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Nursing Reports
Volume 15
Issue 10
10.3390/nursrep15100360
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Article

Caregiver Contribution to Patient Self-Care and Associated Variables in Older Adults with Multiple Chronic Conditions Living in a Middle-Income Country: Key Findings from the ‘SODALITY-AL’ Observational Study

by
Sajmira Adëraj
1,
Manuela Saurini
1,
Rocco Mazzotta
1,2,*,
Edona Gara
1,
Dasilva Taҫi
1,
Alta Arapi
3,
Vicente Bernalte-Martí
4,
Alessandro Stievano
2,5,
Ercole Vellone
1,6,
Gennaro Rocco
2,7 and
Maddalena De Maria
8
1
Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
2
Center of Excellence for Nursing Culture and Research, Order of Nursing Professions of Rome, 00165 Rome, Italy
3
Albanian Order of Nurses, 1000 Tirana, Albania
4
Department of Nursing, Faculty of Health Sciences, University of Jaume I, 12071 Castellón, Spain
5
Department of Clinical and Experimental Medicine, University of Messina, 98100 Messina, Italy
6
Faculty of Nursing and Midwifery, Wroclaw Medical University, 50-996 Wrocław, Poland
7
International Center for Nursing Research Montianum Our Lady of Good Counsel, Catholic University, 1000 Tirana, Albania
8
Department of Life Science, Health, and Health Professions, Link Campus University, 00165 Rome, Italy
*
Author to whom correspondence should be addressed.
Nurs. Rep. 2025, 15(10), 360; https://doi.org/10.3390/nursrep15100360 (registering DOI)
Submission received: 28 June 2025 / Revised: 13 September 2025 / Accepted: 6 October 2025 / Published: 8 October 2025
(This article belongs to the Special Issue Self-Management of Chronic Disease)
Review Reports Versions Notes

Abstract

Background/Objectives: Multiple chronic conditions (MCCs) pose global health and social challenges, with caregiving often relying on family members, especially in low- and middle-income countries (LMICs). However, limited evidence exists regarding the factors influencing caregiver contribution (CC) to patient self-care among older adults with MCCs in these settings. Aim: The aim of this study was to examine the associations between caregivers’ and patients’ socio-demographic characteristics and patients’ clinical variables and the CC to patient self-care behaviors in adults with MCCs in an LMIC context. Methods: This multicenter, cross-sectional study included patient–caregiver dyads recruited from outpatient and community settings across Albania, between August 2020 and April 2021. CC was assessed using the Caregiver Contribution to Self-Care of Chronic Illness Inventory scale (CC-SCCII). Three multivariable linear regression models were used to explore associations with the three dimensions of CC to self-care maintenance, monitoring, and management. Results: Caregivers were mostly female, children, or spouses with a high level of education and employed. Patients were primarily female and had low education. Hypertension and diabetes were the most prevalent. Older and employed caregivers contributed less to CC to self-care maintenance, while higher education and caregiving experience increased it. Living with the patient and being a spouse reduced CC to self-care monitoring, whereas more caregiving hours and experience improved it. CC to self-care management was negatively influenced by cohabitation, presence of a second caregiver, and being a spouse, but improved with more caregiving hours. Conclusions: Socio-demographic and caregiving factors differently influence CC to self-care dimensions in older adults with MCCs in an LMIC. Tailored caregiver support programs are essential to enhance caregiver involvement and improve MCC patient outcomes in LMICs.
Keywords: aging; caregiver; caregiver contribution; informal caregiving; middle-income country; multiple chronic conditions; nursing; self-care aging; caregiver; caregiver contribution; informal caregiving; middle-income country; multiple chronic conditions; nursing; self-care

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MDPI and ACS Style

Adëraj, S.; Saurini, M.; Mazzotta, R.; Gara, E.; Taҫi, D.; Arapi, A.; Bernalte-Martí, V.; Stievano, A.; Vellone, E.; Rocco, G.; et al. Caregiver Contribution to Patient Self-Care and Associated Variables in Older Adults with Multiple Chronic Conditions Living in a Middle-Income Country: Key Findings from the ‘SODALITY-AL’ Observational Study. Nurs. Rep. 2025, 15, 360. https://doi.org/10.3390/nursrep15100360

AMA Style

Adëraj S, Saurini M, Mazzotta R, Gara E, Taҫi D, Arapi A, Bernalte-Martí V, Stievano A, Vellone E, Rocco G, et al. Caregiver Contribution to Patient Self-Care and Associated Variables in Older Adults with Multiple Chronic Conditions Living in a Middle-Income Country: Key Findings from the ‘SODALITY-AL’ Observational Study. Nursing Reports. 2025; 15(10):360. https://doi.org/10.3390/nursrep15100360

Chicago/Turabian Style

Adëraj, Sajmira, Manuela Saurini, Rocco Mazzotta, Edona Gara, Dasilva Taҫi, Alta Arapi, Vicente Bernalte-Martí, Alessandro Stievano, Ercole Vellone, Gennaro Rocco, and et al. 2025. "Caregiver Contribution to Patient Self-Care and Associated Variables in Older Adults with Multiple Chronic Conditions Living in a Middle-Income Country: Key Findings from the ‘SODALITY-AL’ Observational Study" Nursing Reports 15, no. 10: 360. https://doi.org/10.3390/nursrep15100360

APA Style

Adëraj, S., Saurini, M., Mazzotta, R., Gara, E., Taҫi, D., Arapi, A., Bernalte-Martí, V., Stievano, A., Vellone, E., Rocco, G., & Maria, M. D. (2025). Caregiver Contribution to Patient Self-Care and Associated Variables in Older Adults with Multiple Chronic Conditions Living in a Middle-Income Country: Key Findings from the ‘SODALITY-AL’ Observational Study. Nursing Reports, 15(10), 360. https://doi.org/10.3390/nursrep15100360

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