | Ref. | .001 | Ref. | .014 | ||
| ≥1 | 29 (48.3) | 31 (51.7) | 3.38 | 1.64–6.96 | 3.18 | 1.27–7.99 | ||
| Caregiver burdens | ||||||||
| 0–1 | 58 (74.4) | 20 (25.6) | Ref. | .002 | Ref. | .424 | ||
| ≥2 | 31 (49.2) | 32 (50.8) | 2.99 | 1.47–6.08 | 1.45 | 0.58–3.62 | ||
| Number of BPSD of care recipient | ||||||||
| 0 | 43 (67.2) | 21 (32.8) | Ref. | .362 | Ref. | .377 | ||
| ≥1 | 46 (59.7) | 31 (40.3) | 1.38 | 0.69–2.76 | 1.47 | 0.63–3.44 | ||
| Number of caregiving tasks | ||||||||
| 0–2 | 35 (62.5) | 21 (37.5) | Ref. | .901 | Ref. | .163 | ||
| ≥3 | 54 (63.5) | 31 (36.5) | 0.96 | 0.48–1.92 | 0.54 | 0.23–1.29 | ||
| Support from family members, friends, or others | ||||||||
| Yes | 68 (64.8) | 37 (35.2) | Ref. | .420 | Ref. | .815 | ||
| No | 20 (57.1) | 15 (42.9) | 1.38 | 0.63–3.01 | 1.13 | 0.42–3.03 | ||
| Relationship between the family caregiver and the care recipient | ||||||||
| Intermediate, fair, or very good | 79 (63.2) | 46 (36.8) | Ref. | .292 | Ref. | .274 | ||
| Poor or slightly poor | 3 (42.9) | 4 (57.1) | 2.29 | 0.49–10.69 | 2.77 | 0.45–17.12 | ||
Note. BPSD = behavioral and psychological symptoms of dementia, OR = odds ratio, 95% CI = 95% confidence interval.
Appendix 2.
Results of moderations between number of obstacles to balancing work and family caregiving responsibilities (work–family care obstacles) and caregiver burdens using multiple logistic regression models for life satisfaction.
| OR | 95% CI | p | |
|---|---|---|---|
| Age (years) | |||
| ≥58 | Ref. | .634 | |
| <57 | 1.23 | 0.53–2.86 | |
| Gender | |||
| Male | Ref. | .113 | |
| Female | 2.53 | 0.80–7.95 | |
| Marital status | |||
| Married | Ref. | .594 | |
| Unmarried or divorced | 1.27 | 0.53–3.04 | |
| Self-rated health | |||
| Intermediate, fair, or very good | Ref. | .012 | |
| Poor or slightly poor | 5.32 | 1.43–19.73 | |
| Employment status | |||
| Part time | Ref. | .303 | |
| Full time | 1.62 | 0.65–4.05 | |
| Number of BPSD of care recipient | |||
| 0 | Ref. | .303 | |
| ≥1 | 1.58 | 0.66–3.79 | |
| Number of caregiving tasks | |||
| 0–2 | Ref. | .165 | |
| ≥3 | 0.53 | 0.21–1.30 | |
| Support from family members, friends, or others | |||
| Yes | Ref. | .941 | |
| No | 0.96 | 0.34–2.69 | |
| Relationship between family caregiver and care recipient | |||
| Intermediate, fair, or very good | Ref. | .315 | |
| Poor or slightly poor | 2.65 | 0.39–17.75 | |
| Number of work–family care obstacles × Caregiver burdens | |||
| Work–family care obstacle (<1) × Caregiver burden (≤1) | Ref. | ||
| Work–family care obstacles (≥1) × Caregiver burden (≤1) | 0.79 | 0.13–4.70 | .794 |
| Work–family care obstacle (<1) × Caregiver burdens (≥2) | 1.01 | 0.29–3.50 | .983 |
| Work–family care obstacles (≥1) × Caregiver burdens (≥2) | 5.51 | 1.97–15.43 | .001 |
Note. BPSD = behavioral and psychological symptoms of dementia, OR = odds ratio, 95% CI = 95% confidence interval.
Footnotes
Declaration of Conflicting Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding: The authors acknowledge the receipt of the following financial support for the research, authorship, and/or publication of this article. This work was supported by the Sasakawa Scientific Research Grant (No. 27-627) from The Japan Science Society and JSPS KAKENHI Grant Number 17K12460.
Supplemental Material: Supplemental material for this article is available online.
ORCID iD: Ayumi Honda https://orcid.org/0000-0003-1068-5755
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Supplemental material, sj-docx-1-son-10.1177_23779608241293686 for Work–Family Care Obstacles and Life Satisfaction among Japanese Working Family Caregivers Living with an Older Care Recipient by Ayumi Honda, Yin Liu, Elizabeth B. Fauth and Sumihisa Honda in SAGE Open Nursing
Supplemental material, sj-docx-2-son-10.1177_23779608241293686 for Work–Family Care Obstacles and Life Satisfaction among Japanese Working Family Caregivers Living with an Older Care Recipient by Ayumi Honda, Yin Liu, Elizabeth B. Fauth and Sumihisa Honda in SAGE Open Nursing