• Naw Wah Ka Paw Karen Baptist Theological Seminary, Seminary Hill, Yangon 11011, Myanmar
  • Nuchanad Hounnaklang College of Public Health Science, Chulalongkorn University, Bangkok 10330, Thailand
  • Chawapon Sarnkhaowkhom Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok 10400, Thailand



Caregivers, End stage renal disease, Hemodialysis, Myanmar, Quality of life


Diminishing quality of life of caregivers could increase their pressures, burdens and interfere with their quality services. The aim of this study is to determine the factors predicting the QoL of the caregivers who took care of end stage renal disease undergoing hemodialysis people. A cross-sectional study was conducted involving 210 caregivers providing services to patients suffering from end stage renal disease undergoing hemodialysis in Yangon, Myanmar. Purposive sampling was performed to selection the participants and the data were collected by using self-administered questionnaires. Hierarchical linear regression was performed with the QoL as dependent variable and three blocks of predictors (the first block; burden, the second block; caregiver's age and monthly family income, and the third block; marital status and relationships with patients). The study found that caregiver’s burden and age negatively and significantly affected the QoL whereas monthly family income positively affected the QoL. The best model was [Quality of life = ?0 + ?1 (level of burden) + ?2 (caregiver’s age) + ?3 (caregiver’s monthly family income)] where ?0, ?1, ?2 and ?3 were 98.135, (-0.395), (-0.149) and 0.010 respectively. The health professionals, related government agencies, communities, and health related officers should develop the proper strategies and programs for improving the QoL of caregivers.


Srivastava G, Tripathi RK, Tiwari SC, Singh B, Tripathi SM. Caregiver burden and quality of life of key caregivers of patients with dementia. Indian J Psychol Med 2016;38(2): 133-136.

Neuen BL, Chadban SJ, Demaio AR, Johnson DW, Perkovic V. Chronic kidney disease and the global NCDs agenda. BMJ Global Health 2017;2(2): e000380.

Luyckx VA, Tonelli M, Stanifer JW. The global burden of kidney disease and the sustainable development goals. Bulletin of the World Health Organization. 2018;96(6): 414.

Organization T. Current and Future Long-term Care. Accessed November. 2021;22.

Sham F, Salim N, Shohor NHA, Anuar SFZM, Azamuddin AA, Aman N. Quality of life and social support among breast cancer patients in Malaysia. Malaysian J Public Health Med 2022; 22(1): 154-163.

Al-Abadla Z, Elgzyri T, Moussa, M.The effect of diabetes on health-related quality of life in Emirati patients. Dubai Diabetes Endocrinol J 2022; 28: 35–43

Saini M, Rana M, Bhatti K, Das R, Mehta DK. Understanding health related quality of life in hypertensive patients: interrogating effect of psychological and environmental factors. J Young Pharm 2022; 14(1): 100-105.

Fletcher BR, Damery S, Aiyegbusi OL, Anderson N, Calvert M, et al. Symptom burden and health-related quality of life in chronic kidney disease: A global

Malaysian Journal of Public Health Medicine 2023, Vol. 23 (2): 55-62

systematic review and meta-analysis. PLOS Medicine 2022; 19(4): e1003954.

Cai T, Verze P, Johansen TEB. The quality of life definition: where are we going?. Uro 2021; 1: 14-22.

Lin ML, Chu KH. The experience of urgent dialysis patients with end-stage renal disease: a qualitative study. PLOS ONE 2022; 17: e0261941.

Tan LH, Chen PS, Chiang HY, King E, Yeh HC, Hsiao YL, Chang DR, Chen SH, Wu MY, Kuo CC. Insomnia and poor sleep in CKD: a systematic review and meta-analysis. Kidney Med 2022; 4(5):100458.

Pio TMT, Prihanto JB, Jahan Y, Hirose N, Kazawa K, Moriyama M. Assessing burden, anxiety, depression and quality of life among caregivers of hemodialysis patients in Indonesia: a cross-sectional study. Int J Environ Res Public Health 2022; 19: 4544.

Abebe A, Arba A, Paulos K, Abera W, Sidamo T, Shiferaw S, Abraham Z, Baza D, Nega B, Woldeyohannes S. The lived experience of primary family caregivers of patients on hemodialysis treatment in Southern Ethiopia: a phenomenological study. Int J Nephrol Renovasc Dis 2022; 15: 41-52.

Masuda T. The dialysis situation in Asian countries symposium: providing new insights to improve dialysis in the

region. Blood Purif. 2017; 44 :3-18.

Hair JJF, Black WC, Babin BJ, Anderson RE. Multivariate data analysis: a global perspective. 7th Edition, Pearson Education, Upper Saddle River 2010.

Kheng Seng B, Luo N, Yee Ng W, et al. Validity and Reliability of the Zarit Burden Interview in Assessing Caregiving Burden. Vol 392010.

Zarit SH, Reever KE, Bach-Peterson J. Relatives of the Impaired Elderly: Correlates of Feelings of Burden1. The Gerontologist 1980;20(6):649-655.

Mapi Research Trust: Mapi Research Trust Unveils New Clinical Outcome Assessments (COA) Website for the Zarit Burden Interview (ZBI) Questionnaire. 2017.

