Previous research suggests that employment plays an

Previous research suggests that employment plays an important role in understanding the relationship between caregiving and mental health; given that most caregivers are employed and employment may either provide relief in terms of time away from the caregiving role or add to the overall burden of responsibilities. A search of the previous literature on the topic of ‘caregiving’, ‘work’, and ‘mental health’ in the past two decades found that empirical evidence on the intersection between work, care and mental health derives mainly from Western Prostaglandin E2 (Leach et al., 2010; Butterworth, Pymont, Rodgers, Windsor, & Anstey, 2010; Farfan-Portet, Popham, Mitchell, Swine, & Lorant, 2010; Berecki-Gisolf, Lucke, Hockey, & Dobson, 2008; Schneider, Trukeschitz, Muhlmann, & Ponocny, 2013; Lyonette & Yardley, 2006). Research conducted in Britain and Belgium demonstrates the importance of formal employment as a factor modifying the relationship between informal caregiving and adverse health outcomes (Farfan-Portet et al., 2010). An Australian study documents the adverse effects of transitioning into the provision of informal care on reduced labour force participation among middle-aged women (Berecki-Gisolf et al., 2008). A European-based economic study assessing the work–care relationship revealed gender differences in intentions to remain in formal employment. Among females and males, respectively, time demands associated with job change and physical care burden affected decisions to exit the labour market (Schneider et al., 2013). In the UK, work stress also predicted overall psychological distress among working caregivers after a one year follow-up (Lyonette & Yardley, 2006). Further investigation shows some evidence of the interplay between care and mental health in Asia, but mainly in ageing populations. Among Hong Kong Chinese caregivers, family burden and caregiving have been shown to significantly impact on the mental health of caregivers (Wong, Tsui, Pearson, Chen, & Chiu, 2004). In Singapore, informal caregivers were also reported to have higher levels of depression and to have worse health outcomes than non-caregivers (Chan, Malhotra, Malhotra, Rush, & Ostbye, 2013). Less research has explored caregiving and mental health in the context of employment within Asia. However, one study from Japan showed that eldercare among employees was a significant risk for depression (Honda, Date, Abe, Aoyagi, & Honda, 2014), and another showed that the size of the social support network protected against physical and mental ill health among caregivers of disabled people (Arai, Nagatsuka, & Hirai, 2008). Many middle and lower income countries now need increased family caregiving due to rapid population ageing, but research examining the effects of caregiving on workers in middle-income Asian countries remains limited. Local data are needed to understand the effects of increased family caregiving within these specific contexts. Our research focuses on a specific Asian country with rapid population ageing – Thailand. With projections that 23.1% and 37.1% of the population in 2025 and 2050, respectively, will be aged over 60 years (United Nations, Department of Economic and Social Affairs, Population Division (2015)), the need for informal caring will rise. Thailand has a strong Buddhist culture and a belief system supportive of care for family members. The current study aims to investigate the impact of caregiving on mental health among Thai workers, accounting for differences in relevant covariates such as job characteristics. This is one of the first population-based, longitudinal investigations of the interaction between caregiving and psychological distress among workers in Thailand. By identifying those at risk for adverse mental health consequences of caregiving, and the magnitude of the problem, this information can be used to devise and advocate for preventive measures such as respite care support.
Methods