Purpose: To estimate the rating scale values of individuals with a child, parent or spouse with Alzheimer's disease, arthritis, cancer or depression, and examine the heterogeneity in these values by relationship type, across illnesses.
Methods: Adult (≥18 years) and adolescent (13-17 years) participants were selected from a nationally representative research panel to complete an internet survey and were screened for the presence of a parent, spouse or child in their household with Alzheimer's disease, arthritis, cancer or depression. Those who met these inclusion criteria answered a series of rating scale questions to value the impact that their family member's illness had on their own health, as well as socio-demographic and caregiver responsibility questions. A minimum rating scale value of 0 is equivalent to being dead, and a maximum value of 1 represents the best health the respondent could imagine. Ordinary least squares regression models were used to evaluate the changes in rating scale values associated with having an ill parent and an ill child, both compared with having an ill spouse, for each illness separately. Regression analyses controlled for caregiving responsibility.
Results: Of those screened, 1369 (1267 adults, 102 adolescents) met inclusion criteria. In adjusted analyses, having a child with cancer or depression was significantly associated with lower rating scale values compared with having a spouse with one of these conditions (-0.28 for cancer (95% CI: -0.18- -0.38) and -0.08 for depression (95% CI: -0.01- -0.16)). Lower rating scale values were significantly associated with having a parent with arthritis (-0.04; 95% CI: -0.08- -0.01), cancer (-0.08; 95% CI: -0.16- -0.01) or depression (-0.06; 95% CI: -0.11- -0.02) compared with having a spouse with one of these conditions, but these values were not significantly different from each other. There was no significant difference in the value associated with the parent versus spouse relationship for Alzheimer's disease.
Conclusions: The impact of illness on family members, measured with rating scale values, varies by relationship type for certain illnesses. Having a parent or child with arthritis, cancer or depression is significantly associated with greater health loss compared to having a spouse with one of these conditions. Having a child with cancer is associated with the greatest health loss across all relationship and illness categories studied.