Study design, materials and methods
The study was a cross-sectional design conducted from June 2018 to February 2019 involving family caregivers who stay with the patients at home and are involved in direct care of elderly patients with incontinence. A door-to-door survey using snowball technique identified 103 caregivers of elderly and included in the study. Incontinence questions using International Continence Society’s current terminology was used for the inclusion of elderly participants. A family caregiver definition for this study is someone who has completed at least 18 years and providing care to a relative; the elderly who has completed 60 years of age and suffering from incontinence condition for which they need to care and assist, and live at home of the elderly. The subjects were explained regarding objectives and duration of the study. Data was obtained from 103 patients using Revised Urinary Incontinence Scale (RUIS) to assess elderly patient’s incontinence, Demographic data like age, gender, habitat, educational status, marital status, continence status of the cared elderly, their relationship and the duration of care were collected for care receiver and caregiver. Modified Caregivers Strain Index (MCSI) used to measure the caregiver strain and WHOQol-BREF questionnaire to assess caregiver’s quality of life. The scoring of short 5 items RUIS are categorized as mild(4-8),moderate(9-12),severe (13 or above).MCSI consists 13 items with a maximum score of 26 and minimum of zero and measures financial, physical, psychological, social, and personal strain. The caregiver strain was categorized as low (0-8), moderate (9-18), and high (19-26).The WHOQol-BREF questionnaire consists of 24 items with four domains: Physical health(7 items), psychological health(6items),social relationship(3 items), and environmental health(8 items). Higher scores denote higher quality of life. The data was analyzed using descriptive and inferential statistics. Frequency and percentages were used for descriptive and student’s t-test was used to compare means of different groups. Pearson correlation was used to find out significant relationships. All the analysis was done using SPSS 17 and a significant was considered p<0.05.
We assessed 103 elderly subjects above 60 years, among whom 63 were female and 39 were male. The average time spent by the caregivers was found to be 15.52 months and there were 33 male and 70 female caregivers, daughters were 35.9%, sons were 26.2% .The marital status of caregivers showed that 89 were married, 10 were widowed and 4 were divorced. In terms of educational qualification of caregivers, majority of them had a graduation (71.8%) and were doing business or were employed in government setting. Comparison of urinary incontinence of elderly using the revised urinary incontinence scale showed that there was no statistical significant difference found between male and female patients p=0.189 and moderate incontinence has been noted.About 51.54% of the caregivers were found to have mild burden, 35% with moderate burden, and 13.6% having severe burden.75% of caregivers reported that caregiving contributed to financial strain.Sleep disturbance was reported by 24.3% caregivers,while 72.15% of them felt that caregiving lead to physical strain and 24.3% felt overwhelmed due to the care giving experience. There was no statistical significant difference found on caregiver’s strain between male and female p=0.531. There was no statistical difference found on psychological dimension of quality of life p>0.05.When comparing the male and female caregivers on quality of life, there was no statistical difference found on psychological dimension of quality of life p>0.05.On the contrary, there was a statistical difference found on physical, social and environmental dimension of quality of life p<0.05. There was a positive correlation found between the age of caregivers and month of care they delivered to the elderly, also the there was positive relationship found on strain perceived by the caregivers r=0.232, p=0.018. There was no relationship found when male and female were compared for relationship between age and strain perceived.
Interpretation of results
The present study was carried out on the family caregivers of the elderly patients with urinary incontinence. Most of the elderly in our study were females which was consistent with research studies.. Elderly in this study had moderate urinary incontinence. The majority of caregivers in the present study were daughters (35.9%) and sons (26.2%) of the patients. We noted majority of the caregivers have a mild level of burden (51.54%).Gender difference (33 male and 70 female caregivers), is observed in this study which is likely due to sociocultural factors  .Caregiving for a longer duration can have tremendous negative effects on caregivers’ physical health and quality of life.Sociocultural factors,economical status can play a pivotal role increasing caregiver strain.Age of the caregiver had a significant relationship with caregiver burden. Managing caregiving along with job and household activities would add to their stress.Other demographic factors of the caregivers such as gender, education, marital status were found to have no significant influence on the care burden in this study.