ReviewPhysical activity in caregivers: What are the psychological benefits?
Introduction
In the last decade there has been an expansion of research on the benefits associated with physical activity in adults of all ages. Physical activity (PA) has both physical and psychological health benefits. Studies have demonstrated that PA reduces the risk of cardiovascular disease (Dubbert, 2002) and some cancers, improves pulmonary function, reduces the risk of some chronic diseases, minimizes falls and improves pain management (Warburton, Nicol, & Bredin, 2006). PA has been found to decrease morbidity and mortality (Warburton et al., 2006). Psychological benefits include stress reduction and prevention and improvement of depressive symptoms (Castro, Wilcox, O'Sullivan, Baumann, & King, 2002) and improved sleep (King, Baumann, O'Sullivan, Wilcox, & Castro, 2002). There is also evidence to suggest that PA can improve cognition (Lautenschlager, Cox, & Cyarto, 2012).
In studies focusing on older people, PA improves balance, strength and gait, endurance and general quality of life (Blake, Mo, Malik, & Thomas, 2009). It may also delay mobility limitations and further disability so that independent living can continue (Bennett & Winters-Stone, 2011). Psychological benefits of PA in older people include improvements in cognitive function, mood and well-being (Kerse et al., 2010).
The term “carer” or “caregiver” is commonly defined as someone who provides care to another person who is dependent on the caregiver for help (Oyebode, 2003). Informal caregivers are unpaid, and are usually spouses or other family members. They are a vulnerable group of people (Oyebode, 2003) who play an important role in providing practical help and support, which enables people with chronic conditions to remain living in the community. Although there are positive aspects to providing care, the physical and psychological effort required to provide ongoing care can impact significantly on caregivers’ well-being. Caregivers have been shown to be at increased risk of stress and depression, to experience sleep problems more often, and have poor physical health (Oyebode, 2003). They often do not have the time to engage in preventive health behaviors such as regular PA, and studies have found that caregivers participate in less formal PA compared to non-caregivers (Fredman et al., 2006, Hirano et al., 2011).
There have been numerous interventions aimed at improving the psychological health of caregivers such as education, counseling and respite. However, these have had conflicting results (Pinquart and Sorensen, 2006, Sorensen et al., 2002). Due to benefits PA has in the general population, interventions aiming to increase PA have also been trialed in the caregiver population. However, it is less clear whether the psychological benefits seen in the general population also extend to the caregiver population, at least one third of whom experience significant impact on their well-being due to their caring role (Oyebode, 2003).
This review provides an overview of the literature reporting on PA in caregivers and its effect on their psychological health, from the period of January 1975 to December 2012.
The purpose of this review is to examine the psychological benefits of PA in caregivers, what types of PA interventions have resulted in psychological benefits, and the limitations of study results obtained to date. The potential caregiver-specific barriers will also be highlighted. This review will present an overview of this topic, clarify in which psychological domains PA may be useful, and help guide future directions in this area.
Section snippets
Search strategy and selection criteria
The scientific databases MEDLINE, PsycINFO, PubMed and Google Scholar were searched using the terms: exercise, physical activity, motor activity, physical exertion, physical fitness, caregivers, carers and caring. References listed in articles were also followed up. Limits of English language and human studies were used. Studies published between 1975 and 2012 were included. These dates were selected as caregiver literature dates approximately from the mid 1970s, and we wished to capture as
Results
There were a total of 750 published articles found by the search. All 750 abstracts were reviewed using a standard evaluation form by SL, with consultation with other authors (NL, BD, KM), and checked if these fit the criteria for inclusion. Although this review was not specifically focusing on older caregivers, all of the eligible studies investigated outcomes in caregivers who were over 60 years of age.
Fig. 1 shows the flow chart of the search. There were a total of fifteen studies found
Discussion
Previous observational studies investigating levels of PA in caregivers consistently demonstrated that caregivers were less physically active compared to non-caregivers, and caregivers who did less PA had more depressive symptoms (Fredman et al., 2006), burden (Hirano et al., 2011) and generally worse psychological health (Gusi et al., 2009) compared to caregivers who did more PA.
This literature review extends the knowledge in this area, seeking to evaluate the psychological benefit of PA in
Conclusions
Physical activity, that is, walking, appears to have some benefit for caregivers, in that it can decrease levels of stress, depression and burden. However, the small number of trials, the heterogeneity of physical activity interventions and outcome measures, and limited sample sizes, restrict the generalizability of results. Providing care can be a stressful and time-consuming task which may be one of the reasons why the positive psychological effects of physical activity interventions are not
Conflicts of interest
There are no conflicts of interest. All authors disclose that there is no financial and personal relationships with other people or organizations that could inappropriately influence the work.
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