***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: PURPOSE This study assessed overall quality of life of caregivers , using a path model in which burden was conceptualized as distinct from well-being . DESIGN AND METHODS Data were drawn from a representative sample of caregivers to dementia and nondementia care receivers in British Columbia , Canada ( N = 243 ) . The model used was based on a previously proposed stress/ appraisal path model and used multiple regression path estimates . Primary stressors were care receiver cognitive status , physical function , and behavioral problems ; the primary appraisal variable was hours of caregiving during the previous week . Mediators were perceived social support , frequency of getting a break , and hours of formal service use ; secondary appraisal was subjective burden . The outcome measure was generalized well-being . RESULTS Well-being was directly affected by four variables : perceived social support , burden , self-esteem , and hours of informal care . Burden was affected directly by behavioral problems , frequency of getting a break , self-esteem , and informal hours of care and was not affected by perceived social support . DISCUSSION The finding that perceived social support is strongly related to well-being but unrelated to burden reinforces the conceptual distinctiveness of the latter two concepts . This suggests that quality of life of caregivers could be improved even with burden in their lives and that the overwhelming focus in caregiving research on burden should be supplemented with an emphasis on quality of life The purpose of this study was to examine the effects that changes in behavioral and psychological symptoms of dementia of persons with Alzheimer 's disease have on their caregivers ' mental health and physical health . The research design was a prospect i ve , longitudinal follow-up study conducted in a major medical center and in participants ' homes . Longitudinal analysis linking change in behavior to caregiver outcomes was based on 64 cases . Care recipients were assessed at the time of diagnosis with the Mini-Mental State Examination ( MMSE ) .  To provide information on the care recipient 's behaviors , caregivers participated in an interview with the Modified Neuropsychiatric Inventory at diagnosis and at follow-up . Caregivers also completed a battery of established instruments to measure stress appraisal , mental health , and perceptions of their physical health at follow-up . Results showed that increases in problem behaviors among persons living with dementia , along with residence status , were significant predictors of caregivers ' mental health and also their physical health . However , these relationships were mediated through stress appraisal . Variables such as MMSE score of the person with dementia , number of years caregiving , relationship status , and education level were not significant predictors of caregivers ' health when behavior change was in the model This prospect i ve study ( n = 476 ) examined 3 types of caregiving transitions experienced by wives and daughters of older persons : entry , institutionalization , and bereavement . Daughters were more likely to enter the caregiving role than wives , but the impact of entering the role was more pronounced for wives . After becoming a caregiver , wives decreased in their participation in leisure activities , perceptions of quality of family relations , and marital satisfaction .  Daughter caregivers were more likely than wives to place their care recipient in an institution , and they increased in social participation and decreased in subjective burden after placement . Roughly the same percentage of wife and daughter caregivers were bereaved during the study period , and for wives bereavement was accompanied by an increase in social involvement and personal growth . The results underscore the highly dynamic nature of the caregiving career and the importance of the kinship relationship between caregiver and care recipient in conditioning the effects of caregiving transitions OBJECTIVES This study reports the findings of an evaluation of the psychological benefits of use of adult day care by family caregivers assisting a relative with dementia . METHODS The study used a quasi-experimental design in which caregivers in the treatment group used substantial amounts of services , whereas  caregivers in a control group did not use day care at any point during the evaluation and only small amounts of other respite services . The evaluation was guided by the stress process model of caregiving which distinguishes between appraisal s of primary stressors and well-being . RESULTS Results after 3 months of day care use showed that the treatment group had significantly lower scores than the control group on two of the three measures of primary appraisal s ( overload and strain ) and two of the three measures of well-being ( depression and anger ) . Findings at one year showed that the treatment group had significantly lower scores on overload and depression than the control group . DISCUSSION These results demonstrate that use of adult day care by caregivers of dementia patients results in lower levels of caregiving-related stress and better psychological well-being when compared to that of controls 
    Output:
    
The strongest effects were domain-specific : uplifts of caregiving were associated with subjective well-being and caregiving stressors were associated with depression .
In addition , weaker effects that crossed domains were present : uplifts were weakly associated with depressive symptoms .
In addition , lower levels of caregivers ’ subjective well-being were weakly related to care receivers ’ physical and cognitive impairments , as well as behaviour problems , but not to the amount of caregiving .
Type of care recipients ’ illness and the measure of well-being moderated , in part , the association between stressors/uplifts and subjective well-being