Background/Purpose: The number of older Thai people is projected to increase every year, and most of them experience problems, such as changes in mental and physical status. They also need help with activities of daily living. Increasing dependence of chronically ill elders results in a need for more family members to care for them. Studies have shown that family caregivers experience physical difficulties as a result of assisting with elders' increasing impairments and behavioral problems. Caregivers' functional status as an ability to perform their own daily life tasks was considered to be one of the important variables in the caregiving role that may influence caregiver health-related quality of life (HRQOL). The primary purpose of the study was to examine a model in which selected family caregiver and elderly care recipient (ECR) characteristics were hypothesized to predict HRQOL among rural Buddhist Thai family caregivers. Framework: The study was guided by the revised Wilson and Cleary model for HROQL, a conceptual model of client outcome assessing caregiver HRQOL. Specific Aims: To examine (1) the relationships among the following variables: family caregiver characteristics (age, sex, relationship to ECR, religious activities, chronic health conditions, household income, and social support), ECR characteristics (age, sex, levels of physical disability, and ECRs' symptoms), length of caregiving, caregiver tasks of care, rewards of caregiving, and caregiver functional status; (2) the relationships among family caregiver characteristics, ECR characteristics, selected variables from Specific Aim 1, and overall HRQOL of rural Buddhist Thai family caregivers; and (3) whether the relationship between family caregiver functional status and overall HRQOL of family caregivers is mediated by the rewards of caregiving, controlling for all other variables. Methods: This study was a cross-sectional, descriptive study conducted from October 2011 to January 2012 at two primary care units in two rural districts in the Uttaradit province of northern Thailand. The study sample included rural primary family caregivers of ECRs who had one or more chronic conditions and needed assistance for two or more ADLs at home for at least three months. A total of 201 family caregivers were included. Results: (1) Younger male caregivers with few chronic health conditions and caring for ECRs with fewer symptoms were more likely to have better functional status than were older female caregivers with more chronic health conditions and caring for ECRs more symptoms. (2). Older and spousal caregivers participating in more religious activities, who had few chronic health conditions, better functional status, higher perceived social support, and higher perceived rewards of caregiving were most likely to have a greater overall HRQOL. (3) Rewards of caregiving appear to significantly, partially mediate the relationship between caregiver functional status and overall HRQOL. Implications: Positive aspects of caregiving include religious activities, social support and rewards of caregiving, and are to be of concern for health care teams. Hospital and/or community health care providers are able to improve caregivers' overall HRQOL by offering training programs or discharge plans that include knowledge and skills suited to their elders' conditions. In addition, in wards or primary care units, private rooms with the Buddha image for praying or chanting and meditating would allow caregivers to participate in religious activities when their elders are admitted. Also, the Ministry of Public Health should request an annual budget to fund educational institutes of nursing for research and nursing education not only on elders, but also on family caregivers.
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