Background
The impact of employment on family caregivers has been
well studied. For example, working caregivers of older persons
suffered financial and health costs due to care-giving
and were less productive, resulting in increased cost to business
(Mahoney & Tarlow 2006, Hawranik & Strain 2007,
Heitmueller & Inglis 2007). Conflict between parental care
and employment was reported for 38% of 278 US women
caregivers (Stephens et al. 2001). Greater on-the-job conflict
was related to higher role overload, worry, and strain for
caregivers of cognitively impaired older relatives (Edwards
et al. 2002). Women who care for older family members
suffered work-related disadvantages, including reduced
income, retirement benefits, and health benefits due to
greater involvement with elder care (Zhan 2005, Wakabayashi
& Donato 2006). On the other hand, among mid-life
and older American women caregivers in one study, the
association between informal care and depressive symptoms
was not modified by employment status (Cannuscio et al.
2004).
Among these studies on working caregivers, few
addressed interrelationships between paid employment,
well-being, and informal care, especially in non-white or
Asian family caregivers in Western societies and on the
Asian continent. In particular, no studies have fully clarified
the role of work-related conditions such as having a fulltime
job, work flexibility, and conflict between work and
family care-giving in predicting caregiver outcomes such as
role strain and health outcomes. Furthermore, working conditions
have not been explored in terms of their interactions
with family care-giving dynamics and their influence on
caregiver outcomes.
Family caregivers were found to be protected from the
harmful effects of care-giving by care-giving-interactive
moderating variables such as relationship quality and
caregiver’s preparedness (Williamson & Schulz 1995,
Schumacher et al. 2007). These variables play a role during
interactions between the family caregiver–care receiver dyad
and can provide a more dynamic picture of family care-giving
than contextual variables such as the family caregiver’s
characteristics or care receiver’s functional impairment. For
example, relationship quality was reported to moderate the
association between caregiver burden and depression; with
poorer relationship quality, caregivers’ affect was depressed
at both high and low burden, but with better relationship
quality, affect was depressed only at higher burden
(Williamson & Schulz 1995). Specifically, a three-way interaction
has been reported among care-giving demand, preparedness
for the care-giving role, and mutuality, which
was defined as relationship quality (Schumacher et al.
2007). The joint functions of mutuality and preparedness
protected family caregivers of people with cancer from
adverse outcomes. Moreover, more mutuality and more
preparedness jointly protected family caregivers from the
negative impact of high care-giving demand. Finally, family
caregivers were vulnerable to even low care-giving demand
when both mutuality and preparedness were low (Schumacher
et al. 2007).
However, the mechanisms by which these interactive
family care-giving variables and work-related conditions
jointly or independently moderate family caregiver outcomes
have not been investigated. Specifically, no research
has documented how the conflict between work and caregiving,
relationship quality and caregiver’s preparation
interact to influence the association between care-giving
demand, caregiver health, and caregiver strain.
The study