Moderation and Path Analysis: Exploring Trajectories of Burden of Care, Somatization and Depression among Informal Caregivers of Children with Congenital Heart Disease
Oluwatobiloba Ajibola Okeniyi *
Department of Psychology, Faculty of Social Sciences, Redeemer's University, Ede, Nigeria.
Bede Chinonye Akpunne
Department of Psychology, Faculty of Social Sciences, Redeemer's University, Ede, Nigeria.
Obaloluwa David Adeyemo
Department of Psychology, Faculty of Social Sciences, Redeemer's University, Ede, Nigeria.
Stephen Ikechukwu Akpunne
Department of Health Science, Towson University, Towson, Maryland 2125, Baltimore, United States.
Elizabeth Nkechi Akpunne
Department of Psychology, Faculty of Social Sciences, Redeemer's University, Ede, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Aims: This study investigated the relationships among burden of care, somatization and depression among informal caregivers of children living with congenital heart disease at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Nigeria.
Study Design: A cross-sectional survey design was used.
Place and Duration of Study: The study was conducted at a university teaching hospital in Nigeria between April and June 2024.
Methodology: Using census sampling, 60 informal caregivers of children with congenital heart disease were recruited. Data were collected using the Zarit Burden Interview, the Patient Health Questionnaire Physical Symptom Scale (PHQ-15), and the Redeemer's University Depression Scale (RUDS). Hierarchical regression and mediation analyses were performed.
Results: The findings showed low-to-moderate levels of burden of care (71.7%), somatization (61.6%) and depression (38.4%). Burden of care significantly predicted depression (β = .54, P < .01), accounting for 29% of the variance. Somatization also significantly predicted depression (β = .50, P < .01), explaining 25% of the variance. However, burden of care did not moderate the association between somatization and depression. A significant interaction effect between age and income was found in predicting depression, with younger adults (20–40 years) in higher income brackets reporting higher depression levels. Gender and income did not independently predict depression.
Conclusion: The findings indicate relationships among caregiving burden, physical symptom reporting and mental health outcomes. Recommendations include establishing caregiver support programmes, implementing routine mental health screening and developing culturally sensitive interventions.
Keywords: Burden of care, informal caregivers, congenital heart disease, depression, somatization, paediatric cardiac care, caregiver mental health, mediation analysis, moderation analysis, psychological distress