WHO WHOsQuality of life. WHOQUALITY OF LIFE-sBREF Introduction. Administration and Scoring. Field Trial version. 1996.

Thein TL. Nature of accessibility to health care services and health related quality of life among adult Myanmar migrant workers in Mahachai Subdistrict, Samut Sakhon Province, Thailand: College of Public health science, Chulalongkorn University; 2008.

Tradingeconomics: Myanmar Minimum Wages - 2022 Data - 2023 Forecast - 2015-2021 Historical – Chart. 2022.

S Gill A, Singh A, Matreja P, Gupta A, Singh N, Khosla P, et al. Assessment of the quality of life of caregivers of patients suffering from chronic kidney disease. Bantao J. 2011; 9(1): 31-35.

Meecharoen W, Sirapo-ngam Y, Monkong S, Oratai P, Northouse LL. Factors influencing quality of life among family caregivers of patients with advanced cancer: a causal model. Pacific Rim Int J Nur Res. 2013;17(4): 304-316.

Boralingiah P, Baby A, Kulkarni P, Ramachandrappa SM, Manjunath R. Assessment of quality of life among caregivers of persons with permanent disabilities attending rehabilitation centre in H. D. Kote Taluq, Mysore district, Karnataka, India. Int J Community Med Public Health. 2016; 3: 2645-2650.

Jafari H, Ebrahimi A, Aghaei A, Khatony A. The relationship between care burden and quality of life in caregivers of hemodialysis patients. BMC Nephrol. 2018 Nov 12;19(1):321.

Pfender E: Caregiver Statistics Broken Down by Age, Gender, Race, and Infographic. 2017.

Embracing carers: Embracing the critical role of caregivers around the world. 2017. www. %20Carers%20White%20Paper_KGaA_FINAL.pdf

Belasco AG, Sesso R. Burden and quality of life of caregivers for hemodialysis

Malaysian Journal of Public Health Medicine 2023, Vol. 23 (2): 55-62

patients. Am J Kidney Dis. 2002 Apr;39(4):805-12.

Abdollahpour I, Nedjat S, Salimi Y, Noroozian M, Majdzadeh R. Which variable is the strongest adjusted predictor of quality of life in caregivers of patients with dementia?

Psychogeriatrics: the official journal of the Japanese Psychogeriatric Society 2015; 15(1): 51-57.

Du J, Shao S, Jin G-H, Qian C-G, Xu W, Lu X-Q. Factors associated with health-related quality of life among family caregivers of disabled older adults: a cross-sectional study from Beijing. Med 2017;96(44): e8489.

Turkoglu N, Kilic D. Effects of care burdens of caregivers of cancer patients on their quality of life. Asian Pacific J Cancer Prev 2012; 13(8): 4141-4145.

Prasad N, Jha V. Haemodialysis in Asia. Kidney Diseases 2015;1(3): 165-177.

Sumriddetchkajorn K, Shimazaki K, Ono T, Kusaba T, Sato K, Kobayashi N. Universal health coverage and primary care, Thailand. Bull World Health Organ. 2019;97(6):415-422.

Organization WH. Monitoring progress on universal health coverage and the health-related Sustainable Development Goals in the South-East Asia Region: 2018 update. 2018.

Rajesh Purohit, Mehrotra PR. Healthcare availability, accessibility, and affordability in Myanmar: What do the experts say? International J Man and Comm Inn 2018; 6(1): 2224-2234.

Aljuaid M, Ilyas N, Altuwaijri E, Albedawi H, Alanazi O, Shahid D, Alonazi W. Quality of life among caregivers of patients diagnosed with major chronic

disease during COVID-19 in Saudi Arabia. Healthcare (Basel) 2022; 10(3): 523-538.

Rico-Blázquez M, Quesada-Cubo V, Polentinos-Castro E, Sánchez-Ruano R, Rayo-Gómez MÁ, Cura-González I, CuidaCare G. Health-related quality of life in caregivers of community- dwelling individuals with disabilities or chronic conditions. a gender-differentiated analysis in a cross-sectional study. BMC Nurs 2022; 21: 69-80.

Hazzan AA, Dauenhauer J, Follansbee P, Hazzan JO, Allen K, Omobepade I. Family caregiver quality of life and the care provided to older people living with dementia: qualitative analyses of caregiver interviews. BMC Geriatr 2022; 22: 86-97.

Morimoto T, Schreiner AS, Asano H. Caregiver burden and health?related quality of life among Japanese stroke caregivers. Age and Ageing 2003; 32(2): 218-223.

Awadalla AW, Ohaeri JU, Salih AA, Tawfiq AM. Subjective quality of life of family caregivers of community living Sudanese psychiatric patients. Social psychiatry and psychiatric epidemiology 2005; 40(9): 755-763.

Meecharoen W, Sirapo-ngam Y, Monkong S, Oratai P, Northouse L. Factors influencing quality of fife among family caregivers of patients with advanced cancer: a causal model. Pacific Rim Int J Nurs Res 2013; 17(4): 304-316.

Wong DFK, Lam AYK, Chan SK, Chan SF. Quality of life of caregivers with relatives suffering from mental illness in Hong Kong: roles of caregiver characteristics, caregiving burdens, and satisfaction with psychiatric services. Health and Qual of Life Outcomes 2012; 10:15-24.




How to Cite