It’s all about the attitude: findings on internalized caregiver stigma and mental health of informal caregivers

ObjectivesIn this study, we aim to explore the associations between internalized care-related stigma, positive aspects of caregiving, caregiver burden, and mental health of informal long-term caregivers for older adults.MethodsData from the project, Attitudes Towards Informal Caregivers, collected in December 2023 in Germany, was used, including 433 informal long-term caregivers of adults aged ≥60 years. The Internalized Care Stigma Scale measures positive and negative attitudes toward informal care for older adults (aged ≥60 years) as internalized by informal caregivers. Additionally, the Burden Scale for Family Caregivers short scale, the short Patient Health Questionnaire, and the Positive Aspects of Care Scale (PAC) were used. Linear regression analysis with robust standard errors and path analysis with bootstrapped standard errors were conducted. The models were adjusted for sociodemographic background and care-related factors.ResultsRegression analyses showed an association between stronger negative care stigma beliefs and higher burden and lower positive aspects of care, while stronger positive care stigma was associated with higher burden and higher positive aspects of care. Path analyses revealed significant direct and indirect effects (via PAC) of both positive and negative attitudes on burden. Also, positive and negative care stigma were associated indirectly with poorer mental health, via PAC and burden.DiscussionCare-related stigma played a significant role in caregivers’ stress appraisal and mental health. Informal caregivers may benefit from actions targeting internalized negative care-related stigma, while further investigation of the more complex associations between positive care-­related stigma and caregivers’ mental health is recommended.