Extending the demand-control model to informal caregiving

Objective: Karasek's demand-control model of job strain was used in an attempt to extend previous work examining the psychological impact of informal caregiving in stroke. Method: Data were gathered from 138 informal caregivers/patient dyads at two time points. The dependent variables were the caregiver's anxiety and depression [Hospital Anxiety and Depression Scale (HADS)]. The predictor variables were caregiver demand (stroke survivor's assessment of their physical and psychosocial functional limitations) and control (caregiver's perceived control over stroke survivor's recovery). Results: In a cross-sectional analysis of Times 1 and 2 data, main effects for demand and/or control were detected for anxiety and depression. Contrary to prediction, in longitudinal analysis of change, it was found that decreasing control, along with increasing demand, was associated with reduced distress. Conclusion: The model was moderately successful in predicting emotional distress. The relative importance of caregiver demand and control in predicting outcomes changed over time in these data. Attempts to replicate these findings are recommended.