Unraveling the subjective well-being of formal and informal caregivers for people with dementia: a comparative analysis

Background: Both formal and informal caregivers play pivotal roles in long-term dementia care, demonstrating a shared dedication to providing comprehensive care and support for individuals with dementia. These two caregiver groups exhibit both similarities and differences in their caregiving experiences, contributing to variations in subjective well-being outcomes. However, limited research has compared the psychological well-being and self-rated health of these two caregiver groups, or explored the influencing factors. This knowledge gap hinders the development of targeted interventions and support strategies tailored to different caregiving contexts and informs supportive policymaking. Methods: A cross-sectional survey was conducted among 440 caregivers of individuals with dementia, including 229 informal caregivers and 211 formal caregivers. Psychological well-being was assessed using the short version of Ryff’s Psychological Well-being Scale, while self-rated health was measured using a summative item from a validated instrument. Caregiving appraisal and coping were evaluated separately using the Chinese version of the Caregiving Appraisal Scale and Ways of Coping Questionnaire. Descriptive statistics, t-tests, Chi-square tests, and multivariate stepwise regression analyses were employed for data analysis. Results: Formal caregivers exhibited significantly better psychological well-being and self-rated health compared to informal caregivers. Moreover, formal caregivers reported more positive caregiving appraisals than their informal counterparts. However, there was no statistical difference in coping strategies between the two groups. The psychological well-being of informal caregivers was primarily influenced by coping (standardized β = 0.309) and caregiving mastery (standardized β = 0.270). For formal caregivers, their psychological well-being was mainly influenced by caregiving satisfaction (standardized β = 0.267) and caregiving intensity (standardized β = 0.242). Both informal (standardized β = 0.354) and formal caregivers’ (standardized β = 0.156) self-rated health were influenced by passive coping. Conclusions: This study provides valuable insights for developing tailored interventions and support systems aimed at improving the psychological well-being and self-rated health of informal and formal caregivers of people with dementia. To enhance the psychological well-being of informal caregivers, interventions targeting improvements in coping skills and caregiving mastery can be designed; while for formal caregivers, interventions focusing on enhancing caregiving satisfaction and effective coping strategies may be beneficial. Improving the passive coping and caregiving appraisals may help improve the self-rated health of both groups.