Employment Status, Self-Rated Health, and Stress Among Family Caregivers of Community-Dwelling Care Recipients in Japan

Background/Objectives: With population aging, increasing attention has been directed toward family caregivers balancing paid employment and caregiving responsibilities. This study aimed to investigate the association between employment status and self-rated health and stress among family caregivers and to explore associations between caregiving-related factors and these outcomes according to employment status. Methods: This study included 409 family caregivers of patients receiving home-visit nursing services in Japan. Data on caregiver characteristics, self-rated health, stress during the past month, and caregiving-related factors, including caregiving situations, support situations, and negative appraisal of caregiving assessed using the Negative Appraisal of Care (NAC) Scale, were collected. Logistic regression analyses with inverse probability weighting were conducted to examine the association between employment status and health outcomes. Exploratory stratified univariate analyses were performed by employment status to examine associations between caregiving-related factors and self-rated health and stress. Results: Of the 409 participants, 126 were working carers and 283 were non-working carers. After IPW and multivariable adjustment, employment status was not significantly associated with self-rated health, whereas working carers were significantly more likely to report stress than non-working carers. In the exploratory stratified analyses, among working carers, poor self-rated health was more frequently observed among those without additional caregivers, those using short-stay services, and those with higher NAC scores. Stress was also more frequently observed among those without additional caregivers. Among non-working carers, poor self-rated health was more frequently observed among those with higher NAC scores, whereas stress was more frequently observed among female caregivers, those caring for recipients with cognitive impairment, and those using short-stay services. Conclusions: Working carers reported higher levels of stress than those of non-working carers, even after adjustment for caregiving-related factors. Exploratory analyses among working carers suggested that the presence of additional caregivers was associated with both self-rated health and stress, indicating that caregiving support may be an important factor in balancing employment and caregiving responsibilities.